Profile of patients with poor ovarian reserve among patients attending fertility clinic at Universitas Academic Hospital, Free State province, South Africa

Abstract

BACKGROUND

Ovarian reserve, follicular pool and oocyte quality decline in women in their mid to late thirties. Screening for poor ovarian reserve and identifying risk factors assist clinicians in counselling infertile women.

OBJECTIVES

To determine the prevalence of poor ovarian reserve and its associated factors among women attending the fertility clinic at Universitas Academic Hospital, Bloemfontein.

 
METHODS

This was a prospective descriptive study conducted from September 2019–September 2020. Consenting females, ≥ 18 years, seeking infertility management were included. An anonymous, self-administered questionnaire was used to collect socio-demographics, chronic illness/previous surgery, gynaecologic and obstetric history, lifestyle habits and risk factors. The antral follicular count (AFC), blood tests for basal follicle-stimulating hormone (FSH), basal oestradiol level, and anti-Müllerian hormone (AMH) were determined.

RESULTS

The study population comprised 72 women with mean age 32.5 years (range 18–41). Most patients were Black (81.9%); 55.6% reported having ever been pregnant; and 45.0% ≥ 35 years. Pain during intercourse (29.2%), treatment for abnormal vaginal discharge (8.3%) and surgery for pelvic inflammatory disease (4.2%) were all uncommon.

Only 4.2% patients had abnormal basal FSH, and 80.6% had abnormal basal oestradiol levels (no statistically significant difference between two age groups). About a third (29.2%) had abnormal AMH while 23.6% had abnormal AFC, both showed a statistically significant difference between the two age groups. No statistically significant differences between race, smoking, alcohol use, gynaeco-obstetrical history and poor ovarian reserve were found between the two age groups.

CONCLUSION

In this study, only age had a statistically significant effect on ovarian reserve.