EVALUATION OF OVARIAN RESERVE IN LATE REPRODUCTIVE AGE

Year 2022, Volume: 39 Issue: 3, 719 - 722, 30.08.2022

Deniz Kulaksız , Recep Erin

Abstract

Although follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), antimullerian hormone (AMH), and ovarian volume are commonly used to assess ovarian reserve and ovarian response to stimulation, no test directly indicates this. It was aimed to observe how ovarian reserve tests help us in diagnosis and treatment for women of late reproductive age.
190 patients were included in this prospective cohort study. FSH, LH, E2 and AMH blood samples were taken on the third day of menstruation to biochemically evaluate the ovarian reserve in 190 patients who were planned for hysterectomy and bilateral salpingoopherectomy at late reproductive age, and antral follicle count (AFC) and ovarian volume were recorded by transvaginal ultrasonography for ultrasonographic evaluation. Ovarian weight was weighed postoperatively.
When the data of 190 women aged 39-44.9 years are analyzed, AMH and ovarian volume, ovarian volume and AFS show significant positive correlations. FSH, LH and E2 levels do not show a significant relationship with AFS.
AMH, ovarian volume and ovarian weight, and AFC can show us the ovarian reserve with the highest reliability in women of late reproductive age.

Keywords

Antimüllerian hormone, antral follicle, infertility, ovarian reserves

References

• 1. Josso N, Legeai L, Forest MG, Enfants-malades H, Cedex P, Recherches U De, et al. An Enzyme Linked Immunoassay for Anti-Miillerian Hormone : A New Tool for the Evaluation of Testicular Function in Infants and Children. 2015;70(1):23–7.
• 2. Hazout A, Bouchard P, Seifer DB, Aussage P, Junca AM, Cohen-Bacrie P. Serum antimüllerian hormone/müllerian-inhibiting substance appears to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B, or estradiol. Fertil Steril. 2004;82(5):1323–9.
• 3. Durlinger ALL, Gruijters MJG, Kramer P, Karels BAS, Ingraham HA, Nachtigal MW, et al. ¨ llerian Hormone Inhibits Initiation of Primordial Follicle Growth in the Mouse Ovary. 2014;143(October):1076–84.
• 4. Melado L, Lawrenz B, Sibal J, Abu E, Coughlan C, Navarro AT, et al. Anti-müllerian Hormone During Natural Cycle Presents Significant Intra and Intercycle Variations When Measured With Fully Automated Assay. Front Endocrinol (Lausanne) [Internet]. 2018 Nov 27;9.
• 5. Ulrich ND, Marsh EE. Ovarian Reserve Testing: A Review of the Options, Their Applications, and Their Limitations. Clin Obstet Gynecol. 2019;62(2):228–37.
• 6. Broekmans FJ, Scheffer GJ, Bancsi LFJMM, Dorland M. Ovarian reserve tests in infertility practice and normal fertile women. 1998;30:205–14.
• 7. Hall JE. Endocrinology of the Menopause. Endocrinol Metab Clin NA [Internet]. 2015;44(3):485–96.
• 8. Rosendahl M, Ernst E, Rasmussen PE, Andersen CY. True ovarian volume is underestimated by two-dimensional transvaginal ultrasound measurement. Fertil Steril [Internet]. 2010 Feb;93(3):995–8.
• 9. C Augood , K Duckitt AAT. Smoking and female infertility : a systematic review and. 1998;13(6):1532–9.
• 10. Bressler LH, Bernardi LA, De PJD. HHS Public Access. 2017;215(6):1–20.
• 11. Kee K, Flores M, Cedars MI, Pera RAR. Human Primordial Germ Cell Formation Is Diminished by Exposure to Environmental Toxicants Acting through the AHR Signaling Pathway. 2010;117(1):218–24.
• 12. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem [Internet]. 2018 Dec;62:2–10.
• 13. te Velde E., Scheffer G., Dorland M, Broekmans F., Fauser BCJ. Developmental and endocrine aspects of normal ovarian aging. Mol Cell Endocrinol [Internet]. 1998 Oct;145(1–2):67–73.
• 14. Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update. 2014;20(3):370–85.
• 15. Lie Fong S, Visser JA, Welt CK, de Rijke YB, Eijkemans MJC, Broekmans FJ, et al. Serum Anti-Müllerian Hormone Levels in Healthy Females: A Nomogram Ranging from Infancy to Adulthood. J Clin Endocrinol Metab [Internet]. 2012 Dec 1;97(12):4650–5.
• 16. Zhou SJ, Zhao MJ, Li C, Su X. The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women. Medicine (Baltimore). 2020;99(36):e21979.
• 17. de Vet A, Laven JSE, de Jong FH, Themmen APN, Fauser BCJM. Antimüllerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril [Internet]. 2002 Feb;77(2):357–62.
• 18. Fanchin R. Serum anti-Mullerian hormone is more strongly related to ovarian follicular status than serum inhibin B, estradiol, FSH and LH on day 3. Hum Reprod [Internet]. 2003 Feb 1;18(2):323–7.
• 19. Sova H, Unkila-Kallio L, Tiitinen A, Hippeläinen M, Perheentupa A, Tinkanen H, et al. Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes. Gynecol Endocrinol [Internet]. 2019 Jul 3;35(7):595–600.
• 20. Moolhuijsen LME, Visser JA. Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function. J Clin Endocrinol Metab [Internet]. 2020 Nov 1;105(11).
• 21. Dafopoulos A, Dafopoulos K, Georgoulias P, Galazios G, Limberis V, Tsikouras P, et al. Smoking and AMH levels in women with normal reproductive history. Arch Gynecol Obstet. 2010;282(2):215–9.
• 22. Buyalos RP, Ghosh K, Daneshmand ST. Infertile women of advanced reproductive age. Variability of day 3 FSH and E2 levels. J Reprod Med [Internet]. 1998 Dec;43(12):1023–6.
• 23. Mullen RD, Wang Y, Liu B, Moore EL, Behringer RR. Osterix functions downstream of anti-Müllerian hormone signaling to regulate Müllerian duct regression. Proc Natl Acad Sci [Internet]. 2018 Aug 14;115(33):8382–7.
• 24. Hale GE, Zhao X, Hughes CL, Burger HG, Robertson DM, Fraser IS. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060–7.
• 25. De Vasconcelos GL, MacUlan R, Da Cunha EV, Silva AWB, Batista ALS, Donato MAM, et al. Antral follicular count and its relationship with ovarian volume, preantral follicle population and survival, oocyte meiotic progression and ultrastructure of in vitro matured bovine cumulus-oocyte complexes. Zygote. 2020. Dec;28(6):495-503
• 26. Korsholm AS, Hvidman HW, Bentzen JG, Nyboe Andersen A, Birch Petersen K. Left–right differences in ovarian volume and antral follicle count in 1423 women of reproductive age. Gynecol Endocrinol [Internet]. 2017;33(4):320–3.