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Barreto MCDA, Treistman N, Cavalcante LBCP, Bulzico D, de Andrade FA, Corbo R, Alves Junior PAG, Vaisman F. Serum anti-Müllerian hormone is lower in patients with multiple radioiodine dose for treatment of pediatric thyroid cancer. Eur Thyroid J 2024; 13:e230252. [PMID: 38290210 PMCID: PMC10959028 DOI: 10.1530/etj-23-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/30/2024] [Indexed: 02/01/2024] Open
Abstract
Introduction Treatment of patients with pediatric differentiated thyroid cancer (DTC) often involves radioiodine (RAI), which is associated with increased risks of short- and long-term adverse outcomes. The impact of RAI treatment on the female reproductive system remains uncertain. Anti-Müllerian hormone (AMH) is a marker of ovarian reserve and is related to fertility. Objective The aim was to analyze the association between RAI and serum AMH level in women treated with RAI. Methods We evaluated women with pediatric DTC treated with RAI at the age of ≤19 years. Serum AMH was measured. Results The study included 47 patients with a mean age of 25.1 years (12.4-50.8) at AMH measurement and follow-up of 11.8 ± 8.4 years. The mean RAI administered was 235 mCi (30-1150). Sixteen (34%) received multiple RAI doses (471 ± 215 mCi). Mean AMH level was 2.49 ng/mL (0.01-7.81); the level was 1.57 ng/mL (0.01-7.81) after multiple RAI doses and 2.99 ng/mL (0.01-6.63) after a single RAI dose (P = 0.01). Patients who received a cumulative RAI lower than 200 mCi had higher AMH levels (2.23 ng/mL, 0.39-7.81) than those who received more (1.0 ng/mL, 0.01-6.63; P = 0.02). In patients with similar cumulative RAI activities, administration of multiple RAI doses was significantly and independently associated with AMH level lower than the reference range for age (HR: 5.9, 1.55-52.2, P = 0.014) after age adjustments. Conclusion Levels of AMH were lower after multiple RAI doses, especially after a cumulative RAI dose above 200 mCi. More studies are needed to clarify the impact of RAI on fertility considering its cumulative activity and treatment strategy.
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Affiliation(s)
- Marise Codeco de Andrade Barreto
- Department of Oncologic Endocrinology, Instituto Nacional de Câncer – INCA, Rio de Janeiro, RJ, Brazil
- Department of Endocrinology, Universidade Federal do Rio de Janeiro – UFRJ, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
| | - Natalia Treistman
- Department of Endocrinology, Universidade Federal do Rio de Janeiro – UFRJ, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
| | | | - Daniel Bulzico
- Department of Oncologic Endocrinology, Instituto Nacional de Câncer – INCA, Rio de Janeiro, RJ, Brazil
| | | | - Rossana Corbo
- Department of Oncologic Endocrinology, Instituto Nacional de Câncer – INCA, Rio de Janeiro, RJ, Brazil
| | - Paulo Alonso Garcia Alves Junior
- Department of Oncologic Endocrinology, Instituto Nacional de Câncer – INCA, Rio de Janeiro, RJ, Brazil
- Department of Endocrinology, Universidade Federal do Rio de Janeiro – UFRJ, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
| | - Fernanda Vaisman
- Department of Oncologic Endocrinology, Instituto Nacional de Câncer – INCA, Rio de Janeiro, RJ, Brazil
- Department of Endocrinology, Universidade Federal do Rio de Janeiro – UFRJ, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
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Gui J, Ni Y, Liu Q, Wang X, Xie Q. Comparison of clinical effects between early follicular prolonged GnRH agonist protocol and GnRH antagonist protocol in 3310 cycles: a retrospective study. BMC Pregnancy Childbirth 2022; 22:942. [PMID: 36522703 PMCID: PMC9756476 DOI: 10.1186/s12884-022-05295-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND It is the duty of doctors to choose a safe, simple, economic and effective controlled ovulation stimulation (COS) protocol for the patients. This study aims to compare the clinical effects of the early follicular prolonged GnRH agonist (EFPL) and GnRH antagonist (GnRH-Ant) protocols, hoping to provide some reference for clinicians when choosing COS program. METHODS A retrospective study included 3310 ovum pick up cycles undergoing assisted reproductive technology during January 2019 to May 2022 in Renmin Hospital of Wuhan University. Propensity Score Matching (PSM) and multivariable logistic regression analysis were used to improve the comparability between the two protocols. Subgroups were divided according to age, body mass index (BMI) and