Evaluation Of Ovarian Reserve Research Articles

Evaluation of ovarian reserve and the assisted reproductive technology (ART) cycles’ outcome as well as the relapse rate within one year after ART in women with multiple sclerosis: a case-control study

ObjectiveTo compare the ovarian reserve and the results of infertility treatment, as well as to investigate the relapse rate in the first year after the assisted reproductive technology (ART) cycle in patients with multiple sclerosis (MS) referred to Royan Institute.Materials and methodsThis retrospective study was carried out to evaluate all women diagnosed with MS and referred to Royan Institute for assessment and treatment of possible infertility between 2011 and 2022. The control group consisted of randomly selected healthy women with tubal factor infertility who were referred for treatment during the same time period and matched in terms of age. A comparison was made between groups in terms of ovarian reserve and infertility treatment outcomes. Additionally, patients with MS who met the criteria were monitored via telephone to evaluate the symptoms, disability and relapse rate both pre- and post-ART.ResultsOver the course of a decade, the database documented a total of 60 cases diagnosed with MS. Upon examination of the records, it was found that in 27 patients only admission was done without any hormonal assessment or infertility treatment cycle and 5 patients proceeded with the intrauterine insemination cycle. Eventually, 28 women with MS underwent the ART cycle and all of them were treated with interferon beta, glatiramer acetate, or some oral disease modifying therapies. No statistically significant difference in terms of the basal levels of luteinizing hormone, follicle-stimulating hormone and anti-Müllerian hormone was found between the MS and control groups (P > 0.05). Two groups were comparable in terms of menstrual status. The study revealed that both groups exhibited similarities in terms of the controlled ovarian stimulation protocol and duration, the dosage of gonadotropin administered, as well as the ovarian response type, clinical pregnancy rate, and live birth rate (P > 0.05). After follow up, only 2 patients (9.5%) reported relapse of symptoms within one year after ART.ConclusionThe ovarian reserve and ovarian stimulation cycle and pregnancy outcomes following the ART cycle in MS patients were similar to the age-matched control group. The relapse rate of multiple sclerosis did not show a significant increase within a year following the ART cycle.

Evaluation of Knowledge and Attitudes of Female University Students about Ovarian Reserve Awareness and Technologies for Ovarian Reserve: A Cross-Sectional Study

Purpose: The aim of this study was to evaluate the knowledge and attitudes of female university students about ovarian reserve awareness and technologies for ovarian reserve. Materials and methods: This study was designed as a descriptive and cross-sectional study and was conducted on 660 female university students. The data were collected by using a questionnaire form based on the literature on ovarian reserve and related technologies. The mean, standard deviation and percentage distributions of the data obtained through the WEB page and face-to-face interview technique were analysed in the SPSS programme. Results: 86.2% of the students wanted to have children in the future and 75.8% planned to have children between the ages of 26-30. 56.7% of the students were aware of the availability of tests related to ovarian reserve and 86.6% of them demanded the development of new tests. In case of low ovarian reserve, 65.6% of the students stated that they could have children earlier, 68% could freeze their eggs, 51.2% could freeze their embryos, 73.8% could adopt a child and 84.7% could continue their work/education. Conclusion: It is remarkable that the majority of the students did not make any attempt for ovarian reserve evaluation although they wanted to have a child. Among the reasons for this situation, besides the fact that the students are still receiving education, they have false beliefs that their ovarian reserves will be sufficient at the age when they want to have children, that a healthy lifestyle and activity protect the ovarian reserve, and that they can have children with assisted reproductive techniques even if their ovarian reserves are low. It is important to evaluate the ovarian reserves of young women at an early stage in order for them to make a more conscious career and family planning.

Evaluation of ovarian reserve after different surgical techniques in management of endometrioma

Evaluation of ovarian reserve after different surgical techniques in management of endometrioma

The impact of chronic insomnia disorder on menstruation and ovarian reserve in childbearing-age women: A cross-sectional study.

