1
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Jiang L, Liu X, Deng F, Wang Y, Fan Q. Edible bird's nest improves the premature ovarian failure induced by tripterygium glycosides. Food Sci Nutr 2024; 12:4713-4722. [PMID: 39055185 PMCID: PMC11266920 DOI: 10.1002/fsn3.4119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 07/27/2024] Open
Abstract
Premature ovarian failure (POF) is a common disease in the field of gynecological endocrinology that seriously affects the physical and mental health of patients. Previous studies found that edible bird's nest (EBN) could improve uterine function. These suggested that EBN might also have an ameliorating effect on POF. Therefore, in this study, tripterygium glycosides (TGs) were used to induce POF in rats, and the effect of EBN on the improvement of POF was investigated. After the administration of EBN for 14 days, ovarian index and uterine index, serum hormone levels, apoptosis rate of ovarian granulosa cells, follicle-stimulating hormone receptor (FSHR) protein expression level, and the histopathological examination of the ovaries were determined. It was found that administration of medium and high EBN dose groups increased the ovarian index and granular layer thickness of rats with POF. Particularly, higher follicle-stimulating hormone levels and lower corpus luteum content were observed in the high EBN dose group. In addition, there were lower luteinizing hormone levels and fewer atretic follicles but higher progesterone levels in the medium EBN dose group. These results indicated that EBN had preventive and curative effects on POF induced by TGs. Its mechanism of action might be related to the reduction of ovarian granulosa cell apoptosis, regulation of hormones and receptors, and inhibition of follicle closure.
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Affiliation(s)
- Lin Jiang
- School of Pharmaceutical SciencesSun Yat‐Sen UniversityGuangzhouChina
| | - Xuncai Liu
- Bird's Nest Research Institute, Xiamen Yan Palace Seelong Biotechnology Co., Ltd.XiamenChina
| | - Fenghong Deng
- Bird's Nest Research Institute, Xiamen Yan Palace Seelong Biotechnology Co., Ltd.XiamenChina
| | - Yaxin Wang
- Bird's Nest Research Institute, Xiamen Yan Palace Seelong Biotechnology Co., Ltd.XiamenChina
| | - Qunyan Fan
- Bird's Nest Research Institute, Xiamen Yan Palace Seelong Biotechnology Co., Ltd.XiamenChina
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2
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Kim MR, Kim DI, Park SY, Kang HJ, Park SD, Lee JH. The Protective Role of Magnoliae Flos in Preventing Ovotoxicity and Managing Ovarian Function: An In Vitro and In Vivo Study. Int J Mol Sci 2024; 25:6456. [PMID: 38928161 PMCID: PMC11203778 DOI: 10.3390/ijms25126456] [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: 05/02/2024] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Magnoliae Flos (MF) is a medicinal herb widely employed in traditional medicine for relieving sinusitis, allergic rhinitis, headaches, and toothaches. Here, we investigated the potential preventive effects of MF extract (MFE) against 4-vinylcyclohexene diepoxide (VCD)-induced ovotoxicity in ovarian cells and a mouse model of premature ovarian insufficiency (POI). The cytoprotective effects of MFE were assessed using CHO-K1 or COV434 cells. In vivo, B6C3F1 female mice were intraperitoneally injected with VCD for two weeks to induce POI, while MFE was orally administered for four weeks, beginning one week before VCD administration. VCD led to a significant decline in the viabilities of CHO-K1 and COV434 cells and triggered excessive reactive oxygen species (ROS) production and apoptosis specifically in CHO-K1 cells. However, pretreatment with MFE effectively prevented VCD-induced cell death and ROS generation, while also activating the Akt signaling pathway. In vivo, MFE increased relative ovary weights, follicle numbers, and serum estradiol and anti-Müllerian hormone levels versus controls under conditions of ovary failure. Collectively, our results demonstrate that MFE has a preventive effect on VCD-induced ovotoxicity through Akt activation. These results suggest that MFE may have the potential to prevent and manage conditions such as POI and diminished ovarian reserve.
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Affiliation(s)
- Mi Ra Kim
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea; (M.R.K.); (D.-I.K.); (S.Y.P.)
| | - Dong-Il Kim
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea; (M.R.K.); (D.-I.K.); (S.Y.P.)
| | - Sung Yun Park
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea; (M.R.K.); (D.-I.K.); (S.Y.P.)
| | - Hyo Jin Kang
- Department of Biomedical Laboratory Science, Honam University, Gwangju 62399, Republic of Korea;
| | - Sun-Dong Park
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea; (M.R.K.); (D.-I.K.); (S.Y.P.)
| | - Ju-Hee Lee
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea; (M.R.K.); (D.-I.K.); (S.Y.P.)
