Abstract / Summary
Objective: To assess the diagnostic accuracy of inhibin B in evaluating ovarian reserve and ovarian response.
Methods: We searched EMBASE, PubMed, Web of Science, ScienceDirect, and the Cochrane Library up to July 2, 2025, for diagnostic test accuracy studies comparing inhibin B with anti-Müllerian hormone (AMH). The review followed the PRISMA-DTA and MOOSE guidelines. The risk of bias was assessed using QUADAS-2. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio (DOR), and diagnostic score were estimated using bivariate random-effects models. Summary receiver operating characteristic (SROC) curves, a Fagan nomogram (pre-test probability = 0.5), and Deeks' funnel plot were used to evaluate performance and publication bias. Subgroup analyses compared inhibin B's accuracy between ovarian reserve and response.
Results: Eight studies (12 datasets; 2878 women) were included, all at low risk of bias. For ovarian reserve, inhibin B showed sensitivity of 0.69, specificity of 0.88, DOR of 16.52, and an SROC AUC of 0.89; for ovarian response: sensitivity of 0.60, specificity of 0.79, DOR of 5.80, and AUC of 0.77. No significant publication bias was detected (P = 0.78 for ovarian reserve; P = 0.21 for ovarian response). The sensitivity was significantly higher for ovarian reserve than for the response (P < 0.001).
Conclusions: Inhibin B has moderate diagnostic accuracy for the ovarian reserve and lower accuracy for the ovarian response. It may be considered a complementary biomarker, but AMH remains superior.