The percentage of follicles that effectively respond to FSH by reaching pre-ovulatory maturation is negatively and independently related to serum AMH levels. Although the mechanisms underlying this finding remain unclear, it is in keeping with the hypothesis that AMH inhibits follicle sensitivity to FSH.
The objective of this study was to assess the reproductive competence of oocytes obtained by follicular flushing in poor responder patients. This prospective comparative study, at the University of Paris XI, Assistance Publique des Hopitaux de Paris, INSERM Unit 782, was performed on 165 infertile IVF embryo transfer candidates. A total of 271 consecutive minimal stimulation IVF cycles were studied. Oocyte retrieval was performed 34 h after human chorionic gonadotrophin administration and oocytes were allocated into two groups according to their retrieval method: oocytes obtained in the first follicular aspiration (FA, n = 127); and oocytes retrieved in the subsequent follicular flushing (FF, n = 102). The principal outcome was to evaluate clinical pregnancy and embryo implantation rates. Thus, patient characteristics, fertilization rate and clinical pregnancy rate per oocyte were comparable in both of groups. In contrast, embryo morphology (41 versus 59%, P < 0.01) and implantation rates (20.4 versus 34.8%, P < 0.04) were better in the FF group. In conclusion, an optimal reproductive competence was observed in oocytes retrieved by follicular flushing in minimal stimulation IVF in poor responder patients.
Objective: The aim of the present prospective study was to evaluate which ovarian reserve marker would be more reliable as the quality of the A + B embryos (day 3 and blastocyst). Methods: We ran a prospective study with 124 infertile women, aged 24-48 years, from 2017 to 2018. The patients were divided into 3 groups according to age and the subgroups were compared for AMH, AFC, number of A+B embryos. New division of the 3 groups was performed based on the AMH, and the subgroups were compared for age, AFC and number of A+B embryos. Finally, we divided the patients into 3 groups, based on the AFC, and we compared the subgroups for age, AMH and number of A+B embryos. P<0.05 was considered statistically significant. Results: When the 124 patients were divided according to age, we found a significant fall in an A+B embryo quality (day3; blastocyst) after 35 years (p<0.038; p<0.035), and more severely after 37 years (p<0.032; p<0.027). When the 124 patients were divided according to AMH, there was a significant fall in A+B embryo quality (day 3; blastocyst), with AMH<1ng/ml (p<0.023; p<0.021). When the 124 patients were divided according to AFC, there was a significant fall in A+B embryo quality (day 3; blastocyst) with AFC<7 (p<0.025; p<0.023). These markers had significant associations with embryo quality (p<0.005). Conclusion: Age, AFC and AMH have significant associations with A +B embryo quality on day 3 and blastocyst.
Objective:
This study aimed to evaluate the effects of three different luteal phase
support protocols with estrogen on the pregnancy rates and luteal phase
hormone profiles of patients undergoing
in vitro
fertilization-embryo transfer (IVF-ET) cycles. A secondary objective was to
evaluate which ovarian reserve markers correlated with pregnancy rates.
Methods:
This retrospective observational study was carried out at a private tertiary
reproductive medicine teaching and research center. The study enrolled 104
patients undergoing intracytoplasmic sperm injection (ICSI) on an antagonist
protocol for controlled ovarian hyperstimulation (COH). The women were
divided into three groups based on the route of administration of estrogen
(E2) for luteal phase support: oral (Primogyna); transdermal patches
(Estradott); or transdermal gel (Oestrogel Pump). The administration of
estrogen provided the equivalent to 4 mg of estradiol daily. All women
received 600mg of vaginal progesterone (P) per day (Utrogestan) for luteal
phase support. Blood samples were drawn on the day of hCG administration and
on the day of beta hCG testing to measure E2 and P levels. Clinical
pregnancy rate (PR) was the main endpoint.
Results:
The patients included in the three groups were comparable. No significant
differences were found in implantation rates, clinical PR, miscarriage
rates, multiple-pregnancy rates, E2 or P levels on the day of beta hCG
measurement. Concerning ovarian reserve markers, significant correlations
between testing positive for clinical pregnancy and AMH (r = 0.66
,
p
<0.0001) and E2 levels on beta hCG measurement day (r =
0.77;
p
<.0001) were observed.
Conclusions:
No significant differences were seen in the pregnancy rates of patients
submitted to IVF-ET cycles with GnRH antagonists given oral, transdermal
patches, or transdermal gel E2 during the luteal phase. A correlation was
found between clinical pregnancy rate and AMH and E2 levels on beta hCG
testing day.
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