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3
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Zhang L, Zou J, Wang Z, Li L. A Subpathway and Target Gene Cluster-Based Approach Uncovers lncRNAs Associated with Human Primordial Follicle Activation. Int J Mol Sci 2023; 24:10525. [PMID: 37445702 DOI: 10.3390/ijms241310525] [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: 05/21/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) are emerging as a critical regulator in controlling the expression level of genes involved in cell differentiation and development. Primordial follicle activation (PFA) is the first step for follicle maturation, and excessive PFA results in premature ovarian insufficiency (POI). However, the correlation between lncRNA and cell differentiation was largely unknown, especially during PFA. In this study, we observed the expression level of lncRNA was more specific than protein-coding genes in both follicles and granulosa cells, suggesting lncRNA might play a crucial role in follicle development. Hence, a systematical framework was needed to infer the functions of lncRNAs during PFA. Additionally, an increasing number of studies indicate that the subpathway is more precise in reflecting biological processes than the entire pathway. Given the complex expression patterns of lncRNA target genes, target genes were further clustered based on their expression similarity and classification performance to reveal the activated/inhibited gene modules, which intuitively illustrated the diversity of lncRNA regulation. Moreover, the knockdown of SBF2-AS1 in the A549 cell line and ZFAS1 in the SK-Hep1 cell line further validated the function of SBF2-AS1 in regulating the Hippo signaling subpathway and ZFAS1 in the cell cycle subpathway. Overall, our findings demonstrated the importance of subpathway analysis in uncovering the functions of lncRNAs during PFA, and paved new avenues for future lncRNA-associated research.
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Affiliation(s)
- Li Zhang
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Jiyuan Zou
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zhihao Wang
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lin Li
- Guangdong Provincial Key Laboratory of Proteomics, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
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4
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Mi X, Jiao W, Yang Y, Qin Y, Chen ZJ, Zhao S. HGF Secreted by Mesenchymal Stromal Cells Promotes Primordial Follicle Activation by Increasing the Activity of the PI3K-AKT Signaling Pathway. Stem Cell Rev Rep 2022; 18:1834-1850. [PMID: 35089464 PMCID: PMC9209380 DOI: 10.1007/s12015-022-10335-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 01/08/2023]
Abstract
Primordial follicle activation is fundamental for folliculogenesis and for the maintenance of fertility. An effective therapeutic strategy for patients with premature ovarian insufficiency (POI) is to promote the activation of residual primordial follicles. The secretome of human umbilical cord mesenchymal stromal cells (hUC-MSC-sec) contains several components that might promote the activation of primordial follicles. In the present study, we revealed that treatment with the hUC-MSC-sec significantly increased the proportion of activated primordial follicles in mouse ovaries both in vitro and in vivo. The activating effects of hUC-MSC-sec on primordial follicles were attributed to the activation of the PI3K-AKT signaling pathway by hepatocyte growth factor (HGF). While the effect of the hUC-MSC-sec was attenuated by the neutralizing antibodies against HGF, application of exogenous HGF alone also promoted the activation of primordial follicles. Furthermore, we demonstrated that HGF promoted the expression of KITL in granulosa cells by binding with the HGF receptor c-Met, thereby increasing the activity of the PI3K-AKT signaling pathway to activate primordial follicles. Taken together, our findings demonstrate that hUC-MSC-sec promotes primordial follicle activation through the functional component HGF to increase the PI3K-AKT signaling activity, highlighting the application of the hUC-MSC-sec or HGF for the treatment of POI patients.
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Affiliation(s)
- Xin Mi
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Wenlin Jiao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yajuan Yang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yingying Qin
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135, China
| | - Shidou Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
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Shareghi-Oskoue O, Aghebati-Maleki L, Yousefi M. Transplantation of human umbilical cord mesenchymal stem cells to treat premature ovarian failure. Stem Cell Res Ther 2021; 12:454. [PMID: 34380572 PMCID: PMC8359553 DOI: 10.1186/s13287-021-02529-w] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022] Open
Abstract
As one of the problems and diseases for women before 40 years, premature ovarian failure (POF) could be characterized by amenorrhea, low estrogen levels, infertility, high gonadotropin levels, and lack of mature follicles. Causes of the disease involve some genetic disorders, autoimmunity diseases, and environmental factors. Various approaches have been employed to treat POF, however with limited success. Today, stem cells are used to treat POF, since they have the potential to self-repair and regenerate, and are effective in treating ovarian failure and infertility. As mesenchymal stem cell (MSC) could simultaneously activate several mechanisms, many researchers consider MSC transplantation to be the best and most effective approach in cell therapy. A good source for mesenchymal stem cells is human umbilical cord (HUCMSC). Animal models with cyclophosphamide are required for stem cell treatment and performance of HUCMSC transplantation. Stem cell therapy could indicate the levels of ovarian markers and follicle-stimulating hormone receptor. It also increases ovarian weight, plasma E2 levels, and the amount of standard follicles. Herein, the causes of POF, effective treatment strategies, and the effect of HUCMSC transplantation for the treatment of premature ovarian failure are reviewed. Many studies have been conducted in this field, and the results have shown that stem cell treatment is an effective approach to treat infertility.
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Affiliation(s)
- Oldouz Shareghi-Oskoue
- Stem Cell Research Center, Tabriz University of Medical Science, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Aghebati-Maleki
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Immunology, School of Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Science, Tabriz, Iran.
