scholarly journals Follicular Fluid Perfluoroalkyl and Polyfluoroalkyl Substances Are Associated With Adverse ART Outcomes in Women With Poor Ovarian Reserve

2021 ◽  
Author(s):  
Yunying Cai ◽  
LanPing Zhong ◽  
Ze Wu ◽  
Min Wang ◽  
Heng Su
Keyword(s):  
Live Birth ◽  
Follicular Fluid ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Ultra Performance Liquid Chromatography ◽  
Reproductive Technology ◽  
Female Fecundity ◽  
Polyfluoroalkyl Substances ◽  
Perfluoroalkyl And Polyfluoroalkyl Substances ◽  
Poor Ovarian Reserve

Abstract BackgroundPrevious evidence suggests that perfluoroalkyl and polyfluoroalkyl substances (PFASs) adversely affect ovarian function and female fecundity. However, the evidence remains insufficient to infer a direct relationship between PFAS exposure and adverse assisted reproductive technology (ART) outcomes. To fill this gap, we examined follicular fluid PFAS exposure and ART outcomes in patients with poor ovarian reserve (POR) in a prospective study.MethodsIn total, 147 women with POR were included. Eight PFASs were measured in follicular fluid (n=104) samples using simultaneous analysis by ultra-performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry. The PFAS contamination status of the patients’ follicular fluid and the association between characteristics and ART outcomes were investigated by logistic regression.ResultsAfter adjustment for age and BMI, PFOA, PFNA, PFHxS and ∑PFAS were strongly associated with a decreased probability of pregnancy (PFOA highest vs. lowest tertile: OR=1.95, 95% CI: 1.61, 2.38; PFNA highest vs. lowest tertile: OR= 3.0, 95% CI: 2.46, 3.68; PFHxS highest vs. lowest tertile: OR= 1.95, 95% CI: 1.61, 2.35; ∑PFAS second vs. lowest tertile: OR=3.31, 95% CI: 2.74, 3.89). PFOS and PFUnDA were inversely associated with failed implantation. No relationships were noted between failed implantation and other PFAS analytes. The same result was obtained when using live birth as an outcome measure.ConclusionsIn women with POR, follicular fluid PFAS exposure may decrease the probability of clinical pregnancy and live birth.

scholarly journals Comparison of IVF Outcomes between Minimal Stimulation and High-Dose Stimulation for Patients with Poor Ovarian Reserve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tal Lazer ◽  
Shir Dar ◽  
Ekaterina Shlush ◽  
Basheer S. Al Kudmani ◽  
Kevin Quach ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Poor Responders ◽  
High Dose ◽  
Poor Ovarian Reserve

We examined whether treatment with minimum-dose stimulation (MS) protocol enhances clinical pregnancy rates compared to high-dose stimulation (HS) protocol. A retrospective cohort study was performed comparing IVF and pregnancy outcomes between MS and HS gonadotropin-antagonist protocol for patients with poor ovarian reserve (POR). Inclusion criteria included patients with an anti-Müllerian hormone (AMH) ≤8 pmol/L and/or antral follicle count (AFC) ≤5 on days 2-3 of the cycle. Patients from 2008 exclusively had a HS protocol treatment, while patients in 2010 had treatment with a MS protocol exclusively. The MS protocol involved letrozole at 2.5 mg over 5 days, starting from day 2, overlapping with gonadotropins, starting from the third day of letrozole at 150 units daily. GnRH antagonist was introduced once one or more follicles reached 14 mm or larger. The HS group received gonadotropins (≥300 IU/day) throughout their antagonist cycle. Clinical pregnancy rate was significantly higher in the MS protocol compared to the HS protocol (P=0.007). Furthermore, the live birth rate was significantly higher in the MS group compare to the HS group (P=0.034). In conclusion, the MS IVF protocol is less expensive (lower gonadotropin dosage) and resulted in a higher clinical pregnancy rate and live birth rate than a HS protocol for poor responders.

scholarly journals Perfluoroalkyl and polyfluoroalkyl substances (PFAS) and their effects on the ovary

2020 ◽  
Vol 26 (5) ◽  
pp. 724-752 ◽  
Author(s):  
Ning Ding ◽  
Siobán D Harlow ◽  
John F Randolph Jr ◽  
Rita Loch-Caruso ◽  
Sung Kyun Park
Keyword(s):  
Human Population ◽  
Ovarian Function ◽  
Experimental Studies ◽  
Epidemiologic Studies ◽  
Experimental Models ◽  
Human Populations ◽  
Reverse Causality ◽  
Toxicological Studies ◽  
Polyfluoroalkyl Substances ◽  
Perfluoroalkyl And Polyfluoroalkyl Substances

Abstract BACKGROUND Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are found widespread in drinking water, foods, food packaging materials and other consumer products. Several PFAS have been identified as endocrine-disrupting chemicals based on their ability to interfere with normal reproductive function and hormonal signalling. Experimental models and epidemiologic studies suggest that PFAS exposures target the ovary and represent major risks for women’s health. OBJECTIVE AND RATIONALE This review summarises human population and toxicological studies on the association between PFAS exposure and ovarian function. SEARCH METHODS A comprehensive review was performed by searching PubMed. Search terms included an extensive list of PFAS and health terms ranging from general keywords (e.g. ovarian, reproductive, follicle, oocyte) to specific keywords (including menarche, menstrual cycle, menopause, primary ovarian insufficiency/premature ovarian failure, steroid hormones), based on the authors’ knowledge of the topic and key terms. OUTCOMES Clinical evidence demonstrates the presence of PFAS in follicular fluid and their ability to pass through the blood–follicle barrier. Although some studies found no evidence associating PFAS exposure with disruption in ovarian function, numerous epidemiologic studies, mostly with cross-sectional study designs, have identified associations of higher PFAS exposure with later menarche, irregular menstrual cycles, longer cycle length, earlier age of menopause and reduced levels of oestrogens and androgens. Adverse effects of PFAS on ovarian folliculogenesis and steroidogenesis have been confirmed in experimental models. Based on laboratory research findings, PFAS could diminish ovarian reserve and reduce endogenous hormone synthesis through activating peroxisome proliferator-activated receptors, disrupting gap junction intercellular communication between oocyte and granulosa cells, inducing thyroid hormone deficiency, antagonising ovarian enzyme activities involved in ovarian steroidogenesis or inhibiting kisspeptin signalling in the hypothalamus. WIDER IMPLICATIONS The published literature supports associations between PFAS exposure and adverse reproductive outcomes; however, the evidence remains insufficient to infer a causal relationship between PFAS exposure and ovarian disorders. Thus, more research is warranted. PFAS are of significant concern because these chemicals are ubiquitous and persistent in the environment and in humans. Moreover, susceptible groups, such as foetuses and pregnant women, may be exposed to harmful combinations of chemicals that include PFAS. However, the role environmental exposures play in reproductive disorders has received little attention by the medical community. To better understand the potential risk of PFAS on human ovarian function, additional experimental studies using PFAS doses equivalent to the exposure levels found in the general human population and mixtures of compounds are required. Prospective investigations in human populations are also warranted to ensure the temporality of PFAS exposure and health endpoints and to minimise the possibility of reverse causality.

scholarly journals Fertility Preservation: How to Preserve Ovarian Function in Children, Adolescents and Adults

2021 ◽  
Vol 10 (22) ◽  
pp. 5247
Author(s):  
Marie-Madeleine Dolmans ◽  
Camille Hossay ◽  
Thu Yen Thi Nguyen ◽  
Catherine Poirot
Keyword(s):  
Fertility Preservation ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Ovarian Tissue Cryopreservation ◽  
High Fertility ◽  
Birth Rates ◽  
Endocrine Activity ◽  
Live Birth Rates ◽  
Future Fertility

Chemotherapy, pelvic radiotherapy and ovarian surgery have known gonadotoxic effects that can lead to endocrine dysfunction, cessation of ovarian endocrine activity and early depletion of the ovarian reserve, causing a risk for future fertility problems, even in children. Important determinants of this risk are the patient’s age and ovarian reserve, type of treatment and dose. When the risk of premature ovarian insufficiency is high, fertility preservation strategies must be offered to the patient. Furthermore, fertility preservation may sometimes be needed in conditions other than cancer, such as in non-malignant diseases or in patients seeking fertility preservation for personal reasons. Oocyte and/or embryo vitrification and ovarian tissue cryopreservation are the two methods currently endorsed by the American Society for Reproductive Medicine, yielding encouraging results in terms of pregnancy and live birth rates. The choice of one technique above the other depends mostly on the age and pubertal status of the patient, and personal and medical circumstances. This review focuses on the available fertility preservation techniques, their appropriateness according to patient age and their efficacy in terms of pregnancy and live birth rates.

AMH Highly Correlates with Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve Independent of Age

2021 ◽  
Author(s):  
Reshef Tal ◽  
David B Seifer ◽  
Renana Tal ◽  
Emily Granger ◽  
Ethan Wantman ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Linear Regression Analysis ◽  
Reproductive Technology ◽  
Diminished Ovarian Reserve ◽  
Cumulative Live Birth Rate ◽  
Preimplantation Genetic Testing ◽  
Cumulative Live Birth ◽  
Highly Correlated

Abstract Context Antimullerian hormone (AMH) level is strongly associated with ovarian response in reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBR) in women with diminished ovarian reserve (DOR). Objective To examine the association between serum AMH and CLBR among women with DOR undergoing ART. Design Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. Setting Not applicable Patients A total of 34,540 index retrieval cycles of women with AMH<1 ng/ml Interventions None Main Outcome Measures Cumulative live birth Results A total of 34,540 (25.9%) cycles with AMH<1 ng/ml out of 133,442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data was stratified according to AMH and age and regression analysis of AMH and CLBR was performed for each age strata. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (Odds ratio 1.39, 95%CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer,. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age strata. Conclusions Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.

