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Human Reproduction, Vol. 14, No. 11, 2822-2826, November 1999
© 1999 European Society of Human Reproduction and Embryology

Accuracy of ovarian reserve tests

Bülent Gülekli1,2,4, Yesim Bulbul1, Ata Onvural1,2, Kutsal Yorukoglu3, Cemal Posaci1,2, Namik Demir1 and Oktay Erten1

1 Obstetrics and Gynaecology, 2 Reproductive Endocrinology and 3 Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey

Several tests predict ovarian reserve in women undergoing assisted reproductive technologies. However, the accuracy of these tests in assessing the number of the remaining follicles within the ovary (ovarian reserve) has not been previously validated. The aim of this study was to assess the accuracy of ovarian reserve tests, namely basal and clomiphene-stimulated follicle stimulating hormone (FSH) concentrations and gonadotrophin-releasing hormone (GnRH) agonist stimulation test in predicting the number of the follicles within the ovaries. The ovaries of 22 parous women over 35 years of age who underwent oophorectomy were examined histologically for follicle number. Early follicular phase serum FSH, clomiphene citrate challenge tests (CCCT) and GnRH agonist stimulation test (GAST) were performed in the menstrual cycle prior to the surgery. The predictive value of these tests was then assessed. A positive correlation was detected between basal serum oestradiol concentrations and follicles per unit tissue but no significant correlation was detected between basal and clomiphene-stimulated FSH and follicles per unit tissue. The receiver operator characteristic curves indicated that the clomiphene citrate challenge test was the most accurate of the three tests assessed. In conclusion, none of the tests in this study accurately reflects ovarian reserve.

Key words: ageing/ovarian reserve tests/ovary

4 To whom correspondence should be addressed at: McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, 687 Pine Avenue West, # F6.58, Montreal, Quebec Canada H3A 1A1


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