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Cao Y, Zhao X, Dou Z, Gong Z, Wang B, Xia T. The correlation between menstrual characteristics and fertility in women of reproductive age: a systematic review and meta-analysis. Fertil Steril 2024:S0015-0282(24)00547-8. [PMID: 38936536 DOI: 10.1016/j.fertnstert.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/20/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
IMPORTANCE Menstruation serves as an indicator of women's reproductive well-being and plays a pivotal role in their fertility; nevertheless, there remains an ongoing debate regarding the epidemiological evidence linking menstrual characteristics as well as fertility. OBJECTIVE To explore the correlation between menstrual characteristics and fertility in women of reproductive age. DATA SOURCES A comprehensive literature search was conducted using PubMed, Embase, Web of Science, and Cochrane libraries to identify research articles published up until February 9, 2024. STUDY SELECTION AND SYNTHESIS We included all studies in which the relationship between menstrual characteristics and pregnancy rates among women of reproductive age was investigated. We excluded studies involving the administration of oral contraceptives, the application of assisted reproductive technologies, and individuals with a documented history of infertility or partners with a known history of infertility. MAIN OUTCOME MEASURE(S) Clinical pregnancy and miscarriage. RESULT(S) This meta-analysis was composed of nine studies involving a total of 399,966 women, and the evidential quality derived from these studies was deemed to be high with a low risk of bias. Compared with a normal menstrual cycle length (25-32 days), the impact of a short (<25 days) or long (>32 days) menstrual cycle on a woman's pregnancy was relatively insignificant ([odds ratio {OR}, 0.81; 95% confidence interval {CI}, 0.65-1.01; I2, 68%]; [OR, 0.89; 95% CI, 0.75-1.06; I2, 60%], respectively); however, a change in cycle length may increase the risk of miscarriage ([relative risk, 1.87; 95% CI, 1.11-3.15; I2, 0]; [relative risk, 1.66; 95% CI, 1.07, 2.57; I2, 43%], respectively). In comparison to women experiencing menarche at a typical age (12-14 years), those with a late age at menarche (>14 years) exhibited a decreased likelihood of pregnancy (OR, 0.92; 95% CI, 0.91-0.93; I2, 0%); and compared with women experiencing a normal duration of menstrual bleeding (4-7 days), those with a short duration of menstrual bleeding (<4 days) exhibited reduced fertility potential (OR, 0.86; 95% CI, 0.84-0.88; I2, 29%). CONCLUSION(S) Short and long menstrual cycle lengths may elevate women's susceptibility to spontaneous abortion, whereas late age at menarche as well as short duration of menstrual bleeding appear to be linked to diminished fertility among women of reproductive age. CLINICAL TRIAL REGISTRATION PROSPERO CRD42023487458 (9 December 2023).
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Affiliation(s)
- Yingqi Cao
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China
| | - Xiaoli Zhao
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China
| | - Zhen Dou
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China
| | - Zheng Gong
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China
| | - Baojuan Wang
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China
| | - Tian Xia
- Department of Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China.
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Mengelkoch S, Cunningham K, Gassen J, Targonskaya A, Zhaunova L, Salimgaraev R, Hill SE. Longitudinal associations between women's cycle characteristics and sexual motivation using Flo cycle tracking data. Sci Rep 2024; 14:10513. [PMID: 38714675 PMCID: PMC11076276 DOI: 10.1038/s41598-024-60599-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/25/2024] [Indexed: 05/10/2024] Open
Abstract
In the current research, we used data from a sample of 16,327 menstrual cycle tracking app users to examine the association between menstrual cycle characteristics and sexual motivation tracked over 10 months of app use. Guided by past work that finds links between menstrual cycle characteristics related to conception risk and sexual motivation, we found that (a) between-women, shorter (r = - 0.04, p = 0.007), more regular cycles predicted small increases in sexual motivation (r = - 0.04, p = 0.001); (b) within-women, shorter cycles predicted greater sexual motivation that month (r = - 0.04, p < 0.001) and (c) the next month (βs: - 0.10 to - 0.06, ps < 0.001), but (d) changes in sexual motivation did not reliably precede changes in cycle length (βs: - 0.01 to 0.02, ps > 0.15). Within-woman analyses also revealed that (e) shorter cycles were followed by more frequent reports of fatigue (β = - 0.06, p < 0.001), insomnia (β = - 0.03, p < 0.001), and food cravings (β = - 0.04, p < 0.001). Together, results suggest that menstrual cycles characteristics and sexual motivation may covary together in ways that reflect changing investments in reproduction. Small effect sizes and lack of experimental control warrant cautious interpretations of results.
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Affiliation(s)
- Summer Mengelkoch
- Laboratory for Stress Assessment and Research, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095-7076, USA.
| | - Katja Cunningham
- Department of Psychology, Texas Christian University, Fort Worth, TX, 76129, USA
| | - Jeffrey Gassen
- Laboratory for Stress Assessment and Research, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095-7076, USA
| | | | | | | | - Sarah E Hill
- Department of Psychology, Texas Christian University, Fort Worth, TX, 76129, USA
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Cushman RA, Kaps M, Snider AP, Crouse MS, Woodbury BL, Keel BN, McCarthy KL. Relationship of length of the estrous cycle to antral follicle number in crossbred beef heifers. Transl Anim Sci 2024; 8:txae074. [PMID: 38800103 PMCID: PMC11127629 DOI: 10.1093/tas/txae074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Length of the menstrual cycle was positively associated with antral follicle number in women. If this pattern is consistent in cattle, a value-added benefit to using automated activity monitors to determine estrous status could be the ability to predict antral follicle count (AFC). We, therefore, hypothesized that as inter-estrous interval increased ultrasonographic AFC would be greater in crossbred beef heifers. Over 3 yr, crossbred beef heifers (n = 1,394) were fitted with automated activity monitors for 81 d. From days 42 to 46, heifers were submitted for ultrasonographic examination to determine AFC. From days 60 to 81, heifers were visually observed twice daily for 45 min for signs of behavioral estrus. Heifers that had a behavioral estrus that coincided with a sensor-based estrus and had a previous sensor-based estrus between 15 and 26 d earlier were used for the analysis (n = 850). A combination of regression analyses and correlation analyses were applied to understand the association between data collected by sensors and follicle number determined by ultrasonographic examination. Antral follicle count was analyzed using the GLM procedure of SAS with estrous cycle length (15 to 26 d) as a fixed effect. Estrus was more likely to initiate in the early morning hours and peak activity was greater (P < 0.0001) when estrus initiated between 0200 and 0800 hours then when estrus initiated at other times of the day. Antral follicle count did not differ due to length of the estrous cycle (P = 0.87). Thus, length of the estrous cycle obtained from three-axis accelerometers cannot be used to predict follicle number in crossbred beef heifers; however, machine learning approaches that combine multiple features could be used to integrate parameters of activity with other relevant environmental and management data to quantify AFC and improve reproductive management in beef cows.
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Affiliation(s)
- Robert A Cushman
- USDA, ARS, US. Meat Animal Research Center, Clay Center, NE, USA
| | - Martim Kaps
- USDA, ARS, US. Meat Animal Research Center, Clay Center, NE, USA
| | | | - Matthew S Crouse
- USDA, ARS, US. Meat Animal Research Center, Clay Center, NE, USA
| | - Bryan L Woodbury
- USDA, ARS, US. Meat Animal Research Center, Clay Center, NE, USA
| | - Brittney N Keel
- USDA, ARS, US. Meat Animal Research Center, Clay Center, NE, USA
| | - Kacie L McCarthy
- Department of Animal Science, University of Nebraska at Lincoln, Lincoln, NE, USA
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Li J, Deng T, Rao W, Liao H, Wang Y, Guo N, Du Y, Guo Q, Zeng Q, Liu C, Li Y. Phthalate metabolites in urine and follicular fluid in relation to menstrual cycle characteristics in women seeking fertility assistance. ENVIRONMENT INTERNATIONAL 2024; 183:108362. [PMID: 38064925 DOI: 10.1016/j.envint.2023.108362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Phthalates have been shown to disrupt the estrous cycle in animal studies. However, epidemiological research investigating their associations with menstrual cycle characteristics is limited. OBJECTIVE To explore the relationships between phthalate exposure and menstrual cycle characteristics among women seeking fertility assistance. METHODS We determined the levels of eight phthalate metabolites in both follicular fluid (FF) and urine specimens collected from 441 women in the Tongji Reproductive and Environmental (TREE) cohort, using high-performance liquid chromatography and tandem mass spectrometry. Information about menstrual cycle parameters was obtained through a questionnaire. The impacts of individual and joint exposure to phthalates on menstrual cycle characteristics were assessed using multivariable linear regression, Poisson regression, and quantile g-computation approaches. RESULTS After adjusting for relevant covariates, we found that per log10-unit increase in mono(2-ethylhexyl) phthalate (MEHP) level in urine specimens was associated with a decrease of 0.20 days (95 % CI: -0.37, -0.03) in bleeding duration. We also observed that mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) and the sum of di(2-ethylhexyl) phthalate (DEHP) metabolites (∑DEHP) concentrations in FF samples were inversely related to cycle length [β = -1.92 (95 % CI: -3.10, -0.75) and -1.87 (95 % CI: -3.56, -0.19), respectively]. However, we generally observed null associations between phthalate metabolites and irregular cycle, dysmenorrhea, hypomenorrhea, or cycle length variation. Furthermore, we also found that phthalate metabolite mixtures in FF and urine were generally unrelated to menstrual cycle characteristics. CONCLUSION Our findings suggest that some DEHP metabolites in FF and urine are inversely associated with menstrual cycle length and menstrual bleeding duration in women attending a fertility center.
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Affiliation(s)
- Juan Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Taoran Deng
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Wentao Rao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Hongmei Liao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Yi Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Na Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Yaoyao Du
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Qingchun Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, PR China
| | - Chong Liu
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China.
| | - Yufeng Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, Hubei 430030, PR China.
