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Feres LFR, Siqueira LGB, Palhao MP, Dos Santos LL, Pfeifer LFM, Fernandes CADC, Viana JHM. Selecting oocyte donors based on anti-Müllerian hormone (AMH) concentrations: A critical analysis of using cutoff values as exclusion criterion for an in vitro embryo production program in Gir cattle. Anim Reprod Sci 2024; 266:107491. [PMID: 38754337 DOI: 10.1016/j.anireprosci.2024.107491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/13/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
The aims of this study were to determine anti-müllerian hormone (AMH) cutoff values for selecting Gir (Bos taurus indicus) oocyte donors and estimate the impact of using AMH concentrations as a selection criterion. In Exp. 1, Gir heifers (n=120) were sampled for AMH analysis and submitted to ovum pick-up and in vitro embryo production (OPU-IVEP). AMH cutoff values were calculated using ROC analysis or, alternatively, by the successive exclusion of heifers with the lowest AMH values. The correlations between AMH and OPU-IVEP outcomes were significant (P<0.001), though low or moderate (r= 0.34-0.52). We estimated an improvement (P<0.05) after the use of AMH cutoff values to select donors of +15.3% for total oocyes, +19.4% for viable COC, and +23.4% for blastocysts. This selection pressure, however, led to the exclusion of 32.8%, 37.9%, and 50.0% of the initial potential donors, respectively. In Exp. 2, we analyzed data from OPU-IVEP sessions of 658 Gir donors with known genomic values for predicted transmitting ability for milk (GPTAm) and age at first calving (GPTAafc). The selection based on the number of oocytes recovered had no effect (P>0.05) on the average GPTAm nor GPTAafc values of the remaining donors. In summary, plasma AMH ≥700 pg/mL is a cutoff value that can be used to select Gir heifers with a greater potential as oocyte donors. Nevertheless, this selection leads to the exclusion of up to 50% of potential donors. Finally, exclusion of poor responders had no effect on mean genomic estimates for milk production or age at first calving in the selected subset of donors.
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Affiliation(s)
| | | | | | | | | | | | - Joao Henrique Moreira Viana
- Universidade José do Rosário Vellano, Alfenas, MG 37130-000, Brazil; Embrapa Recursos Genéticos e Biotecnologia, Brasília, DF 70770-901, Brazil.
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Brochado C, Duran BJ, Kieffer JD, Pinczak A, Menchaca A, Garcia-Guerra A. Reduced embryo yield obtained from superstimulated ewes with low circulating AMH concentration is improved by lengthening the FSH treatment. Theriogenology 2024; 218:79-88. [PMID: 38301510 DOI: 10.1016/j.theriogenology.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
The aim of the present study was to evaluate: 1) the association between AMH, AFC, superovulatory response and embryo yield in sheep; and 2) the effect of FSH treatment length during superstimulation of the first follicular wave on ovarian response and embryo yield, particularly in ewes with low and high AMH. The experiment was performed on 63 Polled Dorset ewes that received an ovarian superstimulatory treatment during the first follicular wave (Day 0 protocol). Ewes were administered a total dose of 240 mg of FSH distributed in six (6-dose regimen, n = 30) or eight (8-dose regimen, n = 33) decreasing doses administered 12 h apart. On Day -9 (random stage of the estrous cycle) and Day 0 (day of the first FSH dose) ovarian ultrasonography was performed and blood samples were collected for AFC and AMH determinations, respectively. A weak positive correlation between AMH and small AFC (follicles <4 mm) was observed (r = 0.23; P = 0.07), and AMH concentration was positively correlated (r = 0.29; P < 0.05) with the number of corpora lutea (CL) determined at embryo collection (i.e., 6 d after insemination). The length of FSH treatment tended (P = 0.06) to affect the ovarian response, such that the number of CL was greater in 8-dose than 6-dose treated ewes, while no differences (P > 0.10) in embryo yield outcomes were observed. For further analysis, ewes were classified into low (<7 ng/mL) and high (>10 ng/mL) serum AMH. In high AMH ewes, there were no differences (P > 0.05) in the number of CL nor embryo yield between the 6-dose and 8-dose treatment (e.g., 7.8 ± 2.4 and 8.3 ± 2.5 transferable embryos, respectively; P = 0.92). Conversely, for low AMH ewes, fertilized ova and embryo yield were greater (P ≤ 0.05) for ewes receiving the 8-dose than the 6-dose superstimulatory treatment (e.g., 8.4 ± 2.8 vs. 2.7 ± 0.9 transferable embryos, respectively, P ≤ 0.05). In conclusion, embryo production in poor responding ewes with low low circulating AMH is improved by extending the superstimulatory treatment length from 6 to 8 FSH doses.
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Affiliation(s)
| | - B J Duran
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA
| | - J D Kieffer
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA
| | - A Pinczak
- Fundación IRAUy, Montevideo, Uruguay
| | - A Menchaca
- Fundación IRAUy, Montevideo, Uruguay; Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Montevideo, Uruguay.
| | - A Garcia-Guerra
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA.
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de Moraes FLZ, Morotti F, Barca Junior FA, Seneda MM. Effects of maternal antral follicle count in Bos taurus indicus cattle on the genetic merit of male offspring and antral follicle count of female offspring. Theriogenology 2024; 217:151-158. [PMID: 38277797 DOI: 10.1016/j.theriogenology.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
This study evaluated the effects of antral follicle count (AFC) in female cattle on offspring characteristics. Recently calved multiparous Bos indicus cows (Nelore; n = 222) were evaluated using ultrasonography on random days of their estrous cycle to determine the AFC and were classified into "low" (≤15 follicles), "intermediate" (≥16 and ≤ 29 follicles), and "high" (≥30 follicles) AFC groups. Weight and scrotal circumference (SC) of male offspring from these cows (n = 127) were determined from 20 to 27 months, and the data were added to a genetic evaluation program (economic total genetic merit, MGTe and TOP value) that uses the kinship matrix to evaluate the genetic relationship between animals. The AFC of female offspring from these cows (n = 95) was evaluated to analyze the relationship between the AFC of mothers and daughters. The effects of maternal AFC on the genetic merit of male and female offspring were analyzed using GLIMMIX and GLM, respectively. Correlations were assessed using the Pearson's coefficient. Male offspring of cows with high AFC had superior MGTe (P = 0.005) and TOP values (P = 0.01) than those from cows with low AFC. Additionally, the AFC of mothers was positively correlated with MGTe (R = 0.33; P < 0.0001) and negatively correlated with TOP values (R = -0.32; P < 0.0001). The SC (P = 0.01), but not body weight of the offspring (P = 0.46) was affected by maternal AFC. The daughters' AFC were correlated (R = 0.29; P = 0.004) with mothers' AFC and were influenced by maternal (P = 0.05) but not paternal (P = 0.77) effect. In conclusion, cows with high AFC produced males with greater MGTe, superior TOP values and higher SC. Maternal AFC did not influence the weight of male offspring but was correlated with the AFC of daughters.
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Affiliation(s)
| | - Fábio Morotti
- Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil; Universidade Norte do Parana, UNOPAR, Arapongas, PR, Brazil
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Delchiaro SB, Oliveira PVDLF, Júnior RJP, Gonçalves GD, Morotti F, Seneda MM. Relationships between antral follicle count and reproductive characteristics of embryo-recipient mares. J Equine Vet Sci 2024; 134:105029. [PMID: 38346582 DOI: 10.1016/j.jevs.2024.105029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024]
Abstract
Mares (n = 77) were evaluated by antral follicle count (AFC) and selected as embryo recipients. Cyclic recipients received embryos between days 4-6 after ovulation. The acyclic recipients received an intramuscular (i.m.) protocol with 5mg of estradiol benzoate (EB) on the day of donor ovulation (D0; D-4 recipient), 3mg of EB on the following day (D1; D-3 recipient), and 3mg of EB (D2; D-2 recipient). Furthermore, 1500mg of progesterone (P4) i.m. given on D0 of the recipient (D4 donor) followed by 1500mg of P4 on the day of ET (D4-6 recipient). On the ET day, the AFC and animals' weight, body condition score (BCS), corpus luteum diameter, age and degree of uterine edema (UE) were measured. Pregnancy was confirmed on days 12 and 30. Low AFC was defined as ≤11 follicles (n = 43 mares) and high AFC as >11 follicles (n = 34 mares). Data were analyzed by a mixed effect model, including AFC group, reproductive seasonality, and season (P ≤ 0.05). UE was influenced (P = 0.05) by reproductive seasonality. The conception rate was higher (P = 0.016) in recipients with low (79.07 %) than high AFC (61.76 %) and higher (P = 0.005) in cyclic (81.40 %) than anestrus (58.82 %) mares. In addition, we observed a tendency (P = 0.06) for the interaction of AFC*reproductive seasonality, showing that high*anoestrus recipients had the lowest conception rate (37.50 %b) compared to high*cyclic (83.33 %a), low*anoestrus (77.78 %a) and low*cyclic (80 %a). The conception rate was higher in cyclic recipients with low AFC. Furthermore, UE was influenced by reproductive seasonality and mares in anestrus showed a higher degree of UE than cyclic mares.
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Affiliation(s)
- Sofia Botsaris Delchiaro
- State University of Londrina (UEL), Highway Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina, PR, 86057-970, Brazil.
| | | | - Rubens José Paulossi Júnior
- State University of Londrina (UEL), Highway Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina, PR, 86057-970, Brazil
| | - Gabrieli Dutra Gonçalves
- State University of Londrina (UEL), Highway Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina, PR, 86057-970, Brazil
| | - Fábio Morotti
- State University of Londrina (UEL), Highway Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina, PR, 86057-970, Brazil
| | - Marcelo Marcondes Seneda
- State University of Londrina (UEL), Highway Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina, PR, 86057-970, Brazil.
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Melado L, Ata B. Chapter 11. Endometriosis-related complications in women undergoing in-vitro fertilization. Best Pract Res Clin Obstet Gynaecol 2024; 93:102456. [PMID: 38277906 DOI: 10.1016/j.bpobgyn.2024.102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
As a chronic inflammatory disease, endometriosis generates fibrosis and anatomic distortion, which add extra-challenges to assisted reproductive technology cycles and requires a personalized approach. Patients with endometriomas have significantly decreased ovarian reserve and the ultrasound examination tends to be challenging, possibly underestimating follicle counts. It is crucial to assess the feasibility of oocyte retrieval procedure during the initial examination of the patient, as the distortion of the pelvic anatomy, the presence of hydrosalpinges and endometriomas might render the procedure difficult and increase the risk of complications. Possible injury to adjacent organs and risk of infection must be considered. Assisted reproductive technology seems to have limited or no impact on endometriosis recurrence, pain symptom progression or the size of endometrioma.
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Affiliation(s)
- Laura Melado
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Baris Ata
- ART Fertility Clinics, Dubai, United Arab Emirates; Dept. of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkiye.
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Hochberg A, Dahan MH, Yarali H, Vuong LN, Esteves SC. Significance of serum AMH and antral follicle count discrepancy for the prediction of ovarian stimulation response in Poseidon criteria patients. J Assist Reprod Genet 2024; 41:717-726. [PMID: 38358433 PMCID: PMC10957796 DOI: 10.1007/s10815-024-03050-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE To determine the risk of not being a poor responder in ovarian stimulation (OS) for in vitro fertilization (IVF) when ovarian reserve markers are discordant-one falling within Poseidon's criteria normal range (e.g., anti-Müllerian hormone (AMH) ≥ 1.2 ng/mL or antral follicle count (AFC) ≥ 5), and the other in the poor ovarian reserve range. METHODS A tri-center retrospective cohort study (2015-2017) involving women with discordant AMH and AFC values undergoing their first IVF/ICSI cycle using conventional OS (cOS, ≥ 150 IU/day of follicle-stimulating hormone). Discordant serum AMH and AFC values were defined according to Poseidon's criteria (AMH < 1.2 ng/mL and AFC ≥ 5 or AMH ≥ 1.2 ng/mL and AFC < 5). Poor ovarian response (POR) was < 4 retrieved oocytes. Receiver operating characteristic (ROC) curves were used to determine AMH and AFC cut-offs for non-POR. Logistic regression analysis evaluated factors associated with non-POR. RESULTS Out of 8797 patients who underwent assessment with both AMH and AFC, 1172 (13.3%) exhibited discordant values. Of these, 854 (72.9%) had ≥ 4 oocytes retrieved. Within this group, 726 (85.0%) had "low" AMH values, whereas 128 (15.0%) had "low" AFCs. An AFC of 6 had 77% sensitivity and 52% specificity (AUC = 0.700), while AMH of 1.19 ng/mL had 31% sensitivity and 85% specificity (AUC = 0.492) for non-POR. AFC and the use of recombinant gonadotropins were positive predictors of non-POR. CONCLUSIONS When serum AMH is < 1.19 ng/mL, but AFC is ≥ 6, there is a moderate likelihood of a non-POR during stimulation. Conversely, if AFC is < 5 but serum AMH is ≥ 1.19 ng/mL, the chances of non-POR are low. Among patients with discordant markers, AFC emerges as the primary predictor of oocyte yield.
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Affiliation(s)
- Alyssa Hochberg
- Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada.
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada
| | - Hakan Yarali
- Anatolia IVF, Ankara, Turkey
- Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Lan N Vuong
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
- HOPE Research Center, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil
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Casalechi M, Di Stefano G, Fornelli G, Somigliana E, Viganò P. Impact of endometriosis on the ovarian follicles. Best Pract Res Clin Obstet Gynaecol 2024; 92:102430. [PMID: 38311379 DOI: 10.1016/j.bpobgyn.2023.102430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/10/2023] [Indexed: 02/10/2024]
Abstract
A significant body of evidence has supported a negative impact of endometriosis on ovarian follicles; however, the origin and relevance of this ovarian impairment in endometriosis is still a matter of debate. The ovarian damage can be caused by endometriosis itself or by surgeries aiming to remove endometriotic lesions. In this review, we summarized the existing knowledge on the mechanisms by which endometriosis can impact the ovarian follicles, from molecular to clinical points of view. From a molecular standpoint, the presence of endometriosis or its consequences can induce oxidative stress, inflammation, aberrant mitochondrial energy metabolism and inappropriate steroid production in granulosa cells, phenomena that may impair the quality of oocytes to variable degrees. These alterations may have clinical relevance on the accelerated exhaustion of the ovarian reserve, on the ovarian response to gonadotrophin stimulation in IVF cycles and on the competence of the oocytes. Critical points to be considered in current clinical practices related to fertility issues in endometriosis are discussed.
