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Xin L, Li F, Yu H, Xiong Q, Hou Q, Meng Y. Honokiol alleviates radiation-induced premature ovarian failure via enhancing Nrf2. Am J Reprod Immunol 2023; 90:e13769. [PMID: 37766410 DOI: 10.1111/aji.13769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The ovary is highly sensitive to radiation, and patients receiving radiotherapy are at significant risk of premature ovarian failure (POF). This study aimed to explore the radioprotective effect of honokiol (HKL) on ionizing radiation (IR)-induced POF. METHODS Female C57BL/6 mice were administered intraperitoneally with vehicle or HKL once daily for 7 days. On day 7, the mice in the IR and HKL+IR groups were exposed to 3.2 Gy whole-body radiation for one hour after the intraperitoneal injection and sacrificed 12 or 72 h after radiation exposure. The gonadosomatic index (GSI) was calculated. Blood samples were collected for enzyme-linked immunosorbent assay (ELISA). Ovaries were harvested for histological examination, immunohistochemistry, immunofluorescence, TUNEL, western blot, and qPCR. The fertility assessment was evaluated by calculating live offspring number. RESULTS The optimum dose of HKL against radiation was 10 mg/kg via intraperitoneal injection. POF was induced 72 h after irradiation with significantly downregulated proliferating cell nuclear antigen (PCNA). The numbers of primordial and preantral follicles decreased significantly after irradiation (p < .001), whereas the number of atretic follicles increased (p < .001). The serum levels of estradiol (E2 ) and anti-Müllerian hormone (AMH) decreased to 50% of the control group after irradiation (p < .05). Moreover, the GSI after irradiation was 27% lower than in the control group (p < .05). The number of offspring in the IR group dropped by 50% compared with the control group (p < .05). HKL pretreatment protected the animals' fertility, GSI, PCNA, serum levels of E2 and AMH, and the number of primordial and preantral follicles. Significant upregulation of apoptosis-related proteins such as Pho-P53, Bax, Cyto C, C-caspase-3, C-PARP, and pyroptosis-related proteins such as Pho-NF-κB p65, NLRP3, caspase-1, IL-1β, and IL-18 was observed after irradiation, while the expression of Bcl-2 decreased. HKL pretreatment prevented these changes. After irradiation, malondialdehyde (MDA), Nrf2, and HO-1 were upregulated. HKL treatment activated the expression of Nrf2 and HO-1 and promoted the nucleus translocation of Nrf2. Furthermore, HKL did not affect ovarian reserves under physiological conditions. CONCLUSIONS HKL ameliorated IR-induced POF by inhibiting apoptosis and pyroptosis by enhancing Nrf2 expression and translocation.
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Affiliation(s)
- Lingli Xin
- Department of Graduate Administration, General Hospital of Chinese PLA, Beijing, China
- Department of Obstetrics and Gynecology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Fengsheng Li
- Department of Nuclear Radiation Injury and Monitoring, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Huijie Yu
- Department of Nuclear Radiation Injury and Monitoring, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Qi Xiong
- Department of Oncology, General Hospital of Chinese PLA, Beijing, China
| | - Qingxiang Hou
- Department of Obstetrics and Gynecology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yuanguang Meng
- Department of Graduate Administration, General Hospital of Chinese PLA, Beijing, China
- Department of Obstetrics and Gynecology, General Hospital of Chinese PLA, Beijing, China
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Zhou B, Kwan B, Desai MJ, Nalawade V, Ruddy KJ, Nathan PC, Henk HJ, Murphy JD, Whitcomb BW, Su HI. Long-term antimüllerian hormone patterns differ by cancer treatment exposures in young breast cancer survivors. Fertil Steril 2022; 117:1047-1056. [PMID: 35216831 PMCID: PMC9081208 DOI: 10.1016/j.fertnstert.2022.