anti-Mullerian hormone (AMH). The live birth rate (LBR) and clinical pregnancy rate (CPR) were the primary outcomes. RESULTS After PSM, the endometrial thickness, fresh embryo transplantation rate, chemical pregnancy rate, CPR were significantly higher in EFPL group than that in GnRH-Ant group (P < 0.001). The E2, LH, P values on trigger day were significantly lower in EFPL group (P < 0.001). The cycle cancellation rate was significantly reduced in EFPL group (P < 0.001). However, the total amount of Gn and duration of Gn were significantly increased in the EFPL group (P < 0.001). Multivariable logistic regression analysis showed that the LBR was significantly higher in EFPL group after matching [OR (95%CI), 1.86 (1.13, 3.05), P = 0.02], especially for those with age < 35 years [OR (95%CI), 1.95 (1.14, 3.34), P = 0.02], BMI < 24 kg/m2 [OR (95%CI), 2.08 (1.14, 3.80), P = 0.02], AMH levels ≥ 4.5 ng/ml [OR (95%CI), 4.19 (1.53, 11.43), P < 0.01]. CONCLUSION EFPL regimen is more suitable to elicit live birth for those young patients with BMI < 24 kg/m2 and AMH ≥ 4.5 ng/ml. However, for patients with decreased ovarian reserve or advanced age, EFPL regimen has no advantage over the GnRH-Ant regimen.
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Affiliation(s)
- Juan Gui
- grid.412632.00000 0004 1758 2270Dept. of Reproductive center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, 430060 Wuhan, China ,Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan, China
| | - Yuan Ni
- grid.412632.00000 0004 1758 2270Dept. of Reproductive center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, 430060 Wuhan, China ,Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan, China
| | - Qian Liu
- grid.412632.00000 0004 1758 2270Dept. of Reproductive center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, 430060 Wuhan, China ,Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan, China
| | - Xiaochen Wang
- grid.412632.00000 0004 1758 2270Dept. of Reproductive center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, 430060 Wuhan, China ,Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan, China
| | - Qingzhen Xie
- grid.412632.00000 0004 1758 2270Dept. of Reproductive center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, 430060 Wuhan, China ,Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan, China
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Hosseinzadeh F, Kabodmehri R, Mehrafza M, Mansour-Ghanaei M, Sorouri ZZ, Gashti NG, Hanifi S, Ghalandari M. The Effect of Age and AMH Level on ART Outcomes in Patients With Reduced Ovarian Reserve: A Retrospective Cross-Sectional Study. J Obstet Gynaecol India 2022; 72:420-425. [PMID: 36458067 PMCID: PMC9568644 DOI: 10.1007/s13224-021-01582-y] [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: 07/15/2021] [Accepted: 10/07/2021] [Indexed: 10/18/2022] Open
Abstract
Background Despite many advances, patients with a poor ovarian response to stimulation are one of the most important and challenging factors of infertility. Chronological and ovarian ages are two effective factors responsible for poor response to assisted reproduction treatment. The purpose of this study was to determine the effect of age and AMH level on the in vitro fertilization (IVF) outcomes in participants with a reduced ovarian reserve. Methods In this retrospective cross-sectional study, 210 participants with anti-Mullerian hormone (AMH) < 1.1 ng/ml were included. The effect of age and AMH on pregnancy outcomes including dominant follicle count, serum estradiol level on the day of trigger administration, number of metaphase II (MII) oocytes, number of embryos, biochemical pregnancy, clinical pregnancy, abortion and live birth rate were evaluated. Results The number of dominant follicle (p < 0.001), MII oocyte (p < 0.001), grade A (p < 0.001) and B (p < 0.001) embryos, serum estradiol level (p < 0.001), gonadotropin level ( p< 0.001), AMH (p = 0.001), biochemical pregnancy (p = 0.007), clinical (p = 0.01) pregnancy, and live birth rate (p = 0.003) were higher in participants younger than 35 years old. In univariable logistic regression, the chance of retrieving more than 3 oocytes in individuals over 35 years old was 97.1% lower than in individuals younger than 35 years old (p < 0.001). Conclusion It has been concluded that the higher clinical pregnancy and live birth rate in participants younger than 35 years can be due to the higher AMH level in this group. Under the same conditions of AMH and other variables, age can affect the number of retrieved oocytes.
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Affiliation(s)
- Fatemeh Hosseinzadeh
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Roya Kabodmehri
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Marzieh Mehrafza
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mandana Mansour-Ghanaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Ziba Zahiri Sorouri
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasrin Ghanami Gashti
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Sakineh Hanifi
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Ghalandari
- Vice-Chancellorship of Research and Technology, Guilan University of Medical Science, Rasht, Iran
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Garba SR, Makwe CC, Osunkalu VO, Kalejaiye OO, Soibi-Harry AP, Aliyu AU, Afolabi BB. Ovarian reserve in nigerian women with sickle cell anaemia: a cross- sectional study. J Ovarian Res 2021; 14:174. [PMID: 34895288 PMCID: PMC8666009 DOI: 10.1186/s13048-021-00927-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Sickle cell disease is the most common monogenetic disorder worldwide. There have been reports of endocrine dysfunction and gonadal failure among affected individuals, especially in males. The findings on ovarian reserve and failure in women with sickle anaemia have been inconsistent. AIM AND OBJECTIVE The aim of this study was to determine and compare the ovarian reserve of Nigerian women with and without sickle cell anaemia attending a University Teaching Hospital. STUDY DESIGN This cross-sectional study was carried out at the Adult Sickle Cell Clinic and the Community Health Clinic of the Lagos University Teaching Hospital. METHODOLOGY A total of 166 participants who met the selection criteria, were recruited for the study. The study population consisted of two groups of women matched for age: 83 women with HbSS and 83 women with HbAA. The haemoglobin phenotype of each participant was determined on alkaline electrophoresis (pH 8.4) before analysis. Serum Anti-Mullerian Hormone (AMH) was determined using Enzyme-linked immunosorbent assay (ELISA) method (Calbiotech Inc. USA, Catalog no AM448T). RESULTS The mean ± SD of serum AMH level in women with HbSS was 3.64 ± 0.65 ng/mL and was lower than that of women with HbAA 7.35 ±1.19 ng/mL (p < 0.001). Serum AMH negatively correlated with age in both study groups (HbAA and HbSS). Also, a significant negative correlation was found between serum AMH and BMI in women with HbAA. CONCLUSION The study showed diminished ovarian reserve in women with HbSS when compared to age-matched women with HbAA.
