Ovarian reserve analysis in subfertile women based on physical, ultrasound and hormonal parameters

Figures & data

Figure 1. Patient inflow diagram of the research.

Table 1. Description of ovarian reserve parameters evaluated in the analysis.

Parameter	Description
Age	Age is a predominant factor in determining pregnancy’s potential in regularly cycling women, although fertility does not uniformly decline in women. Nevertheless, chronological age has limited value in predicting individual ovarian response.
Follicle-stimulating hormone	The levels of Basal FSH (stimulating follicle hormone), calculated on the third day of the menstrual cycle, are widely utilized ORT for accessing the ovarian response. A wide range in the threshold values is greater than or equal to 25 IU per L, which defines the basal FSH abnormal levels.
AMH	The AMH levels are potentially associated with basal AFC (Antral Follicle Count), calculated using transvaginal ultrasonography. Further, the utilization of nomograms finds age-related physiological decline in levels of AHM. Also, it has been considered that AMH indicates the perimenopausal transition at 0.5 to 1.26 ng per ml.
Antral follicle count	The ovaries’ count has been added to the total antral follicle count. The AFC was utilized as a marker of the ovarian reserve. Further, 8 to 10 count is the predictor of normal responses. It has been identified that the count of antral follicles at size 2 to 6 mm declines with age and relates to various other markers like CCCT and FSH.

Table 2. Physical parameter analysis.

Variable	Category	Age		Total
		Age < 30	Age > 30
BMI	<25	23 (29%)	39 (32%)	62 (31%)
	25–30	39 (50%)	55 (45%)	94 (47%)
	>30	16 (21%)	28 (23%)	44 (22%)
	Total	78 (39%)	122 (61%)	200

Figure 2. FSH levels of subfertile women in comparison with BMI and age (years).

Table 3. Follicular stimulating hormone (FSH) levels of subfertile women in comparison with body mass index (BMI) and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	1,222.285	611.143	16.333	.001
Age category	1	331.270	331.270	8.854	.004
BMI category × age category	2	134.839	67.420	1.802	.170

Figure 3. AMH levels of subfertile women in comparison with BMI and age (years).

Table 4. AMH levels of subfertile women in comparison with BMI and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	18.327	9.163	7.541	.001
Age category	1	13.234	13.234	10.891	.001
BMI category × age category	2	2.476	1.238	1.019	.364

Figure 4. Day 2-AFC of subfertile women in comparison with body mass index (BMI) and age (years).

Table 5. Day 2-AFC of subfertile women in comparison with BMI and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	745.019	372.510	12.268	.001
Age category	1	135.287	135.287	4.455	.037
BMI category × age category	2	20.332	10.166	0.335	.716

Figure 5. Serum E2 levels of subfertile women in comparison with body mass index (BMI) and age (years).

Table 6. Serum E2 levels of subfertile women in comparison with BMI and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	477,839.752	238,919.876	21.912	.001
Age category	1	2,017.472	2,017.472	0.185	.668
BMI category × age category	2	45,111.367	22,555.684	2.069	.131

Figure 6. Right ovarian volume of subfertile women in comparison with body mass index (BMI) and age (years).

Table 7. Right ovarian volume of subfertile women in comparison with BMI and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	142.221	71.110	16.336	.001
Age category	1	0.0873	0.0873	0.0201	.888
BMI category × age category	2	17.275	8.637	1.984	.142

Figure 7. Left ovarian volume of subfertile women in comparison with body mass index (BMI) and age (years).

Table 8. Left ovarian volume of subfertile women in comparison with BMI and age (years).

Source of variation	DF	SS	MS	F	p
BMI category	2	128.478	64.239	22.537	.001
Age category	1	0.00539	0.00539	0.00189	.965
BMI category × age category	2	14.107	7.054	2.475	.089

Table 9. Bonferroni t test comparisons of FSH and BMI and age.

Comparison	Diff of means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	9.675	5.230	.001	Yes
BMI > 30 vs. BMI 25–30	8.618	5.268	.001	Yes
BMI 25–30 vs. BMI < 25	1.057	0.759	.000	No
Age category
Age > 30 vs. age < 30	3.977	2.975	.004	Yes
Age category within BMI < 25
Age > 30 vs. age < 30	0.512	0.221	.826	No
Age category within BMI 25–30
Age > 30 vs. age < 30	5.525	3.573	.001	Yes
Age category within BMI > 30
Age > 30 vs. age < 30	5.894	2.044	.043	Yes
BMI category within age < 30
BMI > 30 vs. BMI 25–30	8.433	3.074	.008	Yes
BMI > 30 vs. BMI < 25	6.984	2.364	.060	No
BMI < 25 vs. BMI 25–30	1.449	0.745	1.000	No
BMI category within age > 30
BMI > 30 vs. BMI < 25	12.366	5.554	.001	Yes
BMI > 30 vs. BMI 25–30	8.803	4.937	.001	Yes
BMI 25–30 vs. BMI < 25	3.564	1.787	.230	No

Table 10. Bonferroni t test comparisons of AMH and BMI and age.

