J Cohen1,2, N Chabbert-Buffet3,4, E Darai3,4. 1. Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC 6-UPMC Centre Expert en Endométriose (C3E), Université Pierre et Marie Curie Paris 6, Paris, France. drcohenjonathan@gmail.com. 2. Inserm UMRS938, Université Pierre et Marie Curie, Paris, France. drcohenjonathan@gmail.com. 3. Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC 6-UPMC Centre Expert en Endométriose (C3E), Université Pierre et Marie Curie Paris 6, Paris, France. 4. Inserm UMRS938, Université Pierre et Marie Curie, Paris, France.
Abstract
PURPOSE: Diminished ovarian reserve (DOR) is characterized by poor fertility outcomes, and it represents a major challenge in reproductive medicine. Although consensus exists on the concept of DOR, its definition remains blurry. DOR has to be distinguished from premature ovarian failure (POF) and poor ovarian responders (POR), who are clearly defined. METHODS: We performed a PubMed search with the terms "diminished ovarian reserve" and "in vitro fertilization (IVF)" to assess the homogeneity of the definition of DOR. RESULTS: Out of 121 articles, 14 gave a definition for DOR. Only one definition was used by two different teams (basal follicle-stimulating hormone (FSH) value >10 IU/l) and eight teams used 11 different definitions. Among those, four definitions did not include antral follicular count (AFC) and seven studies did. Two definitions included the results from a previous cycle. CONCLUSIONS: The heterogeneity in the definition of DOR used in these studies contributes to confusing results. Hence, there is a need for a clear definition of DOR. It appears that AFC and anti-Müllerian hormone (AMH) serum levels are the most relevant criteria. One option could be the use of the following definition: (i) woman with any of the risk factors for POR and/or (ii) an abnormal ovarian reserve test (i.e., antral follicular count (AFC) <5-7 follicles or AMH <0.5-1.1 ng/ml). This hypothesis requires validation.
PURPOSE: Diminished ovarian reserve (DOR) is characterized by poor fertility outcomes, and it represents a major challenge in reproductive medicine. Although consensus exists on the concept of DOR, its definition remains blurry. DOR has to be distinguished from premature ovarian failure (POF) and poor ovarian responders (POR), who are clearly defined. METHODS: We performed a PubMed search with the terms "diminished ovarian reserve" and "in vitro fertilization (IVF)" to assess the homogeneity of the definition of DOR. RESULTS: Out of 121 articles, 14 gave a definition for DOR. Only one definition was used by two different teams (basal follicle-stimulating hormone (FSH) value >10 IU/l) and eight teams used 11 different definitions. Among those, four definitions did not include antral follicular count (AFC) and seven studies did. Two definitions included the results from a previous cycle. CONCLUSIONS: The heterogeneity in the definition of DOR used in these studies contributes to confusing results. Hence, there is a need for a clear definition of DOR. It appears that AFC and anti-Müllerian hormone (AMH) serum levels are the most relevant criteria. One option could be the use of the following definition: (i) woman with any of the risk factors for POR and/or (ii) an abnormal ovarian reserve test (i.e., antral follicular count (AFC) <5-7 follicles or AMH <0.5-1.1 ng/ml). This hypothesis requires validation.
Authors: A La Marca; G Sighinolfi; D Radi; C Argento; E Baraldi; A Carducci Artenisio; G Stabile; A Volpe Journal: Hum Reprod Update Date: 2009-09-30 Impact factor: 15.610
Authors: Sara Pinelli; Paolo Giovanni Artini; Stefano Basile; Maria Elena Rosa Obino; Claudia Sergiampietri; Diana Giannarelli; Giovanna Simi; Vito Cela Journal: J Assist Reprod Genet Date: 2017-12-05 Impact factor: 3.412