Menstrual cycle length: a surrogate measure of reproductive health capable of improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART

Abstract

BackgroundAim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.MethodsA retrospective-observational-study in Padua’ public tertiary level Centre was conducted. A total of 455 normo-ovulatory infertile women scheduled for their first fresh non-donor IVF/ICSI treatment. The mean menstrual cycle length (MCL) during the preceding 6 months was calculated by physicians on the basis of information contained in our electronic database (first day of menstrual cycle collected every month by telephonic communication by single patients). We evaluated the relations between MCL, ovarian response to stimulation protocol, oocytes fertilization ratio, ovarian sensitivity index (OSI) and pregnancy rate in different cohorts of patients according to the class of age and the estimated ovarian reserve.ResultsIn women younger than 35 years, MCL over 31 days may be associated with an increased risk of OHSS and with a good OSI. In women older than 35 years, and particularly than 40 years, MCL shortening may be considered as a marker of ovarian aging and may be associated with poor ovarian response, low OSI and reduced fertilization rate. When AMH serum value is lower than 1.1 ng/ml in patients older than 40 years, MCL may help Clinicians discriminate real from expected poor responders. Considering the pool of normoresponders, MCL was not correlated with pregnancy rate while a positive association was found with patients’ age.ConclusionsMCL diary is more predictive than chronological age in estimating ovarian biological age and response to COH and it is more predictive than AMH in discriminating expected from real poor responders. In women older than 35 years MCL shortening may be considered as a marker of ovarian aging while chronological age remains most accurate parameter in predicting pregnancy.

Recombinant LH supplementation during IVF cycles with a GnRH-antagonist in estimated poor responders: A cross-matched pilot investigation of the optimal daily dose and timing

“…This enables the recruitment and support of all 'responder' follicles until the pre ovulatory phase. Therefore, the substrate of FSH action depends only on the number of primordial and primary follicles available in the ovarian cortex at the beginning of the cycle ( 26 ).…”

Salpingectomy before assisted reproductive technologies: a systematic literature review

“…It is important to remember that AFC is only a surrogate of ovarian reserve that should be interpreted ideally in association with basal AMH, FSH and chronological age [39–41]. Trials investigating variations in ovarian reserve determined by the combination of both AFC and biochemical assay of FSH and AMH levels seems to suggest a non-significant reduction in the cohort of treated patients compared to controls [8, 16, 17, 20–23, 25–27, 31].…”

Pretreatment with oral contraceptive pills to identify poor responders that may benefit from rLH supplementation during GnRH-antagonist treatment for IVF: A pilot perspective study proposal

“…Patients in groups A and B will be treated with GnRH-antagonist (short protocol) stimulation according to our Units Protocol ( 25 , 26 ). All stimulation cycles will be performed using 350 IU rFSH (Gonal F; Merck Serono S.A., Geneva, Switzerland) daily for the first 5 days.…”