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Affiliation(s)
- Maíra Casalechi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Infertility Unit, Milan, Italy.
| | - Giorgia Di Stefano
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Infertility Unit, Milan, Italy
| | - Gianfranco Fornelli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Infertility Unit, Milan, Italy
| | - Edgardo Somigliana
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Infertility Unit, Milan, Italy
| | - Paola Viganò
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Infertility Unit, Milan, Italy
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Hochberg A, Dahan MH, Yarali H, Vuong LN, Esteves SC. Clinical factors associated with unexpected poor or suboptimal response in Poseidon criteria patients. Reprod Biomed Online 2024; 49:103852. [PMID: 38657290 DOI: 10.1016/j.rbmo.2024.103852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 04/26/2024]
Abstract
RESEARCH QUESTION What clinical factors are associated with 'unexpected' poor or suboptimal responses to IVF ovarian stimulation per POSEIDON's criteria, and which AMH and AFC threshold values distinguish this population? DESIGN Tri-centre retrospective cohort study (2015-2017) involving first-time IVF and ICSI cycles with conventional ovarian stimulation (≥150 IU/day of FSH). Eligibility criteria included sufficient ovarian reserve markers according to POSEIDON's classification (AMH ≥1.2 ng/ml; AFC ≥5). Ovarian response categories were poor (<4 oocytes), suboptimal (4-9 oocytes) and normal (≥9 oocytes). Primary outcomes included clinical factors associated with an unexpected poor or suboptimal response to conventional ovarian stimulation using logistic regression analyses, and the threshold values of AMH and AFC predicting increased risk of such responses using ROC curves. RESULTS A total of 7625 patients met the inclusion criteria: 204 (9.3%) were poor and 1998 (90.7%) were suboptimal responders. Logistic regression identified significant clinical predictors for a poor or suboptimal response, including AFC, AMH, total gonadotrophin dose, gonadotrophin type and trigger type (P ≤ 0.02). The ROC curves indicated that AMH 2.87 ng/ml (AUC 0.740) and AFC 12 (AUC 0.826) were the threshold values predicting a poor or suboptimal response; AMH 2.17 ng/ml (AUC 0.741) and AFC 9 (AUC 0.835) predicted a poor response; and AMH 2.97 ng/ml (AUC 0.722) and AFC 12 (AUC 0.801) predicted a suboptimal response. CONCLUSIONS The threshold values of AMH and AFC predicting 'unexpected' poor or suboptimal response were higher than expected. These findings have critical implications for tailoring IVF stimulation regimens and dosages.
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Affiliation(s)
- Alyssa Hochberg
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel..
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Hakan Yarali
- Anatolia IVF, Ankara, Turkey.; Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Lan N Vuong
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.; HOPE Research Center, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil
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Zhu S, Luan C, Zhang S, Wang X, Long F, Zhang Q, Yan J. Effect of SARS-CoV-2 infection and vaccine on ovarian reserve: A systematic review. Eur J Obstet Gynecol Reprod Biol 2024; 292:63-70. [PMID: 37976767 DOI: 10.1016/j.ejogrb.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To evaluate the effect of SARS-CoV-2 infection and vaccination on ovarian reserve. METHODS Relevant articles were identified in the EMBASE, PubMed, and Web of Science databases from January 2020 to May 2023. Available clinical indicators of ovarian reserve, such as anti-Müllerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), and estradiol (E2), as well as the time interval from infection or vaccination to measurements, were assessed. RESULTS Only 2 studies provided evidence that SARS-CoV-2 infection could damage ovarian function. In a comparison of the vaccinated and unvaccinated groups, although 1 prospective cohort study observed the transient statistically significant decrease on serum AMH levels at 3 or 6 months of follow-up, serum AMH levels remained within the normal reserve range (>1.1 ng/dl) throughout the study period. CONCLUSION Overall, whether ovarian reserve may be affected by SARS-CoV-2 infection remains controversial and further investigations are warranted to clarify this issue. Based on the current evidence, it is safe to assume that COVID-19 vaccination does not exert any adverse effect on ovarian reserve parameters such as AMH, AFC, FSH, and E2, which will provide reassurance for women attempting to fall pregnant.
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Affiliation(s)
- Shiheng Zhu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Chun Luan
- College of Clinical Medicine, Jining Medical University, Jining, China
| | - Shungeng Zhang
- College of Clinical Medicine, Jining Medical University, Jining, China
| | - Xinqing Wang
- College of Clinical Medicine, Jining Medical University, Jining, China
| | - Fangyuan Long
- College of Clinical Medicine, Jining Medical University, Jining, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.
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La Marca A, Longo M, Sighinolfi G, Grisendi V, Imbrogno MG, Giulini S. New insights into the role of LH in early ovarian follicular growth: a possible tool to optimize follicular recruitment. Reprod Biomed Online 2023; 47:103369. [PMID: 37918055 DOI: 10.1016/j.rbmo.2023.103369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 11/04/2023]
Abstract
Evidence shows that LH participates in enhancing transition from the early stage to the antral stage of folliculogenesis. It has been demonstrated that functional LH receptors are expressed, albeit at a very low level and even in smaller follicles, during the phase that was traditionally considered to be gonadotrophin independent, suggesting a role for LH in accelerating the rate of progression of non-growing and primary follicles to the preantral/antral stage. Hypogonadotropic hypogonadism, together with other clinical conditions of pituitary suppression, has been associated with reduced functional ovarian reserve. The reduction in LH serum concentration is associated with a low concentration of anti-Müllerian hormone. This is the case in hypothalamic amenorrhoea, pregnancy, long-term GnRH-analogue therapy and hormonal contraception. The effect seems to be reversible, such that after pregnancy and after discontinuation of drugs, the functional ovarian reserve returns to the baseline level. Evidence suggests that women with similar primordial follicle reserves could present with different numbers of antral follicles, and that gonadotrophins may play a fundamental role in permitting a normal rate of progression of follicles through non-cyclic folliculogenesis. The precise role of gonadotrophins in early folliculogenesis, as well as their use to modify the functional ovarian reserve, must be investigated.
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Affiliation(s)
- Antonio La Marca
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy.
| | - Maria Longo
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Giovanna Sighinolfi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Valentina Grisendi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Maria Giovanna Imbrogno
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Simone Giulini
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
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Liu Y, Pan Z, Wu Y, Song J, Chen J. Comparison of anti-Müllerian hormone and antral follicle count in the prediction of ovarian response: a systematic review and meta-analysis. J Ovarian Res 2023; 16:117. [PMID: 37370145 DOI: 10.1186/s13048-023-01202-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Increasingly studies reported that the Anti-Müllerian hormone (AMH) seems to be a promising and reliable marker of functional ovarian follicle reserve, even better than the AFC test. Our study aimed to conduct a meta-analysis to assess the predictive value of AMH and AFC for predicting poor or high response in IVF treatment. An electronic search was conducted, and the following databases were used: PubMed, EMBASE, and the Cochrane Library (up to 7 May 2022). The bivariate regression model was used to calculate the pooled sensitivity, specificity, and area under the receiver operator characteristic (ROC) curve. Subgroup analyses and meta-regression also were used in the presented study. Overall performance was assessed by estimating pooled ROC curves between AMH and AFC. RESULTS Forty-two studies were eligible for this meta-analysis. Comparison of the summary estimates for the prediction of poor or high response showed significant difference in performance for AMH compared with AFC [poor (sensitivity: 0.80 vs 0.74, P < 0.050; specificity: 0.81 vs 0.85, P < 0.001); high (sensitivity: 0.81 vs 0.87, P < 0.001)]. However, there were no significant differences between the ROC curves of AMH and AFC for predicting high (P = 0.835) or poor response (P = 0.567). The cut-off value was a significant source of heterogeneity in the present study. CONCLUSIONS The present meta-analysis demonstrated that both AMH and AFC have a good predictive ability to the prediction of poor or high responses in IVF treatment.
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Affiliation(s)
- Yang Liu
- Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China.
| | - Zhengmei Pan
- Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China
| | - Yanzhi Wu
- Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China
| | - Jiamei Song
- Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China
| | - Jingsi Chen
- Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China.
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12
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Hosseinisadat R, Farsi Nejad A, Mohammadi F. Intra-ovarian infusion of autologous platelet-rich plasma in women with poor ovarian reserve: A before and after study. Eur J Obstet Gynecol Reprod Biol 2023; 280:60-63. [PMID: 36403398 DOI: 10.1016/j.ejogrb.2022.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Female ovarian reserve progressively declines with increasing age. Intraovarian injection of platelet-rich plasma (PRP) seems to be an alternative treatment to increase fertility in women. Therefore, this study aimed to evaluate the effect of intra-ovarian infusion of PRP in treating women with poor ovarian reserve. MATERIALS AND METHODS In this before-and-after study, 22 infertile women with a poor ovarian reserve who underwent in vitro fertilization with the GnRH antagonist protocol were enrolled. After the oocyte retrieval undergoing vaginal ultrasound guide, PRP was injected into the ovary with a puncture needle under general anesthesia. Finally, the levels of anti-Müllerian hormone (AMH) and antral follicle counts (AFCs) were compared in all participants before and three months after the PRP injection. RESULTS Our findings showed that AMH significantly increased after the intra-ovarian infusion of PRP (P < 0.001) in these women, while no significant changes were observed in AFC (P = 0.140) at the end of the study. In addition, logistic regression indicated that body mass index (BMI) and maternal age had no significant effect on ovarian response to PRP injection. However, the duration of infertility > 5 years was associated with a 20-fold increase in the probability of AFC < 7 in women with poor ovarian reserve. CONCLUSIONS PRP can increase the chance of fertility in women with poor ovarian reserve by significantly increasing AMH levels.
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Affiliation(s)
- Robabe Hosseinisadat
- Department of Obstetrics and Gynecology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Farsi Nejad
- Department of Hematology and Laboratory Sciences, School of Paramedical Sciences, Kerman University of Medical Sciences and Health Services, Kerman, Iran; Pathology and Stem Cell Research Center, Kerman University of Medical Sciences and Health Services, Kerman, Iran.
| | - Frough Mohammadi
- Department of Obstetrics and Gynecology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Peralta S, Solernou R, Barral Y, Roca J, Fabregues F, Manau D, Carmona F. Antral follicle count measured at down-regulation as predictor of ovarian response and cumulative live birth: single center analysis including 2731 long agonist IVF cycles. Gynecol Endocrinol 2022; 38:1079-1086. [PMID: 36476268 DOI: 10.1080/09513590.2022.2154339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Evaluate antral follicle count measured after pituitary suppression (AFCaps) with a GnRH agonist as predictor of ovarian response and cumulative live birth (CLB). METHODS This study is a large cohort analysis of retrospective data between January 2011 and September 2020 in a tertiary-care university hospital. All first initiated IVF/ICSI cycles in women under 43 years of age for whom AFCaps was registered in our database were included. To evaluate CLB rates (CLBRs), only finalized cycles were analyzed (at least one live birth and/or all embryos transferred), excluding PGT cycles and severe male factor requiring testicular sperm extraction. RESULTS AFCaps showed a good predictive ability in predicting ovarian response to ovarian stimulation. Predicting poor response, AFCaps presented an area under the receiver-operating characteristic curve (AUCROC) of 0.85 (95% CI 0.83-0.87), for high response prediction, the AUCROC was 0.80 (95% confidence interval [CI] 0.77-0.83).Although AFCaps was statistically higher in patients who achieved at least one live birth (13.6 ± 6.05 vs. 9.79 ± 6.33) and CLBRs per started cycle significantly increase between AFCaps quartiles (15.9%, 36.2%, 45.1% and 52.9%) its ability to predict CLBR was modest, with an AUCROC of 0.67 (95% CI 0.65-0.69). CONCLUSIONS Women undergoing their first IVF/ICSI cycle following a long agonist GnRH protocol can be counseled with AFCaps measurement about their probability of achieving poor/high response. Based on this marker physicians can personalize ovarian stimulation with the aim of optimizing ovarian response and minimizing its risks. However, AFCaps has failed to predict CLB per started IVF cycle as an isolated marker.
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Affiliation(s)
- Sara Peralta
- Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d ́Investigacions Biomèdiques August Pi i Sunyer (IDIBAP S), Faculty of Medicine-University of Barcelona, Barcelona, Spain
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Rodríguez-Fuentes A, Rouleau JP, Vásquez D, Hernández J, Naftolin F, Palumbo A. Volume-based follicular output rate improves prediction of the number of mature oocytes: a prospective comparative study. Fertil Steril 2022; 118:885-892. [PMID: 36116981 DOI: 10.1016/j.fertnstert.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To test whether volume-based follicular output rate (FORT-V) is superior to diameter based follicular output rate (FORT-D) in predicting the number of mature oocytes. The follicular output rate (FORT) is the ratio between preovulatory follicle count (PFC) and antral follicle count (AFC) and has been proposed as a better predictor of the ovarian response compared with AFC alone. DESIGN A prospective observational study of 215 consecutive women (80 oocyte donors and 135 in vitro fertilization [IVF] patients) undergoing ovarian stimulation for IVF. SETTING University affiliated private IVF center. PATIENT(S) Women undergoing ovarian stimulation between May 2018 and September 2021. INTERVENTION(S) Manual two-dimensional ultrasound and computer-generated (three-dimensional ultrasound, [3D]) AFCs were performed at baseline. During ovulation induction, follicular growth was monitored in each patient using both two-dimensional and 3D ultrasound. Preovulatory follicles were defined as those with a mean diameter of 16-22 mm. The trigger was based on the follicular volume according to our standard protocol: at least 2 follicles with a volume of >2 cc with 70% of the follicles having a volume of >0.7 cc. MAIN OUTCOME MEASURE(S) The primary outcome was the difference between FORT-V and FORT-D in their ability to predict the mature oocyte output rate. RESULT(S) In both IVF patients and oocyte donors, the computer-generated AFC was greater than the manual AFC. The FORT-V was higher than the FORT-D for both computer-generated (the difference was 35 [95% CI {confidence interval}, 32-45] in oocyte donors and 21 [95% CI, 5-46] in IVF patients) and manual FORT (the difference was 38 [95% CI, 32-45] in oocyte donors and 15 [95% CI, 3-43] in IVF patients) and was closer to the mature oocyte output rate. There was a direct correlation between the computer-generated AFC and the PFC based on volume and between PFC based on volume and the number of mature oocytes in oocyte donors and IVF patients. CONCLUSION(S) In this prospective study of 215 women, the FORT based on 3D ultrasound derived follicular volume (FORT-V) was superior to the FORT-D in determining the ovarian response in both oocyte donors and IVF patients. Moreover, our results support the non-inferiority of the computer-generated method compared with the manual method for the determination of AFC. Further studies on the role of computer-generated antral follicle characteristics may be useful in evaluating follicle stimulation regimens.
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Affiliation(s)
- Adela Rodríguez-Fuentes
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Jean Paul Rouleau
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Danízar Vásquez
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Jairo Hernández
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Frederick Naftolin
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Angela Palumbo
- Centro de Asistencia a la Reproducción Humana de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
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15
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Li Y, Yao Y, Xiao N, Liu Y, Du Y, Liu M, Zhang Q, Zhao H, Zhang T, Zhang H, Wang L, Luo H, Zhang Y, Sun H. The association of serum phthalate metabolites with biomarkers of ovarian reserve in women of childbearing age. Ecotoxicol Environ Saf 2022; 242:113909. [PMID: 35999756 DOI: 10.1016/j.ecoenv.2022.113909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Phthalates (PAEs) are widely used plasticizers drawing increasing concern due to reproductive toxicity. However, studies on serum PAEs metabolites (mPAEs) and their associations with human ovarian function remain very scarce. In this study, from April 2019 to August 2020, a total of 297 women of childbearing age were recruited in Tianjin, China. Eleven mPAEs were analyzed in serum samples and eight mPAEs were detected at frequencies > 65% with median concentrations of 0.43-15.3 ng/mL. In multinomial logistic analysis, an increase in serum mono (2-isobutyl) phthalate (miBP) was associated with decline in antral follicle count (AFC) (OR=1.26, 95% CI: 0.99, 1.61) and 5-mono-(2-ethyl-5-hydroxyhexyl) phthalate (mEHHP) was significantly associated with AFC increase (OR=1.43, 95% CI: 1.06, 1.92), which were aligned with the associations found between mPAEs and AMH through generalized linear regression. In multiple linear regression models, per 10% increase in serum mono (2-ethylhexyl) phthalate (mEHP), mono (2-ethyl-5-oxohexyl) phthalate (mEOHP) (oxo-mEHP), and principal component 1 featured for high concentrations of mono-n-butyl phthalate (mBP), miBP and mEHP were associated with 0.15 (95% CI: -0.29, -0.02), 0.01 (95% CI: -0.01, 0.00) and 0.01 (95% CI: -0.02, 0.00) ln-unit decrease in estradiol (E2) levels, respectively, while mono-[(2-carboxymethyl) hexyl] phthalate (mCMHP) (carboxymethyl-mEHP) was positively associated with 0.05 ln-unit increase of E2 (95% CI: 0.02, 0.08). The observed negative associations between mPAEs and the Anti-Müllerian hormone (AMH) also aligned with the change in AFC. Generalized linear regression also revealed nonlinear associations between mono-ethyl phthalate (mEP), mCMHP and follicle-stimulating hormone (FSH). Overall, serum mEHP and its metabolites were negatively associated with E2. miBP was negatively associated with AFC. The nonlinear associations between mPAEs and FSH, and AMH need further study.
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Affiliation(s)
- Yongcheng Li
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Yiming Yao
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Nan Xiao
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Yarui Liu
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Yongrui Du
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Min Liu
- Tianjin Medical University, Tianjin 300070, China
| | - Qiuyue Zhang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Hongzhi Zhao
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Tao Zhang
- School of Environmental Science and Engineering, Sun Yat-Sen University, Guangzhou 510275, China
| | - Huajing Zhang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Lei Wang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Haining Luo
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China.
| | - Yunshan Zhang
- Department of Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Hongwen Sun
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China.
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Rodrigues ARDO, de Sá RAM, Velarde GC, Valle MP, Nóbrega BN, Roque M, Júnior EA. Comparing Two- and Three-dimensional Antral Follicle Count in Patients with Endometriosis. J Med Ultrasound 2022; 30:282-286. [PMID: 36844767 PMCID: PMC9944808 DOI: 10.4103/jmu.jmu_204_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/20/2022] [Accepted: 02/21/2022] [Indexed: 12/28/2022] Open
Abstract
Background The purpose of the study was to compare three-dimensional (3D) ultrasound semiautomatic antral follicle count (AFC) with two-dimensional (2D) ultrasound real-time AFC to evaluate patients with deep endometriosis and/or endometrioma submitted to ovarian stimulation (OS). Methods This was a retrospective cohort study assessing all women with documented diagnosis of deep endometriosis who underwent OS for assisted reproduction treatment. The primary outcome was the difference between AFC by semiautomatic 3D follicle count using 3D volume datasets and 2D ultrasound count with the number of oocytes retrieved at the end of the cycle. The 3D ultrasound AFC was obtained using sonography-based automated volume count (SonoAVC), and the 2D ultrasound AFC data was collected from the electronic medical record. Results Total of 36 women had deep endometriosis documented by magnetic resonance imaging, laparoscopy, or ultrasonography and 3D ovarian volume datasets stored from their first exam. The differences between the 2D and 3D AFC and the number of oocytes retrieved at the end of the stimulation were compared, showing no significant statistical difference between both methods (P = 0.59). Correlations were similar using both methods when compared to the number of oocytes retrieved (2D [r = 0.83, confidence interval (CI) = 0.68-0.9, P < 0.001]); (3D [r = 0.81, CI = 0.46-0.83, P < 0.001]). Conclusion 3D semiautomatic AFC can be used to access the ovarian reserve in patients with endometriosis.
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Affiliation(s)
- Andréia Regina de Oliveira Rodrigues
- Department of Post-Graduation in Medical Sciences, Federal Fluminense University, Rio de Janeiro-RJ, Brazil,Origen-Rio Centre for Reproductive Medicine, Rio de Janeiro-RJ, Brazil
| | | | - Guillermo Coca Velarde
- Department of Post-Graduation in Medical Sciences, Federal Fluminense University, Rio de Janeiro-RJ, Brazil
| | | | | | - Matheus Roque
- Sector of Ultrasound, Mater Prime Reproductive Medicine, São Paulo-SP, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil,Address for correspondence: Prof. Edward Araujo Júnior, Rua Belchior de Azevedo, 156 Apto. 111 Torre Vitoria, CEP 05089-030, São Paulo, Brazil. E-mail:
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Maldonado-Cárceles AB, Mitsunami M, Florio A, Williams PL, Ford JB, Souter I, Chavarro JE, Mínguez-Alarcón L; EARTH Study Team. Beverage intake and ovarian reserve among women from a fertility center. Fertil Steril 2022; 118:148-57. [PMID: 35725116 DOI: 10.1016/j.fertnstert.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the associations of caffeinated, alcoholic, and sweetened beverage intakes with antral follicle count (AFC), a well-accepted biomarker of ovarian reserve. DESIGN Observational prospective cohort study. SETTING Fertility center at an academic hospital. PATIENTS This study includes 567 women seeking fertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study. INTERVENTION None. Women self-reported consumption of caffeinated (coffee, tea, soda), alcoholic (wine, beer, liquor), sugar-sweetened, and artificially sweetened beverages using a validated food-frequency questionnaire. MAIN OUTCOME MEASURE Antral follicle count was assessed using a transvaginal ultrasound performed on the 3rd day of an unstimulated menstrual cycle or on the 3rd day of a progesterone withdrawal bleed. RESULTS Median (interquartile range) age and AFC were 35.0 (32.0-38.0) years and 13.0 (9.0-18.0), respectively. Median (range) intake of caffeinated, alcoholic, sugar-sweetened, and artificially sweetened beverages in servings/day were 1.08 (0-7.08), 0.35 (0-3.84), 0.04 (0-4.80), and 0.04 (0-7.50), respectively. All examined beverages were unrelated to AFC. The multivariable adjusted mean AFC (95% confidence interval) for women in the top and bottom quartiles of intake were 13.8 (13.0-14.7) and 13.8 (12.9-14.7) for caffeinated beverages; 13.8 (13.0-14.7) and 13.8 (13.0-14.6) for alcoholic beverages; 13.5 (12.6-14.4) and 13.3 (12.4-14.2) for sugar-sweetened beverages; and 13.2 (12.4-14.1) and 13.4 (12.6-14.3) for artificially sweetened beverages. CONCLUSION Low-to-moderate intakes of caffeinated, alcoholic, sugar-sweetened, and artificially sweetened beverages were unrelated to ovarian reserve, as measured by AFC, in a cohort of women seeking fertility care.
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Oncul M, Ozcivit IB, Basibuyuk Z, Cebi C, Sahmay S. Anti-Müllerian hormone, an ovarian reserve marker in hypogonadotropic hypogonadism. Eur J Obstet Gynecol Reprod Biol 2022; 273:54-58. [PMID: 35477042 DOI: 10.1016/j.ejogrb.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 01/25/2022] [Accepted: 04/17/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the usefulness of Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) as an ovarian reserve marker in hypogonadotropic hypogonadism (HH) patients and to find a limit value for the gonadotropin levels in the diagnosis of HH patients. STUDY DESIGN It is a retrospective cross-sectional single-center study. One hundred ninety-nine women with HH and 171 healthy controls with no cycle disorders were included into this study. Continuous variables were expressed as mean ± standard deviation. Statistical comparisons were carried out according to the intention to treat by Student's t-test, Mann-Whitney U test, where appropriate. Receiver operating characteristic curve-ROC was used to represent the sensitivity and specificity pair corresponding to decision threshold of FSH and LH levels in HH diagnosis. P < 0.05 was accepted to be statistically significant. RESULTS There was not any statistically significant difference between HH and control group regarding the age (23.94 ± 6.56 vs. 23.92 ± 3.01, respectively; p = 0.09). Serum AMH levels didn't show statistically significant difference between HH and control group (3.26 ± 2.61 ng/mL vs. 3.15 ± 1.46 ng/mL, respectively; p = 0.11). The difference of AFC between HH and control group was statistically significant (6.67 ± 6.33 vs. 10.91 ± 2.92, respectively; p < 0.001). Follicle-stimulating hormone (FSH), Luteinizing-hormone (LH) and Estradiol (E2) levels between the groups were found to be significantly different. Area under the receiver operating characteristic curve-ROC for FSH was 0.98 and for LH was 0.96. For the diagnosis of HH, FSH levels lower than 3.05 IU/L (with a sensitivity of 92% and specificity of 94%) and LH levels lower than 1.55 IU/L (with a sensitivity of 91% and specificity of 92%) can be used. CONCLUSION In conclusion, serum AMH levels reflect the follicle cohort in HH cases validly with negligible underestimation of ovarian reserve. FSH < 3.05 IU/L and LH < 1.55 IU/L could be used with high sensitivity and specificity for the diagnosis of HH.
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Affiliation(s)
- Mahmut Oncul
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Turkey
| | - Ipek Betul Ozcivit
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Department of Obstetrics and Gynecology, Turkey.
| | - Zafer Basibuyuk
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Department of Obstetrics and Gynecology, Turkey
| | - Ceren Cebi
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Department of Obstetrics and Gynecology, Turkey
| | - Sezai Sahmay
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Turkey
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Vitek W, Oh J, Mbowe O, Thurston SW, Christianson MS, Styer AK, Polotsky AJ, Diamond MP, Cedars MI. Preconception ovarian reserve and placenta-mediated pregnancy complications among infertile women. Pregnancy Hypertens 2022; 27:193-196. [PMID: 35131729 PMCID: PMC8922433 DOI: 10.1016/j.preghy.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
RESEARCH QUESTION Are preconception ovarian reserve markers, such as Anti-Mullerian hormone and antral follicle count, associated with preeclampsia and placenta mediated pregnancy complications among women with unexplained infertility who conceive with superovulation? DESIGN This is a secondary analysis of women with unexplained infertility who had a singleton live birth after enrollment in the Analysis of Multiple Intrauterine Gestations after Ovarian Stimulation (AMIGOS) trial that randomized couples to superovulation with letrozole, clomiphene, or gonadotropins with insemination for up to 4 cycles. RESULTS Compared to controls (N = 156), women who developed preeclampsia (N = 17) had lower Anti-Mullerian hormone levels (2.24 ± 1.20 vs. 2.89 ± 2.32, p = 0.07) and lower antral follicle count (18 ± 7.67 vs. 21 ± 11.43, p = 0.16); though these differences were not statistically significant. There was no relationship between Anti-Mullerian hormone (OR: 1.00, 95% CI: 0.76-1.25) or antral follicle count (OR: 0.98, 95% CI 0.93-1.04) with preeclampsia and between Anti-Mullerian hormone (OR: 1.00, 95% CI: 0.83-1.17) and antral follicle count (OR: 1.00, 95% CI: 0.97-1.04) with placenta medicated pregnancy complications after adjusting for age, BMI and race. CONCLUSIONS Preconception ovarian reserve markers are not associated with preeclampsia and placenta mediated pregnancy complications among women with unexplained infertility who conceive with superovulation with insemination.
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Affiliation(s)
- Wendy Vitek
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Jinhee Oh
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Omar Mbowe
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Sally W. Thurston
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | | | | | | | - Marcelle I. Cedars
- University of California San Francisco Medical Center, San Francisco, CA
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20
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Kadir M, Hood RB, Minguez-Alarcon L, Maldonado-Cárceles AB, Ford JB, Souter I, Chavarro JE, Gaskins AJ. Folate intake and ovarian reserve among women attending a fertility center. Fertil Steril 2022; 117:171-180. [PMID: 34809974 PMCID: PMC8714696 DOI: 10.1016/j.fertnstert.2021.09.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the association between dietary folate intake and antral follicle count (AFC) among women seeing treatment for infertility. DESIGN Cohort study. SETTING Academic fertility center. PATIENTS A total of 552 women attending the Massachusetts General Hospital Fertility Center (2007-2019) who participated in the Environment and Reproductive Health Study. INTERVENTIONS None. Folate intake was measured with a validated food frequency questionnaire at study entry. Multivariable Poisson regression models with robust standard errors were used to estimate the association of folate intake with AFC adjusting for calorie intake, age, body mass index, physical activity, education, smoking status, year of AFC, and intakes of vitamin B12, iron, and vitamin D. Nonlinearity was assessed with restricted cubic splines. MAIN OUTCOME MEASURE AFC as measured by transvaginal ultrasonography as part of routine care. RESULTS Among the 552 women (median age, 35.0 years; median folate intake, 1,005 μg/d), total and supplemental folate intake had a significant nonlinear relationship with AFC. There was a positive linear association with AFC up to approximately 1,200 μg/d for total folate intake and up to 800 μg/d for supplemental folate intake; however, there was no additional benefit of higher folate intakes. The magnitude of the association was modest; for example, the predicted adjusted difference in AFC between a woman consuming 400 vs. 800 μg/d of supplemental folate was approximately 1.5 follicles. CONCLUSION Higher intake of folate, particularly from supplements, was associated with modestly higher ovarian reserve as measured by AFC among women attending a fertility center. CLINICAL TRIAL REGISTRATION NUMBER This trial was registered at clinicaltrials.gov as NCT00011713.
