Evaluation of Ovarian Reserve Based on Hormonal Parameters, Ovarian Volume and Antral Follicle Count in Infertile Women

Abstract

Back Ground: It is important to regard the value of ovarian reserve in the evaluation of infertile women, because diminish in the ovarian reserve is a decrease in the quantity and quality of oocyte leading to impaired fertility.Aim: To investigate the risk factors associated with diminished ovarian reserve.Patients & Methods: This Case -control study conducted on 147seven women attending the infertility clinic in Al-Batool Teaching Hospital from 1st march to 1st November 2010 are included in this study. All women are in good health and not known to have any medication in the previous month which might affect her hormonal profile. Ovarian cyst was excluded. All women evaluated by history and examination, review of previous investigation. Clomiphene citrate challenge test and basal FSH hormone was performed to detect women with abnormal ovarian reserve. 86 infertile women proved to have diminished ovarian reserve were considered as cases. The control 61 infertile women with normal ovarian reserve .Different variable were assessed in women with diminished ovarian reserve including female age, BMI, causes of infertility, menstrual irregularity, type of infertility, history of pelvic operation. Results: The results of examining main risk factors for developing diminished ovarian reserve appeared as following. unovulatory cycle ,unexplained infertility and hyperprolactineamia ,they were found significantly to be associated with diminished ovarian reserve. Women more 35 years old with history of irregular menstrual cycle and duration of infertility more than 10 years of primary type, history of operation on the ovaries, BMI<30 were all found to be highly significant for diminished ovarian reserve. Other variable like size of ovaries between (6.2-6.6), size of antral follicles between (0.63000 to 0.89477) were significant as risk factor for diminished ovarian reserve Conclusion: Women more than 35years old, their BMI<30 with irregular unovulatry menstrual cycle and unexplained type infertility, more than 10 years duration of infertility, have positive family history of premature menopause and history of elecrothermal operation on the ovaries. Size of the ovaries between (6.2-6.6), size of antral follicles between (0.63000 & 0.89477); all regarded risk factors for diminished ovarian reserve.Recommendations: The assessment of ovarian reserve help provide valuable information about status of ovarian function .This may help a couple make a more informed decision concerning treatment option and the risk factors affecting their ability to conceive and may to advice all women for screen for diminished ovarian reserve.Key wards: Risk, Factors, Diminished Ovarian Reserve, Hyperprolactineamia, Polycystic ovaries.