Document Type : Original Article
Authors
Abstract
Keywords
Women are born with a fixed number of follicles
in their ovaries that decline with age culminating
in the menopause at 50-51 years (
A serum FSH level ≥10 mIU/ml is usually considered as a threshold for diminished ovarian reserve (
Five hundred women in the follicular phase of menstrual cycle between 18 and 45 years of age who applied to Infertility Department of Ministry of Health Etlik Zübeyde Hanım Women’s Health Training and Research Hospital between January 2012 and June 2012 were enrolled in this prospective study. The patients were either nulligravid admitted to the hospital for any gynaecologic reason or seeking infertility treatment. The demographic characteristics of the patients were obtained from the history of the patients. Serum FSH (mIU/ml) and estradiol levels (E2, pg/ml) were measured on the third day of the menstrual cycle and blood type (A, B, AB or O) was also determined. FSH ≥10 mIU/ml was accepted as a threshold for diminished ovarian reserve (
In independent groups, the difference between the two groups’ means was evaluated by t test (two tailed). The correlation between qualitative variables was evaluated by chi-square test and extension of Fisher’s exact test. Analysis after adjustment of age was done by multiple logistic regression analysis. Numerical data was presented as mean ± standard deviation (SD). A p value of <0.05 was accepted as statistically significant. Data analysis was performed using a Statistical Package for the Social Sciences (SPSS; SPSS Inc., Chicago, IL, USA) version 16.
The study was approved by the ethics board of the hospital. Informed consent was obtained from all the cases enrolled in the study.
There were 438 women (87.6%) in group I and 62 women (12.4%) in group II. A total of 447 of the 500 patients (89.4%) were seeking infertility treatment. The age of the patients in group I was statistically younger than group II (26.97 ± 5.60 years vs. 29.82 ± 7.69 years; p=0.006). There was no statistically difference between the two groups in terms of body mass indices (BMI), significantly (25.03 ± 4.45 kg/m2 vs. 24.73 ± 4.43 kg/m2; p=0.62). The demographical characteristics of the patients are shown in table 1. There was no statistically significant difference in terms of history of the patients between the two groups (p=0.93) in terms of previous ovarian or uterine surgery, hypothyroidism and other chronic diseases like diabetes mellitus, hypertension, epilepsy, migraine, etc. There was also no statistically significant difference between the two groups in parity, smoking, contraception, infertility, menstrual pattern and history of ovulation induction (p>0.05). The distribution of blood groups was: A (39.8%), B (15.4%), AB (9.4%), and O (35.4%). The distribution of blood types according to ovarian reserve is shown in table 2. There was no statistically significant difference among the two groups in terms of blood group proportions, and there was no correlation between ABO blood types and ovarian reserve (p=0.69), this did not change after age adjustment (p=0.77). Also, the blood type A (p=0.36) (p=0.58 after adjustment of age), the presence of A antigen (in A and AB blood type) (p=0.69) (p=0.91 after adjustment of age), the blood type O (p=0.98) (p=0.70 after adjustment of age), and the blood type B (p=0.56) (p=0.51 after adjustment of age) did not statistically significantly affected ovarian reserve. There was also no statistically significant correlation between rhesus factor and ovarian reserve (p=0.70), and this result persists after adjustment of the age (p=0.83). The only factor that affect ovarian reserve was age of the patients (p=0.006).
The demographical characteristics of the patients
FSH < 10 IU/ml | FSH ≥ 10 IU/ml | P value | |
---|---|---|---|
26.97 ± 5.60 | 29.82 ± 7.69 | <0.05 | |
25.03 ± 4.45 | 24.73 ± 4.43 | >0.05 | |
0.64 ± 0.93 | 0.94 ± 1.42 | <0.05 | |
0.38 ± 0.64 | 0.52 ± 0.78 | >0.05 | |
50.27 ± 45.29 | 49.85 ± 54.48 | >0.05 | |
10 patients | 1 patient | >0.05 | |
37 patients | 7 patients | >0.05 | |
15 patients | 2 patients | >0.05 | |
FSH; Follicle stimulating hormone.
The distribution of blood types according to ovarian reserve
Blood type | FSH <10 IU/ml | FSH ≥10 IU/ml | P value | Total |
---|---|---|---|---|
171 | 28 | 0.58 | 199 | |
69 | 8 | 0.51 | 77 | |
43 | 4 | 0.34 | 47 | |
155 | 22 | 0.70 | 177 | |
214 | 32 | 0.91 | 2.46 | |
396 | 57 | 0.83 | 453 | |
FSH; Follicle stinulating hormone.
According to the distribution of blood types in Turkey, 42.5% of the population have type A, 33.7% have type O, 15.8% have type B, and 8.0% have type AB (
In previous work on a large cohort of women of multiple ethnic groups, it was found that there was a significant difference between races in terms of ovarian reserve since AMH and inhibin B levels were signficantly lower in the African American women (
Our results have shown that, blood groups do not constitute a risk or protective factor for ovarian reserve. Therefore, blood groups should not be taken into account while evaluating ovarian reserve. However, our results are needed to be validated by further studies.
Blood groups do not constitute a risk or protective factor for ovarian reserve. Therefore, blood groups do not have any predictive value in evaluating ovarian reserve.