Evaluation of Ovarian Reserve Based on Hormonal Parameters, Ovarian Volume, and Antral Follicle Count in Women with Type 2 Diabetes Mellitus

Objective: The aim of this study was to evaluate ovarian reserve of women with type 2 diabetes mellitus (T2DM). Methodology: Eighty-nine women with T2DM and 73 healthy controls were enrolled and divided into three age groups [group 1 (20-29 yr), seven diabetics and 18 healthy controls; group 2 (30-39 yr): 35 diabetics and 35 healthy controls; and group 3 (40-49 yr): 47 diabetics and 20 healthy controls]. All participants were subjected to transvaginal ultrasonographic examination on the third day of their menstrual periods for the determination of ovarian volume and total antral follicle count (AFC). Results: A significant difference in mean FSH levels (international units per liter) was observed between women with diabetes and healthy controls in all age groups (group 1, 7.8 +/- 0.9 vs. 5.0 +/- 1.0; group 2, 8.2 +/- 1.1 vs. 7.2 +/- 1.8; group 3, 9.5 +/- 3.2 vs. 6.4 +/- 2.4; P +/- 0.001 for all). Similarly, mean AFC was significantly lower in patients with T2DM than in healthy controls in all age groups (group 1, 21.1 +/- 4.8 vs. 25.0 +/- 9.1; group 2, 10.4 +/- 5.2 vs. 23.0 +/- 9.5; group 3, 6.0 +/- 3.5 vs. 21.7 +/- 2.1; P < 0.001 for all). A statistically significant difference in total ovarian volume was only observed in group 1 (9.7 +/- 3.0 in T2DM patients vs. 6.8 +/- 2.7 in healthy controls; P = 0.002). AFC was found to be negatively correlated with FSH (r = -0.406, P < 0.001), age (r = -0.618, P < 0.001), glycolized hemoglobin (r = -0.505, P < 0.001), and fasting blood glucose (r = -0.687, P < 0.001). Conclusion: In this pioneer study, the first to evaluate ovarian reserve in T2DM patients, we managed to demonstrate lower ovarian reserves in women with diabetes compared with healthy controls. (J Clin Endocrinol Metab 97: 261-269, 2012)