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He Y, Liu L, Yao F, Sun C, Meng M, Lan Y, Yin C, Sun X. Assisted reproductive technology and interactions between serum basal FSH/LH and ovarian sensitivity index. Front Endocrinol (Lausanne) 2023; 14:1086924. [PMID: 37206442 PMCID: PMC10190590 DOI: 10.3389/fendo.2023.1086924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/10/2023] [Indexed: 05/21/2023] Open
Abstract
Objectives This study aimed to investigate whether the FSH (follicle-stimulating hormone)/LH (Luteinizing hormone) ratio correlates with ovarian response in a cross-sectional retrospective study of a population with normal levels of anti-Müllerian hormone (AMH). Methods This was a retrospective cross-sectional study with data obtained from medical records from March 2019 to December 2019 at the reproductive center in the Affiliated Hospital of Southwest Medical University. The Spearmans correlation test evaluated correlations between Ovarian sensitivity index (OSI) and other parameters. The relationship between basal FSH/LH and ovarian response was analyzed using smoothed curve fitting to find the threshold or saturation point for the population with mean AMH level (1.1<AMH<6μg/L). The enrolled cases were divided into two groups according to AMH threshold. Cycle characteristics, cycle information and cycle outcomes were compared. The Mann-Whitney U test was used to compare different parameters between two groups separated by basal FSH/LH in the AMH normal group. Univariate logistic regression analysis and multivariate logistic regression analysis were performed to find the risk factor for OSI. Results A total of 428 patients were included in the study. A significant negative correlation was observed between OSI and age, FSH, basal FSH/LH, Gn total dose, and Gn total days, while a positive correlation was found with AMH, AFC, retrieved oocytes, and MII egg. In patients with AMH <1.1 ug/L, OSI values decreased as basal FSH/LH levels increased, while in patients with 1.1<AMH<6 ug/L, OSI values remained stable with increasing basal FSH/LH levels. Logistic regression analysis identified age, AMH, AFC, and basal FSH/LH as significant independent risk factors for OSI. Conclusions We conclude that increased basal FSH/LH in the AMH normal group reduces the ovarian response to exogenous Gn. Meanwhile, basal FSH/LH of 3.5 was found to be a useful diagnostic threshold for assessing ovarian response in people with normal AMH levels. OSI can be used as an indicator of ovarian response in ART treatment.
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Affiliation(s)
- Yumei He
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ling Liu
- Department of Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fei Yao
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Chenyu Sun
- Department of Thyroid and Breast Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Muzi Meng
- UK Program Site, American University of the Caribbean School of Medicine, Preston, United Kingdom
- Bronxcare Health System, New York City, NY, United States
| | - Yunzhu Lan
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengliang Yin
- Faculty of Medicine, Macau University of Science and Technology, Macau, Macao SAR, China
- *Correspondence: Chengliang Yin, ; Xingyu Sun,
| | - Xingyu Sun
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
- *Correspondence: Chengliang Yin, ; Xingyu Sun,
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Lv JB, Han Y, Wang XY, Yuan LN, Diao JR, Fan YZ, Luo HN. New AMH cutoff values for warning of decreased ovarian response based on MCL characteristics in young women: a retrospective study using a propensity score-matching analysis. BMC Pregnancy Childbirth 2022; 22:962. [PMID: 36564774 PMCID: PMC9789575 DOI: 10.1186/s12884-022-05294-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Menstrual cycle length (MCL) and ovarian response varies widely among women of childbearing age. They are provided with anti-Mu¨llerian hormone (AMH) cutoffs for "normal" and "weakened" ovarian responses, which give an early warning of the onset of decreased ovarian response. METHODS This was a retrospective study in women aged 21 to 35 years with MCLs of 21-35 days receiving in vitro fertilization (IVF) treatment at Center for Reproductive Medicine from October 2018 to October 2021. Intergroup variables were balanced using propensity score matching based on age and BMI, and each case patient (patients with MCLs of 21-25 days) was matched with three control patients (patients with MCLs of 26-35 days). A receiver operating characteristic curve was used to calculate the AMH cutoff values. RESULTS We included 135 patients with MCLs of 21-25 days and 405 matched control patients with MCLs of 26-35 days who received IVF treatment. The case group had significantly fewer retrieved oocytes, lower AMH values and higher initial and total Gonadotropin (Gn) levels during controlled ovarian hyperstimulation than the control group. The ovarian response began to decrease when AMH was < 3.5 ng/ml in the case group and < 2.7 ng/ml in the control group. CONCLUSION In young women with MCLs of 21-35 days, short MCL was negatively correlated with AMH values and the number of oocytes retrieved. In patients with MCLs of 21-25 days and 26-35 days, the AMH cutoff values corresponding to the onset of decreased ovarian response were 3.5 ng/ml and 2.7 ng/ml, respectively.
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Affiliation(s)
- Jia-Bei Lv
- grid.265021.20000 0000 9792 1228Tianjin Medical University, Tianjin, China
| | - Ying Han
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Xin-Yan Wang
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Li-Na Yuan
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Jun-Rong Diao
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Ya-Zhen Fan
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Hai-Ning Luo
- grid.216938.70000 0000 9878 7032Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Afliated Maternity Hospital, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
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Abstract
PURPOSE OF REVIEW The aim of this review is to evaluate biological, life history, environmental, and lifestyle factors and exposures that cause variability in menstrual cycle length (MCL). RECENT FINDINGS Recent literature has detailed a number of factors that influence MCL, with particular emphasis placed on novel environmental exposures, such as air pollution and endocrine disrupting chemicals. SUMMARY MCL varies widely in response to intrinsic and extrinsic inputs and is a useful predictor of reproductive health and fecundability. VIDEO ABSTRACT http://links.lww.com/COE/A28.
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Affiliation(s)
| | - Ariel L. Scalise
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health
- Massachusetts General Hospital Fertility Center, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Younis JS, Iskander R, Fauser BCJM, Izhaki I. Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis. Hum Reprod Update 2021; 26:904-928. [PMID: 32514566 DOI: 10.1093/humupd/dmaa013] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/05/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Regular menstrual cycling during the reproductive years is an indicator of spontaneous ovulation but sometimes falsely perceived as an indicator of preserved fertility. In contrast, menstrual cycle shortening, a physiologic occurrence preceding the menopausal transition, is not usually perceived as an indicator of decreased ovarian reserve in the general population. OBJECTIVE AND RATIONALE The individual decrease in menstrual cycle length (MCL) might represent a sensitive biomarker of diminishing ovarian reserve. The aim of this systematic review and meta-analysis is to examine the possible association between MCL in regularly cycling women (21-35 days) and ovarian reserve tests (ORT), fecundability in natural cycles and IVF outcomes. SEARCH METHODS An electronic database search employing PubMed, Web of Science, Trip, EBSCO, ClinicalTrials.gov and the Cochrane library was performed to identify research articles, only on human, published between January 1978 and August 2019. Search terms were pregnancy OR fertility OR fecundity OR fecundability, anti-Müllerian hormone OR AMH OR antral follicle count OR AFC OR ovarian reserve OR ovarian reserve test, in vitro fertilization OR ART OR assisted reproductive therapy OR assisted reproductive treatment OR assisted reproductive technology OR IVF OR ICSI, menstrual cycle length OR menstrual cycle characteristics. We combined these terms to complete the search. All prospective and retrospective studies exploring an association between MCL and proxies of ovarian reserve were included. The exclusions included studies of PCOS, ovarian failure, oral contraception treatment, prior chemotherapy and/or radiotherapy or ovarian surgery. The Newcastle-Ottawa scale was used to assess the quality of studies that were eligible for meta-analysis. OUTCOMES Eleven studies were eligible for meta-analysis, including 12 031 women. The included studies had a low risk of bias. Short MCL (21-27 days) was associated with lower ORT values as compared to normal (28-31 days), long (32-35 days) and all other (28-35 days) MCL sets. The estimated weighted mean difference (WMD) of AMH level was -1.3 ng/mL (95% CI: -1.75 to -0.86, P < 0.001) between the short and normal MCL sets. The estimated WMD of AFC values was -5.17 (95% CI: -5.96 to -4.37, P < 0.001) between the short and normal MCL sets. The weighted overall odds ratio (OR) of fecundability in natural cycles between women with short versus normal MCL sets was statistically significant (overall OR 0.81; 95% CI 0.72-0.91, P < 0.001). In the IVF setting, fewer oocytes were retrieved in short MCL in comparison to normal, long and all other MCL sets, with an estimated WMD of -1.8 oocytes (95% CI: -2.5 to -1.1, P < 0.001) in the short versus normal MCL sets. The weighted overall OR of clinical pregnancy rate between women with short versus all other MCL sets was statistically significant (overall OR 0.76; 95% CI: 0.60 to 0.96, P = 0.02). Low levels of heterogeneity were found in most meta-analyses of MCL and qualitative ovarian reserve biomarkers, while heterogeneity was high in meta-analyses performed for quantitative measures. WIDER IMPLICATIONS MCL in regularly cycling women is closely related to ovarian reserve biomarkers during the reproductive years. A short MCL, as compared to normal, is significantly associated with lower ORT values, reduced fecundability and inferior IVF outcomes, independent of age. The results imply that short MCL may be a sign of ovarian aging, combining the quantitative and qualitative facets of ovarian reserve. Educational efforts ought to be designed to guide women with short MCL at a young age, who desire children in the future, to seek professional counselling.
