1
|
Lazareva L, Suturina L, Atalyan A, Danusevich I, Nadelyaeva I, Belenkaya L, Egorova I, Ievleva K, Babaeva N, Lizneva D, Legro RS, Azziz R. Ovarian Morphology in Non-Hirsute, Normo-Androgenic, Eumenorrheic Premenopausal Women from a Multi-Ethnic Unselected Siberian Population. Diagnostics (Basel) 2024; 14:673. [PMID: 38611586 PMCID: PMC11012196 DOI: 10.3390/diagnostics14070673] [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: 02/12/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a highly prevalent disorder in women, and its diagnosis rests on three principal features: ovulatory/menstrual dysfunction, clinical and/or biochemical hyperandrogenism, and polycystic ovarian morphology (PCOM). Currently, data on age- and ethnicity-dependent features of PCOM remain insufficient. We aimed to estimate ethnicity- and age-dependent differences in ovarian volume (OV) and follicle number per ovary (FNPO) in a healthy, medically unbiased population of Caucasian and Asian premenopausal women, who participated in the cross-sectional Eastern Siberia PCOS epidemiology and phenotype (ESPEP) study (ClinicalTrials.gov ID: NCT05194384) in 2016-2019. The study population consisted of 408 non-hirsute, normo-androgenic, eumenorrheic premenopausal women aged 18-44 years. All participants underwent a uniform evaluation including a review of their medical history and a physical examination, blood sampling, and pelvic ultrasonography. The statistical analysis included non-parametric tests and the estimation of the upper normal limits (UNLs) by 98th percentiles for OV and FNPO. In the total study population, the upper OV percentiles did not differ by ethnicity or age group. By contrast, the UNL of FNPO was higher in Caucasian women than in Asian women, and women aged <35 years demonstrated a higher UNL of FNPO compared to older women. In summary, these data suggest that the estimation of FNPO, but not OV, should take into account the ethnicity and age of the individual in estimating the presence of PCOM.
Collapse
Affiliation(s)
- Ludmila Lazareva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Larisa Suturina
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Alina Atalyan
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Irina Danusevich
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Iana Nadelyaeva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Lilia Belenkaya
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Irina Egorova
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Kseniia Ievleva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Natalia Babaeva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Daria Lizneva
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Richard S. Legro
- Penn State College of Medicine, Penn State University, Hershey, PA 17033, USA
| | - Ricardo Azziz
- Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| |
Collapse
|
2
|
Pea J, Bryan J, Wan C, Oldfield AL, Ganga K, Carter FE, Johnson LM, Lujan ME. Ultrasonographic criteria in the diagnosis of polycystic ovary syndrome: a systematic review and diagnostic meta-analysis. Hum Reprod Update 2024; 30:109-130. [PMID: 37804097 PMCID: PMC10762001 DOI: 10.1093/humupd/dmad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/08/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Polycystic ovary morphology (PCOM) on ultrasonography is considered as a cardinal feature of polycystic ovarian syndrome (PCOS). Its relevance as a diagnostic criterion for PCOS was reaffirmed in the most recent International Evidence-Based Guideline for the Assessment and Management of PCOS. However, there remains a lack of clarity regarding the best practices and specific ultrasonographic markers to define PCOM. OBJECTIVE AND RATIONALE The aim of this systematic review and diagnostic meta-analysis was to assess the diagnostic accuracy of various ultrasonographic features of ovarian morphology in the diagnosis of PCOS. SEARCH METHODS Relevant studies published from 1 January 1990 to 12 June 2023 were identified by a systematic search in PubMed, Web of Science, Scopus, CINAHL, and CENTRAL. Studies that generated diagnostic accuracy measures (e.g. proposed thresholds, sensitivity, specificity) for PCOS using the following ultrasonographic markers met criteria for inclusion: follicle number per ovary (FNPO) or per single cross-section (FNPS), ovarian volume (OV), and stromal features. Studies on pregnant or post-menopausal women were excluded. Risk of bias and applicability assessment for diagnostic test accuracy studies were determined using the QUADAS-2 and QUADAS-C tool for a single index test or between multiple index tests, respectively. Diagnostic meta-analysis was conducted using a bivariate model of pooled sensitivity and specificity, and visualized using forest plots and summary receiver-operating characteristic (SROC) curves. OUTCOMES From a total of 2197 records initially identified, 31 studies were included. Data from five and two studies were excluded from the meta-analysis due to duplicate study populations or limited data for the index test, leaving 24 studies. Pooled results of 20 adult studies consisted of 3883 control participants and 3859 individuals with PCOS. FNPO was the most accurate diagnostic marker (sensitivity: 84%, CI: 81-87%; specificity: 91%, CI: 86-94%; AUC: 0.905) in adult women. OV and FNPS had similar pooled sensitivities (OV: 81%, CI: 76-86%; FNPS: 81%, CI: 70-89%) but inferior pooled specificities (OV: 81%, CI: 75-86%; FNPS: 83%, CI: 75-88%) and AUCs (OV: 0.856; FNPS: 0.870) compared to FNPO. Pooled results from four adolescent studies consisting of 210 control participants and 268 girls with PCOS suggested that OV may be a robust ultrasonographic marker for PCOS diagnosis albeit the current evidence remains limited. The majority of the studies had high risk of bias for the patient selection (e.g. lack of randomized/consecutive patient selection) and index test (e.g. lack of pre-proposed thresholds for comparison) domains across all ultrasonographic markers. As such, diagnostic meta-analysis was unable to determine the most accurate cutoff for ultrasonographic markers to diagnose PCOS. Subgroup analysis suggested that stratification based on previously proposed diagnostic thresholds, age, BMI, or technology did not account for the heterogeneity in diagnostic accuracy observed across the studies. Studies that diagnosed PCOS using the Rotterdam criteria had improved sensitivity for FNPO. Studies from North America had lower diagnostic accuracy when compared to Asian studies (FNPO: sensitivity) and European studies (OV: specificity, diagnostic odds ratio and positive likelihood ratio). Geographic differences in diagnostic accuracy may potentially be due to differences in age, BMI, and diagnostic criteria of the PCOS group across regions. WIDER IMPLICATIONS This diagnostic meta-analysis supports the use of FNPO as the gold standard in the ultrasonographic diagnosis of PCOS in adult women. OV and FNPS provide alternatives if total antral follicle counts cannot be accurately obtained. Our findings support the potential for ultrasonographic evidence of PCOM in adolescents as more data becomes available. Subgroup analysis suggests the need to investigate any relative contributions of geographical differences on PCOS phenotypes. These findings may provide the basis for the development of strategies and best practices toward a standardized definition of PCOM and a more accurate ultrasonographic evaluation of PCOS.
