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 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.

253 OXIDATIVE STRESS MAY IMPAIR OOCYTE QUALITY IN DAIRY COWS OF REPRODUCTIVE AGE WITH A REDUCED ANTRAL FOLLICLE COUNT

2013 ◽  
Vol 25 (1) ◽  
pp. 274 ◽  
Author(s):  
I. Tessaro ◽  
F. Franciosi ◽  
V. Lodde ◽  
D. Corbani ◽  
A. M. Luciano ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Antral Follicle ◽  
Oocyte Quality ◽  
Antral Follicle Count ◽  
Oxide System ◽  
Reproductive Age ◽  
Developmental Competence ◽  
Mitochondrial Activity

In dairy cattle, oocytes isolated from ovaries with a reduced antral follicle count (AFC) have a low embryonic developmental competence. This may be related to oxidative stress, as indicated by our recent finding that ovaries with reduced AFC show a defective endothelial nitric oxide synthase/nitric oxide system. To further test this hypothesis, we evaluated whether the poor developmental competence of these oocytes was possibly due 1) to an imbalance of the reduced glutathione (GSH) system, because GSH is the major antioxidant compound stored within the oocyte and protects the zygote and early embryos from oxidative damage, and 2) to reduced mitochondrial activity. Ovaries were obtained from the abattoir, and oocytes were collected from ovaries with reduced AFC, with fewer than 10 follicles of 2 to 6 mm in diameter, and aged-matched controls, with more than 10 follicles of 2 to 6 mm in diameter. Oocyte GSH content was evaluated using the 5,5′-dithio-bis(2-nitrobenzoic acid)-GSH reductase recycling micro-GSH assay before and after in vitro maturation (IVM) in the presence or absence of 100 µM cysteamine, a GSH precursor. At the same time the developmental competence after IVF was assessed. Moreover, the mitochondrial activity during IVM was evaluated in additional oocytes from the two ovarian categories by specific MitoTracker dyes (MitoTracker FM Green and MitoTracker Orange CMTMRos, Invitrogen, Carlsbad, CA, USA) and subsequent image analysis (ImageJ software). All data were analysed by ANOVA followed by Fisher’s least significant differences test, and P-values <0.05 were considered significant. Experiments were repeated at least three times. Oocytes isolated from ovaries with a low AFC had a similar GSH content compared with oocytes isolated from control ovaries (n = 65 and 85, respectively; 4.31 ± 0.41 v. 4.51 ± 0.42 pmol oocyte–1). After IVM, oocytes from ovaries with reduced AFC showed a significantly lower GSH content compared with control oocytes (n = 55 and 65, respectively; 4.36 ± 0.31 v. 6.59 ± 0.39 pmol oocyte–1); however, cysteamine supplementation during IVM induced GSH accumulation similar to the control (n = 80 and 85, respectively; 9.88 ± 0.77 v. 10.45 ± 0.88 pmol oocyte–1). It is interesting that the increase in intracellular GSH content significantly improved the developmental competence of oocytes from ovaries with a reduced AFC (n = 196 and 201, respectively; 20.1 ± 2.9% v. 6.2 ± 1.6%), although the blastocyst rate remained lower than the control either with or without cysteamine (n = 218 and 212, respectively; 33.3 ± 3.8% and 34.2 ± 2.4%). Further, immature oocytes from ovaries with a low AFC showed a reduced mitochondrial membrane potential compared with control oocytes (n = 13 and 18, respectively; 1.74 ± 1.19 v. 2.22 ± 1.72, calculated as the ratio between the fluorescence of active and total mitochondria), whereas at the end of IVM, it declined in both categories at a comparable level (n = 17 and 24, respectively; 1.19 ± 0.10 and 1.30 ± 0.06). Our data confirmed the hypothesis that both the GSH imbalance and defective mitochondrial activity contribute to the limited developmental competence of oocytes from ovaries with a reduced AFC. This work was supported by Dote ricerca applicata-FSE, Regione Lombardia, Italy (VL, IT).

scholarly journals Single-centre retrospective analysis of growth hormone supplementation in IVF patients classified as poor-prognosis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018107 ◽  
Author(s):  
Kevin N Keane ◽  
John L Yovich ◽  
Anahita Hamidi ◽  
Peter M Hinchliffe ◽  
Satvinder S Dhaliwal
Keyword(s):  
Growth Hormone ◽  
Live Birth ◽  
Poor Prognosis ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Clinical Pregnancy ◽  
In Vitro Fertilisation ◽  
Success Rates ◽  
Younger Women

