Background
Methods
Search strategy and data sources
Inclusion and exclusion criteria
Data extraction
Study quality assessment
Statistical analysis
Results
Study selection and study characteristics
Author | Region | Definition of ovarian response | TP | FP | FN | TN | Cut-off |
---|---|---|---|---|---|---|---|
Poor response | |||||||
Li et al. 2016 [41] | China | ≤ 5 oocytes | 23 | 47 | 21 | 321 | 1.1 ng/ml |
Fouda et al. 2010 [27] | Egypt | < 3 follicles | 8 | 18 | 2 | 32 | 0.9 ng/ml |
Singh et al. 2013 [51] | India | < 4 oocytes | 8 | 9 | 2 | 36 | NS |
Martínez et al. 2013 [42] | Spain | < 6 oocytes | 19 | 29 | 8 | 47 | 2.31 ng/ml |
Baker et al. 2018 [22] | USA | ≤ 4 oocytes | 20 | 13 | 7 | 120 | 0.93 ng/ml |
Kamel et al. 2014 [57] | Egypt | NS | 30 | 1 | 5 | 74 | 2.8ug/l |
Fabregues et al. 2018 [25] | Spain | ≤ 3 oocytes | 43 | 77 | 8 | 310 | NS |
Heidar et al. 2015 [30] | Iran | ≤ 3 oocytes | 16 | 32 | 6 | 134 | 1.2 ng/ml |
Ashrafi et al. 2017 [20] | Iran | ≤ 4 oocytes | 90 | 116 | 32 | 312 | 1.05 ng/ml |
Neves et al. 2020 [48] | Belgiuma | ≤ 3 oocytes | 46 | 56 | 4 | 113 | 1.00 ng/ml |
Islam et al. 2016 [31] | Egypt | ≤ 3 oocytes | 9 | 40 | 6 | 45 | 1.4 ng/ml |
Baker et al. 2021 [21] | USA, Canada | ≤ 4 oocytes | 47 | 43 | 27 | 355 | 0.93 ng/ml |
Palhares et al. 2018 [17] | Brazil | ≤ 3 oocytes | 36 | 41 | 9 | 55 | 1.5 ng/ml |
Jayaprakasan et al. 2010 [34] | UK | ≤ 3 oocytes | 15 | 32 | 0 | 88 | 0.99 ng/ml |
Tolikas et al. 2011 [18] | Greece | < 4 oocytes | 20 | 18 | 9 | 43 | 2.74 ng/ml |
Tremellen et al. 2005 [54] | Australia | ≤ 4 oocytes | 16 | 8 | 4 | 47 | 8.1 pmol/l |
Kunt et al. 2011 [37] | Turkey | < 5 oocytes | 46 | 14 | 0 | 120 | 2.97 ng/ml |
Marca et al. 2007 [38] | Italy | < 4 oocytes | 10 | 3 | 2 | 33 | 0.75 ng/ml |
Mutlu et al. 2013 [10] | Turkey | < 4 oocytes | 34 | 20 | 15 | 123 | 0.94 ng/ml |
Peñarrubia et al. 2005 [49] | Spain | < 3 follicles | 11 | 2 | 9 | 58 | 4.9 pmol/l |
Nardo et al. 2009 [46] | UK | < 4 follicles | 13 | 50 | 2 | 101 | 1.00 ng/ml |
Fiçicioglu et al. 2006 [26] | Turkey | < 5 follicles | 10 | 3 | 1 | 30 | 0.25 pg/ml |
McIlveen et al. 2007 [43] | UK | ≤ 4 oocytes | 11 | 26 | 2 | 45 | 1.25 ng/ml |
Muttukrishna et al. 2004 [44] | UK | < 4 follicles | 15 | 14 | 2 | 38 | 0.1 ng/ml |
Nakhuda et al. 2007 [45] | USA | NS | 20 | 8 | 2 | 36 | 0.35 ng/ml |
Gnoth et al. 2008 [29] | Germany | ≤ 4 oocytes | 32 | 58 | 1 | 41 | 1.26 ng/ml |
Nelson et al. 2007 [47] | UK | ≤ 2 oocytes | 14 | 29 | 5 | 292 | 5 pmol/l |
van Rooij et al. 2002 [55] | Netherlands | < 4 oocytes | 21 | 9 | 14 | 75 | 0.3 ng/ml |
Lee et al. 2011 [39] | Taiwan | NS | 11 | 16 | 6 | 93 | 0.68 ng/ml |
High response | |||||||
Li et al. 2016 [41] | China | > 15 oocytes | 165 | 149 | 38 | 219 | 2.6 ng/ml |
Akbari Sene et al. 2021 [50] | Iran | > 15 oocytes | 31 | 16 | 10 | 43 | 4.95 ng/ml |