- Department of Immunology, School of Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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6
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Chon SJ, Umair Z, Yoon MS. Premature Ovarian Insufficiency: Past, Present, and Future. Front Cell Dev Biol 2021; 9:672890. [PMID: 34041247 PMCID: PMC8141617 DOI: 10.3389/fcell.2021.672890] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/09/2021] [Indexed: 12/21/2022] Open
Abstract
Premature ovarian insufficiency (POI) is the loss of normal ovarian function before the age of 40 years, a condition that affects approximately 1% of women under 40 years old and 0.1% of women under 30 years old. It is biochemically characterized by amenorrhea with hypoestrogenic and hypergonadotropic conditions, in some cases, causing loss of fertility. Heterogeneity of POI is registered by genetic and non-genetic causes, such as autoimmunity, environmental toxins, and chemicals. The identification of possible causative genes and selection of candidate genes for POI confirmation remain to be elucidated in cases of idiopathic POI. This review discusses the current understanding and future prospects of heterogeneous POI. We focus on the genetic basis of POI and the recent studies on non-coding RNA in POI pathogenesis as well as on animal models of POI pathogenesis, which help unravel POI mechanisms and potential targets. Despite the latest discoveries, the crosstalk among gene regulatory networks and the possible therapies targeting the same needs to explore in near future.
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Affiliation(s)
- Seung Joo Chon
- Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, South Korea
| | - Zobia Umair
- Department of Molecular Medicine, College of Medicine, Gachon University, Incheon, South Korea
| | - Mee-Sup Yoon
- Department of Molecular Medicine, College of Medicine, Gachon University, Incheon, South Korea.,Lee Gil Ya Cancer and Diabetes Institute, Incheon, South Korea.,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, South Korea
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Igboeli P, El Andaloussi A, Sheikh U, Takala H, ElSharoud A, McHugh A, Gavrilova-Jordan L, Levy S, Al-Hendy A. Intraovarian injection of autologous human mesenchymal stem cells increases estrogen production and reduces menopausal symptoms in women with premature ovarian failure: two case reports and a review of the literature. J Med Case Rep 2020; 14:108. [PMID: 32680541 PMCID: PMC7368722 DOI: 10.1186/s13256-020-02426-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
Background Premature ovarian failure is a relatively common condition that affects 1–3% of adult women. Premature ovarian failure occurs when there is loss of ovarian function in women younger than 40 years of age. The causes are mostly iatrogenic or idiopathic. Amenorrhea and infertility are the most important clinical manifestations. So far, no therapeutic intervention has been proved effective in restoring fertility in patients with premature ovarian failure. Attempts to stimulate ovarian function through hormone manipulation typically prove unsuccessful, and patients usually resort to egg donation to achieve pregnancy. In our preclinical work, intraovarian administration of human bone marrow–derived mesenchymal stem cells was able to restore ovarian hormone production, reactivate folliculogenesis, and reverse infertility in a chemotherapy-induced ovarian failure mouse model. Case presentation We present two cases of Caucasian women with premature ovarian failure who resumed ovarian estrogen production and menses 7 months following autologous bone marrow–derived mesenchymal stem cell injections into the ovary. This pilot clinical study is registered with ClinicalTrials.gov (identifier NCT02696889). In this report, we present data from our first two cases that have completed study procedures so far. The bone marrow–derived mesenchymal stem cells were harvested from the bone marrow of the iliac crest of the patients with premature ovarian failure and nucleated cells concentrated and enriched in bone marrow–derived mesenchymal stem cells intraoperatively, and then injected into the patient’s right ovary via laparoscopy. Autologous bone marrow stem cell engraftment into the ovary resulted in several improvements in the treated patients with premature ovarian failure. In measurements by transvaginal ultrasound, there were increases of approximately 50% in volume of the treated ovaries in comparison with the contralateral control ovaries that persisted to the end of the study (1 year). Serum levels of estrogen increased by approximately 150% compared with the preoperative levels. Each of the two patients had an episode of menses, and also both of them reported marked improvement of their menopausal symptoms that also persisted to the end of the study (1 year). The bone marrow–derived mesenchymal stem cell implantation procedure was very well tolerated with no reported adverse events. Conclusions Our study reveals promising improvement of premature ovarian failure–related clinical manifestations in two patients after intraovarian autologous bone marrow–derived mesenchymal stem cells engraftment. These early observations call for additional assessment and further development of intraovarian bone marrow–derived mesenchymal stem cell injection for possible treatment of patients with premature ovarian failure.
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Affiliation(s)
- Prosper Igboeli
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Abdeljabar El Andaloussi
- Department of Pathology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Ujalla Sheikh
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Hajra Takala
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Amro ElSharoud
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Ashley McHugh
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | | | - Steven Levy
- MD Stem Cells, Sylvan Road South, Westport, CT, 06880, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA.
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Dragojević Dikić S, Vasiljević M, Jovanović A, Dikić S, Jurišić A, Srbinović L, Vujović S. Premature ovarian insufficiency - novel hormonal approaches in optimizing fertility. Gynecol Endocrinol 2020; 36:162-165. [PMID: 31311350 DOI: 10.1080/09513590.2019.1640203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Premature ovarian insufficiency (POI) is a delicate medical problem in young women. This condition is not unchangeable and permanent but is associated with intermittent and unpredictable ovarian activity, resulting in low conception rate. Over the period of 8 years, the evaluation of secondary amenorrhea was conducted in 90 patients below the age of 40 who wished to restore fertility. Having confirmed the diagnosis and investigated the etiology of POI, hormone replacement therapy was applied (sequential administration of estradiol and norethisterone acetate) in the first 30 patients (group A). Estrogen-progestogen therapy with daily supplementation of 25 mg of micronized oral dehydroepiandrosterone (DHEA) was conducted in 44 patients (group B), whereas a combined regime (estrogen-progestogen therapy, DHEA supplementation in daily dose of 25 mg, and melatonin supplementation in daily dose of 3 mg) was conducted in 16 patients (group C). In the course of our study, 16 pregnancies were realized (18% of all cases: 17% in group A; 18% in group B; 19% in group C) 6 to 20 months after the initiation of hormone therapy, and there have been 13 completed term pregnancies so far with normal fetal growth and development. We concluded that estrogen-progestogen therapy combined with DHEA and melatonin could optimize fertility and lead to successful pregnancy in POI patients.
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Affiliation(s)
- Svetlana Dragojević Dikić
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Mladenko Vasiljević
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Ana Jovanović
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Srdjan Dikić
- University Medical Center "Bezanijska kosa", Belgrade, Serbia
| | - Aleksandar Jurišić
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Ljubomir Srbinović
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Svetlana Vujović
- Medical Faculty, University of Belgrade, Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
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Ferreri J, Fàbregues F, Calafell JM, Solernou R, Borrás A, Saco A, Manau D, Carmona F. Drug-free in-vitro activation of follicles and fresh tissue autotransplantation as a therapeutic option in patients with primary ovarian insufficiency. Reprod Biomed Online 2019; 40:254-260. [PMID: 31956062 DOI: 10.1016/j.rbmo.2019.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/03/2019] [Accepted: 11/14/2019] [Indexed: 01/09/2023]
Abstract
RESEARCH QUESTION Could in-vitro action of follicles and fresh tissue autotransplantation without tissue culture (drug-free IVA) be useful in patients with primary ovarian insufficiency (POI)? DESIGN Prospective observational cohort study in a tertiary university hospital. Drug-Free IVA was carried out in 14 women with POI with a median age of 33 years (29-36 years), median length of amenorrhoea of 1.5 years (1-11 years), median FSH levels 69.2 mIU/ml (36.9-82.8 mIU/ml) and anti-Müllerian hormone of 0.02 ng/ml (0.01-0.1 ng/ml). The surgical procedure included laparoscopic removal of ovarian cortex, fragmentation of tissue and autografting. Human menopausal gonadotrophin (HMG) was started immediately after surgery. RESULTS Follicle development was detected in seven out of the 14 patients, and five women achieved successful oocyte retrieval. In six women, HCG was administered in 10 cycles. Six embryo transfers were carried out in five women resulting in four pregnancies; a clinical pregnancy rate of four in seven oocyte retrievals and four in six embryo transfers. CONCLUSIONS Drug-free IVA could be a useful therapeutic option for patients with POI, leading to successful IVF outcomes.
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Affiliation(s)
- Janisse Ferreri
- Institut Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, Carrer de Villarroel, 170, Barcelona 08036, Spain.
| | - Francesc Fàbregues
- Institut Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, Carrer de Villarroel, 170, Barcelona 08036, Spain
| | | | | | - Aina Borrás
- FIVClinic, Hospital Clinic of Barcelona, Spain
| | - Adela Saco
- Pathological Anatomy Service, Hospital Clinic de Barcelona
| | - Dolors Manau
- Institut Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, Carrer de Villarroel, 170, Barcelona 08036, Spain
| | - Francisco Carmona
- Institut Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, Carrer de Villarroel, 170, Barcelona 08036, Spain
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10
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Pregnancy following diagnosis of premature ovarian insufficiency: a systematic review. Reprod Biomed Online 2019; 39:467-476. [DOI: 10.1016/j.rbmo.2019.04.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/12/2019] [Accepted: 04/23/2019] [Indexed: 11/22/2022]
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11
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Domniz N, Meirow D. Premature ovarian insufficiency and autoimmune diseases. Best Pract Res Clin Obstet Gynaecol 2019; 60:42-55. [PMID: 31495598 DOI: 10.1016/j.bpobgyn.2019.07.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 01/13/2023]
Abstract
Premature ovarian insufficiency (POI) is a clinical syndrome defined by loss of ovarian activity before the age of 40 years and has a potentially devastating effect upon women's health, both physically and psychologically. An underlying autoimmune disease has been identified in approximately 20% of patients with POI, the most common of which are disorders of the thyroid and adrenal glands. Nevertheless, in the majority of cases, the etiology is unknown. The damage mechanism to the ovary is usually caused by antibodies, and autoimmune POI is usually characterized by cellular infiltration of the theca cells of growing follicles by various inflammatory cells. Yet, other various factors and proteins of unknown clinical significance are present. The major diagnostic tool for otherwise idiopathic POI is the presence of autoantibodies against various ovarian components that strongly support the option of autoimmune etiology of POI. Treatment of the underlying cause of POI is the main strategy, although immunosuppressive therapy should be considered in a selected population of well-defined autoimmune POI and, as in idiopathic POI, in whom the resumption of ovarian activity is possible.
