The Impact of Endometriosis on Controlled Ovarian Stimulation Outcome

Endometriosis, a frequent condition in reproductive age women, is also associated with infertility by mechanisms incompletely clarified. The effectiveness of endometriosis treatment for infertility is debated, being possible that in vitro fertilization (IVF) offers a better alternative. The response to controlled ovarian stimulation (COS) is an important predictor of live birth, but it might be affected in endometriosis possibly through a decrease of ovarian reserve. Moreover, the predictive value of anti-mullerian hormone (AMH) for the response to COS could be altered by factors disrupting the AMH production in endometriosis. Therefore, we aim to review the literature regarding the response to COS and the AMH production and their predictive value for COS response in patients with endometriosis.

Serum Metabolomic Signature Predicts Ovarian Response to Controlled Stimulation

Introduction In in vitro fertilization (IVF) cycles, some patients fail to adequately respond to ovarian stimulation. Finding novel biomarkers predicting ovarian response in advance would be meaningful.Objective To identify serum metabolomics predicting the growth of follicles after controlled ovarian stimulation (COS).Methods Blood samples were collected at the start of pituitary downregulation and on the fifth day after controlled ovarian stimulation. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) methods were used to quantify metabolites. Demographic data were calculated with SPSS version 22.0 software. Multivariate statistics were used to analyze metabolomics dataset. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic model.Results The number of retrieved oocytes was higher in the group of Follicle-to-oocyte index (FOI) ≥ 1 group. Analyses revealed 50 different metabolomics between the pre- and post- COS groups. Compared with baseline, amino acids increased significantly following COS. At baseline, acetylglycine was more abundant in the FOI <1 group, while glycine and lipids were more abundant in the FOI ≥1 group. After COS, glycine, N-acetyl-L-alanine, D-alanine, and 2-aminomuconic acid were increased in those with FOI ≥1, but L-glutamine was increased in those with FOI <1. ROC curves indicated that the combination of glycine, acetylglycine and lipids predicts different responses to controlled ovarian stimulation (AUC =0.866).Conclusion Serum metabolism might reflect the response to ovarian stimulation. Higher glycine and PC may be a good predictor for response to COS.

Body Mass Index Showed No Impact on the Outcome of In Vitro Fertilization in Progestin-Primed Ovarian Stimulation Protocol

Purpose. To assess whether body mass index (BMI) affects the outcome of in vitro fertilization (IVF) in progestin-primed ovarian stimulation (PPOS) protocol. Methods. A retrospective study was conducted in the Reproductive Medicine Center, Renmin Hospital of Wuhan University, from June 2016 to June 2017. 636 infertile women who received PPOS protocol in IVF treatment were divided into three groups according to BMI. The data of basic characteristics, embryological outcomes, and cycle characteristics of controlled ovarian stimulation of different groups were collected and studied. Result(s). There was no significant difference in almost all the basic characteristics, embryological outcomes of controlled ovarian stimulation, and cycle characteristics of controlled ovarian stimulation among the three groups. There was a tendency that the duration of infertility was decreased with the increase of patients’ weight, although there was no significant difference ( P = 0.051 ). However, overweight patients had a higher fertilization rate than normal weight patients and underweight patients (70.3 vs. 67.7 vs. 66.8, P = 0.008 ), but two-pronuclei (2PN) fertilization rate and cleavage rate showed no significant difference among the three groups. Conclusion(s). BMI showed no impact on the outcome of the ovarian stimulation outcome in PPOS protocol. PPOS protocol may benefit overweight patients, for it attains the same effect with normal patients and requires no increase in gonadotropin (Gn) dose and Gn duration.