PROGNOSTIC ASSESSMENT OF OVARIAN RESERVE

Objective: To review the literature regarding dimished ovarian reserve , the screening techniques that are currently available, and their app ropriate application in clinical practice. Data Resources: Directed Me dline searches. Results: Ovarian reserve screening identifies women wi th greatly diminished chances of achieving pregnancy. The screening te chniques include the clomiphene citrate challenge test, basal day 3 FS H measurements, and the GnRH agonist stimulation test. AH have been ev aluated in assisted reproduction programs and the predictive values of an abnormal test for failing to conceive is very high. When abnormal, these tests allow physicians to counsel patients that their prognosis for conception is poor. Although the presence of a normal result does indicate better long-term chances for conception, an age-related decl ine in fecundity remains and patient age should still be considered wh en counseling patients with normal screening results. Clinicians are u rged to validate the threshold values with the assay system used in th eir own laboratory before the application of these tests. Conclusion: The literature consistently demonstrates the value of diminished ovari an reserve screening.