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Affiliation(s)
- Johnny S Younis
- Reproductive Medicine, Department of Obstetrics and Gynecology, Baruch-Padeh Medical Center, Poriya 15208, Israel.,Azrieili Faculty of Medicine, Galilee, Bar-Ilan University, Safed, Israel
| | - Rula Iskander
- Reproductive Medicine, Department of Obstetrics and Gynecology, Baruch-Padeh Medical Center, Poriya 15208, Israel
| | - Bart C J M Fauser
- Department of Reproductive Medicine and Gynecology, University of Utrecht and University Medical Center Utrecht, 3508 TC, Utrecht, The Netherlands
| | - Ido Izhaki
- Department of Evolutionary and Environmental Biology, University of Haifa, Haifa 3498838, Israel
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Jacewicz-Święcka M, Wołczyński S, Kowalska I. The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS-A Long-Term Follow-Up Study. J Clin Med 2021; 10:jcm10102101. [PMID: 34068234 PMCID: PMC8153136 DOI: 10.3390/jcm10102101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
The knowledge of polycystic ovary syndrome (PCOS) natural history is limited. Our objective was to assess the effect of aging on clinical, hormonal and sonographic ovarian PCOS features and additionally to identify parameters that impact the course of PCOS. A secondary aim was to supply additional information on the reproductive outcome in women with previously diagnosed PCOS. A longitudinal cohort study with a median follow-up of 120.9 months was conducted, and 31 Caucasian women previously diagnosed with PCOS according to the Rotterdam criteria were re-examined at a median age of 35. Clinical examinations; transvaginal ultrasound scans; and lipid, E-selectin and sex hormone assessments were performed at the beginning and at the end of the follow-up. It was observed that menstrual cycles became regular and sonographic morphology of ovaries was normalized in 55% and 49% of the participants, respectively (all p < 0.05). At the final assessment, 55% of the women no longer met the criteria for PCOS (p < 0.05). The age, follicle-stimulating hormone (FSH) and E-selectin assessed at the baseline were the most important predictors of the PCOS persistence into later years (respectively, OR = 0.84, OR = 0.39, OR = 1.08, all p < 0.05). Ninety-five percent of the patients who had ever been trying to conceive became pregnant a minimum of once. The women with persistent PCOS had worse metabolic and reproductive parameters compared to the women with resolved PCOS. Positive correlations were found between the number of miscarriages and ovarian volume, LH, androstenedione, 17-hydroxyprogesterone and an increase in E-selectin during the follow-up (R = 0.46, R = 0.59, R = 0.54, R = 0.49, R = 0.47, all p < 0.05). In conclusion, progressing from the third to the fourth decade is connected with a reduction in PCOS features, which seems to have a great impact on fertility of women with a previous diagnosis of PCOS. FSH and E-selectin, as determined at the initial PCOS diagnosis, had an impact on the disappearance of the syndrome years after.
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Affiliation(s)
- Małgorzata Jacewicz-Święcka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-089 Białystok, Poland
- Correspondence: or ; Tel.: +48-85-731-8239
| | - Sławomir Wołczyński
- Department of Reproduction and Gynaecological Endocrinology, Medical University of Bialystok, 15-276 Białystok, Poland;
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, 15-089 Białystok, Poland;
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10
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Helfrich-Förster C, Monecke S, Spiousas I, Hovestadt T, Mitesser O, Wehr TA. Women temporarily synchronize their menstrual cycles with the luminance and gravimetric cycles of the Moon. SCIENCE ADVANCES 2021; 7:eabe1358. [PMID: 33571128 PMCID: PMC7840133 DOI: 10.1126/sciadv.abe1358] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/21/2020] [Indexed: 05/03/2023]
Abstract
Many species synchronize reproductive behavior with a particular phase of the lunar cycle to increase reproductive success. In humans, a lunar influence on reproductive behavior remains controversial, although the human menstrual cycle has a period close to that of the lunar cycle. Here, we analyzed long-term menstrual recordings of individual women with distinct methods for biological rhythm analysis. We show that women's menstrual cycles with a period longer than 27 days were intermittently synchronous with the Moon's luminance and/or gravimetric cycles. With age and upon exposure to artificial nocturnal light, menstrual cycles shortened and lost this synchrony. We hypothesize that in ancient times, human reproductive behavior was synchronous with the Moon but that our modern lifestyles have changed reproductive physiology and behavior.
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Affiliation(s)
- C Helfrich-Förster
- Neurobiology and Genetics, Biocenter, Julius-Maximilians University of Würzburg, Germany.
| | - S Monecke
- Institute of Medical Psychology, Ludwig-Maximilians University of Munich, Germany
| | - I Spiousas
- Universidad Nacional de Quilmes, Buenos Aires, Argentina
| | - T Hovestadt
- Theoretical Evolutionary Ecology Group, Biocenter, Department of Animal Ecology and Tropical Biology, Julius-Maximilians University of Würzburg, Germany
| | - O Mitesser
- Field Station Fabrikschleichach, Biocenter, Julius-Maximilians University of Würzburg, Germany
| | - T A Wehr
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
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11
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Siristatidis C, Pouliakis A, Sergentanis TN. Special characteristics, reproductive, and clinical profile of women with unexplained infertility versus other causes of infertility: a comparative study. J Assist Reprod Genet 2020; 37:1923-1930. [PMID: 32504303 DOI: 10.1007/s10815-020-01845-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/28/2020] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To investigate whether women with unexplained infertility (UI) demonstrate different demographic and IVF characteristics compared to those with other causes of infertility. METHODS Data on 245 couples that underwent a total of 413 IVF/ICSI cycles were analyzed (UI 114 cycles, 73 women; anovulation (PCO/PCOS) 83 cycles, 51 women; tubal factor 85 cycles, 47 women; male factor 131 cycles, 74 women). Features of UI were compared versus other infertility groups, after adjustment for multiple comparisons. Generalized least squares (GLS) and random-effects logistic regression analysis were also performed. RESULTS Live birth rates, consisting of the primary outcome, were similar in all compared infertility groups. Compared to male infertility, UI was associated with woman's older age at cycle, lower body mass index (BMI), and higher follicle-stimulating hormone (FSH). Compared to tubal infertility, UI was linked to lower endometrial thickness at oocyte retrieval and lower BMI; compared to anovulatory infertility related to PCO/PCOS, UI was linked to woman's older age, more frequent smoking, and poorer ovarian reserve tests (FSH and antral follicle count). After adjustment for other types of infertility, woman's age, age at menarche, and FSH levels, anovulatory infertility presented with higher odds of clinical pregnancy compared to UI (adjusted OR = 2.13, 95% C: 1.01-4.52). CONCLUSIONS Infertile women with UI undergoing assisted reproduction demonstrate different demographic and clinical characteristics compared to those of other causes of infertility, albeit live birth rates are similar.
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Affiliation(s)
- Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, 1 Rimini Street, Chaidari, 12642, Athens, Greece.
- Assisted Reproducton Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Abraham Pouliakis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, 1 Rimini Street, Chaidari, 12642, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, 80 Vas. Sofias Ave, 11528, Athens, Greece
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12
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The different impact of stimulation duration on oocyte maturation and pregnancy outcome in fresh cycles with GnRH antagonist protocol in poor responders and normal responders. Taiwan J Obstet Gynecol 2020; 58:471-476. [PMID: 31307735 DOI: 10.1016/j.tjog.2019.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To study the impact of stimulation duration on intracytoplasmic sperm injection (ICSI) - embryo transfer (ET) outcome in poor and normal responders during controlled ovarian stimulation using gonadotropin-releasing hormone (GnRH) antagonist protocol. MATERIALS AND METHODS This is a retrospective cohort study. There were 1481 women undergoing ICSI-ET cycles. Women with ovum pick-up number ≤3 were defined as poor responders (n = 235), and those with a number ≥4 were normal responders (n = 1246). RESULTS The mean stimulation duration was shorter in poor responders with pregnancy group as compared with normal responders with pregnancy group (7.8 ± 2.2 vs. 9.2 ± 1.6 days, p < 0.01). Poor responders with a shortest stimulation duration (≤6 days) appeared a higher live birth rate (≤6 days: 33.3%, 7-8 days: 20.0%, 9-10 days: 15.9%, and ≥11 days: 11.1%, p = 0.18). Normal responders with a shortest stimulation duration (≤6 days) appeared a lowest live birth rate (≤6 days: 28.6%, 7-8 days: 35.8%, 9-10 days: 33.6%, and ≥11 days: 29.3%, p = 0.61). Oocyte maturation rate was significantly lower at stimulation durations ≤6 days group (≤6 days: 67%, 7-8 days: 80%, 9-10 days: 85%, and ≥11 days: 87%, p = 0.02) in normal responders. CONCLUSION In ICSI-ET cycles, stimulation duration appears to have different impact on oocyte maturation, clinical pregnancy rates and live birth rates in both poor and normal responders.
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13
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Berglund Scherwitzl E, Lundberg O, Kopp Kallner H, Rowland SP, Holte J, Trussell J, Gemzell Danielsson K, Scherwitzl R. Short- and long-term effect of contraceptive methods on fecundity. EUR J CONTRACEP REPR 2019; 24:260-265. [PMID: 31223036 DOI: 10.1080/13625187.2019.1621999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The aim of the study was to compare the effect of previously used contraceptive methods on women's short- and long-term fecundity. Use of hormonal contraception (HC) was compared with the use of a contraceptive mobile application (app). Methods: This real-life prospective observational study comprised 2874 women who were attempting to become pregnant using the Natural Cycles mobile app to monitor their fertility. The women registered to use the app between August 2014 and June 2016 with the intention of planning a pregnancy and had previously either used the same app to prevent pregnancy or had recently discontinued HC use. We calculated the average time to pregnancy (TTP) for all women who became pregnant during the study and performed Kaplan-Meier life-table analysis to examine the cumulative probabilities of pregnancy for all women in the study. Results: The average TTP was 2.3 (95% confidence interval [CI] 2.1, 2.4) and 3.7 (95% CI 3.4, 3.9) cycles for women who had previously used Natural Cycles and HC, respectively. The time to reach 30% pregnancy probability for women previously on HC was 1.6 (95% CI 1.5, 1.8) times longer than for women previously using Natural Cycles. There was no significant difference in the 13 cycle cumulated pregnancy probability between the two groups. Conclusion: The results show that fertility awareness-based methods of contraception increase short-term pregnancy rates relative to HC, but have no effect on long-term pregnancy rates.
