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Tests show low egg reserves are not linked to infertility

Women with test results indicating low ovarian reserve were not less likely to become pregnant within six or 12 months attempts than women whose lab tests do not point to a limited egg supply.

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Lab tests show that women with low reserves of eggs in their ovaries does not necessarily mean that they will have difficulty to get pregnant, a U.S. study suggests.

For the study, researchers examined the results of blood and urine tests for so-called biomarkers that indicate the ovarian reserve, or egg supply, 750 women in the age group of 30 to 44.

Women with test results indicating low ovarian reserve were not less likely to become pregnant within six or 12 months attempts than women whose lab tests do not point to a limited egg supply, researchers report in JAMA.

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“These blood tests do predict how well a woman will respond to fertility treatment,” said lead study author Dr. Anne Steiner of the University of North Carolina at Chapel Hill.

“But we found that they are not to predict her chances of conceiving naturally,” Steiner said by e-mail. “The challenge is the clinical dogma that diminished ovarian reserve is a cause of infertility.”

Women are born with a limited supply of eggs, and that the range has decreased with age. Tests for ovarian reserve biomarkers are widely used as a growing number of women elect to delay attempting pregnancy until they are in their ’30’s and’ 40’s.

Doctors use the tests to decide whether to recommend egg freezing as an option for women to preserve future fertility options, the researchers note, and home-based tests are also on the market for women who want to assess the fertility on their own.

The study examined the tests of the three biomarkers of ovarian reserve: early follicular phase serum antimullerian hormone (AMH) in serum and urinary follicle-stimulating hormone (FSH) and serum inhibin B.

Women with lower levels of AMH and elevated FSH, which may suggest a limited egg supplies, were not significantly less likely to become pregnant within 6 or 12 months of trying to become pregnant than women with a normal test-results of the study found.

Results of the tests of inhibin B level is also not associated with fertility.

A limitation of the study is that it assessed conception, but not whether the women delivered babies, the authors note. Low ovarian reserve can increase the risk of miscarriage, possibly due to the influence egg quality, researchers suggest.

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The research team also lacked data on the quality of sperm of the women’s male partners, making it impossible to determine how this can impact on the chances of natural conception.

In the study was also an evaluation of the effectiveness of the tests in women who are trying to conceive up to three months, and many of these women may not have had any trouble thinking of a little more time.

Doctors generally recommend that women under 35 to get fertility evaluations after 12 months of trying unsuccessfully to become pregnant and tells an older woman to get fertility checked out after six months of trying.

The best use of the ovarian reserve test is to determine which patients may respond to treatments that stimulate the ovaries produce more mature eggs, said Dr. Nanette Santoro of the University of Colorado School of Medicine in Aurora. When the ovarian reserves are too low, women may not benefit from fertility treatments.

Many women may not need these tests, or it may not be necessary to immediately act on the results, Santoro, author of an accompanying editorial, said by e-mail.

“By the time you have to come to the doctor for help to get pregnant, ovarian reserve is a major consideration,” Santoro said. “But if you never have to see that one of us, you could walk around with a very low ovarian reserve and still have no problem to become pregnant on your own like all the other systems are.”

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