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare antimüllerian hormone (AMH) patterns by cancer status and treatment exposures across 6 years after incident breast cancer using administrative data. DESIGN In a cross-sectional design, AMH levels in patients who developed incident breast cancer between ages 15-39 years during 2005-2019 were matched 1:10 to levels in females without cancer in the OptumLabs Data Warehouse. Modeled AMH patterns were compared among cyclophosphamide-based chemotherapy, non-cyclophosphamide-based chemotherapy, no chemotherapy, and no breast cancer groups. SETTING Commercially insured females in the United States. PATIENT(S) Females with and without breast cancer. EXPOSURE(S) Breast cancer, cyclophosphamide- and non-cyclophosphamide-based chemotherapy. MAIN OUTCOME MEASURE(S) AMH levels. RESULT(S) A total of 233 patients with breast cancer (mean age, 34 years; standard deviation, 3.7 years) contributed 278 AMH levels over a median of 2 years (range, 0-6.7 years) after diagnosis; 52% received cyclophosphamide-based chemotherapy, 17% received non-cyclophosphamide-based chemotherapy (80% platinum-based), and 31% received no chemotherapy. A total of 2,777 matched females without cancer contributed 2,780 AMH levels. The pattern of AMH levels differed among the 4 groups. Among females without cancer and breast cancer survivors who did not undergo chemotherapy, AMH declined linearly over time. In contrast, among those who received cyclophosphamide-based and noncyclophosphamide-based chemotherapy, a nonlinear pattern of AMH level of initial fall during chemotherapy, followed by an increase over 2-4 years, and then by a plateau over 1-2 years before a decline was observed. CONCLUSION(S) In breast cancer survivors, AMH levels from administrative data supported ovarian toxicity of non-cyclophosphamide-based chemotherapy in breast cancer and efficiently depicted the timing and duration of changes in ovarian reserve to reflect the residual reproductive lifespan.
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Affiliation(s)
- Beth Zhou
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Brian Kwan
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093, USA
| | - Milli J. Desai
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Vinit Nalawade
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kathryn J. Ruddy
- Department of Oncology, Mayo Clinic, Rochester, 200 1st St SW, Rochester, MN 55905, USA
| | - Paul C. Nathan
- The Hospital for Sick Children, 555 University Avenue Toronto ON M5G 1X8, CA
| | - Henry J. Henk
- OptumLabs, 11000 Optum Cir, Eden Prarie, MN 55344, USA
| | - James D. Murphy
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Brian W. Whitcomb
- Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 433 Arnold House, Amherst, MA, 01003, USA
| | - H. Irene Su
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093, USA
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Salama S, Sharaf M, Salem SM, Rasheed MA, Salama E, Elnahas T, Lotfy R. FSH versus AMH: age-related relevance to ICSI results. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021; 26:27. [PMID: 34421292 PMCID: PMC8369322 DOI: 10.1186/s43043-021-00071-6] [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] [Received: 06/27/2021] [Accepted: 07/30/2021] [Indexed: 12/04/2022] Open
Abstract
Background Women’s fecundity is known to decrease with the increase in chronologic age. Several biomarkers of the ovarian reserve, including follicle stimulating hormone (FSH), anti Müllerian hormone (AMH), have been proposed as possible predictors for the response to controlled ovarian stimulation (COS). Although there are assumptions indicating that the relationship between age and ovarian reserve is highly variable and the potential different validity of ovarian reserve markers in women in different age groups remains to be demonstrated. The purpose of our study was evaluating FSH and AMH as potential predictors of response to controlled ovarian stimulation and prediction of intracytoplasmic sperm injection (ICSI) outcome according to age. This prospective study has been carried out on 218 women having ICSI cycles. Cases were divided into two groups, group 1 (n 148), their age < 35 years, and group 2 (n 70), their age ≥ 35 years. All women received antagonist protocol during their ICSI cycles. Basal FSH and AMH were measured and correlated to the number of follicles on the day of trigger, the number of oocytes retrieved, chemical, and clinical pregnancies. Results The fertilization rate in group 1 was 68.15%, while in group 2 was 77.82% (p = 0.003) while the implantation rate (number of gestational sacs observed at 6 weeks of pregnancy divided by the number of transferred embryos) was 18.95 and 11.98% in group 1 and group 2, respectively (p = 0.041). The clinical pregnancy rate among both groups was 38.51% in group 1, while 24.29% in group 2 (p = 0.038). Women who got pregnant among those aged < 35 years had significantly lower basal FSH (p < 0.001), while women who got pregnant among those aged ≥ 35 years had significantly higher AMH levels (p value < 0.001) and higher E2 levels on the day of trigger (p = 0.007). Conclusion We found that below the age of 35 years, the chances of pregnancy are more correlated to FSH levels, while above the age of 35 years, AMH was a more relevant test.
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Affiliation(s)
- Sameh Salama
- Reproductive Health and Family Planning Department, Medical Research Division, National Research Centre, 33 Al Bohouth Street, Dokki, Giza, Egypt
| | - Marwa Sharaf
- Obstetrics and Gynaecology Department, Kasr El Eini Teaching Hospital, Cairo University, Cairo, Egypt
| | - Sondos M Salem
- Reproductive Health and Family Planning Department, Medical Research Division, National Research Centre, 33 Al Bohouth Street, Dokki, Giza, Egypt
| | - Mazen Abdel Rasheed
- Reproductive Health and Family Planning Department, Medical Research Division, National Research Centre, 33 Al Bohouth Street, Dokki, Giza, Egypt
| | - Ehab Salama
- Reproductive Health and Family Planning Department, Medical Research Division, National Research Centre, 33 Al Bohouth Street, Dokki, Giza, Egypt
| | - Tamer Elnahas
- Reproductive Health and Family Planning Department, Medical Research Division, National Research Centre, 33 Al Bohouth Street, Dokki, Giza, Egypt
| | - Rehab Lotfy
- Obstetrics and Gynaecology Department, Kasr El Eini Teaching Hospital, Cairo University, Cairo, Egypt
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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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Szkodziak F, Krzyżanowski J, Szkodziak P. Psychological aspects of infertility. A systematic review. J Int Med Res 2021; 48:300060520932403. [PMID: 32600086 PMCID: PMC7328491 DOI: 10.1177/0300060520932403] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objective Fertility may be defined as a capacity to conceive and produce offspring. Infertility is characterized by failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. Infertility concerns an estimated 8–12% of the global population, and is associated with factors including time of unwanted non-conception, age of female partner and number of diseases impacting fertility. Unexplained infertility is described as idiopathic. This study aimed to analyse and evaluate the influence of mental disorders, often considered as reasons for idiopathic infertility, on female and male fertility, including stress, depression, sleep and eating disorders, and addictions. Methods This systematic review comprised a search of MEDLINE, Cochrane and PubMed databases for relevant articles that were analysed by two independent reviewers. Results A total of 106 articles published between 1955–2019 were included. Mental disorders modify endocrine gland and immune system functioning at both the tissue and cellular level, and are negatively associated with female and male fertility. Conclusion Mental disorders may negatively impact female and male fertility. Further studies are required to explain the exact role and contribution of mental disorders to fertility.
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Affiliation(s)
- Filip Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Jarosław Krzyżanowski
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Piotr Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
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Hormonal Effects in Reproductive Technology with Focus on Diminished Ovarian Reserve. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 32406026 DOI: 10.1007/978-3-030-38474-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Modern use of reproductive technologies has revolutionized the treatment of infertile couples. Strategies to improve ovarian function in cases of diminished ovarian reserve are perhaps the least understood area in this field and will be the chief focus of this chapter.
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Jiang L, Cui J, Zhang C, Xie J, Zhang S, Fu D, Duo W. Sigma-1 receptor is involved in diminished ovarian reserve possibly by influencing endoplasmic reticulum stress-mediated granulosa cells apoptosis. Aging (Albany NY) 2020; 12:9041-9065. [PMID: 32409627 PMCID: PMC7288944 DOI: 10.18632/aging.103166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/31/2020] [Indexed: 12/25/2022]
Abstract
Sigma non-opioid intracellular receptor 1 (sigma-1 receptor), a non-opioid transmembrane protein, is located on cellular mitochondrial membranes and endoplasmic reticulum. Current research has demonstrated that sigma-1 receptor is related to human degenerative diseases. This study is focused on the effects of sigma-1 receptor on the pathophysiological process of diminished ovarian reserve (DOR) and granulosa cells (GCs) apoptosis. Sigma-1 receptor concentration in follicular fluid (FF) and serum were negatively correlated with basal follicle-stimulating hormone (FSH) and positively correlated with anti-mullerian hormone (AMH), antral follicle count (AFC). Sigma-1 receptor reduction in GCs was accompanied by endoplasmic reticulum stress (ERS)-mediated apoptosis in women with DOR. Plasmid transfection was used to establish SIGMAR1-overexpressed and SIGMAR1-knockdown human granulosa-like tumor (KGN) cell and thapsigargin (TG) was used to induce ERS KGN cells. We found that KGN cells treated with endogenous sigma-1 receptor ligand dehydroepiandrosterone (DHEA) and sigma-1 receptor agonist PRE-084 showed similar biological effects to SIGMAR1-overexpressed KGN cells and opposite effects to SIGMAR1-knockdown KGN cells. DHEA may improve DOR patients' pregnancy outcomes by upregulating sigma-1 receptor and downregulating ERS-mediated apoptotic genes in GCs. Thus, sigma-1 receptor may be a potential ovarian reserve biomarker, and ligand-mediated sigma-1 receptor activation could be a future approach for DOR therapy.
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Affiliation(s)
- Lile Jiang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jinquan Cui
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Cuilian Zhang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Juanke Xie
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shaodi Zhang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Dongjun Fu
- School of Pharmaceutical Sciences and Collaborative Innovation Center of New Drug Research and Safety Evaluation, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Duo
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Abstract
The reproductive function of humans is regulated by several sex hormones which are secreted in synergy with the circadian timing of the body. Sleep patterns produce generic signatures that physiologically drive the synthesis, secretion, and metabolism of hormones necessary for reproduction. Sleep deprivation among men and women is increasingly reported as one of the causes of infertility. In animal models, sleep disturbances impair the secretion of sexual hormones thereby leading to a decrease in testosterone level, reduced sperm motility and apoptosis of the Leydig cells in male rats. Sleep deprivation generates stressful stimuli intrinsically, due to circadian desynchrony and thereby increases the activation of the Hypothalamus-Pituitary Adrenal (HPA) axis, which, consequently, increases the production of corticosterone. The elevated level of corticosteroids results in a reduction in testosterone production. Sleep deprivation produces a commensurate effect on women by reducing the chances of fertility. Sleeplessness among female shift workers suppresses melatonin production as well as excessive HPA activation which results in early pregnancy loss, failed embryo implantation, anovulation and amenorrhea. Sleep deprivation in women has also be found to be associated with altered gonadotropin and sex steroid secretion which all together lead to female infertility. Poor quality of sleep is observed in middle-aged and older men and this also contributes to reduced testosterone concentrations. The influence of sleep disturbances post-menopausal is associated with irregular synthesis and secretion of female sex steroid hormones.
