scholarly journals Hypergonadotropic hypogonadism: looking beyond ovarian senescence

2021 ◽  
Vol 10 (2) ◽  
pp. 791
Author(s):  
Richa Vatsa ◽  
Vanita Suri ◽  
Neelam Choudahary ◽  
Aashima Arora ◽  
Shruti Sharma
Keyword(s):  
Ovarian Reserve ◽  
In Vitro Maturation ◽  
Elevated Serum ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Hypergonadotropic Hypogonadism ◽  
Primary Infertility ◽  
High Doses ◽  
Resistant Ovary Syndrome

Gonadotropin resistant ovary syndrome (GROS) is a rare cause of primary infertility where ovarian reserve is present but they fail to respond to gonadotropin stimulation. This condition can be easily confused with premature ovarian insufficiency (POI) if thorough workup is not done as in both the cases serum FSH is high, but ovarian reserve is normal in GROS and low or absent in POI. So, we are presenting this case of GROS. A 28-year-old lady presented with oligomenorrhoea since menarche and primary infertility. On workup her serum FSH and LH levels were markedly elevated, serum estradiol was normal. Markers of ovarian reserve, ante Mullerian hormones (AMH) and antral follicle count (AFC), were normal. Her autoantibody assay was also normal. She did not respond to stimulation with high doses of gonadotropins (uHMG). Hypergonadotropic hypogonadism is not always POI. We should not miss diagnosis of GROS where it is possible to have own biological child by in vitro maturation of immature oocytes, whereas in POI donor oocyte is the only fertility option.

scholarly journals Effect of Ayurvedic Treatment Protocol on Diminishing Ovarian Reserve

2020 ◽  
Vol 11 (2) ◽  
pp. 228-234
Author(s):  
Divya U ◽  
Vijayakumar N
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Potential ◽  
Treatment Protocol ◽  
Antral Follicle ◽  
Poor Responder ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Rank Test ◽  
Ayurvedic Treatment

Diminishing ovarian reserve (DOR) is a condition in which the ovary loses reproductive potential, compromising fertility. Nowadays 10-30% of female infertility is due to DOR and considered as “expected poor responder” for In vitro fertilisation (IVF).   Correlation of DOR can be done with Dathukshaya vandya (depletion or inadequate formation of dhatus) explained in Harithasamhita. The objective of the study was to evaluate the effect of Ayurvedic treatment protocol on Diminishing ovarian reserve. The study protocol includes- ashtachurna for deepana (appetiser), pachana (digestives) and kolakulathadi churna for udwarthana (powder massage). Sukumaragrutha used for snehapana (oral administration of medicated ghee), utharabasthi (intrauterine administration) and rasayana (rejuvenation therapy ). Danwantarathaila abhyanga (oleation) and ooshmasweda (sudation) done for 3 days. Sukumaraeranda was used for virechana (therapeutic purgation) and also Yogabasthi (medicated enema). The study design was pre and post interventional study with a sample size of 15 selected as per inclusion and exclusion criteria, conducted at hospital for women and children, Government Ayurveda College, Thiruvananthapuram. Assessment was based on Bologna criteria for DOR. The statistical techniques employed are Wilcoxon’s signed rank test and Paired t test. Results showed statistically significant effect on improving Antral follicle count (AFC) (p- 0.01), Estradiol (p- 0.005), conception (p- 0.014), on regulating amount of bleeding (p- 0.003), menstrual interval correction (p-0.001) and dyspareunia (p-0.005). But insignificant effect on improving Anti Mullerian Hormone (AMH) (p- 0.469) and regularising LH/FSH ratio (p-0.104) was found.

The effect of endometrioma on ovarian reserve

2017 ◽  
Vol 86 (3) ◽  
pp. 237
Author(s):  
Małgorzata Agnieszka Szczepańska ◽  
Paweł P. Jagodziński ◽  
Ewa Wender‑Ożegowska
Keyword(s):  
Ovarian Reserve ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
In Vitro Fertilisation ◽  
Current State ◽  
Ovarian Endometrioma ◽  
State Of Research ◽  
Ovarian Endometriomas

An ovarian endometrioma is a very common form of endometriosis in women of reproductive age. This review presents the current state of research on ovarian reserve in women with ovarian endometriomas. Endometrioma can negatively affect ovarian markers: the anti‑Müllerian hormone (AMH), antral follicle count (AFC) and in vitro fertilisation (IVF) results. Decisions on the surgical treatment of endometrial cysts should be carefully thought through, especially in women who have not given birth.

scholarly journals Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023413 ◽  
Author(s):  
Lan N Vuong ◽  
Vu N A Ho ◽  
Tuong M Ho ◽  
Vinh Q Dang ◽  
Tuan H Phung ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
In Vitro Maturation ◽  
Controlled Trial ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Increased Risk ◽  
Patient Consent ◽  
Randomised Controlled

