الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
In assisted reproductive techniques including IVF, although all the patients were exposed to the same protocol of follicular stimulation, follicular responses among the patients differed significantly. Numerous factors have been postulated to influence the success of IVF for alleviating human infertility. FSH and its receptor play a major role in the development of follicles and regulation of steroidogenesis in the ovary. Single nucleotide polymorphism (SNPs) in FSH receptor gene is located at nucleotide position 2039 in which G is replaced by A. This leads to an amino acid change at position 680 from serine (AGT) to asparagine (AAT). Since FSH receptor variants appear to respond differently to FSH stimulation in vivo, they might play some role in determining ovarian response to pharmacological stimulation with FSH. Anti-Müllerian hormone (AMH) is a member of the transforming growth factor-ß (TGF-ß) family and its levels was reported to decline with increasing female age and to be associated with ovarian response in IVF patients with normal FSH levels. This study aimed at assessing the FSH receptor variants, serum AMH level, serum female sex hormones levels and if they could be helpful in the prediction of success of the ovarian stimulation protocol used in assisted reproductive techniques (ART). This study included 55 women subjected to ovarian stimulation protocol (13 females good responders without polycystic ovary (PCO), 14 females good responders with PCO, 13 females bad responders without PCO and 15 females bad responders with PCO). Blood samples were collected for Asn/Ser polymorphism of FSH Receptor gene detection, Serum level of Anti-mullerian hormone using enzyme linked immunosorbent assay (ELISA) and Serum sex hormones including: β estradiol (E2), 5α-Androstane-3α, 17 β-Diol (3α-Androstanediol ), Testosterone (T), Androstenedione (A), 17 α-OH progesterone (17-OHP) and Progesterone (P) using high performance liquid chromatography (HPLC) method. There were increased frequency of Asn/Asn variant and higher levels of serum AMH among good responders and of Ser/Ser genotype among bad responders. ROC curve analysis showed that AMH might be the most reliable marker for prediction of response of the ovary to ovarian stimulation protocol with sensitivity 100% and specificity 92.86% at cut off 8.97 ng/ml. from this study it is concluded that FSH receptor genotyping, in particular Asn/Ser polymorphism may be helpful in the prediction of the ovarian response and pregnancy outcomes in in vitro fertilization. AMH levels in serum could give a prediction for ovarian response to controlled ovarian hyperstimulation and for the success of oocyte retrieval during IVF treatment.. Finally, this study has revealed the interaction of genetic and hormonal factors in ovarian dysfunction during assisted reproduction programs and allowed us to distiguish between women with poor and good prognosis in achieving the ongoing pregnancy. This early assessment of ovarian stimulation response could help to decide early cancellation, thus avoiding further cost and therapy. But further prospective studies are indicated to evaluate the role of these findings on the management of female infertility to improve the success of ART with higher pregnancy rate, reduced risks and complications of hormonal treatment