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Affiliation(s)
| | | | - Helena Kopp Kallner
- b Department of Clinical Sciences at Danderyd Hospital , Karolinska Institutet , Stockholm , Sweden.,c Department of Women's and Children's Health , Karolinska Institutet and Karolinska University Hospital , Stockholm , Sweden
| | | | - Jan Holte
- d Carl von Linné Clinic , Uppsala , Sweden.,e Centre for Reproductive Biology in Uppsala , Uppsala , Sweden
| | - James Trussell
- f Office of Population Research , Princeton University , Princeton , NJ , USA
| | - Kristina Gemzell Danielsson
- c Department of Women's and Children's Health , Karolinska Institutet and Karolinska University Hospital , Stockholm , Sweden
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14
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Mecklenburg L, Luetjens CM, Weinbauer GF. Toxicologic Pathology Forum*: Opinion on Sexual Maturity and Fertility Assessment in Long-tailed Macaques ( Macaca fascicularis) in Nonclinical Safety Studies. Toxicol Pathol 2019; 47:444-460. [PMID: 30898082 DOI: 10.1177/0192623319831009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
If nonhuman primates represent the only relevant species for nonclinical safety evaluation of biotechnology-derived products, male and female fertility effects can be assessed in repeat dose toxicity studies given that sexually mature monkeys are used. This opinion piece provides recommendations for determining sexual maturity and when/how fertility assessments should be conducted in the cynomolgus monkey. Male sexual maturity should be proven by presence of sperm in a semen sample, female sexual maturity by at least two consecutive menstrual bleedings. As per regulatory guidance, default parameters for an indirect assessment of fertility in both sexes are reproductive organ weight and histopathology. Beyond default parameters, daily vaginal swabs are recommended for females, and for males, it is recommended to include blood collections (for potential analysis of reproductive hormones), testis volume sonography, and collection of frozen testis samples at necropsy. Only if there is a cause for concern, blood collection for potential reproductive hormone analysis should be conducted in females and semen analysis in males. In principle, adverse reproductive effects can be detected within 4 weeks of test article administration, depending on study design and reproductive end point chosen. Therefore, there are options for addressing reproductive toxicity aspects with studies of less than 3 months dosing duration. *This is an opinion article submitted to the Toxicologic Pathology Forum. It represents the views of the authors. It does not constitute an official position of the Society of Toxicologic Pathology, British Society of Toxicological Pathology, or European Society of Toxicologic Pathology, and the views expressed might not reflect the best practices recommended by these Societies. This article should not be construed to represent the policies, positions, or opinions of their respective organizations, employers, or regulatory agencies.
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15
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Amaral MEB, Ejzenberg D, Wajman DS, Monteleone PAA, Serafini P, Soares JM, Baracat EC. Risk factors for inadequate response to ovarian stimulation in assisted reproduction cycles: systematic review. J Assist Reprod Genet 2019; 36:19-28. [PMID: 30269205 PMCID: PMC6338592 DOI: 10.1007/s10815-018-1324-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Controlled ovarian stimulation is a fundamental part of a successful assisted reproduction treatment, and recognizing patients at risk of a poor response allows the development of targeted research to propose new treatment strategies for this specific group. The objective of this systematic review was to determine risk factors for poor ovarian response (POR) to controlled stimulation in assisted reproduction cycles described in the literature. METHODS The primary databases MEDLINE, Cochrane, LILACS, and SciELO were consulted, using specific terms with a restriction for articles in English or Portuguese published in the last 10 years. RESULTS AND CONCLUSION Our data suggest that environmental endocrine disruptors, tobacco, genetic mutations, endometriomas, ovarian surgery, chemotherapy, and short menstrual cycles are factors that influence stimulation in assisted reproduction cycles. Further studies are necessary for characterizing patients with prior risk factors.
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Affiliation(s)
- Maria Eduarda Bonavides Amaral
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
| | - Dani Ejzenberg
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil.
| | - Denis Schapira Wajman
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
| | - Pedro Augusto Araújo Monteleone
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
| | - Paulo Serafini
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
| | - Jose Maria Soares
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil
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16
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Laisk T, Kukuškina V, Palmer D, Laber S, Chen CY, Ferreira T, Rahmioglu N, Zondervan K, Becker C, Smoller JW, Lippincott M, Salumets A, Granne I, Seminara S, Neale B, Mägi R, Lindgren CM. Large-scale meta-analysis highlights the hypothalamic-pituitary-gonadal axis in the genetic regulation of menstrual cycle length. Hum Mol Genet 2018; 27:4323-4332. [PMID: 30202859 PMCID: PMC6276838 DOI: 10.1093/hmg/ddy317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/17/2018] [Accepted: 09/03/2018] [Indexed: 12/31/2022] Open
Abstract
The normal menstrual cycle requires a delicate interplay between the hypothalamus, pituitary and ovary. Therefore, its length is an important indicator of female reproductive health. Menstrual cycle length has been shown to be partially controlled by genetic factors, especially in the follicle-stimulating hormone beta-subunit (FSHB) locus. A genome-wide association study meta-analysis of menstrual cycle length in 44 871 women of European ancestry confirmed the previously observed association with the FSHB locus and identified four additional novel signals in, or near, the GNRH1, PGR, NR5A2 and INS-IGF2 genes. These findings not only confirm the role of the hypothalamic-pituitary-gonadal axis in the genetic regulation of menstrual cycle length but also highlight potential novel local regulatory mechanisms, such as those mediated by IGF2.
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Affiliation(s)
- Triin Laisk
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Competence Centre on Health Technologies, Tartu, Estonia
| | - Viktorija Kukuškina
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Duncan Palmer
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Samantha Laber
- Big Data Institute, Li Ka Shing Center for Health for Health Information and Discovery, Oxford University, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Chia-Yen Chen
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Boston, Massachusetts, USA
| | - Teresa Ferreira
- Big Data Institute, Li Ka Shing Center for Health for Health Information and Discovery, Oxford University, Oxford, UK
| | - Nilufer Rahmioglu
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Krina Zondervan
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, UK
| | - Christian Becker
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, UK
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Margaret Lippincott
- Harvard Reproductive Sciences Center and Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andres Salumets
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Biomedicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Ingrid Granne
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, UK
| | - Stephanie Seminara
- Harvard Reproductive Sciences Center and Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin Neale
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Cecilia M Lindgren
- Big Data Institute, Li Ka Shing Center for Health for Health Information and Discovery, Oxford University, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Program in Medical and Population Genetics, Broad Institute, Boston, MA, USA
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17
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Sibai H, Elgindy E, Mostafa M. ICSI cycles in women over 40 years: analysis of 3 different ovarian stimulation protocols. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2018.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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18
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Huber HF, Considine MM, Jenkins S, Li C, Nathanielsz PW. Reproductive cycling in adult baboons (Papio species) that were intrauterine growth restricted at birth implies normal fertility but increased psychosocial stress. J Med Primatol 2018; 47:427-429. [PMID: 29956833 PMCID: PMC6342511 DOI: 10.1111/jmp.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 01/29/2023]
Abstract
We investigated menstrual cycles in intrauterine growth restricted (IUGR, 7-10 years, n = 8) and age-matched control (n = 10) baboons. Cycle duration and plasma anti-Mullerian hormone were similar. IUGR spent more days per cycle swollen and had elevated early morning fasted serum cortisol, suggesting normal fertility in the presence of increased psychosocial stress.
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Affiliation(s)
| | | | - Susan Jenkins
- Animal Science, University of Wyoming, Laramie, WY, USA
| | - Cun Li
- Animal Science, University of Wyoming, Laramie, WY, USA
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Peter W Nathanielsz
- Animal Science, University of Wyoming, Laramie, WY, USA
- Texas Biomedical Research Institute, San Antonio, TX, USA
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Merklinger-Gruchala A, Jasienska G, Kapiszewska M. Effect of Air Pollution on Menstrual Cycle Length-A Prognostic Factor of Women's Reproductive Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E816. [PMID: 28726748 PMCID: PMC5551254 DOI: 10.3390/ijerph14070816] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/02/2017] [Accepted: 07/13/2017] [Indexed: 12/22/2022]
Abstract
Air pollution can influence women's reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal). Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM10, SO₂, CO, and NOx) to represent a source-related mixture. PM10 and SO₂ assessed separately negatively affected the length of the luteal phase after standardization (b = -0.02; p = 0.03; b = -0.06; p = 0.02, respectively). Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = -0.32; p = 0.02). These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NOx assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women.
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Affiliation(s)
- Anna Merklinger-Gruchala
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-531 Krakow, Poland.
| | - Maria Kapiszewska
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.
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20
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Shilaih M, Clerck VD, Falco L, Kübler F, Leeners B. Pulse Rate Measurement During Sleep Using Wearable Sensors, and its Correlation with the Menstrual Cycle Phases, A Prospective Observational Study. Sci Rep 2017; 7:1294. [PMID: 28465583 PMCID: PMC5431053 DOI: 10.1038/s41598-017-01433-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 03/29/2017] [Indexed: 12/23/2022] Open
Abstract
An affordable, user-friendly fertility-monitoring tool remains an unmet need. We examine in this study the correlation between pulse rate (PR) and the menstrual phases using wrist-worn PR sensors. 91 healthy, non-pregnant women, between 22-42 years old, were recruited for a prospective-observational clinical trial. Participants measured PR during sleep using wrist-worn bracelets with photoplethysmographic sensors. Ovulation day was estimated with "Clearblue Digital-Ovulation-urine test". Potential behavioral and nutritional confounders were collected daily. 274 ovulatory cycles were recorded from 91 eligible women, with a mean cycle length of 27.3 days (±2.7). We observed a significant increase in PR during the fertile window compared to the menstrual phase (2.1 beat-per-minute, p < 0.01). Moreover, PR during the mid-luteal phase was also significantly elevated compared to the fertile window (1.8 beat-per-minute, p < 0.01), and the menstrual phase (3.8 beat-per-minute, p < 0.01). PR increase in the ovulatory and mid-luteal phase was robust to adjustment for the collected confounders. There is a significant increase of the fertile-window PR (collected during sleep) compared to the menstrual phase. The aforementioned association was robust to the inter- and intra-person variability of menstrual-cycle length, behavioral, and nutritional profiles. Hence, PR monitoring using wearable sensors could be used as one parameter within a multi-parameter fertility awareness-based method.
