Number Of Antral Follicle Count Research Articles

Evaluation of the therapeutic effect of very small stem cells from peripheral blood on the treatment of Premature Ovarian Failure: A pilot study.

Premature ovary failure (POF) is a severe health condition with multiple negative outcomes, which deteriorate a patient's life. The current study aimed to evaluate the therapeutic effect of mesenchymal stem cells (MSCs) derived from peripheral blood in the treatment of women with the POF background. The current study was a pilot study carried-out on women younger than 40 with premature ovarian failure. Study participants underwent 4-months cell therapy using Mesenchymal stem cells extracted from peripheral bloods. Serum level of Follicle-stimulating hormone (FSH), Estradiol (E2), Anti-mullerian hormone (AMH), and Antral follicle count (AFC) were the main investigated outcomes that were assessed at baseline, month two and month four of the very small stem cell intervention. Average serum level of FSH was 45.0 (12.1) mIU/mL at baseline and continually decreased during the study and reached 33.2 (12.4) mIU/mL in the fourth month. The average AMH level was 0.10 ng/mL prior to the intervention and increased to 0.13 ng/mL in the 2nd month and 0.15 ng/mL in the fourth month. The level E2 was 85.7 (23.6) pg/ml on average at baseline, while the average E2 reduced to 77.2 (25.6) pg/ml in the fourth month. Average number of AFC was 2.0 (0.8) at baseline. We observed a gradual increase in the second month (Mean AFC=2.2) and after four months it increased to 3.1 (1.8) as the highest menstrual restoration and pregnancy was observed in 10% of our study participants. MSCs could significantly improve hormone secretion in women with POF. Implantation of MSCs in women with POF background was associated with an increase in AMH and AFC, while it downed the serum level of E2 and FSH. MSCs could also lead to menstrual restoration and pregnancy in women with POF.

The effect of ovarian injection of autologous platelet rich plasma in patients with poor ovarian responder: a systematic review and meta-analysis.

To evaluate the effects of ovarian injection of autologous platelet rich plasma (aPRP) on patients with poor ovarian responder (POR) based on the existing clinical evidence. According to systematic review and meta-analysis, we comprehensively searched nine databases established as of September 6, 2023, and evaluated the impact of ovarian PRP infusion on poor ovarian responder. The research results include serum follicle-stimulating hormone(FSH) and anti-Mullerian hormone(AMH) levels, antral Follicle Count(AFC), oocyte number, and embryo number. The Newcastle Ottawa Scale (NOS) was used to evaluate the quality of inclusion in trials. Add up to 10 studies consisting of 793 participants were included in the meta-analysis. A review of existing evidence showed that intraovarian injection of PRP has significant therapeutic effects in increasing levels of anti-Müllerian hormone (AMH) (SMD=0.44,95% CI [0.07,0.81], p=0.02), antral follicle count (AFC) (MD=1.15,95% CI [0.4,1.90], p=0.003), oocyte count (MD=0.91, 95% CI [0.40, 1.41], p=0.0004), and embryo number (MD=0.78, 95% CI [0.5,1.07], p<0.0001). We compared the relevant data of patients before and after treatment after 2 months of intervention. It can be seen that ovarian injection of PRP treatment for 2 months has better effects in reducing FSH levels, increasing AMH levels, increasing antral follicle count, and increasing the number of oocytes and embryos (p<0.05). When the dose of PRP injected into each ovary was ≥ 4ml, there was also a significant correlation (p<0.05) with improving the number of AFC, oocytes and embryos. Significant heterogeneity existed among the studies. The pooled results suggest that intra-ovarian injection of PRP can promote ovarian regeneration and improve the reproductive outcomes of patients with ovarian dysfunction. This therapy may have significant clinical potential in improving sex hormone levels, increasing AFC, oocyte count, and embryo count. However, this findings still requires more rigorous and extensive trials worldwide to determine the value of intra-ovarian injection of PRP in POR patients. https://www.crd.york.ac.uk, Identifier CRD42023451232.

