Full Text:   <3207>

CLC number: R711

On-line Access: 

Received: 2008-01-22

Revision Accepted: 2008-09-23

Crosschecked: 2008-11-26

Cited: 4

Clicked: 5831

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.1 P.35-45


Dynamic measurements of serum inhibin B and estradiol: a predictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Author(s):  Ming-fang MIAO, He-feng HUANG

Affiliation(s):  Department of Reproductive Endocrinology, Women’ more

Corresponding email(s):   mmf1966@sina.com.cn, huanghefg@hotmail.com

Key Words:  Inhibin B, Estradiol, Ovarian response, In vitro fertilization (IVF), Pregnancy

Ming-fang MIAO, He-feng HUANG. Dynamic measurements of serum inhibin B and estradiol: a predictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment[J]. Journal of Zhejiang University Science B, 2009, 10(1): 35-45.

@article{title="Dynamic measurements of serum inhibin B and estradiol: a predictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment",
author="Ming-fang MIAO, He-feng HUANG",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Dynamic measurements of serum inhibin B and estradiol: a predictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment
%A Ming-fang MIAO
%A He-feng HUANG
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 1
%P 35-45
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820029

T1 - Dynamic measurements of serum inhibin B and estradiol: a predictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment
A1 - Ming-fang MIAO
A1 - He-feng HUANG
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 1
SP - 35
EP - 45
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820029

Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (<40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration of gonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (rs=0.46~0.61, P=0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (rs=−0.67~−0.38, P=0.000 or P<0.01) with total rFSH dose and total days of rFSH stimulation. (2) No significant variation (P>0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged >35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age <35 years was found; however, IVF pregnancy outcome is significantly lower in women of age >35 years.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1] Balasch, J., Creus, M., Fábregues, F., Carmona, F., Casamitjana, R., Ascaso, C., Vanrell, J.A., 1996. Inhibin, follicle-timulating hormone, and age as predictors of ovarian response in in vitro fertilization cycles stimulated with gonadotropin-releasing hormone agonist-gonadotropin treatment. Am. J. Obstet. Gynecol., 175(5):1226-1230.

[2] Bancsi, L.F., Broekmans, F.J., Eijkemans, M.J., Jong, F., Habbema, J.D., Velde, E.R., 2002. Predictors of poor ovarian response in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. Fertil. Steril., 77(2):328-336.

[3] Cahill, D.J., Prosser, C.J., Wardle, P.G., Ford, W.C., Hull, M.G., 1994. Relative influence of serum follicle stimulating hormone, age and other factors on ovarian response to gonadotrophin stimulation. Br. J. Obstet., 101(11): 999-1002.

[4] Corson, S.L., Gutmann, J., Batzer, F.R., Wallace, H., Klein, N., Soules, M.R., 1999. Inhibin B as a test of ovarian reserve for infertile woman. Hum. Reprod., 14(11):2818-2824.

[5] Danforth, D.R., Arbogast, L.K., Mrouch, J., Kim, M.H., Kennard, E.A., Seifer, D.B., Friendman, C.I., 1998. Dimeric inhibin: a direct marker of ovarian aging. Fertil. Steril., 70(1):119-124.

[6] Dzik, A., Lambert, M.G., Lzzo, V.M., Soares, J.B., Pinotti, J.A., Seifer, D.B., 2000. Ihibin B response to EFORT is associated with the outcome of oocyte retrieval in the subsequent in vitro fertilization cycle. Fertil. Steril., 74(6): 1114-1117.

[7] Fábregues, F., Balasch, J., Creus, M., Carmona, F., Puerto, B., Quinto, L., Casamitjana, R., Vanrell, J.A., 2000. Ovarian reserve test with human menopausal gonadotropin as a predictor of in vitro fertilization outcome. J. Assist. Reprod. Genet., 17(1):13-19.

[8] Farhi, J., Homburg, R., Ferber, A., Orvieto, R., Ben-Rafael, Z., 1997. Non-response to ovarian stimulation in normogonadotrophic, normogonadal women: a clinical sign of impending onset of ovarian failure pre-empting the rise in the basal follicle stimulating hormone levels. Hum. Reprod., 12(2):241-243.

[9] Frattarelli, J.L., Biergh, P.A., Drews, M.R., Drews, M.R., Sharara, F.I., Scott, J.R., 2000. Evaluation of basal estradiol levels in assisted reproductive technology cycles. Fertil. Steril., 74(3):518-524.

[10] Galtier-Dereure, F., de Bouard, V., Picot, M.C., Vergnes, C., Humeaus, C., Bringer, J., Hédon, B., 1996. Ovarian reserve test with the Gn-releasing hormone agonist buserelin: correlation with in-vitro fertilization outcome. Hum. Reprod., 11(7):1393-1398.

[11] Groome, N.P., Illingworth, P.J., O′Brien, M., Cooke, I., Ganesan, T.S., Baird, D.T., McNeilly, A.S., 1994. Detection of dimeric inhibin throughout the human menstrual cycle by two-site enzyme immunoassay. Clin. Endocrinol. (Oxf), 40(6):717-723.

