Differential rate in decline in ovarian reserve markers in women with polycystic ovary syndrome compared with control subjects: results of a longitudinal study

Ahmad, Asima; Kao, Chia-Ning; Quinn, Molly M.; Lenhart, Nikolaus; Rosen, Mitchell P.; Cedars, Marcelle I.; Huddleston, Heather G.

doi:10.1016/j.fertnstert.2017.11.012

Cited by 20 publications

(17 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The age-related decline in ovarian features, such as FNPO and OV, has been well documented in control women with normal reproductive health (20). Recently, two studies using longitudinal designs have documented the decline in ovarian parameters in women with PCOS and controls using measurements from a single plane (21) or whole ovary (22). Given the known decline in both FNPO and OV with aging, we hypothesized that accounting for age in the ovarian ultrasound thresholds would provide improved diagnostic performance.…”

Section: Discussionmentioning

confidence: 99%

Improved diagnostic performance for the diagnosis of polycystic ovary syndrome using age-stratified criteria

Ahmad

Quinn

Kao

et al. 2019

Fertility and Sterility

Self Cite

View full text Add to dashboard Cite

Controlswere from the Ovarian Aging (OVA) study (2006)(2007)(2008)(2009)(2010)(2011), a longitudinal study including healthy women with regular menstrual cycles. Intervention(s): Clinical data collection. Main Outcome Measure(s): Follicle number per ovary (FNPO) and ovarian volume (OV). Result(s): A total of 245 subjects with PCOS and 756 OVA study subjects were included in the FNPO analysis and had a mean (AE SD) FNPO of 22.6 AE 12.4 and 10 AE 5.3, respectively. Receiver operating characteristic curves were created for both FNPO and OV and analyzed across age group categories (25 to <30, 30 to <35, and 35 to <40 years). Youden's and minimum distance (d) were used to compare efficacies of FNPO and OV thresholds. The optimal threshold for distinguishing PCOS from OVA controls was FNPO > 13. There was a decreasing trend in FNPO threshold with increasing age group (>15, >14, and >12, respectively). A total of 297 PCOS subjects and 756 OVA study subjects were included in the OV analysis and had a mean maximum OV of 10 AE 5 cm 3 and 6.5 AE 5 cm 3 , respectively. The overall threshold was OV > 6.75 cm 3 , with a trend toward decreasing OV with increase in age group (>8.5, >7, and >6.25 cm 3 , respectively). Conclusion(s):Our findings reflect that age-stratified thresholds demonstrate superior diagnostic performance, with an improved balance of sensitivity and specificity compared with a single threshold. We propose age-specific thresholds for better diagnostic performance. (Fertil Steril Ò 2019;111:787-93. Ó2018 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

show abstract

Section: Discussionmentioning

confidence: 99%

Improved diagnostic performance for the diagnosis of polycystic ovary syndrome using age-stratified criteria

Ahmad

Quinn

Kao

et al. 2019

Fertility and Sterility

Self Cite

View full text Add to dashboard Cite

show abstract

“…Circulating AMH levels in T-exposed monkeys, however, do not exceed those of controls, and exhibit an exaggerated, age-related decline [143]. While absence of AMH excess is atypical for women with PCOS, PCOS women over 30 years of age demonstrate a steeper decline in circulating AMH levels than their non-PCOS counterparts [144]. Early-to-mid gestation T reprogramming of ovarian follicle granulosa cells may therefore be less pronounced than ovarian theca, stroma or oocytes, and an extra-ovarian source of fetal hyperandrogenism, alone, may be insufficient to reprogram granulosa cell AMH hypersecretion or increase follicle number and proliferation.…”

Section: Nonhuman Female Primatesmentioning

confidence: 92%

Hyperandrogenic origins of polycystic ovary syndrome – implications for pathophysiology and therapy