IntroductionIn vitro maturation (IVM) is a potential alternative to conventional in vitro fertilisation (IVF) to avoid ovarian hyperstimulation syndrome (OHSS). This is particularly relevant in women with a high antral follicle count (AFC) and/or polycystic ovary syndrome (PCOS), who are at increased risk for OHSS. However, no randomised controlled trials of IVM versus IVF in women with high AFC have reported both pregnancy and OHSS rates. The aim of this study is to compare the effectiveness and safety of one IVM cycle and one IVF with segmentation cycle within women with PCOS or high AFC-related subfertility.Methods and analysisThis randomised controlled trial will be conducted at a specialist IVF centre in Vietnam. Eligible subfertile women with PCOS and/or high AFC will be randomised to undergo either IVM or IVF. The primary outcome is live birth after the first embryo transfer of the started treatment cycle. Cycles in which no embryo is available for transfer will be considered as failures. The study has a non-inferiority design, with a maximal acceptable between-group difference of 5%. Rates of OHSS will also be reported.Ethics and disseminationEthical approval was obtained from the participating centre, and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03405701; Pre-results.

Predictive value of antral follicle count and anti-Müllerian hormone for follicle and oocyte developmental competence during the early prepubertal period in a sheep model

2014 ◽  
Vol 26 (8) ◽  
pp. 1094 ◽  
Author(s):  
Laura Torres-Rovira ◽  
Antonio Gonzalez-Bulnes ◽  
Sara Succu ◽  
Antonio Spezzigu ◽  
Maria E. Manca ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Follicular Development ◽  
Primordial Follicle ◽  
Antral Follicle ◽  
Oocyte Quality ◽  
Antral Follicle Count ◽  
Developmental Competence ◽  
Sheep Model ◽  
Ewe Lambs

Circulating anti-Müllerian hormone (AMH) and antral follicle count (AFC) are addressed as suitable markers of oocyte quantity and quality during adulthood. To investigate whether AFC and circulating AMH could predict follicle development and oocyte quality during the prepubertal period we used 40-day-old ewe lambs with high, intermediate and low AFC (≥30, 16–29 and ≤15 follicles respectively). The analysis of the response to the exogenous FSH ovarian reserve test showed a positive correlation between AFC, AMH plasma levels, total follicle number and the number of large follicles (≥3 mm) grown after exogenous FSH administration. The incorporation of abattoir-derived oocytes collected from ovaries with different AFC in an in vitro embryo production system showed that a high AFC can predict oocyte quality in prepubertal ovaries, reflecting an ovarian status suitable for follicular development. The histological quantification of the ovarian reserve evidenced that AFC was not predictive of differences in either the number of healthy follicles or the size of the primordial follicle pool in prepubertal ovaries. Further studies are needed to investigate the implication on the reproductive performance of the significant inter-individual differences found in the present study in AFC and circulating AMH in the early prepubertal period.

Should fertile women quit drinking alcohol to produce better quality oocytes?

Zygote ◽  
2020 ◽  
pp. 1-3
Author(s):  
Burcu Ozbakir ◽  
Pinar Tulay
Keyword(s):  
Alcohol Consumption ◽  
Young Women ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Control Group ◽  
Social Drinkers ◽  
Antral Follicles ◽  
Healthy Women ◽  
Significant Difference

Summary Alcohol consumption has long been shown to affect both fetal health and pregnancy. In this study, antral follicle count, maturation level of oocytes including morphological assessment and number of metaphase I (MI), metaphase II (MII) and germinal vesicle (GV) stage oocytes obtained from young women (age < 30 years old) with or without alcohol consumption were investigated. In total, 20 healthy women who were social drinkers and 36 healthy women who do not consume alcohol were involved in this study. Women in both study and control groups were undergoing controlled ovarian stimulation. The antral follicle count and the number and quality of the oocytes retrieved were evaluated and recorded. In total, 635 antral follicles, 1098 follicles and 1014 oocytes with 820 MII, 72 MI and 78 GV stage oocytes were collected from the social drinkers. In the control group, 628 antral follicles, 1136 follicles and 1085 oocytes with 838 MII, 93 MI and 102 GV stage oocytes were evaluated. The results of this study showed that the antral follicle count was very similar in both groups. The number of oocytes and MII stage oocytes was slightly higher in the control group, although it was not a significant difference. This study showed that although the consumption of alcohol may have adverse effects post-implantation, it may not have a solid effect during oogenesis in young women. The results of this study are especially important in clinical settings as some women who are social drinkers undergo in vitro fertilization treatments.

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