REDUCTION OF OVARIAN RESERVE IN PATIENTS WITH INFERTILITY IN THE ALTAI REPUBLIC

The Altai Republic has 111,552 female population, of which 51,313 are of reproductive age. At the beginning of 2025, 266 women were under dispensary supervision with a diagnosis of ‘female infertility’, the frequency of which has increased by 25.5% over the past five years. Objective. To study the ovarian reserve and identify the effectiveness of IVF programs in women – residents of the Altai Republic with endocrine infertility, taking into account the place of residence. Materials and Methods. The study included 800 patients with endocrine infertility who were referred to assisted reproductive technology (ART) programs over a 5-year period (2021–2025), of which 17.1% had low levels of AMH. To analyze the ovarian reserve index (AMH level) and the effectiveness of IVF programs, women were divided into groups based on their place of residence (city/village) and the age of the procedure. Results. In a comparative analysis over the past 5 years, there has been a decrease in the number of city dwellers who undergo IVF with low AMH levels from 60.0% to 34.4%, and an increase in the number of rural dwellers with low AMH levels from 40.0% to 65.6% (R2 = 0,961) (p < 0.001). During a 5-year period, there was a trend towards a decrease in the number of positive outcomes of IVF programs, from 33.3% in 2021 to 11.5% in 2024, with no positive results in 2025 (n = 17), indicating a continuing decline in reproductive health, including low ovarian reserve. Conclusions. Age, location, and AMH levels are significant predictors of individual ovarian reserve and should be considered when predicting the effectiveness of IVF programs.