scholarly journals Assessment of Serum Anti-mullerian Hormone Level, Antral Follicle Count and Age as Indicators of Ovarian Reserve Response in Women Diagnosed with Infertility in Abia State, South Eastern Nigeria

2020 ◽  
pp. 1-11
Author(s):  
Ebirien-Agana S. Bartimaeus ◽  
Chukwuma E. J. Obi ◽  
Felix O. Igwe ◽  
Edna O. Nwachuku
Keyword(s):  
Ovarian Reserve ◽  
Hormone Level ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Group 3 ◽  
Group 2 ◽  
And Control ◽  
Experimental Group ◽  
Group 1

Aim: This study aimed at assessing serum anti-mullerian hormone level, antral follicle count and age as indicators of ovarian reserve response in women diagnosed with infertilility. Methodology: Subjects comprised of 200 females: 150 subjects and 50 controls, aged < 20  and up to 49 years, stratified into age < 20 years (control), age 20-29 years  (group 1), age 30-39 years (group 2) and age 40-49 years (group 3). About 5 ml of blood sample for AMH determination was collected on day 2-3 of spontaneous menstrual cycle from all groups and control and serum anti-mullerian hormone analyzed using enzyme linked immunosorbent assay. Baseline transvaginal ultrasound scanning was carried out on the subjects in experimental groups and control on day 2-3 of un-stimulated menstrual cycle for the measurement of antral follicle count, using the 2-dimensional plane. Results: The means±SEM of serum anti-mullerian hormone by experimental groups was 1602.44 ± 54.42 pg/ml for control, 848.06±23.04 pg/ml for group 1, 26.74±1.28 pg/ml for group 2, while group 3 is 10.37±1.26 pg/ml. The means were significantly different (P<0.0001). The mean±SEM of AFC by experimental groups was control; 7.82±0.14, group 1; 5.46±0.18, 1.78±0.10 for group 2, and 0.70±0.08 for group 3. The means of antral follicle count by experimental groups showed significant difference (p<0.0001). Results showed that anti-mullerian hormone level and antral follicle count decreased significantly (p<0.05) as the age of the subjects increases. Subjects in the control and experimental group 1 showed 100% high anti-mullerian hormone level indicating 100% potential of good ovarian response. The antral follicle count result also indicate that 100% and 75% of the control group and experimental group 1 respectively show good ovarian reserve. The ovarian response and reserve in the subjects decreased substantially as the age of the subjects increased. Positive correlations were also observed between the AMH and AFC across the ages of the population studied. Conclusion: The study reveals that good ovarian response and reserve in the population is related to the age of the subjects.

scholarly journals SAT-002 Does the Age of Women Influence the Evaluation of Ovarian Reserve Through the Determination of Antimullerian Hormone and Follicle Count?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Patricia Nieves Amelia Maidana ◽  
Nancy Bravo Briones ◽  
Vanesa Aparicio ◽  
Delfina Ronconi ◽  
Juan Manuel Bonomo ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Transvaginal Ultrasound ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Positive Correlation ◽  
Antimullerian Hormone ◽  
Antimüllerian Hormone ◽  
Group 2 ◽  
Group 1