[12] Groome, N.P., Illingworth, P.J., O′Brien, M., Pai, R., Rodger, F.E., Mather, J.P., McNeilly, A.S., 1996. Measurement of dimeric inhibin-B throughout the human menstrual cycle. J. Clin. Endocrinol. Metab., 81(4):1401-1405.

[13] Hall, J.E., Welt, C.K., Cramer, D.W., 1999. Inhibin A and inhibin B reflect ovarian function in assisted reproduction but are less useful at predicting outcome. Hum. Reprod., 14(2):409-415.

[14] Hofmann, G.E., Danforth, D.R., Seifer, D.B., 1998. Inhibin-B: the physiological basis of the clomiphene citrate challenge test for ovarian reserve screening. Fertil. Steril., 69(3):474-479.

[15] Hughes, E.G., Robertson, D.M., Handelsman, D.J., Hayward, S., Healy, D.L., de Kretser, D.M., 1990. Inhibin and estradiol response to ovarian hyperstimulation: effects of age and predictive value for in vitro fertilization outcome. J. Clin. Endocrinol. Metab., 70(2):358-364.

[16] Kably, A.A., Barron, V.J., Tapia, L.R.C., Krivitsky, S.K., 2000. Effect of blood concentrations of preovulatory estradiol on the quality of eggs and pre-embryos in patients treated with fertilization in vitro. Ginecol. Obstet. Mex., 68(11): 435-441.

[17] Kim, M.R., 1998. Screening for ovarian reserve. Assist. Reprod. Rev., 8(1):17-22.

[18] Kim, Y.K., Wasser, S.K., Fujimoto, V.Y., Klein, N.A., Moore, D.E., Soules, M.R., 1997. Utility of follicle stimulating hormone (FSH), luteinizing hormone ratio (LH), estradiol and FSH: LH ratio in predicting reproductive age in normal women. Hum. Reprod., 12(6):1152-1155.

[19] Laven, J.S., Fauser, B.C., 2004. Inhibins and adult ovarian function. Mol. Cell. Endocrinol., 225(1-2):37-44.

[20] Licciardi, F.L., Liu, H.C., Rosenwaks, Z., 1995. Day 3 estradiol serum concentration as prognostic data of ovarian stimulating response and pregnancy outcome in patients undergoing in vitro fertilization. Fertil. Steril., 64(5): 991-994.

[21] Lockwood, G.M., Muttukrishna, S., Groome, N.P., Knight, P.G., Ledger, W.L., 1996. Circulating inhibins and activin A during GnRH-analogue down-regulation and ovarian hyperstimulation with recombinant FSH for in-vitro fertilization-embryo transfer. Clin. Endocrinol., 45(6):741-748.

[22] Maroulis, G.B., 1991. Effect of aging on fertility and pregnancy. Semin. Reprod. Med., 9(3):165-175.

[23] Mosher, W.D., Pratt, W.F., 1990. Fecundity and Infertility in the United States, 1965-1988. Advanced Data from Vital and Health Statistics, No. 192, Dec. 4. National Center for Health Statistics, Hyattsville, MD.

[24] Mosher, W.D., Pratt, W.F., 1991. Fecundity and infertility in the United States: incidence and trends. Fertil. Steril., 56(2):192-193.

[25] Mukherjee, T., Copperman, A.B., Lapinski, R., Sandler, B., Bustillo, M., Grunfeld, L., 1996. An elevated Day 3 follicle stimulating hormone: luteinizing hormone ratio (FSH/LH) in the presence of a normal Day 3 FSH predicts a poor response to controlled ovarian hyperstimulation. Fertil. Steril., 65(3):588-593.

[26] Navot, D., Rosenwaks, Z., Margalioth, E.J., 1987. Prognostic assessment of female fecundity. Lancet, 330(8560): 645-647. doi:10.1016/S0140-6736(87)92439-1]

[27] Navot, D., Bergh, P.A., Laufer, N., 1992. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil. Steril., 58(2):249-261.

[28] Pellicer, A., Valbuena, D., Cano, F., Remohi, J., Simon, C., 1996. Lower implantation rates in high responders: evidence for altered endocrine milieu during the preimplantation period. Fertil. Steril., 65(6):1190-1195.

[29] Peñarrubia, J., Balasch, J., Fábregues, F., Carmona, F., Casamitjana, R., Moreno, V., Calafell, J.M., Vanrell1, J.A., 2000. Day 5 inhibin B serum concentrations as predictors of assisted reproductive technology outcome in cycles stimulated with gonadotrophin-releasing hormone agonist-gonadotrophin treatment. Hum. Reprod., 15(7):1499-1504.

[30] Phelps, J.Y., Levine, A.S., Hickman, T.N., Zacur, H.A., Wallach, E.E., Hinton, E.L., 1998. Day 4 estradiol levels predict pregnancy success in women undergoing controlled ovarian hyperstimulation for IVF. Fertil. Steril., 69(6):1015-1019.

