Journal club MCQ March 2020

Learning Objectives: Comparison of antral follicle count and serum anti-Müllerian hormone level for determination of gonadotropin dosing in in-vitro fertilization: randomized trial

Upon completion of this activity, the participant will be better able to

Recognise the role of AFC and AMH for assessing ovarian response and its association with IVF outcomes (Q1)
Define the trial setting and methods (Q2)
Recognise the association between AFC, AMH levels and gonadotrophin starting dose in IVF cycles (Q3)
Identify the strengths and weaknesses of AMH levels for managing IVF cycles when compared to AFC (Q4)

Question Title

* 1. Which of the following statements about ovarian response is correct?

a. Antral follicle count and anti-Mullerian hormone levels are predictors of ovarian response

b. Sonographic assessment of antral follicle count is operator independent and not influenced by the equipment used.

c. Anti-Mullerian hormone levels are subject to significant intra- and inter-cycle variation.

d. Anti-Müllerian hormone levels have been standardized across different assay methods available.

Question Title

* 2. The women included in the study were:

a. Repeat IVF cycles

b. Donor cycles

c. Planned for pre-implantation genetic diagnosis

d. First IVF cycles

e. Overweight women with a BMI over 30kg/m2

Question Title

* 3. The women randomized to AFC or AMH groups for deciding the gonadotrophin dose were:

a. Started on higher doses of gonadotrophins if their AMH levels and AFC count was high

b. Starred on the same dose of gonadotrophins regardless of their AMH levels and AFC count

c. Started on lower doses of gonadotrophins if their AMH levels and AFC count was high

d. The starting dose was kept the same throughout the cycle

Question Title

* 4. According to the results of this RCT, women in AMH group had:

a. A higher rate of desired ovarian response compared to AFC group

b. Increased need for dose adjustments (step-up) compared to AFC group

c. Similar serum peak estradiol concentrations compared to AFC group

d. A lower rate of ongoing and clinical pregnancy rates