الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The term ‘ovarian reserve’ refers to the remaining endowment of resting and primary ovarian follicles and is used to define the quantity and quality of follicles present in the ovaries at a given time.
Women who want to become mothers, but whose reproductive future is uncertain for reasons ranging from benign to oncologic causes (e.g. chemotherapy, radiation therapy) to postponement of fertility for social or intentional reasons, require a reliable and predictable evaluation of their ovarian reserve.
Thus, a test for the evaluation of ovarian reserve would be ideal if it permitted to infer the size and quality of the follicle pool remaining in the ovaries after a normal menstrual cycle and therefore to identify candidates for ART with a lower chance of obtaining a pregnancy, even after repeated attempts.
The aim of this study was to evaluate different hormonal markers (FSH and Inhibin-B) and different ultrasound parameters (Ovarian volume and Antral follicle count) as predictors of ovarian reserve, ovarian response to gonadotropin ovarian stimulation and occurance of pregnancy or not as regard:
1- Final E2.
2- Number of retrieved ova.
3- Number of fertilized ova.
4- Number of good embryos.
All women included in the study (n=50) were aged between 25-35 years; all were nulliparous, attending the assisted reproduction unit for planning of IVF.
A basal hormonal profile and transvaginal ultrasound were done on day three of the cycle prior to stimulation. With the next cycle, controlled ovarian stimulation for assisted reproduction using long-term protocol GnRH analogue was applied.
After that oocyte retrieval and embryo transfer were scheduled followed by luteral phase support by natural progesterone supplements 100-200 mg/ twice per day for at least two weeks. Biochemical pregnancy was defined as a positive pregnancy test more than 3 days after the expected menses.
The results of this prospective study were tabulated and statistically correlated where it evaluated the role of passive ovarian reserve tests: (AFC, OV, CD3 FSH and CD3 inhibin-B) in prediction of ovarian reserve, ovarian response to gonadotropin ovarian stimulation and occurance of pregnancy or not.
The basal inhibin-B and AFC have more or less similar value in predicting the ovarian reserve and the ovarian response to controlled ovarian stimulation in women undergoing infertility treatment with IVF.
The predictive value of cycle day three inhibin- B and AFC as regards assessment of ovarian reserve is higher compared to ovarian volume or cycle day 3 FSH.
Women with good ovarian response are younger than those with poor ovarian response.
Poor ovarian response is associated with lower cycle day 3 inhibin-B levels, lower antral follicle counts, increased age, lower ovarian volumes, higher cycle day 3 FSH levels, and higher cycle day 3 LH levels (arranged respective to statistical significance).