Collapse
Affiliation(s)
- Jeffrey Pea
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Jahnay Bryan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Cynthia Wan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Alexis L Oldfield
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Kiran Ganga
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Faith E Carter
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Lynn M Johnson
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| |
Collapse
|
3
|
Jain S, Shukla RC, Jain M, Mishra RN. Age-Specific Nomograms for Antral Follicle Count in Fertile and Infertile Indian Women: A Comparative Study. Indian J Radiol Imaging 2023; 33:463-470. [PMID: 37811172 PMCID: PMC10556339 DOI: 10.1055/s-0043-1768964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
Objectives The aim of this study was to develop age-specific nomograms for antral follicle count (AFC) in fertile and infertile Indian women and (2) to compare the influence of age on AFC in both groups. Setting and Design It is a prospective cross-sectional study in a tertiary-care hospital in north-central India. Methods and Material One-thousand four-hundred seventy-eight fertile and 1,447 infertile women (primary infertility) of reproductive age (18-49 years) were recruited. One-thousand one-hundred eighty-one fertile and 1,083 infertile women fulfilled the selection criteria for the study. Transvaginal ultrasonography was done on the second or third day of the menstrual cycle. Statistical Analysis Age-specific nomograms for AFC were built for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles in both groups. Correlation and regression analysis was done to estimate the relationship between the study variables. Statistical analysis was done by using IBM SPSS Statistics for Windows, version 20. Results At every age, each percentile value of AFC was lower in infertile than in fertile women. The decline of AFC with increasing age was linear in both fertile ( r = - 0.431, p < 0.001) and infertile ( r = - 0.520, p < 0.001) women; however, the rate was higher in the latter (0.50 follicle/year) than in former (0.44 follicle/year) group. The variation in AFC explained by age was 16.3% in fertile and 22.7% in infertile women. Conclusion AFC decreased linearly with advancing age in both fertile and infertile women, but more rapidly in the latter. The age only modestly explained the decline of AFC. The age-specific percentile thresholds for AFC should be used instead of age-independent constant thresholds in infertility counselling.
Collapse
Affiliation(s)
- Shivi Jain
- Department of Radiodiagnosis & Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ram Chandra Shukla
- Department of Radiodiagnosis & Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Madhu Jain
- Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rabindra Nath Mishra
- Centre of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
4
|
Liu Y, Li Y, Xiao N, Liu M, Wang Y, Luo H, Yao Y, Feng Y, Wang S. Serum Organophosphate Flame retardants and plasticizers in Chinese females of childbearing age: Association with serum reproductive and thyroid hormones. CHEMOSPHERE 2023:139237. [PMID: 37331665 DOI: 10.1016/j.chemosphere.2023.139237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/20/2023]
Abstract
Organophosphate flame retardants (OPFRs) are extensively used as flame retardants and plasticizers, but their endocrine disrupting potentials have raised concerns. However, the impacts of OPFR exposures on reproductive and thyroid hormones in females remains unclear. In this study, serum concentrations of OPFRs were investigated, and levels of reproductive and thyroid hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, anti-Müllerian hormone, prolactin (PRL), testosterone (T), and thyroid stimulating hormone, were analyzed in childbearing-age females undergoing in-vitro fertilization treatment from Tianjin, a coastal city in China (n = 319). Tris (2-chloroethyl) phosphate (TCEP) was the predominant OPFR, with a median concentration of 0.33 ng/mL and a detection frequency of 96.6%. In the whole population, tris(1,3-dichloro-2-propyl) phosphate (TDCIPP) and tris(2-chloroisopropyl) phosphate (TCIPP) were positively associated with T (p < 0.05), while triethyl phosphate (TEP) was negatively associated with LH (p < 0.05) and LH/FSH (p < 0.01). Particularly, TCIPP was negatively associated with PRL in the younger subgroup (age≤30, p < 0.05). Moreover, TCIPP was negatively associated with diagnostic antral follicle counting (AFC) in the mediation analysis by a dominating direct effect (p < 0.01). In conclusion, serum levels of OPFRs were significantly associated with reproductive and thyroid hormone levels and a risk of decreased ovarian reserve in childbearing-age females, with age and body mass index being significant influencing factors.