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Affiliation(s)
- Mohaned Shilaih
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland.
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21
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Vaegter KK, Lakic TG, Olovsson M, Berglund L, Brodin T, Holte J. Which factors are most predictive for live birth after in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) treatments? Analysis of 100 prospectively recorded variables in 8,400 IVF/ICSI single-embryo transfers. Fertil Steril 2017; 107:641-648.e2. [DOI: 10.1016/j.fertnstert.2016.12.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/09/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022]
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Crawford S, Smith RA, Kuwabara SA, Grigorescu V. Risks Factors and Treatment Use Related to Infertility and Impaired Fecundity Among Reproductive-Aged Women. J Womens Health (Larchmt) 2017; 26:500-510. [PMID: 28186831 DOI: 10.1089/jwh.2016.6052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Population-level data on infertility and impaired fecundity are sparse. We explored the use of self-reported information provided by reproductive-aged women participating in the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). MATERIALS AND METHODS Three out of 12 questions on reproductive history, family planning, and infertility that seven states included in the 2013 BRFSS were used for this study. In addition to descriptive statistics, we used multinomial logistic regression to identify factors associated with ever experiencing infertility only, difficulty staying pregnant only, and neither infertility nor difficulty staying pregnant. We also explored the association between healthcare coverage and type of treatment received among women ever experiencing infertility only or difficulty staying pregnant only. RESULTS Compared with women reporting having never experienced either infertility or difficulty staying pregnant, women who reported ever experiencing difficulty staying pregnant only were significantly more likely to report a history of depressive disorders and smoking (adjusted odds ratio [aOR] = 1.69, 95% confidence interval [CI] = 1.07-2.68 and aOR = 1.98, 95% CI = 1.22-3.20, respectively). Women who ever experienced infertility only were also more likely to report a history of depressive disorders (aOR = 2.02, 95% CI = 1.14-3.59), but less likely to report healthcare coverage (aOR = 0.26, 95% CI = 0.14-0.46). Only 18.9% (95% CI = 11.4-29.9) of women who ever experienced difficulty staying pregnant only reported seeking infertility treatment compared with 49.6% (95% CI = 34.9-64.4) of women who ever experienced infertility only. CONCLUSIONS Ongoing public health surveillance systems of state-specific self-reported data, such as BRFSS, provide the opportunity to explore preventable risk factors and treatment use related to infertility and impaired fecundity.
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Affiliation(s)
- Sara Crawford
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Ruben A Smith
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Sachiko A Kuwabara
- 2 Division of Emergency Operations, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Violanda Grigorescu
- 3 Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention , Atlanta, Georgia
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Zhu R, Lee BH, Huang Z, Indran IR, Li J, Shen L, Kramer MS, Yong EL. Antimüllerian hormone, antral follicle count and ovarian volume predict menstrual cycle length in healthy women. Clin Endocrinol (Oxf) 2016; 84:870-7. [PMID: 26608631 DOI: 10.1111/cen.12984] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/20/2015] [Accepted: 11/19/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although menstrual cycle length is one of the main concerns of women and may have important health consequences, little is known about its predictors. The aim of this study was to identify predictors of menstrual cycle length variability in healthy women. DESIGN Prospective cross-sectional study. PATIENTS Two hundred healthy women aged 21-45. MEASUREMENTS A questionnaire was administered to determine lifestyle factors. Ovarian parameters, metabolic parameters, pituitary hormones, sex steroids and antimüllerian hormone (AMH) were measured. RESULTS Women with long (≥35 days) and normal (25-34 days) menstrual cycles had >5-fold and >2-fold higher serum AMH levels, respectively, compared to those with short cycles (<25 days). Menstrual cycle length was associated with age but not lifestyle factors. Only one factor group (AMH, antral follicle count [AFC], ovarian volume, testosterone and LH) was significantly associated with menstrual cycle length. Within this factor group, only the ovarian parameters (AMH, AFC, ovarian volume) predicted menstrual cycle length. Each SD increase in AMH (32·9 pmol/l) and ovarian volume (2·29 cm(3) ) was associated with 2·80-fold (95% CI: 1·67-4·69) and 1·62-fold (95% CI: 1·08-2·43) increased risks, respectively, for longer menstrual cycles. CONCLUSIONS AMH, AFC and ovarian volume are positively associated with menstrual cycle length in healthy women. Our identification of AMH as an independent predictor of menstrual cycle length puts forth a new notion of utilizing menstrual cycle length to predict possible AMH-dependent/-associated outcomes. In addition, this novel relationship may facilitate the interpretation of AMH levels and its clinico-pathological significance across different centres.
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Affiliation(s)
- Ruoyan Zhu
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Bao Hui Lee
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Zhongwei Huang
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Inthrani Raja Indran
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Jun Li
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
| | - Michael S Kramer
- Departments of Pediatrics and Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada
| | - Eu-Leong Yong
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore city, Singapore
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Wesselink AK, Wise LA, Hatch EE, Rothman KJ, Mikkelsen EM, Stanford JB, McKinnon CJ, Mahalingaiah S. Menstrual cycle characteristics and fecundability in a North American preconception cohort. Ann Epidemiol 2016; 26:482-487.e1. [PMID: 27449569 DOI: 10.1016/j.annepidem.2016.05.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/02/2016] [Accepted: 05/22/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to evaluate the association between menstrual cycle characteristics in early life and adulthood and fecundability. METHODS Pregnancy Study Online (PRESTO) is an Internet-based preconception cohort study of pregnancy planners from the United States and Canada. During the preconception period, we enrolled 2189 female pregnancy planners aged 21-45 years who had been attempting conception for ≤6 cycles. Women self-reported menstrual cycle characteristics via an online baseline questionnaire, and pregnancy status was ascertained through bimonthly follow-up questionnaires. Proportional probabilities models were used to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS Compared with usual menstrual cycle lengths of 27-29 days, cycle lengths of <25 (FR = 0.81, 95% CI: 0.54-1.22) and 25-26 days (FR = 0.92, 95% CI: 0.75-1.14) were associated with reduced fecundability. Compared with women who reached menarche at the age of 12-13 years, those who reached menarche at <12 years had reduced fecundability (FR = 0.87, 95% CI: 0.76-0.99). Women whose cycles never regularized after menarche (FR = 0.93, 95% CI: 0.81-1.06) had slightly reduced fecundability compared with women whose cycles regularized within 2 years of menarche. Bleed length and heaviness of bleeding were not appreciably associated with fecundability. CONCLUSIONS Menstrual cycle characteristics, specifically cycle length and age at menarche, may act as markers of fertility potential among pregnancy planners.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Slone Epidemiology Center, Boston University School of Public Health, Boston, MA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; RTI Health Solutions, Research Triangle Park, NC
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
| | - Craig J McKinnon
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Shruthi Mahalingaiah
- Department of Obstetrics & Gynecology, Boston University Medical Center, Boston, MA
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Dixson BJW, Rantala MJ. The Role of Facial and Body Hair Distribution in Women's Judgments of Men's Sexual Attractiveness. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:877-89. [PMID: 26292838 DOI: 10.1007/s10508-015-0588-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 01/27/2015] [Accepted: 04/18/2015] [Indexed: 05/12/2023]
Abstract
Facial and body hair are some of the most visually conspicuous and sexually dimorphic of all men's secondary sexual traits. Both are androgen dependent, requiring the conversion of testosterone into dihydrotestosterone via the enzyme 5α reductase 2 for their expression. While previous studies on the attractiveness of facial and body hair are equivocal, none have accounted as to how natural variation in their distribution may influence male sexual attractiveness. In the present study, we quantified men's facial and body hair distribution as either very light, light, medium, or heavy using natural photographs. We also tested whether women's fertility influenced their preferences for beards and body hair by comparing preferences among heterosexual women grouped according their fertility (high fertility, low fertility, and contraceptive use). Results showed that men with more evenly and continuously distributed facial hair from the lower jaw connecting to the mustache and covering the cheeks were judged as more sexually attractive than individuals with more patchy facial hair. Men with body hair were less attractive than when clean shaven, with the exception of images depicting some hair around the areolae, pectoral region, and the sternum that were significantly more attractive than clean-shaven bodies. However, there was no effect of fertility on women's preferences for men's beard or body hair distribution. These results suggest that the distribution of facial and body hair influences male attractiveness to women, possibly as an indication of masculine development and the synthesis of testosterone into dihydrotestosterone via 5α reductase.
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Affiliation(s)
- Barnaby J W Dixson
- School of Psychology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia.