BackgroundPatients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.MethodsData were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.ResultsClinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient’s age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality.ConclusionThese data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.

scholarly journals Ovarian Response and Cumulative Live Birth Rate of Women Undergoing In-Vitro Fertilisation Who Had Discordant Anti-Mullerian Hormone and Antral Follicle Count Measurements: A Retrospective Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e108493 ◽  
Author(s):  
Hang Wun Raymond Li ◽  
Vivian Chi Yan Lee ◽  
Estella Yee Lan Lau ◽  
William Shu Biu Yeung ◽  
Pak Chung Ho ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth

Effects of excision of ovarian endometrioma on the antral follicle count and collected oocytes for in vitro fertilization

2010 ◽  
Vol 94 (6) ◽  
pp. 2340-2342 ◽  
Author(s):  
Benny Almog ◽  
Boaz Sheizaf ◽  
Einat Shalom-Paz ◽  
Fady Shehata ◽  
Ayman Al-Talib ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Vitro Fertilization ◽  
Ovarian Endometrioma

scholarly journals The Correlation of Basal Serum FSH, Antral Follicle Count with Ovarian Response in Women with Advanced Reproductive Age

2016 ◽  
Vol 30 (1) ◽  
pp. 20-24
Author(s):  
Tanzeem S Chowdhury ◽  
Shirin Akhter Begum ◽  
TA Chowdhury
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Antral Follicle ◽  
Reproductive Technologies ◽  
Antral Follicle Count ◽  
Female Partner ◽  
Reproductive Age ◽  
Mature Follicle ◽  
Basal Serum ◽  
Tertiary Center

Objective (s): The aim of this study was to find out the correlation between basal serum Follicle Stimulating Hormone (FSH) level, antral follicle count and number of oocytes retrieved during IVF cycle in women with advanced reproductive age.Method: It was a cross sectional observational study which was done between January 2015 and December 2015 in Infertility Management Center, a tertiary center in Dhaka where assisted reproductive technologies are being offered. Eighty nine (89) infertile patients who were between 35 to 45 years of age and have come for IVF treatment for the first time were included in this study. The selected patients had undergone estimation of basal serum FSH by automated immuno assay analyzer and counting of the antral follicles by transvaginal sonography on day two or three. In total sixty nine (69) patients started IVF treatment according to GnRH long agonist protocol. Controlled ovarian stimulation started with 225 IU rFSH. Follicle monitoring was done on day 5 and day 9 and the dosage was kept same or changed according to the patient’s response. After day nine of stimulation, ten women were excluded as they had no mature follicle of 18 mm or more and cycle was cancelled. So in fifty nine (59) cases ovulation was triggered with hCG 5000 IU on the day when at least one mature follicle measuring 18mm was observed. The ovum pickup was done 32 hours after the trigger and the number of collected oocytes was counted under microscope. Outcome measures of this study was to compare basal FSH and antral follicle count as predictors of ovarian reserve by correlating with the number of oocytes retrieved and to correlate the age of the female partner with the number of oocytes retrieved.Results: Most couples in this study (68.33%) have been suffering from primary infertility and majority of them had six to ten years of infertility. Higher proportion of the female partners (75%) was between 35 to 37 years. The majority of infertile couples have male factor infertility (32%). The second commonest cause found was tubal factor in female partner (20%).Stepwise multiple regression analysis was done. Significant positive correlation was noticed between AFC and number of oocytes (b = 0.2413).There was negative correlation between the basal FSH level and the number of oocytes (b= -0.5083). Age of female partner had weak correlation with ovarian reserve.Conclusion: Measurement of antral follicle number in the follicular phase is a better predictor of ovarian reserve in comparison to basal FSH and age of the women.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 20-24

scholarly journals Investigation and management of subfertility

2019 ◽  
Vol 72 (9) ◽  
pp. 579-587 ◽  
Author(s):  
Layla Thurston ◽  
Ali Abbara ◽  
Waljit S Dhillo
Keyword(s):  
Polycystic Ovary ◽  
Uterine Cavity ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Semen Parameters ◽  
In Vitro Fertilisation ◽  
Expert Assessment ◽  
Serum Progesterone ◽  
Tubal Patency

