Journal of the Scientific Society (Jan 2020)
Determination of ovarian reserve in different age groups of infertile women
Abstract
Background: Infertility is a major global issue, and the childbearing potential can be estimated by determining the ovarian reserve. Ovarian reserve is described as a quantity of the ovarian follicles and quality of oocytes. Aims and Objectives: The objective of our study was to identify the correlations between follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), and antral follicle count (AFC) in different age groups of infertile women and to distinguish the most reliable marker for ovarian reserve with the objective of selecting a strategy for initial stages of infertility management. Materials and Methods: In this prospective study, 101 infertile women were assessed. The study participants were divided into three age groups: 20–29 years, 30–39 years, and >40 years. FSH, LH, AMH, and AFC were done on day 2–3 of menstrual cycle. Results: A total of 101 infertile women were assessed in our study. The mean age of the participants was 33.3 ± 4.37 years and the mean infertility period was 3.36 ± 2.26 years. The mean body mass index was 23.75 ± 2.97 kg/m2. The mean FSH level was 8.18 ± 5.54 and the mean AMH was 1.98 ± 1.0. The mean AFC was 9.29 ± 5.09. There was a statistically significantly elevated negative correlation between age and AMH level (rs = -0.667, P < 0.0001) and AFC (rs = -0.64, P < 0.0001). We observed a statistically significantly positive correlation between age and FSH (rs = 0.569, P < 0.0001). The correlation analysis performed in separate groups showed that AMH and AFC showed a statistically significant positive correlation for Group I (r = 0.953, P < 0.0001), Group II (r = 0.966, P < 0.0001), and Group III (r = 0.865, P < 0.001). A statistically significant negative correlation between FSH/LH and AMH was detected only in Group II (r = -0.661, P < 0.0001) and Group III (r = -0.735, P < 0.003). A statistically significant correlation existed between FSH and AFC in Group II (r = -0.657, P < 0.000), Group III (r = -0.664, P < 0.01), as well as between age and FSH only in Group III (r = 0.551, P < 0.04). Conclusion: AMH is more reliable marker of ovarian reserve compared to FSH/LH as the correlation between AMH and AFC is strongly positive. AMH can detect decrease in ovarian reserve much earlier than FSH/LH. The use of AMH combined with AFC definitely improves the evaluation of ovarian reserve in all age groups of infertile women.
Keywords
