Follicular Fluid Anti-Müllerian Hormone and Leptin in Women Undergoing In Vitro Fertilization for Diminished Ovarian Reserve or Unexplained Infertility: A Prospective Observational Study
Objective: Follicular-fluid biomarkers may characterize the peri-oocyte microenvironment, but their incremental value beyond established ovarian-reserve tests is uncertain.
Methods: This prospective observational study included 42 women aged 18–40 years undergoing in vitro fertilization at Ankara Etlik City Hospital, including 21 with diminished ovarian reserve and 21 with unexplained infertility. Follicular-fluid anti-Müllerian hormone was measured by electrochemiluminescence immunoassay and leptin by enzyme-linked immunosorbent assay.
Results: Pregnancy analyses used complete-case data from 22 of 25 women who underwent embryo transfer. Follicular-fluid anti-Müllerian hormone was lower in the diminished ovarian reserve group [1.13 (0.94–1.45) versus 3.40 (2.69–5.93) nanograms per milliliter; P<0.001], whereas leptin was similar (1243.73±340.50 versus 1265.78±233.35 picograms per milliliter; P=0.808). Women with diminished ovarian reserve had fewer retrieved, mature, and fertilized oocytes. Fourteen clinical pregnancies occurred among the 22 transfers with complete follow-up. Serum and follicular-fluid anti-Müllerian hormone and antral follicle count were higher among women with clinical pregnancy, but exploratory penalized regression did not identify anti-Müllerian hormone as an independent predictor. Leptin was not associated with infertility group or clinical pregnancy.
Conclusion: Follicular-fluid anti-Müllerian hormone appears to reflect ovarian-reserve phenotype and granulosa-cell activity rather than provide proven incremental clinical value over serum anti-Müllerian hormone and antral follicle count. Larger follicle-matched studies with live-birth endpoints are required before either marker is used in routine clinical decision-making.
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Article Information
- Article Type Research Article
- Submitted May 13, 2026
- Accepted June 28, 2026
- Published August 1, 2026
- Issue Volume 12 - Issue 8 (August 2026)
- Section Research Article
- Categories
The datasets generated and/or analyzed during the current study are not publicly available due to patient privacy considerations but are available from the corresponding author on reasonable request.
