A characterization of the relationship of ovarian reserve markers with age

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1、AcharacterizationoftherelationshipofovarianreservemarkerswithageaabcMitchellP.Rosen,M.D.,EricaJohnstone,M.D.,CharlesE.McCulloch,Ph.D.,SonyaM.Schuh-Huerta,Ph.D.,dcaBarbaraSternfeld,Ph.D.,ReneeA.Reijo-Pera,Ph.D.,andMarcelleI.Cedars,M.D.abDepartmentofObstetrics,Gynecology,andReproductiveSciences

2、andDepartmentofEpidemiologyandBiostatics,UniversityofcdCalifornia,SanFrancisco;InstituteforStemCellBiologyandRegenerativeMedicine,StanfordUniversity,Stanford;andDivisionofResearch,KaiserPermanente,Oakland,CaliforniaObjective:Toidentifymarkersofovarianagethatbestmatchthepatternofoocytelossseen

3、inhistologyspecimens.Design:Cross-sectionalstudy.Setting:University.Patient(s):Caucasianwomen(n¼252)aged25–45years.Intervention(s):none.MainOutcomeMeasure(s):Therelationshipbetweenantralfolliclecount(AFC),antimullerianhormone(AMH),inhibinB,FSH,andE€2withagewasestimatedusingthepowermodel,which

4、previouslyhasbeenshowntomostaccuratelydescribeoocytelossinhistologicspecimens.Thepowermodelwas2fittoeachmarkerandusedtocomparetheratesofchangeatages30and40withthehistologicpattern.Amongthosemarkersfollowingthepattern,Rwasusedtocomparethedegreeofrelationshipwithage.Result(s):BothAMHlevelsandAFC

5、exhibitedsignificantprogressivedeclineswithage.TheaverageratesoflossperyearforAFCandAMHwere,2respectively,0.57and1.09atage30,and1.33and3.06atage40.FSH,inhibinB,andE2didnotexhibitprogressiveratesofchange.TheRforAFCwas27.3%andforAMHwas22.7%.Conclusion(s):OnlyAFCandAMHfollowthepatternofoocyte

6、lossobservedhistologically.AlthoughAMHmaybemorecost-effective,AFCisaslightlymoreaccuratenoninvasivemeasureforovarianaging.(FertilSterilÒ2012;97:238–43.Ó2012byAmericanSocietyforReproductiveMedicine.)KeyWords:AFC,AMH,ovarianreserve,fertility,FSH,oocyte,follicleidevariabilityexistsbe-noninvasive

7、testingtocharacterizetheincreasinganeuploidy).However,inWtweenwomenbothintherateandpatternofoocyteloss.areanalysisoftheirdata,agradualageatwhichmenopauseSeveralstudieshavedirectlyaccelerationindeclinefitthedataoccursandintheonsetofdiminishedas