A characterization of the relationship of ovarian reserve markers with age

Capsule:
Antral follicle count and antimullerian hormone rate of decline is similar to histologic oocyte loss.

Authors:
Mitchell P. Rosen, M.D., Erica Johnstone, M.D., Charles E. McCulloch, Ph.D., Sonya M. Schuh-Huerta, Ph.D., Barbara Sternfeld, Ph.D., Renee A. Reijo-Pera, Ph.D., Marcelle I. Cedars, M.D.
Volume 97, Issue 1 , Pages 238-243, January 2012

Objective:
To identify markers of ovarian age that best match the pattern of oocyte loss seen in histology specimens.

Design:
Cross-sectional study.

Setting:
University.

Patient(s):
Caucasian women (n = 252) aged 25–45 years.

Intervention(s):
None.

Main Outcome Measure(s):
The relationship between antral follicle count (AFC), antimüllerian hormone (AMH), inhibin B, FSH, and E2 with age was estimated using the power model, which previously has been shown to most accurately describe oocyte loss in histologic specimens. The power model was fit to each marker and used to compare the rates of change at ages 30 and 40 with the histologic pattern. Among those markers following the pattern, R2 was used to compare the degree of relationship with age.

Result(s):
Both AMH levels and AFC exhibited significant progressive declines with age. The average rates of loss per year for AFC and AMH were, respectively, −0.57 and −1.09 at age 30, and −1.33 and −3.06 at age 40. FSH, inhibin B, and E2 did not exhibit progressive rates of change. The R2 for AFC was 27.3% and for AMH was 22.7%.

Conclusion(s):
Only AFC and AMH follow the pattern of oocyte loss observed histologically. Although AMH may be more cost-effective, AFC is a slightly more accurate noninvasive measure for ovarian aging.

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