P-565 Pharmacogenetic (PGx) Gene-Drug Association in IVF: clinical relevance of a panel test for ovarian stimulation

Abstract Study question Could the PGx approach be useful for increasing the number of mature oocytes after personalized COS? Summary answer There was an increase in the number of MII in the cycle after the PGx implementation compared to the previous cycle. What is known already Pharmacogenetics (PGx) is the study of variability in drug responses associated with genetic differences amongst individuals. There is a growing evidence-based indications for PGx testing, but the implications of PGx test results for individual patients poses the next challenge. An efficient controlled ovarian stimulation (COS) is essential for IVF, as its success is tightly related to the oocytes retrieved. PGx for COS may provide an alternative approach to predict ovarian response, as it may help to understand the unexpected response and design a personalized therapy. We evaluated the application and clinical impact of pharmacogenetic test for ovarian response to COS. Study design, size, duration We conducted an observational multicentric cohort study that evaluated the results of a PGx panel test and their implementation for personalized COS between June 2016 and November 2021. The primary outcome was the number of mature oocytes in the cycle after the PGx management compared with the previous cycle without PGx approach. PGx panel test includes the analysis of S680N in the FSHR gene and CAG repeats in exon 1 in AR gene. Participants/materials, setting, methods We included 228 patients who underwent PGx testing previous COS and a preceding COS without PGx approach. In total 549 cycles were included. For the cycle preceding to PGx test (C0-cycle), patients followed a COS protocol according to their clinical characteristic. For the cycle using PGx approach (C1-cycle) the gonadotrophin and doses were selected according to the polymorphism S680N in FSHR gene and an androgen pretreatment regarding to the number of repeats in AR gene. Main results and the role of chance Clinical characteristics of patients were measured. The median and IQR of age, AMH and number of antral follicle count of the patient included in the study were 39.1y [36.4-41.4], 0.72pmol/L [0.38-1.19] and 5 [4-8], respectively. These characteristics agree with the Bologna criteria for poor ovarian reserve. The mean duration of stimulation and total dose of gonadotrophins required were similar between C0 and C1 cycles (9.25 + 2.59 vs 9.15 + 3.68, p = 0.62; 2885 + 1383 vs 2645 + 1352, p = 0.16). Differences were shown in the female age 38.4 + 4.1y in C0 vs 39.1 + 4.1y in C1 (p &amp;lt; 0.0001). Patients in C1 were older than their previous cycle C0. This difference is in favour of better ovarian stimulation outcome in the first cycle where patients were younger. Statistical differences were shown in MII yield (3.1 + 2.2 vs 4.2 + 3.2; p &amp;lt; 0.001). Regarding the differences observed in the COS outcome among the different genotypes and PGx interventions, all the patients showed a clear benefit of PGx. On the other hand, for patients that carried a number of repeats lower than 22 and higher than 24 in AR gene and NN genotype for 680-FSHR, to which no PGx intervention has to be done according to the test result, no significances differences were reported (3.60 vs 4.22; p = 0.33). Limitations, reasons for caution A small sample size and the inherent limitations of an observational study. A clinical randomized trial will be necessary to draw firm conclusions. More research in the genes involved in ovarian function is warranted. Wider implications of the findings This project represents the first effort to investigate whether a PGx test could improve COS outcomes in POR cohort. Our results suggest that PGx test could benefit the process of controlled ovarian stimulation towards a true individualized approach in clinical practice. Trial registration number Not applicable

Evaluation of Serum AMH, INHB Combined with Basic FSH on Ovarian Reserve Function after Laparoscopic Ovarian Endometriosis Cystectomy.

