scholarly journals Effect of Ayurvedic Treatment Protocol on Diminishing Ovarian Reserve

2020 ◽  
Vol 11 (2) ◽  
pp. 228-234
Author(s):  
Divya U ◽  
Vijayakumar N
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Potential ◽  
Treatment Protocol ◽  
Antral Follicle ◽  
Poor Responder ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Rank Test ◽  
Ayurvedic Treatment

Diminishing ovarian reserve (DOR) is a condition in which the ovary loses reproductive potential, compromising fertility. Nowadays 10-30% of female infertility is due to DOR and considered as “expected poor responder” for In vitro fertilisation (IVF).   Correlation of DOR can be done with Dathukshaya vandya (depletion or inadequate formation of dhatus) explained in Harithasamhita. The objective of the study was to evaluate the effect of Ayurvedic treatment protocol on Diminishing ovarian reserve. The study protocol includes- ashtachurna for deepana (appetiser), pachana (digestives) and kolakulathadi churna for udwarthana (powder massage). Sukumaragrutha used for snehapana (oral administration of medicated ghee), utharabasthi (intrauterine administration) and rasayana (rejuvenation therapy ). Danwantarathaila abhyanga (oleation) and ooshmasweda (sudation) done for 3 days. Sukumaraeranda was used for virechana (therapeutic purgation) and also Yogabasthi (medicated enema). The study design was pre and post interventional study with a sample size of 15 selected as per inclusion and exclusion criteria, conducted at hospital for women and children, Government Ayurveda College, Thiruvananthapuram. Assessment was based on Bologna criteria for DOR. The statistical techniques employed are Wilcoxon’s signed rank test and Paired t test. Results showed statistically significant effect on improving Antral follicle count (AFC) (p- 0.01), Estradiol (p- 0.005), conception (p- 0.014), on regulating amount of bleeding (p- 0.003), menstrual interval correction (p-0.001) and dyspareunia (p-0.005). But insignificant effect on improving Anti Mullerian Hormone (AMH) (p- 0.469) and regularising LH/FSH ratio (p-0.104) was found.

The effect of endometrioma on ovarian reserve

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.

scholarly journals Single-centre retrospective analysis of growth hormone supplementation in IVF patients classified as poor-prognosis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018107 ◽  
Author(s):  
Kevin N Keane ◽  
John L Yovich ◽  
Anahita Hamidi ◽  
Peter M Hinchliffe ◽  
Satvinder S Dhaliwal
Keyword(s):  
Growth Hormone ◽  
Live Birth ◽  
Poor Prognosis ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Clinical Pregnancy ◽  
In Vitro Fertilisation ◽  
Success Rates ◽  
Younger Women

BackgroundPatients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.MethodsData were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.ResultsClinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient’s age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality.ConclusionThese data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.

scholarly journals Investigation and management of subfertility

2019 ◽  
Vol 72 (9) ◽  
pp. 579-587 ◽  
Author(s):  
Layla Thurston ◽  
Ali Abbara ◽  
Waljit S Dhillo
Keyword(s):  
Polycystic Ovary ◽  
Uterine Cavity ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Semen Parameters ◽  
In Vitro Fertilisation ◽  
Expert Assessment ◽  
Serum Progesterone ◽  
Tubal Patency

Subfertility affects one in seven couples and is defined as the inability to conceive after 1 year of regular unprotected intercourse. This article describes the initial clinical evaluation and investigation to guide diagnosis and management. The primary assessment of subfertility is to establish the presence of ovulation, normal uterine cavity and patent fallopian tubes in women, and normal semen parameters in men. Ovulation is supported by a history of regular menstrual cycles (21–35 days) and confirmed by a serum progesterone >30 nmol/L during the luteal phase of the menstrual cycle. Common causes of anovulation include polycystic ovary syndrome (PCOS), hypothalamic amenorrhoea (HA) and premature ovarian insufficiency (POI). Tubal patency is assessed by hysterosalpingography, hystero-contrast sonography, or more invasively by laparoscopy and dye test. The presence of clinical or biochemical hyperandrogenism, serum gonadotrophins (luteinising hormone/follicle stimulating hormone) / oestradiol, pelvic ultrasound to assess ovarian morphology / antral follicle count, can help establish the cause of anovulation. Ovulation can be restored in women with PCOS using letrozole (an aromatase inhibitor), clomifene citrate (an oestrogen antagonist) or exogenous gonadotrophin administration. If available, pulsatile gonadotrophin releasing hormone therapy is the preferred option for restoring ovulation in HA. Spermatogenesis can be induced in men with hypogonadotrophic hypogonadism with exogenous gonadotrophins. Unexplained subfertility can be treated with in vitro fertilisation after 2 years of trying to conceive. Involuntary childlessness is associated with significant psychological morbidity; hence, expert assessment and prompt treatment are necessary to support such couples.

Kinderwunsch in der menopausalen Übergangszeit

2021 ◽  
Vol 78 (8) ◽  
pp. 407-411
Author(s):  
Bruno Imthurn
Keyword(s):  
Antral Follicle ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Egg Freezing ◽  
Social Egg Freezing

Zusammenfassung. Die menopausale Übergangszeit ist gekennzeichnet durch den Verlust der Eizellreserve, das heisst der Zahl und Qualität der Oozyten. Diese Beeinträchtigung führt zu einer schnellen und massiven Abnahme der Fertilität. Die Eizellreserve lässt sich mit der Messung von FSH und AMH im Serum bestimmen sowie mit der Zählung der ultrasonografisch sichtbaren Follikel, dem sogenannten «antral follicle count» (AFC). Therapeutisch können zur Erfüllung des Kinderwunsches homologe Behandlungen wie monofollikuläre Hormonstimulationen und die In-Vitro-Fertilisation eingesetzt werden. Wesentlich aussichtsreicher ist jedoch meist die heterologe Eizellspendenbehandlung. Präventiv wird zunehmend die Methode des «Social Egg Freezing» angewendet.

scholarly journals The Benefits of Testosterone Therapy in Poor Ovarian Responders Undergoing In Vitro Fertilisation (IVF)

2020 ◽  
Keyword(s):  
Free Testosterone ◽  
Antral Follicle ◽  
Dehydroepiandrosterone Sulfate ◽  
Antral Follicle Count ◽  
Sex Hormone Binding Globulin ◽  
In Vitro Fertilisation ◽  
Control Group ◽  
Poor Responders ◽  
Cancellation Rate

Introduction: Poor ovarian responders are the most challenging patients in reproductive medicine and no successful treatment has been proposed. Androgens are thought to play an important role during early folliculogenesis and diminished levels are associated with decreased ovarian sensitivity to follicle-stimulating hormone. This study aimed to determine whether pretreatment with testosterone improves the results in poor responders undergoing in vitro fertilisation (IVF). Materials and methods: This observational pilot study enrolled 33 poor responders undergoing IVF. Eleven patients were pretreated with 250 mg intramuscular testosterone and compared to a control group of 22 patients. The participants were tested for free testosterone, dehydroepiandrosterone sulfate, sex hormone binding globulin, and anti-mullerian hormone (AMH). Results: The two groups had similar baseline characteristics. Significant improvement was reached in the hormones free testosterone, dehydroepiandrosterone sulfate, and sex hormone binding globulin in the testosterone-pretreatment group. No difference was detected in antral follicle count (5.06 versus 4.24); AMH (0.51 versus 0.53), mature oocytes (2.2 versus 2.32), and the number of embryos (1.2 versus 1.33) between the study and control groups, respectively. There was a slow improvement in fertilisation rate but without any significance (62.97% versus 57.61%). However, the cancellation rate of the ovarian stimulation was much greater in the control group (18.18%) in comparison with the study group (0.0%). Pregnancy rate (PR) in the testosterone group was higher than controls (PR per cycle: 27.3% versus 4.6; p=0.09). Conclusion: Based on the limited number of patients studied, pretreatment with testosterone seems to improve PR and cancellation rate in poor responders but failed to affect antral follicle count, AMH, and the number of mature oocytes and embryos. Given these results, further research would provide more certainty.

scholarly journals Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023413 ◽  
Author(s):  
Lan N Vuong ◽  
Vu N A Ho ◽  
Tuong M Ho ◽  
Vinh Q Dang ◽  
Tuan H Phung ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
In Vitro Maturation ◽  
Controlled Trial ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Increased Risk ◽  
Patient Consent ◽  
Randomised Controlled

IntroductionIn vitro maturation (IVM) is a potential alternative to conventional in vitro fertilisation (IVF) to avoid ovarian hyperstimulation syndrome (OHSS). This is particularly relevant in women with a high antral follicle count (AFC) and/or polycystic ovary syndrome (PCOS), who are at increased risk for OHSS. However, no randomised controlled trials of IVM versus IVF in women with high AFC have reported both pregnancy and OHSS rates. The aim of this study is to compare the effectiveness and safety of one IVM cycle and one IVF with segmentation cycle within women with PCOS or high AFC-related subfertility.Methods and analysisThis randomised controlled trial will be conducted at a specialist IVF centre in Vietnam. Eligible subfertile women with PCOS and/or high AFC will be randomised to undergo either IVM or IVF. The primary outcome is live birth after the first embryo transfer of the started treatment cycle. Cycles in which no embryo is available for transfer will be considered as failures. The study has a non-inferiority design, with a maximal acceptable between-group difference of 5%. Rates of OHSS will also be reported.Ethics and disseminationEthical approval was obtained from the participating centre, and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03405701; Pre-results.

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