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Testing for Ovarian Reserve in Assisted Reproduction programs: the current point of view.

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Female age is not always accurate for fertility. Ovarian reserve tests like AMH and AFC may predict stimulation response but not pregnancy outcomes. Routine testing is not recommended.

Keywords:
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Area of Science:

  • Reproductive Endocrinology
  • Assisted Reproductive Technology (ART)

Background:

  • Female fertility declines with age, but individual variation is significant.
  • Chronological age alone is an imperfect predictor of reproductive potential in assisted reproduction.
  • The utility of quantitative ovarian reserve tests alongside female age is debated.

Purpose of the Study:

  • To evaluate the added value of ovarian reserve tests beyond female age in predicting outcomes of assisted reproductive technology (ART).
  • To assess the effectiveness of tests like Antral Follicle Count (AFC) and Anti-Müllerian Hormone (AMH) in predicting ovarian stimulation response and pregnancy.
  • To determine if routine ovarian reserve testing is justified prior to IVF/ICSI treatment.

Main Methods:

  • Systematic reviews of existing literature were analyzed.
  • The predictive value of ovarian reserve tests (AFC, AMH) was compared to chronological female age.
  • Focus was placed on predicting ovarian stimulation response (poor vs. hyper response) and pregnancy outcomes.

Main Results:

  • The added value of ovarian reserve tests upon knowing female age is not clearly established.
  • AFC and AMH are considered adequate for predicting ovarian stimulation response, particularly for poor responders.
  • Predicting pregnancy outcomes using these tests remains challenging.
  • Management strategies for predicted poor or hyper responders are not well-investigated.

Conclusions:

  • Routine ovarian reserve testing is not recommended due to unclear added value and lack of established management options.
  • A first cycle poor response to adequate stimulation, in the absence of other signs of advanced ovarian aging, may help identify suitable candidates for continued ART treatment.