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Affiliation(s)
- Mumta Kadir
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
| | - Robert B. Hood
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
| | - Lidia Minguez-Alarcon
- Department of Environmental Health, Harvard T.H. Chan
School of Public Health, Boston, MA, 02115, USA
| | | | - Jennifer B. Ford
- Department of Environmental Health, Harvard T.H. Chan
School of Public Health, Boston, MA, 02115, USA
| | - Irene Souter
- Massachusetts General Hospital Fertility Center and Harvard
Medical School, Boston, MA, 02114, USA
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, 02115, USA,Department of Epidemiology, Harvard T.H. Chan School of
Public Health, Boston, MA, 02115, USA,Channing Division of Network Medicine, Department of
Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston,
MA, 02115, USA
| | - Audrey J. Gaskins
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
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21
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Sun X, Xiong W, Liu L, Xiong J, Liao C, Lan Y, Li F, Tao S, Meng M, Sun C, Mao X. Comparison of the predictive capability of antral follicle count vs. the anti-Müllerian hormone for ovarian response in infertile women. Front Endocrinol (Lausanne) 2022; 13:862733. [PMID: 36387919 PMCID: PMC9659916 DOI: 10.3389/fendo.2022.862733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the predictive capability of antral follicle count (AFC) and the anti-Müllerian hormone (AMH) on ovarian response in infertile women and to identify potential factors influencing retrieved oocytes. METHODS A total of 2585 infertile women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles had been enrolled in this study. Spearman correlation was used to investigate the correlation between retrieved oocytes and AFC. Multiple linear regression analysis was used to study the parameters affecting the number of retrieved oocytes. RESULTS Spearman correlation and multiple linear regression analysis revealed that the oocyte retrieval number was positively correlated with AFC (r = 0.651, p < 0.001) and AMH (r = 0.566, p < 0.001) and negatively correlated with age (r = -0.425, p < 0.001) and regimen selection (r = -0.233 p < 0.001). There was no significant correlation between retrieved oocytes and BMI (p = 0.913). ROC analysis revealed that AFC was a better predictor of adverse effects than AMH, BMI, and age (AUC: 0.916 VS 0.791, 0.575, 0.752). Meanwhile, AFC and AMH were comparable in predicting high response (AUC = 0.731 and AUC = 0.733, respectively). CONCLUSIONS This study showed that retrieved oocytes were positively correlated with serum AMH and AFC and negatively correlated with age and BMI. AFC had an ideal predictive performance in ovarian response prediction. The mechanism of the effect of AFC on ovarian response during controlled ovarian hyperstimulation (COH) needs to be further investigated.
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Affiliation(s)
- Xingyu Sun
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Wang Xiong
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Liting Liu
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Junjun Xiong
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Chenlu Liao
- Department of Ophthalmology, The First People’s Hospital of Neijiang, Neijiang, China
| | - Yunzhu Lan
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Feifei Li
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shufei Tao
- Family Medicine, Carle Foundation Hospital, Urbana, IL, United States
| | - Muzi Meng
- American University of the Caribbean School of Medicine, Preston, United Kingdom
- Bronxcare Health System, The Bronx, NY, United States
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, United States
| | - Xiguang Mao
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Xiguang Mao,
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22
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Vagnini LD, Renzi A, Petersen CG, Dieamant F, Oliveira JBA, Canas MDCT, Franco Junior JG, Oliani AH. Correlation of TP53 (rs1625895), TP73 (rs3765730), MMP9 (rs17576), and MTHFR (rs868014) polymorphisms with low ovarian reserve. Eur J Obstet Gynecol Reprod Biol 2021; 269:132-137. [PMID: 34953598 DOI: 10.1016/j.ejogrb.2021.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 06/18/2021] [Accepted: 08/26/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the influence of the Single Nucleotide Polymorphisms (SNPs) TP53 rs1625895, TP73 rs3765730, MMP9 rs17576, and MTHFR rs868014 on ovarian reserve (OR) in infertile patients. STUDY DESIGN A prospective cross-sectional study was carried out in 145 infertile women. The patients were divided into two groups according to ovarian reserve, characterized by association between AMH levels and AFC:After patient distribution, both groups were compared (LOR X NOR) regarding the genotypes of the SNPs TP53 T/C rs1625895, TP73 G/A rs3765730, MMP9 Gln/Arg rs17576, and MTHFR A/G rs868014. RESULT(S) The frequency of the TP53-T/T genotype was greater in the LOR and the TP53-C/C genotype was more frequent in patients with NOR. This association was confirmed by the frequency of alleles, where the presence of the T allele was significantly higher in patients who exhibited LOR (P = 0.0003). The frequency of the TP73-G/G genotype and of the G allele was higher in the LOR group (P = 0.01). Considering the MMP9 gene, the frequency of the Gln/Gln genotype was higher in the LOR group. However, the Gln/Arg genotype and the Arg allele prevailed in the NOR group (P = 0.006). The frequency of the MTHFR-A/A genotype was higher in the LOR group, whereas that of the MTHFR-GG genotype was higher in the NOR group. The presence of allele A was significantly higher in the LOR group (P = 0.002). The regression analysis shows that patients who present the TP53-T/T, TP73-G/G, MMP9-Gln/Gln, and MTHFR-A/A genotypes are 3.6X, 3.1X, 3.2X, and 3.7X more likely of having LOR, respectively. In addition, the association of the TP53/TT + TP73/GG genotypes increased the chance of women being included in the LOR group in 5.7-fold. CONCLUSION(S) The genotypes TP53-T/T, TP73-G/G, MMP9-Gln/Gln, and MTHFR-A/A increase the chance of women to exhibit LOR. These polymorphisms could be useful as genetic markers of low ovarian reserve in infertile patients.
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Affiliation(s)
- Laura D Vagnini
- Paulista Centre for Diagnosis Research and Training, CPDP, Ribeirao Preto, Brazil.
| | - Adriana Renzi
- Paulista Centre for Diagnosis Research and Training, CPDP, Ribeirao Preto, Brazil
| | - Cláudia G Petersen
- Paulista Centre for Diagnosis Research and Training, CPDP, Ribeirao Preto, Brazil; Centre for Human Reproduction Prof Franco Jr, Ribeirao Preto, Brazil
| | - Felipe Dieamant
- Centre for Human Reproduction Prof Franco Jr, Ribeirao Preto, Brazil
| | - João Batista A Oliveira
- Paulista Centre for Diagnosis Research and Training, CPDP, Ribeirao Preto, Brazil; Centre for Human Reproduction Prof Franco Jr, Ribeirao Preto, Brazil
| | | | - José G Franco Junior
- Paulista Centre for Diagnosis Research and Training, CPDP, Ribeirao Preto, Brazil; Centre for Human Reproduction Prof Franco Jr, Ribeirao Preto, Brazil
| | - Antônio H Oliani
- São José do Rio Preto School of Medicine FAMERP, Sao Jose do Rio Preto, Brazil
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23
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Razafintsalama-Bourdet M, Bah M, Amand G, Vienet-Lègue L, Pietin-Vialle C, Bry-Gauillard H, Pinto M, Pasquier M, Vernet T, Jung C, Levaillant JM, Massin N. Random antral follicle count performed on any day of the menstrual cycle has the same predictive value as AMH for good ovarian response in IVF cycles. J Gynecol Obstet Hum Reprod 2021; 51:102233. [PMID: 34571198 DOI: 10.1016/j.jogoh.2021.102233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/28/2021] [Accepted: 09/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine whether the predictive value of AFC for ovarian response to stimulation for IVF depends on the day of the menstrual cycle when ultrasound is performed. METHODS 410 women undergoing their first IVF cycle were included. All the women had AFC performed twice. The first measurement, random AFC (r-AFC), was performed during the fertility workup whatever the day of their menstrual cycle. Three groups were constituted according to the period of ultrasound performance: at early follicular phase i.e., day 1 to day 6 (eFP-AFC); at mid follicular phase i.e., day 7 to 12 (mFP-AFC) and at luteal phase i.e., day 13 or after (LP-AFC). A second AFC measurement was performed before the start of the ovarian stimulation (SD1-AFC). AMH dosing was done in the early follicular phase. RESULTS Random AFC (r-AFC) was correlated to AMH (r = 0.69; p<0.001), SD1-AFC (r = 0.75; p<0.001) and number of oocytes retrieved (r = 0.49; p<0.001). When regarding AFC depending on the cycle day group, the correlation with AMH was 0.65, 0.66 and 0.85 for the eFP-AFC, the mFP-AFC and the LP-AFC respectively (all p were <0.001). The ROC analysis showed the same predictive value for good ovarian response (more than 6 oocytes retrieved) for the eFP-AFC, mFP-AFC and LP-AFC (AUC 0.73, 0.75 and 0.84 respectively; p = 0.28). The AUC of r-AFC (0.76) were similar to those of AMH (0.74) and SD1-AFC (0.74) (p = 0.21 and 0.92 respectively). CONCLUSION AFC is strongly correlated with AMH and highly predictive of good ovarian response during the whole menstrual cycle.
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Affiliation(s)
- M Razafintsalama-Bourdet
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - M Bah
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - G Amand
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - L Vienet-Lègue
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - C Pietin-Vialle
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - H Bry-Gauillard
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - M Pinto
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - M Pasquier
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - T Vernet
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France
| | - C Jung
- Clinical Research Center, Intercommunal Hospital- University Paris XII, Creteil, France
| | - J M Levaillant
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France; Hopital privé Armand Brillard, Nogent sur Marne, France
| | - N Massin
- Department of Gynecology-Obstetrics and Reproductive Medicine, Intercommunal Hospital- University Paris XII, Creteil, France.
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24
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Guo Y, Jiang H, Hu S, Liu S, Li F, Jin L. Efficacy of three COS protocols and predictability of AMH and AFC in women with discordant ovarian reserve markers: a retrospective study on 19,239 patients. J Ovarian Res 2021; 14:111. [PMID: 34454544 PMCID: PMC8403432 DOI: 10.1186/s13048-021-00863-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/18/2021] [Indexed: 12/17/2022] Open
Abstract
Background Recent studies have consistently shown that AFC and serum AMH are good predictors of ovarian response and have shown strong correlations. However, it is not unusual for reproductive medicine specialists to encounter discordance between them. This is the first study to investigate the efficacies of the different COS protocols when the AFC and AMH levels are discordant. Based on the association between COS protocols and pregnancy outcomes, we attempt to explain the controversial results and clarify the predictive value of AMH and AFC in this context. Methods 19,239 patients undergoing their first fresh in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles with GnRH antagonist protocols, GnRH-a long protocols or GnRH-a ultra-long protocols between January 1, 2016, and December 31, 2019, were enrolled and then divided into four groups in accordance with the boundaries for the AFC and serum AMH level provided by the Poseidon Classification. Our study was divided into two parts. Firstly, we retrospectively compared the effects of the three COS protocols in patients with discordant AMH and AFC. Multivariate logistic regression models were conducted in a forward manner to exclude the influence of confounding factors. Afterward, to increase comparability between Group 2 (low AMH and normal AFC) and Group 3 (normal AMH and low AFC), propensity score matching (PSM) analysis was performed based on age, BMI, the number of embryos transferred, and COS protocol. IVF intermediate and reproductive outcomes were compared between Group 2 and Group 3. Results For people with low AMH and normal AFC (Group 2), the number of total oocytes, clinical pregnancy rate (CPR), live birth rate (LBR) and cumulative live birth rate (CLBR) were significantly higher in GnRH-a ultra-long protocol compared with GnRH antagonist protocol. In multivariate logistic regression models, significant associations of COS protocol with fresh LBR and CPR were found after adjusting for age, BMI, AFC, AMH and the number of embryos transferred. Whereas, in patients with normal AMH and low AFC (Group 3), the number of total oocytes, CLBR, LBR and CPR were highest in the long GnRH-a protocol although there was no statistically significant difference. After PSM, the results showed that although oocytes yield and available embryos in patients with normal AMH and low AFC were significantly higher, there was no significant difference in reproductive outcomes between Group 2 and Group 3. Conclusions We found that women with normal AFC and low AMH may benefit from the GnRH-a ultra-long protocol. Nevertheless, for women with normal AMH and low AFC, the long GnRH-a protocol seems to be associated with better clinical outcomes. Furthermore, after eliminating the confounding factors including the COS protocol, we found that AMH can only predict the number of oocytes but not the quality of oocytes when there was discordance between AFC and AMH. Supplementary Information The online version contains supplementary material available at 10.1186/s13048-021-00863-4.
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Affiliation(s)
- Yaxin Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Huahua Jiang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shiqiao Hu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shuai Liu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Fei Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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25
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Denis-Laroque L, Drouet Y, Plotton I, Chopin N, Bonadona V, Lornage J, Salle B, Lasset C, Rousset-Jablonski C. Anti-müllerian hormone levels and antral follicle count in women with a BRCA1 or BRCA2 germline pathogenic variant: A retrospective cohort study. Breast 2021; 59:239-247. [PMID: 34304065 PMCID: PMC8326804 DOI: 10.1016/j.breast.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background Some studies suggested a decreased ovarian reserve among BRCA1/2 pathogenic variant carriers, with conflicting results. Methods We conducted a retrospective single-center observational study of ovarian reserve and spontaneous fertility comparing BRCA1/2 pathogenic variant carriers to controls (women who attended consultations to discuss fertility preservation before gonadotoxic treatment). Measures of associations between plasma AMH concentration, AFC and BRCA1/2 status were modelled by nonlinear generalized additive regression models and logistic regressions adjusted for age at plasma storage, oral contraceptive use, body mass index, cigarette smoking, and the AMH assay technique. Results The whole population comprised 119 BRCA1/2 pathogenic variant carriers and 92 controls. A total of 110 women (42 carriers, among whom 30 were cancer-free, and 68 controls) underwent an ovarian reserve evaluation. Spontaneous fertility analysis included all women who previously attempted to become pregnant (134 women). We observed a tendency towards a premature decrease in ovarian reserve in BRCA1/2 pathogenic variant carriers, but no difference in mean AMH or AFC levels was found between BRCA1/2 pathogenic variant carriers and controls. An analysis of the extreme levels of AMH (≤5 pmol/l) and AFC (≤7 follicles) by logistic regression suggested a higher risk of low ovarian reserve among BRCA1/2 pathogenic variant carriers (adjusted odds ratio (OR) = 3.57, 95% CI = 1.00–12.8, p = 0.05; and adjusted OR = 4.99, 95% CI = 1.10–22.62, p = 0.04, respectively). Discussion Attention should be paid to BRCA1/2 pathogenic variant carriers’ ovarian reserve, considering this potential risk of premature alteration. A tendency towards a premature decrease in the ovarian reserve in BRCA1/2 pathogenic variant carriers was found. BRCA1/2 pathogenic variant carriers presented a higher risk of a low ovarian reserve. Information and education regarding reproduction is mandatory among BRCA1/2 pathogenic variant carriers.
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Affiliation(s)
- Laurie Denis-Laroque
- Centre Léon Bérard, Department of Surgical Oncology, 28 rue Laënnec, 69008, Lyon, France
| | - Youenn Drouet
- Centre Léon Bérard, Département Prévention et Santé Publique, 28, Rue Laënnec, Lyon, 69008, France; CNRS UMR 5558, Laboratoire de Biométrie et Biologie évolutive, 16, rue Raphael Dubois, Villeurbanne Cedex, 69622, France
| | - Ingrid Plotton
- Hormonology and Molecular Endocrinology, Biology and Est Pathology Center, Hospices Civils de Lyon, 69500, U1208, Université Claude Bernard Lyon1, Bron, France
| | - Nicolas Chopin
- Centre Léon Bérard, Department of Surgical Oncology, 28 rue Laënnec, 69008, Lyon, France
| | - Valérie Bonadona
- Centre Léon Bérard, Département Prévention et Santé Publique, 28, Rue Laënnec, Lyon, 69008, France; CNRS UMR 5558, Laboratoire de Biométrie et Biologie évolutive, 16, rue Raphael Dubois, Villeurbanne Cedex, 69622, France
| | - Jacqueline Lornage
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Médecine de La Reproduction, Bron, France
| | - Bruno Salle
- Hospices Civils de Lyon, Groupement Hospitalier Est, Service de Médecine de La Reproduction, Bron, France
| | - Christine Lasset
- Centre Léon Bérard, Département Prévention et Santé Publique, 28, Rue Laënnec, Lyon, 69008, France; CNRS UMR 5558, Laboratoire de Biométrie et Biologie évolutive, 16, rue Raphael Dubois, Villeurbanne Cedex, 69622, France
| | - Christine Rousset-Jablonski
- Centre Léon Bérard, Department of Surgical Oncology, 28 rue Laënnec, 69008, Lyon, France; Hospices Civils de Lyon, Lyon Sud University Hospital, Department of Obstetrics and Gynecology, 165 Chemin Du Grand Revoyet, 69310, Pierre-Bénite, France; Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, France.
