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Hum. Reprod. Advance Access published online on December 4, 2008
Human Reproduction, doi:10.1093/humrep/den384
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© The Author 2008. 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

The predictive value of ovarian reserve tests for miscarriage in a population of subfertile ovulatory women

M.L. Haadsma1,2,6, H. Groen3, V. Fidler3, L.H.M. Seinen1, F.J.M. Broekmans4, M.J. Heineman1,5 and A. Hoek1

1 Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands 2 Department of Genetics, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands 3 Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands 4 Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands 5 Department of Obstetrics and Gynaecology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands

6 Correspondence address. E-mail: m.l.haadsma{at}medgen.umcg.nl

BACKGROUND: The increase in miscarriage rate with female age is attributed to a decline in oocyte quality. This age-related decrease of oocyte quality is accompanied by a decrease in oocyte quantity. Assessment of the number of oocytes by ovarian reserve tests (ORTs) may therefore also represent their quality. The objective of our study was to assess the predictive value of ORTs for miscarriage in subfertile women.

METHODS: This study was a subanalysis within a prospective cohort study of 474 subfertile ovulatory couples in two hospitals in Groningen, The Netherlands. The ORTs performed were: antral follicle count (AFC), basal and stimulated levels of follicle-stimulating hormone (FSH) and inhibin B, and the clomiphene citrate challenge test (CCCT). Women who achieved an ongoing pregnancy (n = 233) were compared with women experiencing miscarriage (n = 72) on the results of their ORTs and patient characteristics.

RESULTS: In univariate analysis, the outcome of the ORTs did not differ between the groups. Logistic regression analysis including patient characteristics such as female age did not reveal an association between the ORT results and miscarriage either.

CONCLUSIONS: Neither AFC, basal and stimulated levels of FSH and inhibin B, nor the CCCT have a statistically significant predictive value for miscarriage in subfertile ovulatory women.

Key words: ovarian reserve/ovarian reserve test/miscarriage/pregnancy loss/predictive value

Submitted on June 4, 2008; resubmitted on August 22, 2008; accepted on September 24, 2008.


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