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Investigation of the Predictive Factors of Diminished Ovarian Reserve in Women Aged Less Than 40 Years and Undergoing ICSI Cycle

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Abstract

Diminished ovarian reserve (DOR) is one of the primary causes of poor ICSI outcomes. Therefore, this study was performed to speculate which of the following parameters: AMH, AFC, and women’s age can be used as a predictor factor of the DOR in women aged < 40 years. This prospective study enrolled 500 women suffering from idiopathic infertility problems and who underwent GnRH antagonist multiple-dose stimulation protocol. The women were divided into two groups: normal fertility (FSH ≤ 10 mIU/mL, n = 300) and DOR (FSH > 10 mIU/mL, n = 200). At the time of the study, the average of women age was 29.3 ± 5.7 years. A significant reduction was found in AMH level, AFC, number of mature, immature oocytes, fertilized oocytes, embryos transferred, and β-hCG level in the DOR group compared to the normal fertility group (P < 0.001). Conversely, a significant increase was shown in the age of the DOR group compared to the normal fertility group (30.8 ± 5.8 vs. 28.2 ± 5.4, respectively; P < 0.001). A significant negative association was found between the AFC, the number of mature oocytes, fertilized oocytes, embryos transferred, and the basal level of FSH in the DOR group (P < 0.01). The receiver operating characteristics (ROC) demonstrated that AMH level and AFC had the highest accuracy, followed by age in the prediction of DOR (P < 0.001) with a cut-off value of ≤ 1.2 ng/mL, ≤ 4.5, and > 29.5 years, respectively. This study exhibited that the levels of AMH and AFC are the best biomarkers, followed by age for the prediction of DOR in women < 40 years old. Furthermore, AMH is the only independent factor that is significantly related to DOR in women.

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Acknowledgements

The authors would like to express their gratitude to all the doctors and clinical staff at the Al Bassma Fertility Center, Palestinian Territories.

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  1. Faculty of Health Sciences, Department of Medical Laboratory Sciences, Islamic University, P.O. Box 108, Gaza, Palestine

    Mohammed M. Laqqan

  2. Faculty of Medicine, Department of Human Physiology, Islamic University, P.O. Box 108, Gaza, Palestine

    Maged M. Yassin

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  1. Mohammed M. Laqqan
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Correspondence to Mohammed M. Laqqan.

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This study was approved by the Palestinian Health Research Council (Reference. No. PHRC/HC/03/10), and consent was provided according to the Declaration of Helsinki. All samples were analyzed according to the guidelines and standard procedures of Al Basma Fertility Center, Palestinian Territories.

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Laqqan, M.M., Yassin, M.M. Investigation of the Predictive Factors of Diminished Ovarian Reserve in Women Aged Less Than 40 Years and Undergoing ICSI Cycle. Reprod. Sci. 30, 873–882 (2023). https://doi.org/10.1007/s43032-022-01055-1

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