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 - National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Network
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 P.
AU - Huddleston, Heather G.
N1 - Publisher Copyright:
© 2017 American Society for Reproductive Medicine
PY - 2017/12
Y1 - 2017/12
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
UR - http://www.scopus.com/inward/record.url?scp=85036512272&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85036512272&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2017.09.015
DO - 10.1016/j.fertnstert.2017.09.015
M3 - Article
C2 - 29202959
AN - SCOPUS:85036512272
SN - 0015-0282
VL - 108
SP - 1070
EP - 1077
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 6
ER -