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Relationship between Serum Inhibin A and B and Ovarian Follicle Development after a Daily Fixed Dose Administration of Recombinant Follicle-Stimulating Hormone¹

Monash IVF (T.E.-G., M.P.G., V.M., D.L.H) and the Department of Obstetrics and Gynecology, Monash University (T.E.-G., D.L.H), Prince Henry’s Institute of Medical Research (D.M.R., N.C.), Clayton, Victoria 3168, Australia; and Oxford Brookes University (N.G.), Oxford, United Kingdom

Address all correspondence and requests for reprints to: Dr. T. Eldar-Geva, Monash IVF and the Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria 3168, Australia.

The aim of this study was to investigate the relationship of serum inhibin A and inhibin B to ovarian follicular development in women undergoing pituitary down-regulation and ovarian stimulation with a fixed daily dose of recombinant human FSH in an in vitro fertilization program. Thirty-eight patients were treated randomly with either 100 or 200 IU/day recombinant human FSH (Puregon) for a period of 9–14 days. Serum FSH, inhibin A, inhibin B, 17ß-estradiol, and follicular size and number were determined before FSH treatment and every second day from days 4–6 throughout FSH treatment. Serum FSH increased in a dose-related manner to reach a maximum by days 4–6 and remained unchanged over the duration of treatment. Serum inhibin A and 17ß-estradiol also increased with increasing FSH dose and continued to rise throughout the FSH treatment period. By contrast, serum inhibin B was increased by days 4–6 at both doses of FSH to reach a maximum by days 7–8, remaining unchanged thereafter. Serum inhibin B and, to a lesser extent, inhibin A correlated significantly with the number of oocytes retrieved even when assessed early (days 4–6) in the treatment period (inhibin B vs. number of oocytes: r = 0.89; P < 0.001; inhibin A vs. number of oocytes: r = 0.61; P < 0.05). Serum inhibin A, inhibin B, and 17ß-estradiol were weakly correlated with the number of follicles less than 11 mm when assessed on a daily basis; stronger correlations were observed with the greater than 11-mm follicles during the late stages of treatment. It is concluded that serum inhibin B levels determined during the early stages (e.g. days 4–6) of fixed dose FSH treatment provide an early indicator of the number of recruited follicles that are destined to form mature oocytes. In this context, serum inhibin B may be of predictive value in monitoring ovarian hyperstimulation treatment for in vitro fertilization.

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