Testing ovarian reserve in pre-menopausal women: why, whom and how?

• Published in: Maturitas 2018-03, Vol.109, p.112-117
• Main Authors: Podfigurna, Agnieszka, Lukaszuk, Krzysztof, Czyzyk, Adam, Kunicki, Michal, Maciejewska-Jeske, Marzena, Jakiel, Grzegorz, Meczekalski, Blazej
• Format: Article
• Language: English
• Subjects: Anti-Mullerian Hormone - blood; anti-Müllerian hormone; Female; Follicle Stimulating Hormone - blood; Humans; Ovarian Follicle - diagnostic imaging; Ovarian Reserve; premenopausal women; Premenopause - blood; Premenopause - physiology; Ultrasonography
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/j.maturitas.2017.11.014

•Many women postpone the decision to get pregnant, but this can increase the likelihood of difficulties in conception.•The main goal of ovarian reserve testing is the identification of women with so-called diminished ovarian reserve.•The most useful methods of assessment of ovarian reserve are an ultrasonographic count of ovarian antral follicles and serum tests of both the anti-Müllerian hormone level and the third-day level of follicle stimulating hormone (FSH). Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women’s decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.