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26
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Shrem G, Salmon-Divon M, Mahfoudh AM, Balayla J, Volodarsky-Perel A, Henderson S, Zeadna A, Son WY, Steiner N, Dahan MH. Influence of Maternal Age and Ovarian Reserve on the Decision to Continue or to Cancel IVF Cycles in Patients with One or Two Large Follicles: a Dual Effect. Reprod Sci 2021; 29:291-300. [PMID: 34115367 DOI: 10.1007/s43032-021-00649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to study whether IVF stimulation that results in one or two mature follicles should proceed to oocyte retrieval. This is a retrospective cohort study conducted at McGill University Health Center on 459 patients who underwent IVF treatment between 2011 and 2014, undergoing hormonal stimulation and monitoring of their ovarian response. The primary outcomes were pregnancy and live birth rates. Statistical modeling was used to determine individual roles of patient age and ovarian reserve on outcomes, while controlling for the other factors. Of the 459 cycles included in the study, 360 cycles (78.4%) ended in embryo transfer. Live birth rates per cycle were 15.6%, for the ≤ 34-year-olds; 6.5%, for the 35-39-year-olds; and 2.7%, for the ≥ 40-year-olds (p < 0.01). Twenty-five percent of the cycles in the ≥ 40-year-old group were canceled versus 17% and 15% in the 35-39-year-old and ≤ 34-year-old groups, respectively (p < 0.05). Testing likelihood of live birth as a function of age and antral follicular count (AFC) revealed that a 1-year increase in age reduces the likelihood of live birth by 11% (p < 0.05) and one-unit increase in AFC count leads to a 9% increase in the odds of a live birth (p < 0.05). For the youngest age group, the AFC had a most significant effect, and those with AFC > 11 had 56% live birth rate, while those with AFC ≤ 11 had only 6% of live birth rate. This study supports a shift in reasoning from age being the predictor of outcomes in women with a low response at IVF to both age and ovarian reserve needing to be taken into consideration.
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Affiliation(s)
- Guy Shrem
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada. .,MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada. .,Department of Obstetrics and Gynecology, IVF Unit, Kaplan Medical Center, Rehovot, Israel.
| | - Mali Salmon-Divon
- Department of Molecular Biology, Ariel University, 40700, Ariel, Israel. .,Adelson School of Medicine, Ariel University, Ariel, Israel.
| | - Alina M Mahfoudh
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Jacques Balayla
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada
| | - Alexander Volodarsky-Perel
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada.,MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada.,Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
| | - Sara Henderson
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Atif Zeadna
- Ben-Gurion University of the Negev, Medicine, Southern, Beer-Sheva, Israel
| | - Weon-Young Son
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Naama Steiner
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada.,MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada.,Ben-Gurion University of the Negev, Medicine, Southern, Beer-Sheva, Israel
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada.,MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
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Feng X, Luo J, Wang X, Xie W, Jiao J, Wu X, Fan L, Qin G. Association of exposure to ambient air pollution with ovarian reserve among women in Shanxi province of north China. Environ Pollut 2021; 278:116868. [PMID: 33735795 DOI: 10.1016/j.envpol.2021.116868] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Air pollution has been an important risk factor for female reproductive health. However, epidemiological evidence of ambient air pollution on the predictor for ovarian reserve (antral follicle count, AFC) is deficient. We aim to comprehensively evaluate the association of long-term exposure to ambient air pollution with AFC among women of reproductive age in Shanxi of north China. 600 women with spontaneous menstrual cycle, not using controlled ovarian stimulation, were enrolled in the retrospective study. Two distinct periods of antral follicle development were designed as exposure windows. Generalized linear model was employed to estimate the change of AFC associated with exposure of atmospheric pollutants (SO2, NO2, PM10, PM2.5, CO and O3). Stratification analysis based on age (<30, ≥30 years), university degree (yes, no), years of exposure (2013-2016, 2017-2019) and duration of infertility (<2, 2-5, >5 years) along with two pollutants model were employed to further illustrate the association. We found every 10 μg/m3 increase in SO2 concentration level during the entire development stage of antral follicle was associated with a -0.01 change in AFC (95% confidence interval: -0.016, -0.002) adjusting for the confounders including age, BMI, parity and infertility diagnosis factors. The significant association of increased SO2 level with decreased AFC was particularly observed during the early transition from primary follicle to preantral follicle stage by 10 μg/m3 increase in SO2 exposure level with a -0.01 change (95% CI: -0.015, -0.002) in AFC. The negative association was pronounced among women aged ≥30 years old, and also significant in two pollutants model after adjusting the confounders. No significant associations between other air pollutants and AFC were observed. Our finding suggests that long-term exposure to air pollutant SO2 is associated with lower AFC, raising our concern that atmospheric SO2 exposure may have potential adverse impact on women ovarian reserve.
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Affiliation(s)
- Xiaoqin Feng
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, China; Department of Reproductive Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Jinhong Luo
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Xiaocheng Wang
- Department of Medical Record and Statistics, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Wolong Xie
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Jiao Jiao
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Xiaohui Wu
- Shanxi Dadi Environment Investment Holdings Company, Ltd, Taiyuan, Shanxi, 030000, China
| | - Lingling Fan
- Department of Reproductive Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Guohua Qin
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, China.
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Morales-Martínez FA, Sordia-Hernández LH, Ruiz MM, Garcia-Luna S, Valdés-Martínez OH, Vidal-Gutierez O. Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism. Thyroid Res 2021; 14:6. [PMID: 33752726 PMCID: PMC7983266 DOI: 10.1186/s13044-021-00095-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/02/2021] [Indexed: 12/11/2022] Open
Abstract
Background The ovarian function and therefore the ovarian reserve may be compromised by the pathogenesis of autoimmune diseases of which, Hashimoto’s thyroiditis (HT) is the most common in women of reproductive age. Furthermore, a prolonged reduction in thyroid hormone concentration results in a broad spectrum of reproductive alteration. Previous reports in the literature have been controversial regarding the impact of hypothyroidism and alterations in the ovarian reserve. Thus, this prospective and comparative study aimed to evaluate the association of hypothyroidism with low ovarian reserve. Materials and Methods A subset of 27 patients with primary autoimmune hypothyroidism were compared to healthy women. The ovarian reserve was assessed through the anti-Mullerian hormone (AMH) and the antral follicle count (AFC). Results Overall, the two groups did not display significant differences in length of their menstrual cycles neither in the AMH serum levels nor the AFC. Conclusions No significant alteration was found in the ovarian reserve of women with HT.
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Affiliation(s)
- Felipe A Morales-Martínez
- Centro Universitario de Medicina Reproductiva, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León. Monterrey, Edificio Rodrigo Barragán 3er piso Ave., Av. Francisco I. Madero s/n y Gonzalitos Col. Mitras Centro, NL, C.P. 64460, Monterrey, Mexico.
| | - Luis H Sordia-Hernández
- Centro Universitario de Medicina Reproductiva, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León. Monterrey, Edificio Rodrigo Barragán 3er piso Ave., Av. Francisco I. Madero s/n y Gonzalitos Col. Mitras Centro, NL, C.P. 64460, Monterrey, Mexico
| | - Martha Merino Ruiz
- Centro Universitario de Medicina Reproductiva, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León. Monterrey, Edificio Rodrigo Barragán 3er piso Ave., Av. Francisco I. Madero s/n y Gonzalitos Col. Mitras Centro, NL, C.P. 64460, Monterrey, Mexico
| | - Selene Garcia-Luna
- Centro Universitario de Medicina Reproductiva, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León. Monterrey, Edificio Rodrigo Barragán 3er piso Ave., Av. Francisco I. Madero s/n y Gonzalitos Col. Mitras Centro, NL, C.P. 64460, Monterrey, Mexico
| | - Otto H Valdés-Martínez
- Centro Universitario de Medicina Reproductiva, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León. Monterrey, Edificio Rodrigo Barragán 3er piso Ave., Av. Francisco I. Madero s/n y Gonzalitos Col. Mitras Centro, NL, C.P. 64460, Monterrey, Mexico
| | - Oscar Vidal-Gutierez
- Departamento de Ginecología y Obstetricia, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, NL, Monterrey, México
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Martinez-Garcia JM, Candas B, Suarez-Salvador E, Gomez M, Merino E, Castellarnau M, Carreras M, Carrarach M, Subirats N, Gonzalez S, Fernández-Montolí E, Ponce J, Garcia-Tejedor A. Comparing the effects of alcohol sclerotherapy with those of surgery on anti-Müllerian hormone and ovarian reserve after endometrioma treatment. A prospective multicenter pilot cohort study. Eur J Obstet Gynecol Reprod Biol 2021; 259:60-66. [PMID: 33592391 DOI: 10.1016/j.ejogrb.2021.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/09/2021] [Accepted: 01/16/2021] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE To compare the effects of ultrasound-guided aspiration and ethanol sclerotherapy with those of laparoscopic surgery on anti-Müllerian hormone (AMH) levels and ovarian reserve in benign-appearing ovarian endometrioma. DESIGN A prospective, cohort pilot study. SETTING Multiple centers, Spain. PATIENTS Forty patients with a suspected ovarian endometrioma with a maximum diameter of 35-100 mm. Serum hormonal concentrations were analyzed in 26 of these women. INTERVENTIONS Two groups: one that received US-guided aspiration plus alcohol sclerotherapy (n = 16) and the other that underwent laparoscopic cystectomy (n = 10). MEASUREMENTS AND MAIN RESULTS We studied serum hormonal concentrations (AMH, FSH and 17-β-estradiol) and antral follicle counts (AFC) in each patient at baseline, and after the procedures and pregnancies. No differences were found when comparing AMH and FSH concentrations before and after each procedure. 17-β-estradiol concentrations were significantly increased after alcohol sclerotherapy (p < 0.001). AFC recovery after 6 months seemed to be higher after sclerotherapy than after surgery. Three patients became pregnant in the sclerotherapy group. CONCLUSION This pilot study indicated that alcohol sclerotherapy preserves fertility in patients with endometriomas better than surgery, with significant increases in serum estradiol concentrations, possible AFC recovery and spontaneous pregnancies observed in the patients after sclerotherapy.
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Affiliation(s)
- Jose M Martinez-Garcia
- Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain.
| | - Beatriz Candas
- Department of Biochemistry and Molecular Biology, Clinical Laboratory, Hospital Universitari Bellvitge, Hospitalet de Llobregat, IDIBELL, Barcelona, Spain
| | | | - Maria Gomez
- Department of Gynaecology, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Elisabet Merino
- Department of Gynaecology, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Marta Castellarnau
- Department of Gynaecology, Consorci Sanitari Integral, Hospitalet de Llobregat, Barcelona, Spain
| | - Manuel Carreras
- Department of Gynaecology, Hospital de Sant Joan de Déu de Sant Boi, Sant Boi de Llobregat, Barcelona, Spain
| | - Marta Carrarach
- Department of Gynaecology, Hospital de Viladecans, Viladecans, Barcelona, Spain
| | - Neus Subirats
- Department of Gynaecology, Hospital Verge de La Cinta, Tortosa, Tarragona, Spain
| | - Santiago Gonzalez
- Department of Gynaecology, Hospital de Sant Joan de Déu d'Esplugues, Esplugues de Llobregat, Barcelona, Spain
| | - Eulalia Fernández-Montolí
- Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
| | - Amparo Garcia-Tejedor
- Department of Gynaecology, Hospital Universitari Bellvitge, Hospitalet de Llobregat Idibell, Barcelona, Spain
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Tian H, Mao X, Su N, La X. The correlation between AMH and number of embryos in POSEIDON groups: a retrospective cohort study. Reprod Biomed Online 2020; 42:842-848. [PMID: 33736991 DOI: 10.1016/j.rbmo.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
RESEARCH QUESTION What is the association between serum anti-Müllerian hormone (AMH) concentrations and the number of utilizable embryos obtained per stimulation cycle of IVF/intracytoplasmic sperm injection (ICSI) in POSEIDON Groups 3 and 4? DESIGN Retrospective cohort study of 412 cycles, in which patients in POSEIDON Groups 3 and 4 (antral follicle count [AFC] ≤5 and AMH <1.2 ng/ml) underwent complete IVF/ICSI treatment cycles in the Reproductive Center of the First Affiliated Hospital of Xinjiang Medical University between January 2017 and March 2019. Patients underwent IVF/ICSI treatment using either progestin-primed ovarian stimulation (PPOS) or gonadotrophin-releasing hormone (GnRH) antagonist protocol as ovarian stimulation protocol. RESULTS Three models were established to analyse the correlation between AMH and the number of utilizable embryos in this study. After adjusting for covariates (age, baseline FSH, stimulation protocol and AFC), the number of embryos increased by 0.1 (95% confidence interval [CI] 0.06-0.14) with each increment of 0.1 ng/ml in AMH concentration. AMH was transformed from a continuous variable to a categorical variable (through trisection of AMH concentrations) and for the sensitivity analysis it was found that the number of embryos in the high AMH group (0.52-1.19 ng/ml) was 0.62 (95% CI 0.37-0.97) higher than in the low AMH group (0.06-0.24 ng/ml). CONCLUSIONS High AMH in patients in POSEIDON Groups 3 and 4 was found to be associated with an increase in the number of available embryos in IVF/ICSI. The potential reproductive prognosis can be assessed by AMH, to reduce the abandonment of treatment due to underestimation or to implement multiple ineffective stimulation cycles of treatment.
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Affiliation(s)
- Haiqing Tian
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xinmin Mao
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Nan Su
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaolin La
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
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Yalçın Bahat P, Kadiroğulları P, Topbas Selcuki NF, Yücel B, Çakmak K, Üreyen Özdemir E. Ovarian reserve in patients with ankylosing spondylitis. Arch Gynecol Obstet 2020; 303:189-193. [PMID: 33030584 DOI: 10.1007/s00404-020-05824-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to determine the autoimmune effects of ankylosing spondylitis (AS) on the fertility potential of women by evaluating ovarian reserves of AS patients. METHODS A total of 104 patients, 52 in the AS group (study group) and 52 in the control group were included in the study. Ovarian reserve was evaluated by serum anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and baseline serum follicle-stimulating hormone (FSH) levels. RESULTS The mean serum AMH levels were significantly lower in the study group when compared to the controls (2.203 ± 1.110 vs. 1.188 ± 0.891, p < 0.001). In addition, the mean AFC was also significantly lower in the study group. (10.67 ± 1.81 vs. 9.54 ± 2.50, p = 0.009). Mean FSH levels were calculated to be 6.72 ± 1.14 in the study group and 7.21 ± 1.22 in the control group. The difference was not statistically significant (p = 0.781). CONCLUSION This study shows that AS like several other autoimmune conditions has an adverse effect on the female fertility potential. Therefore, an early start and long-term management of AS patients who have fertility desire is recommended. Serum AMH levels can be used in monitoring ovarian reserve and in early detection of reproductive decline of AS patients. CLINICALTRIAL NUMBER NCT04209881.