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Affiliation(s)
- Sunusi Rimi Garba
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
| | - Christian Chigozie Makwe
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Vincent Oluseye Osunkalu
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Hematology and Blood Transfusion, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Olufunto Olufela Kalejaiye
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Medicine, College of Medicine University of Lagos, Lagos, Nigeria
| | - Adaiah Priscillia Soibi-Harry
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
| | - Amina Umar Aliyu
- Department of Nursing, Lagos University Teaching Hospital, Idi-Araba Lagos, Lagos, Nigeria
| | - Bosede Bukola Afolabi
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
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Li F, Niu A, Feng X, Yan Y, Chen Y. The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology. Sci Rep 2021; 11:11368. [PMID: 34059771 PMCID: PMC8166946 DOI: 10.1038/s41598-021-90970-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/18/2021] [Indexed: 01/07/2023] Open
Abstract
We explored the independent risk factors associated with cases of spontaneous abortion in infertile patients treated with human-assisted reproductive technology (ART) and established a smooth curve fit and perform a threshold effect analysis can provide guidance and a valuable reference for predicting the probability of spontaneous abortion. This was a retrospective cohort study of 16,097 patients successfully conceived with ART in Shangqiu First People's Hospital from June 2013 to December 2018. Overall, 2,378 (14.77%) had an abortion and 13,719 (85.23%) did not have an abortion. Multivariate logistic regression analysis showed that female age (OR 1.050; 95% CI 1.032–1.069; P < 0.001), male age (OR 1.100; 95% CI 1.086–1.115; P < 0.001), follicular-stimulating hormone (OR 1.049; 95% CI 1.022–1.076; P < 0.001), anti-Mullerian hormone (OR 0.893; 95% CI 0.862–0.925; P < 0.001) and the number of fetuses at pregnancy diagnosis were independent factors associated with spontaneous abortion. The threshold effect analysis found that when female age > 32 years (cut-off point) old, age and the risk of spontaneous abortion were positively correlated. When follicular-stimulating hormone > 6.1 IU/L (cut-off point), follicular-stimulating hormone was positively correlated with the occurrence of spontaneous abortion, When anti-Mullerian hormone ≤ 3.1 ng/mL (cut-off point), anti-Mullerian hormone was negatively correlated with the occurrence of spontaneous abortion and there was a linear positive correlation between antral Follicle Counting and live birth. In addition, the older the male age, the higher the incidence of abortion. The smooth curve fit and threshold effect analyses can provide a more detailed estimate of the probability of spontaneous abortion for pregnant couples.
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Affiliation(s)
- Fei Li
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - AiQin Niu
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - XingMei Feng
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - Ying Yan
- Department of Molecular Biology, The First People's Hospital of Shangqiu, Henan, People's Republic of China
| | - Ying Chen
- Department of Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Henan, People's Republic of China.
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Laqqan MM, Yassin MM. Predictive factors of ovarian response to GnRH antagonist stimulation protocol: AMH and age are potential candidates. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021. [DOI: 10.1186/s43043-021-00062-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Prediction of ovarian response prior to the ovarian stimulation cycle is useful in determining the optimal starting dose of recombinant follicle-stimulating hormone (r-FSH). This study was designed to (I) evaluate which of the following parameters (age, AMH, and FSH) can be used as a predictor of ovarian response to GnRH antagonist stimulation protocol, (II) determine the cutoff value of AMH and age for predicting poor and high ovarian response, and (III) investigate the relationship between age, AMH level, and other clinical parameters. It is a retrospective study. A total of 318 women with a mean age of 28.2 ± 5.9 years old were included in this study. Hormone levels (FSH, LH, PRL, E2, and AMH) and the number of collected oocytes were determined. Based on the number of retrieved oocytes, the participants were divided into three groups: poor response (oocytes < 4, n= 51), normal response (oocytes 4–14, n= 192), and high response (oocytes > 14, n= 75).
Results
A significant increase has been found in AMH level and number of retrieved oocytes and mature oocytes from low to normal and high ovarian response group (P < 0.001). Also, the age in the poor ovarian response group was significantly greater than normal and high ovarian response groups (P < 0.001). A significant positive correlation has been found between the number of retrieved oocytes and mature oocytes and level of AMH (P < 0.001). The receiver operating characteristic (ROC) curves showed that both AMH and age had the highest accuracy in the prediction of poor ovarian response with a cutoff value < 1.45 and > 31.5 years, respectively. Additionally, the ROC analysis has shown that the AMH had the highest accuracy, followed by age in the prediction of high ovarian response with a cutoff value > 3.55 and < 27.5 years, respectively.
Conclusions
This study demonstrates that AMH level and women’s age may be used as potential predictors of ovarian response to GnRH antagonist stimulation protocol.