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Kensington, Sydney, Australia.
| | - Markus J Rantala
- Turku Brain and Mind Center, Section of Department of Biology, University of Turku, Turku, Finland
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Wainman BC, Kesner JS, Martin ID, Meadows JW, Krieg EF, Nieboer E, Tsuji LJ. Menstrual cycle perturbation by organohalogens and elements in the Cree of James Bay, Canada. CHEMOSPHERE 2016; 149:190-201. [PMID: 26855224 PMCID: PMC4827016 DOI: 10.1016/j.chemosphere.2015.12.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 11/23/2015] [Accepted: 12/15/2015] [Indexed: 05/29/2023]
Abstract
Persistent organohalogens (POHs) and metals have been linked to alterations in menstrual cycle function and fertility in humans. The Cree First Nations people living near James Bay in Ontario and Quebec, Canada, have elevated levels of POHs, mercury and lead compared to other Canadians. The present study examines the interrelationships between selected POHs and elements on menstrual cycle function in these Cree women. Menstrual cycle characteristics were derived from structured daily diaries and endocrine measurements from daily urine samples collected during one cycle for 42 women age 19-42. We measured 31 POHs in blood plasma and 18 elements in whole blood, for 31 of the participants. POHs and elements detected in ≥ 70% of the participants were transformed by principal component (PC) analysis to reduce the contaminant exposure data to fewer, uncorrelated PCA variables. Multiple regression analysis revealed that, after adjusting for confounders, PC-3 values showed significant negative association with cycle length, after adjusting for confounders (p = 0.002). PC-3 accounted for 9.2% of the variance and shows positive loadings for cadmium, selenium, and PBDE congeners 47 and 153, and a negative loading for copper. Sensitivity analysis of the model to quantify likely effect sizes showed a range of menstrual cycle length from 25.3 to 28.3 days using the lower and upper 95% confidence limits of mean measured contaminant concentrations to predict cycle length. Our observations support the hypothesis that the menstrual cycle function of these women may be altered by exposure to POHs and elements from their environment.
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Affiliation(s)
- Bruce C Wainman
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada L8S 4K1.
| | - James S Kesner
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Ian D Martin
- Ian Martin Consultants, Elora, ON, Canada N0B 1S0
| | - Juliana W Meadows
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Edward F Krieg
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Evert Nieboer
- Biochemistry & Biomedical Sciences, McMaster University, Hamilton, ON, Canada L8S 4K1; Institute of Community Medicine, University of Tromsø, Norway
| | - Leonard J Tsuji
- Health Studies, The Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada M1C 1A4
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The Bologna criteria for poor ovarian response: a contemporary critical appraisal. J Ovarian Res 2015; 8:76. [PMID: 26577149 PMCID: PMC4650906 DOI: 10.1186/s13048-015-0204-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/05/2015] [Indexed: 01/24/2023] Open
Abstract
Postponement of child bearing and maternal age at first pregnancy are on the rise, contributing considerably to an increase in age-related infertility and the demand for assisted reproductive technologies (ART) treatment. This brings to the infertility clinics many women with low ovarian reserve and poor ovarian response (POR) to conventional stimulation. The Bologna criteria were released to standardize the definition of POR and pave the way for the formulation of evidence-based, efficient modalities of treatment for women undergoing IVF-ET. More than four years have passed since the introduction of these criteria and the debate is still ongoing whether a revision is due. Women with POR comprise several sub-groups with diverse baseline distinctiveness, a major issue that has fueled the discussion. Although antral follicle count (AFC) and anti-Müllerian hormone (AMH), are considered good predictors of ovarian reserve, their threshold values are still not universally standardized. Different definitions for sonographic AFC and diverse assays for AMH are held responsible for this delay in standardization. Adding established risk factors to the criteria will lead to more reliable and reproducible definition of a POR, especially in young women. The original criteria did not address the issue of oocyte quality, and the addition of risk factors may yield specific associations with quality vs. quantity. Patient’s age is the best available criterion, although limited, to predict live-birth and presumably oocyte quality. High scale studies to validate these criteria are still missing while recent evidence raises concern regarding over diagnosis.
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Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Comparing four ovarian reserve markers--associations with ovarian response and live births after assisted reproduction. Acta Obstet Gynecol Scand 2015; 94:1056-63. [PMID: 26184379 DOI: 10.1111/aogs.12710] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/09/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We compared the ability of four different ovarian reserve tests (ORTs) to predict live births per started in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) cycle, and poor and excessive response to controlled ovarian hyperstimulation. MATERIAL AND METHODS This was a cohort study in a private infertility center in collaboration with Uppsala University, comprising 1230 IVF-ICSI cycles in 892 consecutive women between April 2008 and June 2011. Anti-Müllerian hormone (AMH) levels, antral follicle counts (AFC), combinations of basal levels of follicle-stimulating hormone and luteinizing hormone, and menstrual cycle lengths were analyzed for correlation and treatment outcome prediction in age-adjusted statistical models. Stepwise multivariable generalized estimating equation analyses were carried out in a sub-group with complete data on all four ORTs (620 cycles in 443 women). Odds ratios and c-statistics were calculated in the largest available set of data for each significant variable. Primary outcomes were live birth rate per started cycle and poor and excessive ovarian response to controlled ovarian hyper-stimulation (defined by the ovarian sensitivity index). RESULTS All ORTs correlated significantly with each other, with the strongest correlation between AFC and AMH (r = 0.71, p < 0.0001). Univariately, AMH and age equivalently predicted live birth (c-statistic 0.61), and together they provided a significantly better model (c-statistic 0.64). For prediction of poor and excessive response the best model included AMH, AFC and age (c-statistic 0.89). CONCLUSIONS AMH improves the ability to estimate live birth rates after assisted reproduction compared with female age alone. AMH, AFC and age together constituted the best model for prediction of ovarian response.
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Affiliation(s)
- Thomas Brodin
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Carl von Linné Clinic, Uppsala, Sweden
| | | | | | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jan Holte
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Carl von Linné Clinic, Uppsala, Sweden.,Centre for Reproductive Biology in Uppsala (CRU), Uppsala, Sweden
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Gizzo S, Andrisani A, Noventa M, Quaranta M, Esposito F, Armanini D, Gangemi M, Nardelli GB, Litta P, D'Antona D, Ambrosini G. Menstrual cycle length: a surrogate measure of reproductive health capable of improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART. Reprod Biol Endocrinol 2015; 13:28. [PMID: 25884482 PMCID: PMC4396168 DOI: 10.1186/s12958-015-0024-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/31/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Aim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART. METHODS A retrospective-observational-study in Padua' public tertiary level Centre was conducted. A total of 455 normo-ovulatory infertile women scheduled for their first fresh non-donor IVF/ICSI treatment. The mean menstrual cycle length (MCL) during the preceding 6 months was calculated by physicians on the basis of information contained in our electronic database (first day of menstrual cycle collected every month by telephonic communication by single patients). We evaluated the relations between MCL, ovarian response to stimulation protocol, oocytes fertilization ratio, ovarian sensitivity index (OSI) and pregnancy rate in different cohorts of patients according to the class of age and the estimated ovarian reserve. RESULTS In women younger than 35 years, MCL over 31 days may be associated with an increased risk of OHSS and with a good OSI. In women older than 35 years, and particularly than 40 years, MCL shortening may be considered as a marker of ovarian aging and may be associated with poor ovarian response, low OSI and reduced fertilization rate. When AMH serum value is lower than 1.1 ng/ml in patients older than 40 years, MCL may help Clinicians discriminate real from expected poor responders. Considering the pool of normoresponders, MCL was not correlated with pregnancy rate while a positive association was found with patients' age. CONCLUSIONS MCL diary is more predictive than chronological age in estimating ovarian biological age and response to COH and it is more predictive than AMH in discriminating expected from real poor responders. In women older than 35 years MCL shortening may be considered as a marker of ovarian aging while chronological age remains most accurate parameter in predicting pregnancy.
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Affiliation(s)
- Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Alessandra Andrisani
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Marco Noventa
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Michela Quaranta
- Department of Obstetrics and Gynaecology, University of Verona, Piazzale Ludovico Scuro 10 street, 37134, Verona, Italy.
| | - Federica Esposito
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Decio Armanini
- Department of Medicine-Endocrinology, University of Padua, Giustiniani 2 street, 35128, Padua, Italy.
| | - Michele Gangemi
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Giovanni B Nardelli
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Pietro Litta
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Donato D'Antona
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
| | - Guido Ambrosini
- Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy.
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Jacobs MB, Boynton-Jarrett RD, Harville EW. Adverse childhood event experiences, fertility difficulties and menstrual cycle characteristics. J Psychosom Obstet Gynaecol 2015; 36:46-57. [PMID: 25826282 PMCID: PMC4854288 DOI: 10.3109/0167482x.2015.1026892] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Increased childhood adversity may be affect adult fertility, however, the mechanism through which this occurs is unclear. Menstrual cycle abnormalities are predictive of fertility difficulties, and stress influences menstrual cycle characteristics. Here, we assess whether adverse childhood experiences (ACEs) are associated with fertility difficulties and menstrual cycle dysregulation, offering a plausible mechanism for the link between lifetime stress and fertility. METHODS From April 2012 to February 2014, 742 pregnant and non-pregnant women aged 18-45 years residing in southeastern Louisiana provided information on childhood adversity and reproductive history. Associations between ACEs and fertility difficulties and menstrual cycle patterns were evaluated. RESULTS As the number of ACEs increased, risk of fertility difficulties and amenorrhea increased (RR = 1.09, 95% CI 1.05-1.13 and RR = 1.07, 95% CI 1.04-1.10, respectively), while fecundability decreased [fecundability ratio (FR) = 0.97, 95% CI 0.95-1.00]. Compared to women with no adversity, women in the high adversity group were more likely to experience both infertility and amenorrhea (RR = 2.75, 95% CI 1.45-5.21 and RR = 2.54, 95% CI 1.52-4.25, respectively), and reduced fecundability (FR = 0.75, 95% CI 0.56-1.00). Although similar patterns were seen for menstrual cycle irregularity, associations were diminished. Associations did not materially change following adjustment for age, body mass index, race, education, smoking and income. Results are constrained by the self-report nature of the study and the limited generalizability of the study population. DISCUSSION To our knowledge, this is the first study to present evidence of a link between childhood stressors, menstrual cycle disruption and fertility difficulties. The effect of childhood stress on fertility may be mediated through altered functioning of the HPA axis, acting to suppress fertility in response to less than optimal reproductive circumstances.
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Affiliation(s)
- Marni B. Jacobs
- Tulane University School of Public Health and Tropical Medicine, Department of Epidemiology, 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA
| | - Renee D. Boynton-Jarrett
- Boston University School of Medicine, Department of Pediatrics, 88 East Newton Street, BUSM, Vose Hall 3, Boston, MA 02118, USA
| | - Emily W. Harville
- Tulane University School of Public Health and Tropical Medicine, Department of Epidemiology, 1440 Canal Street, Suite 2000, New Orleans, LA 70112, USA
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Sundström Poromaa I, Gingnell M. Menstrual cycle influence on cognitive function and emotion processing-from a reproductive perspective. Front Neurosci 2014; 8:380. [PMID: 25505380 PMCID: PMC4241821 DOI: 10.3389/fnins.2014.00380] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 11/07/2014] [Indexed: 12/17/2022] Open
Abstract
The menstrual cycle has attracted research interest ever since the 1930s. For many researchers the menstrual cycle is an excellent model of ovarian steroid influence on emotion, behavior, and cognition. Over the past years methodological improvements in menstrual cycle studies have been noted, and this review summarizes the findings of methodologically sound menstrual cycle studies in healthy women. Whereas the predominant hypotheses of the cognitive field state that sexually dimorphic cognitive skills that favor men are improved during menstrual cycle phases with low estrogen and that cognitive skills that favor women are improved during cycle phases with increased estrogen and/or progesterone, this review has not found sufficient evidence to support any of these hypotheses. Mental rotation has gained specific interest in this aspect, but a meta-analysis yielded a standardized mean difference in error rate of 1.61 (95% CI -0.35 to 3.57), suggesting, at present, no favor of an early follicular phase improvement in mental rotation performance. Besides the sexually dimorphic cognitive skills, studies exploring menstrual cycle effects on tasks that probe prefrontal cortex function, for instance verbal or spatial working memory, have also been reviewed. While studies thus far are few, results at hand suggest improved performance at times of high estradiol levels. Menstrual cycle studies on emotional processing, on the other hand, tap into the emotional disorders of the luteal phase, and may be of relevance for women with premenstrual disorders. Although evidence at present is limited, it is suggested that emotion recognition, consolidation of emotional memories, and fear extinction is modulated by the menstrual cycle in women. With the use of functional magnetic resonance imaging, several studies report changes in brain reactivity across the menstrual cycle, most notably increased amygdala reactivity in the luteal phase. Thus, to the extent that behavioral changes have been demonstrated over the course of the menstrual cycle, the best evidence suggests that differences in sexually dimorphic tasks are small and difficult to replicate. However, emotion-related changes are more consistently found, and are better associated with progesterone than with estradiol such that high progesterone levels are associated with increased amygdala reactivity and increased emotional memory.
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Affiliation(s)
| | - Malin Gingnell
- Department of Psychology, Uppsala University Uppsala, Sweden
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van de Vijver A, Polyzos N, Van Landuyt L, De Vos M, Camus M, Stoop D, Tournaye H, Blockeel C. Cryopreserved embryo transfer in an artificial cycle: is GnRH agonist down-regulation necessary? Reprod Biomed Online 2014; 29:588-94. [DOI: 10.1016/j.rbmo.2014.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/11/2014] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
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Vassena R, Vidal R, Coll O, Vernaeve V. Menstrual cycle length in reproductive age women is an indicator of oocyte quality and a candidate marker of ovarian reserve. Eur J Obstet Gynecol Reprod Biol 2014; 177:130-4. [DOI: 10.1016/j.ejogrb.2014.03.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 03/07/2014] [Accepted: 03/31/2014] [Indexed: 11/16/2022]
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Fehring RJ, Mu Q. Cohort efficacy study of natural family planning among perimenopause age women. J Obstet Gynecol Neonatal Nurs 2014; 43:351-8. [PMID: 24754305 DOI: 10.1111/1552-6909.12307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the efficacy of using natural family planning (NFP) methods to avoid unintended pregnancy among women of perimenopause age (i.e., age 40-55 years). DESIGN A secondary analysis of subset data from two prospective observational cohort studies. SETTING A university based in-person and online NFP service program. PARTICIPANTS One hundred and sixty couples who used either a website or an in-person NFP service to learn how to avoid pregnancy from January 2001 to November 2012. METHODS A prospective 12-month effectiveness study among 160 women (between ages 40-55) who used NFP to avoid pregnancy. The women used either a hormonal fertility monitor, cervical mucus monitoring, or both to estimate the fertile phase of their menstrual cycles. Survival analysis was used to determine the pregnancy rate over 12 months of use. RESULTS There were a total of five unintended pregnancies among the participants. The typical use pregnancy rate was six per 100 women over 12 months. The monitor alone participants (n = 35) had a 12-month pregnancy rate of three, the participants (n = 73) who used mucus alone had a pregnancy rate of four, and the participants (n = 42) who used the fertility monitor plus mucus had a pregnancy rate of six. CONCLUSION Natural family planning methods can be effective for older women to avoid an unintended pregnancy with correct use and adequate instructions. The pregnancy rate most likely was affected by diminished fertility and motivation to limit family size.
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Huber M, Hadziosmanovic N, Berglund L, Holte J. Using the ovarian sensitivity index to define poor, normal, and high response after controlled ovarian hyperstimulation in the long gonadotropin-releasing hormone-agonist protocol: suggestions for a new principle to solve an old problem. Fertil Steril 2013; 100:1270-6. [DOI: 10.1016/j.fertnstert.2013.06.049] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/26/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
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Bussiere JL, Moffat G, Zhou L, Tarlo KS. Assessment of menstrual cycle length in cynomolgus monkeys as a female fertility endpoint of a biopharmaceutical in a 6month toxicity study. Regul Toxicol Pharmacol 2013; 66:269-78. [DOI: 10.1016/j.yrtph.2013.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/03/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
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Murto T, Bjuresten K, Landgren BM, Stavreus-Evers A. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility. Reprod Biol Endocrinol 2013; 11:61. [PMID: 23844631 PMCID: PMC3711921 DOI: 10.1186/1477-7827-11-61] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 07/04/2013] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Infertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth. METHODS In this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases of an arbitrary menstrual cycle. Serum concentrations of FSH, LH, AMH, inhibin B, estradiol, progesterone, PRL and TSH were determined. The predictive value of ovulation and hormonal analysis was determined by identifying the proportion of women with at least one live birth. Mann Whitney U test, chi2 test and Spearman's correlation were used for statistical analysis. A value of p < 0.05 was considered statistically significant. RESULTS There were no differences in hormone values and live birth rates between women with unexplained infertility and male infertility. The best sole predictors of live birth were age of the women, followed by ovulatory cycle, defined as serum progesterone concentration of greater than or equal to 32 nmol/L, and a serum TSH concentration of less than or equal to 2.5 mIU/L. Combining the age with the ovulatory cycle and serum TSH less than or equal to 2.5 mIU/L or serum AMH greater than or equal to 10 pmol/L the predictive value was close to 90%. CONCLUSIONS Age in combination with the presence of an ovulatory cycle and serum TSH or serum AMH is predictive for long-term live birth. The advantage of serum AMH compared with serum TSH is the very little variation throughout the menstrual cycle, which makes it a useful tool in infertility diagnosis.
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Affiliation(s)
- Tiina Murto
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Kerstin Bjuresten
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Britt-Marie Landgren
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
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Qiao J, Wang ZB, Feng HL, Miao YL, Wang Q, Yu Y, Wei YC, Yan J, Wang WH, Shen W, Sun SC, Schatten H, Sun QY. The root of reduced fertility in aged women and possible therapentic options: current status and future perspects. Mol Aspects Med 2013; 38:54-85. [PMID: 23796757 DOI: 10.1016/j.mam.2013.06.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 06/06/2013] [Indexed: 12/21/2022]
Abstract
It is well known that maternal ageing not only causes increased spontaneous abortion and reduced fertility, but it is also a high genetic disease risk. Although assisted reproductive technologies (ARTs) have been widely used to treat infertility, the overall success is still low. The main reasons for age-related changes include reduced follicle number, compromised oocyte quality especially aneuploidy, altered reproductive endocrinology, and increased reproductive tract defect. Various approaches for improving or treating infertility in aged women including controlled ovarian hyperstimulation with intrauterine insemination (IUI), IVF/ICSI-ET, ovarian reserve testing, preimplantation genetic diagnosis and screening (PGD/PGS), oocyte selection and donation, oocyte and ovary tissue cryopreservation before ageing, miscarriage prevention, and caloric restriction are summarized in this review. Future potential reproductive techniques for infertile older women including oocyte and zygote micromanipulations, derivation of oocytes from germ stem cells, ES cells, and iPS cells, as well as through bone marrow transplantation are discussed.
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Affiliation(s)
- Jie Qiao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Zhen-Bo Wang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Huai-Liang Feng
- Department of Laboratory Medicine, and Obstetrics and Gynecology, New York Hospital Queens, Weill Medical College of Cornell University, New York, NY, USA
| | - Yi-Liang Miao
- Reproductive Medicine Group, Laboratory of Reproductive and Developmental Toxicology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Qiang Wang
- Department of Obstetrics and Gynecology, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO 63110, USA
| | - Yang Yu
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Yan-Chang Wei
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Jie Yan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Wei-Hua Wang
- Houston Fertility Institute, Tomball Regional Hospital, Tomball, TX 77375, USA
| | - Wei Shen
- Laboratory of Germ Cell Biology, Department of Animal Science, Qingdao Agricultural University, Qingdao 266109, People's Republic of China
| | - Shao-Chen Sun
- Department of Animal Science, Nanjing Agricultural University, Nanjing 210095, People's Republic of China
| | - Heide Schatten
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
| | - Qing-Yuan Sun
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China.
