title: Women with declining ovarian reserve may demonstrate a decrease in day 3 serum inhibin B before a rise in day 3 follicle-stimulating hormone.
abstract: 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.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Tertiary care fertility center.
  
  
  METHODS
  One hundred nine women with nonovarian infertility (tubal factor or male factor) and 47 women with declining ovarian reserve who underwent assisted reproductive techniques.
  
  
  METHODS
  None.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center 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
authors.forename: D B
authors.initials: DB
authors.lastname: Seifer
authors.forename: R T
authors.initials: RT
authors.lastname: Scott
authors.forename: P A
authors.initials: PA
authors.lastname: Bergh
authors.forename: L K
authors.initials: LK
authors.lastname: Abrogast
authors.forename: C I
authors.initials: CI
authors.lastname: Friedman
authors.forename: C K
authors.initials: CK
authors.lastname: Mack
authors.forename: D R
authors.initials: DR
authors.lastname: Danforth
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007246:Infertility / Q000097:blood* / Q000188:drug therapy; D007265:Inhibins / Q000097:blood*; D008597:Menstrual Cycle / Q000502:physiology; D010053:Ovary / Q000502:physiology*
chemical_list: D006062:Gonadotropins; D004958:Estradiol; D007265:Inhibins; D005640:Follicle Stimulating Hormone