ObjectiveThe value of serum AMH, INHB, and bFSH levels in assessing postoperative ovarian reserve function was analyzed by measuring serum anti-Mullerian hormone (AMH), inhibin B (INHB), and basal follicle-stimulating hormone (bFSH) levels in patients after laparoscopic cystectomy for endometrioma.MethodsFrom June 2019 to December 2021, 124 patients underwent laparoscopic cystectomy for endometrioma in our hospital were selected, and the serum AMH, INHB, bFSH level, antral follicle count (AFC) of all patients before and after operation were detected and compared. According to the results of postoperative testing, all the patients were divided into normal group (n = 86), diminished ovarian reserve (DOR) group (n = 27), and premature ovarian failure (POF) group (n = 11). Pearson correlation model and subject operating characteristic curve (ROC) were used to analyze the correlation and diagnostic value of serum AMH, INHB and bFSH levels with postoperative ovarian reserve function, respectively.ResultsAfter operation, the levels of serum AMH, INHB and AFC in the DOR group and POF group decreased compared with those before the operation, and the serum bFSH levels increased (p < 0.05). After operation, the levels of serum AMH, INHB and AFC in DOR group and POF group were lower than those in normal group,and the serum bFSH levels were higher than the normal group; the levels of serum AMH, INHB and AFC in POF group were lower than those in DOR group, and the serum bFSH levels were higher than the DOR group (p < 0.05). Pearson analysis showed that serum AMH and INHB levels were negatively correlated with bFSH, and positively correlated with the number of AFC, the serum bFSH level was negatively correlated with the number of AFC (p < 0.05). The diagnostic values of serum AMH, bFSH, INHB and the combination of the three tests for postoperative abnormal ovarian reserve function were 0.866 (95% CI, 0.801–0.923), 0.810 (95% CI, 0.730–0.890), 0.774 (95% CI, 0.687–0.860) and 0.940 (95% CI, 0.900–0.981), respectively.ConclusionSerum AMH and INHB levels decreased and bFSH levels increased in patients after laparoscopic cystectomy for endometrioma, both of which were closely related to postoperative ovarian reserve function, and both could evaluate ovarian reserve function after ovarian cyst debulking, and the combined test could significantly improve the detection rate.

Calcium gluconate infusion is not as effective as dopamine agonists in preventing ovarian hyperstimulation syndrome.

The aim of the study was to compare the effectiveness of calcium gluconate and cabergoline therapy in the prevention of ovarian hyperstimulation syndrome (OHSS). Eight hundred and forty-five women who underwent GnRH antagonist protocol and at high risk for developing OHSS were divided into two groups, those given cabergoline (n=435) or calcium gluconate (n=410). In cabergoline group, 0.5 mg of cabergoline was administered once daily p.o. starting on the day of ovulation trigger and continued until the following 8 days. In calcium gluconate group, intravenous calcium gluconate was administered daily for four days starting on the day of oocyte pickup (OPU). 10 ml of 10% calcium gluconate solution was dissolved in 200 ml of physiological saline and administered by intravenous route within 40 minutes. Infusion was started within the first 30 minutes following the OPU and continued on the 1st, 2nd and 3rd days after OPU. Mild OHSS was developed in 367 (89%) patients receiving calcium gluconate infusion, while 251 patients (57%) in the cabergoline group developed mild OHSS. The frequency of mild OHSS in the calcium group was significantly higher than the cabergoline group (p<.001). Moderate OHSS was observed in 32 people (7.8%) in the calcium gluconate group, while it was observed in 184 people in the cabergoline group (42.3%). Calcium gluconate infusion significantly reduced the development of moderate OHSS compared to cabergoline therapy (p<.001). Severe OHSS developed in 11 patients (2.7%) in the calcium gluconate group, while severe OHSS did not develop in those given cabergoline (0%, p<.001). Clinical pregnancy, live birth and abortion rates were similar in the two groups. When logistic regression analysis was performed, a significant correlation was found between age, BMI, AMH, the number of antral follicle count, OHSS history, paracentesis, progesterone on the day of hCG, 2 PN zygotes, and HbA1c levels and the development of OHSS. No correlation was found between the use of metformin or cetrotide and the development of OHSS. Calcium gluconate treatment is not effective in the prevention of OHSS.

Pregnancy outcomes in patients with late-onset severe OHSS following different methods of ascetic fluid drainage and a comparison with non-OHSS IVF patients.

In this study, we aimed to identify whether there are any differences in pregnancy outcomes in patients with severe ovarian hyperstimulation syndrome (OHSS) following the drainage of ascites by central venous catheter or paracentesis. We also aimed to identify differences in pregnancy outcomes between severe OHSS patients and non-OHSS IVF patients. This was a retrospective cohort analysis carried out in a university-affiliated reproductive center between 2012 and 2019 featuring 359 women with severe OHSS following ascites draining and 345 non-OHSS women (matched by age and the number of oocytes retrieved). We investigated the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, and preterm delivery, between the two groups. Within the OHSS group (central venous catheter group vs paracentesis group), we also analyzed the odds ratios and 95% confidence intervals of clinical pregnancy. The rate of biochemical pregnancy loss in non-OHSS patients was significantly higher than that of severe OHSS patients (11.1% vs. 0.6%; P < 0.05). Live birth rate and the rate of multiple pregnancy (twin pregnancy) were much higher in the severe OHSS group than in the non-OHSS group (88.9% vs. 73.5%; 57.6% vs. 28.1%, respectively). There was no significant difference between the rate of singleton and twin preterm delivery, and neonatal birth weight between the OHSS and the non-OHSS groups. Binary logistic regression analysis revealed that multiple pregnancy and the long superovulation protocol had high odds ratios (odds ratio (OR) = 2.53), thus suggesting that these are significant risk factors for severe OHSS. When considering the patients with severe OHSS and the manner in which they underwent ascites drainage, we found that the volume of ascites in the central venous catheter group was significantly higher than that in the abdominal paracentesis group (P < 0.05). There were no significant difference between the two groups with regards to the number of live births and the birth weight of singletons and twins (P>0.05), although the premature birth rate of singletons in abdominal paracentesis group was 9.3% (10/107), compared with 3.75% in the central venous catheter group (P < 0.05). Analysis indicated that for women undergoing in vitro fertilization embryo transfer (IVF-ET), a higher number of antral follicle count, COS long protocol, and multiple pregnancy may be risk factors for late-onset OHSS. Both paracentesis and central venous catheters are effective modalities for the management of ascites in patients with severe OHSS. Catheters represent a safe and effective way to treat patients who need to undergo repeated paracentesis.

Comparison of Clinical Pregnancy Rates and Implantation Rates in Hysteroscopic Lateral Metroplasty versus Endometrial Scratching in Patients of Repeated Implantation Failures

ABSTRACT Introduction Implantation is one of the rate-limiting steps of success rates in patients undergoing in vitro fertilization. Repeated implantation failure is defined as failure of good-quality embryos to successfully implant in uterine cavity in repeated IVF treatment cycle. The cause of such implantation failures may be maternal or embryonal. Endometrial scratching and lateral metroplasty are found to increase successful implantation rates in various studies. There is hardly any study in the literature comparing the success rates of endometrial scratching and hysteroscopic lateral metroplasty. Keeping in mind this fact, we conducted this comparative study to compare the successful pregnancy rates and clinical pregnancy rates in patients who had undergone endometrial scratching and hysteroscopic lateral metroplasty for repeated implantation failures. Materials and methods A total of 60 patients having primary or secondary infertility and had history of repeated implantation failure were included in this study on the basis of a predefined inclusion and exclusion criteria. The patients were divided into two groups on the basis of treatment they received. In group A, 30 patients underwent endometrial scratching, and in group B, 30 patients underwent hysteroscopic lateral metroplasty. The successful pregnancy rates and clinical pregnancy rates in both the groups were compared. SPSS 22.0 was used for statistical analysis, and P value less than 0.05 was taken as statistically significant. Results Out of 60 patients, 50 (87.5%) patients belonged to primary infertility, whereas 10 (12.5%) patients were found to have secondary infertility. The mean age of patients in group A was 34.12 ± 3.12, whereas the mean age in group B was 35.42 ± 4.46 years. The mean duration of infertility in patients of group A and group B was found to be 7.43 ± 2.50 and 6.93 ± 2.54 years, respectively. The mean number of antral follicle count in group A was 9.52 ± 1.82, whereas in group B, it was 10.42 ± 1.52. In group A, 12 (40%) patients were confirmed to be having successful pregnancy on the basis of β-hCG levels on D14, whereas 17 (56.67%) patients in group B were found to have successful pregnancy on the basis of β-hCG. Fetal cardiac activity was present in 13 (43.33%) patients and 18 (60%) patients in group A and group B, respectively (p = 0.301). The difference was not found to be statistically significant (p = 0.30). Conclusion Endometrial scratching and hysteroscopic lateral metroplasty both are effective management strategies in patients having history of repeated implantation failure. Though lateral metroplasty appears to be a better choice, the difference was statistically insignificant (p &gt; 0.05). How to cite this article Kale A, Kale A. Comparison of Clinical Pregnancy Rates and Implantation Rates in Hysteroscopic Lateral Metroplasty versus Endometrial Scratching in Patients of Repeated Implantation Failures. J South Asian Feder Obst Gynae 2020;12(6):348–352.

Repeatability of antral follicle count according parity in dairy cows.

