Ovarian reserve evaluation: state of the art.
OBJECTIVE
Revise role of hormonal basal and dynamic tests, as well as ultrasonographic measures as ovarian reserve markers, in order to provide better counseling to subfertile couples.


METHODS
Review of publications on the topic, with an emphasis on recent well designed articles.


RESULTS
Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, even for premature ovarian senescence patients who do not present subfertility complaints. However, these markers occupy important place in initial approach to treatment of subfertile couples, predicting unsatisfactory results that could be improved by differentiated induction schemes and reducing excessive psychological and financial burdens, and adverse effects.


CONCLUSIONS
In order to remedy the limitations due to the scarcity of strong evidence about this topic, future studies should try to clarify predictive value of markers in groups of specific diseases-related subfertility and pay special attention to propaedeutic multivariate models including anti-Müllerian hormone and antral follicle count.
de Carvalho
Bruno Ramalho
BR
Sector of Human Reproduction, Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. bramalho@usp.br
Rosa e Silva
Ana Carolina Japur de Sá
AC
Rosa e Silva
Júlio César
JC
dos Reis
Rosana Maria
RM
Ferriani
Rui Alberto
RA
Silva de Sá
Marcos Felipe
MF
D054304:Anti-Mullerian Hormone / Q000378:metabolism; D016922:Cellular Senescence; D002996:Clomiphene / Q000494:pharmacology; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007265:Inhibins / Q000378:metabolism; D008297:Male; D006080:Ovarian Follicle / Q000378:metabolism; D010050:Ovarian Function Tests / Q000379:methods*; D010053:Ovary / Q000502:physiology*; D016649:Primary Ovarian Insufficiency / Q000628:therapy; D014463:Ultrasonography / Q000379:methods
D005300:Fertility Agents, Female; C422364:inhibin B; D002996:Clomiphene; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone