RISK FACTORS AND A MULTIFACTORIAL PREDICTIVE MODEL OF DIMINISHED OVARIAN RESERVE IN ADOLESCENT GIRLS AND WOMEN OF REPRODUCTIVE AGE IN OUTPATIENT PRACTICE

Background. Diminished ovarian reserve (DOR) is a leading cause of infertility, with early signs increasingly detected in adolescence. Objective: to assess risk factors and develop a multifactorial predictive model for early detection of DOR in adolescent girls and women of reproductive age in outpatient settings. Materials and methods: a two-stage study: retrospective analysis of 280 outpatient records from five risk groups and a prospective examination of 300 patients assessing hormonal profile and ovarian morphometry (AFC); the model used logistic regression with ROC analysis. Results: the most pronounced decline in AMH and AFC occurred after chemo/radiotherapy and with hereditary predisposition to POI. Independent predictors were FSH ≥10 mIU/mL, AMH <1.2 ng/mL, and AFC ≤5; AUC 0.91 at threshold P ≥0.48 (sensitivity 86%, specificity 83%). Conclusions: combined clinical, hormonal, and ultrasound assessment reliably predicts DOR risk and supports risk stratification in outpatient practice.