Ovarian reserve in cattle can be predicted by an indicator, the antral follicle count (AFC), which is easily determined via ovarian ultrasonography. However, the repeatability of AFC measurements in the same individual taken approximately 1 year apart after first parity remains unclear. This study, thus, aimed to clarify the between-lactation repeatability of AFC after first parity in dairy cows. We measured the AFC of the same individual cows consecutively across both first and second parity, both second and third parity, and both third and fourth parity in 31, 37, and 26 heads, respectively. The values of the intraclass correlation coefficients (ICC) for the AFCs in first–second and second–third parity cows were more than 0.8, and the value of the ICC for the AFCs in third–fourth parity cows was significantly lower than that in first–second parity cows (P = 0.01). Subsequently, based on the average number of AFCs measured at some points from first to third parity, we classified the cows into three tertiles: <11 (low), 11–15 (intermediate), and ≥ 15 (high). We then compared the reproductive performance of the first through third parity cows among the groups. The hazards of pregnancy by 200 days postpartum were higher in the high group than in the other groups (P < 0.05). Our findings demonstrate that between-lactation repeatability of AFC from first through third parity in dairy cows is very high, and that cows with an AFC of ≥ 15 have a better reproductive performance than cows with a low AFC.

Bilaterality of ovarian endometriomas does not affect the outcome of in vitro fertilization/intracytoplasmic sperm injection in infertile women after laparoscopic cystectomy

BackgroundTo assess whether the unilateral or bilateral lesions can affect ovarian reserve and pregnancy outcome in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in infertility patients underwent laparoscopic cystectomy. MethodsA total of 148 IVF/ICSI cycle in patients who had undergone laparoscopic cystectomy for unilateral or bilateral endometriomas were reviewed retrospectively. There were 103 cycles where laparoscopic cystectomy had been carried out for unilateral endometriomas and 45 cycles after bilateral-side surgery. Primary outcome measures were ovarian reserve and ovarian response. Secondary outcome measures were the implantation rate, clinical pregnancy rate, and live birth rate. ResultsThe number of dominant follicle on the day of human chorionic gonadotropin (hCG) administration (5.2 ± 3.1 vs. 4.2 ± 2.7; p = 0.048), and oocytes retrieved (10.0 ± 6.9 vs. 7.6 ± 6.6; p = 0.047) were significantly lower in the bilateral-side group compare with the unilateral-side group. However, the mean number of antral follicle count, metaphase II oocytes, the doses of gonadotropin used, fertilization rate, the rate of good quality embryos transferred, implantation rate and clinical pregnancy, live-birth rate and miscarriage rate were similar between the two groups. ConclusionThere were no associations among the bilaterality of ovarian endometriomas, ovarian reserve and pregnancy outcomes in IVF/ICSI cycles. However, bilateral ovarian endometriomas after laparoscopic cystectomy may impair ovarian response as compared to unilateral ovarian endometrioma.

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.

Effects of laparoscopic ovarian endometrioma surgery on the number of antral follicle count

The aim of this study was to investigate the impact of laparoscopic surgery for endometriomas on ovarian reserve as determined by ultrasonographic measurement of antral follicle count. Cross sectional, double blind, operated and non-nonoperated site comparative study. Twenty one women with previous history of laparoscopic surgery for unilateral ovarian endometriomas greater than to 30 mm in diameter were recruited. Removal of endometrioma was performed by laparoscopic ovarian tissue-sparing stripping technique. Ultrasound assessment of postoperative reduction in the ovarian antral follicle count (AFC). Twenty one women with comparable baseline characteristics were requested to undergone sonographic measurement of ovarian reserve marker. There was statistically significant difference in the mean number of antral follicles in the endometrioma-removed ovary (2.61 ± 1.24) when compared to the contra-lateral ovary (4.23 ±0.88)(student t test p<0,001). The results of this study suggest a negative impact of excision of endometriomas on ovarian reserve as evidenced by a significant postoperative fall in AFC in the operated site.