Abstract INTRODUCTION: Oocyte number and quality are known to decline with age. However, fertility varies significantly even among women of the same age. Given that maternal age has been delayed in recent years, an ovarian biomarker that could reflect follicular activity with precision and accuracy is needed in reproductive medicine. In recent years, two key methods, the concentration of serum antimüllerian hormone (AMH), which reflects the number of small antral follicles and is predictive of ovarian response, and antral follicle count (AFC) performed by ultrasonography, have emerged as preferred methods for assessing ovarian reserve. AIM: To assess the influence of women’s age in the association between AMH serum level and antral follicle count by ultrasonography in the evaluation of ovarian reserve SUBJECTS AND METHODS: 49 women between 25 and 45 years old who attended our laboratory with request for AMH and transvaginal ultrasound in early follicular phase were included in the study. In all of them serum AMH was tested using an electrochemiluminescence immunoassay (ECLIA) on a Roche Diagnostic Cobas e801 analyzer. Transvaginal ultrasonography follicle count was performed in both ovaries by Philips affinity 70 on first days of the menstrual cycle. Statistical analysis was performed through SPSS 23 software. RESULTS: Median and ranges of the variables are the following: AMH: 0.78 (&lt;0.03-9.98) ng/ml and AFC: 6 (1.0-60.0) follicles. AMH and AFC were negatively associated with age (r: -0.302, p&lt; 0.01; r: -0.267 p&lt;0.01, respectively). AMH showed a positive correlation with AFC (r=0.567,p&lt;0.01). We then divided the study population in two subgroups, according to age: Group 1, women &lt;40 years old(n=28) and Group 2, women ≥40 years old (n=21).Considering AMH= 1ng/ml and AFC = 7, the cut-off value used routinely in our institution, we calculated the Kappa coefficient in each group to test the degree of agreement between these two variables, with the following results: Group 1, Kappa= 0.4510, CI 95% [0.1566 – 0.7453], p= 0.0088; Group 2, Kappa= -0.0370, CI 95% [-0.4371 – 0.3630], p=ns. CONCLUSION: despite the positive correlation found between AMH levels and AFC in the whole group, Kappa values show that in women younger than 40 years serum AMH&gt;1 ng/ml is a good predictor of AFC &gt;7, but this agreement is lost in women above this age, with the cut-off values used in this study. These results must be confirmed with a larger group of women.

scholarly journals An Ovarian Reserve Assessment Model Based on Anti-Müllerian Hormone Levels, Follicle-Stimulating Hormone Levels, and Age: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Huiyu Xu ◽  
Li Shi ◽  
Guoshuang Feng ◽  
Zhen Xiao ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Hormone Level ◽  
Follicle Stimulating Hormone ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Poor Ovarian Response ◽  
Predicted Probability ◽  
Age Model ◽  
Stimulating Hormone

BACKGROUND Previously, we reported a model for assessing ovarian reserves using 4 predictors: anti-Müllerian hormone (AMH) level, antral follicle count (AFC), follicle-stimulating hormone (FSH) level, and female age. This model is referred as the AAFA (anti-Müllerian hormone level–antral follicle count–follicle-stimulating hormone level–age) model. OBJECTIVE This study aims to explore the possibility of establishing a model for predicting ovarian reserves using only 3 factors: AMH level, FSH level, and age. The proposed model is referred to as the AFA (anti-Müllerian hormone level–follicle-stimulating hormone level–age) model. METHODS Oocytes from ovarian cycles stimulated by gonadotropin-releasing hormone antagonist were collected retrospectively at our reproductive center. Poor ovarian response (&lt;5 oocytes retrieved) was defined as an outcome variable. The AFA model was built using a multivariable logistic regression analysis on data from 2017; data from 2018 were used to validate the performance of AFA model. Measurements of the area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predicative value were used to evaluate the performance of the model. To rank the ovarian reserves of the whole population, we ranked the subgroups according to the predicted probability of poor ovarian response and further divided the 60 subgroups into 4 clusters, A-D, according to cut-off values consistent with the AAFA model. RESULTS The AUCs of the AFA and AAFA models were similar for the same validation set, with values of 0.853 (95% CI 0.841-0.865) and 0.850 (95% CI 0.838-0.862), respectively. We further ranked the ovarian reserves according to their predicted probability of poor ovarian response, which was calculated using our AFA model. The actual incidences of poor ovarian response in groups from A-D in the AFA model were 0.037 (95% CI 0.029-0.046), 0.128 (95% CI 0.099-0.165), 0.294 (95% CI 0.250-0.341), and 0.624 (95% CI 0.577-0.669), respectively. The order of ovarian reserve from adequate to poor followed the order from A to D. The clinical pregnancy rate, live-birth rate, and specific differences in groups A-D were similar when predicted using the AFA and AAFA models. CONCLUSIONS This AFA model for assessing the true ovarian reserve was more convenient, cost-effective, and objective than our original AAFA model.

