Antral follicle assessment after down-regulation may be a useful tool for predicting pregnancy loss in<b><i>in vitro</i></b>fertilization pregnancies

Elter, Koray; Kavak, Zehra Neşe; Gökaslan, Hüsnü; Pekin, Tanju

doi:10.1080/09513590500099313

Cited by 32 publications

(21 citation statements)

References 5 publications

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“…Some studies show concern about the use of OV as a test of ovarian reserve and raised doubts on its reliability being evaluated by two-dimensional ultrasound [99, 100], leading some authors to recommend assessment by three-dimensional ultrasound in order to minimize interobserver variability [101–103]. Thus, OV alone should not be considered as a predictor of ovarian reserve, but we believe that because of its easy performance, it may be included as a routine in diagnostic procedures, adding information to the patient medical records and providing data for further study.…”

Section: Ultrasonographic Markersmentioning

confidence: 99%

Ovarian Reserve Assessment for Infertility Investigation

Carvalho¹,

Sobrinho²,

Vieira³

et al. 2012

ISRN Obstetrics and Gynecology

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The current trends to postpone motherhood and the increase in demand for assistance in reproductive medicine highlight the need for seeking guidelines for the establishment of individualized treatment protocols. Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, but they may occupy important place in initial counseling, predicting unsatisfactory results that could be improved by individualized induction schemes and reducing excessive psychological and financial burdens, and adverse effects. In this paper, we revise the role of hormonal basal and dynamic tests, as well as ultrasonographic markers, as ovarian reserve markers, in order to provide embasement for propaedeutic strategies and their interpretation in order to have reproductive success.

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Section: Ultrasonographic Markersmentioning

confidence: 99%

Ovarian Reserve Assessment for Infertility Investigation

Carvalho¹,

Sobrinho²,

Vieira³

et al. 2012

ISRN Obstetrics and Gynecology

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“…Typically, as a woman’s age increases, her ovarian reserve diminishes (“ovarian aging”); this is associated with reduced fertility. Among women undergoing assisted reproductive technology (ART), ovarian aging is also associated with a decreased response to ovarian stimulation protocols and lower pregnancy success rates (Elter et al 2005; Levi et al 2001). This diminished ovarian reserve is generally indicated by higher day-3 FSH levels and lower AFC and OV.…”

Section: Introductionmentioning

confidence: 99%

Urinary Paraben Concentrations and Ovarian Aging among Women from a Fertility Center

Smith¹,

Souter

Dimitriadis

et al. 2013

Environ Health Perspect

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Background: Parabens are preservatives commonly used in personal care products, pharmaceuticals, and foods. There is documented widespread human exposure to parabens, and some experimental data suggest that they act as estrogenic endocrine disruptors. As far as we are aware, no epidemiologic studies have assessed female reproductive health effects in relation to paraben exposure.Objective: We examined the association of urinary paraben concentrations with markers of ovarian reserve in a prospective cohort study of women seeking fertility treatment at Massachusetts General Hospital, Boston, Massachusetts.Methods: Measures of ovarian reserve were day-3 follicle-stimulating hormone (FSH), antral follicle count (AFC), and ovarian volume. Paraben concentrations [methylparaben (MP), propylparaben (PP), and butylparaben (BP)] were measured in spot urine samples collected prior to the assessment of outcome measures. We used linear and Poisson regression models to estimate associations of urinary paraben concentrations (in tertiles) with ovarian reserve measures.Results: Of the women enrolled in 2004–2010, 192 had at least one ovarian reserve outcome measured (mean age ± SD, 36.1 ± 4.5 years; range, 21.0–46.7 years). MP and PP were detected in > 99% of urine samples and BP in > 75%. We found a suggestive trend of lower AFC with increasing urinary PP tertiles [mean percent change (95% CI) for tertiles 2 and 3 compared with tertile 1, respectively, were –5.0% (–23.7, 18.4) and –16.3% (–30.8, 1.3); trend p-value (ptrend) = 0.07] as well as higher day-3 FSH with higher urinary PP tertiles [mean change (95% CI) for tertiles 2 and 3 compared with tertile 1 were 1.16 IU/L (–0.26, 2.57) and 1.02 IU/L (–0.40, 2.43); ptrend = 0.16]. We found no consistent evidence of associations between urinary MP or BP and day-3 FSH or AFC, or between urinary MP, PP, or BP and ovarian volume.Conclusions: PP may be associated with diminished ovarian reserve. However, our results require confirmation in further studies.Citation: Smith KW, Souter I, Dimitriadis I, Ehrlich S, Williams PL, Calafat AM, Hauser R. 2013. Urinary paraben concentrations and ovarian aging among women from a fertility center. Environ Health Perspect 121:1299–1305; http://dx.doi.org/10.1289/ehp.1205350

