Clinical manifestations of decreased ovarian reserve in premenopausal women: a cross-sectional study

AIM: To estimate clinical manifestation of decreased ovarian reserve in women of reproductive age from Eastern Siberia.

MATERIAL AND METHODS: A total of 1119 women aged 18 to 40 years who underwent an annual preventive medical examination at their place of work were invited to participate in a cross-sectional study performed in 2017–2019 in Irkutsk Region and Buryat Republic (Russia). Among the 1119 women, 907 aged 31.78±5.13 years were included in the study, after which clinical, instrumental, and laboratory research methods and statistical analysis were utilized. Among the 907 women included in the study, 117 (12.9%) had <5 follicles per ovary and were diagnosed with decreased ovarian reserve (DOR). The laboratory study showed that 56 of the 117 (47.8%) women had an antimullerian hormone (AMH) level below 1.2 ng/mL, the average value of which was 0.53±0.43 ng/mL.

RESULTS: In women with reduced AMH levels, a shortening of the menstrual cycle (p=0.0187) and high parity were observed. Moreover, premature ovarian failure was diagnosed in 4 of the 117 (3.4%) patients with a reduced number of antral follicles.

CONCLUSION: The frequency of women with DOR in the Eastern Siberia region based on one AFC criterion was 12.9%. Only 3.4% of women satisfied all criteria for premature ovarian failure. The average age of women with signs of DOR in this region was 35.12±3.87 years and did not depend on ethnicity. Moreover, 47.8% of the women with an AMH <1.2 had a follicle-stimulating hormone (FSH) level of 12.14 ME/mL, while 52.2% of the those with AMH >1.2 had a FSH level of 5.91 ME/mL. Patients with AMH <1.2 can be characterized by high parity in the anamnesis and shortening of the menstrual cycle.