Izhar et al. 2021 [32] | Pakistan | NS | 50 | 14 | 4 | 208 | 6.43 ng/ml |
Tan et al. 2021 [53] | China | > 15 oocytes | 137 | 15 | 30 | 154 | 3.6 ng/ml |
Heidar et al. 2015 [30] | Iran | > 12 oocytes | 30 | 34 | 23 | 93 | 3.40 ng/ml |
Ashrafi et al. 2017 [20] | Iran | ≥ 15 oocytes | 79 | 129 | 40 | 302 | 2.5 ng/ml |
Vembu et al. 2017 [11] | India | ≥ 20 oocytes | 11 | 15 | 2 | 132 | 4.85 ng/ml |
Neves et al. 2020 [48] | Belgiuma | > 15 oocytes | 13 | 16 | 11 | 179 | 2.25 ng/ml |
Nardo et al. 2009 [46] | UK | > 20 oocytes | 14 | 45 | 2 | 104 | 3.5 ng/ml |
Eldar-Geva et al. 2005 [24] | Israel | > 20 oocytes | 12 | 4 | 5 | 35 | 3.5 ng/ml |
Aflatoonian et al. 2009 [19] | Iran | > 15oocytes | 42 | 22 | 3 | 76 | 34.5 pmol/l |
Lee et al. 2008 [40] | China | NS | 19 | 45 | 2 | 196 | 3.36 ng/ml |
Nelson et al. 2007 [47] | UK | ≥ 21 oocytes | 15 | 16 | 10 | 299 | 25 pmol/l |
Author | Region | Definition of ovarian response | TP | FP | FN | TN | Cut-off |
---|---|---|---|---|---|---|---|
Poor response | |||||||
Fabregues et al. 2018 [25] | Spain | ≤ 3 oocytes | 40 | 61 | 10 | 326 | NS |
Ashrafi et al. 2017 [20] | Iran | ≤ 4 oocytes | 100 | 116 | 22 | 312 | 8 |
Neves et al. 2020 [48] | Belgiuma | ≤ 3 oocytes | 42 | 32 | 8 | 137 | 6 |
Islam et al. 2016 [31] | Egypt | ≤ 3 oocytes | 13 | 34 | 2 | 51 | 7 |
Palhares et al. 2018 [17] | Brazil | ≤ 3 oocytes | 36 | 40 | 9 | 56 | 8 |
Frattarelli et al. 2003 [28] | USA | < 3 oocytes | 7 | 10 | 16 | 234 | 4 |
Jayaprakasan et al. 2010 [34] | UK | ≤ 3 oocytes | 14 | 14 | 1 | 106 | 10 |
Tolikas et al. 2011 [18] | Greece | < 4 oocytes | 21 | 12 | 8 | 49 | 5 |
Mutlu et al. 2013 [10] | Turkey | < 4 oocytes | 45 | 13 | 4 | 130 | 6 |
Jayaprakasan et al. 2007 [35] | UK | < 4 follicles | 5 | 4 | 0 | 91 | 6 |
McIlveen et al. 2007 [43] | UK | ≤ 4 oocytes | 6 | 14 | 7 | 57 | 5 |
Bancsi et al. 2004 [23] | Netherlands | < 4 oocytes | 22 | 10 | 14 | 74 | 4 |
Yong et al. 2003 [56] | UK | < 3 oocytes | 1 | 1 | 7 | 37 | 4 |
Järvelä et al. 2003 [32] | Canada | < 5 follicles | 10 | 5 | 2 | 28 | 4 |
Soldevila et al. 2007 [52] | Spain | ≤ 5 follicles | 75 | 52 | 46 | 154 | 8 |
High response | |||||||
Izhar et al. 2021 [32] | Pakistan | NS | 51 | 6 | 3 | 216 | 18 |
Tan et al. 2021 [53] | China | > 15 oocytes | 145 | 19 | 22 | 150 | 18 |
Ashrafi et al. 2017 [20] | Iran | ≥ 15 oocytes | 87 | 116 | 32 | 315 | 15 |
Neves et al. 2020 [48] | Belgiuma | ≤ 3 oocytes | 19 | 46 | 5 | 149 | 10 |
Eldar-Geva et al. 2005 [24] | Israel | > 20 oocytes | 16 | 26 | 1 | 13 | 14 |
Aflatoonian et al. 2009 [19] | Iran | > 15oocytes | 40 | 8 | 5 | 90 | 16 |
Study quality
Accuracy of AMH and AFC for predicting poor response
Subgroup | Number (n) | Sensitivity (95%CI) | Specificity (95%CI) | PLR (95%CI) | NLR (95%CI) | DOR (95%CI) |
---|---|---|---|---|---|---|
