Combined effects of age and endometriosis on ovarian reserve in women with infertility.

Abstract

To evaluate the combined effects of age and endometriosis on ovarian reserve in women with infertility. We conducted a cross-sectional study using an institutional database. Women with sonographic, laparoscopic, or histologic evidence of endometriosis were defined as the study group and the remaining women served as a control group. We evaluated demographic and clinical characteristics of the groups as a whole and stratified the patients into those aged 35 years or older and those younger than 35 years at the time of ovarian reserve testing. Of a total of 656 women included in the final analysis, 71 women had a diagnosis of endometriosis. When compared with women without endometriosis, the median anti-Müllerian hormone (AMH) and antral follicular count (AFC) values were significantly lower in the group of women with endometriosis-median 2.1ng/ml (interquartile range [IQR] 1.1-3.9) versus 1.2ng/ml (IQR 0.6-2.4; P< 0.001) for AMH and 14 follicles (IQR 8-23) versus 7 follicles (IQR 5-14; P< 0.001) for AFC. When stratified into two age groups the association between a lower AFC and endometriosis remained significant for both age groups whereas the association between a lower AMH and endometriosis was significant only for the group of women aged 35 years oor older. Our study highlights a detrimental effect by endometriosis and an age enhancement effect of endometriosis on ovarian reserve.