OC 14.07 Comparision of AFC and AMH for assessment of

ovarian reserve

Dr. Sonal Panchal, Dr. C.B.Nagori

Dr. Nagori’s Institute for Infertility and IVF, Ahmedabad, India

Aim: This study aims to compare the efficacy of AFC &

AMH, as markers for ovarian reserve based on computation of correlation between AFC and AMH.

Method: 75 PCO patients + 75 non PCO patients undergoing

IVF (BMI : 22 – 26) . Baseline 3D US -AFC was done for all on day 3. AMH was measured in all on the same day. Primary end point was number of follicles > 12 mm

on day of hCG Final end point was ova retrieved on ovum pick up. Correlation of AFC and AMH was checked with both

these endpoints Correlation of AFC was also checked with AMH.

Table 1: Correlation of AFC & AMH with follicles >12mm on day of hCG for Polycystic and nonPCO category of ovaries N= 75

Normal ovaries

AFC >12mm Polycystic ovaries

AFC >12mm

AFC 1.0 0.63 AFC 1.0 0.56

>12mm 0.63 1.0 > 12mm 0.56 1.0

AMH >12mm AMH >12mm

AMH 1.0 0.47 AMH 1.0 0.42

>12mm 0.47 1.0 >12mm 0.42 1.0

Correlation between AFC and follicles of > 12mm diameter on the day of hCG and AMH and follicle >12mm on the day of hCG, significant at .01 level at 0.283(99.9% as per Pearson’s correlation coefficient).

Normal ovaries

AFC OPU Polycystic ovaries

AFC OPU

AFC 1.0 0.50 AFC 1.0 0.44

OPU 0.50 1.0 OPU 0.44 1.0

AMH OPU AMH OPU

AMH 1.0 0.43 AMH 1.0 0.39

OPU 0.43 1.0 OPU 0.39 1.0

Table 2: Correlation of AFC and AMH with ova retrieved on OPU for Polycystic & normal category of ovaries N= 75

(correlation between AFC and AMH and ova retrieved on OPU for both the types of ovaries. significant at 0.01 level)

NonPCO Ovaries Test of Significance

Polycystic Ovaries Test of Significance

>12mm Z Value <12mm Z value AMH .63 1.39* .56 1.11*aAFC .47 .42Difference .16 .14

Table 3: Z score for difference in correlation of AFC and AMH with number of follicles larger than12mm for nonPCO and Polycystic Ovaries.

NonPCO Ovaries Test of Significance

Polycystic Ovaries Test of Significance

OPU Z Value OPU Z value AMH .50 0.54* .44 0.36*aAFC .43 .39Difference .07 ..05

Table 4: Z score for difference in correlation of AFC and AMH with ova retrieved on OPU for Normal Ovaries and Polycystic Ovaries

*Values for Level of Significance 0.2946 (one tailed) and 0.5892 (two tailed test) *Values for Level of Significance 0.3594 (one tailed) and 0.7188 (two tailed test)

*Values for Level of Significance 0.0823 (one tailed) and 0.1645 (two tailed test) * Values for Level of Significance 0.1335 (one tailed) and 0.267 (two tailed test)

ConclusionAFC & AMH both correlate with each other but have

independent significance for estimating follicles larger

than 12 mm on the day of hCG.

Difference of correlation coefficient between AFC and

AMH for ova retrieved on OPU, is minimally significant in

non PCO and is not significant in PCO group .

Z values for both nonpco & pco group are equal to or

below the tabulated one tailed significance value, for ova

retrieved on OPU.

Therefore for both groups, AFC alone may suffice as

a test for estimation of ovarian reserve.