Assessment of the follicle stimulating hormone and anti-mullerian hormone in women with primary infertility

Infertility is a medical disorder that can affect either the male or female reproductive system. The medical definition of sexual infertility is the failure to conceive following regular, unprotected sexual intercourse for a year or longer. In addition, infertility is a clinical condition that can cause the patient to suffer from psychological, physical, mental, and spiritual issues in addition to those associated with their health. What makes this medical ailment unique is that it affects not just the patient but also the patient's spouse in a unique way, especially in Iraqi women. Studies show that 25% of all female infertility is caused by ovulation problems. Anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) are two different hormones that predict ovarian reserve at different stages of follicle development. AMH measurements indicate the state after the primordial pre-antral follicle pool, whereas FSH levels indicate the development of antral and post-antral follicles. The aim of the research is to evaluate AMH and FSH in infertile women in Iraq, in addition to testing the degree of correlation between AMH and FSH hormones and with other markers such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) and with age. Blood samples were collected from 160 women who consented to participate in this comparative case-control study, 80 fertile as a control group and 80 infertile women as a patient group after administering a questionnaire and obtaining informed consent at one of Baghdad hospitals, in Iraq. This study was conducted from September 2022 to February 2023. AMH and FSH were measured the ELISA technique and the Mindray biochemistry analyzer was used for TC, TG, HDL, LDL, and VLDL measurements. The results indicated that FSH levels were higher (p-value <0.001) in patients women compared to control women and it increased with the age of the participating women. At the same time, the AMH levels of the three age groups of the patients were significantly lower than the control group with a p-value <0.001 and levels decrease with increasing age. Moreover, AMH showed significant negative correlations with age (r = −0.740, p < 0.0001), FSH (r = −0.737, p < 0.0001), TC (r = −0.240, p = 0.032), and LDL (r = −0.246, p= 0.028). It was found that there was a negative correlation between FSH with HDL (r = −0.250, p = 0.025) and a positive correlation between FSH with age (r = 0.859, p < 0.0001), and with LDL (r = 0.242, p = 0.031). There was no significant relationship between AMH levels and TG, HDL and VLDL, and between TC, TG and VLDL and FSH levels. It was found that infertile women had higher blood levels of FSH and lower blood levels of AMH hormone. Hormone testing should be a regular component of research on infertile women in Iraq to assess infertile patients and identify treatable patients. This study might help the potential to provide significant advances in providing accurate chemical diagnostics and counseling in fertility treatment.