Follicle stimulating hormone and anti-mullerian hormone among fertile and infertile women in Ile-Ife, Nigeria: is there a difference?

Background: Reduced ovarian reserve predicts poor ovarian response and poor success rates in infertile women who undergo assisted reproductive technology [ART]. Ovarian reserve also decreases with age but the rate of decline varies from one woman to another. This study aims to detect differences in ovarian reserve as measured by basal serum follicle stimulating hormone [FSH] and anti-Mullerian hormone [AMH] between a matched cohort of fertile and infertile regularly menstruating women, 18-45 years of age

Materials and Methods: This case-control study involved 64 fertile and 64 subfertile women matched by age at recruitment. Peripheral blood samples were taken from the women recruited from the Gynecological and Outpatient Clinics of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Serum FSH and AMH were quantified using ELISA at the Metabolic Research Laboratory of LAUTECH Teaching Hospital, Ogbomoso, Nigeria

Results: A significant difference existed in the mean FSH of fertile [6.97 +/- 3.34] and infertile [13.34 +/- 5.24, P=0.013] women. We observed a significant difference in AMH between fertile [2.71 +/- 1.91] and infertile [1.60 +/- 2.51, P=0.029] women. There was a negative correlation between FSH and AMH in both fertile [r=-0.311, P=0.01] and infertile [r=-0.374, P=0.002] women

Conclusion: The difference in ovarian reserve observed in this study suggests that reduced ovarian reserve in regularly menstruating women may be associated with early ovarian ageing or subfertility

Age-specific nomograms for follicle stimulating hormone and anti-Mullerian hormone: a pilot study in Ile-Ife, Nigeria

Background: Assessment of ovarian reserve is one of the steps in the management of infertile couples. Follicle Stimulating hormone [FSH] and anti-Mullerian hormone [AMH] are commonly used ovarian reserve markers in Africa. However, there is paucity of age-specific reference values for FSH and AMH among the African population

Objective: This study aimed at conducting a pilot study for generation of age-specific nomograms for FSH and AMH among fertile women in Ile-Ife, Nigeria

Materials and Methods: A pilot cross-sectional study that involved 65 fertile women within the age range of 18-45 yr were prospectively and consecutively recruited from November 2014 to January 2015. Peripheral blood samples were taken for basal serum FSH and random serum AMH. The samples were processed using enzyme linked immunosorbent [ELISA] assays

Results: Age-specific FSH nomogram showed a gradual increase which became steeper at age 35 yr with an average yearly increase of 0.2 IU/L in basal serum FSH, while age-specific AMH nomogram showed a peak at 25 yr and then; an average yearly decrease of 0.11 ng/ml in random serum AMH from 25 yr

Conclusion: The age-specific nomograms generated by this pilot study suggest that AMH may be an earlier marker of reduced ovarian reserve; which if validated by future multicenter population based studies may facilitate counseling of women on their reproductive potentials