Integrative Profiling of the Ovarian Reserve Using Ultrasound and MRI Data by Comparative Analysis: A Systematic Review.

Abstract

Background: Ovarian reserve reflects the functional capacity of a woman's ovaries, encompassing factors such as follicle quantity, egg quality, and fertilization potential. Assessment of ovarian reserve is essential in reproductive medicine, particularly for fertility evaluation and assisted reproductive technologies (ART). While traditional biochemical markers such as anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) are commonly used, instrumental diagnostic methods like ultrasound and magnetic resonance imaging (MRI) provide valuable morphological and functional insights. This systematic review without a comprehensive meta-analysis evaluates the role of ultrasound and MRI in assessing ovarian reserve and their potential applications in clinical and research settings.

Methods: A comprehensive literature search was conducted across multiple databases to identify relevant studies evaluating ovarian reserve using ultrasound and MRI. Studies were screened based on predefined inclusion criteria, focusing on imaging parameters such as ovarian volume, follicular count, stromal characteristics, and vascularization. The effectiveness of these imaging techniques was analyzed in comparison to established biochemical markers. Due to heterogeneity in the included studies, a systematic review was performed without a formal meta-analysis.

Results: Ultrasound, particularly transvaginal ultrasound (TVUS), remains the gold standard for ovarian reserve assessment, allowing real-time visualization of antral follicle count (AFC), ovarian volume, and follicular morphology. Doppler ultrasound provides additional insights into ovarian blood flow, which correlates with follicular development and ovarian function. MRI offers high-resolution, three-dimensional imaging, enabling detailed assessment of ovarian structure, follicular density, and stromal composition. While MRI provides superior soft-tissue contrast, its role in routine ovarian reserve assessment is limited due to cost and accessibility. The findings indicate that although both modalities are valuable for ovarian reserve evaluation, there is no consensus on standardized imaging parameters for defining ovarian functional viability. The available literature also presents inconsistencies in the correlation between imaging findings and ovarian function.

Conclusion: Ultrasound and MRI are essential tools for assessing ovarian reserve, providing complementary morphological and functional data. However, the lack of standardized imaging parameters limits their ability to definitively determine ovarian functional viability. Further research is needed to establish validated diagnostic criteria and integrate imaging techniques with biochemical markers to enhance the accuracy of ovarian reserve assessment in clinical practice and reproductive research.