Collapse
Affiliation(s)
- Yarui Liu
- College of Environmental Science and Engineering, Nankai University, 38 Tongyan Road, Jinnan District, Tianjin, 300350, China; School of Environmental Science and Engineering, Academy of Environment and Ecology, Tianjin University, 92 Weijin Road, Nankai District, Tianjin, 300072, China.
| | - Yongcheng Li
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, 38 Tongyan Road, Jinnan District, Tianjin, 300350, China.
| | - Nan Xiao
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, 156 Nankaisanma Road, Nankai District, Tianjin, 300100, China.
| | - Min Liu
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, 156 Nankaisanma Road, Nankai District, Tianjin, 300100, China.
| | - Yu Wang
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, 38 Tongyan Road, Jinnan District, Tianjin, 300350, China.
| | - Haining Luo
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, 156 Nankaisanma Road, Nankai District, Tianjin, 300100, China.
| | - Yiming Yao
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, 38 Tongyan Road, Jinnan District, Tianjin, 300350, China.
| | - Yujie Feng
- School of Environmental Science and Engineering, Academy of Environment and Ecology, Tianjin University, 92 Weijin Road, Nankai District, Tianjin, 300072, China; State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, No. 73 Huanghe Road, Nangang District, Harbin, 150090, China.
| | - Shuo Wang
- College of Environmental Science and Engineering, Nankai University, 38 Tongyan Road, Jinnan District, Tianjin, 300350, China; Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, 94 Weijin Road, Nankai District, Tianjin, 300071, China.
| |
Collapse
|
5
|
Wang RR, Su MH, Liu LY, Lai YY, Guo XL, Gan D, Zheng XY, Yang H, Yu SY, Liang FR, Wei W, Zhong Y, Yang J. Systematic review of acupuncture to improve ovarian function in women with poor ovarian response. Front Endocrinol (Lausanne) 2023; 14:1028853. [PMID: 36992800 PMCID: PMC10040749 DOI: 10.3389/fendo.2023.1028853] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/24/2023] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE To determine the effect of acupuncture in treating poor ovarian response (POR). METHODS We searched MEDLINE (via PubMed), EMBASE, Allied and Complementary Medicine Database, CNKI, CBM, VIP database, Wanfang Database, and relevant registration databases from inception to January 30, 2023. In this review, both Chinese and English peer-reviewed literature were included. Only randomized controlled trials (RCTs) using acupuncture as an intervention for POR patients undergoing in vitro fertilization were considered. RESULTS Seven clinical randomized controlled trials (RCTs) were eventually included for comparison (516 women). The quality of included studies was generally low or very low. For the meta-analysis, seven studies showed that compared with controlled ovarian hyperstimulation (COH) therapy, acupuncture combined with COH therapy could significantly increase the implantation rate (RR=2.13, 95%CI [1.08, 4.21], p=0.03), the number of oocytes retrieved (MD=1.02, 95%CI [0.72, 1.32], p<0.00001), the thickness of endometrium (MD=0.54, 95%CI [0.13, 0.96], p=0.01), and the antral follicle count (MD=1.52, 95%CI [1.08, 1.95], p<0.00001), reduce follicle-stimulating hormone (FSH) levels (MD=-1.52, 95%CI [-2.41, -0.62], p=0.0009) and improve estradiol (E2) levels (MD=1667.80, 95%CI [1578.29, 1757.31], p<0.00001). Besides, there were significant differences in the duration of Gn (MD=0.47, 95%CI [-0.00, 0.94], p=0.05) between the two groups. However, no statistical variation was observed in improving clinical pregnancy rate (CPR), fertilization rate, high-quality embryo rate, luteinizing hormone (LH) value, anti-mullerian hormone (AMH) value, or reducing the dose of gonadotropin (Gn) values between the acupuncture plus COH therapy group and the COH therapy group. CONCLUSION Acupuncture combined with COH therapy is doubtful in improving the pregnancy outcome of POR patients. Secondly, acupuncture can also improve the sex hormone level of POR women, and improve ovarian function. Furthermore, more RCTs of acupuncture in POR are needed to be incorporated into future meta-analyses. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42020169560.
Collapse
Affiliation(s)
- Rong-Rong Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Meng-Hua Su
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Li-Ying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuan-Yuan Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiao-Li Guo
- Traditional Chinese Medicine Department, Chengdu Xi'nan Gynecology Hospital, Chengdu, Sichuan, China
| | - Di Gan
- Traditional Chinese Medicine Department, Chengdu Xi'nan Gynecology Hospital, Chengdu, Sichuan, China
| | - Xiao-Yan Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Han Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Yi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fan-Rong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Wei
- Traditional Chinese Medicine Department, Chengdu Xi'nan Gynecology Hospital, Chengdu, Sichuan, China
- *Correspondence: Wei Wei, ; Ying Zhong, ; Jie Yang,
| | - Ying Zhong
- Traditional Chinese Medicine Department, Chengdu Xi'nan Gynecology Hospital, Chengdu, Sichuan, China
- *Correspondence: Wei Wei, ; Ying Zhong, ; Jie Yang,
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Traditional Chinese Medicine Department, Chengdu Xi'nan Gynecology Hospital, Chengdu, Sichuan, China
- Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, China
- *Correspondence: Wei Wei, ; Ying Zhong, ; Jie Yang,
| |
Collapse
|
6
|
Park CJ, Oh JE, Feng J, Cho YM, Qiao H, Ko C. Lifetime changes of the oocyte pool: Contributing factors with a focus on ovulatory inflammation. Clin Exp Reprod Med 2022; 49:16-25. [PMID: 35255655 PMCID: PMC8923630 DOI: 10.5653/cerm.2021.04917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/11/2022] [Indexed: 12/24/2022] Open
Abstract
In mammalian species, females are born with a number of oocytes exceeding what they release via ovulation. In humans, an average girl is born with over a thousand times more oocytes than she will ovulate in her lifetime. The reason for having such an excessive number of oocytes in a neonatal female ovary is currently unknown. However, it is well established that the oocyte number decreases throughout the entire lifetime until the ovary loses them all. In this review, data published in the past 80 years were used to assess the current knowledge regarding the changing number of oocytes in humans and mice, as well as the reported factors that contribute to the decline of oocyte numbers. Briefly, a collective estimation indicates that an average girl is born with approximately 600,000 oocytes, which is 2,000 times more than the number of oocytes that she will ovulate in her lifetime. The oocyte number begins to decrease immediately after birth and is reduced to half of the initial number by puberty and almost zero by age 50 years. Multiple factors that are either intrinsic or extrinsic to the ovary contribute to the decline of the oocyte number. The inflammation caused by the ovulatory luteinizing hormone surge is discussed as a potential contributing factor to the decline of the oocyte pool during the reproductive lifespan.
Collapse
Affiliation(s)
- Chan Jin Park
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA.,Epivara Inc., Champaign, IL, USA
| | - Ji-Eun Oh
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA
| | - Jianan Feng
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA
| | - Yoon Min Cho
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA
| | - Huanyu Qiao
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA
| | - CheMyong Ko
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL ,USA
| |
Collapse
|
7
|
Stegemiller MR, Murdoch GK, Rowan TN, Davenport KM, Becker GM, Hall JB, Murdoch BM. Genome-Wide Association Analyses of Fertility Traits in Beef Heifers. Genes (Basel) 2021; 12:genes12020217. [PMID: 33540904 PMCID: PMC7913221 DOI: 10.3390/genes12020217] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
The ability of livestock to reproduce efficiently is critical to the sustainability of animal agriculture. Antral follicle count (AFC) and reproductive tract scores (RTS) can be used to estimate fertility in beef heifers, but the genetic mechanisms influencing variation in these measures are not well understood. Two genome-wide association studies (GWAS) were conducted to identify the significant loci associated with these traits. In total, 293 crossbred beef heifers were genotyped on the Bovine GGP 50K chip and genotypes were imputed to 836,121 markers. A GWAS was performed with the AFC phenotype for 217 heifers with a multi-locus mixed model, conducted using the year, age at time of sampling and principal component analysis groupings as the covariates. The RTS GWAS was performed with 289 heifers using an additive correlation/trend test comparing prepubertal to pubertal heifers. The loci on chromosomes 2, 3 and 23 were significant in the AFC GWAS and the loci on chromosomes 2, 8, 10 and 11 were significant in the RTS GWAS. The significant region on chromosome 2 was similar between both analyses. These regions contained genes associated with cell proliferation, transcription, apoptosis and development. This study proposes candidate genes for beef cattle fertility, although future research is needed to elucidate the precise mechanisms.
Collapse
Affiliation(s)
- Morgan R. Stegemiller
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
| | - Gordon K. Murdoch
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
- Department of Animal Sciences, Washington State University, Pullman, WA 99164, USA
| | - Troy N. Rowan
- Division of Animal Sciences, University of Missouri, Columbia, MO 65211, USA;
| | - Kimberly M. Davenport
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
| | - Gabrielle M. Becker
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
| | - John B. Hall
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
- Nancy M. Cummings Research, Education, and Extension Center, University of Idaho, Carmen, ID 83462, USA
- Correspondence: (J.B.H.); (B.M.M.); Tel.: +1-208-756-2749 (J.B.H.); +1-208-885-2088 (B.M.M.)
| | - Brenda M. Murdoch
- Department of Animal, Veterinary & Food Sciences, University of Idaho, Moscow, ID 83843, USA; (M.R.S.); (G.K.M.); (K.M.D.); (G.M.B.)
- Center for Reproductive Biology, Washington State University, Pullman, WA 99164, USA
- Correspondence: (J.B.H.); (B.M.M.); Tel.: +1-208-756-2749 (J.B.H.); +1-208-885-2088 (B.M.M.)
| |
Collapse
|
8
|
Mai Z, Liu M, Pan P, Li L, Huang J, Chen X, Yang D. Comparison of Cumulative Live Birth Rate Between Aged PCOS Women and Controls in IVF/ICSI Cycles. Front Endocrinol (Lausanne) 2021; 12:724333. [PMID: 34650517 PMCID: PMC8505977 DOI: 10.3389/fendo.2021.724333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022] Open
Abstract
The present study aimed to assess whether women with polycystic ovarian syndrome (PCOS) ≥35 years age undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles experienced a higher cumulative live birth rate (CLBR) over a two-year period compared with age- and body mass index (BMI)-matched patients with tubal factor infertility. Through propensity score matching (PSM) approach, the authors retrospectively analyzed the IVF/ICSI outcomes of 263 PCOS patients (35-46 years of age [mean, 37 years]) and 526 age- and BMI-matched tubal factor controls two years after oocyte retrieval. Multivariate regression analysis was performed to explore factors influencing cumulative live birth. Women with PCOS exhibited better ovarian reserve and response, and higher CLBR in two years compared with age- and BMI-matched controls (CLBR: 55.51% in PCOS vs. 38.02% in control, p<0.001). Multivariate logistic regression analysis revealed that the number of transferable embryos and antral follicle counts were both significant independent factors predicting cumulative live birth after adjusting for female age, female body mass index, percentage of transferred blastocysts, number of embryos transferred per embryo-transfer cycle, diagnosis of PCOS and freeze-all cycles (p<0.001, p=0.045). Women with PCOS ≥ 35 years of age demonstrated a higher CLBR over two years compared with age- and BMI-matched controls. This could be explained by favorable oocyte reserve and more available embryos compared with controls, which overcome the compromised oocyte quality in aged PCOS patients.
Collapse
Affiliation(s)
| | | | | | | | | | - Xiaoli Chen
- *Correspondence: Xiaoli Chen, ; Dongzi Yang,
| | - Dongzi Yang
- *Correspondence: Xiaoli Chen, ; Dongzi Yang,
| |
Collapse
|
9
|
Cellular, Extracellular and Extracellular Vesicular miRNA Profiles of Pre-Ovulatory Follicles Indicate Signaling Disturbances in Polycystic Ovaries. Int J Mol Sci 2020; 21:ijms21249550. [PMID: 33333986 PMCID: PMC7765449 DOI: 10.3390/ijms21249550] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 12/16/2022] Open
Abstract
Cell-free RNAs have the potential to act as a means of gene expression regulation between cells and are therefore used as diagnostic markers describing the state of tissue environment. The origin and functions of such RNAs in human ovarian follicle, the environment of oocyte maturation, are unclear. The current study investigates the difference in the microRNA profiles of fertile women and polycystic ovary syndrome (PCOS) patients in three compartments from the same preovulatory follicle: mural granulosa cells (MGC), cell-free follicular fluid (FF), and extracellular vesicles (EV) of the FF by small RNA sequencing. In silico analysis was used for the prediction and over-representation of targeted pathways for the detected microRNAs. PCOS follicles were distinguished from normal tissue by the differential expression of 30 microRNAs in MGC and 10 microRNAs in FF (FDR < 0.1) that commonly regulate cytokine signaling pathways. The concentration of EV-s was higher in the FF of PCOS patients (p = 0.04) containing eight differentially expressed microRNAs (p < 0.05). In addition, we present the microRNA profiles of MGC, FF, and EV in the fertile follicle and demonstrate that microRNAs loaded into EVs target mRNAs of distinct signaling pathways in comparison to microRNAs in FF. To conclude, the three follicular compartments play distinct roles in the signaling disturbances associated with PCOS.
Collapse
|
10
|
Liao S, Xiong J, Tu H, Hu C, Pan W, Geng Y, Pan W, Lu T, Jin L. Prediction of in vitro fertilization outcome at different antral follicle count thresholds combined with female age, female cause of infertility, and ovarian response in a prospective cohort of 8269 women. Medicine (Baltimore) 2019; 98:e17470. [PMID: 31593108 PMCID: PMC6799863 DOI: 10.1097/md.0000000000017470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Antral follicle count (AFC) has been widely investigated for the prediction of clinical pregnancy or live birth. This study discussed the effects of AFC quartile levels on pregnancy outcomes combined with female age, female cause of infertility, and ovarian response undergoing in vitro fertilization (IVF) treatment. At present, many research about AFC mainly discuss its impact on clinical practice at different thresholds, or the analyses of AFC with respect to assisted reproductive technology outcomes under using different ovarian stimulation protocols. Factors that include ovarian sensitivity index, female age, and infertility cause are all independent predictors of live birth undergoing IVF/intracytoplasmic sperm injection, while few researchers discussed influence of female-related factors for clinical outcomes in different AFC fields.A total of 8269 infertile women who were stimulated with a long protocol with normal menstrual cycles were enrolled in the study, and patients were categorized into 4 groups based on AFC quartiles (1-8, 9-12, 13-17, and ≥18 antral follicles).The clinical pregnancy rates increased in the 4 AFC groups (28.25% vs 35.38% vs 37.38% vs 40.13%), and there was a negative association between age and the 4 AFC groups. In addition, female cause of infertility like polycystic ovary syndrome, Tubal factor, and other causes had great significance on clinical outcome, and ovarian response in medium (9-16 oocytes retrieved) had the highest clinical pregnancy rate at AFC quartiles of 1 to 8, 9 to 12, 13 to 17, and ≥18 antral follicles.This study concludes that the female-related parameters (female cause of infertility, female age, and ovarian response) combined with AFC can be useful to estimate the probability of clinical pregnancy.
Collapse
Affiliation(s)
- ShuJie Liao
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Jianwu Xiong
- School of Economic and Management
- Management Science and Data Analytics Research Center, Wuhan University, Wuhan
| | - Haiting Tu
- School of Economic and Management
- Management Science and Data Analytics Research Center, Wuhan University, Wuhan
| | - Cheng Hu
- School of Economic and Management
- Management Science and Data Analytics Research Center, Wuhan University, Wuhan
| | - Wulin Pan
- School of Economic and Management
- Management Science and Data Analytics Research Center, Wuhan University, Wuhan
| | - Yudi Geng
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Wei Pan
- School of Economic and Management
- Management Science and Data Analytics Research Center, Wuhan University, Wuhan
| | - Tingjuan Lu
- 117th Hospital of PLA, Hangzhou, Zhejiang, China
| | - Lei Jin
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| |
Collapse
|
11
|
Mossa F, Ireland JJ. Physiology and endocrinology symposium: Anti-Müllerian hormone: a biomarker for the ovarian reserve, ovarian function, and fertility in dairy cows. J Anim Sci 2019; 97:1446-1455. [PMID: 30668706 DOI: 10.1093/jas/skz022] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/15/2019] [Indexed: 12/24/2022] Open
Abstract
This review summarizes studies we conducted to test the hypothesis that size of the ovarian reserve (number of healthy follicles and oocytes in ovaries) positively impacts ovarian function and fertility in cattle. Key results, primarily in Bos taurus dairy cattle, show that antral follicle count (AFC) during follicular waves is highly variable between individuals, but very highly repeatable within individuals. Cycling heifers with low (≤15 follicles ≥3 mm, ~20% of a herd) vs. a high AFC (≥25, ~20% of a herd) have a smaller ovarian reserve, higher FSH but lower anti-Müllerian hormone (AMH), androstenedione, estradiol, and progesterone concentrations. Moreover, cattle with low AFC have a thinner endometrium, decreased response of granulosal, thecal, or luteal cells to FSH or LH and a poorer response to superovulation compared to cattle with high AFC. Interestingly, cows with a very high AFC as heifers have reduced fertility, fewer lactations, and shorter herd longevity, whereas cows with a low vs. intermediate AFC have reduced fertility, fewer lactations, and shorter herd longevity. Anti-Müllerian hormone concentrations are static within individuals but highly positively correlated with AFC, but fertility is not correlated with circulating AMH concentration in heifers and dairy cows with low vs. a higher AMH as heifers have reduced fertility and a shorter herd longevity. Anti-Müllerian hormone concentrations in dairy heifers are a moderately heritable trait (36%), and negatively impacted by inadequate maternal nutrition during early pregnancy or high maternal somatic cell count. We conclude that genetic or environmental manipulations of AMH could enhance size of the ovarian reserve and ovarian function, thereby improving fertility, response to superovulation, and longevity in dairy cows.
Collapse
Affiliation(s)
- Francesca Mossa
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - James J Ireland
- Molecular Reproductive Endocrinology Laboratory, Department of Animal Science, Michigan State University, East Lansing, MI
| |
Collapse
|
12
|
Li J, Liu X, Hu L, Zhang F, Wang F, Kong H, Dai S, Guo Y. A Slower Age-Related Decline in Treatment Outcomes After the First Ovarian Stimulation for in vitro Fertilization in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2019; 10:834. [PMID: 31866942 PMCID: PMC6906164 DOI: 10.3389/fendo.2019.00834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/14/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) patients have a better ovarian reserve and age-related improvement in endocrine disturbances than non-PCOS patients. The effects of age on in vitro fertilization (IVF) treatment outcomes associated with cumulative live birth rate (CLBR) remain unclear. Objectives: To study the effect of age on CLBR after the first ovarian stimulation in IVF in PCOS patients. Method: This retrospective cohort study included 3,502 PCOS patients and 18,596 patients with tubal factor infertility, who underwent their first IVF cycles and subsequent frozen embryo transfer (ET) attempts. The primary outcome was CLBR associated with a single stimulation cycle and secondary outcomes included the implantation rate, clinical pregnancy rate, live birth rate (LBR), large for gestational age (LGA) rate, small for gestational age (SGA) rate, and preterm birth (PTB) rate of fresh ET cycles. Results: PCOS patients over 40 years had a higher implantation rate (27.8 vs. 15.7%, P < 0.05), clinical pregnancy rate (51.4 vs. 26.1%, P < 0.05), LBR (42.3 vs. 18.2%, P < 0.05), and CLBR (50.0 vs. 21.5%, P < 0.05) than non-PCOS patients over 40 years. These rates were comparable between PCOS patients aged 35 to 40 years and those aged over 40 years (P = 0.263, 0.385, and 0.112, respectively). The changes in the implantation rate, clinical pregnancy rate, and CLBR by age were slower for PCOS patients than for non-PCOS patients (all P < 0.05). Among PCOS patients less than 35 years, BMI was negatively associated with CLBR [aOR: 0.961 (0.939-0.985); P < 0.05]; however, among PCOS patients over 35 years, instead of BMI (P = 0.353), age [aOR: 0.891 (0.803-0.990); P < 0.05] and the number of oocytes retrieved [aOR: 1.093 (1.002-1.078); P < 0.05] were significantly associated with CLBR. No significant differences in LGA, LGA, or PTB were detected between PCOS and non-PCOS patients over 35 years (all P > 0.05). Conclusions: The declines in treatment outcomes with age are slower for PCOS patients than for non-PCOS patients. For patients over 40 years, PCOS patients have reproductive advantages over non-PCOS patients. In contrast to younger PCOS patients (<35 years), older PCOS patients (≥35 years) may benefit less from taking time to lose weight before IVF treatment, and the immediate initiation of assisted reproductive treatment is essential.
Collapse
Affiliation(s)
- Jing Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaocong Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linli Hu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fuli Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fang Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huijuan Kong
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shanjun Dai
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yihong Guo
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Yihong Guo
| |
Collapse
|
13
|
Ahmad AK, Kao CN, Quinn M, Lenhart N, Rosen M, Cedars MI, Huddleston H. Differential rate in decline in ovarian reserve markers in women with polycystic ovary syndrome compared with control subjects: results of a longitudinal study. Fertil Steril 2018; 109:526-531. [PMID: 29428308 DOI: 10.1016/j.fertnstert.2017.11.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/09/2017] [Accepted: 11/10/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To estimate rates of ovarian aging in polycystic ovary syndrome (PCOS) subjects versus a community control population. DESIGN Longitudinal. SETTING Tertiary academic center. SUBJECT(S) PCOS subjects diagnosed according to the 2004 Rotterdam criteria were systematically enrolled in a PCOS cohort study. The comparison control subjects were from the Ovarian Aging study, a prospective longitudinal study of ovarian aging in healthy women with regular menstrual cycles. INTERVENTION(S) Clinical data collection over two study visits. MAIN OUTCOME MEASURE(S) Antral follicle count (AFC), ovarian volume (OV), and antimüllerian hormone level (AMH). RESULT(S) PCOS subjects were found to have higher baseline values for all ovarian reserve markers compared with control subjects. Univariate models indicated that, compared with control subjects, PCOS patients experienced significantly faster rates of decline for both AFC and AMH. Change in OV did not differ significantly. To account for potential confounder effects, multiple analysis of covariance models were evaluated for the best fit, considering age, body mass index, and baseline ovarian reserve markers. Adjusted models demonstrated that PCOS patients do not experience a significant difference in AFC decline compared with control subjects, but they do experience a faster rate of decline in AMH (P<.01) and slower rate of decline in OV (P<.01). CONCLUSION(S) Ovarian aging in PCOS is characterized by a more rapid decline in AMH and a slower decline in OV compared with control subjects.
Collapse
Affiliation(s)
- Asima K Ahmad
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California.
| | - Chia-Ning Kao
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| | - Molly Quinn
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| | - Nikolaus Lenhart
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| | - Mitchell Rosen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| | - Heather Huddleston
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California
| |
Collapse
|
14
|
Jimenez-Krassel F, Scheetz D, Neuder L, Pursley J, Ireland J. A single ultrasound determination of ≥25 follicles ≥3 mm in diameter in dairy heifers is predictive of a reduced productive herd life. J Dairy Sci 2017; 100:5019-5027. [DOI: 10.3168/jds.2016-12277] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/23/2017] [Indexed: 11/19/2022]
|
15
|
Palomba S, Daolio J, La Sala GB. Oocyte Competence in Women with Polycystic Ovary Syndrome. Trends Endocrinol Metab 2017; 28:186-198. [PMID: 27988256 DOI: 10.1016/j.tem.2016.11.008] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/17/2016] [Accepted: 11/23/2016] [Indexed: 02/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and affects fertility and pregnancy in cases of oligoanovulation. Ovulation induction is often used to treat anovulatory patients with PCOS, but many of these women fail to conceive and resort to assisted reproductive technologies. Alterations in oocyte competence (OC) are considered potential causative factors for subfertility in women with PCOS. In this review we present and critically assess all recent clinical and experimental data regarding OC in women with PCOS. Our analysis demonstrates that the contribution of OC to reproductive potential in women with PCOS varies and largely depends on the PCOS phenotype and comorbidities associated with PCOS.
Collapse
Affiliation(s)
- Stefano Palomba
- Unit of Gynecology and Obstetrics, IRCCS - Arcispedale Santa Maria Nuova, Viale Risorgimento 80, Reggio Emilia 42123, Italy.
