October 10, 2017

Ovarian Reserve Tests Fail to Predict Fertility

BETHESDA, Md -- October 10, 2017 -- Tests that estimate ovarian reserve before menopause do not appear to predict short-term chances of conception, according to a study of women with no history of infertility published in JAMA.

“This study suggests that testing for biomarkers of ovarian reserve does not predict the chances for conception in older women still of reproductive age,” said Esther Eisenberg, MD, Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health (NIH), Bethesda, Maryland.

As a woman ages and her egg supply declines, cells in the ovary secrete lower amounts of inhibin B and anti-Müllerian hormone. The ovaries also produce higher amounts of follicle stimulating hormone (FSH) in the days before ovulation. Although there is little research to support their use, tests for anti-Müllerian hormone are routinely offered in many fertility clinics on the assumption that women with a lower ovarian reserve would be less likely to respond to treatment. Moreover, home fertility tests of urinary FSH are commercially available.

The researchers enrolled 750 women aged 30 to 44 years who had been attempting to conceive for ≤3 months. Women were ineligible to participate if they had known fertility problems, such as polycystic ovarian syndrome, tubal blockage or endometriosis. The women provided a urine and blood sample and checked for conception with home pregnancy test kits. The researchers statistically corrected for factors known to reduce fertility, such as smoking, recent use of oral contraceptives, and obesity.

After 6 cycles of attempting to conceive, results did not differ significantly between women with low levels (65% chance of conception) and normal levels (62% chance of conception) of anti-Müllerian hormone. Similarly, results were not statistically different after 12 cycles (82% vs 75%, respectively).

Chances for conception also did not differ significantly according to high versus normal levels of FSH, with conception rates of 61% versus 62% after 6 cycles and 82% versus 75% after 12 cycles. The researchers found no association of inhibin B levels and conception after 6 cycles or 12 cycles.

“Our study suggests that younger women with biomarker levels indicating lower ovarian reserve should not become anxious that they won’t be able to have a baby,” said first author Anne Steiner, MD, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Reference: DOI:10.1001/jama.2017.14588

SOURCE: National Institutes of Health

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