Effects of environmental, social and surgical factors on ovarian reserve: Implications for age‐relative female fertility
Ying Wang, Yuncang Yuan, Dan Meng, Xiaona Liu, Yucui Gao, Fang Wang, Yuyan Li, Wei He
Abstract
OBJECTIVE: To investigate new risk factors for female fertility by analyzing the effects of environmental, social, and surgical factors on antral follicle counts (AFC) and anti-Müllerian hormone (AMH) levels. METHODS: A total of 1513 women aged 20-47 years who underwent in vitro fertilization/intracytoplasmic injection treatment in Southwest Hospital from December 2017 to December 2019 were included. Women were assessed for AFC and AMH levels, and completed a questionnaire. Ordinal logistic regression analyses with generalized linear mixed models were used to calculate the adjusted odds ratio (OR) for diminished ovarian reserve. RESULTS: Adnexal surgery was the only risk factor associated with low AFC in women aged 20-30 years. Younger age at menarche, alcohol drinking, and adnexal surgery are three independent risk factors for AMH decline in women aged 20-30 years. Intense exercise, sleep quality, and adnexal surgery are three independent risk factors for a low AFC in women aged 31-36 years. Alcohol drinking and adnexal surgery are two independent risk factors for AMH decline in women aged 31-36 years. CONCLUSION: With age, female fertility becomes sensitive to high-intensity exercise and poor sleep quality. Adnexal surgery and alcohol drinking are two important risk factors for female fertility in women under age 37 years.