Australians' understanding of the decline in fertility with increasing age and attitudes towards ovarian reserve screening

The aim of this study is to determine Australians’ understanding of the decline in fertility with age, social determinants that influence their decision to start a family and attitudes towards ovarian reserve screening as a tool allowing personalised reproductive life planning. An online survey of 383 childless Australian men and women, aged 18–45 years, was conducted. Both sexes overestimated natural and in vitro fertilization (IVF)-assisted fertility potential with increasing age, with the magnitude of overestimation being more pronounced for men and IVF treatment compared with natural conception. The primary determinants for starting a family were a stable relationship, followed by establishment of career; availability of accessible child care and paid parental leave were considered less important. Finally, the majority of women (74%) would alter their reproductive life planning if they were identified as having low ovarian reserve on screening. Despite increased education, Australians continue to have a poor understanding of age-related decline in natural and IVF-assisted conception, potentially explaining why many delay starting a family. Ovarian reserve screening may help identify individuals at increased risk of premature diminished fertility, giving these women the ability to bring forward their plans for natural conception or undertake fertility preservation (oocyte freezing).

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CH50 Activity and its Relationship to Antimüllerian Hormone in Patients with Infertility

10.53902/cicmr.2021.01.000513 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

José Manuel Lozano Sánchez

Keyword(s):

Ovarian Reserve ◽

Spearman Correlation ◽

Complement Pathway ◽

Cross Sectional ◽

Vitro Fertilization ◽

Tertiary Referral Center ◽

Antimullerian Hormone ◽

Age Related ◽

Antimüllerian Hormone

Objective: To study the importance of immunological screening (CH50, C3, C4) to determine the correlation between the ovarian reserve and complement pathway. Design: A cross-sectional multivariate study. Setting: Single tertiary referral center. Patients: 40 Women with infertility diagnosis who underwent In Vitro Fertilization (IVF). Intervention(s): Basal blood samples collected to measure complement pathway and antimüllerian hormone. Main Outcome Measure(s): To correlate complement pathways (CH50 levels) with AMH. Results: The complement system and ovarian reserve were studied in 40 women aged from 28-48 years (mean=37.87 years), finding the values of CH50 65-268 CAE (mean=153.2 CAE), C3 13.9- 183mg/dl (mean=128.52mg/dl), C4 11.5-106mg/dl (mean=29.86mg/dl), AMH 0.10-3.9ng/dl (mean=1.32ng/dl). A multivariate analysis comparison was also conducted yielding significant results: negative correlation between AMH and age (Spearman correlation -0.6; P=0.001), as well as between AMH and CH50 (Spearman correlation -0.4; P=0.0129). Conclusion: High CH50 levels are correlated with an AMH decrease and it could be accordingly associated with age-related chronic inflammation. Capsule: High levels of CH50 are correlated with a decrease in AMH levels and could also be considered as a marker of poor response in IVF cycles.

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Unexplained infertility and expectant management in women aged 39 or above: is it acceptable to ask couples to wait one year before receiving IVF? A retrospective cohort study

10.21203/rs.3.rs-131936/v1 ◽

2020 ◽

Author(s):

Andrea Roberto Carosso ◽

Rik van EEKELEN ◽

Alberto Revelli ◽

Stefano CANOSA ◽

Noemi MERCALDO ◽

...

Keyword(s):

In Vitro Fertilization ◽

Live Birth ◽

Expectant Management ◽

Unexplained Infertility ◽

Vitro Fertilization ◽

Age Related ◽

Significant Difference ◽

Natural Conception ◽

One Year

Abstract Background: in older women, it is difficult to distinguish between ‘true’ unexplained infertility and age-related infertility. Unexplained infertile couples can have further expectant management before starting assisted reproductive treatments to avoid unnecessary, invasive and expensive treatment. However, ovarian reserve rapidly declines after 39 years or more, as the live birth rate after in vitro fertilization. It is thus uncertain if such a waiting policy, is also appropriate for women of advanced age.Methods: couples who had access to a waiting list for approximately one year before receiving reimbursed public IVF were compared with those paying for access to immediate private treatment at the IVF unit of S. Anna academic hospital and its private appendix. To allow for comparisons between these two strategies, we followed up couples who opted to pay for one year after the last embryo transfer from their first cycle. Clinical procedures regarding diagnosis and treatment were the same for both groups. We calculated the proportion of live births in both groups and compared these using a two-sample Z test for equality of proportions. The imbalance between these groups in terms of prognosis was accounted for using inverse probability weighting.Results: 635 couples were evaluated. Out of 359 couples in the immediate group, 70 (19.5%) had a live birth of which 11 after natural conception and 59 after IVF. Out of 276 couples in the waiting group, 57 (20.7%) had a live birth of which 37 after natural conception and 20 after IVF. There was no statistically significant difference between the two strategies in terms of the cLBR (19.5% immediate versus 20.7% waiting, 95% CI for difference: -0.07to 0.05), also after weighting (16.8% immediate versus 26.6% waiting, bootstrap 95%, CI for difference: -0.20 to 0.01).Conclusion(s): the cLBR for the ‘waiting before in vitro fertilization’ and the ‘immediate’ strategies were similar. Further studies are necessary to validate these findings and to better characterize these patients in order to individualize treatment and optimize economic resources, particularly in a setting of publicly-funded IVF.Trial registration: retrospectively registered

