scholarly journals The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women

Medicine ◽  
2020 ◽  
Vol 99 (36) ◽  
pp. e21979
Author(s):  
Shan-Jie Zhou ◽  
Ming-Jia Zhao ◽  
Cui Li ◽  
Xing Su
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Response ◽  
Response Prediction ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Response Functions ◽  
Infertile Women ◽  
Age Ratio

Antral Follicle Diameter Variance Within Each Ovary May Be A Predictor For Poor Response In Cases With Normal Ovarian Reserve

2018 ◽  
Vol 126 (08) ◽  
pp. 521-527
Author(s):  
Ilhan Sanverdi ◽  
Enis Ozkaya ◽  
Suna Kucur ◽  
Dilsat Bilen ◽  
Meryem Eken ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Multivariate Regression Analysis ◽  
Antral Follicle Count ◽  
Estradiol Level ◽  
Poor Ovarian Response ◽  
Follicle Diameter ◽  
The Right

Abstract Objectives To determine the predictive value of antral follicle diameter variance within each ovary for ovarian response in cases with normal ovarian reserve tests. Methods This is a prospective observational study. One hundred and thirty nine infertile women who underwent ART in IVF-ICSI unit of Zeynep Kamil women and children’s Health Training and research hospital between January 2017 to June 2017 were recruited. Blood samples were collected on day 2/day 3 for assessment of serum FSH and estradiol. Trans-vaginal sonography was done for antral follicle count. During antral follicle count, in order to determine antral follicle diameter variance, diameters of the largest and smallest follicles were recorded. Variance was calculated by subtracting the smallest diameter from the largest one. Following ovarian stimulation with antagonist protocol, poor response was determined in cases with total oocyte number≤3. Ovarian reserve tests and antral follicle diameter variance were utilized to predict cases with poor response in women with normal ovarian reserve. Results Antral follicle diameter variance both in right (AUC=0.737, P<0.001) and left (AUC=0.651, P<0.05) ovaries significantly predicted poor ovarian response. Variance>3.5 mm was found to have 75% sensitivity to predict poor response. Basal serum FSH with estradiol levels and AFC failed to predict poor response (P>0.05). Other significant predictors for poor response were day 5 estradiol level and estradiol level at trigger day (P<0.05). In multivariate regression analysis, both AFC and antral follicle diameter variance in the right ovary were found to be significantly associated with clinical pregnancy, on the other hand peak estradiol concentration and antral follicle diameter variance in the right ovary were significantly associated with poor response. Conclusion Antral follicle diameter variance may be utilized to predict poor ovarian response in cases with normal ovarian reserve.

scholarly journals Correlation Between Follicle Stimulating Hormone, Anti-Müllerian Hormone and Antral Follicle Count with Different Age Groups in Infertile Women

2021 ◽  
Vol 20 (1) ◽  
pp. 22-27
Author(s):  
Juthi Bhowmik ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Farzana Deeba ◽  
Sheuli Chowdhury ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Ovarian Reserve ◽  
Follicle Stimulating Hormone ◽  
Age Groups ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Age Group ◽  
Infertile Women ◽  
Group A ◽  
Study Population

Background: Reduced ovarian reserve predicts poor ovarian response and poor suc-- cess rates in infertile women who undergo Assisted Reproductive Technology (ART). Ovarian reserve decreases with age but the rate of decline varies from one woman to another. Follicle Stimulating Hormone (FSH) Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) represent the three most frequently utilized laboratory tests in determining Ovarian Reserve (OR). To determine correlation between FSH, AMH and AFC in infertile female. Materials and methods: It was an observational (Cross sectional) study. This study was done in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, between July 2018 to June 2019. The study population consisted of all the diagnosed female infertility patients of reproductive age. The women attending the study center during study period having primary or secondary infertility was considered as study population. They were divided in 4 age groups 21-25, 26-30, 31-35 yrs and 36-40 yrs years. Data was collected using a structured questionnaire following physical & lab examination. For D2 FSH level fasting blood was collected on D2/3 of menstrual cycle, serum FSH level was measured by ADVIA Centraur(R) XP immunoassay system. For S. AMH level blood sample was collected on 2nd day of cycle and measured by BECKMAN COULTER machine using Chemiluminescent Immunoassay method. For AFC count TVS was done on D2-5 of cycle using KONTRON medical USG machine. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS version 23. Results: Out of 74 patients the mean age was found 32.6±5.5 years. Serum FSH, AMH and AFC were significantly associated with different age group. A negative correlation was found between serum FSH and serum AMH in all age group. But strong correlation found in age group 31-35 yrs and in 36-40 years age group. A negative correlation was found between serum FSH and total AFC in age group 26- 30 years, 31-35 years and 36-40 years respectively. A positive correlation was found between serum AMH and total AFC in all age group but most strong in age group 31-35 years. In multivariate logistic regression analysis serum AMH (<1.0 ng/ml) and total AFC (<5 number) were found to be significantly associated with age group >35 years patients. Conclusion: In all age grqoup, FSH, AMH and AFC correlates but it is more pronounced in advanced age that means >35 years age group. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 22-27

scholarly journals The evaluative effectiveness of a combined index exceeded that of a single variable for the ovarian reserve and response of infertile women