Comparison	Diff of Means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	1.212	3.636	.001	Yes
BMI > 30 vs. BMI 25–30	1.029	3.489	.002	Yes
BMI 25–30 vs. BMI < 25	0.183	0.730	1.000	No
Age category
Age > 30 vs. age < 30	0.795	3.300	.001	Yes
Age category within BMI < 25
Age > 30 vs. age < 30	0.329	0.786	.433	No
Age category within BMI 25–30
Age > 30 vs. Age < 30	1.013	3.635	.001	Yes
Age category within BMI > 30
Age > 30 vs. age < 30	1.043	2.008	.047	Yes
BMI category within Age < 30
BMI > 30 vs. BMI 25–30	1.013	2.050	.128	No
BMI > 30 vs. BMI < 25	0.159	0.453	1.000	Do not test
BMI < 25 vs BMI 25–30	0.855	1.605	.334	Do not test
BMI category within age > 30
BMI > 30 vs. BMI < 25	1.569	3.912	.001	Yes
BMI > 30 vs. BMI 25–30	1.044	3.249	0.005	Yes
BMI 25–30 vs. BMI < 25	0.526	1.462	.440	No

Table 11. Bonferroni t test comparisons of Day-2 AFC and BMI and age.

Comparison	Diff of means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	7.882	4.730	.001	Yes
BMI > 30 vs. BMI 25–30	6.364	4.318	.001	Yes
BMI 25–30 vs. BMI < 25	1.517	1.209	.688	No
Age category
Age > 30 vs. age < 30	2.542	2.111	.037	Yes
Age category within BMI < 25
Age > 30 vs. age < 30	1.426	0.683	.496	No
Age category within BMI 25–30
Age > 30 vs. age < 30	3.477	2.496	.014	Yes
Age category within BMI > 30
Age > 30 vs. age < 30	2.722	1.048	.297	No
BMI category within age < 30
BMI > 30 vs BMI 25–30	6.741	2.728	.022	Yes
BMI > 30 vs BMI < 25	7.233	2.717	.023	Yes
BMI < 25 vs BMI 25–30	0.492	0.281	1.000	No
BMI category within age > 30
BMI > 30 vs. BMI < 25	8.530	4.253	.001	Yes
BMI > 30 vs. BMI 25–30	5.987	3.727	.001	Yes
BMI 25–30 vs. BMI < 25	2.543	1.415	0.480	No

Table 12. Bonferroni t test comparisons of serum E2 level and BMI and age.

Comparison	Diff of means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	180.461	5.715	.001	Yes
BMI > 30 vs. BMI 25–30	177.445	6.354	.001	Yes
BMI 25–30 vs. BMI < 25	3.016	0.127	1.000	No
Age category
Age > 30 vs. Age < 30	9.815	0.430	.668	No
Age category within BMI < 25
Age > 30 vs. age < 30	23.200	0.586	.559	No
Age category within BMI 25–30
Age > 30 vs. Age < 30	59.521	2.255	.026	Yes
Age category within BMI > 30
Age > 30 vs. age < 30	53.278	1.082	.281	No
BMI category within age < 30
BMI > 30 vs. BMI 25–30	233.845	4.993	.001	Yes
BMI > 30 vs. BMI < 25	218.700	4.336	.001	Yes
BMI < 25 vs. BMI 25–30	15.145	0.456	1.000	No
BMI category within age > 30
BMI > 30 vs. BMI < 25	142.222	3.742	.001	Yes
BMI > 30 vs. BMI 25–30	121.046	3.977	.001	Yes
BMI 25–30 vs. BMI < 25	21.176	0.622	1.000	No

Table 13. Bonferroni t test comparisons of right ovarian volume and BMI and age.

Comparisonc	Diff of means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	3.394	5.378	.001	Yes
BMI > 30 vs. BMI 25–30	2.846	5.101	.001	Yes
BMI 25–30 vs. BMI < 25	0.547	1.152	.756	No
Age category
Age > 30 vs. age < 30	0.0646	0.142	.888	No
Age category within BMI < 25
Age > 30 vs. age < 30	0.496	0.627	.532	No
Age category within BMI 25–30
Age > 30 vs. age < 30	1.024	1.942	.055	No
Age category within BMI > 30
Age > 30 vs. age < 30	0.722	0.734	.464	No
BMI category within age < 30
BMI > 30 vs. BMI 25–30	3.720	3.975	.001	Yes
BMI > 30 vs. BMI < 25	3.507	3.479	.002	Yes
BMI < 25 vs. BMI 25–30	0.213	0.321	1.000	No
BMI category within age > 30
BMI > 30 vs. BMI < 25	3.280	4.320	.001	Yes
BMI > 30 vs. BMI 25–30	1.973	3.244	.005	Yes
BMI 25–30 vs. BMI < 25	1.307	1.922	.172	No

Table 14. Bonferroni t test comparisons of left ovarian volume and BMI and age.

Comparison	Diff of Means	t	p	p < .050
BMI category
BMI > 30 vs. BMI < 25	3.155	6.180	.001	Yes
BMI > 30 vs. BMI 25–30	2.778	6.152	.001	Yes
BMI 25–30 vs. BMI < 25	0.378	0.982	.985	No
Age category
Age > 30 vs. age < 30	0.0160	0.0435	.965	No
Age category within BMI < 25
Age > 30 vs. age < 30	0.365	0.571	.569	No
Age category within BMI 25–30
Age > 30 vs. age < 30	0.798	1.870	.064	No
Age category within BMI > 30
Age > 30 vs. age < 30	1.211	1.522	.131	No
BMI category within age < 30
BMI > 30 vs. BMI 25–30	3.782	4.995	.001	Yes
BMI > 30 vs. BMI < 25	3.943	4.835	.001	Yes
BMI < 25 vs. BMI 25–30	0.161	0.300	1.000	No
BMI category within age > 30
BMI > 30 vs. BMI < 25	2.367	3.852	.001	Yes
BMI > 30 vs. BMI 25–30	1.773	3.603	.001	Yes
BMI 25–30 vs. BMI < 25	0.594	1.079	.849	No