scholarly journals Serum Metabolomic Signature Predicts Ovarian Response to Controlled Stimulation

2021 ◽  
Author(s):  
XIN MU ◽  
Mei-li Pei ◽  
Feng Zhu ◽  
Ya-juan Fan ◽  
Juan-zi Shi ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Demographic Data ◽  
Roc Curves ◽  
Ovarian Response ◽  
Controlled Ovarian Stimulation ◽  
Diagnostic Model ◽  
Vitro Fertilization ◽  
Liquid Chromatography Tandem Mass ◽  
Novel Biomarkers

Abstract Introduction In in vitro fertilization (IVF) cycles, some patients fail to adequately respond to ovarian stimulation. Finding novel biomarkers predicting ovarian response in advance would be meaningful.Objective To identify serum metabolomics predicting the growth of follicles after controlled ovarian stimulation (COS).Methods Blood samples were collected at the start of pituitary downregulation and on the fifth day after controlled ovarian stimulation. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) methods were used to quantify metabolites. Demographic data were calculated with SPSS version 22.0 software. Multivariate statistics were used to analyze metabolomics dataset. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic model.Results The number of retrieved oocytes was higher in the group of Follicle-to-oocyte index (FOI) ≥ 1 group. Analyses revealed 50 different metabolomics between the pre- and post- COS groups. Compared with baseline, amino acids increased significantly following COS. At baseline, acetylglycine was more abundant in the FOI <1 group, while glycine and lipids were more abundant in the FOI ≥1 group. After COS, glycine, N-acetyl-L-alanine, D-alanine, and 2-aminomuconic acid were increased in those with FOI ≥1, but L-glutamine was increased in those with FOI <1. ROC curves indicated that the combination of glycine, acetylglycine and lipids predicts different responses to controlled ovarian stimulation (AUC =0.866).Conclusion Serum metabolism might reflect the response to ovarian stimulation. Higher glycine and PC may be a good predictor for response to COS.

scholarly journals Comparison of Automated Anti-Müllerian Hormone Assays and Antral Follicle Count in Predicting Ovarian Response During Ovarian Stimulation

2019 ◽  
Vol 01 (02) ◽  
pp. 99-105
Author(s):  
Eek Chaw Tan ◽  
Pallavi Chincholkar ◽  
Su Ling Yu ◽  
Serene Liqing Lim ◽  
Rajkumaralal Renuka ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
High Response ◽  
Controlled Ovarian Stimulation ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
And Performance

Objective: Various parameters had been used to predict ovarian response. Among them, Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) demonstrate the most favourable analytical and performance characteristics. In this pilot study, we aim to determine the cut-off levels of AMH using automated AMH assays and AFC in the prediction of poor and high responders. Study Design: Prospective study of 43 women between 21 to 45 years old scheduled for assisted reproduction. AMH levels on day 3 of menstruation were analysed using two immunoassay kits, namely the Beckman Coulter Access AMH and the Roche Elecsys AMH on the two automated analysers Beckman Coulter DxI 800 and Roche Cobas e602 respectively. AFC was also assessed on day 3 of menstruation prior to in vitro fertilization (IVF). These were compared with the number of oocytes retrieved after controlled ovarian stimulation. Results: AMH (Beckman Coulter Access AMH and Roche Elecsys AMH) highly correlated with AFC and the number of oocytes retrieved after ovarian stimulation. Beckman Coulter Access AMH was the better predictor for poor ovarian response with ROC [Formula: see text] of 0.83. For the prediction of a high response, AFC had a higher ROC [Formula: see text] of 0.95. Through ROC, the AMH cut-off level for poor ovarian response was 2.23 ng/ml with Beckman Coulter Access AMH and 2.02 ng/ml with Roche Elecsys AMH, while the AMH cut-off for a high ovarian response was 5.19 ng/ml with Beckman Coulter Access AMH and 4.60 ng/ml with Roche Elecsys AMH. For AFC, the cut-off for poor ovarian response was 18 and for high response was 34. Conclusion: AMH and AFC are reliable predictors of ovarian response. Establishment of specific levels may improve individualised controlled ovarian stimulation and optimise the oocyte yield. Larger studies are required to establish these findings.

scholarly journals Use of androgens and aromatase inhibitors in poor responders undergoing in vitro fertilization

2020 ◽  
Vol 68 (6) ◽  
pp. 37-46
Author(s):  
Alexandra I. Merkulova ◽  
Lyailya Kh. Dzhemlikhanova ◽  
Dariko A. Niauri ◽  
Alexander M. Gzgzyan ◽  
Igor Yu. Kogan ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Aromatase Inhibitors ◽  
Ovarian Stimulation ◽  
Poor Response ◽  
Ovarian Response ◽  
Controlled Ovarian Stimulation ◽  
Controlled Clinical Trial ◽  
Poor Responders ◽  
Vitro Fertilization

Hypothesis/aims of study. Poor ovarian response is still considered one of the most challenging tasks in reproductive medicine. Poor responders have decreased circulating androgens during spontaneous cycles. Androgens are known to play an important role in follicular growth and development. Hence, the use of various androgens and androgen inhibitors in poor responders undergoing ovarian stimulation for IVF has been proposed to improve efficacy of treatment. This study was aimed to examine the efficacy of aromatase inhibitors and androgens in infertility treatment in patients with poor response. Study design, materials and methods. This prospective cohort-controlled clinical trial included 204 patients under 42 years of age with infertility and poor response to ovarian stimulation. In vitro fertilization treatment with an antagonist FSH/hMG protocol with letrozole (5 mg/day) was administered in the first group of patients (n = 26) during the first 5 days of stimulation. Patients of the second group (n = 38) were applied testosterone (25 mg/day) transdermally, starting from the 5th day of the menstrual cycle preceding controlled ovarian stimulation for in vitro fertilization. The third group of patients (n = 18) was administered dehydroepiandrosterone (100 mg/day) for 3 months prior to controlled ovarian stimulation for in vitro fertilization. Results. Improved response to FSH stimulation with letrozole co-treatment was evidenced, with parameters of stimulation efficacy and embryo development being better in the testosterone group. No significant improvement in ovarian response markers, ovarian response to gonadotrophin stimulation and in vitro fertilization outcomes were found in poor responders receiving pre-treatment dehydroepiandrosterone. Conclusion. Further studies are necessary to improve approaches of testosterone and aromatase inhibitors use in poor responders undergoing in vitro fertilization.

scholarly journals Aromatase inhibitors in “poor” ovarian responders undergoing in vitro fertilization

2017 ◽  
Vol 66 (3) ◽  
pp. 169-175
Author(s):  
Alexandra I. Merkulova
Keyword(s):  
Aromatase Inhibitors ◽  
Ovarian Stimulation ◽  
Treatment Protocol ◽  
Ovarian Response ◽  
Controlled Ovarian Stimulation ◽  
Poor Responders ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
The Ideal

Since the IVF treatment expands worldwide, it has become apparent that a proportion of women responds suboptimally to controlled ovarian stimulation with exogenous gonadotrophins. There is still no consensus on the ideal controlled ovarian stimulation protocol for patients with “poor” ovarian response. Many strategies have been studied. However, no compelling advantage for one treatment protocol over another has been identified. The addition of aromatase inhibitors in “poor” responders stimulation protocols is described in this article.

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