eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
3/2018
vol. 14
 
Share:
Share:
more
 
 
abstract:
Clinical research

Decline in ovarian reserve may be an undiagnosed reason for unexplained infertility: a cohort study

Burak Yücel, Sefa Kelekci, Emine Demirel

Arch Med Sci 2018; 14, 3: 527–531
Online publish date: 2016/03/23
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Unexplained infertility refers to the absence of a definable cause for a couple’s failure to achieve pregnancy. Reproductive aging plays a role in pathogenesis of unexplained infertility. We investigated the results of ovarian reserve tests in unexplained infertility.

Material and methods
The patients were divided into two groups: unexplained infertility (n = 148) and male factor infertility (n = 112). Follicle-stimulating hormone, estradiol, inhibin b levels and anti-Müllerian hormone levels were evaluated. Antral follicle count and ovarian volume measurements were performed.

Results
The demographic variables were comparable. Follicle-stimulating hormone levels were higher in the unexplained infertility group than the male factor infertility group, although this difference did not reach statistical significance (p = 0.071). Estradiol levels, inhibin b concentrations and ovarian volume showed no difference between groups. However, antral follicle count was significantly lower in the unexplained infertility group than the male factor infertility group (p = 0.023). The median anti-Müllerian hormone concentrations were significantly lower in the unexplained infertility group 1.42 (0.4–6.2) than in the male factor infertility group (2.04 (0.64–8.2); p = 0.001).

Conclusions
Although anti-Müllerian hormone values and antral follicle count were higher than the low thresholds, a statistically significant decline of ovarian reserve in the unexplained infertility group was found in the present study. This might be an undiagnosed reason for unexplained infertility.

keywords:

ovarian reserve, infertility, anti-Müllerian hormone, unexplained infertility

references:
Crosignani PG, Collins J, Cooke ID et al. Recommendations of the ESHRE workshop on ‘Unexplained Infertility’. Anacapri, August 28-9, 1992. Hum Reprod 1993; 8: 977-80.
Marc A, Fritz LS. Female infertility. In: Clinical Gynecologic Endocrinology and Infertility. 8th ed. Speroff L, Fritz MA (eds.). Lippincott Williams & Wilkins 2011; 1131-90.
Oner G, Ulug P, Elmali F. Ovarian reserve markers in unexplained infertility patients treated with clomiphene citrate during intrauterine insemination. Arch Med Sci 2015; 11: 1250-4.
van Rooij IA, Broekmans FJ, Hunault CC, et al. Use of ovarian reserve tests for the prediction of ongoing pregnancy in couples with unexplained or mild male infertility. Reprod Biomed Online 2006; 12: 182-90.
Murto T, Bjuresten K, Landgren BM, Stavreus-Evers A. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility. Reprod Biol Endocrinol 2013; 11: 61.
Leach RE, Moghissi KS, Randolph JF, et al. Intensive hormone monitoring in women with unexplained infertility: evidence for subtle abnormalities suggestive of diminished ovarian reserve. Fertil Steril 1997; 68: 413-20.
Practice Committee of American Society for Reproductive M. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril 2012; 98: 302-7.
Guzick DS, Sullivan MW, Adamson GD, et al. Efficacy of treatment for unexplained infertility. Fertil Steril 1998; 70: 207-13.
Scott RT Jr, Elkind-Hirsch KE, Styne-Gross A, et al. The predictive value for in vitro fertility delivery rates is greatly impacted by the method used to select the threshold between normal and elevated basal follicle-stimulating hormone. Fertil Steril 2008; 89: 868-78.
Frattarelli JL, Lauria-Costab DF, Miller BT, et al. Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles. Fertil Steril 2000; 74: 512-7.
La Marca A, Malmusi S, Giulini S, et al. Anti-Mullerian hormone plasma levels in spontaneous menstrual cycle and during treatment with FSH to induce ovulation. Hum Reprod 2004; 19: 2738-41.
Tsepelidis S, Devreker F, Demeestere I, et al. Stable serum levels of anti-Mullerian hormone during the menstrual cycle: a prospective study in normo-ovulatory women. Hum Reprod 2007; 22: 1837-40.
FEATURED PRODUCTS
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe