Urinary Bisphenol A Concentrations and Parameters of Ovarian Reserve among Women from A Fertility Clinic

Background: Human exposure to environmentally widespread endocrine disruptors, especially bisphenol A (BPA), has been suggested to affect reproductive health. Animal studies indicate that BPA may play a role in the process of reproduction and impact on maturing oocytes, meiotic cell division or fertilization rate. Nevertheless, data regarding the effects of exposure to BPA on women’s ovarian function are still limited. Therefore, the aim of the current study is to assess the effects of environmental exposure to BPA on ovarian reserve. Methods: The study participants consisted of 511 women in reproductive age (25–39 years) who attended an infertility clinic for diagnosis, due to the couples’ infertility. BPA urinary concentrations were assessed by the validated gas chromatography ion-trap mass spectrometry method. The ovarian reserve was assessed using ovarian reserve parameters: Hormones concentrations: E2 (estradiol), FSH (follicle stimulating hormone), AMH (anti-Müllerian hormone), and AFC (antral follicle count). Results: In the present study, the negative association between BPA urinary concentrations and AMH (p = 0.02) and AFC (p = 0.03) levels was found. Exposure to BPA was not related to other examined parameters of ovarian reserve (FSH, E2). Conclusions: Our results suggest that BPA exposure may affect women ovarian reserve parameters and reduce ovarian reserve. As this is one of the first studies of its kind, the findings need confirmation in a further investigation.

Download Full-text

Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism

Thyroid Research ◽

10.1186/s13044-021-00095-0 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Felipe A. Morales-Martínez ◽

Luis H. Sordia-Hernández ◽

Martha Merino Ruiz ◽

Selene Garcia-Luna ◽

Otto H. Valdés-Martínez ◽

...

Keyword(s):

Ovarian Reserve ◽

Ovarian Function ◽

Thyroid Autoimmunity ◽

Antral Follicle ◽

Serum Levels ◽

Antral Follicle Count ◽

Reproductive Age ◽

Autoimmune Hypothyroidism ◽

Thyroid Hormone Concentration ◽

The Impact

Abstract Background The ovarian function and therefore the ovarian reserve may be compromised by the pathogenesis of autoimmune diseases of which, Hashimoto’s thyroiditis (HT) is the most common in women of reproductive age. Furthermore, a prolonged reduction in thyroid hormone concentration results in a broad spectrum of reproductive alteration. Previous reports in the literature have been controversial regarding the impact of hypothyroidism and alterations in the ovarian reserve. Thus, this prospective and comparative study aimed to evaluate the association of hypothyroidism with low ovarian reserve. Materials and Methods A subset of 27 patients with primary autoimmune hypothyroidism were compared to healthy women. The ovarian reserve was assessed through the anti-Mullerian hormone (AMH) and the antral follicle count (AFC). Results Overall, the two groups did not display significant differences in length of their menstrual cycles neither in the AMH serum levels nor the AFC. Conclusions No significant alteration was found in the ovarian reserve of women with HT.

Download Full-text

The effect of endometrioma on ovarian reserve

Journal of Medical Science ◽

10.20883/jms.2017.201 ◽

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.

Download Full-text

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

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v30i1.30503 ◽

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 patients 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

Download Full-text

Ovarian reserve in patients who have undergone endometriosis surgery

Vojnosanitetski pregled ◽

10.2298/vsp160408363d ◽

2018 ◽

Vol 75 (7) ◽

pp. 644-650

Author(s):

Olivera Dzatic-Smiljkovic ◽

Mladenko Vasiljevic ◽

Ivana Rudic ◽

Jelena Vugdelic ◽

Aleksandar Ristic ◽

...

Keyword(s):

Ovarian Reserve ◽

Ovarian Function ◽

Uterine Cavity ◽

Antral Follicle ◽

Antral Follicle Count ◽

Inhibin B ◽

Ca 125 ◽

Control Group ◽

Study Group ◽

Ovarian Volume

Background/Aim. Endometriosis is a gynaecological disorder characterized by the presence of endometrial tissue outside the uterine cavity. The aim of this paper was to determine the effect of laparoscopic cystotomy and cystectomy on ovarian function, as well as to compare these two methods in terms of qualitative and quantitative damage to the ovaries, achieved pregnancies and recurrence. Methods. The prospective study, conducted in ?Narodni Front? Obstetrics and Gynaecology Clinic in Belgrade at the Endoscopic Infertility Treatment Ward, included a total of 150 patients. The study group was represented by 100 patients who underwent a surgical treatment of endometrial ovarian cysts. The patients in the study group were divided into 2 subgroups: Subgroup I consisted of 50 patients who underwent a laparoscopic cystotomy (incision of the cyst and thermal coagulation) and subgroup II which included 50 women who underwent a laparoscopic cystectomy. The control group consised of patients who underwent a surgery due to tubal factor infertility. The following parameters of the ovarian function were tested: the ovarian volume, the antral follicle count, the presence of the preovulatory follicle on the operated ovary, the serum levels of anti- M?llerian hormone (AMH), follicle-stimulating hormone (FSH), ovarian tumor marker (Ca 125), inhibin B, as well as the rate of achieved pregnancies one year after the surgery. Results. The ovarian volume and the antral follicle count as well as the FSH values were significantly higher in the control group in comparison with the patients in the study group. There were no significant differences in the ovarian volume, the antral follicle count, the AMH values and inhibin B values in the study group between the patients with cystectomy and those with the incision and coagulation of the cyst. Conclusion. Both surgical techniques diminished the ovarian reserve: cystectomy was more aggressive method in terms of the damage inflicted on the ovarian tissue, and incision with coagulation carried a higher risk of recurrence.

Download Full-text

Evaluation of the Ovarian Reserve in Women With Systemic Lupus Erythematosus

Journal of Family & Reproductive Health ◽

10.18502/jfrh.v15i1.6076 ◽

2021 ◽

Author(s):

Felipe Arturo Morales-Martínez ◽

Celina Salas-Castro ◽

Manuel Rolando. García-Garza ◽

Otto Valdés-Martínez ◽

Selene Marysol García-Luna ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Ovarian Reserve ◽

Lupus Erythematosus ◽

Ovarian Function ◽

Autoimmune Disorder ◽

Antral Follicle ◽

Antral Follicle Count ◽

Pharmacological Treatments ◽

Systemic Lupus ◽

Normal Individuals

Objective: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder where the disease activity itself and the medications used for its treatment, may have adverse effects on ovarian function. This study aimed to assess the ovarian reserve (OR) in SLE patients. Materials and methods: The anti-müllerian hormone (AMH) and the antral follicle count (AFC), two markers to evaluate the OR was assessed in 64 SLE patients and compared to normal individuals. Additionally, we assessed whether the disease per se or the pharmacological treatments affect the OR. Results: Patients with SLE displayed alterations in the OR regardless of the presence of alterations of the menstrual cycle. The AFC and AMH were significantly lower in SLE patients with and without menstrual alterations when compared to control individuals (p<0.0001). However, the AFC and AMH levels were significantly correlated (p=0.006) in the SLE patients with menstrual alterations. Except for hydroxychloroquine that was statistically higher in SLE patients with menstrual alterations (p=0.04), the cumulative dose for cyclophosphamide, corticosteroid, and methotrexate was similar in SLE patients regardless of the occurrence of menstrual alterations. Conclusion: The monitoring of AMH and AFC in SLE patients should be used to detect the rapid and irreversible decline of the OR to provide a possibility of pregnancy to the SLE patients.

Download Full-text

Epinephrine minimizes the use of bipolar coagulation and preserves ovarian reserve in laparoscopic ovarian cystectomy: a randomized controlled trial

Scientific Reports ◽

10.1038/s41598-020-77781-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Eun Young Park ◽

Kyu-Hee Hwang ◽

Ji-Hee Kim ◽

San-Hui Lee ◽

Kyu-Sang Park ◽

...

Keyword(s):

Ovarian Reserve ◽

Ovarian Function ◽

Controlled Trial ◽

Antral Follicle ◽

Antral Follicle Count ◽

Histopathological Analysis ◽

Bipolar Coagulation ◽

Ovarian Cystectomy ◽

Novel Method ◽

Group Serum

AbstractWe propose a novel method, the epinephrine compression method (Epi-pledget), as a hemostasis method for ovarian cystectomy. A total of 179 patients undergoing laparoscopic ovarian cystectomy with stripping were randomly allocated into three groups: the bipolar coagulation group, the Epi-pledget group, and the coagulation after Epi-pledget (Epi & Coagulation) group. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) by ultrasonography were measured to determine the preservation of ovarian function. To evaluate the postoperative ovarian cellular proliferative activity and tissue damage in a mouse model, we operated on the ovaries of mice with an artificial incision injury and applied two hemostatic methods: coagulation and Epi-pledget. Eight weeks after surgery, the AMH rate significantly decreased in the bipolar coagulation group compared with the Epi-pledget group. The AFC decline rate was also significantly greater in the coagulation group than the Epi-pledget group. Specifically, patients with endometrioma had a significantly greater decline of serum AMH in the coagulation group than the Epi-pledget group. In a histopathological analysis in mice, the Epi-pledget group showed ameliorated fibrotic changes and necrotic findings in the injured lesion compared with the bipolar coagulation group. The Epi-pledget method for ovarian stripping has an additional benefit of maximizing the preservation of the ovarian reserve, especially for the endometriotic ovarian cyst type.