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Faculty Opinions recommendation of Higher rates of aneuploidy in blastocysts and higher risk of no embryo transfer in recurrent pregnancy loss patients with diminished ovarian reserve undergoing in vitro fertilization.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726479192.793521046 ◽

2016 ◽

Author(s):

Fatma F Verit

Keyword(s):

In Vitro Fertilization ◽

Embryo Transfer ◽

Ovarian Reserve ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Diminished Ovarian Reserve ◽

Vitro Fertilization

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The relation between ovarian reserve and In-vitro fertilization success

10.21619/iaog.2016.1.2 ◽

2016 ◽

Vol 1 (1) ◽

pp. 8-15 ◽

Cited By ~ 1

Author(s):

Prashant Purohit ◽

◽

Mike Savvas ◽

Keyword(s):

In Vitro Fertilization ◽

Ovarian Reserve ◽

Fertilization Success ◽

Vitro Fertilization

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Prevalence of pathogenic copy number variants among children conceived by donor oocyte

Scientific Reports ◽

10.1038/s41598-021-86242-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sandra Monfort ◽

Carmen Orellana ◽

Silvestre Oltra ◽

Mónica Rosello ◽

Alfonso Caro-Llopis ◽

...

Keyword(s):

In Vitro Fertilization ◽

Copy Number ◽

Assisted Reproductive Technologies ◽

Copy Number Variants ◽

Reproductive Technologies ◽

Significant Excess ◽

Vitro Fertilization ◽

Donor Oocyte ◽

Increased Risk

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.

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Age-related decline in the expression of GDF9 and BMP15 genes in follicle fluid and granulosa cells derived from poor ovarian responders

Journal of Ovarian Research ◽

10.1186/s13048-020-00757-x ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Yan Gong ◽

Jesse Li-Ling ◽

Dongsheng Xiong ◽

Jiajing Wei ◽

Taiqing Zhong ◽

...

Keyword(s):

Granulosa Cells ◽

Enzyme Linked Immunosorbent Assay ◽

Mrna Levels ◽

Clinical Trial Registry ◽

Altered Expression ◽

Vitro Fertilization ◽

Age Related ◽

Tertiary Teaching ◽

Poor Ovarian Responders

Abstract Background Growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) genes play important roles in folliculogenesis. Altered expression of the two have been found among patients with poor ovarian response (POR). In this prospective cohort study, we have determined the expression of the GDF9 and BMP15 genes in follicle fluid (FF) and granulosa cells (GCs) derived from poor ovarian responders grouped by age, and explored its correlation with the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods A total of 196 patients with POR were enrolled from a tertiary teaching hospital. The patients were diagnosed by the Bologna criteria and sub-divided into group A (< 35 year old), group B (35–40 year old), and group C (> 40 year old). A GnRH antagonist protocol was conducted for all patients, and FF and GCs were collected after oocyte retrieval. Expression of the GDF9 and BMP15 genes in the FF and GCs was determined with enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. Results Compared with group C, groups A and B had significantly more two pronuclei (2PN) oocytes and transplantable embryos, in addition with higher rates of implantation and clinical pregnancy (P < 0.05). The expression level of GDF9 and BMP15 genes in the FF and GCs differed significantly among the three groups (P < 0.05), showing a trend of decline along with age. The ratio of GDF9/BMP15 mRNA levels were similar among the three groups (P > 0.05). The relative levels of GDF9 and BMP15 proteins in GCs have correlated with the relative mRNA levels in GCs and protein concentrations in FF (P < 0.05). Conclusions For poor ovarian responders, in particular those over 40, the expression of GDF9 and BMP15 is declined along with increased age and in accompany with poorer oocyte quality and IVF outcome, whilst the ratio of GDF9/BMP15 mRNA levels remained relatively constant. Trial registration Chinese Clinical Trial Registry Center (ChiCTR1800016107). Registered on 11 May 2018.

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