title: Possibilities and limits of ovarian reserve testing in ART.
abstract: Markers of ovarian reserve are associated with ovarian aging as they decline with chronologic age, and hence may predict stages of reproductive aging including the menopause transition. Assessment of ovarian reserve include measurement of serum follicle stimulating hormone (FSH), anti-M�llerian hormone (AMH), and inhibin-B. Ultrasound determination of antral follicle count (AFC), ovarian vascularity and ovarian volume also can have a role. The clomiphene citrate challenge test (CCCT), exogenous FSH ovarian reserve test (EFORT), and GnRH-agonist stimulation test (GAST) are dynamic methods that have been used in the past to assess ovarian reserve. In infertile women, ovarian reserve markers can be used to predict low and high oocyte yield and treatment failure in women undergoing in vitro fertilization. However the markers may have limitations when an in depth analysis of their accuracy, cost, convenience, and utility is performed. As ovarian reserve markers may permit the identification of both the extremes of ovarian stimulation, a possible role for their measurement may be in the individualization of treatment strategies in order to reduce the clinical risk of ART along with optimized treatment burden. It is fundamental to clarify the cost/benefit of its use in the ovarian reserve testing before initiation of an IVF cycle and whether the ovarian reserve markers-determined strategy of ovarian stimulation for assisted conception may be associated to improved live birth rate.
authors.affiliation: Mother Infant Department Institute of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Policlinico di Modena, Largo del Pozzo, 41100 Modena, Italy. antlamarca@libero.it
authors.forename: Antonio
authors.initials: A
authors.lastname: La Marca
authors.forename: Cindy
authors.initials: C
authors.lastname: Argento
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sighinolfi
authors.forename: Valentina
authors.initials: V
authors.lastname: Grisendi
authors.forename: Marilena
authors.initials: M
authors.lastname: Carbone
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Ippolito
authors.forename: Alfredo Carducci
authors.initials: AC
authors.lastname: Artenisio
authors.forename: Gaspare
authors.initials: G
authors.lastname: Stabile
authors.forename: Annibale
authors.initials: A
authors.lastname: Volpe
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D003362:Cost-Benefit Analysis; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007265:Inhibins / Q000097:blood; D008875:Middle Aged; D009865:Oocytes / Q000502:physiology; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000502:physiology; D010050:Ovarian Function Tests / Q000379:methods*; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D014463:Ultrasonography
chemical_list: C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone