Biomarkers of ovarian reserve and fertility

This review analyzed recent studies evaluating biomarkers of ovarian reserve as indicators of reproductive potential and fertility.

Ovarian reserve (referring to the pool of eggs within the ovaries) is known to be closely associated with reproductive potential. Diminishing ovarian reserve results in an insufficient number of eggs to ensure a reasonable chance of pregnancy. Several indicators, such as the length of the menstrual cycle, follicle-stimulating hormone (FSH) levels, anti-Müllerian hormone levels and inhibin B levels, have all been investigated as potential biomarkers of ovarian reserve. The ability of these indicators to predict reproductive potential is currently being investigated.

This review evaluated recent studies investigating whether ovarian reserve markers could predict the chances of achieving spontaneous (natural) or medically-assisted pregnancy.

A short menstrual cycle was associated with a lower probability of conceiving both naturally and following fertility treatments. In one study evaluating women attempting to conceive naturally, those with a cycle length of less than 25 days were 36% less likely to conceive in any given cycle compared to women with menstrual cycle lengths of between 27 and 29 days. In another study investigating women undergoing fertility treatments, the probability of conceiving in each treatment cycle increased with increasing menstrual cycle length. Interestingly, women with a cycle length of more than 34 days were almost twice as likely to conceive compared to those with a menstrual cycle length of less than 26 days.

FSH levels during early stages of the cycle, as well as Inhibin B levels, although known to be associated with ovarian reserve, were not significantly associated with the chance of conception among women undergoing fertility treatments or women attempting natural pregnancy.

Studies investigating the ability of anti-Müllerian hormone to predict fertility potential showed that the anti-Müllerian hormone levels correlated with the chance of achieving pregnancy among older aged women attempting assisted reproduction. However, two studies evaluating women attempting natural conception showed inconsistent results. One of the studies showed low anti-Müllerian hormone levels to be associated with significantly lower chances of conception, while the other study demonstrated no significant association.

This review concluded that menstrual cycle length may assist in predicting reproductive potential among women attempting pregnancy. Among ovarian reserve biomarkers, anti-Müllerian hormone seems to provide an accurate assessment of reproductive potential among older women attempting assisted reproduction.