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Affiliation(s)
- Pınar Yalçın Bahat
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Health Sciences University, 34000, Istanbul, Turkey.
| | - Pınar Kadiroğulları
- Department of Obstetrics and Gynecology, Acibadem University Atakent Hospital, Istanbul, Turkey
| | - Nura Fitnat Topbas Selcuki
- Department of Obstetrics and Gynecology, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Burak Yücel
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Health Sciences University, 34000, Istanbul, Turkey
| | - Kübra Çakmak
- Obstetrics and Gynecology, Esenler Maternity and Children's Hospital, Istanbul, Turkey
| | - Eda Üreyen Özdemir
- Department of Obstetrics and Gynecology Ankara, Çubuk Halil Şıvgın Hospital, Çubuk, Turkey
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Tian Z, Zhang Y, Zhang C, Wang Y, Zhu HL. Antral follicle count is reduced in the presence of endometriosis: a systematic review and meta-analysis. Reprod Biomed Online 2020; 42:237-247. [PMID: 33168492 DOI: 10.1016/j.rbmo.2020.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/16/2020] [Accepted: 09/08/2020] [Indexed: 12/29/2022]
Abstract
Studies suggest that the presence of endometriosis may lead to impaired ovarian reserve, while results evaluating the changes in antral follicle count (AFC) in endometriosis remain controversial. A systematic search returned 15 studies, of which nine compared AFC between patients with and without endometriosis, five articles reported differences in AFC between affected and unaffected ovaries in patients with unilateral ovarian endometriosis and one reported both of the above two situations. Overall results showed a significant decrease in AFC and anti-Müllerian hormone (AMH) and increase in serum FSH concentrations in patients with endometriosis when compared with controls. Additionally, the AFC for the ovary with the endometrioma was also significantly lower than that of the contralateral ovary in patients with unilateral ovarian endometriosis. Moreover, it appears that the AFC in patients with endometriosis where the ovaries are not affected or in early stage were not significantly different in the control group. These findings demonstrate that endometriosis is associated with reduced AFC and AMH and elevated serum concentrations of FSH, suggesting a reduction in ovarian reserve in patients with endometriosis, especially in those with ovarian endometrioma and advanced stage.
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Affiliation(s)
- Zhao Tian
- Department of Obstetrics and Gynecology, People's Hospital, Peking University, Beijing 100044, China
| | - Yang Zhang
- Department of Pediatrics, People's Hospital, Peking University, Beijing 100044, China
| | - Chen Zhang
- Department of Obstetrics and Gynecology, People's Hospital, Peking University, Beijing 100044, China
| | - Yue Wang
- Department of Obstetrics and Gynecology, People's Hospital, Peking University, Beijing 100044, China
| | - Hong-Lan Zhu
- Department of Obstetrics and Gynecology, People's Hospital, Peking University, Beijing 100044, China.
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Garcia SM, Morotti F, Cavalieri FLB, Lunardelli PA, Santos AO, Membrive CMB, Castilho C, Puelker RZ, Silva JOF, Zangirolamo AF, Seneda MM. Synchronization of stage of follicle development before OPU improves embryo production in cows with large antral follicle counts. Anim Reprod Sci 2020; 221:106601. [PMID: 32961391 DOI: 10.1016/j.anireprosci.2020.106601] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 11/21/2022]
Abstract
In the present study, there was an evaluation of in vitro embryo production (IVEP) in Bos indicus donor cows with small or large antral follicle counts (AFCs) when there was synchronization of follicular dynamics among cows before ovum pick-up (OPU). Donor cows classified as having small or large AFC were submitted to OPU/IVEP program (Experiment-I) or had follicular-stage synchronization imposed before OPU/IVEP (Experiment-II). In Experiment-I, the cows with a large AFC had a greater (P < 0.01) mean of embryos developing to the blastocyst stage compared to those with a small AFC. In Experiment-II, percentage of viable oocytes/OPU were not affected (P = 0.33) by synchronization of follicular dynamics, but the AFC had an effect (P < 0.0001). There was an interaction (P = 0.01) indicating the larger AFC, with or without imposing of a synchronization treatment regimen, resulted in the most desirable outcome. The number of embryos was affected (P < 0.001) by follicular-stage synchronization and AFC, with there being an interaction (P = 0.002) with the most desirable results for the large AFC-synchronized group. Number of pregnancies was greater (P ≤ 0.02) for recipient females with embryos from synchronized donors and with a large AFC. There was an interaction (P = 0.03) with there being a greater pregnancy percentage for cows with synchronized follicular stages and the large AFC. Bos indicus donor with a large AFC when associated with the synchronization of stage of follicular dynamics pre-OPU results in improvement of the efficacy of IVEP.
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Camargo-Mattos D, García U, Camargo-Diaz F, Ortiz G, Madrazo I, Lopez-Bayghen E. Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation. J Ovarian Res 2020; 13:94. [PMID: 32807228 PMCID: PMC7433193 DOI: 10.1186/s13048-020-00688-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To determine if a modified ovarian sensitivity index (MOSI), based on initial follicular measurements and the initial follicle-stimulating hormone (FSH) dose, can predict the production of high-quality embryos for successful implantation during in vitro fertilization (IVF). METHODS This study consisted of two phases: 1) a retrospective study and 2) a prospective observational study. For the first phase, 363 patients charts were reviewed, of which 283 had embryos transferred. All women underwent a standardized antagonist-based IVF protocol. At the first follow-up (Day 3/4), the number and size of the follicles were determined. MOSI was calculated as ln (number follicles (≥6 mm) × 1000 / FSH initial dose). Afterward, the number and quality of the ova, embryo development, and the number and quality of the blastocysts were determined. Embryo implantation was confirmed by β-hCG. For the second phase, 337 IVF cycles were followed to determine MOSI's accuracy. RESULTS MOSI could predict the production of ≥4 high-quality embryos by Day 2 (AUC = 0.69, 95%CI:0.63-0.75), ≥2 blastocysts (AUC = 0.74, 95%CI:0.68-0.79), and ≥ 35% rate of blastocyst formation (AUC = 0.65, 95%CI:0.58-0.72). Using linear regression, MOSI was highly associated with the number of ova captured (β = 5.15), MII oocytes (β = 4.31), embryos produced (β = 2.90), high-quality embryos (β = 0.98), and the blastocyst formation rate (β = 0.06, p < 0.01). Using logistic regression, MOSI was highly associated with achieving ≥4 high-quality embryos (odds ratio = 2.80, 95%CI:1.90-4.13), ≥2 blastocysts (odds ratio = 3.40, 95%CI:2.33-4.95), and ≥ 35% blastocysts formation rate (odds ratio = 1.96, 95%CI:1.31-2.92). This effect was independent of age, BMI, and antral follicle count. For implantation, MOSI was significantly associated with successful implantation (odds ratio = 1.79, 95%CI:1.25-2.57). For the prospective study, MOSI was highly accurate at predicting ≥6 high-quality embryos on Day 2 (accuracy = 68.5%), ≥6 blastocysts (accuracy = 68.0%), and a blastocyst formation rate of ≥35% (accuracy = 61.4%). CONCLUSION MOSI was highly correlated with key IVF parameters that are associated with achieved pregnancy. Using this index with antagonist cycles, clinicians may opt to stop an IVF cycle, under the assumption that the cycle will fail to produce good blastocysts, preventing wasting the patient's resources and time.
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Affiliation(s)
- David Camargo-Mattos
- Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México City, Mexico
| | - Uziel García
- Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México City, Mexico
| | - Felipe Camargo-Diaz
- Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México City, Mexico
| | - Ginna Ortiz
- Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México City, Mexico
| | - Ivan Madrazo
- Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México City, Mexico
| | - Esther Lopez-Bayghen
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Avenida Instituto Politécnico Nacional 2508, San Pedro Zacatenco, 07360, México City, Mexico.
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Maldonado-Cárceles AB, Mínguez-Alarcón L, Souter I, Gaskins AJ, Arvizu M, Williams PL, Ford JB, Chavarro JE. Dietary patterns and ovarian reserve among women attending a fertility clinic. Fertil Steril 2020; 114:610-617. [PMID: 32712021 DOI: 10.1016/j.fertnstert.2020.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/28/2020] [Accepted: 04/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the associations between dietary patterns and antral follicle count (AFC), a marker of ovarian reserve. DESIGN Prospective cohort study. SETTING Fertility center at an academic hospital. PATIENT(S) A total of 363 women seeking preconception evaluation and infertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study. INTERVENTION(S) None. At enrollment, women reported diet through a food frequency questionnaire, from which we computed three dietary pattern adherence scores: the Mediterranean diet, the Fertility diet, and the Profertility diet. MAIN OUTCOME MEASURE(S) The AFC was assessed with a transvaginal ultrasound performed on the third day of an unstimulated menstrual cycle or on the third day of a P withdrawal bleed. RESULT(S) Higher adherence to the three dietary patterns examined were unrelated to AFC. The multivariable adjusted AFC means and 95% confidence intervals for women in the highest compared with the lowest quartile of adherence score were 13.9 (13.0-14.9) and 13.5 (12.6-14.4) for the Mediterranean diet, 14.0 (13.2-14.9) and 13.5 (12.7-14.3) for the Fertility diet, and 12.5 (11.6-13.5) and 13.3 (12.5-14.2) for the Profertility diet. CONCLUSION(S) Dietary patterns were unrelated to AFC among a cohort of women presenting at a fertility center. Due to the limited and heterogeneous current evidence, it is important to evaluate this association in further studies, and in particular among women from the general population.
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Affiliation(s)
- Ana B Maldonado-Cárceles
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Murcia, Spain.
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Irene Souter
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, Massachusetts
| | - Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Chen T, Zhao F, Wang Q, Liu C, Lan Y, Wang S, Xin Z, Yang X. Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35-39 years: a retrospective study. J Ovarian Res 2020; 13:80. [PMID: 32684158 PMCID: PMC7370502 DOI: 10.1186/s13048-020-00678-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/29/2020] [Indexed: 01/26/2023] Open
Abstract
Purpose Problems with fallopian tubes are one of the main reasons for women to undergo in vitro fertilization-embryo transfer (IVF-ET). A large proportion of women with ectopic pregnancy, fallopian tube obstruction and hydrosalpinx have had one or both fallopian tubes removed by salpingectomy. With increasing age, ovarian reserve deteriorates, the numbers of retrieved oocytes, available embryos and high-quality embryos are reduced, and the live birth rate for women treated with IVF treatment is affected. Thus, it is important to understand how salpingectomy affects live birth rates for IVF patients of different ages. This study analyzed how patients’ age and salpingectomy influenced ovarian reserve, ovarian response and pregnancy outcomes for infertile women undergoing IVF-ET. Methods A total of 1922 patients that underwent IVF-ET treatment from January 1, 2012, to December 31, 2018, were included in this retrospective study. The patients were divided into two groups according to whether or not they had a previous history of salpingectomy. The salpingectomy (group A, 534 patients) and control groups (group B, 1388 patients) were then further divided into two subgroups according to patient age (age<35 years, and age 35–39 years). Ovarian reserve, ovarian response, and IVF outcomes were investigated for each subgroup. Logistic regression model was used to estimate the relationship between clinical pregnancy and live births and patients’ baseline characteristics. Results In the salpingectomy group, antral follicle counts (AFC) were significantly lower for the subgroup aged 35 to 39 years compared with the control group. But this difference did not appear in women younger than 35 years. In addition, there were no significant differences in levels of basal follicle stimulation hormone (FSH), basal luteinizing hormone (LH), basal estradiol (E2), total gonadotropins (Gn) dose, duration of Gn, numbers of retrieved oocytes, fertilization rates, numbers of available embryos, live birth rates, clinical pregnancy rates, miscarriage rates, ectopic pregnancy rates, or multiple pregnancy rates between the salpingectomy group and the control group (P > 0.05). Age is a risk factor for the clinical pregnancy and live birth. Conclusion Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35–39 years. The increased female age was negative related with clinical pregnancy and live birth.
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Affiliation(s)
- Tong Chen
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Feiyan Zhao
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Qin Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Chang Liu
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Yonglian Lan
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Shuyu Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Zhimin Xin
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
| | - Xiaokui Yang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
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Abdallah A, Shawki H, Abdel-Rasheed M, Salem S, Hosni M. Role of 3-D Transvaginal Ultrasonography in Women Undergoing in Vitro Fertilization/Intra-cytoplasmic Sperm Injection. Ultrasound Med Biol 2020; 46:1424-1427. [PMID: 32217031 DOI: 10.1016/j.ultrasmedbio.2020.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/28/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Both 2-D and 3-D transvaginal ultrasonography are effective imaging modalities for assessment of ovarian reserve. Our aim was to compare both modalities in assessment of ovarian reserve of women undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Fifty women were scheduled according to their menstrual cycle to be examined by both 2-D and 3-D transvaginal ultrasonography. We found that the average time for computerized analysis of the 3-D ultrasound data was significantly shorter than that for analysis of the 2-D ultrasound data, for both total antral follicle count and ovarian volume. However, there were no statistically significant differences between the methods in total antral follicle count and ovarian volume. We conclude that, where available, 3-D ultrasonography can be used for assessment of ovarian reserve in addition to the biochemical marker, particularly in overcrowded in vitro fertilization centers that need to save time.
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Affiliation(s)
- Ameer Abdallah
- Obstetrics and Gynecology Department, Minia University, El Minia, Egypt
| | - Hossam Shawki
- Obstetrics and Gynecology Department, Minia University, El Minia, Egypt
| | - Mazen Abdel-Rasheed
- Reproductive Health Research Department, National Research Centre, Cairo, Egypt.
| | - Sondos Salem
- Reproductive Health Research Department, National Research Centre, Cairo, Egypt
| | - Mahmoud Hosni
- Obstetrics and Gynecology Department, Minia University, El Minia, Egypt
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Kadiroğulları P, Demir E, Bahat PY, Kıyak H, Seckin KD. Evaluation of relationship between HbA1c levels and ovarian reserve in patients with type 1 diabetes mellitus. Gynecol Endocrinol 2020; 36:426-430. [PMID: 31909635 DOI: 10.1080/09513590.2019.1708893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
In organ or non-organ-specific autoimmune disorders, human ovary is usually the target of the autoimmune attack. We aimed to demonstrate the correlation between ovarian reserve and DM1, based on the view that women with type-1 diabetes mellitus (DM1) will have lower AMH levels secondary to poor glycemic control and autoimmune attacks. Ovarian functions of 42 patients diagnosed with DM1 who use insulin and 65 healthy volunteers were analyzed. Basal hormone and AMH levels were measured during the follicular phase. Fasting and postprandial blood glucose concentrations, HbA1c and C-peptide levels were evaluated. The mean antral follicle count (AFC) was significantly lower in DM1 patients than in healthy controls (p = .001). The AMH levels were lower in women with DM1 than in the controls (p = .001). The HbA1c values of DM1 patients, who formed the study group, was significantly higher than the control group. Ovarian reserve that is evaluated with serum AMH level is affected by poor glycemic control in type 1 diabetes. Due to the time of the autoimmune damage in the ovaries and the observable effects of this damage, more comprehensive and longer-term studies are needed to be conducted for the follow-up of reproductive abnormalities.
