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Women with declining ovarian reserve may demonstrate a decrease in day 3 serum inhibin B before a rise in day 3
D B Seifer1, R T Scott, P A Bergh
1Center for Reproduction, Endocrinology and Fertility, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08902, USA. seiferdb@umdnj.edu
Fertility and Sterility
|July 31, 1999
Summary
Declining ovarian reserve in women may be indicated by lower day 3 inhibin B levels before a rise in day 3 follicle-stimulating hormone (FSH) levels. This finding suggests inhibin B as an early marker for diminished ovarian responsiveness.
Area of Science:
- Reproductive Endocrinology
- Infertility Research
- Ovarian Physiology
Background:
- Diminished ovarian reserve is a significant factor in female infertility.
- Current markers for ovarian reserve, such as FSH, may not detect early decline.
- Identifying earlier indicators of declining ovarian reserve is crucial for timely intervention.
Purpose of the Study:
- To investigate whether declining ovarian reserve is associated with decreased day 3 serum inhibin B levels preceding an elevation in day 3 serum FSH levels.
- To evaluate the utility of inhibin B as an early biomarker for diminished ovarian responsiveness.
Main Methods:
- A case-control study was conducted at a tertiary care fertility center.
- Included 109 women with nonovarian infertility and 47 women with declining ovarian reserve undergoing assisted reproductive techniques.
- Measured serum inhibin B and FSH levels, gonadotropin dosage, estradiol levels, oocyte yield, pregnancy rates, and cycle cancellation rates.
Main Results:
- Women with declining ovarian reserve showed lower day 3 inhibin B levels.
- These women also exhibited increased gonadotropin requirements, reduced E2 response, fewer oocytes retrieved, lower pregnancy rates, and higher cycle cancellation.
- Day 3 FSH levels were not elevated in women with declining ovarian reserve, similar to controls.
Conclusions:
- Decreased day 3 serum inhibin B levels are observed in women with declining ovarian responsiveness, even with normal day 3 FSH levels.
- A decline in day 3 inhibin B may precede the rise in day 3 FSH, serving as an earlier indicator of diminished ovarian reserve.