Ovarian reserve and endometrial receptivity in patients after organ-sparing surgeries for ovarian endometriotic cysts

2021 ◽  
Vol 20 (1) ◽  
pp. 64-70
Author(s):  
A.A. Solomatina ◽  
◽  
L.M. Mihaleva ◽  
I.Z. Khamzin ◽  
O.V. Bratchikova ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Endometrial Thickness ◽  
Ovarian Tissue ◽  
Reproductive Potential ◽  
Resistance Index ◽  
Reproductive Technologies ◽  
Endometrial Receptivity ◽  
Group I ◽  
Organ Sparing

Objective. To analyze the significance of the ovarian reserve (OR) in the assessment of endometrial receptivity in patients after cystectomy for ovarian endometriotic cysts (OECs). Patients and methods. We examined 172 patients after organ-sparing surgeries for OECs. The mean patient age was 28.7 ± 4.8 years. Group I included 114 women with low OR. Group II comprised 58 patients with unchanged OR. All study participants underwent pelvic ultrasonography in the middle luteal phase 6 and 12 months postoperatively. We evaluated endometrial thickness and its echostructure, as well as Doppler-angle-independent flow indices, including resistance index, pulsatility index, and systolic/diastolic ratio. Reduced OR was diagnosed according to the ESHRE recommendations (2011 Anti-Müllerian hormone ≤ 0.5–1.1 ng/mL and ≤5–7 antral follicles in one ultrasound section. Results. Impairments in the morphological and functional state of the ovaries were associated with changes of the endometrial thickness, its ultrasonic structure, and hemodynamic parameters in the terminal branches of the uterine arteries (hypovascularization, increased flow indices). Simultaneous use of various methods for the assessment of ovarian tissue and endometrium allowed the detection of a decreased reproductive potential. Patients with a reduced OR after surgeries for OECs demonstrated improvement of both morphological/functional characteristics of ovarian tissue and endometrial receptivity, which allows pregnancy planning. Patients with extremely thin endometrium (3.0–5.0 mm) that does not improve are recommended to resort to assisted reproductive technologies. Key words: ovarian reserve, endometrium, ovarian endometriotic cysts

Does endometrioma surgery affect assisted reproductive technologies cycle outcome in patients with decreased ovarian reserve diagnosed by Bologna criteria?

2021 ◽  
pp. 228402652110121
Author(s):  
Inci Kahyaoglu ◽  
Cavidan Gülerman ◽  
Nafiye Yılmaz ◽  
Mehmet Ufuk Ceran ◽  
Ayşe Seval Ozgu-Erdinc ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Bologna Criteria ◽  
Stimulation Parameters ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Group Ii ◽  
Research And Education

Objectives: Data regarding whether the assisted reproductive technologies (ART) outcome of patients with decreased ovarian reserve (DOR) secondary to an endometrioma surgery differs from that of patients with DOR secondary to other etiologies is limited. The aim of this study was to compare the ART outcomes of DOR patients diagnosed by Bologna criteria secondary to a previous endometrioma surgery with DOR patients without a history of an endometrioma surgery. Methods: This retrospective cohort study was conducted in the assisted reproduction unit of a tertiary research and education hospital. Medical records of the patients with DOR were reviewed retrospectively. Group I included 23 cycles of DOR patients secondary to a previous endometrioma surgery and Group II consisted of 260 cycles of DOR patients without a history of endometrioma surgery. Results: No significant difference was demonstrated between groups regarding demographic features except for the age (32 (24–41) in Group I vs 35 (23–47) in Group II, p = 0.031). The data comparing the controlled ovarian stimulation parameters and ART outcomes showed similar results in both groups. No statistically significant difference was found between groups regarding pregnancy rates per transfer (23% vs 22.2 %) and per cycle (13% vs 15.4%) ( p > 0.05). Conclusion: Cycle outcomes of DOR patients secondary to an endometrioma surgery did not differ from that of DOR without an endometrioma surgery history.

Ovarian endometriosis associated infertility: a modern view to the problem

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 44-49
Author(s):  
Mekan R. Orazov ◽  
Marina B. Khamoshina ◽  
Marianna Z. Abitova ◽  
Lyudmila M. Mikhaleva ◽  
Snezhana V. Volkova ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Ovarian Tissue ◽  
Reproductive Function ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Ovarian Endometriosis ◽  
Surgical Interventions ◽  
Ovarian Endometriomas

