Gynecology Book

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Markers of Ovarian Reserve

Aka: Markers of Ovarian Reserve, Ovarian Reserve Assessment
  1. See Also
    1. Secondary Amenorrhea
    2. Menopause
    3. Premature Ovarian Failure
  2. Physiology
    1. Ovarian follicles decrease with aging to Perimenopause (thousands of follicles) to Menopause (<1000 follicles)
  3. Labs
    1. Anti-Mullerian Hormone (AMH)
      1. Stable marker of ovarian reserve (gradually declines from age 25 to Menopause)
      2. AMH <1.0 suggests decreased ovarian reserve
    2. Follicle Stimulating Hormone (FSH)
      1. Obtain on day 3 of cycle
      2. FSH >10 IU/L suggest decreased ovarian reserve (but poor reliability due to variable levels)
    3. Estradiol (E2)
      1. Obtain on day 3 of cycle
      2. Estradiol decreased in decreased ovarian reserve
  4. Imaging
    1. Pelvic Ultrasound
      1. Ovarian Volume
      2. Antral follicle count
        1. Count follicles 2-10 mm in diameter during early Follicular Phase
  5. References
    1. kruszynska (2017) Prz Menopauzalny 16(2): 47-50 +PMID:28721129 [PubMed]
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509971/

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