Role of ovarian reserve markers antimüllerian hormone and antral follicle count as aneuploidy markers in ongoing pregnancies and miscarriages

Capsule:
Antral follicle count appears to reflect the risk of autosomal trisomy better than maternal age. In contrast, antimullerian hormone does not deviate from the expected maternal age levels.

Authors:
Maribel Grande, B.Sc., Ph.D., Virginia Borobio, M.D., Mar Bennasar, M.D., Ph.D., Iosifina Stergiotou, M.D., Ph.D., Inmaculada Mercadé, Ph.D., Narcís Masoller, M.D., Joana Peñarrubia, M.D., Ph.D., Antoni Borrell, M.D., Ph.D.

Volume 103, Issue 5, Pages 1121-1227

Abstract:

Objective:
To assess the role of two ovarian reserve markers, antimüllerian hormone (AMH) and antral follicle count (AFC), as markers of the background risk for fetal trisomy.

Design:
Prospective study.

Setting:
Tertiary referral hospital.

Patient(s):
Assessment was carried out either in ongoing pregnancies or miscarriages in our center.

Intervention(s):
AFC was assessed transvaginally during a routine (11–13 weeks) or referral scan. AMH was determined either during the first-trimester maternal serum markers assessment or in cases referred for chorionic villi sampling after the invasive procedure.

Main Outcome Measure(s):
AMH reference ranges were constructed according to maternal age, and AMH- and AFC-derived ovarian ages were compared among three different cytogenetic groups (normal karyotype, autosomal trisomies, and other chromosomal anomalies) in both ongoing pregnancies and miscarriages.

Result(s):
In autosomal trisomies, the median AFC-derived ovarian age was 3–5 years above the median maternal age. No differences were observed between AMH-derived ovarian age and maternal age.

Conclusion(s):
AFC-derived ovarian biologic age reflects a more precise background risk for fetal aneuploidy that is not observed for AMH-derived age.

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