Antral follicle count is reduced in the presence of endometriosis: a systematic review and meta-analysis. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Tian, Zhao; Zhang, Yang; Zhang, Chen; Wang, Yue; Zhu, Hong-Lan
• Is Part Of: Reproductive biomedicine online. Volume 42:Issue 1(2021)
• Page Start: 237
• Page End: 247
• Publication Date: 2021-01
• Subjects: Antral follicle count -- Endometriosis -- Meta-analysis -- Ovarian reserve; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2020.09.014
• Languages: English
• ISSNs: 1472-6483

Abstract

Highlights: Ovarian reserve test is important in the clinical application of reproduction. AFC has been recognized for many years as a reliable indicator of ovarian reserve. Endometriosis itself, and surgery, can affect ovarian reserve as measured by AMH. Current research remains controversial on whether endometriosis will affect AFC. Abstract: Studies suggest that the presence of endometriosis may lead to impaired ovarian reserve, while results evaluating the changes in antral follicle count (AFC) in endometriosis remain controversial. A systematic search returned 15 studies, of which nine compared AFC between patients with and without endometriosis, five articles reported differences in AFC between affected and unaffected ovaries in patients with unilateral ovarian endometriosis and one reported both of the above two situations. Overall results showed a significant decrease in AFC and anti-Müllerian hormone (AMH) and increase in serum FSH concentrations in patients with endometriosis when compared with controls. Additionally, the AFC for the ovary with the endometrioma was also significantly lower than that of the contralateral ovary in patients with unilateral ovarian endometriosis. Moreover, it appears that the AFC in patients with endometriosis where the ovaries are not affected or in early stage were not significantly different in the control group. These findings demonstrate that endometriosis is associated with reduced AFC and AMH and elevated serum concentrations of FSH, suggesting a reduction in ovarian reserve in patients with endometriosis, especially in those with ovarian endometrioma and advanced stage.