Androgen concentrations in follicular fluid samples collected from patients undergoing in vitro fertilization (IVF) may provide useful clinical indicators. This study aimed to analyze possible associations of the androgen levels in follicular fluid and blood plasma in patients with diminished ovarian reserve (POR) in IVF programs. Cross-sectional study with a parallel group design, conducted in 2019–2021, enrolled 300 patients with infertility, aged 18–42 years, applying for assisted reproduction involving IVF/intracytoplasmic sperm injection and embryo transfer. The androgen profiles of blood plasma and follicular fluid were determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS). Androgen concentrations in blood plasma and follicular fluid, particularly those of dehydroepiandrosterone (DHEA-S), androstenedione and total testosterone, significantly correlated. The results implicate androgen levels in blood plasma and follicular fluid as early markers of POR in patients with infertility.
Study question is there correlation between the mtDNA copy number in cumulus cells and anti-Mullerian hormone level,female age, oocyte quality, embryo morphology, ploidy and blastocyst implantation rate? Summary answer A positive correlation of mtDNA quantity in CCs with the AMH,female age was revealed.There was no correlation between mtDNA quantity and embryo morphology,ploidy,implantation rate What is known already Recent studies have suggested that age-related decreased competence of oocytes may be due to low quantity of mtDNA copy number. Moreover, quantification of mtDNA in CCs may serve as an predictor of blastocysts viability. The purpose of this study is to investigate relative levels of mtDNA in the OCCCs in association with female age, ovarian reserve, embryo morphology, ploidy and blastocyst implantation rate. Study design, size, duration Prospective clinical study performed on 470 CCs retrieved from 72 advanced reproductive age patients undergoing ART treatment with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A). Out of the 130 obtained blastocysts 56 embryos were diagnosed as aneuploid, and 74 as euploid. Presently, 51 frozen euploid embryos were transferred (FET). All transferred euploid blastocysts (n = 51) divided into 2 groups: 1 group (n = 21) - implanted embryos, 2 group (n = 30) - non-implanted. Participants/materials, setting, methods Inclusion criteria: age 35-45years;BMI: 18 – 24,9kg/m2; FSH ≤15IU/ml; normal female/male karyotype; non-smokers. Exclusion criteria: genital endometriosis III-IV;severe extragenital pathology; polycystic ovary syndrome; chronic endometritis; > 96% of sperm with abnormal morphology (WHO criteria). MtDNA was assessed by using a quantitative real-time polymerase chain reaction technique. DNA from the trophectoderm samples were amplified and subjected to aneuploidy analysis using array comparative genomic hybridization. In statistic analysis was used Pearson’s correlation coefficients and Fisher’s exact test; p < 0.05 was considered significant. Main results and the role of chance The median age was 37.8 years old (range, 35–45), the mean level of anti-Mullerian hormone (AMH) was 2.66±1.09, and the mean body mass index was 22.3±1.5. A positive correlation of the relative level of mtDNA in the CCs with the patients' age (p = 0.008) and AMH levels (p = 0.003) was revealed. There was no statistically significant correlation between mtDNA copy number and embryo morphology on day 5 (p = 0.7). There was a tendency to increase mtDNA copy number in group 1 vs. group 2, 390 and 299, respectively (p > 0.05). In this study we didn’t find relationship between median mtDNA content of CCs and embryos ploidy (356 vs. 325, in euploid (n = 74) and aneuploidy (n = 56) blastocyst, respectively, p > 0.05). Limitations, reasons for caution Our study was carried out in a relatively small subset of participants and obtained embryos. Correspondingly, the results obtained cannot be readily extrapolated on other groups of patients and need to be confirmed in larger trials. Wider implications of the findings This study showed that mtDNA quantification in CCs isn’t a useful biomarker for prediction embryos implantation potential or ploidy. MtDNA content in CCs correlated only with female age and AMH level. Trial registration number *
The androgen deficiency and associated states represent is an important problem that affects the quality of women live. The most widely the androgen influence has been studied in the reproductive period in relation to polycystic ovary syndrome; however about laboratory methods to determine the impact of androgen deficiency and its clinical manifestation in the case of young women with a reduced ovarian reserve and with infertility are still actively discussed. Clinical medicine still needs generally approved markers of androgen deficiency states and its lower reference values. In this work we illustrate the perspective of measurements of steroid hormones panel to verify the diagnosis on the basis of high performance liquid chromatography with tandem mass spectrometry and immunochemical methods.
Androgens play a key role in the physiology of the female body and the reproductive system. Androgen receptor expression in the various tissues points to the importance of androgens in the regulation of the female sexual and social functioning. The study aimed to evaluate sexual functioning in women with infertility and diminished ovarian reserve (DOR) using the Female Sexual Functioning Index questionnaire (FSFI). A cross-sectional study of 496 patients with infertility and DOR assessed the degree of sexual dysfunction in conjunction with the changes in the androgenic profiles as indicated by the androstenedione levels in the blood serum. Women with infertility and DOR were significantly more likely to report changes in sexual functioning, including a decrease in libido and in the quality and frequency of sexual relations. Furthermore, patients with normal androstenedione levels generally significantly outscored patients with decreased androstenedione levels (average questionnaire scores 21.2 ± 7.2 and 15.17 ± 3.0 respectively), indicating a lesser degree of sexual dysfunction in the former group; on the other hand, the latter group reported increased pain and decreased attraction, arousal, lubrication, orgasm, and satisfaction. Hormonal profile changes in patients with DOR, including decreased androstenedione levels, significantly impact sexual functioning, and their detection in clinical practice will allow to objectify complaints at an earlier state in order to assess the severity of sexual dysfunction and determine further personalized management tactics.
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