Assessment of ovarian reserve in Assisted Reproductive Technology

Ovarian reserve is an important factor for fertility in a couple and, when reduced, has negative impact on assisted reproductive technology. Therefore, methods for assessment of ovarian reserve could be used to determine the appropriate management. However, the true mean of which one of these tests is still questionable and they may be more confusing than elucidative to both physician and couple. The objective of this review is to critically study the ovarian reserve tests as a prognosis factor in patients treated with assisted reproductive technology. We studied the following tests: dosage in the early follicular phase of follicle-stimulating hormone, estradiol, inhibin B and anti-mullerian hormone; dynamic tests using clomiphene citrate, exogenous FSH and GnRH agonist and ultra-sound evaluation (antral follicle count and ovarian volume measurement). We concluded that the more accurate tests are antral follicle count, antimullerian hormone dosage, clomiphene citrate challenge test and GnRH agonist stimulating test. However, there are no tests capable to predict the chance of pregnancy after assisted reproductive treatment.