Inhibin B response to EFORT is associated with the outcome of oocyte retrieval in the subsequent in vitro fertilization cycle

Objective: To examine whether the magnitude of the rise in inhibin B levels after gonadotropin challenge is associated with subsequent response to ovarian stimulation during IVF. Design: Inhibin B serum levels after EFORT (exogenous follicle-stimulating hormone ovarian reserve test). Setting: Academic clinical practice. Patient(s): Serum samples from women who had undergone ovarian reserve screening with FSH in preparation for IVF. Thirteen of these women had a poor response in IVF (canceled cycle for low estradiol and/or no oocytes retrieved), and 19 had a good response (≥10 oocytes retrieved). Intervention(s): EFORT test. Main Outcome Measure(s): Baseline (day 3) serum E 2 (bE 2), FSH (bFSH), and inhibin B (bInhB) levels and inhibin B and E 2 levels 24 hours after EFORT (ΔInhB and ΔE 2). Result(s): The mean bInhB and ΔInhB levels were significantly higher in good vs. poor responders. The odds ratio of having a good response for women with a ΔInhB of 202 pg/mL was 51.8 times (95% CI = 6.1–1,244) the corresponding odds for women with a ΔInhB of 49 pg/mL. As expected, ΔE 2 was also significantly higher in good vs. poor responders; however, combination of ΔE 2 plus ΔInhB did not improve the odds for predicting IVF response. Conclusion(s): Our data suggest that ΔInhB after EFORT may provide a method for predicting ovarian response to hyperstimulation in a subsequent IVF cycle.