scholarly journals An Ovarian Reserve Assessment Model Based on Anti-Müllerian Hormone Levels, Follicle-Stimulating Hormone Levels, and Age: Retrospective Cohort Study

10.2196/19096 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19096 ◽  
Author(s):  
Huiyu Xu ◽  
Li Shi ◽  
Guoshuang Feng ◽  
Zhen Xiao ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Hormone Level ◽  
Follicle Stimulating Hormone ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Poor Ovarian Response ◽  
Predicted Probability ◽  
Age Model ◽  
Stimulating Hormone

Background Previously, we reported a model for assessing ovarian reserves using 4 predictors: anti-Müllerian hormone (AMH) level, antral follicle count (AFC), follicle-stimulating hormone (FSH) level, and female age. This model is referred as the AAFA (anti-Müllerian hormone level–antral follicle count–follicle-stimulating hormone level–age) model. Objective This study aims to explore the possibility of establishing a model for predicting ovarian reserves using only 3 factors: AMH level, FSH level, and age. The proposed model is referred to as the AFA (anti-Müllerian hormone level–follicle-stimulating hormone level–age) model. Methods Oocytes from ovarian cycles stimulated by gonadotropin-releasing hormone antagonist were collected retrospectively at our reproductive center. Poor ovarian response (<5 oocytes retrieved) was defined as an outcome variable. The AFA model was built using a multivariable logistic regression analysis on data from 2017; data from 2018 were used to validate the performance of AFA model. Measurements of the area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predicative value were used to evaluate the performance of the model. To rank the ovarian reserves of the whole population, we ranked the subgroups according to the predicted probability of poor ovarian response and further divided the 60 subgroups into 4 clusters, A-D, according to cut-off values consistent with the AAFA model. Results The AUCs of the AFA and AAFA models were similar for the same validation set, with values of 0.853 (95% CI 0.841-0.865) and 0.850 (95% CI 0.838-0.862), respectively. We further ranked the ovarian reserves according to their predicted probability of poor ovarian response, which was calculated using our AFA model. The actual incidences of poor ovarian response in groups from A-D in the AFA model were 0.037 (95% CI 0.029-0.046), 0.128 (95% CI 0.099-0.165), 0.294 (95% CI 0.250-0.341), and 0.624 (95% CI 0.577-0.669), respectively. The order of ovarian reserve from adequate to poor followed the order from A to D. The clinical pregnancy rate, live-birth rate, and specific differences in groups A-D were similar when predicted using the AFA and AAFA models. Conclusions This AFA model for assessing the true ovarian reserve was more convenient, cost-effective, and objective than our original AAFA model.

Antral Follicle Diameter Variance Within Each Ovary May Be A Predictor For Poor Response In Cases With Normal Ovarian Reserve

2018 ◽  
Vol 126 (08) ◽  
pp. 521-527
Author(s):  
Ilhan Sanverdi ◽  
Enis Ozkaya ◽  
Suna Kucur ◽  
Dilsat Bilen ◽  
Meryem Eken ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Multivariate Regression Analysis ◽  
Antral Follicle Count ◽  
Estradiol Level ◽  
Poor Ovarian Response ◽  
Follicle Diameter ◽  
The Right