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Çelebi F, Ordu Ç, Ilgün S, Oztürk A, Erdoğan Iyigün Z, Alço G, Duymaz T, Aktepe F, Soybir G, Baysal B, Özmen V. The Effect of Systemic Chemotherapy on Ovarian Function: A Prospective Clinical Trial. Eur J Breast Health 2020; 16:177-182. [PMID: 32656517 DOI: 10.5152/ejbh.2020.5114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/25/2019] [Indexed: 11/22/2022]
Abstract
Objective Premenopausal women with breast cancer are at risk of developing ovarian failure after chemotherapy. The aim of this study was to investigate the negative effects of systemic chemotherapy on ovarian function in premenoupausal women with breast cancer. Materials and Methods Thirty-one premenopausal women with operable breast cancer aged between 26-48 years were enrolled in this prospective cohort study to investigate preliminary results. Additional 69 patients' data will be included after the completion of all five measurements. The change in serum Antimullerian Hormone (AMH) levels, mean ovarian volumes (MOV) and antral follicle counts (AFCs) at 3-month intervals were recorded to evaluate ovarian function. Women who had at least one pretreatment and four post-treatment measurements in one year follow-up period were included in the study. Decision of chemotherapy regimen was taken by the Tumor Board. Results Thirty-one patients had all five AMH, MOV and AFCs results. There was a statistically significant negative correlation between 1st - 5th AMH levels (p=0.006) and 1st - 5th AFCs during the follow-up period (p<0.0001). However pre- and post-chemotherapy measurements of MOVs did not demonstrate any significant correlation (p=0.799). BMI, parity, lactation, histopathology and molecular subtypes of breast cancer, alcohol intake, smoking and type of chemotherapy regimen were not significantly correlated with AMH, AFC and MOV. Conclusion Pretreatment AMH levels and AFC were shown to have a significant role in early prediction of ovarian-reserve after chemotherapy.
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Affiliation(s)
- Filiz Çelebi
- Department of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Çetin Ordu
- Department of Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Serkan Ilgün
- Department of General Surgery, Demiroğlu Bilim University School of Medicine, İstanbul, Turkey
| | - Alper Oztürk
- Department of General Surgery, Biruni University Hospital, İstanbul, Turkey
| | - Zeynep Erdoğan Iyigün
- Department of Physical Therapy and Rehabilitation, Demiroğlu Bilim University School of Medicine, İstanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physical Therapy and Rehabilitation, Bilgi University, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Gürsel Soybir
- Department of General Surgery, Memorial Etiler Hospital, İstanbul, Turkey
| | - Bülent Baysal
- Department of Obstetrics and Gynecology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
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Evans A, de Lacey S, Tremellen K. Australians' understanding of the decline in fertility with increasing age and attitudes towards ovarian reserve screening. Aust J Prim Health 2019; 24:428-433. [PMID: 30158051 DOI: 10.1071/py18040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/21/2018] [Indexed: 01/18/2023]
Abstract
The aim of this study is to determine Australians' understanding of the decline in fertility with age, social determinants that influence their decision to start a family and attitudes towards ovarian reserve screening as a tool allowing personalised reproductive life planning. An online survey of 383 childless Australian men and women, aged 18-45 years, was conducted. Both sexes overestimated natural and in vitro fertilization (IVF)-assisted fertility potential with increasing age, with the magnitude of overestimation being more pronounced for men and IVF treatment compared with natural conception. The primary determinants for starting a family were a stable relationship, followed by establishment of career; availability of accessible child care and paid parental leave were considered less important. Finally, the majority of women (74%) would alter their reproductive life planning if they were identified as having low ovarian reserve on screening. Despite increased education, Australians continue to have a poor understanding of age-related decline in natural and IVF-assisted conception, potentially explaining why many delay starting a family. Ovarian reserve screening may help identify individuals at increased risk of premature diminished fertility, giving these women the ability to bring forward their plans for natural conception or undertake fertility preservation (oocyte freezing).
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Affiliation(s)
- Alisha Evans
- Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
| | - Sheryl de Lacey
- Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
| | - Kelton Tremellen
- Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
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Pils S, Stepien N, Kurz C, Nouri K, Promberger R, Ott J. Anti-Mullerian hormone is linked to the type of early pregnancy loss in idiopathic recurrent miscarriage: a retrospective cohort study. Reprod Biol Endocrinol 2017; 15:60. [PMID: 28768516 PMCID: PMC5541661 DOI: 10.1186/s12958-017-0278-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/25/2017] [Indexed: 11/10/2022] Open
Abstract
We correlated Anti-Mullerian hormone (AMH) levels and other parameters for ovarian reserve to the gestational age at the time of pregnancy loss in women with idiopathic recurrent miscarriage. In a retrospective study, 79 patients had suffered a total of 266 miscarriages. When comparing women with an "unembryonic" to those with an "embryonic" most recent miscarriage, there was no difference in median age (36.3 years, IQR 31.6-40.1 versus 34.2 years, IQR 29.9-38.0; p = 0.303) but in median AMH levels (0.7, IQR 0.2-18, versus median 1.8, IQR 1.3-3.3, respectively, p = 0.044) and in the rate of patients with an AMH ≤ 1 ng/mL (23/37, 62.2%, versus 8/42, 19%; p < 0.001). Thus, AMH might add to the diagnostic process in recurrent miscarriage in the future.
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Affiliation(s)
- Sophie Pils
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Natalia Stepien
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Christine Kurz
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Kazem Nouri
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Regina Promberger
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- Department of Obstetrics and Gynecology, Saint John of God Hospital Eisenstadt, Johannes von Gott-Platz 1, 7000 Eisenstadt, Austria
| | - Johannes Ott
- 0000 0000 9259 8492grid.22937.3dDepartment of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- 0000 0000 9259 8492grid.22937.3dClinical Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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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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Kloss JD, Perlis ML, Zamzow JA, Culnan EJ, Gracia CR. Sleep, sleep disturbance, and fertility in women. Sleep Med Rev 2015; 22:78-87. [PMID: 25458772 PMCID: PMC4402098 DOI: 10.1016/j.smrv.2014.10.005] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 01/27/2023]
Abstract
Sleep and sleep disturbances are increasingly recognized as determinants of women's health and well-being, particularly in the context of the menstrual cycle, pregnancy, and menopause. At present, however, little is known about whether fertility is affected by sleep quantity and quality. That is, to what degree, and by what mechanisms, do sleep and/or its disturbances affect fertility? The purpose of this review is to synthesize what is known about sleep disturbances in relation to reproductive capacity. A model is provided, whereby stress, sleep dysregulation, and circadian misalignment are delineated for their potential relevance to infertility. Ultimately, if it is the case that sleep disturbance is associated with infertility, new avenues for clinical intervention may be possible.
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Affiliation(s)
| | - Michael L Perlis
- Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, USA
| | | | | | - Clarisa R Gracia
- Department of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, USA
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14
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Pelosi E, Simonsick E, Forabosco A, Garcia-Ortiz JE, Schlessinger D. Dynamics of the ovarian reserve and impact of genetic and epidemiological factors on age of menopause. Biol Reprod 2015; 92:130. [PMID: 25904009 PMCID: PMC4645983 DOI: 10.1095/biolreprod.114.127381] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/05/2015] [Accepted: 04/06/2015] [Indexed: 01/27/2023] Open
Abstract
The narrow standard age range of menopause, ∼50 yr, belies the complex balance of forces that govern the underlying formation and progressive loss of ovarian follicles (the "ovarian reserve" whose size determines the age of menopause). We show here the first quantitative graph of follicle numbers, distinguished from oocyte counts, across the reproductive lifespan, and review the current state of information about genetic and epidemiological risk factors in relation to possible preservation of reproductive capacity. In addition to structural X-chromosome changes, several genes involved in the process of follicle formation and/or maintenance are implicated in Mendelian inherited primary ovarian insufficiency (POI), with menopause before age 40. Furthermore, variants in a largely distinct cohort of reported genes-notably involved in pathways relevant to atresia, including DNA repair and cell death-have shown smaller but additive effects on the variation in timing of menopause in the normal range, early menopause (age <45), and POI. Epidemiological factors show effect sizes comparable to those of genetic factors, with smoking accounting for about 5% of the risk of early menopause, equivalent to the summed effect of the top 17 genetic variants. The identified genetic and epidemiological factors underline the importance of early detection of reproductive problems to enhance possible interventions.
