Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Fleming, Richard; Seifer, David B.; Frattarelli, John L.; Ruman, Jane

doi:10.1016/j.rbmo.2015.06.015

Cited by 227 publications

(177 citation statements)

References 121 publications

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“…Usually, both of these parameters have been shown to decrease with aging [35]. But we confirmed significant improvements in these parameters after DHEA supplementation.…”

Section: Discussionsupporting

confidence: 60%

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Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis

Zhang

Niu

Wang

et al. 2016

J Assist Reprod Genet

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Purpose We reviewed the influence of dehydroepiandrosterone (DHEA) supplementation in patients with poor ovarian response (POR) undergoing in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). Methods We searched Embase, MEDLINE, PubMed, and the Cochrane Library for relevant papers and used the Newcastle-Ottawa Scale scoring system to evaluate study quality. Dichotomous data were expressed as pooled relative risk (RR) estimates with fixed or random effect models. Continuous variables were expressed as the weighted mean difference (WMD). All data were analyzed using Revman Software v. 5 and are shown with 95 % confidence intervals (CI). Results Twenty-one studies met the inclusion criteria. DHEA pretreatment increased the clinical pregnancy rate (RR 1.53, 95 % CI 1.25-1.86), live birth rate (RR 1.87, 95 % CI 1.22-2.88), implantation rate (RR 1.56, 95 % CI 1.20-2.01), and antral follicle count (WMD 0.4, 95 % CI 0.14 to 0.66) while reducing miscarriages (RR 0.50, 95 % CI 0.27-0.90). After subgroup analysis, oocyte numbers and anti-Müllerian hormone levels were also enhanced after DHEA treatment. However, the endometrial thickness and estradiol levels on the day of injecting hCG to induce ovulation were similar between the DHEA supplementation groups and controls. Conclusions Based on the limited available evidence, DHEA supplementation seems to improve ovarian reserves and IVF/ ICSI outcome in patients with POR. Further research is required to clarify the effect of DHEA exposure in assisted reproduction technology.

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“…Usually, both of these parameters have been shown to decrease with aging [35]. But we confirmed significant improvements in these parameters after DHEA supplementation.…”

Section: Discussionsupporting

confidence: 60%

“…Because decreases in ovarian reserve markers are correlated with increased age [35], some articles divided women into groups according to age. Therefore, our meta-analysis divided these studies into subgroups to reduce heterogeneity.…”

Section: Ovarian Reserve Markersmentioning

confidence: 99%

Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis

Zhang

Niu

Wang

et al. 2016

J Assist Reprod Genet

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“…In the past ovarian biopsy has been required to clarify a diagnosis of ROS, but nowadays many non-invasive approaches are helpful in proving the presence of antral follicles. It is well known that antral follicles as small as 2 mm in diameter can be visualized by high-resolution transvaginal ultrasonography [7]. Furthermore, hormone biomarkers such as inhibin B and AMH have been suggested to have a diagnostic role in women with ROS [4, 7], which are secreted by granulosa cells of growing follicles and closely related to ovarian reserve.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that antral follicles as small as 2 mm in diameter can be visualized by high-resolution transvaginal ultrasonography [7]. Furthermore, hormone biomarkers such as inhibin B and AMH have been suggested to have a diagnostic role in women with ROS [4, 7], which are secreted by granulosa cells of growing follicles and closely related to ovarian reserve. In the report of Arici et al, Inhibin B has a diagnostic role in two women with ROS who manifested by secondary amenorrhea, high gonadotropin level but normal inhibin B level and normal primordial follicles after ovarian biopsy, while AMH level was not measured [4].…”

Section: Discussionmentioning

confidence: 99%

Successful live birth in a woman with resistant ovary syndrome following in vitro maturation of oocytes

