Maternal Obesity and the Risk of Selected Foetal Abnormalities (Neural Tube Defects and Orofacial Clefts) In Malaysia: A Retrospective Observational Study

Abstract

Background: Clomiphene citrate (CC) is first choice as an ovulation-stimulating drug in polycystic ovarian syndrome. Anovulation problems could occur in some patients presenting with CC resistance. In PCOS patients, very high levels of AMH were observed. The role of anti-Müllerian hormone (AMH) in the prediction of ovarian response to CC in women with the polycystic ovarian syndrome (PCOS) is investigated in this study. Objective: To assess the predictive value of Anti Mullerian hormone (AMH) in Clomiphene citrate response in patients with polycystic ovary syndrome. Methods: This cross-sectional study was conducted at Tanta University Hospitals, Egypt. The study included 120 anovulatory PCOS women who underwent ovarian stimulation with clomiphene citrate. Day 3 measurement of AMH concentrations was done. Results: Cycles with poor response had significantly (p<0.0001) higher basal serum AMH concentration compared to that of cycles with normal response. AMH area under receiver operating characteristic curve (ROCAUC) 0.88; (p<0.001) and 0.81; (p<0.007) respectively. Using a cut-off level of 6.3 ng/ml, the good response rate was significantly (p < .001) higher in cycles with lower AMH (<6.3 ng/ml) compared to that in those with AMH (> = 6.3) ng/ml. Conclusion: AMH levels could predict the ovarian response to clomiphene citrate in PCO women.