[31] Porchet, H.C., Cotonnec, J.Y.L., Loumaye, E., 1994. Clinical pharmacology of recombinant human follicle-stimulating hormone. III. Pharmacokinetic-pharmacodynamic modelling after repeated subcutaneous administration. Fertil. Steril., 61(4):687-695.

[32] Ranieri, D.M., Phophong, P., Khadum, I., Meo, F., Davis, C., Serhal, P., 2001. Simultaneous evaluation of basal FSH and estradiol response to GnRH analogue (F-G-test) allows effective drug regimen selection for IVF. Hum. Reprod., 16(4):673-675.

[33] Ravhon, A., Lavery, S., Michael, S., Donaldson, M., Margara, R., Trew, G., Winston, R., 2000. Dynamic assays of inhibin B and estradiol following buserelin acetate administration as predictors of ovarian response in IVF. Hum. Reprod., 15(11):2297-2301.

[34] Roest, J., van Heusden, A.M., Mous, H., Zeilmaker, G.H., Verhoeff, A., 1996. The ovarian response as a predictor for successful in vitro fertilization treatment after the age of 40 years. Fertil. Steril., 66(6):969-973.

[35] Rotsztejn, D.A., Asch, R.H., 1991. Effect ofagingon assisted reproductive technologies (ART): experience from oocyte donation. Semin. Reprod. Med., 9(3):272-279.

[36] Scott, R.T., Hofmann, G.E., 1995. Prognostic assessment of ovarian reserve. Fertil. Steril., 63(1):1-11.

[37] Scott, R.T., Toner, J.P., Muasher, S.J., Oehninger, S., Robinson, S., Rosenwaks, Z., 1989. Follicle stimulating hormone levels on cycle Day 3 are predictive of in vitro fertilization outcome. Fertil. Steril., 51(4):651-654.

[38] Seifer, D.B., Lambert-Messerlian, G., Hogan, J.W., Gardiner, A.C., Blazar, A.S., Berk, C.A., 1997. Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome. Fertil. Steril., 67(1):110-114.

[39] Seifer, D.B., Scott, R.T., Bergh, P.A., Abrogast, L.K., Friedman, C.I., Mack, C.K., Danforth, D.R., 1999. Women with declining ovarian reserve may demonstrate a decrease in Day 3 serum inhibin B before a rise in Day 3 follicle-stimulating hormone. Fertil. Steril., 72(1):63-65.

[40] Shanthi, M.K., Harris, S., Hugh, M.G., Muttukrishna, S., 2004. Inhibin B and anti-Mullerian hormone: markers of ovarian response in IVF/ICSI patients? Int. J. Obstet. Gynaecol., 111(Suppl.):1248-1253.

[41] Sharara, F.I., McClamrock, H.D., 1999. High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil. Steril., 72(3):401-405.

[42] Simon, C., Cano, F., Valbuena, D., Remohi, J., Pellicer, A., 1995. Clinical evidence for a detrimental effect on uterine receptivity of high serum estradiol levels in high and normal responder patients. Hum. Reprod., 10(9):2432-2437.

[43] Simon, C., Garcia, V.J.J., Valbuena, D., Painado, J.A., Moreno, C., Remohí, J., Pellicer, A., 1998. Increasing uterine receptivity by decreasing estradiol levels during the preimplantation period in high responders with the use of a follicle-stimulating hormone step-down regimen. Fertil. Steril., 70(2):234-239.

[44] Spandorfer, S., Chung, P., Kligman, I., Liu, H.C., Davis, O.K., Rosenwake, Z., 2000. An analysis of the effect of age on implantation rates. J. Assist. Reprod. Genet., 17(6): 303-306.

[45] Toner, J.P., Brzyski, R.G., Oehninger, S., Veeck, L.L., Simonetti, S., Muasher, S.J., 1991a. Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum. Reprod., 14:284-289.

[46] Toner, J.P., Philput, C.B., Jones, G.S., Muasher, S.J., 1991b. Basal follicle stimulating hormone level is a better predictor of in vitro fertilization performance than age. Fertil. Steril., 55(4):784-791.

[47] Urbancsek, J., Hauzman, E., Klinga, K., Rabe, T., Papp, Z., Strowitzki, T., 2005a. Use of serum inhibin B levels at the start of ovarian stimulation and at oocyte pickup in the prediction of assisted reproduction treatment outcome. Fertil. Steril., 83(2):341-348.

[48] Urbancsek, J., Hauzman, E.E., Murber, A., Lagarde, A.R., Rabe, T., Papp, Z., Strowitzki, T., 2005b. Serum CA-125 and inhibin B levels in the prediction of ovarian response to gonadotropin stimulation in in vitro fertilization cycles. Gynecol. Endocrinol., 21(1):38-44.

[49] Watt, A.H., Legedza, A.T., Ginsburg, E.S., Barbieri, R.L., Clarke, R.N., Hornstein, M.D., 2000. The prognostic value of age and follicle-stimulating hormone levels in women over forty years of age undergoing in vitro fertilization. J. Assist. Reprod. Genet., 17(5):264-268.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE