1
|
Purewal S, Chapman SCE, van den Akker OBA. A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies. J Psychosom Obstet Gynaecol 2019; 40:2-18. [PMID: 29172958 DOI: 10.1080/0167482x.2017.1403418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Lifestyle (smoking, drinking alcohol) and body mass index (BMI) predictors of successful outcomes in assisted reproductive technology (ART) treatments were examined in this meta-analysis. METHOD A bibliographic search was undertaken using six databases. The review was informed by PRISMA/MOOSE guidelines. Meta-analytic data were analysed using random effects models. RESULTS We included 77 studies examining effects of BMI, smoking and drinking alcohol. Patients with a BMI< =24.9 were significantly more likely to achieve LB/pregnancy than with BMI> =25 OR = 1.219 (95% CI:1.128-1.319, z = 4.971, p < .001; I2 = 53.779%, p = .001). Non-smokers were significantly more likely to achieve a LB or pregnancy than smokers OR = 1.457 (95% CI:1.228-1.727, z = 4.324, p < .001; I2 = 51.883; p = .001). Meta-regression revealed the number of embryos transferred significantly moderated the effects of smoking on ART outcomes, and there was a trend indicating primary infertility and high BMI were also significant moderators. The evidence for drinking alcohol was inconclusive due to the small number of studies. CONCLUSIONS This meta-analysis confirms that ART treatment success can be predicted with lifestyle factors. Further, non-smokers' relative odds of pregnancy/live birth increase as more embryos were transferred but there was a trend that the odds of pregnancy/live birth decrease with primary infertility and high BMI.
Collapse
Affiliation(s)
- Satvinder Purewal
- a Institute of Psychology, Faculty of Education, Health and Wellbeing , University of Wolverhampton , Wolverhampton , UK
| | - S C E Chapman
- b Department of Pharmacy & Pharmacology , University of Bath , Bath , UK
| | - O B A van den Akker
- c Department of Psychology, School of Science and Technology , Middlesex University , London , UK
| |
Collapse
|
2
|
Purewal S, Chapman SCE, van den Akker OBA. Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: a meta-analysis. Reprod Biomed Online 2018; 36:646-657. [PMID: 29622404 DOI: 10.1016/j.rbmo.2018.03.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
This meta-analysis investigated whether state anxiety and depression scores during assisted reproductive technology (ART) treatment and changes in state anxiety and depression scores between baseline and during ART treatment are associated with treatment outcome. PubMed, PsycInfo, Embase, ScienceDirect, Web of Science and Scopus were searched and meta-analytic data analysed using random effects models to estimate standardized mean differences. Eleven studies (2202 patients) were included. Women who achieved pregnancy had significantly lower depression scores during treatment than women who did not become pregnant (-0.302; 95% CI: -0.551 to -0.054, z = -2.387, P = 0.017; I2 = 77.142%, P = 0.001). State anxiety scores were also lower in women who became pregnant (-0.335; 95% CI: -0.582 to -0.087, z = -2.649, P = 0.008; I2 = 81.339%, P = 0.001). However, changes in state anxiety (d = -0.056; 95% CI: -0.195 to 0.082, z = -0.794; I2 = 0.00%) and depression scores (d = -0.106; 95% CI: -0.296 to 0.085, z = -1.088; I2 = 0.00%) from baseline to treatment were not associated with ART outcome. Clinics should aim to promote better psychosocial care to help patients manage the psychological and physical demands of ART treatment, giving realistic expectations.
Collapse
Affiliation(s)
- Satvinder Purewal
- Institute of Psychology, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1AD, UK.
| | - Sarah C E Chapman
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down Road, Bath, BA2 7AY, UK
| | - Olga B A van den Akker
- Department of Psychology, Faculty of Science and Technology, Middlesex University, London, NW4 4BT, UK
| |
Collapse
|
3
|
Purewal S, Chapman SCE, van den Akker OBA. A systematic review and meta-analysis of psychological predictors of successful assisted reproductive technologies. BMC Res Notes 2017; 10:711. [PMID: 29212545 PMCID: PMC5719749 DOI: 10.1186/s13104-017-3049-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/30/2017] [Indexed: 01/27/2023] Open
Abstract
Objectives The aim of this systematic review and meta-analysis was to perform an updated investigation of the effects of depression and anxiety on pregnancy outcomes following assisted reproductive technologies. A bibliographic search was performed using PubMed, PsycINFO, Embase, Science Direct databases. Data retrieved were analysed using a random effects model to estimate standardised mean differences. Results Of the 22 included studies, 18 investigated depression, 15 state anxiety, and seven trait anxiety. Data from 4018 patients were included in the meta-analysis. Results indicated that women who achieved pregnancy or a live birth reported lower levels of depression pre-treatment than those who did not, although the effects were small d = − 0.177 (95% CI − 0.327 to − 0.027, z = 2.309, p = 0.021). These results were consistent under different methodological conditions and the quality of these observational were graded as satisfactory. A similar pattern was seen for state (d = − 0.096, 95% CI − 0.180 to − 0.012: z = 2.241, p = 0.025) and trait anxiety (d = − 0.188, 95% CI − 0.007 to 0.356, z = 2.181, p = 0.029). More research is needed to investigate the impact of psychological variables on assisted reproductive technologies outcomes and moderator influences during assisted reproductive technologies processes. Electronic supplementary material The online version of this article (10.1186/s13104-017-3049-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- S Purewal
- Institute of Psychology, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1AD, UK.
| | - S C E Chapman
- Department of Pharmacy & Pharmacology, University of Bath, Claverton Down Road, Bath, BA2 7AY, UK
| | - O B A van den Akker
- Department of Psychology, School of Science and Technology, Middlesex University, London, NW4 4BT, UK
| |
Collapse
|
4
|
Hardy TM, McCarthy DO, Fourie NH, Henderson WA. Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain. J Obstet Gynecol Neonatal Nurs 2016; 45:772-780. [PMID: 27639111 PMCID: PMC5107147 DOI: 10.1016/j.jogn.2016.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To explore the association of hypothalamic-pituitary-adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP). DESIGN AND SETTING A secondary data analysis was performed with data from female participants in a natural history protocol at the National Institutes of Health. PARTICIPANTS A total of 36 women (age range = 19-39 years, mean = 27.11 years) were included in the study. METHODS This pilot study was conducted with a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included participants with and without CAP who provided a 5-hour urine sample for determination of cortisol levels and serum samples for determination of circulating levels of cortisol, luteinizing hormone, and follicle-stimulating hormone. CAP was defined as presence or absence of chronic pain for at least 6 months and was determined via self-report. RESULTS Anti-Müllerian hormone (AMH) concentrations declined significantly with age as expected. When AMH levels were dichotomized as normal or abnormal (defined as higher or lower than age-specific normative ranges, respectively), there were significant associations between abnormal AMH levels and CAP and urine cortisol levels. Participants with CAP or low urine cortisol levels were significantly more likely to have abnormal AMH levels. CONCLUSION Results suggest that chronic abdominal pain and hypothalamic-pituitary-adrenal dysregulation may be associated with abnormal AMH levels.
Collapse
|
5
|
Wu B, Shi J, Zhao W, Lu S, Silva M, Gelety TJ. Understanding reproducibility of human IVF traits to predict next IVF cycle outcome. J Assist Reprod Genet 2014; 31:1323-30. [PMID: 25119191 PMCID: PMC4171406 DOI: 10.1007/s10815-014-0288-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/29/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Evaluating the failed IVF cycle often provides useful prognostic information. Before undergoing another attempt, patients experiencing an unsuccessful IVF cycle frequently request information about the probability of future success. Here, we introduced the concept of reproducibility and formulae to predict the next IVF cycle outcome. METHODS The experimental design was based on the retrospective review of IVF cycle data from 2006 to 2013 in two different IVF centers and statistical analysis. The reproducibility coefficients (r) of IVF traits including number of oocytes retrieved, oocyte maturity, fertilization, embryo quality and pregnancy were estimated using the interclass correlation coefficient between the repeated IVF cycle measurements for the same patient by variance component analysis. The formulae were designed to predict next IVF cycle outcome. RESULTS The number of oocytes retrieved from patients and their fertilization rate had the highest reproducibility coefficients (r = 0.81 ~ 0.84), which indicated a very close correlation between the first retrieval cycle and subsequent IVF cycles. Oocyte maturity and number of top quality embryos had middle level reproducibility (r = 0.38 ~ 0.76) and pregnancy rate had a relative lower reproducibility (r = 0.23 ~ 0.27). Based on these parameters, the next outcome for these IVF traits might be accurately predicted by the designed formulae. CONCLUSIONS The introduction of the concept of reproducibility to our human IVF program allows us to predict future IVF cycle outcomes. The traits of oocyte numbers retrieved, oocyte maturity, fertilization, and top quality embryos had higher or middle reproducibility, which provides a basis for accurate prediction of future IVF outcomes. Based on this prediction, physicians may counsel their patients or change patient's stimulation plans, and laboratory embryologists may improve their IVF techniques accordingly.
Collapse
Affiliation(s)
- Bin Wu
- Arizona Center for Reproductive Endocrinology and Infertility, Tucson, AZ, 85712, USA,
| | | | | | | | | | | |
Collapse
|
6
|
O'Neill SM, Khashan AS, Henriksen TB, Kenny LC, Kearney PM, Mortensen PB, Greene RA, Agerbo E. Does a Caesarean section increase the time to a second live birth? A register-based cohort study. Hum Reprod 2014; 29:2560-8. [PMID: 25217610 DOI: 10.1093/humrep/deu217] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does a primary Caesarean section influence the rate of, and time to, subsequent live birth compared with vaginal delivery? SUMMARY ANSWER Caesarean section was associated with a reduction in the rate of subsequent live birth, particularly among elective and maternal-requested Caesareans indicating maternal choice plays a role. WHAT IS KNOWN ALREADY Several studies have examined the relationship between Caesarean section and subsequent birth rate with conflicting results primarily due to poor epidemiological methods. STUDY DESIGN, SIZE, DURATION This Danish population register-based cohort study covered the period from 1982 to 2010 (N = 832 996). PARTICIPANTS/MATERIALS, SETTING, METHODS All women with index live births were followed until their subsequent live birth or censored (maternal death, emigration or study end) using Cox regression models. MAIN RESULTS AND THE ROLE OF CHANCE In all 577 830 (69%) women had a subsequent live birth. Women with any type of Caesarean had a reduced rate of subsequent live birth (hazard ratio [HR] 0.86, 95% confidence intervals [CI] 0.85, 0.87) compared with spontaneous vaginal delivery. This effect was consistent when analyses were stratified by type of Caesarean: emergency (HR 0.87, 95% CI 0.86, 0.88), elective (HR 0.83, 95% CI 0.82, 0.84) and maternal-requested (HR 0.61, 95% CI 0.57, 0.66) and in the extensive sub-analyses performed. LIMITATIONS, REASONS FOR CAUTION Lack of biological data to measure a woman's fertility is a major limitation of the current study. Unmeasured confounding and limited availability of data (maternal BMI, smoking, access to fertility services and maternal-requested Caesarean section) as well as changes in maternity care over time may also influence the findings. WIDER IMPLICATIONS OF THE FINDINGS This is the largest study to date and shows that Caesarean section is most likely not causally related to a reduction in fertility. Maternal choice to delay or avoid childbirth is the most plausible explanation. Our findings are generalizable to other middle- to high-income countries; however, cross country variations in Caesarean section rates and social or cultural differences are acknowledged. STUDY FUNDING/COMPETING INTERESTS Funding was provided by the National Perinatal Epidemiology Centre, Cork, Ireland and conducted as part of the Health Research Board PhD Scholars programme in Health Services Research (Grant No. PHD/2007/16). L.C.K. is a Science Foundation Ireland Principal Investigator (08/IN.1/B2083) and the Director of the SFI funded Centre, INFANT (12/RC/2272). The authors have no competing interests to declare.
Collapse
Affiliation(s)
- Sinéad M O'Neill
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, 5th Floor, Wilton, Cork, Ireland
| | - Ali S Khashan
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Tine B Henriksen
- Perinatal Epidemiology Research Unit, Department of Paediatrics, Aarhus University Hospital, Skejby DK - 8200 Aarhus N, Denmark
| | - Louise C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Preben B Mortensen
- National Centre for Register-based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Richard A Greene
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, 5th Floor, Wilton, Cork, Ireland
| | - Esben Agerbo
- National Centre for Register-based Research (NCRR), Aarhus University, Aarhus, Denmark CIRRAU-Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| |
Collapse
|
7
|
O'Neill SM, Kearney PM, Kenny LC, Henriksen TB, Lutomski JE, Greene RA, Khashan AS. Caesarean delivery and subsequent pregnancy interval: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2013; 13:165. [PMID: 23981569 PMCID: PMC3765853 DOI: 10.1186/1471-2393-13-165] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 08/13/2013] [Indexed: 11/25/2022] Open
Abstract
Background Caesarean delivery has increased worldwide, however, the effects on fertility are largely unknown. This systematic review aims to compare subsequent sub-fertility (time to next pregnancy or birth) among women with a Caesarean delivery to women with a vaginal delivery. Methods Systematic review of the literature including seven databases: CINAHL; the Cochrane Library; Embase; Medline; PubMed; SCOPUS and Web of Knowledge (1945 - October 2012), using detailed search-strategies and reference list cross-checking. Cohort, case–control and cross-sectional studies were included. Two assessors reviewed titles, abstracts, and full articles using standardised data abstraction forms and assessed study quality. Results 11 articles were eligible for inclusion in the systematic review, of these five articles which adjusted for confounders were combined in a meta-analysis, totalling 750,407 women using fixed-effect models. Previous Caesarean delivery was associated with an increased risk of sub-fertility [pooled odds ratio (OR) 0.90; 95% CI 0.86, 0.93]. Subgroup analyses by parity [primiparous women: OR 0.91; 95% CI 0.87, 0.96; not limited to primiparous women: OR 0.81; 95% CI 0.73, 0.90]; by publication date (pre-2000: OR 0.80, 95% CI 0.68, 0.94; post-2000: OR 0.90, 95% CI 0.86, 0.94); by length of follow-up (<10 years: OR 0.81, 95% CI 0.73, 0.90; >10 years: OR 0.91, 95% CI 0.87, 0.96); by indication for mode of delivery (specified: 0.92, 95% CI 0.88, 0.97; not specified: OR 0.81, 95% CI 0.73, 0.90); by cohort size (<35,000: OR 0.79, 95% CI 0.67, 0.92; >35,000: OR 0.90, 95% CI 0.87, 0.95), by definition of sub-fertility used divided into (birth interval [BI]: OR 0.89, 95% CI 0.84, 0.94; inter-pregnancy interval [IPI]: OR 0.91, 95% CI 0.85, 0.97; and categorical measures: OR 0.81, 95% CI 0.73, 0.90); continuous measures: OR 0.91, 95% CI 0.87, 0.96) were performed. Results of the six studies not included in the meta-analysis (which did not adjust for confounders) are presented individually. Conclusions The meta-analysis shows an increased waiting time to next pregnancy and risk of sub-fertility among women with a previous Caesarean delivery. However, included studies are limited by poor epidemiological methods such as variations in the definition of time to next pregnancy, lack of confounding adjustment, or details of the indication for Caesarean delivery. Further research of a more robust methodological quality to better explore any underlying causes of sub-fertility and maternal intent to delay childbearing is warranted.
Collapse
Affiliation(s)
- Sinéad M O'Neill
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, 5th Floor, Cork University Maternity Hospital, Wilton, Cork, Ireland.
| | | | | | | | | | | | | |
Collapse
|
8
|
Eriksson C, Larsson M, Skoog Svanberg A, Tydén T. Reflections on fertility and postponed parenthood-interviews with highly educated women and men without children in Sweden. Ups J Med Sci 2013; 118:122-9. [PMID: 23305524 PMCID: PMC3633327 DOI: 10.3109/03009734.2012.762074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Different reasons influence the current low birth-rate and the postponement of the birth of the first child throughout Europe. The aim of this study was to explore how highly educated women and men in Sweden reflect on fertility and postponed parenthood. METHODS We interviewed women (n = 22) and men (n = 18) who had started their professional careers and still had no children. Data were analysed with qualitative content analysis. RESULTS Fertility was perceived as an unconsidered capacity, sometimes unpredictable, and different for women and men, but nevertheless taken for granted. The participants were of the opinion that fertility could be restored by assisted reproductive technologies or replaced by alternatives to a biological child. Postponed parenthood was described as an adaptation to societal changes and current discourses about parenthood as well as a consequence of a contemporary lifestyle with many competing priorities. CONCLUSION Highly educated young women and men in contemporary Sweden have competing priorities when planning and setting goals for their lives, and having children is one of them. They describe fertility as an imperceptible and retrievable capacity and postponed parenthood as a rational adaptation to changes in society. These findings suggest that increased information about the limitations of human reproduction is needed, but also that societal support for younger parents is of utmost importance.
Collapse
Affiliation(s)
- Carola Eriksson
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Sweden
| | | | - Tanja Tydén
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| |
Collapse
|
9
|
Ovarian biopsy has no role as a routine diagnostic test of ovarian reserve: a systematic review. Reprod Biomed Online 2012; 24:492-5. [DOI: 10.1016/j.rbmo.2012.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 01/04/2012] [Accepted: 01/24/2012] [Indexed: 11/23/2022]
|
10
|
Milán M, Cobo AC, Rodrigo L, Mateu E, Mercader A, Buendía P, Peinado V, Delgado A, Mir P, Simón C, Remohí J, Pellicer A, Rubio C. Redefining advanced maternal age as an indication for preimplantation genetic screening. Reprod Biomed Online 2010; 21:649-57. [DOI: 10.1016/j.rbmo.2010.06.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 05/27/2010] [Accepted: 06/02/2010] [Indexed: 10/19/2022]
|
11
|
Reproduction expediting: Sexual motivations, fantasies, and the ticking biological clock. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2010.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
12
|
Gibreel A, Maheshwari A, Bhattacharya S, Johnson NP. Ultrasound tests of ovarian reserve; a systematic review of accuracy in predicting fertility outcomes. HUM FERTIL 2009; 12:95-106. [PMID: 19802960 DOI: 10.1080/14647270902896256] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We conducted a systematic review of studies evaluating the diagnostic accuracy of all the ultrasound based tests of ovarian reserve, including antral follicle count (AFC), ovarian volume and stromal blood flow in predicting fertility outcomes and, where appropriate, performed a meta-analysis to determine the predictive_value at each cut-off value described in the literature. Included in the analysis were 17 studies for AFC, six studies for ovarian volume and six studies for stromal blood flow. Meta-analyses showed that women with AFC less than four were 8.7 times more likely not to get pregnant after IVF (two studies; 95% CI, 2.4-31.7) than women with AFC four or more. The sensitivity and specificity of AFC to predict cycle cancellation was 66.7% and 94.7%, respectively. Women with an AFC of less than four were 37 times (two studies; 95% CI, 13.68-100.45) more likely to have their cycle cancelled than women with AFC of four o r more. Ovarian volume measurement, at a cut off value of 3 cm3, showed specificity for prediction of cycle cancellation and non-pregnancy of 92% (three studies, 95% CI, 89-94) and 93% (three studies, 95% CI, 87-97), respectively. The clinical value of Doppler studies for ovarian stromal blood flow was unclear.
Collapse
Affiliation(s)
- Ahmed Gibreel
- Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, UK
| | | | | | | |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW It is estimated that 10% of women experience a rapid decline in their ovarian reserve from the early 30s. This is called 'early ovarian ageing'. With the development of the so-called 'ovarian reserve tests', it was hoped that it would be possible to assess each woman's ovarian biological age and screen for 'early ovarian ageing' in the general population. This review examines the progress that has been made in this area. RECENT FINDINGS Almost the entire literature on ovarian reserve tests refers to women having IVF, rather than women in the general population. Recent systematic reviews have shown that the currently known 'ovarian reserve' tests are reasonably good at predicting the number of eggs that are collected following ovarian stimulation with gonadotrophins in the context of an IVF cycle. They show very poor correlation with live-birth rates. The reason is that they cannot directly assess oocyte quality. SUMMARY Screening for 'early ovarian ageing' in the general population is desirable but still not possible. Therefore, postponing childbearing to the late 30s remains a risky gamble. Advice to individual women should be given by specialist reproductive endocrinologists, though home-testing is not advisable.
Collapse
|
14
|
Current world literature. Curr Opin Obstet Gynecol 2008; 20:602-7. [PMID: 18989138 DOI: 10.1097/gco.0b013e32831ceeb3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Leese H. The legacy of IVF. HUM FERTIL 2008; 11:69-70. [PMID: 18569060 DOI: 10.1080/14647270802191519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|