Antral Follicle Count In Women Research Articles

Associations between urinary phthalate concentrations and antral follicle count among women undergoing in vitro fertilization.

Phthalates are ubiquitously used in a variety of products and have an adverse effect on folliculogenesis. However, previous epidemiological studies on the associations between phthalate exposure and antral follicle count (AFC) produced conflicting results. The present study aimed to evaluate the associations between urinary phthalate metabolite concentrations and AFC among women undergoing in vitro fertilization (IVF). We collected 525 urine samples and measured 8 phthalate metabolites from IVF patients. Poisson regression models were conducted to evaluate the associations between phthalate metabolite concentrations and AFC. In addition, participants were stratified into a younger group (< 35 years) and an older group (≥ 35 years) to explore the potential effect modification by age. We also performed sensitivity analyses by restricting our analyses to only infertile women diagnosed with tubal factor infertility to test the robustness of the results. Significant positive associations were observed among urinary MBP, MEOHP and ∑PAEs concentrations and AFC after adjusting for age, BMI, year of study and infertility diagnosis. Compared with women in the first tertile, women in the third tertile of MBP and MEOHP had 7.02% (95% CI: 1.18%, 12.9%) and 8.84% (95% CI: 2.83%, 14.9%) higher AFC, respectively, and women in the second and third tertiles of ∑PAEs had 6.19% (95% CI: 0.37%, 12.0%) and 9.09% (95% CI: 3.22%, 15.0%) higher AFC, respectively. In addition, MBP, MEOHP and ∑PAEs also had significant positive associations with AFC in trend tests for dose-response. In the age-stratified analysis, we found a stronger relationship between phthalate metabolite concentrations and AFC among older women and an inverse association among younger women. We observed similar results in the sensitivity analyses. We found positive associations between phthalate exposure and AFC, which support the idea that phthalate exposure may accelerate primordial follicle recruitment and lead to higher AFC in women undergoing IVF. More studies are needed to better understand their relationships.

The association between Diet Quality Index-International score and risk of diminished ovarian reserve: a case-control study.

Although limited evidence exists on the beneficial reproductive effects of diet quality indices, the association is still largely unknown. We aimed to investigate the association between Diet Quality Index-International (DQI-I) and antral follicle count (AFC) and serum antimullerian hormone (AMH) as precise and sensitive markers of ovarian reserve and to assess the risk of diminished ovarian reserve (DOR) in women seeking fertility treatments. In a case-control study, 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and body mass index (BMI), were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The quality of diets was assessed using DQI-I, which included four major dietary components: variety (0-20 points), adequacy (0-40 points), moderation (0-30 points), and overall balance (0-10 points). DQI-I score was categorized by quartiles based on the distribution of controls. AFC, serum AMH and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of DQI-I score. Increased adherence to DQI-I was associated with higher AFC in women with DOR. After adjusting for potential confounders, the odds of DOR decreased with increasing DQI-I score (0.39; 95% CI: 0.18-0.86). Greater adherence to DQI-I, as a food and nutrient-based quality index, may decrease the risk of DOR and improve the ovarian reserve in women already diagnosed with DOR. Our findings, though, need to be verified through prospective studies and clinical trials.

Comparison of Female Ovarian Reserve Before vs After COVID-19 Vaccination

This cohort study examines the association of COVID-19 vaccination with levels of anti-Mullerian hormone and antral follicle count in women seeking fertility treatment.

Low anti-mullerian hormone decreased clinical pregnancy and increased risk of poor ovarian response in women over 35 years of age.

Low anti-mullerian hormone decreased clinical pregnancy and increased risk of poor ovarian response in women over 35 years of age.

Effect of cigarette smoking on serum anti-Mullerian hormone and antral follicle count in women seeking fertility treatment: a prospective cross-sectional study.

