Tests for ovarian reserve: reliability and utility.
OBJECTIVE
This review discusses ovarian reserve tests for ovulation induction and their application in determining fertility capacity, and their current applications to assess risk of natural ovarian failure and to estimate ovarian function after cancer treatment.


RESULTS
The current arsenal of ovarian reserve tests comprises hormonal markers [basal follicle stimulating hormone, estradiol, inhibin-B, antimullerian hormone (AMH)] and ultrasonographic markers [ovarian volume, antral follicle counts (AFCs)]. These markers have limitations in terms of which test(s) should be used to reliably predict ovarian reserve with regard to accuracy, invasiveness, cost, convenience, and utility. Several studies have correlated sonographic AFCs with serum AMH levels for predicting the ovarian response to ovulation induction protocols during assisted reproduction treatments.


CONCLUSIONS
Serum AMH levels and AFC are reliable tests for predicting the ovarian response to ovulation induction. However, none of the currently employed tests of ovarian reserve can reliably predict pregnancy after assisted conception. Further, ovarian reserve tests cannot predict the onset of reproductive and hormonal menopause; thus, they should be used with caution for reproductive life-programming counseling. Moreover, there is no evidence to support the use of ovarian reserve tests to estimate the risk of ovarian sufficiency after cancer treatments.
Domingues
Thaís S
TS
Huntington Medicina Reprodutiva, Av. República do Líbano, 529 - São Paulo, São Paulo 04501-000, Brazil.
Rocha
André M
AM
Serafini
Paulo C
PC
D054304:Anti-Mullerian Hormone / Q000097:blood; D005260:Female; D005498:Follicular Phase / Q000097:blood / Q000502:physiology*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000503:physiopathology; D009369:Neoplasms / Q000628:therapy; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction
D054304:Anti-Mullerian Hormone