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Sun TC, Zhou SJ, Song LL, Li JH, Chen X, Tian L. High anti-Müllerian hormone levels might not reflect the likelihood of clinical pregnancy rate in IVF/ICSI treatment. JBRA Assist Reprod 2021; 25:266-271. [PMID: 33710839 PMCID: PMC8083848 DOI: 10.5935/1518-0557.20200094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: To investigate if high anti-Müllerian hormone (AMH) concentration is a useful tool to predict the outcome of assisted reproductive treatment. Methods: Retrospective cohort study involving 520 patients who underwent IVF/ICSI procedures in a university hospital. We measured the serum AMH level on day 3 of the menstrual cycle. Based on AMH levels, we divided the patients into three groups as follows: low (<25th percentile) AMH group, average (25th to 75th percentile) AMH group and high (>75th percentile) AMH group. We recorded the fertilization rate (FR), the number of oocytes retrieved, the number of good quality embryos (GQEs) and the clinical pregnancy rate (CPR). Results: There was no difference between the three AMH groups in terms of maternal age, body mass index (BMI), follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH) and testosterone (T) in the IVF/ICSI cycles. The women in the high serum AMH group had a higher number of retrieved oocytes than those in the low or average AMH groups (p < 0.01) in the IVF/ICSI cycles. Compared with the low or average AMH groups, the women with high AMH levels had a higher number of good quality embryos (GQEs) in the IVF/ICSI cycles (p < 0.01). However, high AMH women had no significantly higher clinical pregnancy rate (CPR) compared to the women in the low or average AMH groups. In addition, for the prediction of CPR, the AMH levels alone were not an independent predictor of CPR for IVF and ICSI cycles in the ROC curve analysis. Conclusions: High anti-Müllerian hormone levels are an independent predictor of the number of retrieved oocytes and good quality embryos (GQEs), but might not reflect the likelihood of higher clinical pregnancy rates (CPR) in IVF/ICSI treatment.
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Affiliation(s)
- Tie-Cheng Sun
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, 102206, China
| | - Shan-Jie Zhou
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, 102206, China
| | - Ling-Li Song
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, 102206, China
| | - Jian-Hua Li
- Center of Reproductive Medicine and Genetics, Seventh Medical Center of PLA General Hospital, Beijing 100027, China
| | - Xi Chen
- Reproductive Medicine Centre Peking University Second Affiliated Hospital, Beijing, 100044, China
| | - Li Tian
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, 102206, China.,Reproductive Medicine Centre Peking University Second Affiliated Hospital, Beijing, 100044, China
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Umarsingh S, Adam JK, Krishna SBN. The relationship between anti-Müllerian hormone (AMH) levels and pregnancy outcomes in patients undergoing assisted reproductive techniques (ART). PeerJ 2021; 8:e10390. [PMID: 33391866 PMCID: PMC7761264 DOI: 10.7717/peerj.10390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/27/2020] [Indexed: 11/20/2022] Open
Abstract
A variety of predictors are available for ovarian stimulation cycles in assisted reproductive technology (ART) forecasting ovarian response and reproductive outcome in women including biomarkers such as anti- Müllerian hormone (AMH). The aim of our present study was to compare the relationship between AMH levels and pregnancy outcomes in patients undergoing intra-cytoplasmic sperm injection (ICSI). Overall, fifty patients (n = 50), aged 20-45 years were recruited for the present prospective study. Three AMH levels were presented with high often poly cystic ovarian syndrome (PCOS) amongst 52.4% patients, 40.5% in normal and 7.1% in low to normal, correspondingly. There was statistically significant relationship between AMH and day of embryo transfer (p < 0.05). The Pearson analysis between AMH, age, E2 and FSH displayed no statistically significant relationship between E2 and AMH (p < 0.05) and negative correlation between FSH and age (p > 0.05). The area under the receiver operating characteristic curve for E2 was 0.725 and for AMH levels as predictors of CPR was 0.497 indicating E2 as better predictor than AMH. The number of oocytes, mature oocytes and fertilized oocytes all presented a weak positive relationship to AMH. Our results confirm the clinical significance of AMH to accurately predict ovarian reserve as a marker and its limitations to use as predictor for a positive pregnancy outcome. Additional prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.