2019 ◽  
Author(s):  
Shan-Jie Zhou ◽  
Ming-Jia Zhao ◽  
Cui Li ◽  
Xing Su
Keyword(s):  
Ovarian Reserve ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Ovarian Response ◽  
Antral Follicle ◽  
The Other ◽  
Single Variable ◽  
Infertile Women ◽  
Better Than

Abstract Aim of the present study was to explore the evaluative effectiveness of age, ovarian volume, antral follicle count (AFC), serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), FSH/LH ratio and ovarian response prediction index (ORPI) to determine which could most advantageously assess ovarian reserve and response.Methods This research enrolled 319 consecutive infertile women who had undergone IVF-ET/ICSI treatments. Abovementioned variables were measured and calculated. Receiver Operating Characteristic Curve analysis was used to analyze the predictive accuracy of variables and to calculate cut-off values and corresponding sensitivity and specificity.Results Our study revealed that the significant variables for evaluating a decline in ovarian reserve include age, total volume of bilateral ovary, FSH, and ORPI. Moreover, the area under the curve (AUC) of ORPI was higher than other three variables (AUC = 0.903), and the cut-off value of ORPI was 0.245 (sensitivity 90.1%, specificity 73.9%). The significant variables forecasting excessive ovarian response were age, AFC, AMH, ORPI, FSH and FSH/LH ratio, and the significant variables forecasting low ovarian response were AMH and FSH/LH ratio. ORPI and FSH/LH ratio presented better effectiveness in evaluating ovarian response. When they were used to predict excessive response, the cut-off values of ORPI and FSH/LH ratio was 0.886 (sensitivity 84.7%, specificity 67.3%) and 1.753 (sensitivity 56.2%, specificity 67.6%), respectively. When used to predict low response, the cut-off value of FSH/LH ratio was 2.983 (sensitivity 75.0%, specificity 83.8%).Conclusions ORPI performed better than did the other variables in evaluating ovarian reserve and predicting excessive ovarian response, and the FSH/LH ratio performed better than did the other variables in predicting low ovarian response. Consequently, we agreed that the evaluative effectiveness of a combined index exceeded that of a single variable for evaluating the ovarian reserve and response of infertile women.

scholarly journals Diminished Ovarian Reserve, Causes, Assessment and Management

2013 ◽  
Vol 4 (2) ◽  
pp. 45-55 ◽  
Author(s):  
Mala Arora ◽  
Mandeep Kaur
Keyword(s):  
Ovarian Reserve ◽  
Treatment Options ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Diminished Ovarian Reserve ◽  
Assisted Hatching ◽  
Ovum Donation ◽  
Antagonist Protocol

ABSTRACT Diminished ovarian reserve predicts diminished ovarian response to stimulation but does not predict cycle fecundity. It has been recently defined by ESHRE, the Bologna's criteria, according to which at least two of the following three features should be present: (1) Age >40 years/any other risk factor for DOR, (2) abnormal ovarian reserve test, i.e. antral follicle count, AMH, (3) poor ovarian response in a previous stimulated cycle, i.e. less than three follicles after standard gonadotropin stimulation. Poor response to maximal stimulation on two previous occasions also defines DOR. The treatment options are limited. Avoiding the GnRH agonist long protocol and stimulation with microdose flare or antagonist protocol yields better results. Adjuvant therapy with LH, DHEAS and growth hormone shows some benefit in improving the oocyte yield. It is advisable to perform ICSI for all obtained oocytes and some advocate assisted hatching. Pregnancy rates are, however, poor and often these patients require ovum donation. Developing tests that will diagnose DOR in a low-risk population will allow women to plan their reproductive careers early. How to cite this article Kaur M, Arora M. Diminished Ovarian Reserve, Causes, Assessment and Management. Int J Infertility Fetal Med 2013;4(2):45-55.

scholarly journals Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

2019 ◽  
Vol 79 (07) ◽  
pp. 731-737 ◽  
Author(s):  
Umit Gorkem ◽  
Cihan Togrul
Keyword(s):  
Menstrual Cycle ◽  
Ovarian Reserve ◽  
Luteal Phase ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Infertile Women ◽  
Significant Difference ◽  
Response Groups ◽  
N 93 ◽  
Response Group

