Antimüllerian hormone levels and antral follicle counts are not reduced compared with community controls in patients with rigorously defined unexplained infertility

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Abstract

Objective To test the hypothesis that women with unexplained infertility demonstrate evidence of diminished ovarian reserve when compared with a population of community controls. Design Cross-sectional study. Setting Multicenter university-based clinical practices. Patient(s) Study participants included 277 healthy, normo-ovulatory female partners with rigorously defined unexplained infertility randomly selected from a multicenter trial (Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation). Controls included 226 healthy, normo-ovulatory women not seeking treatment for fertility from a community-based cohort (Ovarian Aging study). Intervention(s) Serum antimüllerian hormone (AMH) assay at a central laboratory, FSH, fasting serum metabolic testing, transvaginal ultrasonography for antral follicle counts (AFCs), anthropometric measurements. Main Outcome Measure(s) Average AMH, AFC, and AMH/AFC were compared between infertile and control women by age. Analyses of covariance compared these outcomes while controlling for confounders, including age, race, body mass index, smoking history, and study site. Result(s) In our models, AMH, AFC, and AMH/AFC ovarian reserve indices did not differ between infertile women and community-based controls, after controlling for age, race, body mass index, smoking history, and study site. Conclusion(s) Currently utilized predictors of ovarian reserve do not discriminate women with rigorously defined unexplained infertility from healthy community-based women of similar demographic characteristics. Contrary to our hypothesis, among women with FSH in the normal range (≤12 IU/L), women with unexplained infertility did not show evidence of decreased ovarian reserve as measured by AMH and AFC. Ovarian reserve markers in isolation may not serve as predictors of future fertility.

Original languageEnglish (US)
Pages (from-to)1070-1077
Number of pages8
JournalFertility and sterility
Volume108
Issue number6
DOIs
StatePublished - Dec 1 2017

Fingerprint

Infertility
Hormones
Fertility
Body Mass Index
Smoking
History
Population Control
Antral
Ovulation Induction
Serum
Multicenter Studies
Fasting
Ultrasonography
Reference Values
Cross-Sectional Studies
Demography
Outcome Assessment (Health Care)
Ovarian Reserve
Pregnancy

Keywords

  • AFC
  • AMH
  • ovarian reserve
  • unexplained infertility

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

@article{f60244a4511747fa89a4902fb0274046,
title = "Antim{\"u}llerian hormone levels and antral follicle counts are not reduced compared with community controls in patients with rigorously defined unexplained infertility",
abstract = "Objective To test the hypothesis that women with unexplained infertility demonstrate evidence of diminished ovarian reserve when compared with a population of community controls. Design Cross-sectional study. Setting Multicenter university-based clinical practices. Patient(s) Study participants included 277 healthy, normo-ovulatory female partners with rigorously defined unexplained infertility randomly selected from a multicenter trial (Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation). Controls included 226 healthy, normo-ovulatory women not seeking treatment for fertility from a community-based cohort (Ovarian Aging study). Intervention(s) Serum antim{\"u}llerian hormone (AMH) assay at a central laboratory, FSH, fasting serum metabolic testing, transvaginal ultrasonography for antral follicle counts (AFCs), anthropometric measurements. Main Outcome Measure(s) Average AMH, AFC, and AMH/AFC were compared between infertile and control women by age. Analyses of covariance compared these outcomes while controlling for confounders, including age, race, body mass index, smoking history, and study site. Result(s) In our models, AMH, AFC, and AMH/AFC ovarian reserve indices did not differ between infertile women and community-based controls, after controlling for age, race, body mass index, smoking history, and study site. Conclusion(s) Currently utilized predictors of ovarian reserve do not discriminate women with rigorously defined unexplained infertility from healthy community-based women of similar demographic characteristics. Contrary to our hypothesis, among women with FSH in the normal range (≤12 IU/L), women with unexplained infertility did not show evidence of decreased ovarian reserve as measured by AMH and AFC. Ovarian reserve markers in isolation may not serve as predictors of future fertility.",
keywords = "AFC, AMH, ovarian reserve, unexplained infertility",
author = "{For the} and Greenwood, {Eleni A.} and Cedars, {Marcelle I.} and Nanette Santoro and Esther Eisenberg and Kao, {Chia Ning} and Haisenleder, {Daniel J.} and Diamond, {Michael Peter} and Huddleston, {Heather G.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1016/j.fertnstert.2017.09.015",
language = "English (US)",
volume = "108",
pages = "1070--1077",
journal = "Fertility and Sterility",
issn = "0015-0282",
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}

TY - JOUR

T1 - Antimüllerian hormone levels and antral follicle counts are not reduced compared with community controls in patients with rigorously defined unexplained infertility

AU - For the

AU - Greenwood, Eleni A.

