Anti-Mullerian hormone and Insulin-like growth factor-1 are predictive markers for ovarian reserve

Abstract

Background: Ovarian reserve is defined as the existent quantitative and qualitative supply of follicles which are found in the ovaries that can potentially develop into mature follicles which in effect determines a woman’s reproductive potential. Many tests of ovarian reserve are employed including clinical, endocrine static, endocrine dynamic and  ultrasonographic markers.

Aims of study: To determine the age-related changes in AMH and IGF-1 levels that occurs in Iraqi women as markers of ovarian reserve and to determine the specificity and sensitivity of IGF-1 and FSH for ovarian reserve.

Subjects, material and methods: One hindered cases were collected dividing into two groups; first group includes fifty cases of child bearing age, healthy, fertile females with regular menstrual cycle while second group includes fifty cases of postmenopausal aging group, healthy with normal fertility history. Serum levels of Follicle stimulating hormone, Luteinizing hormone, Prolactin, Anti Müllerian Hormone and Insulin like Growth Factor-1 were estimated for all cases.

Results: The overall mean age of the respondents was 45.06 ± 16.68 years old with significant statistical difference between the mean age of pre and post-menopausal women. Results of Anti Müllerian Hormone showing a significant statistical difference between means of Anti Müllerian Hormone hormone for pre-menopausal women (2.89± 2.07 ng/ml) and post-menopausal women (0.0± 0.0 ng/ml). Measuring of Insulin like Growth Factor-1 showing significant statistical difference between pre-menopausal women (211.04± 63.81 ng/ml) and post-menopausal groups' women (120.70± 39.69 ng/ml). Similarly results of Follicle stimulating hormone reveal significant differences between means of Follicle stimulating hormone for pre-menopausal women (6.03± 1.53 ml U/ ml) and post-menopausal women (56.06± 17.07 ml U/ ml). There was no significant association between AMH and IGF1 hormones and IGF1 hormone has been failed to detect ovarian reserve and still the AMH is the gold standard test.

Conclusion: Significant changes occur in Anti Müllerian Hormone, I Insulin like Growth Factor-1  and Follicle stimulating hormone with progression of the age and Anti Müllerian Hormone still the stander ovarian reserve test in compare with Insulin like Growth Factor-1 and Follicle stimulating hormone.

Key words: Ovarian reserve, AMH, IGF-1.