Subfertility affects one in seven couples and is defined as the inability to conceive after 1 year of regular unprotected intercourse. This article describes the initial clinical evaluation and investigation to guide diagnosis and management. The primary assessment of subfertility is to establish the presence of ovulation, normal uterine cavity and patent fallopian tubes in women, and normal semen parameters in men. Ovulation is supported by a history of regular menstrual cycles (21–35 days) and confirmed by a serum progesterone >30 nmol/L during the luteal phase of the menstrual cycle. Common causes of anovulation include polycystic ovary syndrome (PCOS), hypothalamic amenorrhoea (HA) and premature ovarian insufficiency (POI). Tubal patency is assessed by hysterosalpingography, hystero-contrast sonography, or more invasively by laparoscopy and dye test. The presence of clinical or biochemical hyperandrogenism, serum gonadotrophins (luteinising hormone/follicle stimulating hormone) / oestradiol, pelvic ultrasound to assess ovarian morphology / antral follicle count, can help establish the cause of anovulation. Ovulation can be restored in women with PCOS using letrozole (an aromatase inhibitor), clomifene citrate (an oestrogen antagonist) or exogenous gonadotrophin administration. If available, pulsatile gonadotrophin releasing hormone therapy is the preferred option for restoring ovulation in HA. Spermatogenesis can be induced in men with hypogonadotrophic hypogonadism with exogenous gonadotrophins. Unexplained subfertility can be treated with in vitro fertilisation after 2 years of trying to conceive. Involuntary childlessness is associated with significant psychological morbidity; hence, expert assessment and prompt treatment are necessary to support such couples.

Kinderwunsch in der menopausalen Übergangszeit

2021 ◽  
Vol 78 (8) ◽  
pp. 407-411
Author(s):  
Bruno Imthurn
Keyword(s):  
Antral Follicle ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Egg Freezing ◽  
Social Egg Freezing

Zusammenfassung. Die menopausale Übergangszeit ist gekennzeichnet durch den Verlust der Eizellreserve, das heisst der Zahl und Qualität der Oozyten. Diese Beeinträchtigung führt zu einer schnellen und massiven Abnahme der Fertilität. Die Eizellreserve lässt sich mit der Messung von FSH und AMH im Serum bestimmen sowie mit der Zählung der ultrasonografisch sichtbaren Follikel, dem sogenannten «antral follicle count» (AFC). Therapeutisch können zur Erfüllung des Kinderwunsches homologe Behandlungen wie monofollikuläre Hormonstimulationen und die In-Vitro-Fertilisation eingesetzt werden. Wesentlich aussichtsreicher ist jedoch meist die heterologe Eizellspendenbehandlung. Präventiv wird zunehmend die Methode des «Social Egg Freezing» angewendet.

scholarly journals The Benefits of Testosterone Therapy in Poor Ovarian Responders Undergoing In Vitro Fertilisation (IVF)

2020 ◽  
Keyword(s):  
Free Testosterone ◽  
Antral Follicle ◽  
Dehydroepiandrosterone Sulfate ◽  
Antral Follicle Count ◽  
Sex Hormone Binding Globulin ◽  
In Vitro Fertilisation ◽  
Control Group ◽  
Poor Responders ◽  
Cancellation Rate

Introduction: Poor ovarian responders are the most challenging patients in reproductive medicine and no successful treatment has been proposed. Androgens are thought to play an important role during early folliculogenesis and diminished levels are associated with decreased ovarian sensitivity to follicle-stimulating hormone. This study aimed to determine whether pretreatment with testosterone improves the results in poor responders undergoing in vitro fertilisation (IVF). Materials and methods: This observational pilot study enrolled 33 poor responders undergoing IVF. Eleven patients were pretreated with 250 mg intramuscular testosterone and compared to a control group of 22 patients. The participants were tested for free testosterone, dehydroepiandrosterone sulfate, sex hormone binding globulin, and anti-mullerian hormone (AMH). Results: The two groups had similar baseline characteristics. Significant improvement was reached in the hormones free testosterone, dehydroepiandrosterone sulfate, and sex hormone binding globulin in the testosterone-pretreatment group. No difference was detected in antral follicle count (5.06 versus 4.24); AMH (0.51 versus 0.53), mature oocytes (2.2 versus 2.32), and the number of embryos (1.2 versus 1.33) between the study and control groups, respectively. There was a slow improvement in fertilisation rate but without any significance (62.97% versus 57.61%). However, the cancellation rate of the ovarian stimulation was much greater in the control group (18.18%) in comparison with the study group (0.0%). Pregnancy rate (PR) in the testosterone group was higher than controls (PR per cycle: 27.3% versus 4.6; p=0.09). Conclusion: Based on the limited number of patients studied, pretreatment with testosterone seems to improve PR and cancellation rate in poor responders but failed to affect antral follicle count, AMH, and the number of mature oocytes and embryos. Given these results, further research would provide more certainty.

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