Abstract Objectives To determine the predictive value of antral follicle diameter variance within each ovary for ovarian response in cases with normal ovarian reserve tests. Methods This is a prospective observational study. One hundred and thirty nine infertile women who underwent ART in IVF-ICSI unit of Zeynep Kamil women and children’s Health Training and research hospital between January 2017 to June 2017 were recruited. Blood samples were collected on day 2/day 3 for assessment of serum FSH and estradiol. Trans-vaginal sonography was done for antral follicle count. During antral follicle count, in order to determine antral follicle diameter variance, diameters of the largest and smallest follicles were recorded. Variance was calculated by subtracting the smallest diameter from the largest one. Following ovarian stimulation with antagonist protocol, poor response was determined in cases with total oocyte number≤3. Ovarian reserve tests and antral follicle diameter variance were utilized to predict cases with poor response in women with normal ovarian reserve. Results Antral follicle diameter variance both in right (AUC=0.737, P<0.001) and left (AUC=0.651, P<0.05) ovaries significantly predicted poor ovarian response. Variance>3.5 mm was found to have 75% sensitivity to predict poor response. Basal serum FSH with estradiol levels and AFC failed to predict poor response (P>0.05). Other significant predictors for poor response were day 5 estradiol level and estradiol level at trigger day (P<0.05). In multivariate regression analysis, both AFC and antral follicle diameter variance in the right ovary were found to be significantly associated with clinical pregnancy, on the other hand peak estradiol concentration and antral follicle diameter variance in the right ovary were significantly associated with poor response. Conclusion Antral follicle diameter variance may be utilized to predict poor ovarian response in cases with normal ovarian reserve.

350 EFFECT OF DIFFERENT SUB-DOSES OF EQUINE CHORIONIC GONADOTROPIN ON PREGNANCY AND TWINNING RATES OF CYCLIC ZEBU COWS SUBMITTED TO FIXED-TIME ARTIFICIAL INSEMINATION

2015 ◽  
Vol 27 (1) ◽  
pp. 263 ◽  
Author(s):  
R. H. Alvarez ◽  
F. L. N. Natal ◽  
R. M. L. Pires ◽  
K. M. R. Duarte ◽  
C. A. Oliveira
Keyword(s):  
Artificial Insemination ◽  
Ovarian Response ◽  
Fixed Time ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Group 3 ◽  
Group 2 ◽  
Twin Pregnancies ◽  
Group 1

The injection of a low dose of eCG has the potential to induce multiple ovulation and pregnancies in cattle. The present study aimed to evaluate the ovarian response, conception rate and incidence of twin pregnancies of cyclic cows receiving 1 of 2 low doses of eCG. Multiparous Nellore (Bos t. indicus) cows with plasma progesterone levels >1 ng∙mL–1 on at least one of 2 blood samples collected at 10-day intervals (Day –10 and Day 0) received an intramuscular (IM) injection of 2 mg of oestradiol benzoate (EB; Estrogin®, AUSA, São Paulo, Brazil) and a vaginal device (DIP) containing 1 g of progesterone (Primer®, Tecnopec, São Paulo, SP, Brazil) on Day 0. On Day 8, the DIP was removed and cows received an IM injection of 150 μg of cloprostenol (Veteglan®, Hertape Calier, Juatuba, MG, Brazil). At this time, the animals were randomly distributed into 3 groups. Group 1 (n = 30) received an IM injection of 2 mL of saline, whereas groups 2 (n = 41) and 3 (n = 23) received 600 IU and 900 IU of eCG (Novormon® MSD Saude Animal, São Paulo, Brazil), respectively. Twenty-four hours later (Day 9), all groups received 1 mg of EB and were submitted to fixed-time artificial insemination (FTAI) 30 h later (i.e. 54 h after DIP removal). Oestrus observation was performed daily from the time of the withdrawal of the DIP until the day of FTAI. Ovaries were examined ultrasonically at the time of FTAI, the following day and 7 days after FTAI. Pregnancy diagnosis was done by ultrasonography 30 days after FTAI and the incidence of twin or single calves was recorded at birth. Data were analysed by chi-square test. The rate of expression of oestrus was 70.0% (group 1), 82.9% (group 2), and 78.2% (group 3; P = 0.25). Cows that had 2 or more large follicles at the time of FTAI was 0% (group 1), 14.6% (group 2), and 34.8% (group 3; P < 0.05). The ovulation rate of cows in group 1 (80.0%) was higher than cows in groups 2 (48.8%) and 3 (52.2%; P < 0.05). The conception rates for groups 1, 2, and 3 were 50.0, 26.8, and 39.1%, respectively (P < 0.05). Two animals in group 3, one in group 2, and none of group 1 had twin pregnancies on Day 30 after FTAI. Only one of these cows (group 3) had a twin calving. It was concluded that the injection of 600 or 900 IU eCG, in an oestradiol/progestogen FTAI protocol does not result in an increase in the rate of twin calvings, but may negatively affect pregnancy rates of cyclic Nellore cows.Financial support was provided by FAPESP (proc. 2011/13096–0).

