Amaç: Over rezervinin değerlendirilmesi, infertilite yönetimi açısından büyük önem taşımaktadır. Bu çalışmada, üç boyutlu power Doppler ultrasonografi ile ölçülen over stromal kan akımı, over hacmi ve serum Anti-Müllerian Hormon (AMH) düzeyleri arasındaki ilişkinin fertil ve infertil kadınlarda değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, yaşları 30-40 arasında olan, 40 fertil ve 40 infertil kadın dahil edilmiştir. Fertil grup, düzenli adet döngüsü ve son bir yıl içinde spontan gebelik öyküsüne sahip kadınlardan; infertil grup ise erkek faktörü dışlanarak infertilite tanısı alan, polikistik over görünümü olmayan kadınlardan oluşmaktadır. Katılımcıların tümünde erken foliküler fazda over hacmi, stromal kan akımı (Vaskülarizasyon İndeksi [VI], Akım İndeksi [AI], Vaskülarizasyon-Akım İndeksi [VAI]), antral folikül sayısı (AFS) ve serum AMH düzeyleri ölçülmüştür. Bulgular: Her iki grupta da yaş ile birlikte AMH düzeylerinde anlamlı azalma saptandı (p<0.01). Aynı yaş grubunda infertil kadınların AFC değerleri fertil kadınlara göre anlamlı olarak düşüktü (p<0.01). Fertil ve infertil gruplarda AMH ile AFC arasında pozitif korelasyon gözlendi (fertil: r=0.476, infertil: r=0.375). Sadece infertil grupta AMH ile over hacmi arasında pozitif korelasyon saptandı (r=0.358, p=0.015). AMH ile Doppler parametreleri arasında anlamlı ilişki bulunmadı. Sonuç: AMH ve AFS, over rezerv değerlendirmesinde en güvenilir göstergelerdir. Üç boyutlu ultrasonografi ile ölçülen over hacmi infertil popülasyonda ek bilgi sağlayabilir; ancak stromal Doppler parametrelerinin prediktif değeri sınırlıdır. Daha büyük örneklem içeren prospektif çalışmalara ihtiyaç vardır.

Objective: Ovarian reserve assessment is crucial for fertility management. Serum Anti-Müllerian hormone (AMH) is widely accepted as a reliable biomarker. This study aimed to evaluate the relationship between ovarian stromal blood flow, ovarian volume (measured by three-dimensional power Doppler ultrasonography), and serum AMH levels in fertile and infertile women. Material and Methods: This retrospective study included 80 women (40 fertile, 40 infertile) aged between 30 and 40 years, categorized into two age subgroups(30–35 and 36–40 years). Fertile participants had regular menstrual cycles,spontaneous conception within the last year, and no polycystic ovarian appearance. Infertile participants were non-polycystic and had infertility unrelated to male factors.Ovarian volumes, stromal blood flow indices (vascularization index [VI], flow index [FI], and vascularization-flow index [VFI]), antral follicle count (AFC), and serum AMH levels were measured during the early follicular phase using three-dimensional power Doppler ultrasound with VOCAL software. Results: AMH levels significantly decreased with age in both fertile (p<0.01) and infertile groups (p<0.01). AFC values were significantly lower in infertile compared to fertile groups within the same age categories (p<0.01). AMH correlated positively with AFC in fertile (r=0.476, p=0.002) and infertile populations (r=0.375, p=0.01). Ovarian volume showed a positive correlation with AMH only in the infertile group (r=0.358, p=0.015). There were no significant correlations between AMH and Doppler indices (VI, FI, VFI) in either group. Conclusions: AMH levels and AFC remain the most reliable markers for assessing ovarian reserve. Three-dimensional ovarian volume may be useful particularly in infertile populations, but ovarian stromal Doppler indices seem less predictive. Prospective studies with larger samples are recommended to confirm these observations.

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