scholarly journals Ovarian Reserve Markers in Premature Ovarian Insufficiency: Within Different Clinical Stages and Different Etiologies

2021 ◽  
Vol 12 ◽  
Author(s):  
Xue Jiao ◽  
Tingting Meng ◽  
Yiwei Zhai ◽  
Lijuan Zhao ◽  
Wei Luo ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Predictive Value ◽  
Inhibin B ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Hormone Status ◽  
Endocrine Hormones ◽  
Quantitative Changes ◽  
Ovarian Reserve Markers ◽  
Disease Stages

ObjectiveTo characterize the ovarian reserve indicators for premature ovarian insufficiency (POI) at different disease stages and with various etiologies.MethodsAccording to different FSH levels and menstrual conditions, patients with normal ovarian reserve (NOR with 5 IU/L<FSH<10 IU/L, n=987), precursor stage of POI (pre-POI with 10 IU/L<FSH ≤ 25 IU/L, n=410), early POI (25 IU/L<FSH ≤ 40 IU/L n=147), and premature ovarian failure (POF with FSH>40 IU/L, n=454) were retrospectively screened and their records were abstracted from Reproductive Hospital Affiliated to Shandong University between 2014 and 2019. Based on the known etiologies, POI patients were subdivided into genetic, iatrogenic, autoimmune and idiopathic subsets according to the known etiologies. The phenotypic features were compared within different subgroups, and the predictive value of ovarian reserve markers was analyzed.ResultsThe ovarian reserve indicators consecutively deteriorated with the progress of ovarian insufficiency, indicated as an increase of FSH and LH but decrease of AMH, inhibin B, AFC, E2 and T (P<0.01). Most of them changed significantly from NOR to pre-POI while remained relatively stable at a low level or even undetectable at early POI and POF stage. AMH showed the highest predictive value for pre-POI (AUC 0.932, 95% CI 0.918-0.945) and POI (AUC 0.944, 95% CI 0.933-0.954), and the combination of AMH and AFC was highly promising for early prediction. Additionally, significant differences existed in AMH, inhibin B and AFC among women with different etiologies of POI (P<0.05), and the genetic POI presented the worst hormone status.ConclusionsOur study indicated a high heterogeneity of POI in both endocrine hormones and etiological phenotypes. The quantitative changes and cutoff values of AMH and AFC could provide new insights in the prediction and early diagnosis of POI.

scholarly journals Comparative study of assisted reproductive outcomes between young patients with occult premature ovarian insufficiency and advanced-age patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093465
Author(s):  
Ling-nv Yao ◽  
Wen-qin Lin ◽  
Nan Jiang ◽  
Chuyan Li ◽  
Hai-feng Cao ◽  
...  
Keyword(s):  
Live Birth ◽  
Ovarian Reserve ◽  
Embryo Implantation ◽  
Young Patients ◽  
Abortion Rate ◽  
Advanced Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Vitro Fertilization

Objective The purpose of this study was to compare the pregnancy outcomes among young patients with occult premature ovarian insufficiency (OPOI), advanced-age patients with diminished ovarian reserve (DOR), and advanced-age patients with normal ovarian reserve. Methods We retrospectively reviewed 324 women who underwent their first cycles of in vitro fertilization/intracytoplasmic sperm injection. The women were divided into the following groups: young women with OPOI, advanced-age women with DOR, and advanced-age women with normal ovarian reserve. The outcomes were compared among the different groups: Results The rates of live birth and embryo implantation in the young OPOI group were significantly higher than in the advanced-age DOR group, but comparable to those in the advanced-age normal ovarian reserve group. Moreover, the abortion rate was significantly lower in young OPOI patients compared with advanced-age patients with or without DOR. Conclusion Higher embryo implantation and live birth rates and a lower abortion rate can be achieved in young patients with OPOI compared with older patients. The better outcomes in advanced-age patients with normal ovarian reserve compared with DOR may be related to egg quantity rather than quality.

scholarly journals Ovarian Fragmentation and AKT Stimulation for Expansion of Fertile Lifespan

2021 ◽  
Vol 3 ◽  
Author(s):  
Kim Cat Tuyen Vo ◽  
Kazuhiro Kawamura
Keyword(s):  
Ovarian Reserve ◽  
Enzyme Inhibitor ◽  
Premature Ovarian Insufficiency ◽  
Hippo Signaling ◽  
Follicle Growth ◽  
Ovarian Insufficiency ◽  
Phosphatase And Tensin Homolog ◽  
Primordial Follicles ◽  
Tensin Homolog

Since the first baby was born after in vitro fertilization, the female infertility treatment has been well-developed, yielding successful outcomes. However, successful pregnancies for patients with premature ovarian insufficiency and diminished ovarian reserve are still difficult and diverse therapies have been suggested to improve the chances to have their genetically linked offspring. Recent studies demonstrated that the activation Akt pathway by using a phosphatase and tensin homolog enzyme inhibitor and a phosphatidylinositol-3 kinase stimulator can activate dormant primordial follicles in both mice and human ovaries. Subsequent researches suggested that the disruption of Hippo signaling pathway by ovarian fragmentation increased the expression of downstream growth factors and secondary follicle growth. Based on the combination of ovarian fragmentation and Akt stimulation, the in vitro activation (IVA) approach has resulted in successful follicle growth and live births in premature ovarian insufficiency patients. The approach with disruption of Hippo signaling only was also shown to be effective for treating poor ovarian responders with diminishing ovarian reserve, including advanced age women and cancer patients undergoing sterilizing treatments. This review aims to summarize the effectiveness of ovarian fragmentation and Akt stimulation on follicle growth and the potential of IVA in extending female fertile lifespan.

P–640 High physical activity and ovarian reserve: A prospective study of normo-ovulatory professional athletes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Miller ◽  
Y Pasternak ◽  
C Dornstein ◽  
E Haiki. Herzberger ◽  
N Zada ◽  
...  
Keyword(s):  
Physical Activity ◽  
Ovarian Reserve ◽  
Inhibin B ◽  
Reproductive Age ◽  
Control Group ◽  
Age At Menarche ◽  
Physically Active ◽  
High Physical Activity ◽  
Reproductive Age Women ◽  
Ovarian Reserve Markers

Abstract Study question Is high physical activity (HPA) associated with low ovarian reserve in normo-ovulatory, reproductive-age women? Summary answer HPA does not affect ovarian reserve negatively. What is known already HPA is associated with menstrual irregularities and subsequent potential infertility, probably through hypothalamic neuroendocrine pathways. However, it is not yet known whether HPA influences the ovarian reserves of normo-ovulatory, reproductive-age women. Study design, size, duration This observational, cross-sectional study compared 30 professional female athletes who were engaged in HPA for at least 3 years prior to study recruitment, with high International Physical Activity Questionnaire (IPAQ) scores and 30 women who did not engage in physical activity. The study was conducted at a tertiary medical center from 2017–2020. Participants/materials, setting, methods Physically active, normo-ovulatory women (n = 30), ages 20–35 years were recruited from The Wingate Institute, the Israeli National Institute for Sport Excellence. Non-physically active women (n = 30), matched by age and BMI to the HPA group, were recruited from the hospital staff. Both groups were evaluated for ovarian reserve markers on day 2–5 of the menstrual cycle, including follicular stimulating hormone (FSH), antral follicle count (AFC), anti-Mullerian hormone (AMH) and Inhibin B. Main results and the role of chance The average age of the athletes (HPA group) was 30.1±2.1 years and of the nonactive (control) group 31.6±3.8 years (p = 0.071). BMI of the 2 groups was similar (22.6±2.4 vs. 21.3±2.6; p = 0.075) for the HPA and control groups, respectively. Regarding ovarian reserve, no significant differences were observed between the HPA group and the control group with respect to FSH (p = 0.304), AFC (p = 0.27), AMH (0.507) or Inhibin B (p = 0.074). For the HPA group, older age at menarche was positively associated with AFC (p = 0.008) and AMH (p = 0.009) and not with FSH levels (p = 0.313). For the nonactive group, no significant association between age at menarche and FSH levels, AFC or AMH was found (p = 0.433, p = 0.274 and p = 0.163, respectively). Additionally, for the HPA group, duration of physical activity per week (hours) was not significantly associated with FSH levels, AFC or AMH (p = 0.619, p = 0.608 or p = 0.997, respectively). Limitations, reasons for caution Although we investigated the ovarian reserves of 30 women engaged in HPA, a larger cohort would provide more information. Information on diet and sleep habits was not evaluated and may result in some confounding. Moreover, it would be more informative if we also followed these women regarding fecundability and fertility. Wider implications of the findings: This study demonstrated that HPA may not negatively affect ovarian reserve markers. These findings may provide reassurance for women who are engaged in HPA and attempting pregnancy. Further research needs s to be confuted. Trial registration number 0247–16

Analysis of NR5A1 in 142 patients with premature ovarian insufficiency, diminished ovarian reserve, or unexplained infertility

Maturitas ◽  
2020 ◽  
Vol 131 ◽  
pp. 78-86 ◽  
Author(s):  
Sylvie Jaillard ◽  
Rajini Sreenivasan ◽  
Marion Beaumont ◽  
Gorjana Robevska ◽  
Christèle Dubourg ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Unexplained Infertility ◽  
Diminished Ovarian Reserve ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency
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