scholarly journals Higher follicular fluid (FF) levels of di(2-ethylhexyl) phthalate (DEHP) metabolites in indian women with poor ovarian reserve (POR)

2018 ◽  
Vol 110 (4) ◽  
pp. e170-e171
Author(s):  
F.R. Parikh ◽  
S. Uttamchandani ◽  
A.S. Velumani ◽  
A. Athalye ◽  
P. Sinkar ◽  
...  
Keyword(s):  
Follicular Fluid ◽  
Ovarian Reserve ◽  
Indian Women ◽  
Ethylhexyl Phthalate ◽  
Poor Ovarian Reserve

scholarly journals Predictive Factors for Live Birth in Fresh In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatment in Poor Ovarian Reserve Patients Classified by the POSEIDON Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Li ◽  
Tian Ye ◽  
Huijuan Kong ◽  
Jing Li ◽  
Linli Hu ◽  
...  
Keyword(s):  
Live Birth ◽  
Predictive Factors ◽  
Ovarian Reserve ◽  
Inflection Point ◽  
Multivariate Logistic Regression Analysis ◽  
Threshold Effect ◽  
Poor Responders ◽  
Female Age ◽  
Live Births ◽  
Poor Ovarian Reserve

The mechanisms underlying poor ovarian response (POR) in assisted reproductive technology remain unclear, there is no consensus on the management of poor responders, the POSEIDON stratification classifies infertility patients into “expected” or “unexpected” groups to provide a more nuanced picture of POR, but few researchers have discussed the independent predictive factors (smoothed plots and the threshold effect) for live birth in POR patients classified by the new criteria. We conducted a retrospective cohort study using clinical data from 6,580 POR patients classified by the POSEIDON criteria in the First Affiliated Hospital of Zhengzhou University, and explored the live birth based on the results before and after the threshold inflection point of each independent influencing factor. Among 6,580 poor ovarian reserve patients classified by the POSEIDON criteria, 1,549 (23.54%) had live births, and 5,031 (76.46%) did not have live births. Multivariate logistic regression analysis showed that female age (OR 0.901; 95% CI 0.887~0.916; P < 0.001), body mass index (OR 0.963; 95% CI 0.951~0.982; P < 0.001), antral follicle counting (OR 1.049; 95% CI 1.009~1.042; P < 0.001) and controlled ovarian hyperstimulation protocol were independent factors predicting live birth in patients with POR. The threshold effect analysis found that the inflection point of female age was 34 years old, and when age was > 34 years old, the probability of live birth in POR patients dropped sharply (OR 0.7; 95% CI 0.7~0.8; P < 0.001). The inflection point of BMI was 23.4 kg/m2, and BMI had a negative correlation with live birth (OR 0.963; 95% CI 0.951~0.982; P < 0.001). The threshold inflection point of AFC was 8n. Female age, BMI, AFC and COH protocol were independent predictive factors associated with live birth in POR patients classified by the POSEIDON criteria. The smooth curve fit and threshold effect analyses provide clinical management strategies for these patients. In addition, the early-follicular-phase long-acting GnRH-agonist long protocol seems to have a higher live birth rates than other protocols. It is worth highlighting that BMI should be considered as well in the POSEIDON criteria.

scholarly journals Biological Ovarian Age Predestinate Female Fecundity? Exosomes in Follicular Microenvironment Expose the Potentiality of Young

2021 ◽  
Author(s):  
Ting Hu ◽  
Yun xing Fu ◽  
Rong Hu ◽  
Fei-Miao Wang ◽  
Li-Guo Pei ◽  
...  
Keyword(s):  
Electron Microscope ◽  
Follicular Fluid ◽  
Ovarian Reserve ◽  
Underlying Mechanism ◽  
Diminished Ovarian Reserve ◽  
Control Group ◽  
Biological Functions ◽  
Female Fecundity ◽  
Female Patients ◽  
Ivf Outcomes

Abstract Background: This study aimed to investigate the biological functions of exosome in follicle microenvironment and illustrate the underlying mechanism about the different IVF outcomes among normal, diminished ovarian reserve (DOR) and aging female patients with the same biological ovarian age. Methods: Follicular fluid (FF) was collected from control(n=35), DOR(n=35), aging(n=35) who underwent IVF therapy in 2017 and 2018. Electron microscope and NanoSight were used to detect the exosomes morphology and concentration. Hormones levels and anti-Müllerian hormone (AMH) in the serum were detected by ELISA. Results: Serum FSH and FSH level of the DOR group and the aging group significantly increased, AFC was decreased compared to the control. Exosomes concentrations were significantly lower in DOR and aging as compared with control group and were also significantly lower in the aging group compared with the DOR group. Exosomes was negatively correlated with FSH and FSH/LH, exosomes was positively correlated with AMH. GDF9 and BMP15 were secreted by exosomes. Conclusions: Exosome was highly represented in human FF and are involved in maturation of follicle. The concentration of exosomes in FF can be an indicator of ovarian reserve. Oocytes may secrete exosomes.

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