Diminished ovarian reserve (DOR) is a disorder characterized by impaired ovarian function. Sleep disorders are disruptions of the circadian rhythm, which appears to be closely linked to reproductive systems. This study aimed to investigate the impact of poor sleep quality on the ovarian reserve of childbearing-age women. A cross-sectional study was conducted in China from June 2021 to March 2023. In total, 102 participants diagnosed with chronic insomnia disorder were included in the study. Questionnaires were administered to assess participants' menstrual patterns, insomnia severity, anxiety, and depression. The anti-Müllerian hormone level and the basal antral follicle count were measured for ovarian reserve evaluation. Correlation analysis and ordinal logistic regression analysis were conducted. The women with insomnia presented high percentages of hypomenorrhea, premenstrual syndrome, and dysmenorrhea (78.4%, 74.5%, and 46.1%, respectively). Severe sleep disorder in the past month was identified as an independent risk factor for hypomenorrhea and premenstrual syndrome (odds ratio [OR], 2.64 and OR, 2.688; p<0.05). The prevalence of DOR among women with insomnia (33.3%) was significantly higher than the average reported in previous studies for young women. Insomnia duration exceeding 1 year was determined to be an independent risk factor for DOR in women aged 36 to 40 years (OR, 4.5; p=0.033). This study highlights the association between sleep disorders and menstrual problems. Prolonged poor sleep quality in women aged 36 to 40 years was identified as a significant risk factor for DOR. We should pay more attention to improving sleep quality in order to maintain normal ovarian function.

Evaluation of ovarian reserve in women with thyroid autoimmunity.

To compare the ovarian reserve of women of reproductive age with and without thyroid autoimmunity (TAI). We performed a retrospective analysis of medical records from an assisted reproduction clinic from February 2017 to December 2021. Women aged between18 and 47 years with data on antithyroperoxidase and antithyroglobulin (anti-Tg) antibodies and assessment of ovarian reserve by anti-müllerian hormone (AMH) and antral follicle count (AFC) were included. Among the 188 participants included, 63 were diagnosed with TAI, and 125 had both antibodies negative. AMH and AFC were compared between groups. Subanalysis based on age, types of antibodies, and thyroid function markers were performed. In addition, bivariate analysis and regression models were used. Overall, there was no difference in the median levels of AMH or AFC between the two groups. However, in the subgroup analysis by age, we observed a trend towards lower median levels of AMH in women over 39 years with TAI (0.9 ng/mL vs. 1.5 ng/mL, p=0.08). In a subanalysis according to antibodies, we found a significantly lower median AFC in the group with anti-Tg than in the group without this antibody (8.0 follicles vs. 11.5 follicles, p=0.036). We also found a significantly higher prevalence of anti-Tg in patients with low ovarian reserve compared to those with normal reserve (60.7% vs. 39.3%, p=0.038). The ovarian reserve of women with TAI appears to be insidiously compromised over the years, with a decreased ovarian reserve in women with anti-Tg.

Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study

BackgroundThe aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases.Material and methodsThis case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared.ResultsThe mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D.ConclusionIn the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.

Iraqi experience in the assessment of anti-Müllerian hormone utilization in clinical practice: An overview

Abstract Anti-Müllerian hormone (AMH) is a dimeric glycoprotein, first recognized due to its action in male sex development. In women, it is synthesized by granulosa cells, pre-antral, and antral follicles; its main function in the ovary appears to be the inhibition of the early steps of folliculogenesis. Measurement of serum AMH made the assessment of ovarian reserve possible for more than 30 years. Its use has been expanded for many clinical implications, including assisted reproductive techniques, menopause, reproductive dysfunctions, the degree of ovarian damage/toxicity, and others. Numerous studies executed in this field concluded that AMH declines with aging; it has a positive correlation with oocyte yield in assisted reproduction; it is upregulated in polycystic ovarian syndrome and decreases in ovarian surgery and cancer therapy. This review aims to highlight the Iraqi experience in the implication of AMH assessment in clinical practice. We reviewed the PubMed database regarding the most recent literature in the assessment of AMH in Iraqi Clinical Practice; studies in polycystic ovarian syndrome (PCOS) patients were excluded. The review results show the importance of AMH assessment in many clinical fields especially for the evaluation of ovarian reserve of an infertile woman either to begin treatment strategists or follow-up patients and oncofertility counseling; yet studies must be encouraged in Iraq about it.