Pan

Yuan

et al. 2016

J Ovarian Res

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BackgroundResistant ovary syndrome (ROS) is a rare endocrine disorder characterized with hypergonadotrophic hypogonadism. Infertility is a common complaint of woman presenting with ROS, and little progress has been made in term of reproduction with the patient’s own gamete. So far only one case report of live birth has been reported after in vitro maturation (IVM) of oocytes in a patient suffering from ROS in 2013.Case presentationA secondary infertile woman of 33 years-old was manifested with oligomenorrhea and markedly increased gonadotropin levels around postmenopausal range, but had normal antral follicle count, normal serum inhibin B and anti-Müllerian hormone levels. She had normal karyotype of 46,XX and normal thyroid function. There were no abnormal findings in some autoantibody assays and FSH receptor sequencing. After oral contraceptive pills combined with triptorelin depot were administered, her gonadotropin levels reduced but it showed no response to high doses of exogenous gonadotropins (hp-HMG 300IU/d for 15 days). Then endometrium was prepared with estradiol valerate and IVM from small antral follicles were performed. Five immature oocytes were retrieved. Twenty-four hours after IVM culture, 3 oocytes matured to metaphase II stage and were inseminated by intracytoplasmic sperm injection using her husband’s sperm. Two top-quality embryos were transferred and one embryo was cryopreserved. The patient got pregnant and delivered a healthy boy at term.ConclusionIVM using their own oocytes could be an available treatment for infertile women with ROS.

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“…In addition, the statistical model developed evidenced that the decrease in plasma AMH concentrations with age is more marked in the low AFC group compared with the high one. In this regard, AFC and AMH are widely used to predict ovarian reserve and ovarian response to controlled stimulation with exogenous gonadotropins for assisted reproductive technologies (ARTs) treatments (La Marca et al 2007, Aflatoonian et al 2009, Fleming et al 2015; moreover, a better prediction of ovarian responsiveness is achieved when using AMH, AFC, and age together (Brodin et al 2015). Taken together, these results immediately suggest that high AFC and AMH concentrations in the early prepubertal period may represent a precocious marker of the ovarian reserve of a given individual, considering that the quantity and quality of non-growing follicles in the ovary is positively associated with the number of growing follicles, plasma AMH concentrations, and reproductive life-span .…”

Section: Discussionmentioning

confidence: 99%

Postnatal pituitary and follicular activation: a revisited hypothesis in a sheep model

Torres-Rovira¹,

Succu²,

Pasciu³

et al. 2016

Reproduction

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The importance of postnatal pituitary activation as regards female reproductive development is not yet understood. By taking advantage of the experimental model developed in a previous study, i.e. ewe lambs expressing markedly different ovarian phenotypes at 50 days of age, we designed this study to determine whether differences found in ovarian status during the early prepubertal period are due to different patterns of postnatal pituitary activation, and to assess whether these differences have long lasting effects on subsequent reproductive performance. Results showed that ewe lambs with high antral follicle count (AFC) at 50 days of age had significantly lower plasma FSH concentrations and higher anti-Mullerian hormone (AMH) concentrations during the first 9 weeks of age compared with low AFC ewe lambs (P!0.0001). With a longitudinal experiment we showed that a high AFC in the early prepubertal period is associated with consistently higher AMH concentrations and numbers of antral follicles up to the postpubertal period, and with higher pregnancy rates in the first breeding season. In addition, the effect of age in decreasing AMH concentrations was more marked in the low AFC group. Results of the present study demonstrate that ewe lambs undergo different patterns of postnatal pituitary activation. A high AFC at 50 days of age indicates an advanced phase of ovarian maturation, which was accompanied by constantly higher AMH concentrations up to the postpubertal period, a greater ovarian response to FSH stimulation and by higher pregnancy rates at first mating, as compared with the low AFC group.

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Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Cited by 227 publications

References 121 publications

Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis

Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis

Successful live birth in a woman with resistant ovary syndrome following in vitro maturation of oocytes

Postnatal pituitary and follicular activation: a revisited hypothesis in a sheep model

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