Assessment of Serum Anti-mullerian Hormone Level, Antral Follicle Count and Age as Indicators of Ovarian Reserve Response in Women Diagnosed with Infertility in Abia State, South Eastern Nigeria

Abstract

Aim: This study aimed at assessing serum anti-mullerian hormone level, antral follicle count and age as indicators of ovarian reserve response in women diagnosed with infertilility. Methodology: Subjects comprised of 200 females: 150 subjects and 50 controls, aged < 20  and up to 49 years, stratified into age < 20 years (control), age 20-29 years  (group 1), age 30-39 years (group 2) and age 40-49 years (group 3). About 5 ml of blood sample for AMH determination was collected on day 2-3 of spontaneous menstrual cycle from all groups and control and serum anti-mullerian hormone analyzed using enzyme linked immunosorbent assay. Baseline transvaginal ultrasound scanning was carried out on the subjects in experimental groups and control on day 2-3 of un-stimulated menstrual cycle for the measurement of antral follicle count, using the 2-dimensional plane. Results: The means±SEM of serum anti-mullerian hormone by experimental groups was 1602.44 ± 54.42 pg/ml for control, 848.06±23.04 pg/ml for group 1, 26.74±1.28 pg/ml for group 2, while group 3 is 10.37±1.26 pg/ml. The means were significantly different (P<0.0001). The mean±SEM of AFC by experimental groups was control; 7.82±0.14, group 1; 5.46±0.18, 1.78±0.10 for group 2, and 0.70±0.08 for group 3. The means of antral follicle count by experimental groups showed significant difference (p<0.0001). Results showed that anti-mullerian hormone level and antral follicle count decreased significantly (p<0.05) as the age of the subjects increases. Subjects in the control and experimental group 1 showed 100% high anti-mullerian hormone level indicating 100% potential of good ovarian response. The antral follicle count result also indicate that 100% and 75% of the control group and experimental group 1 respectively show good ovarian reserve. The ovarian response and reserve in the subjects decreased substantially as the age of the subjects increased. Positive correlations were also observed between the AMH and AFC across the ages of the population studied. Conclusion: The study reveals that good ovarian response and reserve in the population is related to the age of the subjects.