Ovarian Reserve Tests in Different Age Groups of Infertile Women.
Ludmila Barbakadze (GE), Archil Khomasuridze (GE), Jenara Kristesashvili (GE)
[Barbakadze] Tbilisi State University, Archil Khomasuridze Institute of Reproductology, [Khomasuridze] Tbilisi State University, Archil Khomasuridze Institute of Reproductology, [Kristesashvili] Tbilisi State University, Center for Reproductive Medicine "Univers"
Context: In recent years assessment of ovarian reserve to determine the strategy for treatment of female infertility has become essential. Objective: To identify the correlations between currently used ovarian reserve tests: anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH) and antral follicle count (AFC) and to distinguish the most reliable markers for ovarian reserve. Methods: Subjects were divided into three age groups: group I <35 years (n=39), group II 35-40 years (n=31), and group III 41-46 years (n=42). Patient: In total, we prospectively studied 112 infertile women. Intervention: AMH, FSH and AFC were determined on days 2-3 of menstrual cycle. Main Outcome Measures: Correlations between AMH, FSH and AFC in whole group and in different age groups. Results: There was a significantly correlation between age and AMH (r=-0.67, p<0.0001) and AFC (rs=-0.55, p<0.0001). Significant correlation detected between age and FSH as well (r=0.38, p<0.0001). AMH correlated with FSH (r=-0.48, p<0.0001) and AFC (r=-0.71, p=0.0001). There was a moderate negative relation between FSH and AFC (r=0.41, p=0.0001) and moderate positive relation between age and FSH (r=0.38, p<0.0001). The correlation analysis performed in separate groups revealed significant correlation between AMH and AFC for all groups I (r=0.57, p<0.0001), (r=0.69, p<0.0001), (r=0.47, p<0.002). Significant correlation between FSH and AMH was detected only in groups I (r=0.41, p<0.02) and II (r=-0.55, p<0.0001). Significant correlation existed between FSH and AFC only in group III (r=0.42, p<0.006), as well as between age and AFC only in group I (r=0.35, p<0.03). Conclusions: Currently, AMH should be considered as the more reliable test of ovarian reserve compared to FSH. The use of AMH combined with AFC may improve ovarian reserve evaluation.