WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Zinah Abbas Moshana, Zainab Safar Jabur Alkaldi, Manar Kadhim Dahash

ABSTRACT

Ovarian function is a cornerstone of reproductive health, and its early decline carries serious implications for fertility and long-term well-being. This study aimed to evaluate ovarian reserve markers—anti-Müllerian hormone (AMH), inhibin B, follicle-stimulating hormone (FSH), and antral follicle count (AFC)—in young women with different stages of ovarian failure. A cross-sectional comparative design was adopted, including women aged 25–40 years, categorized into control, incipient ovarian failure (IOF), and premature ovarian failure (POF) groups. Serum FSH, AMH, and inhibin B were measured using standardized immunoassays, while AFC was assessed through transvaginal ultrasonography. The findings revealed no significant age differences between the groups, ensuring comparability. However, ovarian reserve parameters showed progressive and statistically significant deterioration. Mean FSH levels increased sharply from 8.46 IU/L in controls to 18.51 IU/L in IOF and 44.48 IU/L in POF (p = 0.0001), reflecting compensatory gonadotropin rise with follicular depletion. Conversely, AMH values declined from 1.92 ng/mL in controls to 1.88 ng/mL in IOF and 0.29 ng/mL in POF (p = 0.0001), confirming its role as a sensitive predictor of diminished reserve. Inhibin B also fell markedly, with controls averaging 133.85 pg/mL compared to 111.27 pg/mL in IOF and 25.14 pg/mL in POF (p = 0.0001), indicating impaired granulosa function. AFC mirrored hormonal findings, decreasing from 13.13 follicles in controls to 4.73 in IOF and 1.40 in POF (p = 0.003). This study highlights the combined clinical value of AMH, inhibin B, and AFC as early and reliable indicators of ovarian failure, while FSH elevation reflects later stages of follicular exhaustion. Early identification of at-risk women using this multimodal approach is vital for timely fertility counseling and preservation strategies.