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Affiliation(s)
- Shalini Umarsingh
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jamila Khatoon Adam
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Suresh Babu Naidu Krishna
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
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Li F, Ye T, Kong H, Li J, Hu L, Jin H, Guo Y, Li G. Predictive Factors for Live Birth in Fresh In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatment in Poor Ovarian Reserve Patients Classified by the POSEIDON Criteria. Front Endocrinol (Lausanne) 2021; 12:630832. [PMID: 33967954 PMCID: PMC8099421 DOI: 10.3389/fendo.2021.630832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
The mechanisms underlying poor ovarian response (POR) in assisted reproductive technology remain unclear, there is no consensus on the management of poor responders, the POSEIDON stratification classifies infertility patients into "expected" or "unexpected" groups to provide a more nuanced picture of POR, but few researchers have discussed the independent predictive factors (smoothed plots and the threshold effect) for live birth in POR patients classified by the new criteria. We conducted a retrospective cohort study using clinical data from 6,580 POR patients classified by the POSEIDON criteria in the First Affiliated Hospital of Zhengzhou University, and explored the live birth based on the results before and after the threshold inflection point of each independent influencing factor. Among 6,580 poor ovarian reserve patients classified by the POSEIDON criteria, 1,549 (23.54%) had live births, and 5,031 (76.46%) did not have live births. Multivariate logistic regression analysis showed that female age (OR 0.901; 95% CI 0.887~0.916; P < 0.001), body mass index (OR 0.963; 95% CI 0.951~0.982; P < 0.001), antral follicle counting (OR 1.049; 95% CI 1.009~1.042; P < 0.001) and controlled ovarian hyperstimulation protocol were independent factors predicting live birth in patients with POR. The threshold effect analysis found that the inflection point of female age was 34 years old, and when age was > 34 years old, the probability of live birth in POR patients dropped sharply (OR 0.7; 95% CI 0.7~0.8; P < 0.001). The inflection point of BMI was 23.4 kg/m2, and BMI had a negative correlation with live birth (OR 0.963; 95% CI 0.951~0.982; P < 0.001). The threshold inflection point of AFC was 8n. Female age, BMI, AFC and COH protocol were independent predictive factors associated with live birth in POR patients classified by the POSEIDON criteria. The smooth curve fit and threshold effect analyses provide clinical management strategies for these patients. In addition, the early-follicular-phase long-acting GnRH-agonist long protocol seems to have a higher live birth rates than other protocols. It is worth highlighting that BMI should be considered as well in the POSEIDON criteria.
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Affiliation(s)
- Fei Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Center for Reproductive Medicine, The First People’s Hospital of Shangqiu, Shangqiu, China
| | - Tian Ye
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huijuan Kong
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linli Hu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - HaiXia Jin
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YiHong Guo
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Gang Li,
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Kereilwe O, Kadokawa H. Decreased Anti-Müllerian hormone and Anti-Müllerian hormone receptor type 2 in hypothalami of old Japanese Black cows. J Vet Med Sci 2020; 82:1113-1117. [PMID: 32554955 PMCID: PMC7468072 DOI: 10.1292/jvms.20-0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cow fertility decreases with age, but the hypothalamic pathomechanisms are not
understood. Anti-Müllerian hormone (AMH) stimulates gonadotropin-releasing hormone (GnRH)
neurons via AMH receptor type 2 (AMHR2), and most GnRH neurons in the preoptic area (POA),
arcuate nucleus (ARC), and median eminence (ME) express AMH and AMHR2. Therefore, we
hypothesized that both protein amounts would differ in the anterior hypothalamus
(containing the POA) and posterior hypothalamus (containing the ARC and ME) between young
post-pubertal heifers and old cows. Western blot analysis showed lower
(P<0.05) expressions of AMH and AMHR2 in the posterior hypothalamus,
but not in the anterior hypothalamus, of old Japanese Black cows compared to young
heifers. Therefore, AMH and AMHR2 were decreased in the posterior hypothalami of old
cows.
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Affiliation(s)
- Onalenna Kereilwe
- The United Graduate School of Veterinary Science, Yamaguchi University, Yoshida 1677-1, Yamaguchi-shi, Yamaguchi 753-8515, Japan
| | - Hiroya Kadokawa
- The United Graduate School of Veterinary Science, Yamaguchi University, Yoshida 1677-1, Yamaguchi-shi, Yamaguchi 753-8515, Japan
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