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Affiliation(s)
- Noam Domniz
- Dept. Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Hashomer, 52651, Israel.
| | - Dror Meirow
- Dept. Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Hashomer, 52651, Israel
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Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pappas A, Pantou A, Chronopoulou M, Deligeoroglou E, Koutsilieris M, Pantos K. Autologous Platelet-Rich Plasma Treatment Enables Pregnancy for a Woman in Premature Menopause. J Clin Med 2018; 8:jcm8010001. [PMID: 30577435 PMCID: PMC6352170 DOI: 10.3390/jcm8010001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 12/18/2022] Open
Abstract
This report presents the case of a woman aged 40 who has experienced premature menopause from the age of 35. Having rejected oocyte donation, she opted for intraovarian injection of autologous platelet-rich plasma with the aim to rejuvenate the ovarian tissue and enable the employment of her own gametes through in-vitro fertilization. Six weeks following the autologous platelet-rich plasma treatment, a significant reduction in the patient’s follicle-stimulating hormone (FSH) levels were noted. A natural in-vitro fertilization cycle led to a biochemical pregnancy, resulting in a spontaneous abortion at the 5th week of pregnancy. This is the first report of a successful autologous platelet-rich plasma application leading to pregnancy in menopause. This report uniquely contributes to the medical knowledge and challenges current practice in the context of infertility. The efficiency and safety of this treatment with regard to the reproductive system merits further investigation.
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Affiliation(s)
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Nikolaos Nitsos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Athanasios Pappas
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Agni Pantou
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Margarita Chronopoulou
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
| | - Efthymios Deligeoroglou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.
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马 伟, 陈 薪, 周 星, 李 雪, 陈 婉, 叶 德, 陈 士. [Successful pregnancy following intracytoplasmic sperm injection?embryo transfer in a patient with premature ovarian insufficiency: a case report]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1418-1422. [PMID: 29070478 PMCID: PMC6743970 DOI: 10.3969/j.issn.1673-4254.2017.10.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Indexed: 06/07/2023]
Abstract
We report a case of ovarian function fluctuation during long-term follow-up in a patient with premature ovarian insufficiency (POI). The patient finally obtained clinical pregnancy with subsequent uneventful full-term delivery after several intracytoplasmic sperm injection-embryo transfer (ICSI-ET) cycles. This case demonstrates that hormone replacement therapy (HRT) and assisted reproductive therapy should be applied as soon as possible to young patients with POI who have a strong desire for pregnancy in the absence of contraindications. This strategy helps such patients obtain pregnancy and delivery before the exhaustion of ovarian function.
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Affiliation(s)
- 伟旭 马
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 薪 陈
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 星宇 周
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 雪兰 李
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 婉乐 陈
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 德盛 叶
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 士岭 陈
- />南方医科大学南方医院妇产科生殖医学中心, 广东 广州 510515Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Zhai J, Yao G, Dong F, Bu Z, Cheng Y, Sato Y, Hu L, Zhang Y, Wang J, Dai S, Li J, Sun J, Hsueh AJ, Kawamura K, Sun Y. In Vitro Activation of Follicles and Fresh Tissue Auto-transplantation in Primary Ovarian Insufficiency Patients. J Clin Endocrinol Metab 2016; 101:4405-4412. [PMID: 27571179 PMCID: PMC5095246 DOI: 10.1210/jc.2016-1589] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
CONTEXT Recently, two patients with primary ovarian insufficiency (POI) delivered healthy babies after in vitro activation (IVA) treatment followed by auto-transplantation of frozen-thawed ovarian tissues. OBJECTIVE This study sought to report the first case of live birth after IVA treatment following fresh ovarian tissue grafting in patients with POI, together with monitoring of follicle development and serum hormonal changes. DESIGN This was a prospective observational cohort study. SETTING We performed IVA treatment in 14 patients with POI with mean age of 29 years, mean duration since last menses of 3.8 years, and average basal FSH level of 94.5 mIU/mL. INTERVENTIONS Prior to IVA treatment, all patients received routine hormonal treatments with no follicle development. We removed one ovary from patients with POI and treated them with Akt stimulators. We improved upon early procedures by grafting back fresh tissues using a simplified protocol. MAIN OUTCOME MEASURES In six of the 14 patients (43%), a total of 15 follicle development waves were detected, and four patients had successful oocyte retrieval to yield six oocytes. For two patients showing no spontaneous follicle growth, human menopausal gonadotropin treatment induced follicle growth at 6-8 months after grafting. After vitro fertilization of oocyte retrieved, four early embryos were derived. Following embryo transfer, one patient became pregnant and delivered a healthy baby boy, with three other embryos under cryopreservation. CONCLUSION IVA technology can effectively activate residual follicles in some patients with POI and allow them to conceive their own genetic offspring. IVA may also be useful for treating patients with ovarian dysfunction including aging women and cancer survivors.
