Blood type correlates with egg reserve in infertile women

1. Chinese women with the type B blood antigen (blood type B or AB) were more likely to have diminished ovarian reserve.

2. Women with type O blood were less likely to have day 3 hormone levels reflective of diminished ovarian reserve compared to women with the type B or AB blood.

Evidence Rating Level: 3 (Average)

Study Rundown: Ovarian reserve, or how many remaining viable eggs a woman has, is a measure of fertility that decreases dramatically with age. The increasing average age of first pregnancy in the United States calls for non-invasive tests of oocyte reserve. One marker of ovarian reserve is Anti-Mullerian Hormone (AMH), a substance produced in the granulose cells of ovarian follicles that decreases as the number of remaining follicles decreases. Another test of ovarian reserve is assessment of day 3 hormones, follicle-stimulating hormone (FSH) and estradiol (E2), which respectively increase and decrease with decreasing ovarian reserve. Some scientists believe that blood type might also provide predictive information on ovarian reserve as blood group proteins are found on many organs in the body, including ovarian surface epithelium. In this Beijing-based study, researchers investigated whether or not ABO blood type was associated with diminished ovarian reserve in a large Chinese population.

Researchers found that types B and AB blood were associated with a greater likelihood of diminished ovarian reserve, while type O blood was associated with a lesser likelihood. These results are inconsistent with prior studies, which failed to identify an association or identified an association in the opposite direction. Strengths include large sample size and ability to control for potential contributors to decreased fertility, such as age, BMI, endometriosis and prior ovarian surgery. As blood type frequency varies with race and ethnicity, one major limitation of this investigation is the homogenous study population consisting entirely of Chinese women. Further, this study was conducted in women seeking infertility treatments, limiting result generalizability to the fertile population. Future studies in a large, more diverse population would better characterize this association and genetic and molecular studies might identify the mechanism behind this association.

Click to read the study in Fertility and Sterility

Relevant Reading: Association of blood type and patient characteristics with ovarian reserve

In-Depth [retrospective cohort study]: Researchers analyzed data from women under 45 who underwent in vitro fertilization and embryo transfer cycles from 2006-2012 at a large university-affiliated medical center in China. The association between ABO blood type and diminished ovarian reserve (DOR), measured by elevated day-3 FSH levels, was assessed.

Of the 35 479 women included in the analysis 11 395 (32.12%) had type B blood, 10 583 (29.83%) had O blood, 9861 (27.79%) had A blood, and 3640 (10.26%) had AB blood. Women with type O blood were less likely to have DOR compared with type B and type AB blood (OR = 0.653, p < 0.001; OR = 0.659, p < 0.001, respectively). Among women with DOR, there was higher odds of women having type B or AB blood compared to type O (OR = 1.531, p < 0.001; OR = 1.517, p<0.001, respectively). There was no association between type A blood and DOR.

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