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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
Objective:
To test the hypothesis that women with declining ovarian reserve may demonstrate a decrease in day 3 serum inhibin B levels before a rise in day 3 serum FSH levels.
Design:
Case-control study.
Setting:
Tertiary care fertility center.
Patient(S):
One hundred nine women with nonovarian infertility (tubal factor or male factor) and 47 women with declining ovarian reserve who underwent assisted reproductive techniques.
Intervention(S):
None.
Main Outcome Measure(S):
Serum inhibin B and FSH levels, number of ampules of gonadotropins administered, E2 levels on the day of hCG administration, number of oocytes retrieved, clinical pregnancy rate, and cycle cancellation rate.
Result(S):
Women who had declining ovarian reserve as demonstrated by an increased gonadotropin requirement, a decreased E2 response, fewer retrieved oocytes, a lower clinical pregnancy rate, and a higher cycle cancellation rate had lower day 3 serum inhibin B levels despite having nonelevated day 3 FSH levels similar to those of women with nonovarian infertility.
Conclusion(S):
Women with declining ovarian responsiveness and clinical outcomes consistent with declining ovarian reserve had decreased day 3 serum inhibin B levels despite having nonelevated day 3 serum FSH concentrations. Declining ovarian reserve may be demonstrated by a decrease in day 3 inhibin B levels before a rise in day 3 FSH levels.