Ovarian reserve screening in infertility: practical applications and theoretical directions for research.

摘要: The concept of ovarian reserve describes the natural oocyte endowment and is closely associated with female age, which single most important factor influencing reproductive outcome. Fertility potential first declines after age 30 moves downward rapidly thereafter, essentially reaching zero by mid-40s. Conceptions beyond this are exceedingly rare, unless oocytes obtained from a younger donor utilised. How best to estimate clinically remains controversial. Passive assessments include measurement serum follicle stimulating hormone (FSH), oestradiol (E2), anti-Mullerian (AMH), inhibin-B. Ultrasound determination antral count (AFC), vascularity volume also can have role. clomiphene citrate challenge test (CCCT), exogenous FSH (EFORT), GnRH-agonist stimulation (GAST) provocative methods that been used assess reserve. Importantly, patient's prior response gonadotropins provides highly valuable information about function. Regarding prediction outcome, in vitro fertilisation (IVF) experience at our centres elsewhere has shown some perform better than others. In report, these tests discussed compared; we present practical strategies organise screening as presently institutions. Experimental challenges long-held tenet irreversible ageing introduced explored. While pregnancy rates IVF influenced multiple (non-ovarian) factors including laboratory conditions, semen parameters, psychological stress technique embryo transfer, predicting gonadotropin treatment nevertheless an aim evaluation couple struggling infertility.