Download Full-text

AYURVED APPROACH TO DIMINISHING OVARIAN RESERVE (DOR) IN FEMALE INFERTILITY - CASE STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj4408082020 ◽

2020 ◽

Vol 8 (8) ◽

pp. 4297-4302

Author(s):

Divya Pawar ◽

Sameer Gholap

Keyword(s):

Ovarian Reserve ◽

Treatment Protocol ◽

Modern Science ◽

Antral Follicle ◽

Antral Follicle Count ◽

Female Infertility ◽

Reproductive Age ◽

Wide Range ◽

Female Baby

According to Ayurveda Having no Baby is described as Vandhyatva and Infertility in Modern science. In-fertility is a main issue in today’s era. Many couples go for IVF, Surrogacy and many more with very little benefits. Nearly 10-14% of individuals are belonging to the reproductive age group are affected by Infertil-ity. Infertility caused by Diminished Ovarian Reserve (DOR) results from an endocrinological imbalance. The rise in follicle stimulating hormone (FSH), decrease in Anti Mullerian hormone (AMH) and Antral fol-licle count (AFC) etc. for women age more than 35 years can lower pregnancy rates to less than 5 % and increases miscarriage rates to more than 75%. Ayurveda explained wide range of protocols and medicines for the management of Vandhyatva. In Ayurveda its appropriate correlation can be done with Dhatukshaya Vandhya explained in Harita Samhita. Ayurveda states four factors are mentioned Rutu, Kshetra, Ambu, Beeja should be in proper state in order to achieve conception and complete the pregnancy successfully. Aim & Objectives: To evaluate the efficacy of Shamana Aushadhi, Yog Basti, Uttarbasti in the manage-ment of Diminishing Ovarian Reserve (DOR) induced Female Infertility. Materials & Methods: It is the single arm, open labelled case study of the subject of 35 yrs age with pri-mary infertility of Diminishing Ovarian Reserve (DOR) from Ayurveda College who has been treated with Shodhana Chikitsa as Yog Basti, Uttarbasti and Shamana Chikitsa simultaneously. Results & Discussion: There was improvement in hormonal assay with increase in Anti Mullerian hormone (AMH) and Antral follicle count (AFC) followed by conception later on. The Patient delivered with full term normal healthy female baby. Samshodhana and Shamana Aushadha helped to pacify Vata Dosha by Dhatukshaya Vandhya Chikitsa thus restored the fertility. Conclusion: The selected treatment protocol i.e. Samshodhana and Shamana Aushadha is very effective in the management of Diminishing Ovarian Reserve (DOR) induced Female Infertility.

Download Full-text

Effect of obesity on ovarian reserve parameters in mid-reproductive age women

F1000Research ◽

10.12688/f1000research.1-43.v1 ◽

2012 ◽

Vol 1 ◽

pp. 43 ◽

Cited By ~ 2

Author(s):

Hanan Altaee ◽

Zaid Abdul Majeed Al-Madfai ◽

Zainab Hassan Alkhafaji

Keyword(s):

Body Weight ◽

Ovarian Reserve ◽

Antral Follicle ◽

Antral Follicle Count ◽

Reproductive Age ◽

Obese Women ◽

Blood Samples ◽

Reproductive Age Women ◽

Significant Difference ◽

Early Follicular Phase

Background: The initiation and maintenance of reproductive functions are related to an optimal body weight in women. Body weight affects the ovarian reserve, which is basically an estimate of how many oocytes (eggs) are left in the ovaries.Objective: To study the relationship between obesity and serum and ultrasound markers of ovarian reserve in mid-reproductive age women (21–35 years old).Patients and methods: Twenty participants (“obese”) had a body mass index (BMI) of 30 to 35 kg/m2 and another 20 participants (“non-obese”) had a BMI 20–29 kg/m2. The obese women had a mean age of 27.9 years and the non-obese women had a mean age of 29.5 years. Blood samples were collected from all participants, anthropometric measurements were calculated, and transvaginal ultrasonography was performed to measure the antral follicle count (AFC) during the early follicular phase. The blood samples were assayed for antimüllerian hormone (AMH), follicle-stimulating hormone (FSH) and estradiol (E2).Results: There was no significant difference between the two groups regarding ovarian reserve markers and there is no significant correlation between these markers and BMI, except for serum E2 in the obese group.Conclusion: Obesity has no effect on the levels of serum FSH, AMH, or AFC indicating that obesity is unlikely to affect ovarian reserve in the mid-reproductive age group.

