Association of ovarian reserve with age, BMI and serum FSH level in subfertile women

Objective: To examine the association of age, body mass index, serum follicle stimulating hormone levels and antral follicular count with fertility outcomes in terms of conception and delivery. Methods: The prospective cohort study was conducted at Baqai Institute of Reproductive and Developmental Sciences, Karachi, from January to December 2012. and comprised women undergoing the first cycle of in-vitro fertilisation who were categorised into groups A and B depending upon age. Group A consisted of women below 35 years of age, while Group B had women over 35 years of age. Age body mass index (BMI), basal level of serum follicle stimulating hormone and antral follicular count were determined in all subjects. Intracytoplasmic sperm injection was dispensed, and all subjects were followed up prospectively and their cycle outcomes were recorded. SPSS 20 was used for statistical analysis. Results: Of the 148 women in the study, 98(66%) were in Group A and 50(44%) in Group B. In Group A, 15(38.5%) women with body mass index <25 and 24(61.5%) with >25 with normal follicle stimulating hormone levels showed positive outcome. Moreover, 20(51.3%) women with normal ovarian reserve and 19(48.7%) with higher reserves showed positive pregnancy test and outcome. Group B showed <7 follicular count on ultrasonic examination, <5 eggs were retrieved in 36(72%) women and all of them (100%) had negative outcome. Conclusion: Sub-fertile women at age 35 years and above and body mass index over 33 had reduced fertility potential compared to younger women, and ultimately had lower success rate of fertility treatment, including in-vitro fertilisation.