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Affiliation(s)
- Jun Zhai
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Guidong Yao
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Fangli Dong
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Zhiqin Bu
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Yuan Cheng
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Yorino Sato
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Linli Hu
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Yingying Zhang
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Jingyuan Wang
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Shanjun Dai
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Jing Li
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Jing Sun
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Aaron J Hsueh
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Kazuhiro Kawamura
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
| | - Yingpu Sun
- Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan
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Kuroda K, Kitade M, Kumakiri J, Jinushi M, Shinjo A, Ozaki R, Ikemoto Y, Katoh N, Takeda S. Minimum ovarian stimulation involving combined clomiphene citrate and estradiol treatment for in vitro
fertilization of Bologna-criteria poor ovarian responders. J Obstet Gynaecol Res 2015; 42:178-83. [DOI: 10.1111/jog.12862] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/09/2015] [Accepted: 08/23/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Keiji Kuroda
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Mari Kitade
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Jun Kumakiri
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Makoto Jinushi
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Azusa Shinjo
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Rie Ozaki
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Yuko Ikemoto
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Noriko Katoh
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynecology; Juntendo University Faculty of Medicine; Tokyo Japan
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Chen YP, Wu WH, Wu HM, Chen CK, Wang HS, Huang HY. Effects of anti-Müllerian hormone and follicle stimulating hormone levels on in vitro fertilization pregnancy rate. Taiwan J Obstet Gynecol 2015; 53:313-6. [PMID: 25286783 DOI: 10.1016/j.tjog.2013.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To analyze the relationship between in vitro fertilization (IVF) pregnancy rate and basal serum hormone levels before patients begin an IVF course. MATERIALS AND METHODS In this retrospective study, we analyzed patients with anti-Müllerian hormone (AMH) data and IVF data from January 2009 to October 2012. Pregnancy rates were calculated by AMH and follicle stimulating hormone quartiles and analyzed using the independent samples t test. Furthermore, patients were divided into three groups by age. The Chi-square test was used to assess the association between the parameters and IVF pregnancy rates. RESULTS From the 910 IVF treatment courses, 377 (41.4%) clinical pregnancies resulted. The pregnant and nonpregnant groups differed significantly in age and FSH and AMH levels. The pregnancy rate was 53.3% for patients aged <32 years and 22.1% for patients aged >38 years. The pregnancy rate was 53.4% for patients with FSH levels <5.6 mIU/mL and 25.8% for patients with FSH levels >8.9 mIU/mL. The pregnancy rate was 56.8% for patients with AMH levels >4.0 ng/mL and 20.0% for patients with AMH levels <1.1 ng/mL. Furthermore, among patients aged <40 years, AMH and FSH were significantly associated with pregnancy rate. Higher pregnancy rates were found among the groups with higher AMH levels than in groups with lower AMH levels. CONCLUSION For patients aged <40 years, basal serum AMH level and FSH level affected the IVF pregnancy rate, and patients with higher AMH levels had better pregnancy rates.
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Affiliation(s)
- Yi-Pin Chen
- Department of Gynecology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Wen-Hsiang Wu
- Department of Healthcare Management, Yuanpei University, Hsinchu, Taiwan
| | - Hsien-Ming Wu
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Chun-Kai Chen
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Hsin-Shih Wang
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Hong-Yuan Huang
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan.
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Maclaran K, Panay N. Current Concepts in Premature Ovarian Insufficiency. WOMENS HEALTH 2015; 11:169-82. [PMID: 25776291 DOI: 10.2217/whe.14.82] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences. Unfortunately, there are many deficiencies in our understanding of the condition as the underlying etiology and optimum management strategies are poorly understood. Improved awareness of POI and its long-term implications has led to increased research interest in recent years. Current research has allowed a greater understanding of the changing epidemiology in POI, genetic factors in its etiology and randomized controlled trials of hormone therapy are underway to provide evidence for treatment. This article reviews the latest literature on POI to summarize current understanding and future directions.
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Affiliation(s)
- Kate Maclaran
- West Middlesex University Hospital NHS Trust, Twickenham Road, Isleworth, Middlesex TW7 6AF, UK
| | - Nick Panay
- Queen Charlotte's & Chelsea and Chelsea & Westminster Hospitals, West London Menopause & PMS Centre, Du Cane Road, London W12 0HS, UK
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Miyazaki K, Miki F, Uchida S, Masuda H, Uchida H, Maruyama T. Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency. Endocr J 2015; 62:93-9. [PMID: 25312800 DOI: 10.1507/endocrj.ej14-0189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to assess the potential predictive factors for follicle growth, ovulation, and pregnancy rate in patients with primary ovarian insufficiency/premature ovarian failure (POI/POF). We enrolled 25 POI patients with desired fertility who were treated and monitored for a minimum of 7 months between the years of 2000-2009 into this retrospective study. The clinical, endocrinologic, chromosomal, and autoimmunologic parameters of these patients were collected. Furthermore, hormonal backgrounds on each of 620 treatment cycles were investigated. The main outcome measures were follicle growth, ovulation, and pregnancy rate. Four of 25 patients (16%) conceived while being monitored and undergoing treatment. Follicle growth, ovulation, and pregnancy rate were not significantly different as a function of parity, iatrogenic history (e.g., chemotherapy), age of disease onset, serum estradiol (E(2))/follicle stimulating hormone (FSH) level at the time of diagnosis, chromosomal abnormality, and positive autoantibody titer. The serum E2 levels on days 1-5 of withdrawal bleeding (Day 1-5 E(2)) were significantly higher in the cycles with successful follicle growth and ovulation than unsuccessful cycles (P<0.05). Receiver-operator characteristic curve analysis revealed the cut-off value of the Day 1-5 E(2) to be 15.5 pg/mL, and an area under the curve (AUC) value of 0.674 for follicle growth and 0.752 for ovulation. The results suggest that cycles with a Day 1-5 E(2)≥15.5 pg/mL have a higher rate of follicle growth and ovulation in patients with POI.
