The predictive value of ovarian reserve tests for miscarriage in a population of subfertile ovulatory women.
BACKGROUND
The increase in miscarriage rate with female age is attributed to a decline in oocyte quality. This age-related decrease of oocyte quality is accompanied by a decrease in oocyte quantity. Assessment of the number of oocytes by ovarian reserve tests (ORTs) may therefore also represent their quality. The objective of our study was to assess the predictive value of ORTs for miscarriage in subfertile women.


METHODS
This study was a subanalysis within a prospective cohort study of 474 subfertile ovulatory couples in two hospitals in Groningen, The Netherlands. The ORTs performed were: antral follicle count (AFC), basal and stimulated levels of follicle-stimulating hormone (FSH) and inhibin B, and the clomiphene citrate challenge test (CCCT). Women who achieved an ongoing pregnancy (n = 233) were compared with women experiencing miscarriage (n = 72) on the results of their ORTs and patient characteristics.


RESULTS
In univariate analysis, the outcome of the ORTs did not differ between the groups. Logistic regression analysis including patient characteristics such as female age did not reveal an association between the ORT results and miscarriage either.


CONCLUSIONS
Neither AFC, basal and stimulated levels of FSH and inhibin B, nor the CCCT have a statistically significant predictive value for miscarriage in subfertile ovulatory women.
Haadsma
M L
ML
Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. m.l.haadsma@medgen.umcg.nl
Groen
H
H
Fidler
V
V
Seinen
L H M
LH
Broekmans
F J M
FJ
Heineman
M J
MJ
Hoek
A
A
D000022:Abortion, Spontaneous; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007246:Infertility / Q000503:physiopathology / Q000628:therapy; D007265:Inhibins / Q000378:metabolism; D009865:Oocytes / Q000378:metabolism / Q000473:pathology*; D006080:Ovarian Follicle / Q000473:pathology*; D010053:Ovary / Q000473:pathology; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies
C422364:inhibin B; D007265:Inhibins; D005640:Follicle Stimulating Hormone