Predictive value of anti-Müllerian hormone and antral follicle count in ovarian stimulation response in Cameroonian women

Abstract

Background: Infertility affects one in six adults globally, with assisted reproductive techniques (ART) offering tailored treatment options. Predicting ovarian response is essential to optimize outcomes and minimize risks. Anti-Müllerian Hormone (AMH) and Antral Follicle Count (AFC) are key markers of ovarian reserve. The aim of our study was to evaluate the predictive capacity of the combined use of AFC and AMH in the prediction of ovarian response in ART techniques.

Methods: This analytical cross-sectional study included 282 African women aged 20–43 undergoing IVF/ICSI at CHRACERH, Yaoundé. AMH levels were measured via electro-chemiluminescence and AFC via transvaginal ultrasound. Ovarian response was categorized as poor (<4 oocytes), normal (4–19), or hyper-response (≥20). Statistical analyses included correlation tests and multivariate regression.

Results: Normal response occurred in 70.2% of participants; 27% were poor responders. AMH and AFC showed strong positive correlations with both follicle count and mature oocyte yield (p < 0.001). Age and BMI were negatively associated with ovarian response. AFC remained a significant predictor of follicle count in multivariate analysis, while AMH showed borderline significance for mature oocytes. FSH and estradiol levels were less predictive.

Conclusion: AMH and AFC are reliable predictors of ovarian response in African women. AFC, being more accessible and cost-effective, may serve as a practical alternative to AMH in low-resource settings. Age and BMI significantly influence ovarian reserve and stimulation outcomes.