N.S. Macklon, M.D., Ph.D.; B.C.J.M. Fauser, M.D., Ph.D.

Disclosures

Semin Reprod Med. 2005;23(3):248-256. 

In This Article

Abstract and Introduction

The tendency to delay childbirth has increased the importance of ovarian reserve as a determinant of infertility treatment outcome. In the context of assisted reproduction technology, effective strategies to overcome the impact of ovarian aging and diminished ovarian reserve on pregnancy chances remain elusive. Markers of ovarian reserve are increasingly used to aid management and counseling of these patients. Proper interpretation of currently applied hormonal markers, ultrasound parameters, and hormone challenge tests requires an understanding of what constitutes and determines ovarian reserve. This article addresses these aspects and highlights recent developments in the field.

It is now clear that diminished ovarian reserve secondary to ovarian aging is the prime cause of decreasing chances for spontaneous conception with increasing age and poor response to ovarian stimulation for assisted reproductive technologies (ART). The tendency seen in Western countries for couples to delay childbearing has increased the relative importance of diminished ovarian reserve as a factor determining their chance of conceiving.[1] The clinical phenomenon of poor response to ovarian stimulation due to diminished ovarian reserve is not limited to women of advanced reproductive age, however, but is also encountered in young women. The need to develop strategies designed to overcome the impact of poor response to ovarian stimulation on ART outcomes has resulted in the development of a large body of scientific literature addressing the problem, but no effective treatment. In recent years several markers of ovarian reserve have been proposed and adopted into clinical practice to aid counseling and management. Increasing knowledge about the factors that control follicle development and atresia are challenging current concepts of ovarian reserve and promise new avenues for therapeutic intervention.

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