Serum anti-mullerian hormone, basal FSH and basal antral follicle counts and i?n fertile and i?nfertile prospective comparison of populations

The variability of ovarian ageing among women is evident from the large variation in age at menopause. The identification of women who have severely decreased ovarian reserve for age group is clinically relevant. The availability of contraceptive methods, together with a growing economical wealth, provided women the opportunity to increase their level of education and to participate in the labor force. As a result, first childbearing has been postponed considerably by many women. Ovarian reserve tests have appeared to be fairly accurate in predicting the patient's biological age and antral follicles in the ovary and response to ovarian stimulation in the ART setting. Our study included 177 primarily infertile patients who applied to our infertility clinic and initiated IVF treatment between October 2008- April 2010 and 162 healthy fertile patients admitted to our clinic between June 2012- March 2013 were included prospectively. The study was approved by our university ethics committee. Infertile women who had IVF treatment were grouped as normal and poor responder with regard to their response to gonadotropin stimulation. Pregnant and nonpregnant infertile patients were also grouped and analyzed. Hormonal (basal FSH and AMH), ultrasound (AFC) and demographic characteristics were compared between fertile and infertile patients and other subgroups. As a result only basal FSH was different between fertile and infertile patients and AMH and AFS was found to be similar between groups. According to age categories of < 30, 30- 39, and ? 40, AFC, AMH was not different between the in fertile and infertile groups. However, FSH was significantly higher in infertile patients aged between 30 to 39. Infertile patients with normal ovarian response had higher AFS and AMH as compared to poor ovarian responders, but the differences were not significant as compared to the fertile group. Infertile women who become pregnant had high AFC and AMH values as compared to nonpregnant infertile women. AFC was the parameter that correlated strongly with age as compared to AMH; FSH was slightly correlated with age in the population and in fertile and infertile groups separately. As a result, we may conclude that AMH is strong parameter which shows the age related decline in AFS. There is no significant difference in fertile population infertile population with regard to mean AMH and AFS. We may also conclude that decrease in the ovarian reserve in infertile patients was directly related to age not the infertility. AFC and AMH are useful indicators of ovarian reserve. Key words: Ovarian reserve, Anti-Mullerian hormone, antral follicle count.