Abstract Introduction There are numerous conflicting studies which have addressed the question whether the measurement of anti-Müllerian hormone (AMH) concentrations should be done at a certain time during the menstrual cycle. We aimed to investigate AMH fluctuations during the follicular and luteal phases of the menstrual cycle and to determine whether AMH variations, if present, might influence the clinical utility of ovarian reserve markers. Materials and Methods A total of 257 infertile women eligible for inclusion were categorized into three groups based on their total antral follicle count: 1. hypo-response group (< 7 follicles, n = 66), 2. normo-response group (7 – 19 follicles, n = 98), and 3. hyper-response group (> 19 follicles, n = 93). Results Mean follicular AMH levels were elevated compared to levels in the luteal phase in all response groups (p < 0.001). There were significant and strong positive correlations between follicular and luteal AMH levels in all response groups (Spearmanʼs r = 0.822, r = 0.836, and r = 0.899, respectively; p < 0.001 for all groups). Fisherʼs Z-test comparisons of these correlations in all response groups demonstrated that there was no statistically significant difference (Z = 0.277, Z = − 1.001, and Z = − 1.425, respectively; p < 0.001). Conclusion We found that serum AMH levels in the follicular phase were higher than those in the luteal phase in all three response groups. In current practice, fluctuations in serum AMH concentrations are not large enough to alter the timing of AMH measurements during the menstrual cycle. The issue is important for the assessment of ovarian reserve in infertile women with AMH levels near to the cut-off value.

scholarly journals Anti-Mullerian Hormone:Above and Beyond Conventional Ovarian Reserve Markers

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Zehra Jamil ◽  
Syeda Sadia Fatima ◽  
Khalid Ahmed ◽  
Rabia Malik
Keyword(s):  
Ovarian Reserve ◽  
Critical Role ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Gonadal Development ◽  
Antral Follicle Count ◽  
Reproductive Hormones ◽  
Future Research ◽  
Accurate Estimation ◽  
Radiation Induced

Management of ovarian dysfunctions requires accurate estimation of ovarian reserve (OR). Therefore, reproductive hormones and antral follicle count (AFC) are assessed to indicate OR. Serum anti-Mullerian hormone (AMH) is a unique biomarker that has a critical role in folliculogenesis as well as steroidogenesis within ovaries. Secretion from preantral and early antral follicles renders AMH as the earliest marker to show OR decline. In this review we discuss the dynamics of circulating AMH that remarkably vary with sex and age. As it emerges as a marker of gonadal development and reproductive disorders, here we summarize the role of AMH in female reproductive physiology and provide evidence of higher accuracy in predicting ovarian response to stimulation. Further, we attempt to compile potential clinical applications in children and adults. We propose that AMH evaluation has a potential role in effectively monitoring chemotherapy and pelvic radiation induced ovarian toxicity. Furthermore, AMH guided ovarian stimulation can lead to individualization of therapeutic strategies for infertility treatment. However future research on AMH levels within follicular fluid may pave the way to establish it as a marker of “quality” besides “quantity” of the growing follicles.

scholarly journals The relevance of antral follicle count (AFC) as a marker of ovarian reserve in normal and infertile women in a tertiary care centre in Central India

2018 ◽  
Vol 7 (11) ◽  
pp. 4711
Author(s):  
Prasanta K. Nayak ◽  
Chandrima Mukherjee ◽  
Subarna Mitra
Keyword(s):  
Ovarian Reserve ◽  
Local Population ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Control Group ◽  
Antral Follicles ◽  
Infertile Women ◽  
Significant Difference ◽  
Age Range ◽  
And Control

Background: The objective of the present study was to establish the role of AFC as a marker of ovarian reserve in fertility-proven and in sub-fertile Indian women, and to establish the baseline cut-off AFC values for Indian women.Methods: This is an Observational Case-Control type of study. Test subjects (n=30, age range 20-35 years) were selected randomly from all the women coming to our Out-Patient Department with Primary Infertility. Healthy female volunteers (n=30, age range 20-35years) were recruited from the local population. Statistics: Student t test was applied to compare the mean Antral Follicle count between the case and control group. Pearson correlation test was applied to assess the correlation between age and AFC for case and control group.Results: The results of the study show that there is a significant difference between the number of antral follicles between fertile and infertile women (p < 0.001). The baseline cut-off for successful pregnancy was established as an AFC of 12. There exists negative correlation (r = -0.249) between age and AFC case group indicating as the age increases AFC decreases.Conclusions: The findings from this study help in strengthening the idea that AFC serves as a marker for ovarian reserve. Our observation indicates that the number of antral follicles is lower in the subfertile patients as compared to the fertile group (in all age groups), in view of the significantly lower median AFC in women of the former group (P < 0.001).

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