Abbott

Dumesic

Levine

2019

Expert Review of Endocrinology & Metabolism

View full text Add to dashboard Cite

Introduction: Polycystic ovary syndrome (PCOS) diagnosis comprises combinations of female hyperandrogenism, menstrual irregularity and polycystic ovaries. While it is a familial and highly prevalent endocrine disorder, progress towards a cure is hindered by absence of a definitive pathogenic mechanism and lack of an animal model of naturally occurring PCOS. Areas covered: These include an overview of PCOS and its potential etiology, and an examination of insights gained into its pathogenic origins. Animal models derived from experimentally-induced hyperandrogenism during gestation, or from naturally-occurring PCOSlike traits, most reliably demonstrate reproductive, neuroendocrine and metabolic pathogenesis. Expert Commentary: Genetic studies, while identifying at least 17 PCOS risk genes, account for <10% of women with PCOS. A number of PCOS risk genes involve regulation of gonadotropin secretion or action, suggesting a reproductive neuroendocrine basis for PCOS pathogenesis. Consistent with this notion, a number of animal models employing fetal androgen excess demonstrate epigenetic induction of PCOS-like traits, including reproductive neuroendocrine and metabolic dysfunction. Monkey models are most comprehensive, while mouse models provide molecular insight, including identifying the androgen receptor, particularly in neurons, as mediating androgen-induced PCOS-like programming. Naturally-occurring female hyperandrogenism is also demonstrated in monkeys. Animal models are poised to delineate molecular gateways to PCOS pathogenesis.

show abstract

“…This suggests that the inclusion of young women with PCOS with higher serum AMH levels contributed partly to the accelerated decrease in serum AMH with age in the infertile group. Also, previous studies reported that women with PCOS have an accelerated decrease in serum AMH with age compared to non-PCOS controls [28,29].…”

Section: Discussionmentioning

confidence: 88%

Perceived stress, psychological distress and serum anti-Müllerian hormone levels among infertile and fertile women in North-central Nigeria

Lawal

Akinyemi

Yusuff

et al. 2020

Middle East Fertil Soc J

View full text Add to dashboard Cite

Background: Previous studies reported that self-reported stress, stressful life events, and psychological distress influence ovarian ageing and response. However, there are limited, yet conflicting findings on the effect of stress and psychological distress on serum anti-Müllerian hormone (AMH) as a biomarker of ovarian reserve, response, and ageing. This case-control study aimed to determine if stress and psychological distress levels were associated with serum anti-Müllerian hormone levels among 81 infertile and 109 fertile women of reproductive age attending the gynaecology and immunization clinics of a tertiary hospital in North-central Nigeria, respectively. Stress and psychological distress were measured using the Perceived Stress scale-10 and Kessler Psychological Distress Scale-10, respectively. The serum concentration of AMH was determined using enzyme-linked immunosorbent assays. Results: There was a significantly higher stress (p = 0.001) and psychological distress (p = 0.005) levels among infertile women; however, there was no difference in serum anti-Müllerian hormone levels between the two groups (p = 0.409). There was no significant correlation found between perceived stress and serum anti-Müllerian hormone in both infertile (r = 0.041, p = 0.719) and fertile (r = − 0.090, p = 0.353) women. There was also no correlation between psychological distress and serum anti-Müllerian hormone in the infertile (r = − 0.020, p = 0.860) and fertile (r = − 0.049, p = 0.636) groups. Controlling for age and body mass index in multivariate linear regression; stress and psychological distress were not significantly associated with serum anti-Müllerian hormone (B = − 0.005; p = 0.370 and B = − 0.001; p = 0.811). Conclusion: Self-reported stress and psychological distress are not associated with serum anti-Müllerian hormone levels in infertile and fertile women of reproductive age. Also, ovarian ageing was accelerated in infertile women when compared to fertile women; however, this does not appear to be related to stress or psychological distress. More research is needed to understand factors that may contribute to this accelerated decline.

show abstract

Differential rate in decline in ovarian reserve markers in women with polycystic ovary syndrome compared with control subjects: results of a longitudinal study

Abstract: Ovarian aging in PCOS is characterized by a more rapid decline in AMH and a slower decline in OV compared with control subjects.

Cited by 20 publications

References 31 publications

Improved diagnostic performance for the diagnosis of polycystic ovary syndrome using age-stratified criteria

Improved diagnostic performance for the diagnosis of polycystic ovary syndrome using age-stratified criteria

Hyperandrogenic origins of polycystic ovary syndrome – implications for pathophysiology and therapy

Perceived stress, psychological distress and serum anti-Müllerian hormone levels among infertile and fertile women in North-central Nigeria

Contact Info

Product

Resources

About