Cover
Vol. 2 No. 2 (2012)

Published: December 31, 2012

Pages: 34-39

Research Article

Measurement of serum Inhibin B as a predictive evaluation of ovarian response following ovulation induction program in intrauterin insemination

Nawal Khairy AL-Ani 1 Layla Khudur Ghalib
1High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq
History
  • Received: September 1, 2012
  • Available Online: December 1, 2012

Abstract

Background: The evaluation of ovarian reserve has been, and still, the focus of substantial clinical research. The assessment of ovarian reserve is valuable for determining stimulation protocols, and because of limited predictive value of age alone, or other passive hormonal analysis in estimating response to the exogenous stimulation, Dynamic research was done on serum inhibin B. Objective: Measurement of serum inhibin B as a predictive evaluation of early ovarian response following ovulation induction program in intrauterine insemination(IUI). Materials and Methods: Thirty couples were involved in IUI program. They divided into two groups: group (1) 15 women were treated by Gonadotropin(Gn) recombinant follicle -stimulating hormone (rFSH). While group (2), 15 women were treated by Clomiphene citrate (CC). Treatment started at day 3 of the menstrual cycle. Serial hormonal profile tests namely; Inhibin B, Estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH) were done at days 3, 7 of the menstrual cycle and the day of human chorionic gonadotropin hormone (hCG) injection with recurrent ultrasonography (US) to confirm the number and development of the follicles. Results: There was a significant difference in the level of inhibin B (P< 0.05) between day 3 and 7 of the cycle with the mean of the follicle number 1.67±0.18 in group(1), while in group (2) there was a non significant difference (P>0.05) in the level of inhibin B between day 3 and 7 of the cycle with the mean of the follicle number 2.14±0.17. Percentage of pregnancy rate in IUI in this study was 19.23%. Percentage of pregnancy rate in group (1) was 25%,while in group (2) was 14.28%,but there is a significant difference (P<0.05) in the pregnancy rate between the two groups. Conclusion: It was concluded that serum inhibin B obtained at day 7(day 5 of (Gn) therapy) offers an early and accurate prediction of ovarian response to (Gn) stimulation while there was no significant change in the level of inhibin B between day 3 and 7 of the cycle in patients treated by CC.

Keywords

References

  1. JN, Durnerine IC Endocrine characteristics Of ART cycles. In: David K Gardner, Ariel Weissman, Colin Howles ef al Editors Text book of Assisted Reproductive Technologies. ed.lJnited Kingdom. Informa press2C0gpp.511- 538
  2. Navd D, Rosenwaks Z and Margalioth EJ prognostic assessment Of female fecundity Lancet.1987, --647.
  3. RavhonA, Lavery S, Michael S, et al. Dynamic assays of inhibin3 and estradiol folhwing buserelin acetate administration as predictors of ovarian response in IVF Hum.Reprcd. 2000; 2301.
  4. Seifer DB, Lambert-Messerian G, Hogan 'W, et al_ Day 3 serum imibin• B is predictive of assisted reproductive technologies outcome. Fertil. stenl. II
  5. Grcome NR Illingworth O'Brien Measurement Of dimeric inhibin-B throughout the human menstrual cycle J Clin. Endocrinol_ Metab. 1996;
  6. Shanthi MK. Harris S, Hugh WC, e! al. Inhibin B and anti-Mullerian hor- mane: mar*ers of ovarian response IVFIICSI patients? Int. J. Ob- stet. Gynaecol.2004; 111:1248-1253.
  7. Laven JS and Fauser BC. Wiibins and adult ovarian function. MOI. Cell. Endocmol. 2004;
  8. Rao KA, Brnsden PR, SathanantianAH. The infertility manual, edi- tior New Delhi: jaypee brotherS mödical publishers2004. (p) Ltd 2.
  9. Nikola' M. and Malcetus. White head.FemaIe Reproductive Hælth. New York.1S3N.20C5.pp.104. 123.
  10. PD, Peter R and Roman P Insemination technique and in- serination complications In: Richard P. Dickey, Peter R and Roman P Intrauterine inseminaticn and ovulation induction ed. Newyork Cambtidge University Press, 2010. Pp. 109-118.
  11. Lidar G M, Cohen S, and Mashiach S,Managementofwonen with cystic ovary syndronp who experience premature luteinization during CC treatment. Fertil. -752.
  12. Hargreave.T and MahmoudA, Manual for the Standardized Investiga• tion. Diagnosis and Management of the Infertile Male.Cambridge Uni. versity,200C,
  13. Felyyeh E. Ccnparative study of ovulation induction and hormone profile using Tamoxifen, Clomiphene citrate and Dexamethasone in infertile women. submitted to the High Institute of Infertility Diagnosis art Assisted Reproductive Technolcgy. Al- Nahrain university, in Par- tial Fulfillment of the Requirements for the Degree of High Diploma in Assisted Repcoductive Technologies. 2010.
  14. GevaT, Margalioth EJ, Ben CA,et al. Serum inhibin 8 levels measured early during FSH administration for IVF may be of value inpredicthg the number of oocytes to be retrieved in normal and Irw responders. Hum Reprod. 2002; 172331-2337.
  15. Zeev Colin MH, Drugs used for ovanan stimulation: clomiphene citrate, aromatase inhibitors, metformin. gonadotropins, gonadotro- Pln - redeasing hormone analogs. and recombinant gorgdotrogins,ln: David K Gardner, Ariel VWssman, Colin H'wles, a/_Jextb00k Of Assisted Reproductive Technologies 3rd UK Repika Press. 2009 p*488.
  16. 16—Kwee J, Elling MW. Schats R, et al. Compafson Of endocrine tests with respect to their pre(fctive value on the outcome cf ovarian hyper. stlmulation in IVF treatment: restjts Of aprospective randomized study. Hum Reprcd. 2001-18: 1422-1427.
  17. Schorge JC,Schaffer Jl. Halvorson LY, et al. WIUiams Gynecology.2008, http://www.accessmedicinemm.
  18. Hussain SY, Al-Anssari SAM, and Al- Barazanchi M R Follicular growth term of patient and cycle day of clomiphene citrate Asian Symposium on animal biotechnolcgy (Kamiina, Japan) 4th_1998; 7-9. pp.226 -231.
  19. AI- Dujaly SS, Al-Janabi AS Nori Effect Of Glycyrrhiza extract or, in vitro sperm activation Of asthenospermc patients J Babylon Uni- versty20E11(3M77 483
  20. RH, Regan MM, Neumann PJ, et al.. Arariomiz&d clini- cal trial to evaluate optimal treatment for unexplaired ilfertility.Fertil. 99