Implications of Blood Type for Ovarian Reserve

Edward J. Nejat; Sangita Jindal; Dara Berger; Erkan Buyuk; Maria Lalioti; Lubna Pal


Hum Reprod. 2011;26(9):2513-2517. 

In This Article

Materials and Methods

Patients attending the Yale Fertility Center, New Haven, CT, USA (site 1) and Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, NY, USA (site 2) for infertility-related evaluation and care were included in this study. Patients had screening blood tests at local branches of Quest Diagnostics, USA, between January 2007 and December 2008. The study was approved by the Institutional Review Boards of Yale University School of Medicine and Montefiore Medical Center. Data for women ≤45 years of age who had baseline ovarian reserve testing performed at the local Quest Diagnostics during the study period were procured. The laboratory provided information on patient age, serum FSH (mIU/ml) and estradiol (E2, pg/ml) levels and blood type (A, B, AB or O). Serum FSH was analyzed by the reference laboratory using commercial immunoassays [Immulite, Siemens, Deerfield, IL, USA; intra-assay coefficient of variation (CV) 2.9% and inter-assay CV 4.1% for FSH]. FSH > 10 mIU/ml was taken to reflect DOR as per clinical practice guidelines for each participating study site. Given that information on cycle day of blood testing was not available, the analyses were restricted to FSH values with concomitant E2 level < 80 pg/ml to ensure that the data reflected early follicular phase hormone levels.

Statistical Analysis

The distribution of continuous data was evaluated by Shapiro–Wilk normality test. Given the skewed distribution for FSH, non-parametric tests were employed to assess the relationship between FSH and ABO blood types (Kruskal–Wallis rank test and Mann–Whitney U-test). Relationships between categorical variables (DOR and blood type) were assessed using χ2 test. Multivariable logistic regression analyses determined the relationship between elevated FSH with blood type O, and with A antigen bearing blood types (A or AB) after adjusting for patient age, study site and blood type B. Sensitivity analyses utilized higher FSH thresholds (>12 IU/ml) to explore the association between DOR and blood type. Goodness of fit for the respective models was assessed using Hosmer–Lemeshow test (Archer and Lemeshow, 2006). The likelihood of association between DOR and various evaluated parameters is reported as odds ratios (ORs) ± 95% confidence interval (95% CI). STATA IC 10 (StataCorp, College Station, TX, USA) was used for statistical analyses and two-tailed P< 0.05 was considered to be statistically significant.


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