International Journal of Clinical Obstetrics and Gynaecology
2019, Vol. 3, Issue 3, Part B
Prediction of ovarian reserve in sub-fertility: A comparative study
Author(s): Dr. KL Malarvizhi, Dr. V Sujatha, Dr. P Vasanthamani and S Padmanaban
Abstract:Introduction: Infertility is the failure of a couple to conceive after 1 year of regular, unprotected intercourse. Ovulatory disorder is one of the most common reasons of female factor infertility 30% of all cases). The term denotes the capacity of the ovary to provide egg cells which is capable for fertilization results in a good outcome which in turn means a successful pregnancy. With advanced maternal age the capability of the ovary to produce egg cells will decline, constituting a major factor in the inverse correlation between age and female fertility. However, between women of the same chronological age, the quantitative ovarian reserve may vary substantially. To assess the individual quantitative ovarian reserve90, various ovarian reserve tests (ORTs) have been developed, viz. (1) day‑3 follicle stimulating hormone (FSH), (2) anti‑Mullerian hormone (AMH) and (3) antral follicle count (AFC). Aim: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in sub fertile Indian women. (2) To know the cut-off value of antral follicle count in normal and infertile women. Methodology: All the patients attending gynecology outpatient department in reproductive age group (25-35yrs) who are all undergoing workup for infertility are included -50 cases.They were all compared to equal number of controls (fertility proven) in same age group (25-35yrs). 50 controls. Period: January 2018 to June 2018. Place: Department of OG, Govt. KMC Hospital. Results: On evaluating antral follicles up to 10mm in diameter, significant difference in numbers was noted in my study population (6.698±1.688 in cases; 11.46 ± 2.169 in controls; p value of <0.0001). A cut off value of >9 follicles (Aggregate of both ovaries) may be taken as a standard for successful pregnancy outcome. Conclusion: The results of this study indicate that AFC is a viable predictor of fecundity in South Indian women of child bearing age in terms of capability to conceive on a two point scale (i.e. positive or negative). The mean AFC in South Indian women is significantly different from that noted in Western literature, mainly due to racial, geographic and socio-economic reasons. A cut off value of >9 may be used to prognosticate patients undergoing assessment for female factor infertility. On the other hand same data can be utilized for optimum patient selection for ART. This would in turn lead to a higher success rate of this technique.
Dr. KL Malarvizhi, Dr. V Sujatha, Dr. P Vasanthamani, S Padmanaban. Prediction of ovarian reserve in sub-fertility: A comparative study. Int J Clin Obstet Gynaecol 2019;3(3):92-96. DOI: 10.33545/gynae.2019.v3.i3b.18