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Predictive Value of Anti-mullerian Hormone on Ovary Response in PCOS Patients with Clomiphene Citrate(CC)-resistant after Laparoscopic Ovarian Drilling

WEI Chen-hou1,SHEN Hong-wei2,ZHU Guo-ping1(1.Guangdong Provincial Science and Technology Research Institute for Family Planning,Guangzhou 510600,China;2.Department of Obsterics & Gynecology,First Affiliated Hospital of Sun Yat-sen university,Guangzhou 510080,China)  
【Objective】 To investigate the predictive diagnostic value of preoperation serum anti-mullerian hormone(AMH) level measurement on ovary ovulation response after laparoscopic ovarian drilling(LOD) in PCOS patients with clomiphene citrate(CC)-resistant.【Methods】 54 PCOS patients with clomiphene citrate(CC)-resistant were enrolled LOD.Serum AMH levels were measured by enzyme linked immunosorbent assay(ELISA),Follicle growth and ovulation situation were supervised by vaginial ultrasound and urine LH peak.Using ROC(receiver operating characteristic) curve analysis monitoring data.【Results】 ROC curve analysis indicated that AMH had moderate diagnostic value for postoperation high and poor ovary response.Theirs AUC(area under the curve,AUC) were 0.792 and 0.846(95%CI: 0.673-0.911 and 0.696-0.996;P = 0.000 and P = 0.002).Serum AMH at 7.4 ng/mL and 4.3 ng/mL were optium cutoff value for predictive high and poor ovary response,respectively.Sensitivity were 73.1% and 87.5%,respectively.Specificity were 71.4% and 66.7%,respectively.Positive predictive value were 71.9% and 72.4%,respectively.Negative predictive values were 72.6% and 84.2%,respectively.【Conclusions】 The preoperation measurement of serum basal AMH level can predictive the high and poor ovary response after LOD in PCOS patients with clomiphene citrate(CC)-resistant,and act as a single valued predictive index in estimating LOD effectiveness.
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