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Holte J, Brodin T. High levels of anti-Müllerian hormone: what does this mean for IVF treatment? Expert Rev Endocrinol Metab 2013; 8:209-211. [PMID: 30780814 DOI: 10.1586/eem.13.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jan Holte
- a Carl von Linné Clinic, Uppsala Science Park, Uppsala S-751 83, Sweden and Department of Women's and Children's Health, Uppsala University, Akademiskasjukhuset, Uppsala S-751 85, Sweden and Centre for Reproductive Biology in Uppsala (CRU), PO Box 7054, Uppsala S-750 07, Sweden.
| | - Thomas Brodin
- b Carl von Linné Clinic, Uppsala Science Park, Uppsala S-751 83, Sweden and Department of Women's and Children's Health, Uppsala University, Akademiskasjukhuset, Uppsala S-751 85, Sweden and Centre for Reproductive Biology in Uppsala (CRU), PO Box 7054, Uppsala S-750 07, Sweden
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Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Antimüllerian hormone levels are strongly associated with live-birth rates after assisted reproduction. J Clin Endocrinol Metab 2013; 98:1107-14. [PMID: 23408576 DOI: 10.1210/jc.2012-3676] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Previous studies have suggested that antimüllerian hormone (AMH) levels are positively associated with in vitro fertilization (IVF) outcome through their relationship with oocyte yield and not by reflecting oocyte or embryo quality. OBJECTIVE The aim was to investigate whether AMH levels are associated with pregnancy and live-birth rates and whether the results may also reflect qualitative aspects of oocytes and embryos. DESIGN The study was a prospective cohort study between April 2008 and June 2011. SETTING The study was done at a university-affiliated private infertility center. PATIENTS The study cohort consisted of 892 consecutive women undergoing 1230 IVF-intracytoplasmic sperm injection cycles. INTERVENTION(S) AMH levels, analyzed using the DSL ELISA kit, were statistically adjusted for repeated treatments and age and analyzed for associations with treatment outcome. MAIN OUTCOME MEASURES Pregnancy rates, live-birth rates, and stimulation outcome parameters were measured. RESULTS AMH was log-normally distributed with a mean (SD) of 2.3 (2.5) ng/mL. Live-birth rates per started cycle (mean [95% confidence interval]) increased log-linearly from 10.7% [7.2-14.1] for AMH < 0.84 ng/mL (25th percentile) to 30.8% [25.7-36.0] for AMH > 2.94 ng/mL (75th percentile), Ptrend < .0001, being superior in women with polycystic ovaries. These findings were significant also after adjustments were made for age and oocyte yield. AMH was also associated with ovarian response variables and embryo scores. CONCLUSIONS AMH is strongly associated with live-birth rates after IVF-intracytoplasmic sperm injection. AMH may therefore serve as a prognostic factor for the chance of a pregnancy and live birth. Treatment outcome was superior in patients with polycystic ovaries. The findings also indicate that AMH may partially comprise information about oocyte quality.
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Affiliation(s)
- Thomas Brodin
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Dixson BJ, Tam JC, Awasthy M. Do women’s preferences for men’s facial hair change with reproductive status? Behav Ecol 2012. [DOI: 10.1093/beheco/ars211] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Ramalho de Carvalho B, Gomes Sobrinho DB, Vieira ADD, Resende MPS, Barbosa ACP, Silva AA, Nakagava HM. Ovarian reserve assessment for infertility investigation. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:576385. [PMID: 22474591 PMCID: PMC3302183 DOI: 10.5402/2012/576385] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 11/30/2011] [Indexed: 11/23/2022]
Abstract
The current trends to postpone motherhood and the increase in demand for assistance in reproductive medicine highlight the need for seeking guidelines for the establishment of individualized treatment protocols. Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, but they may occupy important place in initial counseling, predicting unsatisfactory results that could be improved by individualized induction schemes and reducing excessive psychological and financial burdens, and adverse effects. In this paper, we revise the role of hormonal basal and dynamic tests, as well as ultrasonographic markers, as ovarian reserve markers, in order to provide embasement for propaedeutic strategies and their interpretation in order to have reproductive success.
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Affiliation(s)
- Bruno Ramalho de Carvalho
- GENESIS-Centre for Assistance in Human Reproduction, SHLS 716, Bloco "L", Salas "L" 328/331, Centro Clínico Sul, Ala Leste, 70.390 Brasília, DF, Brazil
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Baerwald AR, Adams GP, Pierson RA. Ovarian antral folliculogenesis during the human menstrual cycle: a review. Hum Reprod Update 2011; 18:73-91. [DOI: 10.1093/humupd/dmr039] [Citation(s) in RCA: 282] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Brown ZA, Louwers YV, Fong SL, Valkenburg O, Birnie E, de Jong FH, Fauser BC, Laven JS. The phenotype of polycystic ovary syndrome ameliorates with aging. Fertil Steril 2011; 96:1259-65. [DOI: 10.1016/j.fertnstert.2011.09.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 08/29/2011] [Accepted: 09/01/2011] [Indexed: 12/16/2022]
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Holte J, Brodin T, Berglund L, Hadziosmanovic N, Olovsson M, Bergh T. Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries. Fertil Steril 2011; 96:594-9. [DOI: 10.1016/j.fertnstert.2011.06.071] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 06/07/2011] [Accepted: 06/27/2011] [Indexed: 11/26/2022]
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Bongioanni F, Revelli A, Gennarelli G, Guidetti D, Delle Piane LD, Holte J. Ovarian endometriomas and IVF: a retrospective case-control study. Reprod Biol Endocrinol 2011; 9:81. [PMID: 21679474 PMCID: PMC3136410 DOI: 10.1186/1477-7827-9-81] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 06/17/2011] [Indexed: 11/10/2022] Open
Abstract
We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF) cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112) were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142). Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins.
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Affiliation(s)
| | - Alberto Revelli
- Reproductive Medicine and IVF Unit, Department of Obstetrical and Gynecological Sciences, University of Torino, OIRM-S, Anna Hospital, Torino, Italy
| | - Gianluca Gennarelli
- Reproductive Medicine and IVF Unit, Department of Obstetrical and Gynecological Sciences, University of Torino, OIRM-S, Anna Hospital, Torino, Italy
| | | | - Luisa Delle Delle Piane
- Reproductive Medicine and IVF Unit, Department of Obstetrical and Gynecological Sciences, University of Torino, OIRM-S, Anna Hospital, Torino, Italy
| | - Jan Holte
- Carl von Linne' Clinic, Uppsala, Sweden
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Ferraretti AP, La Marca A, Fauser BCJM, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod 2011; 26:1616-24. [PMID: 21505041 DOI: 10.1093/humrep/der092] [Citation(s) in RCA: 1127] [Impact Index Per Article: 86.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The definition presented here represents the first realistic attempt by the scientific community to standardize the definition of poor ovarian response (POR) in a simple and reproducible manner. POR to ovarian stimulation usually indicates a reduction in follicular response, resulting in a reduced number of retrieved oocytes. It has been recognized that, in order to define the poor response in IVF, at least two of the following three features must be present: (i) advanced maternal age or any other risk factor for POR; (ii) a previous POR; and (iii) an abnormal ovarian reserve test (ORT). Two episodes of POR after maximal stimulation are sufficient to define a patient as poor responder in the absence of advanced maternal age or abnormal ORT. By definition, the term POR refers to the ovarian response, and therefore, one stimulated cycle is considered essential for the diagnosis of POR. However, patients of advanced age with an abnormal ORT may be classified as poor responders since both advanced age and an abnormal ORT may indicate reduced ovarian reserve and act as a surrogate of ovarian stimulation cycle outcome. In this case, the patients should be more properly defined as 'expected poor responder'. If this definition of POR is uniformly adapted as the 'minimal' criteria needed to select patients for future clinical trials, more homogeneous populations will be tested for any new protocols. Finally, by reducing bias caused by spurious POR definitions, it will be possible to compare results and to draw reliable conclusions.
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Affiliation(s)
- A P Ferraretti
- S.I.S.Me.R Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy.
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Ferté-Delbende C, Catteau-Jonard S, Barrière P, Dewailly D. L’évaluation de la réserve ovarienne. ACTA ACUST UNITED AC 2010; 39:S27-33. [DOI: 10.1016/s0368-2315(10)70028-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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la Cour Freiesleben N, Gerds TA, Forman JL, Silver JD, Nyboe Andersen A, Popovic-Todorovic B. Risk charts to identify low and excessive responders among first-cycle IVF/ICSI standard patients. Reprod Biomed Online 2010; 22:50-8. [PMID: 21115267 DOI: 10.1016/j.rbmo.2010.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 07/05/2010] [Accepted: 08/25/2010] [Indexed: 10/19/2022]
Abstract
Ovarian stimulation carries a risk of either low or excessive ovarian response. The aim was to develop prognostic models for identification of standard (ovulatory and normal basal FSH) patients’ risks of low and excessive response to conventional stimulation for IVF/intracytoplasmic sperm injection. Prospectively collected data on 276 first-cycle patients treated with 150 IU recombinant FSH (rFSH)/day in a long agonist protocol were analysed. Logistic regression analysis was applied to the outcome variables:low (seven or less follicles) and excessive (20 or more follicles) response. Variables were woman’s age, menstrual cycle length, weight or body mass index, ovarian volume, antral follicle count (AFC) and basal FSH. The predictive performance of the models was evaluated from the prediction error (Brier score, %) where zero corresponds to a perfect prediction. Model stability was assessed using 1000 bootstrap cross-validation steps. The best prognostic model to predict low response included AFC and age (Brier score 7.94) and the best model to predict excessive response included AFC and cycle length (Brier score 15.82). Charts were developed to identify risks of low and excessive ovarian response. They can be used for evidence-based risk assessment before ovarian stimulation and may assist clinicians in individual dosage of their patients.
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Affiliation(s)
- N la Cour Freiesleben
- The Fertility Clinic, Department 4071, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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