Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome

Objective: To determine if women with day 3 serum inhibin-B concentrations < 45 pg/mL (conversion factor to SI unit, 1.00) demonstrate a poorer response to ovulation induction and assisted reproductive technologies outcome relative to women with inhibin-B values ≤ 45 pg/mL. Design: Analysis of inhibin-B, FSH, and E₂ concentrations in day 3 serum samples. Setting: Academic clinical practice. Patient(s): One hundred fifty-Six women who underwent 178 assisted reproductive technology (ART) cycles with luteal phase GnRH agonist suppression plus hMG and urofollitropin stimulation. Main Outcome Measure(s): Serum E₂ on day of hCG, number of oocytes retrieved per patient, fertilization rate, cleavage rate, clinical pregnancy rate (PR) per initiated cycle, cancellation rate per initiated cycle, and spontaneous abortion rate. Result(s): Women with day 3 serum inhibin-B < 45 pg/mL demonstrated 70% of the E₂ response, had 66.6% of the number of oocytes retrieved per patient, with 28% of the clinical PR per initiated cycle, and three times the cancellation rate per initiated cycle than women with day 3 inhibin-B > 45 pg/mL. After controlling for age, day 3 serum FSH, day 3 serum E₂, patient cycle number, and method of ART, day 3 serum inhibin-B ≤ 45 pg/mL was noted to be prognostic of the number of oocytes retrieved and clinical PR. The adjusted odds ratio of clinical pregnancy for those with day 3 serum inhibin-B ≤ 45 pg/mL versus those with inhibin-B < 45 pg/mL was 6.8 (95% confidence interval 1.8 to 25.6). Conclusion(s): Women with low day 3 serum inhibin-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy through ART relative to women with high day 3 inhibin-B.