Effect of hypothyroidism on ovarian reserve status in Iraqi women: hormonal study

Background: Hypothyroidism is a clinical syndrome prevalent in women, even those of reproductive age. Ovarian reserve can be defined as the number and quality of follicles in the ovary at any given time. Evaluation of ovarian reserve is recommended for patients at risk of decreased ovarian reserve. Objective: This study aims to evaluate the effect of hypothyroidism on ovarian reserve in Iraqi women by hormonal measurements of serum anti-mullerian hormones AMH, FSH, and LH. Subjects and methods: This case–control study was carried out at the Department of Biochemistry, College of Medicine, University of Baghdad, in collaboration with Endocrinology and Diabetes Clinic, Baghdad Teaching Hospital, and National Center for Teaching Laboratories, Medical City, during the period from November 2021 to March 2022. This study involved 88 women, age range (20-40 years). Fifty-one of them [Group I (GI)] had primary hypothyroidism and were diagnosed by an endocrinologist based on clinical analysis and thyroid function tests, including serum TSH, T4 and T3. Patients with symptoms and signs suggestive of hypothyroidism and elevated TSH with T4 less than the reference level were considered overt hypothyroidism. While patients with elevated TSH with standard T4 and T3 were considered subclinical hypothyroidism 1 , serum thyroid peroxidase antibody (TPOAb) was used to differentiate hypothyroidism patients with Hashimoto`s disease 2 . Thirty-seven of the included women were healthy and served as a control group and referred to group II (GII). Results: The mean (±SD) value of serum AMH of hypothyroidism women was significantly lower than that of controls (p &lt; 0.0001). However, the mean value of AMH did not differ significantly between women who had overt and subclinical hypothyroidism, regular and irregular menstrual cycle, well and poorly controlled thyroid status, and who had positive and negative anti-TPO. The mean (±SD) value of serum LH of hypothyroidism women was significantly higher than that of the control group (p &lt; 0.004), while that of FSH did not differ significantly. Serum TSH levels positively correlated with LH levels (r=0.3, p 0.03). In addition, BMI values were significantly positively correlated with FSH levels (r= 0.3, p 0.04). Conclusions: This study suggested the need for serum measurement of AMH in women suffering from hypothyroidism. Keywords: hypothyroidism, ovarian reserve, AMH.

Ovarian reserve analysis in subfertile women based on physical, ultrasound and hormonal parameters

Purpose : Despite the availability of several markers for the evaluation of ovarian reserve, the correlation between the markers has not been reported clearly in the existing studies. Therefore, this study investigated the level of subfertility by comparing the physical parameters such as age and BMI in the subfertile women. In addition, the study compared the ultrasound and hormonal parameters with the physical parameters in subfertile women. Methods : A total of 200 subfertile patients presented to outpatient department were considered in this study. The selected candidate was 29 to 39 years old and was investigated after two years of unprotected sexual intercourse. A consecutive enumerative sampling method has been employed for data collection. The collected data are processed to determine correlation and regression coefficients using Statistical Package for Social Sciences (SPSS) version 20.0. Results : The results revealed that follicle stimulating hormone (FSH) level and anti-Mullerian hormone (AMH) values varied among the above 30 age group of respondents with BMI values 25–30. There is no relationship between the respondents’ right and left ovarian volume by comparing age within BMI. Conclusion : In conclusion, there is a strong relationship between the FSH level, AMH and physical parameters age and BMI. The reproductive age of women will be older than or younger than the actual age of the women. The reproductive age will be calculated with the ovarian volume, ovarian reserve, ovary size and time to menopause.

P-616 Evaluation of salivary ELISA for Oestradiol and Progesterone monitoring in IVF patients

Abstract Study question How do salivary E2 and P correlate with serum determinations across ovarian stimulation (OS) for IVF and artificial endometrial preparation cycles for embryo transfer? Summary answer Saliva-blood correlations were higher for E2 than for P. E2 saliva-blood ratios were patient-dependent. High serum P cases on trigger day could be identified. What is known already Steroid hormone concentrations in saliva are lower than in serum, even if the hormone is predominantly free. Therefore, quantitative assays need to be as sensitive as possible. Saliva-based assessments are a reliable and proven method for quantifying female hormone levels in premenopausal women during the natural cycle while being very precise and painless for patients. However, the cumulative experience in ovarian stimulation is relatively low. A recent study including 652 pairs of saliva-serum E2 samples reported correlations between 0.68 and 0.91, while 237 pairs of samples for P showed correlations ranging from -0.02 to 0.22 (Sakkas et al, 2020). Study design, size, duration Prospective cohort study including 300 saliva-blood pair samples from 120 patients undergoing OS for IVF (n = 90) or artificial endometrial preparation for embryo transfer (n = 30) between February and October 2022. Data were collected at each of 3 points of OS: early (days 1-5), mid (days 6-9), and trigger. Patients following endometrial preparation collected just one sample on the day of embryo transfer Participants/materials, setting, methods Thirty expected poor responders, 30 normal, and 30 expected high responders according to ovarian reserve evaluation were included. Two saliva samples per blood sample were collected: immediately after waking up, and at the clinic just before or after the blood sample was taken. Saliva samples were stored at -20ºC and shipped to Mint Diagnostics (Kent, UK) for analysis of salivary E2 and P4 Main results and the role of chance Saliva-blood E2 correlations (Spearman) were 0.68 (fasting) and 0.69 (clinic). 72% of individuals showed saliva-serum correlations &amp;gt; 0.8. Correlations improved when controlling for subgroup (low, normal, high responders). P4 saliva-blood correlations (Spearman) were 0.44 (fasting) and 0.29 (clinic). 41% of individuals showed correlations &amp;gt;0.8 on fasting samples, and 33% on clinic samples. There was a high variance of individual correlations (0-1), which were dependent on ovarian response subgroups (p &amp;lt; 0.05). A multivariable approach was developed to identify patients with a serum P4&amp;gt;1.5 ng/mL the day of trigger (n = 11) with clinic samples showing 81% sensitivity and 91% specificity and fasting samples showing 83% and 91% respectively demonstrating the possibility of shifting hormone analysis to the home rather than the clinic. Eighteen of 30 (60%) saliva samples collected on the day of ET on patients under hormonal replacement therapy showed values out of the assay range (&amp;gt;5000 pg/mL). Therefore, no correlations could be estimated. Limitations, reasons for caution Detection of patients with high P4 on the day of trigger was limited due to a short number of cases. No conclusions could be drawn in HRT patients for embryo transfer due to high salivary P4 values. Wider implications of the findings The current study shows that salivary monitoring of E2 and P4 is feasible. This more friendly non-invasive method could allow frequent hormone monitoring without the need for appointments at the clinic and for phlebotomy, thus resulting in more convenience for both the clinics and the patients. Trial registration number NCT05184777

Evaluation of ovarian reserve in young females with non-iatrogenic ovarian insufficiency to establish criteria for ovarian tissue cryopreservation

Research questionCan ovarian reserve parameters predict the outcome of ovarian tissue cryopreservation (OTCP) in patients ≤18 years with non-iatrogenic premature ovarian insufficiency (POI)? DesignRetrospective cohort analysis carried out in a single tertiary hospital between August 2010 and January 2020. Thirty-seven patients ≤18 years with non-iatrogenic POI (27 with Turner syndrome, six with POI of unknown aetiology, three with galactosemia and one with blepharophimosis, ptosis, epicanthus inversus syndrome) were included. Three parameters were used to evaluate ovarian reserve: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and transabdominal antral follicle count. Fertility preservation (most commonly OTCP) was offered if ovarian reserve was diminished and one or more parameters was positive. Follicles were counted in ovarian samples obtained at the time of OTCP. ResultsOvarian reserve was diminished in 34 patients and 19 of them had one or more positive parameter. Fourteen (11 aged ≥12 years and 3 aged <12) underwent OTCP, one (14 years old) underwent ovarian stimulation and oocyte cryopreservation and four declined fertility preservation. Follicles were detected in 11 of 14 patients who underwent OTCP with one or more positive parameters (79%), and in all those (100%) who had two or three positive parameters. The median number of follicles was 27 (range 5–64) and 48 (range 21–75) in patients ≥12 years and those <12 years, respectively. ConclusionThis study shows that if OTCP is performed in patients with one or more positive parameters of ovarian activity, a 79% positive predictive value is achieved for the detection of follicles. The incorporation of this criterion for OTCP will minimize the risk of harvesting ovarian tissue with a low number of follicles.

Candidates selection for oocyte donation in a public gamete bank-Predictive value of the anti-Müllerian hormone.

Infertility treatments with oocyte donation are becoming frequent. Recruitment of oocyte donors is a demanding and costly process and therefore of crucial importance. The selection of the oocyte donors undergoes a rigorous evaluation process of the candidates with routine measurement of the anti-Müllerian hormone (AMH) levels (ovarian reserve test). Our aim was to assess whether AMH levels could act as a good marker as tool to select the donor candidates and correlate them with the ovarian response to stimulation with a gonadotropin-releasing hormone antagonist protocol as well as to identify and validate the appropriate AMH level threshold by correlating it with the number of oocytes retrieved. A retrospective analysis of the oocyte donors' clinical records was performed. The mean age of the participants was 27 years. The ovarian reserve evaluation showed a mean AMH of 5.20 ng/mL. An average number of 16 oocytes was retrieved (12 mature oocytes MII). AMH levels showed a statistically significant positive correlation with the number of total oocytes retrieved. A threshold value of AMH = 3.2 ng/mL predictive of the retrieval <12 oocytes (areas under the curve, 0.7364; 95% confidence interval: 0.529-0.944) was identified by receiver operating characteristic curve. Using this cutoff, the normal response (12 oocytes) was predicted with a sensitivity of 77% and a specificity of 60%. The measurement of AMH may be a determining factor in the choice of the oocyte donor candidates to maximize the response to requests from beneficiaries who require donor oocytes to perform assisted reproductive technique cycles.

EVALUATION OF AT-HOME SERUM ANTI-MULLERIAN HORMONE TESTING: A HEAD-TO-HEAD COMPARISON OF TWO SELF-ADMINISTERED BLOOD COLLECTION DEVICES

For optimal fertility testing, serum AMH levels are used in combination with other testing to provide a reliable ovarian reserve evaluation. The use of the ADx 100 card is widely commercially available for at-home reproductive hormone testing due to its reported accuracy(1); however, data demonstrating that its results are reproducible outside of a clinical setting are limited. Compared to the ADx card, the TAP II device benefits from less invasive needles and the ability to collect blood in a tube, rather than in desiccated and reconstituted form.

Evaluation of ovarian reserve at late reproductive age

Although follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), antimullerian hormone (AMH), and ovarian volume are commonly used to assess ovarian reserve and ovarian response to stimulation, no test directly indicates this. We aimed to observe how ovarian reserve tests help us in the diagnosis and treatment of women of late reproductive age. We included 190 patients in this prospective cohort study. We took FSH, LH, E2 and AMH blood samples on the third day of menstruation to biochemically evaluate the ovarian reserve of the patients who were planned for hysterectomy and bilateral salpingo-oopherectomy at late reproductive age. We recorded antral follicle counts (AFC) and ovarian volumes by transvaginal ultrasonography for ultrasonographic evaluation and weighed ovarian weights postoperatively. The data of 190 women aged 39-44.9 years revealed that AMH and ovarian volume, ovarian volume and AFS show significant positive correlations, whereas FSH, LH, and E2 levels do not indicate a significant relationship with AFS. AMH, ovarian volume and ovarian weight, and AFC may show us the ovarian reserve with the highest reliability in women of late reproductive age.

Investigating genetic predisposition to premature decline in ovarian reserve

Introduction. Normal ovarian reserve (OR) determining the ovarian response to follicle development containing fully-featured oocytes is an important factor in pregnancy, including assisted reproductive technology (ART) programs. The causes of premature OR decrease are multifactorial. The study of gene polymorphism as a cause of the premature OR decrease deserves attention.Aim: to determine genetic predisposition to premature OR decrease and create a prognostic model based on study results.Materials and Methods. A retrospective comparative cohort study was conducted. A total of 200 reproductively active patients with infertility underwent ART were examined. The patients were divided into 2 groups: Group 1 included 100 patients with a premature OR decrease; Group 2 consisted of 100 patients with a normal OR. All patients underwent molecular genetic study. Genetic polymorphisms of the genes ESR1, ESR2, FSHR, CYP19A were studied.Results. The final clinical phenotype is shaped by multiple factors – genetic and environmental. Several genetic variants contribute to the formation of premature decrease in ovarian reserve. Gene combination of CYP19A1 and FSHR displayed the greatest synergistic effect, potentiating each other and predisposing to a poor ovarian response as part of stimulated superovulation.Conclusion. Identifying genetic markers is a promising method for individual OR evaluation, including its premature decline. Multilocus analysis and a prognostic model based on combining several polymorphic gene variants will allow to assess risks of premature OR decrease and individualize ART programs.

