title: Ethnicity as a determinant of ovarian reserve: differences in ovarian aging between Spanish and Indian women.
abstract: OBJECTIVE
  To investigate differences in ovarian reserve markers (antimüllerian hormone [AMH] and antral follicle count [AFC]) in Indian and Spanish women.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In vitro fertilization (IVF) clinics.
  
  
  METHODS
  Infertile Spanish (n=229) and Indian (n=236) women who underwent controlled ovarian stimulation for IVF from January to October 2012.
  
  
  METHODS
  None.
  
  
  METHODS
  Data on ovarian reserve markers and results after ovarian stimulation were collected.
  
  
  RESULTS
  The mean age of women undergoing their first or second IVF cycle was significantly higher in Spanish than in Indian women (37.5±3.3 years vs. 31.5±3.8 years). Despite this 6-year age gap, AFCs were similar (9.5±4.7 vs. 9.9±4.6), as were day 3 FSH levels (7.5±4.5 IU/L vs. 6.9±2.3 IU/L). AMH levels were slightly lower in Spanish women (1.6±1.7 ng/mL vs. 2.5±1.6 ng/mL). Multivariate regression analysis showed that being Indian decreased AFC by 2.3, such that AFC in Indian women was similar to that in Spanish women 6.3 years older (95% confidence interval 3.39-1.10).
  
  
  CONCLUSIONS
  Similar ovarian reserve markers and ovarian response were observed in women with a 6-year age difference in favor of the Spanish, suggesting ethnic differences in ovarian aging. Further research is needed to understand whether these differences are genetically induced or are caused by other variables, such as nutrition. Our results may help clinicians to counsel infertile women when discussing assisted reproductive technology outcomes according to age and ethnic background.
authors.affiliation: IVI-Madrid, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Iglesias
authors.affiliation: NIF-Ahmedabad, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Banker
authors.affiliation: NIF-Delhi, India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Mahajan
authors.affiliation: IVI-Madrid, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Leyre
authors.initials: L
authors.lastname: Herrero
authors.affiliation: IVI-Valencia, Valencia University, Valencia, Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
authors.affiliation: IVI-Madrid, Rey Juan Carlos University, Madrid, Spain. Electronic address: juan.garcia.velasco@ivi.es.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Garcia-Velasco
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging / Q000097:blood / Q000208:ethnology*; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007194:India / Q000453:epidemiology; D007246:Infertility / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology* / Q000628:therapy; D054315:Oocyte Retrieval; D010053:Ovary / Q000378:metabolism / Q000503:physiopathology*; D010062:Ovulation Induction; D013030:Spain / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: AFC; AMH; Ethnicity; ovarian aging