Laparoscopic ovarian cystectomy of endometriomas: surgeons’ experience may affect ovarian reserve and live-born rate in infertile patients with in vitro fertilization-intracytoplasmic sperm injection

Objective To assess whether the laparoscopist's experience can affect ovarian reserve and pregnancy outcome in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) patients who previously underwent laparoscopic conservative treatment for ovarian endometriomas. Study design One hundred and forty-nine IVF-ICSI cycles with infertile patients who previously underwent laparoscopic conservative treatment for ovarian endometriomas were enrolled. There were 76 cycles with an inexperienced surgeon and 73 cycles with an experienced surgeon. Results The number of antral follicle count (7.5 ± 3.8 vs. 9.6 ± 6.6; p = 0.011), and live-born rate per cycle (9.3% vs. 32.9%; p < 0.001) were significantly lower in the inexperienced group comparing with the experienced group. However, the mean number of oocytes, fertilization rate, mean number of embryos transferred, rate of good-quality embryos transferred, implantation rate and clinical pregnancy were similar between both groups. Conclusions The experience of the laparoscopist may affect ovarian reserve and live-born rate after treating ovarian endometrioma in infertile women with IVF-ICSI.

The experience of the surgeons affects ovarian reserve and pregnancy outcome after laparoscopic treatment of endometriosis in infertile patients with IVF/ICSI

OBJECTIVE: To assess whether the surgeon's experience can significantly affect ovarian reserve and pregnancy outcome in IVF/ICI patients who previously underwent laparoscopic treatment for endometriosis DESIGN: Retrospective study MATERIALS AND METHODS: We retrospectively reviewed all IVF/ICSI cycles with patients who previously underwent laparoscopic surgery for endometriosis from January 2005 through December 2008 in Chang Gung Memorial Hospital Linkou Medical Center. To clarify the impact of experience of the operators on the outcome of IVF/ICSI, we divided the surgeons into experienced and inexperienced surgeons. The main inexperienced surgeons were local clinical physicians, chief residents and fellow physicians. Antral follicle count, number of oocytes, good-quality embryos for transfer, clinical pregnancy rate, implantation rate and “take home” baby were analyzed. RESULTS: The number of antral follicle count, clinical pregnancy, and “take home” baby rate per cycle were significantly lower in the inexperienced group compared to the experienced group.Table 1Comparison of the Treatment Outcome Between the Two GroupsvariableInexperienced surgeonExperienced surgeonP valueCycles7673No. of oocytes retrieved10.1+6.49.2+6.9NSMature (MII) oocytes7.6+4.76.9+5.2NSNormal fertilization rate (%)64.4+21.763.5+22.5NSNo. of embryos transferred3.2+1.32.9+1.0NSGood-quality embryos for transfer (%)57.865.8NSImplantation rate (%)30/21938/205NSClinical pregnancy rate per cycle (%)26.341.1<0.001“take-home” baby rate per cycle (%)9.332.9<0.001 Open table in a new tab However, all other parameters, including mean number of oocytes, metaphase II oocytes, fertilization rate, the mean number of embryos transferred, implantation rate, and the rate of good quality embryos transferred were comparable among the two groups. CONCLUSIONS: The experience of the surgeons on laparoscopic surgery for endometriosis plays a detrimental effect on ovarian reserve and pregnancy outcome.

Morphogenesis of polycystic ovaries as assessed by pituitary–ovarian androgenic function

Despite polycystic ovaries (PCO) being a common morphology in women with polycystic ovary syndrome and regular menstruation, the regulatory principles in the morphogenesis of antral follicles have not yet been elucidated. In recognition of the complementary interaction between androgen-induced expression of the FSH receptor and FSH-augmented expression of the androgen receptor in granulose cells of antral follicles, a possible correlation of antral follicle count (AFC) and pituitary-ovarian androgenic function was investigated in 180 infertile women over days 3-5 of the menstrual cycle. Six discrete types of PCO with decreasing pituitary-ovarian androgenic function were identified: Type I (classical Stein-Leventhal syndrome), Type II (hyperandrogenemism), Type III (singular hyper-LH), Type IV (cryptic hyperandrogenism), Type V (relative LH dominancy) and Type VI (relative FSH dominancy), in parallel to a diminishing number of AFC from Type I to Type VI. Because during the early follicular phase of the cycle until the selection of the dominant follicle, antral follicles are composed of newly emerged healthy follicles plus atretic antral follicles that remain non-ovulated from previous cycles, it is proposed that the six types of PCO may represent the folliculogenetic spectra along which PCO morphogenesis proceeds.