Biomarkers of Diminished Ovarian Reserve and Fertility Testing: What Do Providers Need to Know?
This activity was developed by Med-IQ in collaboration with Duke Health.
Anne Z. Steiner, MD, MPH
Professor of Obstetrics and Gynecology
Division Chief, Reproductive Endocrinology and Infertility
Duke University School of Medicine
Erin Grothey, MS
Clinical Content Manager
Laura Rafferty, ELS
Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
East Lansing, MI
Stephanie Wenick, MPhil
Wenick Communications, LLC
Chevy Chase, MD
Upon completion, participants should be able to:
- Identify the role of FSH and AMH in assessing reproductive potential in older women with no known infertility based on current evidence
This activity is intended for general obstetricians/gynecologists and primary care physicians who provide testing, care, and/or advice to women of reproductive age.
Statement of Need
Women are increasingly looking to become pregnant and grow their families at an older age. As of 2017, approximately one-third of first pregnancies occurred in women aged 30 years or older. To plan their reproductive future, women rely on medical advice from their providers to help understand their possible infertility risk or the timing of the onset of menopause. Although predicting the rate of an individual’s ovarian reserve decline is challenging, ovarian reserve testing has evolved over the years, and advancements have led to greater specificity and convenience. Fertility testing is common in clinics, and at-home kits are readily available. Biomarkers of diminished ovarian reserve (DOR) are useful for assessing fertility, but they have limitations. For instance, they were validated in women who have known infertility and, therefore, are not informative regarding fecundability in women of unknown fertility. Maternal age remains the best indicator of fecundity, but ovarian reserve testing is informative in reproductive-aged women undergoing evaluation for infertility, as biomarkers of ovarian reserve can serve as proxies of oocyte quantity. In contrast to the current trend in fertility testing, the use of biomarkers of DOR to assess the natural fertility of women in the general population is not supported by current evidence.
This activity was developed by Med-IQ in collaboration with Duke Health.
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Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Medium/Method of Participation
This CME activity consists of a 0.25-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: July 31, 2019
Expiration Date: July 30, 2020
Estimated Time to Complete This Activity: 15 minutes
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The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.
Anne Z. Steiner, MD, MPH, has indicated no real or apparent conflicts.
The writer, peer reviewers, and activity planners have no financial relationships to disclose.
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