Effect of autologous platelet rich plasma on anti-mullerian hormone and antral follicle count in sub fertile women with poor ovarian reserve

Background: Ovarian aging may be reversible. Platelet rich plasma (PRP) has growth factors that promote cellular proliferation and folliculogenesis. Recently published studies and case reports suggest that ovarian rejuvenation can be done by PRP treatment. The objective of the study was to evaluate the effect of platelet rich plasma on ovarian reserve markers such as anti mullerian hormone (AMH) and antral follicle count (AFC) in sub fertile women with poor ovarian reserve (POR).Methods: The self-controlled quasi experimental study was carried out on 29 sub fertile women with poor ovarian reserve. They were selected for laparoscopic tubo-peritoneal evaluation as they could not afford in vitro fertilization. During laparoscopy, 5 ml of pre prepared autologous PRP was injected into each ovary. Post-PRP AMH and AFC were measured at every cycle for a period of at least three (3) months and compared with base line values.Results: Mean age of participants was 35.9±3.2 years. Baseline AMH was 0.31±0.17 ng/ml and baseline AFC was 3.41±0.73. AMH was raised on first, second and third cycle from base line values in 58.62%, 86.21% and 91.30% of the study population respectively. AMH changes in all three cycle were statistically significant. Pregnancy occurred in three (10.34%) women during the study period.Conclusions: The injection of autologous PRP into human ovaries is a safe procedure to improve ovarian reserve markers (AMH and AFC) in women with POR.

Folliculogenesis, Fertility and Biotechnology in Dairy Cattle

The ovarian follicle population is formed by thousands of follicles, preantral and antral, where oocytes are included. During fetal life, the first follicles produced are preantral, and, as they undergo the development process, they reach the final stage of antral follicles, where a cavity/or antrum is developed. All this growth phase is called folliculogenesis, and this chapter will abord the most important aspects of this process. Moreover, not all follicles reach the preovulatory phase and can be fertilized, so we will discuss how reproductive biotechniques can positively influence the fertility of bovine females. We will also discuss the possibility of antral follicle count to influence reproductive performance and the correlation to biotechniques. Finally, we present alternatives on how to improve fertility and productive efficiency in dairy herds.

Reproductive developmental dynamics during the early and intermediate prepuberal periods in Nelore breed (Bos indicus) calves

The demand for calves as oocyte donors for in vitro embryo production is growing. However, Bos indicus have a late puberty, and some aspects of the reproductive physiology during the prepubertal period remain unclear. We characterized endocrine and morpho-functional reproductive features in Nelore calves (n=8) at 2- 5 (early prepubertal period, EPP) and from 8-11 months old (mo., intermediate prepubertal period, IPP). The calves’ ovaries and uterus were B-mode transrectal ultrasonography examined, and blood samples were collected every second week. The antral follicles number and size, and ovarian and uterine horn diameters, were recorded, and plasma FSH and LH concentrations were measured (RIA). Non-pregnant, non-lactating cyclic Nelore cows (n=8) were used as controls for endocrine endpoints. Somatic development was monitored by monthly weighing, and 3D scanning of the rump area. The somatic and endocrine endpoints were compared within and between EPP and IPP, and between each period and control cows. Associations were determined by the Spearman correlation method, and the developmental rates were determined by non-linear regression. All morphological endpoints, except antral follicle count, increased (P < 0.001) from the EPP to the IPP. However, within each period differences occurred only at EPP. During the EPP LH and FSH plasma concentrations were similar (P > 0.05), whereas during the IPP LH was lower (P < 0.05) and FSH was higher (P < 0.001) than control cows. The EPP calves showed moderate to high positive correlations among ovarian, uterine, and somatic endpoints. Conversely, the IPP such correlations were mostly weak. In summary, distinct ovarian activity and development patterns of primary and secondary sexual characteristics occurred in Nelore calves at 2- 5 mo compared to 8-11 mo.

Absorbable Hemostatic Particles to Reduce the Damage on the Follicular Reserve After Ovarian Endometriomas Stripping

Objective: to reduce the surgical damage to the ovarian reserve, after stripping of ovarian endometrioma, of the necrotic type given by the electrohaemostasis or ischemic type given by the suture. Design: perform haemostasis on ovarian parenchyma with topical haemostatic agents. Materials and methods: we used Arista AH which is a powder made up of microporous polysaccharide hemospheres that act by osmotic action and accelerate the natural coagulation process. We used Arista AH in 27 women with mono- or bilateral ovarian endometriosis. Results: in all treated cases we obtained a rapid and optimal haemostasis. There were no post-surgical complications related to haemostatic defects. Three months after the surgery, we checked the Antral Follicle Count (AFC) with a trans-vaginal ultrasound probe. AFC in 24 women with full follow-up gave the following results: unilateral endometrioma – AFC between 5 and 8 (MV: 6.3), bilateral endometriomas – the AFC between 5 and 7 (MV: 5.8). Conclusions: The use of Arista AH powder allows highly effective hemostasis and is easy to use, fully respecting the residual ovarian parenchyma after stripping.

Evaluation of Ovarian Reserve in Women with Rheumatoid Arthritis

Objective: Subfertility is commonly observed in patients with rheumatoid arthritis (RA). Although the causes are not well established, the alteration of the ovarian reserve is thought to contribute to the lower chances of pregnancy. This cross-sectional study aimed to evaluate the ovarian reserve in patients with RA. Materials and methods: Two parameters associated with ovarian reserves such as the antral follicle count (AFC) and the anti-müllerian hormone (AMH) were assessed in 38 patients with RA. We also analyzed the correlation of these parameters with the medication used to treat this pathology and with the illness severity. Results: The AMH levels in women with RA were comparable to those found on healthy individuals although the RA patients were more likely to have a low AFC. Ovarian reserve and RA were neither influenced by parameters of disease activity nor by the use of medication. Conclusion: The ovarian reserve in women with RA was similar to that found in healthy individuals.