This review summarizes current understanding of the pathogenesis of one of the most common forms of external genital endometriosis ovarian endometriomas. Due to their frequent occurrence in young women of reproductive age and extremely negative impact on the morphophysiological state of the ovaries, this disease makes a significant contribution to the structure of endometriosis-associated infertility. The main determinant of the negative effect of ovarian endometriomas on reproductive function is a decrease in ovarian reserve, which can occur either due to the direct gonadotoxic effect of the endometriod cyst itself, or due to the unintentional removal of healthy ovarian tissue during surgery or the use of aggressive methods of electrosurgery. Hence, the question of methods for achieving hemostasis during surgery in terms of iatrogenic effects on healthy ovarian tissue is debatable. The management strategy for patients with infertility associated with ovarian endometriosis consists of two components: surgical treatment and/or the use of assisted reproductive technologies. Laparoscopic cystectomy is indicated for cysts larger than 3 cm. Repeated surgical interventions in case of endometriosis do not improve fertility outcomes. Assisted reproductive technologies methods should be considered as a priority tactic in patients of older reproductive age with low ovarian reserve indicators or infertility duration of more than 2 years, as well as in cases of recurrent ovarian endometriomas. Management of such patients must be personalized and take into account the age, state of the ovarian reserve, duration of infertility, stage and number of surgical interventions for this disease.

scholarly journals EFFECT OF AYURVEDIC TREATMENT ON DIMINISHING OVARIAN RESERVE – A PROJECT REPORT

2020 ◽  
Vol 04 (04) ◽  
pp. 2329-2334
Author(s):  
Vijayakumar N. ◽  
Asha Sreedhar ◽  
Maya Balakrishnan ◽  
Shiny S. Raj ◽  
Divya Sreenath. J
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Reproductive Potential ◽  
Treatment Protocol ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
Treatment Result ◽  
College Hospital ◽  
Before And After ◽  
Ayurvedic Treatment

Infertility is defined as the inability of a sexually active non contracepting couple to achieve pregnancy in a year. Infertility is alarmingly increasing world-wide. WHO estimates the incidence of primary infertility in India to be 3.9-16.8%. One of the leading causes of female infertility is Diminishing Ovarian Reserve (DOR). Nowadays 10-30% of female infertility is due to DOR. It is a complex phenomenon in which ovary loses its normal reproductive potential compromising fertility in which there is reduction in the number of oocytes. DOR subjects are often at a risk for poor success outcome of conception even with Assisted Reproductive Technologies (ART) In Ayurveda the most appropriate correlation of DOR can be done with DathukshayaVandya explained in Haritha samhita. It is due to depletion of Dhatus or due to inadequate formation of Dhatus, especially Arthava and Sukradhathu leading to Anapathyatha (infertility). Objectives and Methods: The main objective of the study was to evaluate the effect of Āyurvedic treatment protocol on Diminishing Ovarian Reserve. The study was a single group interventional study with a sample size of 60 patients. Females who were diagnosed with DOR in the age group of 20-35 years attending the OPD of Govt. Ayurveda college hospital for Women and children, Poojappura, Thiruvananthapuram were selected for study. Their data was collected using case proforma and investigations including AMH, AFC (Antral follicular count) was done on the 2nd and 3rd day of menstrual cycle before and after treatment. Result & Conclusion The Āyurvedic treatment protocol was found to be effective in managing diminishing ovarian reserve by effectively increasing the AMH and AFC values. It is also observed that 26% of subjects achieved pregnancy naturally even though most of the subjects were advised to do IVF with donor egg. Keywords: DOR, Dhathukshaya vandhya, AMH, AFC, sukumāra ghritam

Oncological and reproductive outcomes of organ-sparing treatment of patients of reproductive age with gynaecological malignancies

2020 ◽  
Vol 19 (4) ◽  
pp. 159-162
Author(s):  
М.О. Silkina ◽  
◽  
E.A. Sosnova ◽  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Potential ◽  
Reproductive Function ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Comprehensive Treatment ◽  
Reproductive Outcomes ◽  
The Past ◽  
Organ Sparing ◽  
Gynaecological Tumours

In the past decade, the clinical practice of treatment of malignant gynaecological tumours has undergone cardinal changes towards introduction of organ-sparing technologies. In many respects, this is due to the fact that women want their reproductive function to be preserved. This approach is widely discussed among medical doctors and: can organ-sparing techniques influence the outcomes of treatment with respect to tumour recurrence and a woman’s reproductive potential and her ability to bear a baby. As has been found, the survival after successful comprehensive treatment of cervical, endometrial and ovarian cancer is high, and the conception and birth of a healthy child is possible in more than 50% of cases, most often with the help of assisted reproductive technologies. Key words: oncological outcomes, tumours, organ-sparing treatment, reproductive outcomes

Thickness of endometrium: predictor of the effectiveness of IVF/ICSI programs (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva
Keyword(s):  
Assisted Reproductive Technologies ◽  
Endometrial Thickness ◽  
Molecular Genetic ◽  
Uterine Cavity ◽  
Reproductive Technologies ◽  
Genetic Characteristics ◽  
Vitro Fertilization ◽  
Need To Evaluate ◽  
The Relationship

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.

scholarly journals Endometrial receptivity: the molecularmechanisms regulation of implantation

2013 ◽  
Vol 62 (2) ◽  
pp. 63-74 ◽  
Author(s):  
Yuliya Sergeyevna Krylova ◽  
Igor Moiseyevich Kvetnoy ◽  
Eduard Karpovich Aylamazyan
Keyword(s):  
Parameter Estimation ◽  
Molecular Mechanisms ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Signaling Molecules ◽  
Endometrial Receptivity

Presents current views on endometrial receptivity and the molecular mechanisms regulation of implantation. Examines the signaling molecules as potential markers of parameter estimation window of implantation in assisted reproductive technologies.

REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY

2021 ◽  
pp. 41-48
Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Assisted Reproductive Technologies ◽  
Hormone Replacement ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
Pathological Process ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.

scholarly journals Negative impact of high doses of follicle-stimulating hormone during superovulation on the ovulatory follicle function in small ovarian reserve dairy heifers†

2020 ◽  
Author(s):  
Kaitlin R Karl ◽  
Fermin Jimenez-Krassel ◽  
Emily Gibbings ◽  
Janet L H Ireland ◽  
Zaramasina L Clark ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Follicle Stimulating Hormone ◽  
Prostaglandin F2α ◽  
Reproductive Technologies ◽  
Corpora Lutea ◽  
Ovulatory Follicle ◽  
High Doses ◽  
Stimulating Hormone

Abstract When women with small ovarian reserves are subjected to assisted reproductive technologies, high doses of gonadotropins are linked to high oocyte and embryo wastage and low live birth rates. We hypothesized that excessive follicle-stimulating hormone (FSH) doses during superovulation are detrimental to ovulatory follicle function in individuals with a small ovarian reserve. To test this hypothesis, heifers with small ovarian reserves were injected twice daily for 4 days, beginning on Day 1 of the estrous cycle with 35, 70, 140, or 210 IU doses of Folltropin-V (FSH). Each heifer (n = 8) was superovulated using a Williams Latin Square Design. During each superovulation regimen, three prostaglandin F2α injections were given at 12-h interval, starting at the seventh FSH injection to regress the newly formed corpus luteum (CL). Human chorionic gonadotropin was injected 12 h after the last (8th) FSH injection to induce ovulation. Daily ultrasonography and blood sampling were used to determine the number and size of follicles and corpora lutea, uterine thickness, and circulating concentrations of estradiol, progesterone, and anti-Müllerian hormone (AMH). The highest doses of FSH did not increase AMH, progesterone, number of ovulatory-size follicles, uterine thickness, or number of CL. However, estradiol production and ovulation rate were lower for heifers given high FSH doses compared to lower doses, indicating detrimental effects on ovulatory follicle function.

scholarly journals Using Uterine Biophysical Profile as a Predictor of Endometrial Receptivity and Pregnancy in Stimulated IUI Cycles

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Rawaa Saad Hasan Abunayla ◽  
◽  
Lubna Amer Al-Anbari ◽  
Muayad S, Abood ◽  
Huda A. R. Hussaini ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Endometrial Receptivity ◽  
Infertile Women ◽  
Biophysical Profile ◽  
The Mean

Implantation failure and disorders of endometrial receptivity represent an essential cause of infertility; multiple parameters were needed to predict the uterine receptivity understanding that no sole parameter could predict the same. A score was termed as (Uterine Biophysical Profile) could be utilized as a predictor of endometrial receptivity. To evaluate the predictive potential of Uterine biophysical profile of both endometrial receptivity and pregnancy outcome in infertile women undergoing Intrauterine Insemination (IUI). The current cross-sectional study was conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in Al Nahrain University, Baghdad, Iraq from the 1st of Oct. 2018 till 1st of May 2019 involving seventy women of infertile couples with the same inclusion and exclusion criteria. Uterine biophysical profile was evaluated using a doppler ultrasound examination and then a score was calculated and correlated to pregnancy outcome. The mean Uterine Artery Pulsatility Index (UAPI) was significantly lower in women with positive pregnancy in comparison to women with negative pregnancy, 2.10±0.19 versus 2.47±0.65, respectively (P=0.032). Moreover, no women with Pulsatility Index (PI) score (0) succeeded to get pregnant and the higher the score, the higher the rate of pregnancy (P=0.006). Furthermore, Spearman correlation showed significant positive correlation between positive pregnancy outcome and UAPI (r=0.365; P=0.002). The mean total score was significantly higher for pregnant women than in women with negative pregnancy, 18.27±1.33 versus 16.35±2.47, respectively (P=0.005). The cutoff value was >17 with an acceptable accuracy level of 74.2. The sensitivity of that cutoff vale was 80 % and the specificity was 65.5%. Uterine artery pulsatility index and total uterine biophysical score are the principal predictors of positive pregnancy outcomes in infertile women undergoing IUI.

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

Sign in / Sign up

Export Citation Format

Share Document