P-587 Does iron overload affect ovarian reserve? - A 10-year longitudinal study of evaluation of ovarian reserve in women with transfusion-dependent beta thalassaemia major

Abstract Study question Does iron overload affect ovarian reserve markers in women with transfusion-dependent beta thalassaemia major? Summary answer Ovarian reserve markers were lower in women with transfusion dependent beta thalassaemia major as compared to controls suggesting an impact of iron overload on ovary What is known already Although spontaneous fertility and successful pregnancies have been reported in well-chelated and transfused women with beta thalassaemia major (BTM), majority of women are subfertile due to hypogonadotropic hypogonadism (HH). Little is known about the effect of iron overload on ovarian follicles and whether ovarian reserve is affected by the disease or treatment status. Study design, size, duration This study compares the markers of ovarian reserve in women with transfusion-dependent beta thalassaemia major over a period of ten years with healthy women from a control population. It is a 10-year mixed (retrospective and prospective) longitudinal study in 17 women with transfusion-dependent beta thalassaemia major from thalassaemia clinic in a tertiary teaching hospital between July 2007 to June 2017. The results were compared with 52 age-matched healthy women without any medical conditions (control population). Participants/materials, setting, methods Study compared 17 women with transfusion-dependent beta thalassaemia major with 52 age-matched healthy women without any medical conditions attending fertility clinic. Patient demographics, medical history, menstrual history, hormonal parameters (serum levels of FSH, estradiol, TSH and AMH) and antral follicle count (AFC) were recorded in all women from both groups. Serum levels of ferritin, cardiac T2*, liver iron concentration, thyroid function (TSH) and liver function test results were also recorded at three different time points. Main results and the role of chance Serum AMH levels, estradiol levels and antral follicle count were significantly lower in women with beta thalassaemia major compared with the control group (p &amp;lt; 0.05 for all). Low AMH levels were noted in both groups of women (with and without hypogonadotropic hypogonadism) with a background of beta thalassaemia major. Due to part retrospective nature of study, bias arising from patient selection and completeness of information available from medical records cannot be entirely ruled out. Limitations, reasons for caution The sample size was small, and bias cannot be entirely ruled out due to part retrospective nature of the study. We could not verify how many of the BTM women with amenorrhoea needed induction of puberty with certainty. Wider implications of the findings The belief that the gonad might be spared from effects of transfusional iron overload in women with BTM is questionable. Ovarian reserve markers were significantly lower in women with transfusion dependent BTM compared to controls. Further studies are required to elucidate mechanisms by which iron overload can adversely affect ovaries. Trial registration number Not applicable

Comparative advantage of anti-Mullerian hormone over other ovarian reserve metric (basal hormonal test) in prediction of fertility in women with varying menstrual cycle

Objective: Anti-Mullerian hormone has been indicated as a novel biomarker for ovarian reserve assessment. This study aimed to determine the comparative advantage of serum levels of AMH, FSH, LH, E2, and LH/FSH ratio among women with varying menstrual cycles and duration of menstruation. Material and Method: A total of 90 subjects, which consisted of sixty subjects and thirty healthy subjects as control, were recruited. Blood samples were collected on day 3 of the menstrual cycle and evaluated for ovarian markers using the ELISA technique. All data were analyzed using SPSS version 23.0. Results: AMH and LH/FSH levels were lower in women with varying menstrual cycles than in the control group. FSH, LH, and E2 levels were significantly higher in women with varying menstrual cycles and flow duration than in the control group(P&lt;0.05). AMH was negatively correlated with age (r= -0.72), BMI( r= -0.4), FSH(r= - 0.3), LH(r = -0.2) (p&lt;0.05) and E2(r= -0.2, p&gt;0.05). Also age was positively correlated with FSH(r=0.5,p&lt;0.05), E2(r=0.3, p&lt;0.05) and BMI(r=0.4, p&lt;0.05). The level of AMH was not significant with cycle length and days of flow(p&gt;0.05). This implies that AMH can be measured independently of the cycle phase. This show that AMH was lower in women with varying menstrual cycle with an increase in gonadotrophin and E2. The strong negative relationship between age and AMH implies that age is determining factor of ovarian reserve. Conclusion: AMH combined with age and FSH may improve ovarian reserve evaluation, making AMH a better marker