| | - Jessica Daolio
- Unit of Gynecology and Obstetrics, IRCCS - Arcispedale Santa Maria Nuova, Viale Risorgimento 80, Reggio Emilia 42123, Italy
| | - Giovanni Battista La Sala
- Unit of Gynecology and Obstetrics, IRCCS - Arcispedale Santa Maria Nuova, Viale Risorgimento 80, Reggio Emilia 42123, Italy; University of Modena and Reggio Emilia, Via Università 4, Modena 41100, Italy
| |
Collapse
|
16
|
Jacob SL, Field HP, Calder N, Picton HM, Balen AH, Barth JH. Anti-Müllerian hormone reflects the severity of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2017; 86:395-400. [PMID: 27805276 DOI: 10.1111/cen.13269] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/04/2016] [Accepted: 10/28/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the relationship between anti-Müllerian hormone (AMH) and the severity of the phenotype of patients with polycystic ovary syndrome (PCOS) and whether AMH can act as a diagnostic marker for PCOS? DESIGN A prospective diagnostic utility study of AMH as a marker of PCOS. PATIENTS A consecutive series of women presenting to a tertiary infertility clinic (n = 164) plus a second series of women prepared for assisted conception treatments (n = 89) recruited between June 2012 and May 2013. MEASUREMENTS Polycystic ovary syndrome was diagnosed using the Rotterdam criteria. AMH was measured using the Generation II assay (Beckman Coulter). The diagnostic utility of AMH was established using receiver operator characteristic (ROC) curves. Cut-off values for the individual features of PCOS are proposed. RESULTS There was a significant difference in serum AMH concentration in women with normal ovaries (13·2 pmol/l), polycystic ovary morphology (PCOM) alone (37·8 pmol/l) and PCOS (53·2 pmol/l). Follicle number, increasing cycle length and evidence of hyperandrogenism were all independently associated with serum AMH concentration (P < 0·01). AMH was significantly affected by the different phenotypic presentations of PCOS with those with all components (PCOM, HA and OA) having the highest mean value [72·7 pmol/l (P < 0·01)]. CONCLUSIONS Serum AMH has the capacity to act as a diagnostic test for PCOS. Moreover, since its value rises with the more marked phenotypes, different cut-off values need to be used to differentiate those patients with polycystic ovarian morphology (PCOM), hyperandrogenism (HA) and oligoanovulation (OA).
Collapse
Affiliation(s)
- S L Jacob
- Leeds Centre for Reproductive Medicine, Seacroft Hospital, Leeds, UK
| | - H P Field
- Blood Sciences, Leeds General Infirmary, Leeds, UK
| | - N Calder
- Blood Sciences, Leeds General Infirmary, Leeds, UK
| | - H M Picton
- Leeds Centre for Reproductive Medicine, Seacroft Hospital, Leeds, UK
| | - A H Balen
- Leeds Centre for Reproductive Medicine, Seacroft Hospital, Leeds, UK
| | - J H Barth
- Blood Sciences, Leeds General Infirmary, Leeds, UK
| |
Collapse
|
17
|
Huang Z, Yong EL. Ethnic differences: Is there an Asian phenotype for polycystic ovarian syndrome? Best Pract Res Clin Obstet Gynaecol 2016; 37:46-55. [DOI: 10.1016/j.bpobgyn.2016.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/19/2016] [Indexed: 11/17/2022]
|
18
|
Aiyappan SK, Karpagam B, Vadanika V, Chidambaram PK, Vinayagam S, Saravanan KC. Age-Related Normogram for Ovarian Antral Follicle Count in Women with Polycystic Ovary Syndrome and Comparison with Age Matched Controls Using Magnetic Resonance Imaging. J Clin Diagn Res 2016; 10:TC11-3. [PMID: 26894142 DOI: 10.7860/jcdr/2016/17334.7136] [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: 10/14/2015] [Accepted: 12/08/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Antral Follicle count (AFC) is a reliable marker for ovarian reserve. Previous studies have used transvaginal ultrasound for estimation of AFC, however we used magnetic resonance imaging (MRI) for estimation of AFC and for creating an age-related normogram in patients with polycystic ovary syndrome (PCOS) and compared it with normal patients. AIM The aim of this study is to create an age related normogram for AFC in women with PCOS and to compare that with women without polycystic ovarian syndrome using MRI. MATERIALS AND METHODS A total of 1500 women were examined, out of which 400 fitted the criteria for PCOS. They all underwent MRI study and similar age matched women without PCOS also underwent MRI examination. Normogram for AFC were obtained using LMS software and a percentile chart was obtained. RESULTS Normogram for AFC in PCOS women showed decline in number of AFC as the age progresses and the decline was linear. The normogram for AFC was compared with equal number of patients without PCOS and they also showed decline in AFC as the age progresses, however the decline was exponential and faster. CONCLUSION Age related normogram for AFC is widely used and considered as best clinical predictor for ovarian response in assisted reproductive technology. Knowledge of ovarian reserve is important in PCOS and non-PCOS females as PCOS patients are at risk for ovarian hyperstimulation syndrome during gonadotrophin theraphy. MRI is an equally effective and in some times better alternative to transvaginal ultrasound as it has got its own advantages.
Collapse
Affiliation(s)
- Senthil Kumar Aiyappan
- Associate Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| | - Bulabai Karpagam
- Associate Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| | - V Vadanika
- Junior Resident, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| | - Prem Kumar Chidambaram
- Assistant Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| | - S Vinayagam
- Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| | - K C Saravanan
- Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , SRM Nagar, Potheri, Kattankulathur, Kancheepuram, Tamilnadu, India
| |
Collapse
|
19
|
Kollmann M, Martins WP, Raine-Fenning N. Examining the ovaries by ultrasound for diagnosing hyperandrogenic anovulation: updating the threshold for newer machines. Fertil Steril 2014; 101:e25. [DOI: 10.1016/j.fertnstert.2014.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 01/09/2014] [Indexed: 11/24/2022]
|