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Affiliation(s)
- Emanuele Pelosi
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Eleanor Simonsick
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | | | - Jose Elias Garcia-Ortiz
- División de Genética, Centro de Investigacion Biomedica de Occidente-IMSS, Guadalajara, Mexico
| | - David Schlessinger
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
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15
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Spitzer D, Corn C, Stadler J, Wirleitner B, Schuff M, Vanderzwalmen P, Grabher F, Zech NH. Implications of Blood Type for Ovarian Reserve and Infertility - Impact on Oocyte Yield in IVF Patients. Geburtshilfe Frauenheilkd 2014; 74:928-932. [PMID: 25364032 PMCID: PMC4210383 DOI: 10.1055/s-0034-1383045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/29/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022] Open
Abstract
Introduction: Diminished ovarian reserve (DOR) has been linked to certain subpopulations and distinct gene polymorphisms. It has even been hypothesized that the AB0 blood group system could be linked to ovarian reserve (OR) as reflected by early follicular phase follicle stimulating hormone (FSH) levels. Although estimation of OR is routinely done using levels of anti-Müllerian hormone (AMH), FSH, estradiol or inhibin B, the diagnostic accuracy of these markers is often limited. The aim of this study was to evaluate whether there is any correlation between IVF patients' AB0 blood group system and ART outcome. Methods: In this retrospective observational single-center study we investigated the outcome of 1889 IVF cycles carried out between 2005 and 2012 with regard to blood type and OR in different age groups (21-36 years and 37-43 years). The number of cumulus oocyte complexes (COCs) and metaphase II oocytes obtained after ovarian stimulation, fertilization rate (FR), pregnancy rate (PR) and birth rate (BR) were evaluated with respect to maternal age (21-36 and 37-43 years, respectively). Results: We found no significant differences in the average number of COCs after ovum pick-up in either of the age groups. Moreover, the mean number of MII oocytes and 2PN stages were similar for all blood type groups. As regards IVF outcome measured in terms of PR and BR, no significant differences were observed between the different blood groups. In conclusion, no correlation was found between blood type and female fertility. Discussion: The most precise definition of OR is determining the number of competent oocytes. Based on the finding of our study, the hypothesis that there is a correlation between OR and AB0 blood group system can be dismissed for Caucasian IVF patients.
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Affiliation(s)
- D. Spitzer
- IVF Zentren Prof Zech Salzburg, Salzburg, Austria
| | - C. Corn
- IVF Zentren Prof Zech Salzburg, Salzburg, Austria
| | - J. Stadler
- IVF Zentren Prof Zech Salzburg, Salzburg, Austria
| | | | - M. Schuff
- IVF Zentren Prof Zech Bregenz, Bregenz, Austria
| | | | - F. Grabher
- IVF Zentren Prof Zech Bregenz, Bregenz, Austria
| | - N. H. Zech
- IVF Zentren Prof Zech Bregenz, Bregenz, Austria
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16
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La Marca A, Dondi G, Sighinolfi G, Giulini S, Papaleo E, Cagnacci A, Faddy MJ. The ovarian response to controlled stimulation in IVF cycles may be predictive of the age at menopause. Hum Reprod 2014; 29:2530-5. [DOI: 10.1093/humrep/deu234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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17
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Nelson SM, Iliodromiti S, Fleming R, Anderson R, McConnachie A, Messow CM. Reference range for the antimüllerian hormone Generation II assay: a population study of 10,984 women, with comparison to the established Diagnostics Systems Laboratory nomogram. Fertil Steril 2014; 101:523-9. [DOI: 10.1016/j.fertnstert.2013.10.021] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 09/24/2013] [Accepted: 10/12/2013] [Indexed: 11/17/2022]
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