ObjectivesThe relationship between smoking and ovarian reserve markers is inconclusive. The primary objective of our study was to assess the effect of cigarette smoking on the quantitative ovarian reserve parameters, serum anti-Mullerian hormone (AMH) and antral follicle count (AFC) as relevant to prediction of fertility outcomes in women seeking fertility treatment. Our secondary aims were to validate self-reported smoking behaviour using biomarkers and evaluate the association between biomarkers of ovarian reserve (serum AMH and AFC) with biomarkers of smoking exposure (breath carbon monoxide (CO) and urine cotinine levels).DesignProspective, cross-sectional study.SettingSingle tertiary care fertility centre.ParticipantsWomen ≤35 years seeking fertility treatment.Primary outcome measuresSerum AMH and AFC.ResultsSignificant differences were found among current smokers, ex-smokers and never smokers for breath CO (F(2,97)=33.32, p<0.0001) and urine cotinine levels (p<0.001). However, no significant differences were found either for serum AMH (F(2,91)=1.19, p=0.309) or total AFC (F(2,81)=0.403, p=0.670) among the three groups. There was no significant correlation between pack years of smoking and serum AMH (r=−0.212, n=23, p=0.166) or total AFC (r=−0.276, n=19, p=0.126). No significant correlation was demonstrated between breath CO and serum AMH (r=0.082, n=94, p=0.216) or total AFC (r=0.096, n=83, p=0.195). Similarly, no significant correlation was demonstrated between urine cotinine levels and serum AMH (r=0.146, n=83, p=0.095) or total AFC (r=−0.027, n=77, p=0.386).ConclusionWe did not find a statistically significant difference in quantitative ovarian reserve markers between current smokers, ex-smokers and never smokers which would be clinically meaningful in our study population. We confirmed that self-reported smoking correlates well with quantitatively measured biomarkers of smoking. This validated the self-reported comparison groups to ensure a valid comparison of outcome measures. There was no significant association between biomarkers of smoking and biomarkers of ovarian reserve. We were also unable to demonstrate a correlation between the lifetime smoking exposure and ovarian reserve.

Dietary patterns are associated with improved ovarian reserve in overweight and obese women: a cross-sectional study of the Lifestyle and Ovarian Reserve (LORe) cohort

BackgroundGrowing evidence suggests that adherence to certain dietary patterns is associated with improved fecundity and reproductive outcomes in the general population and infertile couples assisted reproductive treatments. The objective of this study was to assess if dietary patterns are associated with ovarian reserve in reproductive age women without a history of infertility.MethodsThis was a cross-sectional study of 185 women in the Lifestyle and Ovarian Reserve (LORe) cohort. Women aged 18–44 without a history of infertility were recruited from the local community at an academic medical center. Subjects completed validated food frequency and physical activity questionnaires to assess patterns over the year prior to presentation. Dietary patterns including a Western (including meat, refined carbohydrates, high-calorie drinks), prudent (including fruits, vegetables, olive oil and nuts), fertility (lower intake of trans fat with higher intake of monounsaturated fatty acids, increased intake of plant based protein, high-fat dairy, lower glycemic load carbohydrates and supplemental iron) and profertility diet (PFD) (characterize by whole grains, soy and seafood, low pesticide residue produce, supplemental folic acid, B12 and vitamin D) were identified through principal component analysis. Main outcome measures were serum antimullerian hormone concentration (AMH) (ng/mL) and antral follicle count (AFC) obtained by transvaginal ultrasound.ResultsAfter stratifying by BMI, adjusting for age, smoking and physical activity, dietary patterns were not associated with ovarian reserve in normal weight women. Increased adherence to a profertility diet in overweight and obese women (BMI ≥ 25 kg/m2) was associated with a significantly higher AMH. Women in the third and fourth quartiles of PFD adherence had a mean AMH concentration of 1.45 ng/mL (95%CI 0.33–2.56, p = 0.01) and 1.67 ng/mL (95%CI 0.60–2.74, p = 0.003) higher than women in the lowest quartile respectively. The highest adherence to PFD was also associated with a higher AFC in women with a BMI ≥ 25 kg/m2 (β = 7.8, 95%CI 0.003–15.34, p < 0.05). Other common dietary patterns were not significantly associated with ovarian reserve.ConclusionsIncreased adherence to a profertility diet is associated with improved markers of ovarian reserve in overweight and obese women. These findings provide novel insight on potential modifiable lifestyle factors associated with ovarian reserve.

