Menstrual cycle length: a surrogate measure of reproductive health capable of improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.

Salvatore Gizzo,Guido Ambrosini,Alessandra Andrisani,Michela Quaranta,Decio Armanini,Pietro Litta,Federica Esposito,Michele Gangemi,Marco Noventa,Giovanni B Nardelli,Donato D’Antona

doi:10.1186/s12958-015-0024-1

Salvatore Gizzo, Guido Ambrosini + Show 9 more

Open Access

https://doi.org/10.1186/s12958-015-0024-1

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Abstract

BackgroundAim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.MethodsA retrospective-observational-study in Padua’ public tertiary level Centre was conducted. A total of 455 normo-ovulatory infertile women scheduled for their first fresh non-donor IVF/ICSI treatment. The mean menstrual cycle length (MCL) during the preceding 6 months was calculated by physicians on the basis of information contained in our electronic database (first day of menstrual cycle collected every month by telephonic communication by single patients). We evaluated the relations between MCL, ovarian response to stimulation protocol, oocytes fertilization ratio, ovarian sensitivity index (OSI) and pregnancy rate in different cohorts of patients according to the class of age and the estimated ovarian reserve.ResultsIn women younger than 35 years, MCL over 31 days may be associated with an increased risk of OHSS and with a good OSI. In women older than 35 years, and particularly than 40 years, MCL shortening may be considered as a marker of ovarian aging and may be associated with poor ovarian response, low OSI and reduced fertilization rate. When AMH serum value is lower than 1.1 ng/ml in patients older than 40 years, MCL may help Clinicians discriminate real from expected poor responders. Considering the pool of normoresponders, MCL was not correlated with pregnancy rate while a positive association was found with patients’ age.ConclusionsMCL diary is more predictive than chronological age in estimating ovarian biological age and response to COH and it is more predictive than AMH in discriminating expected from real poor responders. In women older than 35 years MCL shortening may be considered as a marker of ovarian aging while chronological age remains most accurate parameter in predicting pregnancy.

Highlights

Aim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to Assisted reproductive technique (ART)
We considered as eligible for the study women affected by infertility, aged between 18 and 50 years, with Body mass index (BMI) ranging between 18 and 25, owning a personal menstrual diary of the six months preceding the ART treatment
We considered anti-mullerian hormone (AMH) cohort_1 when the AMH assay showed a value ranging between 0.1-0.4 ng/ml, AMH cohort_2 when the value ranged between 0.5-1.1 ng/ml and AMH cohort_3 when the value was higher than 1.1 ng/ml

Summary

Introduction

Aim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART. Few studies systematically examined whether menstrual cycle features are related to the most direct measures of reproductive health, fertility, and pregnancy outcome. The menstrual pattern is commonly understood to be fairly persistent within the individual, until the late 40s, when cycles lengthen before menopause. Subtle gradual shortening of menstrual cycles occurs in the late 30s in parallel with the increase of FSH serum levels and the decrease of inhibin [2]. Ovarian aging is an inevitable process in all women, ovarian reserve differs significantly between individuals of similar age

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