Diminished ovarian reserve Is it a neglected cause in the assessment of recurrent miscarriage A cohort study

Capsule:
Diminished ovarian reserve may be a hidden cause for recurrent miscarriage regardless of maternal age.

Authors:
Melahat Atasever, M.D., Zeynep Soyman, M.D., Emine Demirel, M.D., Servet Gencdal, M.D., Sefa Kelekci, M.D.

Volume 105, Issue 5, Pages 1236-1240

Abstract:

Objective:
To study whether diminished ovarian reserve is associated with recurrent miscarriage.

Design:
Cross-sectional clinical study.

Setting:
Tertiary-care center.

Patient(s):
Women with history of recurrent miscarriage (RM; n = 71) and sequentially selected age-matched fertile women who were seeking contraception (control; n = 70).

Intervention(s):
None.

Main Outcome Measures(s):
Serum levels of FSH, LH, E2, and antimüllerian hormone (AMH); FSH/LH ratio; ovarian volumes; and antral follicle count (AFC).

Result(s):
The levels of FSH were 8.6 ± 3.7 U/L in the RM group and 7.1 ± 3.9 U/L in the control group; this difference was statistically significant. The levels of AMH were significantly lower in the RM group than in the control group (2.9 ± 1.7 ng/mL vs. 3.6 ± 1.7 ng/mL). The percentage of women with levels of FSH ≥11 U/L was significantly higher in the RM group than in the control group (18.3% vs. 4.3%). In the RM group, the percentage of women with levels of AMH ≤1 ng/mL was significantly higher than in the control group (19.7% vs. 5.7%).

Conclusion(s):
Recurrent miscarriage may be associated with diminished ovarian reserve. Larger prospective randomized controlled trials are warranted to better determine the predictive potential of ovarian reserve markers in recurrent miscarriage.

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