Background: This study aimed to evaluate the strength of anti‑Mullerian HORMONE (AMH) and follicle stimulating HORMONE (FSH) in reflecting the antral follicle count (AFC) in infertile females. Materials and Methods: This cross‑sectional study was conducted on 160 females, visiting infertility clinic for assisted reproduction. Serum samples collected on the 3rd day of the cycle were assayed for FSH, luteinizing HORMONE, and AMH while AFC was assessed via transvaginal ultrasound. The study cohort was segregated into three groups based on AFC. Results: Chronological age and FSH was significantly high in females with very low AFC (P < 0.01 and 0.009, respectively), yet they failed to discriminate patients with normal and higher follicle count (P = 0.65 and 0.84). Conversely, AMH reported highly significant difference between very low AFC and with those having either normal AFC (P = 0.002) or higher AFC (P = 0.001). Moreover, a significant difference in AMH was observed between normal and higher AFC group (P = 0.04). Conclusion: Compared to female’s age and FSH, AMH is superior in clustering study cohort on the bases of antral follicular pool, especially in setups with nonavailability of technological expertise to assess AFC. Incorporation of AMH along with other biomarkers improves estimation of baseline ovarian reserve, required to standardize dose for optimum response; avoiding the risk of failure to retrieve oocyte or inappropriate stimulation leading to ovarian hyperstimulation syndrome. Further prospective studies are required to ascertain its role in predicting the outcomes of ART in such patients.

Background: To evaluate the level Anti-Mullerian HORMONE (AMH) in serum in response to ovarian stimulation (group 1) in low-response (n=26), moderate-response (n=40), and high-response (n=29) patients and to compare its changes (n=23, group 2) throughout the menstrual cycle between pregnant and nonpregnant patients.Materials and Methods: Serum was collected from 210 patients on day 3 of menstrual cycle and studied for the level of AMH, FSH and the number of antral follicles (AF). Furthermore serum and follicular fluid (FF) were collected from 95 IVF/ICSI patients on the day of follicular puncture (FP). The aetiology of patients was tubal or male factor infertility. These patients were divided into two groups: In Group 1 we studied the comparison of AMH level in serum in response to ovarian stimulation and pregnancy rate, respectively. In group 2, 25 patients were monitored throughout the menstrual cycle until 4 weeks after embryo transfer.Results: There was a significant correlation between basal AMH in serum and total AF on day 3 of menstrual cycle (r=0.7, p<0.001). We found inverse relations between serum AMH levels, FSH and advanced patients’age. In group 1 on the day of FP, the mean AMH level in FF was significantly higher than in serum (p<0.001).We found a significant correlation between AMH levels in serum and FF (p<0.001) and also in their correlation to AF. In response to ovarian stimulation AMH levels in serum increased from low, through moderate, to high response patients (p=0.001), pregnancy rates were 17%, 25% and 48%, respectively. In group 2 the levels of AMH in serum of pregnant (n=12) and non-pregnant (n=13) patients decreased throughout stimulation phase and reached a minimum on the day of embryo transfer.Conclusion: Our results demonstrate an association between AMH and ovarian response to gonadotropins.AMH provides a new perspective for clinicians who may now have a reliable serum marker of ovarian reserve.