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Affiliation(s)
- Kaoru Miyazaki
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo 160-8582, Japan
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Honnma H, Asada Y, Baba T, Endo T. Continuous high-dose estrogen controls serum FSH and LH levels: new treatment strategy for extremely low ovarian reserve patients, two case reports. Gynecol Endocrinol 2014; 30:341-4. [PMID: 24397391 DOI: 10.3109/09513590.2013.871524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
At present, there are no proven therapies to improve ovarian function in women with premature ovarian insufficiency (POI) or in those with extremely low ovarian reserve (LOR). We report successful IVF outcomes achieved with continuous high-dose estrogen supplementation in patients with LOR. Patients were 33- and 42-year-old nulligravidae with high-serum FSH (over 30 IU/L) and undetectable serum AMH (under 0.1 ng/mL) levels; however, neither patient fulfilled the diagnostic criteria for POI. After cycle cancellation and unsuccessful IVF treatment, both patients received conjugated estrogen (CE) supplementation (2.5-3.75 mg/day) from day 2 of their menstrual cycle to the day of HCG administration in their IVF treatment cycles. Following continuous high-dose estrogen supplementation, oocytes were successfully retrieved from both patients and fertilized. Both patients also achieved ongoing pregnancy through frozen-thawed embryo transfer cycles. In conclusion, high-dose estrogen supplementation down-regulated serum FSH and LH within their physiological ranges, which led to functional follicle growth and prevented early luteinization. Further studies will be needed to confirm the effect of this treatment on POI patients and to establish a new and individualized protocol for LOR patients.
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Abstract
Premature ovarian insufficiency (POI) is a life-changing condition that affects women in their reproductive age. The condition is not necessarily permanent but is associated with intermittent and unpredictable ovarian activity. Hence, spontaneous pregnancies have been reported to be 5-10%. However, pregnancy in patients with POI is still unlikely and rare. Although, there are reviews on POI in the literature, there is a lack of reports which focus on how to improve the reproductive outcome of these women who wish to conceive spontaneously or use assisted conception with their own oocytes. We found that there is no conclusive evidence of which treatment is optimal for women with POI who wish to conceive using their own gametes. However, one could surmise that it is important to lower gonadotropin levels into the physiological range before embarking on any treatment, even if natural conception is the only choice for the woman/couple. In the future, multi-center, randomized, double-blind, placebo-controlled trials should be carried out, which may entail recruitment of patients from various centers nationally and internationally to increase the sample size and therefore achieve a powered study. This may standardize the treatment of women with POI who wish to conceive and ultimately have their biological child.
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Affiliation(s)
- J Ben-Nagi
- * West London Menopause & PMS Centre, Chelsea and Westminster Hospital , 369 Fulham Road, London
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Luciano AA, Lanzone A, Goverde AJ. Management of female infertility from hormonal causes. Int J Gynaecol Obstet 2013; 123 Suppl 2:S9-17. [DOI: 10.1016/j.ijgo.2013.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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22
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Kalantari H, Madani T, Zari Moradi S, Mansouri Z, Almadani N, Gourabi H, Mohseni Meybodi A. Cytogenetic analysis of 179 Iranian women with premature ovarian failure. Gynecol Endocrinol 2013; 29:588-91. [PMID: 23656387 DOI: 10.3109/09513590.2013.788625] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The importance of chromosomal abnormalities in etiology of premature ovarian failure (POF) is well known but in many cases, POF still remains idiopathic. We investigated the frequency and type of chromosomal aberrations in Iranian women diagnosed with idiopathic POF. Standard cytogenetic analysis was carried out in a total of 179 patients. Karyotype analysis of these patients revealed that 161 (89.95%) patients had normal female karyotype and 18 (10.05%) patients had abnormal karyotypes. The abnormal karyotypes included sex reverse sex determining region Y (SRY) negative (five Cases), X chromosome mosaicism (five cases), abnormal X chromosomes (three cases), abnormal autosomes (three cases) and X-autosome translocation (two cases). The overall prevalence of chromosomal abnormalities was 10.05% in this first large-scale report of chromosomal aberrations in Iranian women with POF. The results confirm previous observations and emphasis on the critical role of X chromosome abnormalities as one of the possible etiologies for POF.