AU - Cedars, Marcelle I.

AU - Santoro, Nanette

AU - Eisenberg, Esther

AU - Kao, Chia Ning

AU - Haisenleder, Daniel J.

AU - Diamond, Michael Peter

AU - Huddleston, Heather G.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Objective To test the hypothesis that women with unexplained infertility demonstrate evidence of diminished ovarian reserve when compared with a population of community controls. Design Cross-sectional study. Setting Multicenter university-based clinical practices. Patient(s) Study participants included 277 healthy, normo-ovulatory female partners with rigorously defined unexplained infertility randomly selected from a multicenter trial (Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation). Controls included 226 healthy, normo-ovulatory women not seeking treatment for fertility from a community-based cohort (Ovarian Aging study). Intervention(s) Serum antimüllerian hormone (AMH) assay at a central laboratory, FSH, fasting serum metabolic testing, transvaginal ultrasonography for antral follicle counts (AFCs), anthropometric measurements. Main Outcome Measure(s) Average AMH, AFC, and AMH/AFC were compared between infertile and control women by age. Analyses of covariance compared these outcomes while controlling for confounders, including age, race, body mass index, smoking history, and study site. Result(s) In our models, AMH, AFC, and AMH/AFC ovarian reserve indices did not differ between infertile women and community-based controls, after controlling for age, race, body mass index, smoking history, and study site. Conclusion(s) Currently utilized predictors of ovarian reserve do not discriminate women with rigorously defined unexplained infertility from healthy community-based women of similar demographic characteristics. Contrary to our hypothesis, among women with FSH in the normal range (≤12 IU/L), women with unexplained infertility did not show evidence of decreased ovarian reserve as measured by AMH and AFC. Ovarian reserve markers in isolation may not serve as predictors of future fertility.

AB - Objective To test the hypothesis that women with unexplained infertility demonstrate evidence of diminished ovarian reserve when compared with a population of community controls. Design Cross-sectional study. Setting Multicenter university-based clinical practices. Patient(s) Study participants included 277 healthy, normo-ovulatory female partners with rigorously defined unexplained infertility randomly selected from a multicenter trial (Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation). Controls included 226 healthy, normo-ovulatory women not seeking treatment for fertility from a community-based cohort (Ovarian Aging study). Intervention(s) Serum antimüllerian hormone (AMH) assay at a central laboratory, FSH, fasting serum metabolic testing, transvaginal ultrasonography for antral follicle counts (AFCs), anthropometric measurements. Main Outcome Measure(s) Average AMH, AFC, and AMH/AFC were compared between infertile and control women by age. Analyses of covariance compared these outcomes while controlling for confounders, including age, race, body mass index, smoking history, and study site. Result(s) In our models, AMH, AFC, and AMH/AFC ovarian reserve indices did not differ between infertile women and community-based controls, after controlling for age, race, body mass index, smoking history, and study site. Conclusion(s) Currently utilized predictors of ovarian reserve do not discriminate women with rigorously defined unexplained infertility from healthy community-based women of similar demographic characteristics. Contrary to our hypothesis, among women with FSH in the normal range (≤12 IU/L), women with unexplained infertility did not show evidence of decreased ovarian reserve as measured by AMH and AFC. Ovarian reserve markers in isolation may not serve as predictors of future fertility.

KW - AFC

KW - AMH

KW - ovarian reserve

KW - unexplained infertility

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U2 - 10.1016/j.fertnstert.2017.09.015

DO - 10.1016/j.fertnstert.2017.09.015

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VL - 108

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JO - Fertility and Sterility

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