IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 5 Ver. X (May. 2017), PP 61-65 www.iosrjournals.org DOI: 10.9790/0853-1605106165 www.iosrjournals.org 61 | Page Biochemical Parameters Serving As Prognostic Indicators of Ovarian Reserve in Females with Unexplained Sub-Fertility Shiuli Roy Adak 1 , Chinmoy Ghosh 2 , Santasmita Pal 3 , Santa Saha-Roy 4, Subhasish Dan 5 , Mini Sengupta 6 , Dibakar Haldar 7 1 Associate Professor, Department of Biochemistry, North Bengal Medical College, Darjeeling 2 Assistant Professor, Department of Biochemistry, NRS Medical College, Kolkata 3 Assistant Professor, Department of Biochemistry, Medical College, Kolkata 4 Associate Professor, Department of Biochemistry, BS Medical College, Bankura 5 Assistant Professor, Department of Biochemistry, BS Medical College, Bankura 6 Assistant Professor, Dept. of G & Obstretics, North Bengal Medical College, Darjeeling 7 Associate Professor, Department of Community Medicine, BS Medical College, Bankura Abstract: Ovarian reserve plays a crucial role in achieving pregnancy following any treatment in subfertile women. The estimation of ovarian reserve is routinely performed through various ovarian reserve tests (ORTs) in an effort to predict the response and outcome in couples prior to In Vitro Fertilization (IVF) and counsel them. Most widely used tests are estimation of basal follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH) and antral follicle count (AFC). In our routine practice the role of different biochemical parameters to estimate ovarian reserve of subfertile women is discussed in this article. Keywords: Subfertility, ovarian reserve tests (ORT), anti-mullerian hormone (AMH), leutinizing hormone (LH). I. Introduction Delayed child-bearing, voluntary or involuntary, is a common feature in couples visiting fertility clinics. Majority of the fertility clinics perform ovarian reserve tests (ORTs) as part of the evaluation of women with infertility prior to In Vitro fertilization (IVF). Diminishing ovarian reserve is a phenomenon noted in women during mid to late thirties and at times earlier, reflecting the declining follicular pool and oocyte quality. 1 The age related decline of ovarian reserve is believed to be more than double when follicle numbers fall below a critical figure of 25,000 at ˜ 37.5 years of age. 2 Assuming fixed time differences between reproductive milestones, fertility will not be lost completely for next 4 years, on an average following the onset of this phase. 3 ORTs provide an indirect estimate of a woman’s remaining follicular pool. An ideal ORT should be easy to perform, reproducible and the decisions based on their results should help differentiate women with a normal and poor ovarian reserve. Various factors on which ovarian reserve depend are age, concentration of basal serum Follicle Stimulating Hormone (FSH), Estradiol (E 2 ), AMH, Inhibin B etc. The various tests done are Clomiphene Citrate Challenge Test, FSH & Gonadotropin Releasing Hormone (GnRH) Challenge test, Ultrasonological estimation of ovarian volume and AFC. Ovarian biopsy is also done. The present study was undertaken to identify the various biochemical and other factors which predict the ovarian reserve in women of unexplained subfertility. The factors to be studied are – BMI, AMH, FSH, LH, TSH and their interdependence on each other. General Objective: Assessment of ovarian reserve in women with unexplained subfertility. Specific Objective(S): 1. To find out correlates (BMI and basal FSH, LH, TSH and AMH concentration) of inferlity. 2. To estimate the interrelationship of these factors. 3. To estblish the accuracy of these factors as predictive indicator of infertility II. Materials And Methods A descriptive cross-sectional comparison study was carried out in the Department of Biochemistry, Medical College, Kolkata involving the patients suffering from infertility attending the Out Patient Department (OPD) of Gynecology & Obstetrics of the same medical college during the period of December, 2013 to June, 2014.