scholarly journals Pengaruh Penggunaan Buah Alpukat dan Virgin Coconut Oil (VCO) Terhadap Perawatan Rambut Rontok

2020 ◽  
Vol 11 (02) ◽  
pp. 74
Author(s):  
Syannaz Rizka Usman ◽  
Yuliana Yuliana
Keyword(s):  
Hair Loss ◽  
Coconut Oil ◽  
Primary Data ◽  
Control Group ◽  
Research Subjects ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Experimental Group ◽  
Group 1

Excessive hair loss will cause baldness. It can will influence someone’s confidence. that is why, hair loss treatment is needed to be done. One of them is by using avocados and VCO. They have good function to stimulate hair growth and make them healthier. This study aims to analyze the effect of avocados and VCO toward hair loss treatment. The research was done by observing the mount of hair loss everyday. this study was conducted with a quasi-experimental method with a quasi exsperiment to explain the influence of using avocados and VCO on the treatment of hair loss. The research subjects were a collection of women who lived in the Parak Laweh area of ​​Lubuk Begalung subdistrict which improved hair loss at the level of 40-100 strands per day. The sample in this study amounted to 12 people used by the technique of taking documentation and interviews. This study consisted of 4 different groups, namely the control group (X0), experimental group 1 (X1), experimental group 2 (X2), and experimental group 3 (X3).The data gathered is primary data. It is directly taken from samples that fill in the research format provided. Data analysis using analysis of variance (anava) and continued with Duncan test, the results of this study show a significant difference in the indicator of the amount of hair detached from the scalp with the number of strands of hair falling after treatment in the control group (X0) (80.50), experimental group 1 (X1) (60.50), experimental group 2 (X2) (58.83) and experimental group 3 (X3) (58.67). So it can be said that for the indicator of the amount of hair loss in the experimental group did not show a statistically significant difference, but there was a significant difference in the treatment of hair loss in the control group. Keywords: hair loss, avocados, VCO

scholarly journals Diminished Ovarian Reserve, Causes, Assessment and Management

2013 ◽  
Vol 4 (2) ◽  
pp. 45-55 ◽  
Author(s):  
Mala Arora ◽  
Mandeep Kaur
Keyword(s):  
Ovarian Reserve ◽  
Treatment Options ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Diminished Ovarian Reserve ◽  
Assisted Hatching ◽  
Ovum Donation ◽  
Antagonist Protocol

ABSTRACT Diminished ovarian reserve predicts diminished ovarian response to stimulation but does not predict cycle fecundity. It has been recently defined by ESHRE, the Bologna's criteria, according to which at least two of the following three features should be present: (1) Age >40 years/any other risk factor for DOR, (2) abnormal ovarian reserve test, i.e. antral follicle count, AMH, (3) poor ovarian response in a previous stimulated cycle, i.e. less than three follicles after standard gonadotropin stimulation. Poor response to maximal stimulation on two previous occasions also defines DOR. The treatment options are limited. Avoiding the GnRH agonist long protocol and stimulation with microdose flare or antagonist protocol yields better results. Adjuvant therapy with LH, DHEAS and growth hormone shows some benefit in improving the oocyte yield. It is advisable to perform ICSI for all obtained oocytes and some advocate assisted hatching. Pregnancy rates are, however, poor and often these patients require ovum donation. Developing tests that will diagnose DOR in a low-risk population will allow women to plan their reproductive careers early. How to cite this article Kaur M, Arora M. Diminished Ovarian Reserve, Causes, Assessment and Management. Int J Infertility Fetal Med 2013;4(2):45-55.

