Ovarian Reserve Markers in Premature Ovarian Insufficiency: Within Different Clinical Stages and Different Etiologies

Frontiers in Endocrinology

Peihao Liu⁴  Xue Jiao⁴  Lijuan Zhao⁴  Yingying Qin⁴  Tingting Meng⁴  Wei Luo⁴  Yiwei Zhai⁴ 

[1] Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China;Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China;National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China;Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China;

关键词: premature ovarian insufficiency (POI);    premature ovarian failure (POF);    ovarian reserve;    clinical staging;    etiology;   

DOI  :  10.3389/fendo.2021.601752

来源: DOAJ

【 摘 要 】

ObjectiveTo characterize the ovarian reserve indicators for premature ovarian insufficiency (POI) at different disease stages and with various etiologies.MethodsAccording to different FSH levels and menstrual conditions, patients with normal ovarian reserve (NOR with 5 IU/L40 IU/L, n=454) were retrospectively screened and their records were abstracted from Reproductive Hospital Affiliated to Shandong University between 2014 and 2019. Based on the known etiologies, POI patients were subdivided into genetic, iatrogenic, autoimmune and idiopathic subsets according to the known etiologies. The phenotypic features were compared within different subgroups, and the predictive value of ovarian reserve markers was analyzed.ResultsThe ovarian reserve indicators consecutively deteriorated with the progress of ovarian insufficiency, indicated as an increase of FSH and LH but decrease of AMH, inhibin B, AFC, E2 and T (P<0.01). Most of them changed significantly from NOR to pre-POI while remained relatively stable at a low level or even undetectable at early POI and POF stage. AMH showed the highest predictive value for pre-POI (AUC 0.932, 95% CI 0.918-0.945) and POI (AUC 0.944, 95% CI 0.933-0.954), and the combination of AMH and AFC was highly promising for early prediction. Additionally, significant differences existed in AMH, inhibin B and AFC among women with different etiologies of POI (P<0.05), and the genetic POI presented the worst hormone status.ConclusionsOur study indicated a high heterogeneity of POI in both endocrine hormones and etiological phenotypes. The quantitative changes and cutoff values of AMH and AFC could provide new insights in the prediction and early diagnosis of POI.

【 授权许可】

Unknown