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Diminished ovarian reserve in recurrent pregnancy loss : a systematic review and meta-analysis
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Bunnewell, Sarah J., Honess, Emma R., Karia, Amar M., Keay, Stephen D., Al Wattar, Bassel H. and Quenby, Siobhan (2020) Diminished ovarian reserve in recurrent pregnancy loss : a systematic review and meta-analysis. Fertility and Sterility, 113 (4). pp. 818-827. doi:10.1016/j.fertnstert.2019.11.014
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WRAP-diminished-ovarian-reserve-recurrent-pregnancy-loss-Al Wattar-2019.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (845Kb) | Preview |
Official URL: https://doi.org/10.1016/j.fertnstert.2019.11.014
Abstract
Objective
To evaluate the association between diminished ovarian reserve (DOR) in women at risk of recurrent pregnancy loss (RPL) using ovarian reserve tests.
Design
Systematic review and meta-analysis.
Setting
University medical schools.
Patient(s)
Women with a history of RPL.
Intervention(s)
Systematic reviews of major electronic databases (MEDLINE, EMBASE, Web of Science, and Scopus) for studies that evaluated the incidence of DOR in women with RPL.
Main Outcome Measure(s)
Association between RPL and DOR.
Result(s)
In studies up to May 2019 we assessed quality using the Newcastle-Ottawa Scale and meta-analyzed data using a random-effect model. We included 15 studies (n = 3,082 women) reporting on six ovarian reserve tests: antimüllerian hormone [AMH], antral follicle count, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and FSH:LH ratio. More women with RPL seemed to have DOR compared with women who did not have RPL as measured by low AMH levels (odds ratio [OR] 2.77; 95% confidence interval [CI], 1.41–5.46) and AFC (OR 2.45; 95% CI, 1.16–5.19). Women with unexplained RPL also seemed to have a higher association with DOR compared with women whose RPL had a known etiology, as measured by low AMH levels (OR 3.23; 95% CI, 1.81–5.76). No statistically significant differences were found in the levels of any of the remaining ovarian reserve tests between those groups of women.
Conclusion(s)
There is an apparent association between DOR and RPL. Low AMH and AFC levels could predict higher odds for pregnancy loss, but more studies are needed to evaluate their prognostic value in the management of women with RPL.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Cell & Developmental Biology Faculty of Medicine > Warwick Medical School > Biomedical Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Fetal death, Reproductive health, Ovaries -- Physiology, Polycystic ovary syndrome, Miscarriage | ||||||||
| Journal or Publication Title: | Fertility and Sterility | ||||||||
| Publisher: | Elsevier Inc. | ||||||||
| ISSN: | 0015-0282 | ||||||||
| Official Date: | April 2020 | ||||||||
| Dates: |
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| Volume: | 113 | ||||||||
| Number: | 4 | ||||||||
| Page Range: | pp. 818-827 | ||||||||
| DOI: | 10.1016/j.fertnstert.2019.11.014 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
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