Parental consanguinity and ovarian reserve: A retrospective cohort study


Background: Infertility affects around 10-15% of couples worldwide and is both a social and medical problem. Parental consanguinity is considered to reduce fertility reserve. Consanguineous marriages, especially first cousin marriages, are very common in Oman according to the Oman National Health Survey data.

Objective: This study aimed to determine whether women born to consanguineous parents have reduced ovarian reserve.

Materials and Methods: This cohort study was conducted on 414 women aged ≤ 39, treated for infertility at Sultan Qaboos University hospital and Royal hospital, Muscat, Oman from January 2019-December 2020. Each participant was interviewed and a complete history, including parental consanguinity and physical examination, were recorded. On day 2 of the menstrual cycle, serum concentration of the following was performed: follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, and anti-Müllerian hormone (AMH). AMH was done, if necessary, on other days of the cycle. Antral follicle count (AFC) was done on day 2 and 3 of the menstrual cycle.

Results: Of the 414 women, parental consanguinity was present in 40.2% of couples. In women with low AFC, parental consanguinity was present in 15.3% compared to 13.0% in the non-consanguineous group. About 15% of women with low AMH had consanguineous parents, compared to 20.2% from the non-consanguineous group. High levels of FSH were present in 6.5% and 4.2% of the consanguineous and nonconsanguineous groups, respectively. No significant difference was observed in AFC with reference to body mass index.

Conclusion: The results from this study showed no statistically significant difference in low ovarian reserves (AFC, AMH, and FSH) in women whose parents had a consanguineous marriage.

Key words: Consanguinity, Ovarian reserves, Infertility, Female.

[1] Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani Z, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13: 113–117.

[2] Sun H, Gong T-T, Jiang Y-T, Zhang Sh, Zhao Y-H, Wu QJ. Global, regional, and national prevalence and disabilityadjusted life-years for infertility in 195 countries and territories, 1990-2017: Results from a Global Burden of Disease Study, 2017. Aging (Albany NY) 2019; 11: 10952– 10991.

[3] Zhang L, Shao H, Huo M, Chen J, Tao M, Liu Zh. Prevalence and associated risk factors for anxiety and depression in infertile couples of ART treatment: A cross-sectional study. BMC Psychiatry 2022; 22: 616.

[4] Mazharul Islam M. Consanguineous marriage in Oman: Understanding the community awareness about congenital effects of and attitude towards consanguineous marriage. Ann Hum Biol 2017; 44: 273–286.

[5] Iqbal S, Zakar R, Fischer F, Zakar MZ. Consanguineous marriages and their association with women’s reproductive health and fertility behavior in Pakistan: Secondary data analysis from demographic and health surveys, 1990-2018. BMC Women’s Health 2022; 22: 118.

[6] Al-Ghanim KA. Consanguineous marriage in the Arab societies. J Psychol Clin Psychiatry 2020; 11: 166–168.

[7] Romdhane L, Mezzi N, Hamdi Y, El-Kamah G, Barakat A, Abdelhak S. Consanguinity and inbreeding in health and disease in North African Populations. Annu Rev Genom Hum Genet 2019; 20: 155–179.

[8] Anwar S, Taslem Mourosi J, Arafat Y, Hosen MJ. Genetic and reproductive consequences of consanguineous marriage in Bangladesh. PLoS One 2020; 15: e0241610.

[9] Jaber L, Nashif AS, Diamond G. Consanguinity, fertility and reproductive outcomes: An international review. Med Res Arch 2023; 11: 7.

[10] Hussein WM, El-Gaafary MM, Wassif GO, Wahdan MM, Sos DG, Hakim SA, et al. Correlates and reproductive consequences of consanguinity in six Egyptian governorates. Afr J Reprod Health 2022; 26: 48–56.

[11] Findlay JK, Hutt KJ, Hickey M, Anderson RA. What is the “ovarian reserve”? Fertil Steril 2015; 103: 628–630.

[12] Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: A committee opinion. Fertil Steril 2020; 114: 1151–1157.

[13] Seher T, Thiering E, Al Azemi M, Heinrich J, Schmidt- Weber CB, Kivlahan C, et al. Is parental consanguinity associated with reduced ovarian reserve? Reprod Biomed Online 2015; 31: 427-433.

[14] Iwase A, Nakamura T, Osuka S, Takikawa S, Goto M, Kikkawa F. Anti-Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know? Reprod Med Biol 2016; 15: 127–136.

[15] Moolhuijsen LME, Visser JA. Anti-Mullerian hormone and ovarian reserve: Update on assessing ovarian function. J Clin Endocrinol Metab 2020; 105: 3361–3373.