[Latar Belakang: Sindrom Ovarium Polikistik (SOPK) menjadi penyebab 60-85%infertilitas pada wanita. Gangguan ovulasi pada SOPK diperbaiki dengan obatobatanyang menstimulasi ovarium seperti klomifen sitrat. Klomifen menstimulasiovarium untuk memulai folikulogenesis hingga terjadi ovulasi. Pada 20-60%wanita SOPK tidak mengalami ovulasi setelah pemberian klomifen. Hal inididuga karena tidak terjadi perkembangan folikel dominan akibat tingginya kadarAMH. AMH yang tinggi menyebabkan sensitivitas reseptor FSH terhadapstimulasi FSH berkurang. AMH memiliki peran negatif terhadap perkembanganfolikel pada SOPK. Kadar AMH tertentu diduga dapat meramal keberhasilanstimulasi ovarium yang bermanfaat untuk menentukan terapi yang tepatTujuan: Mendapatkan titik potong kadar AMH sebagai peramal keberhasilanstimulasi ovarium dengan klomifen sitratMetode: Studi analitik dengan desain potong lintang selama periode Juni 2013hingga April 2014 di Poliklinik Endokrinologi Ginekologi, RSCM, Jakarta.Hasil: Didapatkan 50 subjek SOPK yang diberikan klomifen sitrat 100 mg padahari ke-2 hingga ke-5 haid kemudian dievaluasi folikel dominan > 16 mm padahari ke-12 haid. Kemudian Subjek dibagi dua; kelompok responder (n=23) dankelompok non-responder (n=27). Kadar AMH serum kedua kelompokdibandingkan. Terdapat perbedaan bermakna kadar AMH serum antara keduakelompok (p 0,001). Pada kurva ROC didapatkan AUC Kadar AMH sebesar 0,75(IK 95% 0,62 – 0,88). Titik potong AMH dalam menentukan keberhasilanstimulasi ovarium adalah 4,4 ng/ml dengan sensitifitas 35%, spesifisitas 86%.Pada analisa multivariat probabilitas keberhasilan stimulasi ovarium pada kadarAMH 4,4 ng/ml adalah 71%.Kesimpulan: Kadar AMH serum dapat digunakan sebagai parameter untukmeramal keberhasilan stimulasi ovarium dengan klomifen sitrat pada populasiSOPK.

---

Background: About 60-85% women with infertility have PCOS. It is

characterized by anovulation which is corrected by giving ovulatory medication.

Clomiphene has become first line drug of ovarian stimulation. Since only 40-80 %

women respond to clomiphene, many remains anovulatory. The cessation of

follicle development may be influenced by high level of Anti Mullerian Hormone

(AMH). It decreases sensitivity of FSH receptor within granulose cells. Studies

reveal AMH has regulatory effect of follicle development. It is possible that

certain level of AMH might predict the success of ovarian stimulation and

therefore benefit women’s choice of treatment.

Objective: To obtain AMH cutoff level that can predict success of ovarian

stimulation in PCOS receiving clomiphene

Method: This is a cross sectional study conducted in Endocrinology Gynecology

Clinic in RSCM during a period of June 2013 till April 2014.

Result: Fifty women were enrolled in this study. All subject received 100 mg of

clomiphene and followed to acquire domminat follicle and then divided into two

groups; responder (n=23) and non-responder (n=27). AMH serum level was

obtained. We found statistical difference of AMH serum level between two

groups (p 0,001). On ROC curve, the AUC of AMH was 0,75 (CI 95% 0,62-0,88).

Cut off level of AMH used in this study was 4,4 ng/ml with sensitivity 35% and

specificity 86%. This cut off level has 71% of ovulatory success prediction after

entering it to the multivariate analysis.

Conclusion: The AMH serum level may be used as predictor of ovarian

stimulation success in selected PCOS women receiving clomiphene.;Background: About 60-85% women with infertility have PCOS. It is

characterized by anovulation which is corrected by giving ovulatory medication.

Clomiphene has become first line drug of ovarian stimulation. Since only 40-80 %

women respond to clomiphene, many remains anovulatory. The cessation of

follicle development may be influenced by high level of Anti Mullerian Hormone

(AMH). It decreases sensitivity of FSH receptor within granulose cells. Studies

reveal AMH has regulatory effect of follicle development. It is possible that

certain level of AMH might predict the success of ovarian stimulation and

therefore benefit women’s choice of treatment.

Objective: To obtain AMH cutoff level that can predict success of ovarian

stimulation in PCOS receiving clomiphene

Method: This is a cross sectional study conducted in Endocrinology Gynecology

Clinic in RSCM during a period of June 2013 till April 2014.

Result: Fifty women were enrolled in this study. All subject received 100 mg of

clomiphene and followed to acquire domminat follicle and then divided into two

groups; responder (n=23) and non-responder (n=27). AMH serum level was

obtained. We found statistical difference of AMH serum level between two

groups (p 0,001). On ROC curve, the AUC of AMH was 0,75 (CI 95% 0,62-0,88).

Cut off level of AMH used in this study was 4,4 ng/ml with sensitivity 35% and

specificity 86%. This cut off level has 71% of ovulatory success prediction after

entering it to the multivariate analysis.

Conclusion: The AMH serum level may be used as predictor of ovarian

stimulation success in selected PCOS women receiving clomiphene., Background: About 60-85% women with infertility have PCOS. It is

characterized by anovulation which is corrected by giving ovulatory medication.

Clomiphene has become first line drug of ovarian stimulation. Since only 40-80 %

women respond to clomiphene, many remains anovulatory. The cessation of

follicle development may be influenced by high level of Anti Mullerian Hormone

(AMH). It decreases sensitivity of FSH receptor within granulose cells. Studies

reveal AMH has regulatory effect of follicle development. It is possible that

certain level of AMH might predict the success of ovarian stimulation and

therefore benefit women’s choice of treatment.

Objective: To obtain AMH cutoff level that can predict success of ovarian

stimulation in PCOS receiving clomiphene

Method: This is a cross sectional study conducted in Endocrinology Gynecology

Clinic in RSCM during a period of June 2013 till April 2014.

Result: Fifty women were enrolled in this study. All subject received 100 mg of

clomiphene and followed to acquire domminat follicle and then divided into two

groups; responder (n=23) and non-responder (n=27). AMH serum level was

obtained. We found statistical difference of AMH serum level between two

groups (p 0,001). On ROC curve, the AUC of AMH was 0,75 (CI 95% 0,62-0,88).

Cut off level of AMH used in this study was 4,4 ng/ml with sensitivity 35% and

specificity 86%. This cut off level has 71% of ovulatory success prediction after

entering it to the multivariate analysis.

Conclusion: The AMH serum level may be used as predictor of ovarian

stimulation success in selected PCOS women receiving clomiphene.]