ANTI-MULLERIAN HORMONE AND BASAL ANTRAL FOLLICLE COUNT AS PREDICTORS FOR OVARIAN RESERVE AND OVARIAN RESPONSE IN WOMEN WITH HYPOGONADOTROPIC HYPOGONADISM

To evaluate the use of anti-mullerian hormone (AMH) and basal antral follicle count (AFC) as a predictor of ovarian reserve and ovarian response to controlled ovarian hyperstimulation (COH) in women with hypogonadotropic hypogonadism (HH). This is a retrospective cohort study consisted of the files of 40 women attended a university IVF center during the past 4 years. Nineteen patients has been diagnosed as HH, compared to 21 patients diagnosed as premature ovarian failure (POF). We evaluated the use of AMH value and basal AFC to predict the ovarian reserve and ovarian response to COH in HH women; women with POF have been involved as a control group. We reviewed the recorded AMH and basal AFC, and the total number of retrieved oocytes and fertilized ones in both groups. We used unpaired student t-test for statistical comparison. P<0.05 was considered for statistical significance. Both groups were similar in age, BMI, AMH and basal AFC. Basal FSH and LH were higher in the POF group. Despite the low AMH and the low basal AFC in women with HH ( average 0.46 and 1.6 respectively), we report significant high number of retrieved oocytes and fertilized ones in response to high dose of gonadotropins stimulation compared to the reverse in the POF group. (Table 1) Pregnancy has been reported in 9 women (out of 19) in the HH group. Only one woman (out of 21) got pregnant in the POF group.Table 1Baseline characters and response to COH in women with HH Vs. POF.HH (n=19)POF (n=21)P valueAge26.3323.550.15BMI22.724.90.08FSH0.8724.9<0.001LH0.7521.5<0.001AMH0.460.290.11AFC1.60.910.34Total gonadotrophin dose560040810.03Peak E23344.4427.3<0.001Total retrieved oocytes12.81.3<0.001Total fertilized oocytes8.10.45<0.001 Open table in a new tab AMH and basal AFC has limited value in women with HH regarding prediction of ovarian reserve and ovarian response to COH. Higher doses of gonadotropins can be used rather than early giving up.

Anti-müllerian hormone levels and antral follicle count in women with a BRCA1 or BRCA2 germline pathogenic variant: A retrospective cohort study

BackgroundSome studies suggested a decreased ovarian reserve among BRCA1/2 pathogenic variant carriers, with conflicting results. MethodsWe conducted a retrospective single-center observational study of ovarian reserve and spontaneous fertility comparing BRCA1/2 pathogenic variant carriers to controls (women who attended consultations to discuss fertility preservation before gonadotoxic treatment). Measures of associations between plasma AMH concentration, AFC and BRCA1/2 status were modelled by nonlinear generalized additive regression models and logistic regressions adjusted for age at plasma storage, oral contraceptive use, body mass index, cigarette smoking, and the AMH assay technique. ResultsThe whole population comprised 119 BRCA1/2 pathogenic variant carriers and 92 controls. A total of 110 women (42 carriers, among whom 30 were cancer-free, and 68 controls) underwent an ovarian reserve evaluation. Spontaneous fertility analysis included all women who previously attempted to become pregnant (134 women).We observed a tendency towards a premature decrease in ovarian reserve in BRCA1/2 pathogenic variant carriers, but no difference in mean AMH or AFC levels was found between BRCA1/2 pathogenic variant carriers and controls. An analysis of the extreme levels of AMH (≤5 pmol/l) and AFC (≤7 follicles) by logistic regression suggested a higher risk of low ovarian reserve among BRCA1/2 pathogenic variant carriers (adjusted odds ratio (OR) = 3.57, 95% CI = 1.00–12.8, p = 0.05; and adjusted OR = 4.99, 95% CI = 1.10–22.62, p = 0.04, respectively). DiscussionAttention should be paid to BRCA1/2 pathogenic variant carriers’ ovarian reserve, considering this potential risk of premature alteration.

