Endocrine Abstracts

AFC is related to ovarian function and outcome in assisted reproduction programmes. Current regimens for ovulation induction consider patient age to determine initial FSH dose and may exclude patients from treatment when FSH is high. Increased BMI is also an indication to defer treatment. We aimed to investigate the relationship between AFC and other predictors of ovarian response in candidates for assisted conception.

We studied 89 patients referred to a regional IVF unit at day 3 of their menstrual cycle. Women undergoing hormonal and ultrasound assessment before starting their first IVF cycle were recruited. Inclusion criteria were: first ovarian stimulation cycle, regular menstrual cycles; age <40 years; both ovaries present; no family history of premature ovarian failure, autoimmune disorders and no current hormone therapy. The characteristics of the patients were: age 32.9 years±3.9 S.D., FSH 7.96 IU/l±2.6 S.D. and BMI 24.9 kg/m²±3.6 S.D. AFC (follicles 2–5 mm in diameter) was measured by transvaginal ultrasound. Plasma AMH and inhibin B levels were measured by two site enzyme linked immunosorbent assays. Ethical approval for this study was obtained from the LREC.

Median AFC was 11 (interquartile range 6–16), median AMH was 2.15 ng/ml (interquartile range 0.82–4.15) and median inhibin B was 92 pg/ml (interquartile range 41–151). AFC was correlated negatively to age (r_s=−0.31, P=0.0032), negatively with serum FSH (r_s=−0.25, P=0.018) and positively with plasma AMH (r_s=0.51, P<0.0001). There was no relationship between AFC and BMI or inhibin B. Multiple regression analysis showed AFC to be correlated to plasma AMH (P<0.0001) but not with age or FSH.

These data support the view that functional age rather than chronological age is important in determination of ovarian function for assisted conception purposes.