Diminished ovarian reserve in young women with sickle cell anemia

Abstract Background: Clomiphene citrate (CC) supplementation in the progestin-primed ovarian stimulation (PPOS) protocol effectively alleviated profound pituitary suppression from progestin administration and reduced the gonadotropin (Gn) dose in the population of women with normal-ovarian-reserve or polycystic ovarian syndrome. Limited data are available about the role of CC in PPOS for women with diminished ovarian reserve (DOR). This study aimed to compare the efficiency of the PPOS protocol with CC supplementation and the standard PPOS protocol for various aged women with DOR.Methods: A total of 364 patients with DOR were recruited for this retrospective cohort study. They were divided into subgroups based on female age, ≤35 years and ＞35 years. The clinical characteristics and outcome were compared between the groups in subgroups.Results: In all patients with DOR, the PPOS protocol with CC supplementation was associated with a lower percentage of women with profound pituitary suppression (0.0% vs 18.6%, P ＜0.001 and 1.3% vs 11.0%, P ＝0.002) and a higher mean luteinizing hormone (LH) level during controlled ovarian stimulation (COS) than the standard PPOS protocol (P ＜0.05＝. In young women with DOR, more number of high-quality cleavage-stage embryos (1.96 vs. 1.38, P ＝0.018) was achieved in the PPOS protocol with CC supplementation. In elderly women with DOR, PPOS protocol with CC supplementation led to an increase in the incidence of LH levels above 10 IU/L on the trigger day (12.7% vs. 4.9%, P ＝0.028) and decrease in the rate of oocyte maturation (84.7% vs. 89.9%, P ＝0.034) compared to the standard PPOS protocol. No significant differences were observed in the Gn duration, total dosage of Gn, and pregnancy outcomes between the groups. Conclusions: CC is an effective adjuvant to alleviate pituitary suppression in the PPOS protocol. For young women with DOR, CC supplementation has a positive impact on the number of high-quality embryos in PPOS protocol. However, elderly patients with DOR would be at risk of developing premature LH surge and poor oocyte maturation rate after the PPOS protocol with CC supplementation was applied.

Download Full-text

P–697 screening for adrenocortical and thyroid peroxidase antibodies to look for underlying autoimmune etiologies in women under 35 with idiopathic diminished ovarian reserve

Human Reproduction ◽

10.1093/humrep/deab130.696 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

I Evruke ◽

O Dural ◽

C Akgul ◽

F Gungo. Ugurlucan ◽

C Yasa ◽

...

Keyword(s):

Family History ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Young Women ◽

