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Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age.
Steiner, Anne Z; Pritchard, David; Stanczyk, Frank Z; Kesner, James S; Meadows, Juliana W; Herring, Amy H; Baird, Donna D.
Afiliación
  • Steiner AZ; Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill.
  • Pritchard D; Department of Biostatistics, University of North Carolina, Chapel Hill.
  • Stanczyk FZ; Department of Obstetrics and Gynecology and Preventive Medicine, University of Southern California, Los Angeles.
  • Kesner JS; National Institute for Occupational Safety and Health, Cincinnati, Ohio.
  • Meadows JW; National Institute for Occupational Safety and Health, Cincinnati, Ohio.
  • Herring AH; Department of Statistical Science, Duke University, Durham, North Carolina.
  • Baird DD; Epidemiology Branch, National Institute of Environmental Health Science/National Institutes of Health, Research Triangle Park, North Carolina.
JAMA ; 318(14): 1367-1376, 2017 10 10.
Article en En | MEDLINE | ID: mdl-29049585
Importance: Despite lack of evidence of their utility, biomarkers of ovarian reserve are being promoted as potential markers of reproductive potential. Objective: To determine the associations between biomarkers of ovarian reserve and reproductive potential among women of late reproductive age. Design, Setting, and Participants: Prospective time-to-pregnancy cohort study (2008 to date of last follow-up in March 2016) of women (N = 981) aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, recruited from the community in the Raleigh-Durham, North Carolina, area. Exposures: Early-follicular-phase serum level of antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B and urinary level of FSH. Main Outcomes and Measures: The primary outcomes were the cumulative probability of conception by 6 and 12 cycles of attempt and relative fecundability (probability of conception in a given menstrual cycle). Conception was defined as a positive pregnancy test result. Results: A total of 750 women (mean age, 33.3 [SD, 3.2] years; 77% white; 36% overweight or obese) provided a blood and urine sample and were included in the analysis. After adjusting for age, body mass index, race, current smoking status, and recent hormonal contraceptive use, women with low AMH values (<0.7 ng/mL [n = 84]) did not have a significantly different predicted probability of conceiving by 6 cycles of attempt (65%; 95% CI, 50%-75%) compared with women (n = 579) with normal values (62%; 95% CI, 57%-66%) or by 12 cycles of attempt (84% [95% CI, 70%-91%] vs 75% [95% CI, 70%-79%], respectively). Women with high serum FSH values (>10 mIU/mL [n = 83]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (63%; 95% CI, 50%-73%) compared with women (n = 654) with normal values (62%; 95% CI, 57%-66%) or after 12 cycles of attempt (82% [95% CI, 70%-89%] vs 75% [95% CI, 70%-78%], respectively). Women with high urinary FSH values (>11.5 mIU/mg creatinine [n = 69]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (61%; 95% CI, 46%-74%) compared with women (n = 660) with normal values (62%; 95% CI, 58%-66%) or after 12 cycles of attempt (70% [95% CI, 54%-80%] vs 76% [95% CI, 72%-80%], respectively). Inhibin B levels (n = 737) were not associated with the probability of conceiving in a given cycle (hazard ratio per 1-pg/mL increase, 0.999; 95% CI, 0.997-1.001). Conclusions and Relevance: Among women aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. These findings do not support the use of urinary or blood follicle-stimulating hormone tests or antimüllerian hormone levels to assess natural fertility for women with these characteristics.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hormona Antimülleriana / Tiempo para Quedar Embarazada / Reserva Ovárica / Hormona Folículo Estimulante / Inhibinas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: JAMA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hormona Antimülleriana / Tiempo para Quedar Embarazada / Reserva Ovárica / Hormona Folículo Estimulante / Inhibinas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: JAMA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos