The value of ovarian reserve markers in assisted reproductive technology
Adela Voican, Gabriela Niculescu, Magdalena Manolea, Dominic Iliescu, Carmen Gheta & Liliana Novac
Background and aims: Ovarian reserve screening is considered to play a key role in the prediction of quantitative and qualitative aspects in assisted reproductive technologies (ART). The ovarian reserve markers currently used include the serum levels of FSH, oestadiol, inhibin B, anti-Müllerian hormone (AMH) as well as ultrasound antral follicular counts (AFC). Despite controversial results, most of the existing studies suggest that, compared to other markers of the ovarian reserve, baseline AMH levels have a better capacity in predicting the ovarian response to controlled ovarian stimulation (COS).
The aim of our study was that of evaluating the predictive value of the different biochemical and ultrasound markers of the ovarian reserve in correlation with the age of the patients undergoing COS for IVF.
Patients and method: In this prospective study we have included 21 women, aged 2940 years, undergoing the first cycle of COS for IVF. Clinical and paraclinical evaluation of the patients (including the ovarian reserve assessment) was performed prior to COS. The ovarian reserve assessment included: FSH, oestradiol, inhibin B, AMH and AFC. The patients were divided into two groups according to their age: group A (patients younger than 35 years) and group B (patients age 35 or older). Ethical approval for this study was obtained.
Results: Six patients were included in group A and 15 patients in group B. We obtained a strong correlation between AMH serum levels and AFC, as well as between AMH and the response to COS (P<0.05). AMH and AFC showed a superior correlation with the number of retrieved oocytes compared to FSH and inhibin B. Ovarian reserve biomarkers showed a significant difference between group A and B (P<0.01). After IVF, pregnancy was achieved in 4 patients, 2 in group A and 2 in group B.
Conclusions: Ovarian reserve markers are considerably influenced by the age of the patients undergoing IVF. Among ovarian reserve markers, AMH and AFC are the best correlated with COS results. These are the first preliminary results of the study and we need further investigations for a better correlation between ovarian reserve markers and pregnancy outcome.