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“…Women with impaired ovarian reserve not only have reduced likelihood of pregnancy, but may also have a significantly increased miscarriage rates (6)(7)(8)(9)(10)(11)34). This is felt by some to be due to poorer oocyte quality and/or increased fetal aneuploidy rates (39)(40)(41)(42)(43)(44), although Abdalla and Thum were unable to confirm this association in their study (30).…”

Section: Other Potential Benefits Of Separating Age-related From Non-mentioning

confidence: 99%

“…There are significant consequences associated with the diagnosis, such as reduction in pregnancy rate, increased miscarriage rate (6)(7)(8)(9)(10)(11)34), and increased cost per delivery (31,(35)(36)(37).…”

Section: Should Screening Tests For Ovarian Insufficiency Be Abandoned?mentioning

confidence: 99%

A new approach to ovarian reserve testing

Sun

Stegmann

Henne

et al. 2008

Fertility and Sterility

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Objective-To critically examine ovarian reserve testing prior to assisted reproduction. Design-A PUBMED computer search to identify relevant literature. Setting-Multiple sites Interventions-Testing for ovarian reserve Main Outcome Measures-IVF and pregnancy outcomesResult(s)-The prevalence of ovarian insufficiency varies significantly for women aged 30-45 years. Generalization or averaging of threshold values across different aged women leads to very poor sensitivity, specificity, and positive predictive value for all tests of ovarian reserve. Because of the changing prevalence of ovarian insufficiency, there is no single, suitable threshold value for any screening test of ovarian reserve. Our analysis supports dividing impaired ovarian reserve into two groups: age-dependent ovarian aging (physiologic) and premature (non-physiologic) reductions in the oocyte pool. Interpretation of any screening test used requires that age is considered as a variable. To guide clinical interpretation of test results, we suggest using a nomogram of FSH values versus expected delivery rate-per-cycle-start with ART for a given age. Conclusions(s)-Proper interpretation of screening tests for ovarian insufficiency in couplesconsidering ART is important since the presence of impaired ovarian reserve is associated with a low likelihood of pregnancy. The condition of premature (non-physiologic) ovarian insufficiency warrants additional research. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. More than 100 years ago, population studies clearly documented a decrease in fertility with increasing age (1). In today's culture of widely available birth control and workforce equality, women often delay child-bearing to pursue a career. As a result, the childbearing age for women has been delayed from the 20's to the 30's and even into the early 40s (2). This societal shift has resulted in an increase in the number of women who are interested in fertility and have regular cycles, but who are subfertile due to a reduction in their oocyte (egg) supply. Recognition of the profound adverse effect of a reduction in oocyte supply on fertility led to the concept of ovarian reserve and the moniker of 'Diminished Ovarian Reserve' (DOR (5,13,14). NIH Public AccessThe pathophysiology associated with the age-related reduction in fertility (1) is a reduction in the oocyte pool accompanied by an increase in FSH due to reduced feedback from estrogen and inhibins (15). There are also reduced levels of hormones such as anti-Mullerian hormone (AMH) (16). Theoretically, in some women the reduction in the oocyte po...

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Antral follicle assessment after down-regulation may be a useful tool for predicting pregnancy loss inin vitrofertilization pregnancies

Cited by 32 publications

References 5 publications

Ovarian Reserve Assessment for Infertility Investigation

Ovarian Reserve Assessment for Infertility Investigation

Urinary Paraben Concentrations and Ovarian Aging among Women from a Fertility Center

A new approach to ovarian reserve testing

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