Cut-off value | ||||||
AMH-poor response | ||||||
Overall | 29 | 0.80 (0.74, 0.85) | 0.81 (0.75, 0.85) | 4.10 (3.20, 5.30) | 0.25 (0.19, 0.32) | 14.39 (10.26, 20.17) |
< 1.00 ng/ml 1 | 10 | 0.79 (0.69, 0.89) | 0.84 (0.78, 0.89) | 4.54 (3.55, 5.83) | 0.35 (0.27, 0.44) | 16.07 (11.53, 22.39) |
≥ 1.00 ng/ml 0 | 12 | 0.82 (0.74, 0.90) | 0.70 (0.62, 0.77) | 2.59 (2.05, 3.28) | 0.34 (0.24, 0.49) | 8.13 (5.05, 13.09) |
AMH-high response | ||||||
Overall | 13 | 0.81 (0.75, 0.86) | 0.84 (0.77, 0.89) | 5.00 (3.40, 7.30) | 0.22 (0.16, 0.30) | 22.67 (12.85, 40.00) |
< 4.00 ng/ml | 8 | 0.75 (0.66, 0.83) | 0.80 (0.72, 0.88) | 3.63 (2.53, 5.19) | 0.34 (0.24, 0.49) | 11.83 (5.89, 23.73) |
≥ 4.00 ng/ml | 3 | 0.86 (0.76, 0.96) | 0.88 (0.79, 0.97) | 6.93 (2.56, 18.76) | 0.17 (0.06, 0.52) | 41.01 (5.36, 313.99) |
AFC-poor response | ||||||
Overall | 15 | 0.73 (0.62, 0.83) | 0.85 (0.78, 0.90) | 4.26 (3.23, 5.62) | 0.33 (0.22, 0.49) | 13.93 (8.53, 22.74) |
< 6 | 7 | 0.61 (0.44, 0.79) | 0.90 (0.84, 0.95) | 5.18 (3.41, 7.85) | 0.42 (0.24, 0.76) | 14.06 (5.93, 33.34) |
≥ 6 | 7 | 0.83 (0.72, 0.94) | 0.79 (0.69, 0.88) | 3.60 (2.53, 5.13) | 0.27 (0.17, 0.44) | 12.60 (6.31, 25.14) |
AFC-high response | ||||||
Overall | 6 | 0.85 (0.77, 0.91) | 0.83 (0.64, 0.94) | 5.48 (2.50, 12.02) | 0.18 (0.10, 0.32) | 35.62 (10.06, 126.08) |
< 15 | 3 | 0.76 (0.69, 0.84) | 0.64 (0.45, 0.82) | 2.33 (1.41, 3.85) | 0.35 (0.26, 0.46) | 8.02 (5.32, 12.10) |
≥ 15 | 3 | 0.89 (0.85, 0.93) | 0.94 (0.89, 0.99) | 13.61 (5.92, 31.31) | 0.12 (0.07, 0.20) | 126.72 (33.10, 485.15) |
Definition of poor response (< 4 oocytes) | ||||||
AMH | 11 | 0.78 (0.70, 0.85) | 0.77 (0.69, 0.83) | 3.24 (2.50, 4.21) | 0.33 (0.24, 0.45) | 11.27 (6.62, 19.19) |
AFC | 9 | 0.81 (0.74, 0.87) | 0.80 (0.73, 0.87) | 4.00 (2.76, 5.79) | 0.27 (0.19, 0.38) | 16.76 (8.76, 30.18) |
Sample size | ||||||
AMH-Poor response | ||||||
< 200 | 23 | 0.81 (0.75, 0.87) | 0.80 (0.73, 0.86) | 4.12 (3.00, 5.65) | 0.23 (0.17, 0.32) | 17.80 (10.54, 20.05) |
≥ 200 | 6 | 0.74 (0.61, 0.84) | 0.83 (0.75, 0.88) | 4.26 (3.15, 5.78) | 0.32 (0.22, 0.47) | 13.45 (8.72, 20.74) |
AMH-High response | ||||||
< 200 | 8 | 0.83 (0.72, 0.91) | 0.78 (0.65, 0.87) | 3.79 (2.29, 6.26) | 0.21 (0.12, 0.37) | 17.62 (7.50, 41.44) |
≥ 200 | 11 | 0.81 (0.73, 0.87) | 0.87 (0.79, 0.92) | 6.12 (3.63, 10.33) | 0.22 (0.15, 0.33) | 27.66 (12.24, 62.49) |
AFC-Poor response | ||||||
< 200 | 10 | 0.77 (0.60, 0.88) | 0.85 (0.76, 0.91) | 5.27 (3.16, 8.79) | 0.27 (0.15, 0.50) | 19.23 (7.82, 47.30) |
≥ 200 | 5 | 0.69 (0.50, 0.84) | 0.84 (0.73, 0.91) | 4.33 (2.86, 6.53) | 0.36 (0.22, 0.59) | 11.87 (6.83, 20.63) |
AFC-high response | ||||||
< 200 | 2 | 0.89 (0.78, 0.99) | 0.70 (0.35, 0.99) | - | - | - |
≥ 200 | 4 | 0.84 (0.76, 0.92) | 0.88 (0.75, 0.99) | 6.70 (2.57, 17.45) | 0.17 (0.08, 0.37) | 39.11 (7.15, 213.98) |