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Affiliation(s)
- Pınar Kadiroğulları
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Esra Demir
- Department of Internal Medicine, Istanbul Health Sciences University, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Pinar Yalcin Bahat
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Huseyin Kıyak
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Kerem Doga Seckin
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
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González-Foruria I, Soldevila PB, Rodríguez I, Rodríguez-Purata J, Pardos C, García S, Pascual MÁ, Barri PN, Polyzos NP. Do ovarian endometriomas affect ovarian response to ovarian stimulation for IVF/ICSI? Reprod Biomed Online 2020; 41:37-43. [PMID: 32456967 DOI: 10.1016/j.rbmo.2020.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/10/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022]
Abstract
RESEARCH QUESTION Does the presence of ovarian endometriomas affect ovarian response to ovarian stimulation after adjusting for age and ovarian reserve markers? DESIGN This retrospective cross-sectional study compared the ovarian response between patients with ovarian endometriomas and women with other infertility factors undergoing their first ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI). An age-specific nomogram model for the number of oocytes retrieved was built for both groups, and ovarian response was compared after adjusting for age, gonadotrophin dose, anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC). RESULTS A total of 923 patients were included: 101 women with at least one ovarian endometrioma, and 822 patients with other infertility factors. Comparisons of the nomograms for the number of oocytes retrieved demonstrated that response was significantly lower for women with endometrioma when the results were adjusted for age the z-score for the number of oocytes retrieved (-0.49 ± 0.71 versus -0.20 ± 0.86; 95% confidence interval [CI] -0.47 to -0.12) and also after adjustment for the total dose of gonadotrophins and AMH values (z-score mean difference -0.338; 95% CI -0.54, -0.14). When the z-score was adjusted for gonadotrophin dose and AFC, the number of oocytes retrieved was comparable between the two groups (z-score mean difference -0.038; 95% CI -0.34 to 0.27). CONCLUSIONS Ovarian response after ovarian stimulation for IVF/ICSI in women with endometriomas is significantly lower than in controls after adjusting for age, gonadotrophin dose and AMH. Dose and protocol selection for ovarian stimulation in patients with endometrioma should be based on AFC rather than AMH, as the latter may be overestimated.
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Affiliation(s)
- Iñaki González-Foruria
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
| | - Pedro Barri Soldevila
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Ignacio Rodríguez
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Jorge Rodríguez-Purata
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Clara Pardos
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Sandra García
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - M Ángela Pascual
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Pedro N Barri
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - Nikolaos P Polyzos
- Dexeus Mujer, Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
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de Vasconcelos GL, da Cunha EV, Maculan R, Sánchez Viafara JA, Barbalho Silva AW, Souza Batista AL, Viana Silva JR, de Souza JC. Effects of vulvar width and antral follicle count on oocyte quality, in vitro embryo production and pregnancy rate in Bos taurus taurus and Bos taurus indicus cows. Anim Reprod Sci 2020; 217:106357. [PMID: 32408964 DOI: 10.1016/j.anireprosci.2020.106357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022]
Abstract
It was hypothesized that Brahman cows have greater in vitro embryo production than Simmental cows, and that regardless of breed, antral follicle count (AFC) and vulvar width (VW) are positively associated with oocyte quality, embryo number and pregnancy rate. Brahman (Bos taurus indicus, n = 184) and Simmental (Bos taurus taurus, n = 99) cows were classified as having a large AFC (Brahman: ≥50, Simmental: ≥25); intermediate AFC (Brahman: >30 and ≤49; Simmental: >16 and <24) and small AFC (Brahman: <30, Simmental: ≤15). The VW was considered to be large (Brahman: >123 mm, Simmental: >80 mm); intermediate (Brahman: >102 mm and ≤123 mm; Simmental: >65 mm and ≤80 mm) and small (Brahman: ≤102 mm and Simmental: ≤65 mm). For each group of cows, ovum pick up, oocyte in vitro maturation, fertilization and embryo culture were performed. Embryo transfers were subsequently performed and pregnancy rate was evaluated. Brahman cows had a larger number of viable oocytes, greater efficiency of embryo production and greater pregnancy rate (P < 0.05) than Simmental cows. Pregnancy percentages in Simmental cows with a small AFC were greater than those cows with an intermediate and large AFC. With the Brahman cows, there was no difference in pregnancy rate among the cows with different AFC classifications. In contrast to Simmental cows, Brahman cows with an intermediate VW had a greater pregnancy percentage than those with a small and large AFC. In conclusion, Brahman cows have a larger AFC, number of viable oocytes, and pregnancy rate than Simmental cows.
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Affiliation(s)
| | - Ellen Vasconcelos da Cunha
- Laboratory of Biotecnology and Physiology of Reproduction - LABIREP, Federal University of Ceara, Sobral, CE, Brazil
| | - Renata Maculan
- Animal Science Department, Federal University of Lavras, Lavras, MG, Brazil
| | | | - Anderson Weiny Barbalho Silva
- Laboratory of Biotecnology and Physiology of Reproduction - LABIREP, Federal University of Ceara, Sobral, CE, Brazil
| | - Ana Liza Souza Batista
- Laboratory of Biotecnology and Physiology of Reproduction - LABIREP, Federal University of Ceara, Sobral, CE, Brazil
| | - José Roberto Viana Silva
- Laboratory of Biotecnology and Physiology of Reproduction - LABIREP, Federal University of Ceara, Sobral, CE, Brazil
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Chemerinski A, Cameron K, Sammel M, Ginsberg J, Carlson C, Gracia C. Relationship of menopausal symptoms and ovarian reserve in reproductive-aged cancer survivors. J Cancer Surviv 2020; 14:607-13. [PMID: 32323140 DOI: 10.1007/s11764-020-00857-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This study sought to evaluate the prevalence of menopausal symptoms in a population of reproductive-aged women remote from cancer therapy compared with a group of healthy similar-aged controls and with a cohort of late reproductive-aged (LR) controls. METHODS Participants were assessed for symptoms of menopause, early follicular phase hormones, and ultrasound examinations. Menopausal symptoms were analyzed in exposed participants and controls using χ2 analyses, Wilcoxon-Mann Whitney tests, and multivariable logistic regression models. RESULTS One hundred seventy cancer survivors, 135 similar-aged controls, and 71 LR controls were followed prospectively for an average of 38 months. Compared with similar-aged controls, a greater proportion of survivors reported vasomotor symptoms at some point over the study period (35% vs 19%, p < 0.01), and this proportion was similar to LR controls (44%, p = 0.22). Survivors were more likely to be bothered by vaginal dryness (27%) than similar-aged controls (16%, p = 0.02) or LR controls (14%, p = 0.02). FSH levels were 38.4% higher in those with vasomotor symptoms compared with those without symptoms (p = 0.021). CONCLUSIONS Reproductive-aged cancer survivors have a higher prevalence of vasomotor symptoms and vaginal dryness than their similar-aged peers. IMPLICATIONS FOR CANCER SURVIVORS Providers should be attuned to the high prevalence of menopausal symptoms in cancer survivors.
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Karadağ C, Demircan S, Turgut A, Çalışkan E. Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. Turk J Obstet Gynecol 2020; 17:15-20. [PMID: 32341825 PMCID: PMC7171546 DOI: 10.4274/tjod.galenos.2020.37605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/09/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: To compare the effects of laparoscopic cystectomy on ovarian reserve between women with endometrioma and dermoid cyst. Materials and Methods: Thirty-six patients were diagnosed as having endometrioma (group A) and 32 patients with dermoid cyst (group B) using ultrasonography. Preoperative anti-mullerian hormone (AMH) levels were measured and unilateral antral follicle counts (AFC) were calculated for the ovary side containing the cyst. Laparoscopic cystectomy was performed using the stripping technique for all participants. After 3 months, all participants were re-evaluated between the third and sixth day of their menstrual cycle to determine AFC and AMH levels. Results: The mean serum preoperative AMH level and AFC level were significantly lower in group A than in group B (p=0.001, p=0.002), respectively. At 3 months after the surgery, serum AMH levels decreased significantly in group A from 2.04±0.68 to 1.47±0.55 (p=0.001), and from 2.60±0.57 to 2.17±0.56 in group B (p=0.001). In group A, unilateral (operated side) AFC levels decreased significantly from 4.05±1.24 to 2.16±0.94 (p=0.001), and in group B, it decreased significantly from 4.93±0.94 to 3.40±0.87 (p=0.001). The decrease in AMH levels was significantly higher in group A than in group B (p=0.033). The decrease in AFC levels was also significantly higher in group A than in group B (p=0.044). Conclusion: Laparoscopic stripping has destructive effects on serum AMH levels and the operated side AFC levels after surgery for patients with endometrioma and dermoid cysts, and laparoscopic excision of endometrioma has more destructive effects on ovarian reserve than dermoid cysts.
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Affiliation(s)
- Cihan Karadağ
- Okan University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Sinem Demircan
- İstanbul Medeniyet University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Abdulkadir Turgut
- İstanbul Medeniyet University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Eray Çalışkan
- Okan University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Furukawa E, Masaki T, Sakaguchi K, Bo M, Yanagawa Y, Ueda K, Nagano M. Relationship between the timing of the first postpartum ovulation and antral follicle counts in Holstein cows. J Ovarian Res 2020; 13:7. [PMID: 31926556 PMCID: PMC6954630 DOI: 10.1186/s13048-020-0610-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The timing of the first postpartum ovulation is an important factor affecting the timing of estrous resumption in dairy cows. The first postpartum ovulation is delayed in cows producing large amounts of milk with an intensive negative energy balance. The antral follicle count (AFC) and serum anti-Müllerian hormone concentrations are known to be indicators of the ovarian reserve, which is the number and quality of follicles left in a pair of ovaries and known as an indicator of female fertility. Cows with higher AFC have been proven to show higher pregnancy rate and shorter calving to conception intervals; however, the relationship between the timing of the first postpartum ovulation and ovarian reserve remains unclear. Therefore, this study examined the relationships between postpartum follicular dynamics, the ovarian cycle, nutritional status, and ovarian reserve. METHODS Transrectal ultrasonography was conducted from calving to 70-120 days in milk (DIM) in 26 cows to monitor AFC, follicular dynamics and the ovarian cycle. Body weight (BW) and milk yield were used as indicators of nutritional status. RESULTS The first postpartum ovulation was significantly later in cows with low AFC (< 25) than in those with high AFC (≥25), while changes in BW from calving to the nadir and milk production were similar in both groups. The present results also suggested that cows with low AFC and a delayed first postpartum ovulation had a shorter first ovarian cycle after the first postpartum ovulation. The mean DIM of the first postpartum artificial insemination (AI) and days open (days from calving to AI with which pregnancy was achieved) were similar in high and low AFC groups. CONCLUSIONS The first postpartum ovulation was significantly earlier in cows with high AFC than in those with low AFC. The assumed reason for this result was higher sensitivity to luteinizing hormone and larger androstenedione and estradiol production in follicles in high AFC cows. Therefore, cows with high AFC may be more fertile than those with low AFC while their milk production increase and BW decrease; it means they are in negative energy balance. (340/350 words).
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Affiliation(s)
- Eri Furukawa
- Laboratory of Theriogenology, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, 060-0818, Japan
| | - Tomoyuki Masaki
- Laboratory of Theriogenology, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, 060-0818, Japan
| | - Kenichiro Sakaguchi
- Laboratory of Theriogenology, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, 060-0818, Japan
| | - Min Bo
- Laboratory of Animal Production System, Graduate School of Agriculture, Hokkaido University, Sapporo, 060-8589, Japan
| | - Yojiro Yanagawa
- Laboratory of Theriogenology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, 060-0818, Japan
| | - Koichiro Ueda
- Laboratory of Animal Production System, Research Faculty of Agriculture, Hokkaido University, Sapporo, 060-8589, Japan
| | - Masashi Nagano
- Laboratory of Theriogenology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, 060-0818, Japan. .,Laboratory of Animal Reproduction, Department of Animal Science, School of Veterinary Medicine, Kitasato University, Towada, 034-8628, Japan.
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Chun S. Inter-ovarian differences in ultrasound markers of ovarian size in women with polycystic ovary syndrome. Clin Exp Reprod Med 2019; 46:197-201. [PMID: 31739656 PMCID: PMC6919203 DOI: 10.5653/cerm.2019.00374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/30/2019] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to establish whether differences in ovarian size exist between the right and the left ovary of the same individual in women with polycystic ovary syndrome. Methods In total, 206 Korean women with polycystic ovary syndrome were included in this study. In all participants, a transvaginal or transrectal ultrasound examination was conducted in the early follicular phase of the menstrual cycle. Results A significant linear correlation was found between the two ovaries with regard to antral follicle count and ovarian volume. The mean antral follicle count in the right ovary (26.75±11.72) was significantly higher than that in the left ovary (23.98±10.85), and the mean volume of the right ovary (11.06±5.17 cm3) was significantly different from that of the left ovary (9.12±4.89 cm3). Conclusion Ovarian size is different between the right and the left ovary in women with polycystic ovary syndrome.
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Affiliation(s)
- Sungwook Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Sakaguchi K, Yanagawa Y, Yoshioka K, Suda T, Katagiri S, Nagano M. Relationships between the antral follicle count, steroidogenesis, and secretion of follicle-stimulating hormone and anti-Müllerian hormone during follicular growth in cattle. Reprod Biol Endocrinol 2019; 17:88. [PMID: 31690325 PMCID: PMC6833202 DOI: 10.1186/s12958-019-0534-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/15/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The antral follicle count (AFC) in mammalian ovaries positively correlates with female fertility. To clarify the causes of differences in fertility between low and high AFC cows, we investigated follicular growth dynamics and hormone concentrations in plasma, follicular fluid, and in vitro growth (IVG) media at different stages of follicular growth. METHODS Seven cows were divided into high AFC (n = 4, > 30 follicles) and low AFC (n = 3, < 30 follicles) groups based on the peak AFC detected by ultrasonography. These cows were subjected to estrous synchronization, daily ovarian ultrasonography, and blood collection. Their follicular fluid was collected from dominant follicles at different stages (selection, luteal, and ovulatory phases). In another experiment, we cultured oocyte-cumulus-granulosa cell complexes collected from early antral follicles (< 1 mm) for 12 days. Estradiol-17β (E2), testosterone (T), progesterone (P4), and anti-Müllerian hormone (AMH) concentrations in follicular fluids and plasma were measured. Plasma follicle-stimulating hormone (FSH) concentrations were examined. E2, P4, and AMH concentrations were also measured in IVG media. RESULTS The numbers of small (< 4 mm) and intermediate (4-8 mm) follicles were larger in the high AFC group than in the low AFC group (P < 0.05). The number of intermediate follicles was stable in the low AFC group, indicating consistent development. However, the number of these follicles fluctuated in the high AFC group. Plasma FSH concentrations were higher, whereas E2 and T concentrations were lower in the low AFC group (P < 0.05). E2 concentrations and the E2/P4 ratio in ovulatory follicles and IVG media on day 8 were higher in the high AFC group (P < 0.05). AMH concentrations in plasma and IVG media (P < 0.01) were higher in the high AFC group. CONCLUSIONS The weaker response to FSH of granulosa cells caused low E2 production in the low AFC group, resulting in high FSH concentrations and the consistent development of intermediate follicles. Conversely, higher E2 concentrations suppressed FSH secretion in the high AFC group. Granulosa cells in the high AFC group had the ability to produce more AMH than those in the low AFC group throughout IVG culture.
