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Hum. Reprod. Advance Access originally published online on February 12, 2007
Human Reproduction 2007 22(5):1492; doi:10.1093/humrep/del509
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Letters to the Editor

Assessment of ovarian reserve—should we perform tests of ovarian reserve routinely?

Jose P. Balmaceda1,3 and Juan-Enrique Schwarze2

1 Reproductive Medicine Unit, Clinica Las Nieves, Santiago, Chile 2 Reproductive Medicine Unit, Clinica Las Condes, Santiago, Chile

3 To whom correspondence should be addressed at: Reproductive Medicine Unit, Avda. Santa Maria 5950, Vitacura, Santiago, Chile. E-mail: jpbalma{at}gmail.com

Sir,

We read with much interest the article by Abha Maheshwari et al. (2006)Go, in which they examined the predictive power of currently available tests of ovarian reserve and question the value of routinely subjecting women to them. We do not agree with their conclusions that current evidence does not justify their routine use because these tests cannot predict the likelihood of pregnancy.

The assessment of ovarian reserve is a pivotal key in our workup and counselling of all subfertile couples. We have found that young women with diminished ovarian reserve (as assessed by clomiphene citrate challenge test) undergoing superovulation and intrauterine insemination have half the pregnancy rate of their counterparts with adequate ovarian reserve. Nevertheless, these women have good chances of getting pregnant by means of in vitro fertilization (Magendzo et al., 2006Go).

In the case of woman undergoing IVF/ICSI, although increasing the starting dose of gonadotrophins does not seem to improve the number of retrieved oocytes of women with diminished ovarian reserve, this information provides the couple with more elements to make thoughtful decisions about their treatment.

We agree with Maheshwari et al. (2006)Go that, nowadays, we do not have the perfect test to measure ovarian reserve, but its assessment by whatever test the clinician prefers directs the timing of pro-fertility treatments and, more importantly, provides a better tool to counsel subfertile couples.

References

Magendzo A, Schwarze JE, Diaz de la Vega C, Altieri E, Zegers-Hochschild F, Balmaceda JP. (2006) Clomiphene citrate challenge test predicts outcome of intrauterine insemination in women aged under 37 years. Reprod Biomed Online 12:423–427.[Web of Science][Medline]

Maheshwari A, Fowler P, Bhattacharya S. (2006) Assessment of ovarian reserve—should we perform tests of ovarian reserve routinely? Hum Reprod 21:2729–2735.[Abstract/Free Full Text]


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This Article
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Right arrow All Versions of this Article:
22/5/1492    most recent
del509v1
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Right arrow Articles by Balmaceda, J. P.
Right arrow Articles by Schwarze, J.-E.
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PubMed
Right arrow PubMed Citation
Right arrow Articles by Balmaceda, J. P.
Right arrow Articles by Schwarze, J.-E.
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