Prevalence of Diminished Ovarian Reserve in Sub-fertile Women Under 40 years of Age

Sadia  Anwar; Sadia  Shamsher; Sadaf  Saifullah; Amna  Javed; Kalsoom Essa  Bhettani; Sajjad  Ahmad

doi:10.29054/apmc/2023.1228

Sadia Anwar Associate Professor, Department of Gynecology & Obs., Mufti Mehmood Hospital, Dera Ismail Khan Pakistan
Sadia Shamsher Associate Professor, Department of Gynecology & Obs., Medical & Teaching Institute Hayatabad Medical Complex, Peshawar Pakistan
Sadaf Saifullah Assistant Professor, Department of Gynecology & Obs., Women &Children Hospital, Abbottabad Pakistan
Amna Javed Assistant Professor, Department of Gynecology & Obs., Shaikh Zayed Medical Complex, Lahore Pakistan
Kalsoom Essa Bhettani Assistant Professor, Department of Gynecology & Obs., Mufti Mehmood Hospital, Dera Ismail Khan Pakistan
Sajjad Ahmad Professor, Department of Histopathology, Gomal Medical College, Dera Ismail Khan Pakistan

DOI: https://doi.org/10.29054/apmc/2023.1228

Keywords: Prevalence, Secondary, Primary, Reproduction, Subfertility, Ovarian reserve

Abstract

Background: Diminished ovarian reserve defined as when woman ovaries lose their reproductive potential in terms of quality and quantity of eggs leading to reduced fecundability and poor ovarian response to stimulation. Female age is most common prognostic element but diminished ovarian reserve is quite common under 40 years old young sub-fertile women. It is best assessed by hormonal tests like FSH and AMH levels. Objective: To assess the prevalence of diminished ovarian reserve among sub-fertile women under 40 years age. Study Design: Cross sectional study. Settings: Department of Obstetrics and Gynecology, Mufti Mehmood Hospital, Dera Ismail Khan Pakistan. Duration: One year from January 01, 2022 to December 31, 2022. Methods: After meeting the inclusion criteria 593 sub-fertile women were enrolled. FSH level was performed on day 2 or 3 of menstrual cycle. if found more than 10 IU, it was repeated 4 to 6 weeks apart to satisfy the criteria of poor ovarian reserve. The primary outcome was to find the prevalence of diminished ovarian reserve in local population and secondary outcome was to assess the frequency of menstrual cycle pattern and type of subfertility in these women. The prevalence of diminished ovarian reserve and in respect to different age groups, menstrual cycle patterns like oligomennohoea, and type of infertility (primary or secondary) were presented with frequency percentages. Results: The mean age of the females was 35.98 years with 84 ((68%) women in age group 36-40.15 woman (12.29%) had amenorrhea of less than 4 months.62(50.8%) had oligomenorrhoea with scanty flow while 45(36. 6 %) had regular menstrual cycle with normal flow or scanty flow. 92 women (75.4%) had primary infertility while 30 (24.5%)had secondary infertility. Conclusion: The prevalence of diminished ovarian reserve was 20%among sub-fertile women under 40 years age with mean age of 35.98 years with highest prevalence in age group 36- 40 years. Oligomenohoea with scanty flow was the commonest menstrual pattern with more common primary subfertility.