Age Group-specific Reference Intervals for the Elecsys Anti-Müllerian Hormone Assay in Healthy Korean Women: a Nationwide Population-based Study

Investigation of the Prevalence of Diminished Ovarian Reserve in Korean Women of Reproductive Age

Diminished ovarian reserve can be assessed biochemically using serum anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) tests. This study aimed to evaluate the prevalence of diminished ovarian reserve in a large population of reproductive-aged women by age and geographic region in Korea using different cutoffs of serum AMH and FSH levels. In 2022, 13,351 women underwent both AMH and FSH tests. The prevalence of diminished ovarian reserve increased markedly with age. Although cutoffs for AMH and FSH levels are different in USA and Korean guidelines, the overall prevalence of diminished ovarian reserve was comparable. The maximum prevalence was 3.8%, 6.0%, 11.0%, 28.6%, 69.3%, and 95.0% in women aged 20-24, 25-29, 30-34, 35-39, 40-44, and 45-49 years, respectively. The overall prevalence and age-adjusted prevalence of diminished ovarian reserve were 37.2% and 38.4%, respectively. Women who had only increased serum FSH without decreased AMH represented 1.1% (by Korean guidelines) and 2.5% (by USA guidelines) of all women. Serum AMH and FSH tests were underutilized on Jeju Island. The results of this study provide basic knowledge about diminished ovarian reserve for use in infertility support programs and the field of maternal aging.