Evaluation of Ovarian Reserve among Newly Diagnosed Hashimoto’s Thyroiditis Related Subclinical and Overt Hypothyroid Reproductive Women: A Cross-sectional Study

Introduction: Thyroid autoimmunity is amore common autoimmune disease among reproductive women. It is proposed that, thyroid peroxidase antibodies pass through the blood follicle barrier during follicular development which damages the growing follicles and oocytes. Previous studies have demonstrated the association between thyroid autoimmunity and ovarian failure. Serum Anti-Müllerian Hormone (AMH) levels are used as a marker of ovarian reserve in clinical practice. Aim: To evaluate ovarian reserve among newly diagnosed Hashimoto’s Thyroiditis (HT) related subclinical and overt hypothyroid women. Materials and Methods: A cross-sectional study was conducted at the Department of Biochemistry, Government Medical College Nalgonda, Telangana, India, from August 2020 to July 2021. The study included 180 subjects, 60 in each Overt Hypothyroid (OH group), Subclinical Hypothyroid (SCH group) and Euthyroid subjects (EU group). Socio-demographic details and other parameters age, Body Mass Index (BMI), AMH, Thyroid Stimulating Hormone (TSH), free T4 (fT4), Thyroid Peroxidase Antibodies (TPOAb), Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Antral Follicular Count (AFC) were evaluated and compared in all the three groups. The above data were recorded and analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and the Analysis of Variance (ANOVA) test, Chi-square test, and Spearman’s correlation test were performed for statistical analysis. Results: The median age, BMI, and total AFC were not statistically significant (p-value &gt;0.05). Serum TPOAb levels were significantly (p-value &lt;0.001) high in the OH group and SCH group when compared to the EU group. The AMH levels were significantly (p-value=0.015) high inthe EU group compared to the OH group, but there were no statistically significant differences among other groups. The AMH values were negatively correlated with age among all the three groups. There was no significant correlation between AMH and other parameters analysed among different groups. Conclusion: The AMH levels were significantly low in the OH group when compared to the EU group. There were no statistically significant differences among other groups. Age was found to be an independent factor for low AMH levels among all the three groups.

Ovarian cortex freezing as a method of fertility preservation in endometriosis: A case report

BackgroundEndometriosis affects women in many ways from infertility until reducing ovarian reserve. In women who do not want to immediately conceive, ovarium cortex cryopreservation may be an option for preserving fertility. Case presentationTwo patients with chief complaints dysmenorrhea and abdominal enlargement, then checked Anti-Mullerian Hormone (AMH) level and Ca-125 level. Patient underwent transrectal ultrasonography, with the result of endometriosis cyst (sized 12 × 9x3 cm and 7 × 10 × 11 cm for first patient, while second patient had 18 × 10 × 14 cm). Then patients underwent cystectomy and ovarian cryopreservation. Histopathology results revealed endometriosis cyst, with different results of follicle density on the healthy cortex. Patient have an AMH level of 1.82 ng/mL before surgery and may decline after surgery. From the AMH normogram, the patient is below the 25th percentile and almost below the 10th percentile, and her biological age is 34. Normal histopathology result of the ovarian cortex suggested that 1.8 to 166 follicles per mm3 cortical tissue. DiscussionWe can see from the histopathology examination the density of the follicle was less than normal in this patient. Patients that suffer from endometriosis may have a low ovarian reserve even before surgery. A thorough consultation, followed by ovarian reserve evaluation, disease progression and recurrence of disease are needed to be monitored closely. ConclusionFrom all the methods of fertility preservation, we concluded that this patient is most suitable for ovarian cortex freezing.

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.