The effect of myo-inositol/di-chiro-inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: A systematic review and meta-analysis.

High levels of anti-Mullerian hormone and a high antral follicle count in women with polycystic ovary syndrome, reflecting increased ovarian antral follicles, predisposes them to have a high number of retrieved oocytes with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and an increased risk of ovarian hyperstimulation syndrome. Inositols, which act as insulin sensitizers, have the potential to alter folliculogenesis and the functional ovarian reserve, with subsequent benefits to reproductive outcomes following IVF/ICSI treatment. Published literature is, however, unable to provide definitive evidence of its efficacy. The objective of our review was to evaluate the effect of inositols on anti-Mullerian hormone, antral follicle count and reproductive outcomes in women with polycystic ovary syndrome undergoing IVF/ICSI. We performed a literature search using standard methodology recommended by Cochrane. Randomized controlled trials and non-randomized studies comparing inositols with no treatment, placebo or other treatment were included in the review. Using standard methodology recommended by Cochrane we pooled results using the random effects model; our findings were reported as relative risk or mean differences. PROSPERO registration: CRD42017082275. We included 18 trials. The primary outcome was a change in anti-Mullerian hormone and antral follicle count before and after treatment, for which data were unsuitable for meta-analysis. A narrative review showed no consistent direction or size of effect. A meta-analysis for the secondary outcomes showed no evidence of a significant difference between inositol and control groups for any outcome: number of oocytes (mean difference -0.39, 95% confidence interval [CI] -1.11 to 0.33), number of metaphase II oocytes (mean difference 0.29, 95% CI -0.83 to 1.40), number of top grade embryos (risk ratio [RR] 1.02, 95% CI 0.93-1.12), clinical pregnancy rate (RR 1.16, 95% CI 0.87-1.53), and risk of ovarian hyperstimulation syndrome (RR 0.73, 95% CI 0.39-1.37). The quality of evidence was assessed as very low. There is insufficient evidence for an effect of inositols on ovarian reserve markers and to support their use as pretreatment before IVF/ICSI in women with polycystic ovary syndrome.

Ovarian reserve in an Egyptian cohort with end-stage kidney disease on hemodialysis and after successful kidney transplantation: a prospective study.

Women with chronic kidney disease commonly have menstrual irregularities and fertility abnormalities. Antimüllerian hormone (AMH) and antral follicle count (AFC) are well-recognized indicators of ovarian reserve. To assess AMH level and total AFC in women who are on hemodialysis and after successful kidney transplantation (KTx). Sixty women with end-stage kidney disease (ESKD) on regular hemodialysis were included in this study with 20 patients of them were going to have renal transplant. Fifty age-matched healthy females were enrolled as control. Serum AMH level was measured in all participants once and in transplant patients four times (before surgery, and at 1, 6, and 12months after surgery). AFC was evaluated once in all subjects and in transplant patients twice (before and 1year after surgery). ESKD patients had significantly lower AMH concentration and AFC than healthy controls (1.8 ± 1.2 vs. 3.5 ± 1.7ng/ml, p < 0.001) and (12 ± 4.6 vs. 17.4 ± 4.3, p < 0.001), respectively. In the subgroup transplant patients, AMH level decreased significantly from (1.7 ± 1.3ng/ml) before Ktx to (1.5 ± 1.2ng/ml, p = 0.001) at 1month, (1.1 ± 0.9ng/ml, p < 0.001) at 6months, (0.9 ± 0.8ng/ml, p < 0.001) at 1year after Ktx. Also, total AFC declined in transplant females from (11.1 ± 4.5) before KTx to (6.6 ± 3.4) after KTx (p < 0.001). Women with ESKD who are on hemodialysis have lower ovarian reserve than healthy females. Moreover, renal transplantation was associated with reduction in AMH level and AFC.

