A 35-year-old woman with unexplained infertility for 3 years is considering IVF. Regarding ovarian reserve testing, which combination of tests provides the best prediction of ovarian response to controlled ovarian hyperstimulation?
- A AMH (anti-Müllerian hormone) combined with antral follicle count (AFC) on transvaginal ultrasound ✓
- B Day 3 FSH alone
- C LH:FSH ratio combined with day 3 estradiol
- D Clomiphene citrate challenge test (CCCT)
Correct answer: A. AMH (anti-Müllerian hormone) combined with antral follicle count (AFC) on transvaginal ultrasound
Explanation
AMH combined with antral follicle count (AFC) on transvaginal ultrasound provides the most accurate prediction of ovarian response to stimulation. AMH is secreted by preantral and small antral follicles and reflects the ovarian reserve pool; it does not vary significantly across the menstrual cycle. AFC counts follicles 2–10 mm on Days 2–5. Together they predict both poor response (low AMH/AFC → poor responder) and hyper-response (high AMH/AFC → OHSS risk). Day 3 FSH is less sensitive; CCCT is now largely replaced.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.