title: Ovarian reserve test: an impartial means to resolve the mismatch between chronological and biological age in the assessment of female reproductive chances.
abstract: Nowadays, the ovarian reserve (OR) is considered more important than chronological age to estimate female reproductive capability. We conducted a retrospective, observational, and cohort study in order to detect the best predictor marker of OR, ovarian response, chances to obtain high-quality embryos, and pregnancy after in vitro fertilization (IVF) cycle in elderly women. For all eligible patients (aged between 40 and 50 and admitted to their first IVF cycle for primary infertility), we investigated the biochemical parameters and ultrasound aspects of ovaries and how they affected IVF outcomes. Age, basal follicle-stimulating hormone, basal luteinizing hormone, and basal-17β-estradiol are better related to the dose of gonadotropin used during a controlled ovarian stimulation cycle. Basal anti-Müllerian hormone (AMH), antral follicular count (AFC), and maximum serum level of 17β-estradiol before pickup resulted the best predictors of chances to retrieve at least 6 oocytes (at least 3 in metaphase II) and to have at least 1 to 3 embryos. The basal AMH, AFC and maximum serum level of 17β-estradiol before pickup continue to show higher correlation to pregnancy rate. The maximum endometrial thickness at pickup resulted important to predict the pregnancy rate and the chances to detect ongoing pregnancy. It seems mandatory to well define the ovarian biological age rather than the chronological one in women older than 40 years of age in order to give the best counseling and to choose the most appropriate IVF protocols.
authors.affiliation: 1Department of Woman and Child Health, University of Padua, Padua, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Andrisani
authors.forename: Federica
authors.initials: F
authors.lastname: Esposito
authors.forename: Alessandra
authors.initials: A
authors.lastname: Oliva
authors.forename: Cecilia
authors.initials: C
authors.lastname: Zicchina
authors.forename: Denise
authors.initials: D
authors.lastname: Capuzzo
authors.forename: Michele
authors.initials: M
authors.lastname: Gangemi
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Nardelli
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D054315:Oocyte Retrieval / Q000379:methods / Q000592:standards*; D010050:Ovarian Function Tests / Q000379:methods / Q000592:standards; D065851:Ovarian Reserve / Q000502:physiology*; D011247:Pregnancy; D012098:Reproduction / Q000502:physiology*; D012189:Retrospective Studies
keywords: assisted reproduction techniques; biological ovarian age; chronological ovarian age; embryo quality; pregnancy rate