Association of Thyroid Function and Autoimmunity with Ovarian Reserve in Women Seeking Infertility Care.

While overt thyroid disease is a well known risk factor for infertility, the potential consequences of mild thyroid dysfunction or thyroid autoimmunity remain unknown. Experimental studies suggest a considerable role for thyroid hormone in the physiological mechanisms of ovarian reserve, but translation of such findings to human studies remains rare. A potential role for thyroid function in female reproduction could be especially relevant when the cause of infertility remains unknown, such as in women with diminished ovarian reserve (DOR) or unexplained infertility. The aims of this study were to investigate the association of thyroid function and autoimmunity with markers of ovarian reserve day 3 follicle-stimulating hormone (FSH) concentrations and antral follicle count (AFC), and to investigate whether thyroid function or autoimmunity may have different effects in women with DOR or unexplained infertility. Thyrotropin, free thyroxine, thyroxine, free triiodothyronine (fT3), triiodothyronine, thyroid peroxidase antibodies (TPOAbs), and thyroglobulin antibodies (TgAbs), as well as AFC and the day 3 FSH concentration, were measured among women seeking fertility treatment at the Massachusetts General Hospital Fertility Center. Multiple linear or mixed regression models were used to study the association of thyroid function or autoimmunity with AFC or day 3 FSH. In the total study population (436 women, 530 AFC measurements), there was no association of thyroid function or TPOAb positivity with AFC. However, TgAb positivity was associated with a higher AFC (mean difference = 3.4 [95% confidence interval (CI) 1.8-5.1], p < 0.001). In women with DOR or unexplained infertility, lower fT3 and TPOAb positivity were associated with a lower AFC (fT3: continuous nonlinear association, p = 0.009; TPOAb positivity: -2.3 follicles [confidence interval -3.8 to -0.5], p = 0.01), while TgAb positivity was not associated with AFC. Neither thyroid function nor thyroid antibody positivity was associated with the day 3 FSH concentration. This study found that lower fT3 and TPOAb positivity are associated with a lower AFC in women with DOR or unexplained infertility. Future studies are required to replicate these findings and further elucidate the role of TgAbs and underlying mechanisms through which thyroid function and autoimmunity is associated with ovarian reserve.

Urinary triclosan concentrations and diminished ovarian reserve among women undergoing treatment in a fertility clinic

To investigate the association between urinary triclosan concentrations and antral follicle count (AFC), a well-accepted marker of ovarian reserve, among women from a fertility center. Prospective cohort study. Hospital fertility center. A total of 109 women. Urinary triclosan concentrations quantified by online solid phase extraction-high performance liquid chromatography-isotope dilution tandem mass spectrometry. AFC through transvaginal ultrasonography on the third day of an unstimulated menstrual cycle or on the third day of a progesterone withdrawal bleed. The geometric mean of the specific gravity-adjusted urinary triclosan concentrations for the 225 samples provided by the 109 women was 13.0μg/L (95% confidence interval [CI], 8.9, 19.1). Women had median (with interquartile range) AFC of 13 (8, 18). The specific gravity-adjusted urinary triclosan concentrations were inversely associated with AFC (-4%; 95% CI, -7%, -1%). Women with triclosan concentrations above the median had lower AFC compared with those whose triclosan concentrations were equal to or below the median, with an adjusted difference of -3.2 (95% CI, -3.9, -1.6) among those with a body mass index <25kg/m2 and -1.8 (95% CI, -3.2, -0.3) among those who were <35years old. Specific gravity-adjusted urinary triclosan concentrations were inversely associated with AFC in women seeking care at a fertility center. This association was modified by age and body mass index, with the younger and leaner women showing larger decreases in AFC.

