Ovarian function and disorders
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In normal-BMI PCOS, basal serum A4 is an independent predictor of ovarian response and adds incremental discrimination beyond AMH and AFC for excessive response, and deserves consideration in pre-stimulation risk stratification.
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Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility and a major source of variability in ovarian response during in vitro fertilization (IVF). Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are the established pre-stimulation predictors but do not directly capture the androgenic biochemistry that defines PCOS.To assess basal serum A4 as a predictor of ovarian response operationalized as the follicular output rate (FORT), total oocytes retrieved, and excessive response (≥ 20 oocytes) among normal-BMI women with PCOS undergoing controlled ovarian stimulation (COS)A prospective single- center cohort study enrolled normal-BMI (18.5–24.9 kg/m²) women aged 20–38 years with PCOS by Rotterdam criteria, undergoing first-cycle gonadotropin-releasing hormone (GnRH) antagonist COS for IVF or intracytoplasmic sperm injection (ICSI). Basal day-2 to day-3 serum A4, AMH, AFC. Outcomes were FORT, total oocytes retrieved, mature (metaphase II) oocytes, and excessive response. Mean basal A4 was 3.8 ± 1.4 ng/mL. A4 correlated with FORT (Spearman r = 0.59, p < 0.001) and total oocytes retrieved (r = 0.54, p < 0.001). For prediction of excessive response, A4 achieved an area under the curve (AUC) of 0.84 (95% confidence interval [CI] 0.78–0.90), outperforming AMH (AUC 0.73, 0.65–0.81; DeLong p = 0.02). A combined A4 + AMH + AFC model reached AUC 0.89 (0.84–0.94; DeLong p = 0.01 versus AMH alone). In normal-BMI PCOS, basal serum A4 is an independent predictor of ovarian response and adds incremental discrimination beyond AMH and AFC for excessive response. A4 deserves consideration in pre-stimulation risk stratification.
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@article{Sahib2026Serum,
title = {Serum Androstenedione Predicts Ovarian Response in Normal-BMI PCOS in Thi-Qar Province},
author = {Huda Adnan Sahib},
journal = {Al-mağallaẗ al-ṭibiyyaẗ li-l-ǧāmiʻaẗ Tikrīt.},
year = {2026},
doi = {10.25130/mjotu.32.1.21},
url = {https://doi.org/10.25130/mjotu.32.1.21}
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