Ovarian Reserve ◽

Small Sample ◽

Diminished Ovarian Reserve ◽

Thyroid Peroxidase ◽

History Of ◽

Work Up

Abstract Study question Investigate whether screening for autoimmune etiologies is necessary in women with diminished ovarian reserve (DOR) as recommended in the evaluation of premature ovarian insufficiency (POI). Summary answer Adrenocortical antibodies (ACA) screening can be performed in the evaluation of women with idiopathic DOR, especially those with a family history of autoimmune disease. What is known already Autoimmune disorders are more common in POI than in the general population. The most important association is with autoimmune Addison’s disease. Measurement of ACA and / or 21 OH-A is recommended in every POI patients as they appear to be the marker with the highest diagnostic sensitivity for autoimmune POI. Also thyroid peroxidase autoantibodies (TPO-Ab) should be assayed due to the common association between thyroid disease and POI. The underlying etiologies of DOR in young women can be expected to be similar to the etiology of POI since they represent a continuum in the phenotypic expression of premature ovarian aging. Study design, size, duration This pilot case-control study was conducted between January 2019 and April 2020. The study group consisted of patients under the age of 35, who was diagnosed with idiopathic DOR by ovarian reserve tests during infertility work up. Controls were patients of the same age range who diagnosed with isolated tubal factor or male infertility and had normal ovarian reserve test results during infertility work up. Participants/materials, setting, methods Patients with a history of ovarian surgery, cancer, genetic or autoimmune disease were excluded. Abnormal ovarian reserve tests are defined as antral follicle count < 5 and AMH < 1.2 ng/dl corresponding to group 3 according to POSEIDON criteria. In total, 35 DOR patients and 35 controls were included in the study. ACA and TPO-Ab screening were performed in serum samples using indirect immunofluorescence method. Demographics and family history of autoimmune diseases were also evaluated. Main results and the role of chance A higher rate of ACA positivity was detected in the DOR group (34.3%) compare to controls (17.1%), although it was not found to be statistically significant (p = 0.101). The incidence of family history of autoimmune diseases in first degree relatives was positively correlated with ACA positivity (p = 0.006). In DOR group, autoimmune disease history in the family was significantly higher in ACA (+) patients compared to ACA (-) individuals (p = 0.03). TPO-Ab positivity rates were similar between 2 groups (17.1% vs%20, p = 0.75). Limitations, reasons for caution Since this is an observational study and also due to the small sample size, a causal conclusion cannot be reached. Wider implications of the findings: Even if there is no specific treatment option yet for autoimmune ovarian damage, screening for ACA or 21 OH-A may be considered in young women with idiopathic DOR based on knowledge that identification of women with autoimmune POI is clinically important for the identification of subclinical autoimmune Addison’s cases. Trial registration number non applicable

Download Full-text

Micro-RNAs involved in cellular proliferation have altered expression profiles in granulosa of young women with diminished ovarian reserve

Journal of Assisted Reproduction and Genetics ◽

10.1007/s10815-018-1239-9 ◽

2018 ◽

Vol 35 (10) ◽

pp. 1777-1786 ◽

Cited By ~ 9

Author(s):

Irene Woo ◽

Lane K. Christenson ◽

Sumedha Gunewardena ◽

Sue Ann Ingles ◽

Semara Thomas ◽

...

Keyword(s):

Young Women ◽

Ovarian Reserve ◽

Cellular Proliferation ◽

Expression Profiles ◽

Diminished Ovarian Reserve ◽

Altered Expression ◽

Micro Rnas

Download Full-text

MicroRNAs with Altered Expression Profiles in Granulosa of Women of Advanced Age with Diminished Ovarian Reserve

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.2988 ◽

2020 ◽

Vol 10 (10) ◽

pp. 2316-2323

Author(s):

Danqi Liu ◽

Fang Lian ◽

Shan Xiang ◽

Ying Guo ◽

Haicui Wu ◽

...

Keyword(s):

Young Women ◽

Ovarian Reserve ◽

Target Genes ◽

Expression Profiles ◽

Micro Rna ◽

Diminished Ovarian Reserve ◽

Advanced Age ◽

Altered Expression ◽

Age Related ◽

Microrna Sequencing

Objective: The objective of this study was to investigate the micro-RNA differences between women of advanced age with a diminished ovarian reserve (DOR) and young women with a normal ovarian reserve (NOR), and the causes leading to the decline of ovarian reserve function and oocyte function in women, which may be related to aging. Methods: The prospective cohort investigation method was used in this study. We used microRNA sequencing to detect the microRNA expression profiles for women of advanced age with DOR function and young women with NOR function. Then, the differentially expressed microRNAs were compared and the agerelated mechanism was predicted by the target genes. Results: The microRNA sequencing results revealed that 70 microRNA expressions were different, including 45 downregulated expressions and 25 upregulated expressions. Specifically, miR-221-3p, miR-146b-5p, miR-378a-3p, miR-143-5p, miR-222-5p, and miR-221-5p were significantly downregulated; miR-6881-3p, miR-4787-3p, miR-4745-5p, miR-6513-3p, and miR-3179 were upregulated. The primary pathways are PI3K-Akt, MAPK, Phospholipase D, and Chemokine. Conclusions: Differences were observed between the expression profiles of microRNAs in the granulosa cells of the ovaries of patients with DOR and NOR. These differences may be age-related.

Download Full-text