Comparison of ovarian responsiveness tests with outcome of assisted reproductive technology – a retrospective analysis

INTRODUCTION: This study aims to compare the association between the most commonly used ovarian responsiveness markers – age, anti-Müllerian hormone levels (AMH), antral follicle count (AFC), ovarian sensitivity index (OSI), and ovarian response prediction index (ORPI) – and ovarian responsiveness to gonadotropin stimulation in assisted reproductive technology (ART) cycles. MATERIAL AND METHODS: Patients who underwent intracytoplasmic sperm injection treatment using either a gonadotropin releasing hormone (GnRH) antagonist or agonist protocol were enrolled in the study. Data of the patients were abstracted from the hospital’s database. Tests were compared for total number of retrieved oocytes, metaphase II (MII) oocytes, embryos, good quality embryos on day 1 and day 3, and ongoing pregnancies per cycle. RESULTS: The OSI was the ovarian response test that had the strongest relationship with the ART outcomes. The level of association between the ovarian response tests and poor ovarian response data was (in descending order): OSI, ORPI, AFC, AMH, and age (AUC(OSI) = 0.976, AUC(ORPI) = 0.905, AUC(AFC) = 0.899, AUC(AMH) = 0.864, AUC(age) = 0.617). The overall association between OSI and poor ovarian response was significantly higher than the other parameters (p (1) = 0.0023, p (2) = 0.0014, p (3) = 0.0001, p (4) ≤ 0.0001). In patients with high ovarian response data, OSI had the highest association, followed by AFC and ORPI age (AUC(OSI) = 0.984, AUC(AFC) = 0.907, AUC(ORPI) = 0.887). There was no statistically significant difference among the tests for the data of patients with ongoing pregnancies. CONCLUSIONS: In this study, which is the first study comparing the five most frequently used ovarian responsiveness markers and the second study signifying the role of OSI in an antagonist protocol, OSI was found to be more convenient to calculate, and it could be superior to other ovarian responsiveness markers for poor and high ovarian responses on cycles with agonist or antagonist protocols.