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Affiliation(s)
- Hamid Kalantari
- Department of Genetics at Reproductive Biomedicine Research Center, Royan Institute for Reproductive biomedicine, ACECR, Tehran, Iran
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23
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Tsuji I, Ami K, Fujinami N. Pregnancy following ovarian induction in a patient with premature ovarian failure and undetectable serum anti-Müllerian hormone. J Obstet Gynaecol Res 2013; 39:1070-2. [DOI: 10.1111/j.1447-0756.2012.02068.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/19/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Isao Tsuji
- Department of Obstetrics and Gynecology; Kinki University Faculty of Medicine; Osaka; Japan
| | - Kazumi Ami
- Department of Obstetrics and Gynecology; Kinki University Faculty of Medicine; Osaka; Japan
| | - Nahoko Fujinami
- Department of Obstetrics and Gynecology; Kinki University Faculty of Medicine; Osaka; Japan
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Maruyama T, Miyazaki K, Uchida H, Uchida S, Masuda H, Yoshimura Y. Achievement of pregnancies in women with primary ovarian insufficiency using close monitoring of follicle development: case reports. Endocr J 2013; 60:791-7. [PMID: 23445562 DOI: 10.1507/endocrj.ej13-0031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Women with primary ovarian insufficiency (POI)/premature ovarian failure exhibit hypergonadotropic hypogonadism due to follicle dysfunction and depletion before the age of 40 years. Because ovulation is extremely rare and thought to be unpredictable in women with POI and because no ovulation induction regimens have been shown to be efficacious, oocyte donation is the only evidence-based treatment for women with POI with desired fertility. Oocyte donation is, however, extremely limited in several countries including Japan. Here, we report four women with POI who achieved pregnancies resulting from timed intercourse or intrauterine insemination in combination with cyclic estrogen/progesterone therapy and close monitoring of follicle development. These four patients were diagnosed with POI at the mean age of 27.5 ± 8.5 (mean ± SD; range, 19-35), subjected to follicle monitoring at the mean age of 29.8 ± 5.7 (23-35), and conceived at the mean age of 34.5 ± 3.9 (29-38). The interval between the initiation of follicle monitoring and pregnancy was 4.8 ± 2.8 (2-8) years. In one of the patients, her most recent ovulation occurred after a three-year interval. All four patients had uncomplicated pregnancies with term deliveries. In the event that oocyte donation and adoption are not available and/or various treatments with intensive ovulation induction have been unsuccessful, close and continuous monitoring of follicle growth to identify very rare ovulatory events might be considered for patients with POI and desired fertility.
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Affiliation(s)
- Tetsuo Maruyama
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo 160-8582, Japan.
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25
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Caroppo E, D'Amato G. Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn's disease and premature ovarian insufficiency: a case report. J Assist Reprod Genet 2012; 29:973-7. [PMID: 22688827 DOI: 10.1007/s10815-012-9816-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 05/28/2012] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn's disease. METHOD Here is reported the case of a 20 years old woman with Crohn's disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment. RESULTS Corticosteroid treatment was ineffective in restoring patients gonadotropin levels as well as ovarian volume, while estro-progestins promoted a prompt reduction in gonadotrophin levels, which returned in the normal range after two years of treatment, as well as restoration of ovarian function, which occurred after four years of estrogens administration, as demonstrated by normal ovarian volume and ovulatory follicles at ultrasound, and by the re-establishment of regular menses after estroprogestin discontinuation. CONCLUSIONS Long-term suppression of the endogenous gonadotropins using estroprogestins may be suggested as a treatment able to restore ovarian responsiveness even in patients with premature ovarian insufficiency showing highly elevated gonadotropin levels.
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Affiliation(s)
- Ettore Caroppo
- ASL Bari, IVF Unit, P.O. Conversano, Via Edmondo De Amicis 5, Conversano, Ba, Italy.
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26
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Ghazeeri G, Awwad J. Two successful pregnancies in a patient with chemotherapy-induced ovarian failure while on hormone replacement therapy. Gynecol Endocrinol 2012; 28:286-7. [PMID: 22122545 DOI: 10.3109/09513590.2011.633657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemotherapeutic agents administered for the treatment of malignancies can result in the incidence of premature ovarian failure (POF). Ovarian failure is reflected by elevated serum follicle-stimulating hormone (FSH) levels that may reach menopausal levels, at which the chances of a pregnancy are considered extremely rare. We report a case of a 26-year-old female who experienced two successful pregnancies, despite her diagnosis with chemotherapy-induced POF. This case suggests that patients who suffer from POF secondary to chemotherapy might still retain enough ovarian function with good quality oocytes that could support a healthy pregnancy.
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Affiliation(s)
- Ghina Ghazeeri
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
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Abstract
Lifespan prolongation is a common desire of the human race. With advances in biotechnology, the mechanism of aging has been gradually unraveled, laying the theoretical basis of nucleic acid therapy for lifespan prolongation. Regretfully, clinically applicable interventions do not exist without the efforts of converting theory into action, and it is the latter that has been far from adequately addressed at the moment. This was demonstrated by a database search on PubMed and Web of Science, from which only seven studies published between 2000 and 2010 were found to directly touch on the development of nucleic acid therapy for anti-aging and/or longevity enhancing purposes. In light of this, the objective of this article is to overview the current understanding of the intimate association between genes and longevity, and to bring the prospect of nucleic acid therapy for lifespan prolongation to light.
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Affiliation(s)
- Wing-Fu Lai
- Department of Chemistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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28
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An immunological insight into premature ovarian failure (POF). Autoimmun Rev 2010; 9:771-4. [PMID: 20601203 DOI: 10.1016/j.autrev.2010.06.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 06/23/2010] [Indexed: 01/22/2023]
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29
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Genazzani AR. Comment to article 'hormone replacement therapy and successful pregnancy in a patient with premature ovarian failure' of Dr. Dikic. Gynecol Endocrinol 2009; 25:768. [PMID: 19905993 DOI: 10.3109/09513590903004175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A R Genazzani
- Department of Obstetrics and Gynecology, University of Pisa, Italy
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