Association between vascular health and ovarian ageing in type 1 diabetes mellitus.

Is vascular health associated with ovarian reserve status using type 1 diabetes mellitus (DM-1) as a model for vascular compromise? No conclusive evidence for an association between vascular health and ovarian ageing was found in women with DM-1. The mechanism behind advanced ovarian ageing has not yet been elucidated. We hypothesize that vascular impairment precedes ovarian ageing. DM-1 is hallmarked by premature vascular complications that may consequently play a role in the rate of primordial follicle decline. A cross-sectional, patient-control study was performed in 150 premenopausal, regular cycling women with DM-1, as well as a reference population of 177 healthy, fertile women. In a single-study visit, an inventory of both ovarian reserve and vascular status was carried out in the DM-1 group. A transvaginal ultrasound to calculate the antral follicle count (AFC) and blood sampling for anti-Müllerian hormone (AMH), lipids, C-reactive protein and HbA1c measurements were performed. Furthermore, vascular screening including measurements of blood pressure, flow-mediated dilation, peripheral arterial tonometry, pulse wave velocity, pulse wave analysis and intima-media thickness was carried out. The relative decrease in serum AMH levels in women with DM-1 compared with healthy references was investigated. Systolic blood pressure was negatively correlated with both serum AMH (P= 0.006) and AFC (P= 0.004) in the DM-1 group. A non-linear relationship between HDL-cholesterol and serum AMH was found (P= 0.0001). No associations were detected between other vascular risk factors or vascular function tests and serum AMH or AFC in women with DM-1. With regard to the comparison of AMH levels between women with and without DM-1, mean AMH levels were 2.5 ± 1.9 ng/ml and 3.0 ± 2.8 ng/ml, respectively. After adjustment for confounders the difference in AMH levels between both groups appeared non-significant (fold change: 0.92, 95% confidence interval: 0.68-1.23). The use of different AMH assays and the cross-sectional design may limit the interpretation of this study. The lack of evident association between vascular health and ovarian ageing may be the result of an insufficient vascular compromise in the relatively young, DM-1 group. No external funding was received for conducting or publishing this study. F.Y., W.S., A.F., F.L.J.V., M.J.C.E. and H.W.d.V. have nothing to disclose. F.J.M.B. has received fees and grant support from the following companies: Ferring, Gedeon Richter, Merck Serono, Medical Specialties Distributors and Roche. Not applicable.

Age-Related Normogram for Ovarian Antral Follicle Count in Women with Polycystic Ovary Syndrome and Comparison with Age Matched Controls Using Magnetic Resonance Imaging.

Antral Follicle count (AFC) is a reliable marker for ovarian reserve. Previous studies have used transvaginal ultrasound for estimation of AFC, however we used magnetic resonance imaging (MRI) for estimation of AFC and for creating an age-related normogram in patients with polycystic ovary syndrome (PCOS) and compared it with normal patients. The aim of this study is to create an age related normogram for AFC in women with PCOS and to compare that with women without polycystic ovarian syndrome using MRI. A total of 1500 women were examined, out of which 400 fitted the criteria for PCOS. They all underwent MRI study and similar age matched women without PCOS also underwent MRI examination. Normogram for AFC were obtained using LMS software and a percentile chart was obtained. Normogram for AFC in PCOS women showed decline in number of AFC as the age progresses and the decline was linear. The normogram for AFC was compared with equal number of patients without PCOS and they also showed decline in AFC as the age progresses, however the decline was exponential and faster. Age related normogram for AFC is widely used and considered as best clinical predictor for ovarian response in assisted reproductive technology. Knowledge of ovarian reserve is important in PCOS and non-PCOS females as PCOS patients are at risk for ovarian hyperstimulation syndrome during gonadotrophin theraphy. MRI is an equally effective and in some times better alternative to transvaginal ultrasound as it has got its own advantages.

