Emel ÖZALP, Deniz ERBAŞ, İlknur Alkan KUŞABBİ, Türkan Dikici AKTAŞ, Burcu Gündoğdu ÖZTÜRK, İnci KAHYAOĞLU
The European Research Journal - 2026;12(8):898-911
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.
