The Correlations of Anti-Mullerian Hormone, Follicle-Stimulating Hormone and Antral Follicle Count in Different Age Groups of Infertile Women

Background: The objective of our study was to identify the correlations between the tests currently used in ovarian reserve assessment: anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH) and antral follicle count (AFC) and to distinguish the most reliable markers for ovarian reserve in order to select an adequate strategy for the initial stages of infertility treatment. Materials and Methods: In this prospective study, 112 infertile women were assessed. Subjects were divided into three age groups: group I < 35 years (n=39), group II 35-40 years (n=31), and group III 41-46 years (n=42). AMH, FSH and AFC were determined on days 2-3 of the patients’ menstrual cycles. Results: There was a significantly elevated negative correlation between age and AMH level (rs=-0.67, p < 0.0001) and AFC (rs=-0.55, p < 0.0001). We observed a significantly positive correlation between age and FSH (rs=0.38, p < 0.0001). AMH negatively correlated with FSH (rs=-0.48, p < 0.0001) and positively with AFC (r=- 0.71, p=0.0001). There was a moderate negative relation between FSH and AFC (r=-0.41, p=0.0001) and moderate positive relation between age and FSH (rs=0.38, p < 0.0001). The correlation analysis performed in separate groups showed that AMH and AFC showed a statistically significant positive correlation for group I (r=0.57, p < 0.0001), group II (r=0.69, p < 0.0001) and group III (r=0.47, p < 0.002). A statistically significant correlation between FSH and AMH was detected only in groups I (r=-0.41, p < 0.02) and II (r=-0.55, p < 0.0001). A statistically significant correlation existed between FSH and AFC only in group III (r=-0.42, p < 0.006), as well as between age and AFC only in group I (r=-0.35, p < 0.03). Conclusion: Currently, AMH should be considered as the more reliable of the ovarian reserve assessments tests compared to FSH. There is a strong positive correlation between serum AMH level and AFC. The use of AMH combined with AFC may improve ovarian reserve evaluation.