Prospective study into the value of the automated Elecsys antimüllerian hormone assay for the assessment of the ovarian growing follicle pool

To evaluate a new fully automated assay measuring antimüllerian hormone (AMH; Roche Elecsys) against antral follicle count in women of reproductive age. Prospective cohort study. Hospital infertility clinics and academic centers. Four hundred fifty-one women aged 18 to 44 years, with regular menstrual cycles. None. AMH and antral follicle count (AFC) determined at a single visit on day 2-4 of the menstrual cycle. There was a statistically significant variance in AFC but not in AMH between centers. Both AFC and AMH varied by age (overall Spearman rho -0.50 for AFC and -0.47 for AMH), but there was also significant between-center variation in the relationship between AFC and age but not for AMH. There was a strong positive correlation between AMH and AFC (overall spearman rho 0.68), which varied from 0.49 to 0.87 between centers. An agreement table using AFC cutoffs of 7 and 15 showed classification agreement in 63.2%, 56.9% and 74.5% of women for low, medium, and high groups, respectively. The novel fully automated Elecsys AMH assay shows good correlations with age and AFC in women of reproductive age, providing a reproducible measure of the growing follicle pool.

The Effect of Isotretinoin on Ovarian Reserve Based on Hormonal Parameters, Ovarian Volume, and Antral Follicle Count in Women with Acne

Backgroud/Aims: Widely prescribed in routine practice, isotretinoin has an unknown impact on ovarian reserve. With a long history in acne treatment and numerous potential side effects, it is surprising that very few prospective studies have investigated its effect on ovarian reserve. Therefore, we aimed to evaluate the impact of oral isotretinoin on ovarian reserve based on hormonal parameters, anti-Müllerian hormone (AMH), ovarian volume (OV), and antral follicle count (AFC) in women of reproductive age with acne. Methods: Our study group consisted of 82 women of reproductive age with acne who were treated with oral isotretinoin. The patients were evaluated for ovarian reserve prior to therapy and reevaluated 6 months after isotretinoin treatment with regard to hormonal parameters, AMH, OV, and AFC. Results: Significant differences were found between the pre- and posttreatment period for AMH [2.20 ng/ml (25th-75th percentile 1.14-4.07) vs. 1.31 ng/ml (0.32-2.28)], total AFC [16 (14-18.25) vs. 12.5 (10-15)], and total OV [23 ml (18-29) vs. 15 ml (13-18); p < 0.001]. Conclusion: Our study is the first to analyze the levels of serum AMH, AFC, and OV together in patients treated with oral isotretinoin for acne. The results of our study demonstrated that oral isotretinoin had a significant negative effect on ovarian reserve.

Assessment of ovarian reserve based on hormonal parameters, ovarian volume, and antral follicle count in women with familial Mediterranean fever

ObjectiveTo evaluate ovarian reserve in women with familial Mediterranean fever (FMF). Study designThirty women with FMF (20–29 years) and thirty healthy controls (20–29 years) were admitted to this study. Basal serum levels of follicle-stimulating hormone (FSH), oestradiol (E2), luteinizing hormone (LH) and inhibin B were measured on cycle day 3. All participants underwent transvaginal ultrasonographic examination on the third day of their menstrual cycle for the determination of ovarian volume (OV) and total antral follicle count (AFC). ResultsWomen with FMF had significantly higher concentrations of FSH, LH and E2 than healthy controls. Total AFC was significantly lower in women with FMF than in healthy controls. OV was also lower in the FMF group but there was no statistically significant difference in OV between the groups. Age was negatively associated with FSH and LH. Inhibin B was found to be negatively correlated with LH and OV. ConclusionsIn this preliminary study, the first in FMF patients, we found that ovarian reserve was reduced in women with FMF compared with healthy controls. FMF may affect the ovarian reserve but the mechanism of this effect is unclear.