207 EFFECT OF REPEAT HORMONE STIMULATION ON THE YIELD AND IN VITRO DEVELOPMENT OF JUVENILE CALF OOCYTES

2014 ◽  
Vol 26 (1) ◽  
pp. 217
Author(s):  
X. Q. Lv ◽  
J. H. Xue ◽  
Y. L. Zhu ◽  
H. B. Liang ◽  
B. H. Xuan
Keyword(s):  
Animal Health ◽  
Ovarian Response ◽  
Oocyte Recovery ◽  
Maturation Medium ◽  
Group 3 ◽  
Group 2 ◽  
Free Environment ◽  
Calf Oocytes ◽  
Group 1

Juvenile in vitro embryo transfer can markedly reduce animal generation intervals. The purpose of this study was to investigate the ovarian response of juvenile calves and in vitro oocyte developmental capacity after superstimulation. Experiments on calves were performed in accordance with the Animal Welfare Regulations. A total of 36 donor juvenile calves on standard nutrition and in a disease-free environment, were selected from the breeding farm of the Beijing Dairy Cattle Center. At 60 days of age, calves were randomly assigned into three groups of four calves each, replicated three times. On day 1, Group 1 received a progesterone vaginal insert (CIDR, 300 mg per device); Group 2 received a CIDR and 0.5 mg oestrogen benzoate (China); Group 3 received a CIDR, 0.5 mg oestrogen benzoate, and 50 mg progesterone (China). Then, calves were injected with FSH (Folltropin-V, Bioniche Animal Health, Belleville, ON, Canada) twice daily on days 5 (40 mg/40 mg) and 6 (30 mg/30 mg) at 12 h intervals. Cumulus–oocyte complexes (COCs) were recovered from the superstimulated calves 12 to 14 h after the final FSH treatment. COCs were considered usable unless they were damaged or had expanded cumulus layers. Usable COCs were matured in vitro for 24 h in maturation medium consisting of TCM199, 10% FBS, 10 μg mL–1 FSH, 1 μg mL–1 LH, 1 μg mL–1 E2–17β, 100 IU mL–1 penicillin, 100 μg mL–1 streptomycin, with (+Cys) or without (–Cys) 100 μM Cysteamine. Each calf oocyte was cultured in one well. The final concentration added to each fertilization drop was 5 × 106 sperm mL–1. Sperm and oocytes were co-cultured in IVF-100 medium (BO liquid+10 μg mL–1 heparin, Japan) at 38.5°C, 5% CO2 and a saturated humidity for 6 to 8 h. Blastocyst production rates were determined after 7 and 8 d of in vitro culture in CR1aa medium without the addition of cysteamine. Differences among treatments in each experiment were determined by one-way ANOVA and a multiple range test. Superstimulatory results indicated that more follicles were aspirated (63.2 per calf) and more usable oocytes were recovered (48.0 per calf) in Group 1 than in the other two groups (Group 2–45.2 and 31.8, respectively; Group 3–35.4 and 28.3, respectively; P < 0.05). No difference was observed between Groups 2 and 3. Superstimulation of calves twice at 30 day intervals in Group 2 (n = 12) did not affect the number of follicles or usable oocytes (overall, 44.2 and 28.0 per calf). Maturation rates (86.5% v. 85.0%, respectively) and cleavage rates (84.4% v. 80.0%, respectively) did not differ whether cysteamine was not (–Cys; n = 318) or was (+Cys; n = 330) added to the maturation medium. However, the blastocyst rate differed significantly (12.9% v. 35.2%, respectively; P < 0.01). This study established a protocol for the superstimulation of juvenile calves with an average of 48 oocytes obtained per calf. Superstimulation and surgical oocyte recovery twice at an interval of 30 days had no adverse effect on follicle development or oocyte recovery. The novelty of this research is that the blastocyst production rate of calf oocytes (35.2%) in maturation medium supplemented with cysteamine was similar to that reported in the cow.

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