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Affiliation(s)
- Kenichiro Sakaguchi
- 0000 0001 2173 7691grid.39158.36Laboratory of Theriogenology, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818 Japan
- 0000 0004 0614 710Xgrid.54432.34Research Fellow of the Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, 102-0083 Japan
| | - Yojiro Yanagawa
- 0000 0001 2173 7691grid.39158.36Laboratory of Theriogenology, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818 Japan
| | - Koji Yoshioka
- 0000 0004 0530 9488grid.416882.1National Institute of Animal Health, NARO, Tsukuba, Ibaraki 305-0856 Japan
| | - Tomoko Suda
- 0000 0004 0530 9488grid.416882.1National Institute of Animal Health, NARO, Tsukuba, Ibaraki 305-0856 Japan
| | - Seiji Katagiri
- 0000 0001 2173 7691grid.39158.36Laboratory of Theriogenology, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818 Japan
| | - Masashi Nagano
- 0000 0001 2173 7691grid.39158.36Laboratory of Theriogenology, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818 Japan
- 0000 0000 9206 2938grid.410786.cPresent address: Laboratory of Animal Reproduction Department of Animal Science, School of Veterinary Medicine, Kitasato University, Aomori, 034-8628 Japan
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Moini A, Pirjani R, Rabiei M, Nurzadeh M, Sepidarkish M, Hosseini R, Hosseini L. Can delivery mode influence future ovarian reserve? Anti-Mullerian hormone levels and antral follicle count following cesarean section: a prospective cohort study. J Ovarian Res 2019; 12:83. [PMID: 31481111 PMCID: PMC6720941 DOI: 10.1186/s13048-019-0551-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/07/2019] [Indexed: 01/10/2023] Open
Abstract
Background The incidence of Cesarean has increased in recent years. The purpose of this study is to evaluate the effect of cesarean section on ovarian reserve. This is a prospective cohort study from January 2016 to November 2017. Inclusion criteria included singleton primigravid pregnant women whose gestational age was above 37 weeks. Exclusion criteria included history of infertility, pelvic surgery, underlying chronic diseases, any adverse pregnancy outcome and postpartum complication in current pregnancy and hormonal medication within six months of delivery. Anti-Mullerian hormone was measured at the admission time for delivery. The type of delivery was determined based on obstetrics indications. Six months after delivery, antral follicle count was performed and anti-Mullerian hormone was measured again. Result(s) First blood sample was taken from 730 women. After excluding 550 women, the second blood sample was taken from 180 participants. The mean of first anti-Mullerian hormone in women with cesarean and vaginal delivery were 1.01 ng/mL (95% CI 0.82 to 1.18) and 1.18 ng/mL (95% CI 0.96 to 1.40) respectively (P = 0.211). The mean of second anti-Mullerian hormone in women with cesarean and vaginal delivery were 4.77 ng/mL (95% CI:3.91 to 5.63) and 4.92 ng/mL (95% CI: 4.01 to 5.82) respectively (P = 0.818). No statistically significant difference existed in total AFC between cesarean and vaginal delivery groups (MD: 0.41, 95% CI: − 1.05 to 1.89, P = 0.576). Conclusion Antral follicle count and anti-Mullerian hormone, six month after delivery, are not affected by delivery mode even after adjusting for women’s age, baseline Anti-Mullerian hormone, body mass index, gestational age at delivery, breastfeeding, postpartum menstruation, neonatal sex and weight. Based on our best knowledge, this is the first report that investigates the effects of delivery mode on ovarian reserve. Decreased fertility following cesarean has been shown in some previous studies but most of them had assessed this association based on the incidence of subsequent pregnancy. Since subsequent pregnancy can be influenced by several confounding factors, we investigated the effect of cesarean on fertility using its impact on anti-Mullerian hormone levels and antral follicle count. We hope that this study will be a beginning of more detailed studies in this field. We believe that this link is yet to be studied.
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Affiliation(s)
- Ashraf Moini
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Reihaneh Pirjani
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran.
| | - Maryam Rabiei
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Maryam Nurzadeh
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Reihaneh Hosseini
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Ladan Hosseini
- Research development center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Jurewicz J, Wielgomas B, Radwan M, Karwacka A, Klimowska A, Dziewirska E, Korczak K, Zajdel R, Radwan P, Hanke W. Triclosan exposure and ovarian reserve. Reprod Toxicol 2019; 89:168-72. [PMID: 31377340 DOI: 10.1016/j.reprotox.2019.07.086] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/18/2019] [Accepted: 07/31/2019] [Indexed: 11/22/2022]
Abstract
The objective of the current analysis was to investigate the associations of urinary triclosan concentrations with parameters of ovarian reserve. Five hundred eleven female aged 25-39 years who attended the infertility clinic for diagnostic purposes were recruited. Urinary concentrations of triclosan were measured by a validated gas chromatograohy ion-tap mass spectrometry method. Parameters of ovarian reserve were: antral follicle count (AFC), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and estradiol (E2) levels. Urinary concentrations of triclosan decrease antral follicle count. There were no statistically significant associations between other parameters of ovarian reserve (estradiol, FSH and AMH levels) and triclosan concentrations. Triclosan exposure may negatively affect antral follicle count, a marker of ovarian reserve. As the data on triclosan exposure and ovarian reserve are scarce additional study is needed to confirm the results.
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Zhang Y, Xu Y, Xue Q, Shang J, Yang X, Shan X, Kuai Y, Wang S, Zeng C. Discordance between antral follicle counts and anti-Müllerian hormone levels in women undergoing in vitro fertilization. Reprod Biol Endocrinol 2019; 17:51. [PMID: 31272468 PMCID: PMC6610959 DOI: 10.1186/s12958-019-0497-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/28/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In general, anti-Müllerian hormone (AMH) is positively associated with antral follicle count (AFC). However, there is often discordance between the AMH level and AFC in clinical practice. In cases of discordance, which indicator should be chosen to predict ovarian response and subsequently develop an ovulation induction protocol? The objective of this study was to investigate which indicator was more accurate in predicting ovarian response and pregnancy outcomes when the AMH level and AFC were discordant. METHODS A total of 1121 infertile women undergoing IVF/ICSI were recruited in this study. During the study period, patients were subjected to individualized controlled ovarian hyperstimulation (COH) protocols according to specific characteristics. The AMH levels and AFCs were measured on days 2-3 of the menstrual cycle. Serum samples were obtained to determine AMH levels. Transvaginal ultrasound was performed to determine the AFC. All patients were divided into four groups: Group A had AFCs and AMH levels in the normal range; Group B had normal AFCs and low AMH levels; Group C had low AFCs and normal AMH levels; and Group D had low AFCs and AMH levels. RESULTS Two hundred three women (18.11%) showed discordant AFCs and AMH levels. In the two groups with discordant AFCs and AMH levels, namely, Group B and Group C, the oocyte yield, good-quality embryo rate and clinical pregnancy rate were significantly higher in Group B than in Group C. The incidence of poor ovarian response (POR) was significantly lower in Group B than in Group C. According to the stratified analysis of age, for the three categories above the age of 30, oocyte yield was higher in Group B than in Group C. In all age categories, the clinical pregnancy rate was higher in Group B than in Group C. CONCLUSIONS Our study demonstrated that approximately one in five patients in clinical practice showed discordance between AFCs and AMH levels. In view of the AFC being better than AMH for predicting POR, the AFC should be the preferred indicator for predicting ovarian response to subsequently develop an optimal individualized COH protocol.
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Affiliation(s)
- Yangyang Zhang
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Yang Xu
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Qing Xue
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Jing Shang
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Xiuli Yang
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Xuemin Shan
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Yanrong Kuai
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Sheng Wang
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
| | - Cheng Zeng
- 0000 0004 1764 1621grid.411472.5Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, 100034 China
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de Moraes FLZ, Morotti F, Costa CB, Lunardelli PA, Seneda MM. Relationships between antral follicle count, body condition, and pregnancy rates after timed-AI in Bos indicus cattle. Theriogenology 2019; 136:10-14. [PMID: 31234052 DOI: 10.1016/j.theriogenology.2019.06.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/09/2019] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
Abstract
An experiment was performed to evaluate the association between the antral follicle count (AFC) plus body condition score (BCS) and the pregnancy rate in Bos indicus undergoing timed artificial insemination (TAI). A total of 736 Nelore cows with BCSs ranging from 2 to 4 received a conventional protocol for TAI. On a random day of the estrous cycle (Day 0), all cows received an intravaginal P4 device and an intramuscular (i.m.) injection of 2.0 mg estradiol benzoate. On Day 8, the P4 device was removed, and 150 μg sodium D-cloprostenol, 300 IU equine chorionic gonadotrophin and 1.0 mg estradiol cypionate were administered by i.m. injection. TAI was performed 48 h after P4 device removal, and pregnancy diagnosis was performed by ultrasonography after 30 days. On Day 0, all cows were examined by ultrasonography to determine the AFC by counting the number of follicles >3 mm in diameter that were present in both ovaries and to evaluate the BCS (scale of 1-5). The cows were then classified based on their AFCs as those with low (≤10 follicles), intermediate (11-29 follicles) and high AFC (≥30 follicles). Furthermore, cows were classified as having low (≥2.0 to ≤ 2.9) and high (≥3.0 to ≤ 4.0) BCSs. The AFCs and BCSs were analyzed using the generalized linear model, and the pregnancy rate was assessed with the binary logistic regression model (P ≤ 0.05). The pregnancy rate was influenced (P < 0.05) by AFC and BCS classification and by interactions (P = 0.034) between these factors. Cows with a low AFC exhibited higher a pregnancy rate than did cows with a high or an intermediate AFC (57.7% a, 47.9% b and 49.7% b, P = 0.008). Low BCS resulted in a higher pregnancy rate than did high BCS (55.2% vs. 50.4%, P = 0.008). Cows with a high BCS and a low AFC had a higher pregnancy rate (P < 0.05) than did those with a high BCS and an intermediate or a high AFC (59.8%a, 48.0%b, and 38.0%b, respectively). An interaction (P < 0.05) was observed between the AFC and BCS, and the pregnancy rate decreased significantly in cows with an AFC > 30 and a BCS between 3 and 4. In conclusion, AFC and BCS classifications influence the pregnancy rate of Bos indicus beef cattle subjected to TAI. In addition, an important interaction between these factors was observed, namely, the lowest pregnancy rates were found in cows with high BCSs and high AFCs.
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Affiliation(s)
| | - Fábio Morotti
- University of Londrina (UEL), Laboratory of Animal Reproduction, Londrina, PR, Brazil
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Inal ZO, Engin Ustun Y, Yilmaz N, Aktulay A, Bardakci Y, Gulerman C. Does the anti-Müllerian hormone truly reflect ovarian response in women with endometrioma? J OBSTET GYNAECOL 2019; 39:516-521. [PMID: 30744464 DOI: 10.1080/01443615.2018.1533542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this study, our aim was to determine which factor is more correlated with the number of oocytes retrieved in patients with endometrioma compared with controls undergoing in vitro fertilisation-intracytoplasmic sperm injection (IVF-ICSI) cycles: antral follicle count (AFC) or anti-Müllerian hormone (AMH). A total of 60 women with endometrioma and a control population of 60 women without endometrioma in the same period were randomly selected underwent the injection IVF-ICSI treatment. No significant differences were found between the groups in terms of age (28.78 ± 3.49 vs. 29.52 ± 2.47, p = .187), body mass index (23.62 ± 2.05 vs. 23.91 ± 2.11, p = .449), duration of infertility [(3 (2-4) vs. 3 (2-3), p = .139)], AMH level (1.52 ± 0.51 vs. 1.32 ± 0.92, p = .133), duration of stimulation [(9 (9-10) vs. 10 (9-10), p = .135)], total gonadotropin dose [(2750 (2262.5-3337.5) vs. 2770 (2680-3562.5), p = .125)], endometrial thickness [(10 (10-11) vs. 10 (9-11), p = .463)], fertilisation rates (67.20 ± 18.04 vs. 62.28 ± 17.13, p = .123), grade I embryo (43.3% vs. 30%, p = .185), clinical pregnancy rates (40% vs. 26.7%, p = .123), and the perinatal outcomes between the groups. The AFC was higher in the controls than in those with endometrioma (9.20 ± 1.80 vs. 6.32 ± 2.04, p < .001). The number of oocytes retrieved was also higher in the controls than in those with endometrioma [(7 (6-8) vs. 4 (4-5.75), p < .001)]. We found that women with endometrioma had a significantly lower number of oocytes retrieved than the controls despite the same AMH levels in both groups. AFC is a better marker of ovarian response than AMH in women with endometrioma undergoing IVF-ICSI. Impact statement What is already known on this subject? Utilising the ovarian reserve is important in the success of ovarian stimulation and in evaluating the success of assisted reproductive technologies. The anti-Müllerian hormone (AMH) level and the antral follicle count (AFC) are widely used in the prediction of ovarian functional reserve and response. However, no perfect marker exists in the evaluation of ovarian reserve and ovarian response. What do the results of this study add? Our study demonstrated that women with endometrioma have a significantly lower number of oocytes retrieved than the controls, despite the same AMH levels in both groups; which strongly suggests that AFC is a better reflection of ovarian response than AMH in women with endometrioma undergoing an in vitro fertilisation-intracytoplasmic sperm injection (IVF-ICSI). What are the implications of these findings for clinical practice and/or further research? This important issue has been reviewed and discussed for years, however, the conclusions are still controversial. Additional research is needed to understand which ovarian reserve test could better predict ovarian response outcome?
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Affiliation(s)
- Zeynep Ozturk Inal
- a Department of Reproductive Endocrinology , Konya Education and Research Hospital , Konya , Turkey
| | - Yaprak Engin Ustun
- b Department of Reproductive Endocrinology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Nafiye Yilmaz
- b Department of Reproductive Endocrinology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Ayla Aktulay
- b Department of Reproductive Endocrinology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Yesim Bardakci
- c Department of Embryology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Cavidan Gulerman
- b Department of Reproductive Endocrinology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
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