Download Full-text

PHYSIOLOGY AND ENDOCRINOLOGY SYMPOSIUM: Anti-Müllerian hormone: a biomarker for the ovarian reserve, ovarian function, and fertility in dairy cows

Journal of Animal Science ◽

10.1093/jas/skz022 ◽

2019 ◽

Vol 97 (4) ◽

pp. 1446-1455 ◽

Cited By ~ 11

Author(s):

Francesca Mossa ◽

James J Ireland

Keyword(s):

Dairy Cows ◽

Ovarian Reserve ◽

Maternal Nutrition ◽

Ovarian Function ◽

Bos Taurus ◽

Antral Follicle ◽

Antral Follicle Count ◽

Dairy Heifers ◽

Follicular Waves ◽

Heritable Trait

Abstract This review summarizes studies we conducted to test the hypothesis that size of the ovarian reserve (number of healthy follicles and oocytes in ovaries) positively impacts ovarian function and fertility in cattle. Key results, primarily in Bos taurus dairy cattle, show that antral follicle count (AFC) during follicular waves is highly variable between individuals, but very highly repeatable within individuals. Cycling heifers with low (≤15 follicles ≥3 mm, ~20% of a herd) vs. a high AFC (≥25, ~20% of a herd) have a smaller ovarian reserve, higher FSH but lower anti-Müllerian hormone (AMH), androstenedione, estradiol, and progesterone concentrations. Moreover, cattle with low AFC have a thinner endometrium, decreased response of granulosal, thecal, or luteal cells to FSH or LH and a poorer response to superovulation compared to cattle with high AFC. Interestingly, cows with a very high AFC as heifers have reduced fertility, fewer lactations, and shorter herd longevity, whereas cows with a low vs. intermediate AFC have reduced fertility, fewer lactations, and shorter herd longevity. Anti-Müllerian hormone concentrations are static within individuals but highly positively correlated with AFC, but fertility is not correlated with circulating AMH concentration in heifers and dairy cows with low vs. a higher AMH as heifers have reduced fertility and a shorter herd longevity. Anti-Müllerian hormone concentrations in dairy heifers are a moderately heritable trait (36%), and negatively impacted by inadequate maternal nutrition during early pregnancy or high maternal somatic cell count. We conclude that genetic or environmental manipulations of AMH could enhance size of the ovarian reserve and ovarian function, thereby improving fertility, response to superovulation, and longevity in dairy cows.

Download Full-text

Correlation Analysis Between Ovarian Reserve and Thyroid Hormone Levels in Infertile Women of Reproductive Age

Frontiers in Endocrinology ◽

10.3389/fendo.2021.745199 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jie Wu ◽

Ying-jie Zhao ◽

Min Wang ◽

Ming-qiang Tang ◽

Yao-fang Liu

Keyword(s):

Thyroid Function ◽

Ovarian Reserve ◽

Statistical Significance ◽

Antral Follicle ◽

Antral Follicle Count ◽

Reproductive Age ◽

Thyroid Peroxidase ◽

Infertile Women ◽

Positive Rate ◽

Infertility Patients

ObjectiveTo analyze the correlation between ovarian reserve and thyroid function in women with infertility.MethodsRetrospective analysis of the data of 496 infertility patients who visited the clinic between January 2019 and December 2020. According to the TSH level, it is grouped into <2.5 mIU/L, 2.5~4.0mIU/L and ≥4.0 mIU/L or according to the positive/negative thyroid autoimmune antibody. The relationship was assessed through the ovarian reserve, thyroid function, and anti-Müllerian hormone (AMH) levels in infertile patients. On the other hand, the patients are divided into groups according to age (≤29 years old, 30-34 years old and ≥35 years old), basic FSH (<10 IU/L and ≥10 IU/L), and AMH levels. The ovarian reserve was evaluated through the AMH and the antral follicle count (AFC).ResultsThe average age of the patients was 30.31 ± 4.50 years old, and the average AMH level was 5.13 ± 4.30 ng/mL. 3.63% (18/496) of patients had abnormal TSH levels (normal: 0.35-5.5 mIU/L), the positive rate of thyroid peroxidase antibody (TPOAb) was 14.52% (72/496), the positive rate of anti-thyroglobulin antibody (TgAb) was 16.94% (84/496), and the positive rate of TPOAb and TgAb was 10.48% (52/496). After grouping according to TSH level or thyroid autoimmune antibody positive/negative grouping, the analysis found that there was no statistical significance in age, AMH level and basic FSH level among the groups (P>0.05). There were no significant differences in the levels of TSH, FT3, and FT4 among different ages, AMH, and FSH levels (P>0.05).ConclusionThere is no significant correlation between ovarian reserve and thyroid function in infertile women.

Download Full-text