Age-related normogram for antral follicle count in women with polycystic ovary syndrome

Antral follicle count (AFC) has been shown to be a reliable marker for ovarian reserve. The aims of this study were to create an age-related normogram for AFC in infertile women with polycystic ovary syndrome (PCOS) and to compare age-related decline in AFC between infertile women with and without PCOS. A retrospective cohort study was conducted. Of a total of 4956 women, 619 women fit criteria for PCOS. In those with PCOS, there were large variations in the AFC between the 10th and 90th percentiles in all age groups. The rate of decline in AFC among women with PCOS was linear, while in those with non-PCOS, it was exponential until 30 years of age, and then became similar to that of PCOS. The rate of follicle loss per year was significantly slower in PCOS women compared with that in non-PCOS women. In both groups, the fastest period of follicle loss was between the ages of 18 and 30. The average follicle loss was 0.8 follicles/year in PCOS women and 1.7 follicles/year in those without PCOS (P<0.001). This study concludes that age-related decline in AFC among women with PCOS is slower than in those without PCOS.Antral follicle count (AFC) has been shown to be a reliable marker for ovarian reserve. The aims of this study were to create an age-related normogram for AFC in women with polycystic ovary syndrome (PCOS), and to compare age-related decline in AFC between women with and without PCOS. A retrospective cohort study was conducted. All patients underwent a baseline transvaginal ultrasound that was performed on day 2–4 of the menstrual cycle. The total number of antral follicles of 2–9mm in diameter was recorded. Of total 4956 women, 619 women fit criteria for PCOS. In those with PCOS, there were large variations in the AFC between the 10th 90th percentiles in all age groups. The rate of decline in AFC among women with PCOS was linear; while in those with non-PCOS, it was exponential until 30 years of age, and then became similar to that of PCOS. The rate of follicle loss per year was significantly slower in PCOS women compared with that in non-PCOS women. In both groups, the fastest period of follicle loss was between the ages 18–30 years. The average follicle loss was 0.8 follicles/year in PCOS women and 1.7 follicles/year in those without PCOS (P<0.001). We have concluded that age-related decline in AFC among women with PCOS is slower than in those without PCOS. Further studies are needed to determine if the AFC normogram in women with PCOS could be clinically relevant to select the optimal gonadotrophin dose for ovulation induction.

Depressive symptomatology, psychological stress, and ovarian reserve

The aim of this study was to examine psychological factors in relation to antral follicle count (AFC), a marker of ovarian reserve, in a multiethnic sample of 683 premenopausal women in the Ovarian Aging (OVA) Study. In cross-sectional analyses, linear regression was performed to determine whether AFC decline across women varied over levels of depression as well as depression in combination with psychological stress. The total and subscale scores of the Center for Epidemiological Studies Depression Scale were used to measure depression, and the Perceived Stress Scale was used to measure psychological stress. After covariate adjustment, the two-way interaction of age × positive affect and the three-way interaction of age × positive affect × stress were related to AFC (b = 0.047, P = 0.036; b = 0.012, P = 0.099, respectively). In stratified analyses, stress was related to AFC in women with low positive affect (b = -0.070, P = 0.021) but not in women with high positive affect (b = 0.018, P = 0.54). AFC decline across women was progressively higher in women with low positive affect who reported low (-0.747 follicles/year), mid (-0.920 follicles/year), and high (-1.112 follicles/year) levels of stress. Results examining the Center for Epidemiological Studies Depression Scale total and remaining subscale scores were all nonsignificant (P values > 0.05). Cross-sectional evidence suggests that (1) women with low positive affect may experience accelerated AFC decline and (2) low positive affect may be a vulnerability factor, or, alternatively, high positive affect may be a protective factor, in moderating the negative effects of psychological stress on AFC decline.

Age-related normogram for antral follicles count in women with polycystic ovary syndrome

Antral follicle count (AFC) has been shown to be a good marker for ovarian reserve. The aim of this study was to produce age-related normogram for AFC in women with polycystic ovary syndrome (PCOS), and to compare it with that of non-PCOS.