Correlation of ovarian reserve tests with histologically determined primordial follicle number

Objective: To investigate the relationship between clinical markers of ovarian reserve and the true ovarian reserve as determined by the ovarian primordial follicle number.

Design: Prospective investigation.

Setting: Academic medical center.

Patient(s): Forty-two healthy women (aged 26-52 years) undergoing oophorectomy for benign gynecologic indications.

Intervention(s): Transvaginal ultrasound examination for the determination of the ovarian antral follicle count (AFC) and serum measurements of clinical markers of ovarian reserve. All measurements were obtained within 2 weeks of surgery, irrespective of cycle day. Ovarian primordial follicle count was then determined using a validated fractionator/optical disector method.

Main outcome measure(s): Univariate and partial correlations between ovarian reserve markers and ovarian primordial follicle count.

Result(s): There were significant correlations between the ovarian primordial follicle count and AFC (r=0.78), anti-Müllerian hormone (AMH; r=0.72), FSH (r=-0.32), inhibin B (r=0.40), and chronological age (r=-0.80). After adjusting for age, significant correlations were identified between the ovarian primordial follicle count and AFC (r=0.53) and AMH (r=0.48).

Conclusion(s): The ovarian AFC and serum levels of AMH correlate with the ovarian primordial follicle number even after adjustment for chronological age.