Diminished ovarian reserve not associated with infertility

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Biomarkers of diminished ovarian reserve are not associated with reduced fertility among women of a reproductive age.
Biomarkers of diminished ovarian reserve are not associated with reduced fertility among women of a reproductive age.

Biomarkers of diminished ovarian reserve are not associated with reduced fertility among women of a reproductive age without a history of infertility who have been trying to conceive for less than 3 months, according to a study published in JAMA.

Anne Z. Steiner, MD, MPH, of the University of North Carolina, and colleagues conducted a prospective cohort study of 750 women between 30 and 44 years of age without a history of infertility who had been trying to conceive for less than 3 months. The primary outcomes were the cumulative of probability of conception by 6 and 12 cycles of attempt, defined by a positive pregnancy test result, and relative fecundability.

The researchers found that women with low values of antimüllerian hormone (AMH) <0.7 ng/mL did not have a significantly different predicted probability of conceiving compared with women with normal values by 6 cycles (65% vs 62%) or by 12 cycles (84% vs 75%). In addition, women with high serum levels of follicle-stimulating hormone (FSH) >10 mIU/mL also did not have significantly different predicted probability of conceiving compared with women with normal levels by 6 cycles (63% vs 62%) or by 12 cycles (82% vs 75%).

Compared with women with normal urinary FSH values, women with high values (>11.5 mIU/mg creatinine) did not have a significantly different predicted probability of conceiving after 6 cycles (61% vs 62%) or after 12 cycles (70% vs 76%). The investigators also found that inhibin B levels were not associated with probability of conception in a given cycle (hazard ratio per 1 pg/mL increase, 0.999).

The authors concluded that biomarkers indicating diminished ovarian reserve were not associated with reduced fertility compared with normal ovarian reserve values in women between 30 and 44 years of age without a history of infertility who have been trying to conceive for 3 months or less. “These findings do not support the use of urinary or blood FSH tests or AMH levels to assess natural fertility for women with these characteristics,” they noted.

Reference

Steiner AZ, Pritchard D, Stanczyk FZ, et al. Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA. 2017;318(14):1367-1376.

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