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Karimi E, Arab A, Rafiee M, Amani R. A systematic review and meta-analysis of the association between vitamin D and ovarian reserve. Sci Rep 2021; 11:16005. [PMID: 34362981 PMCID: PMC8346573 DOI: 10.1038/s41598-021-95481-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
It is hypothesized that vitamin D deficiency could be related to ovarian reserve. This systematic review and meta-analysis was undertaken to analyze the possible association between vitamin D and ovarian reserve among adolescent and adult women. All eligible studies identified through the ISI Web of Science, PubMed, and Scopus were included up to May 2021. A random-effects meta-analysis model was implemented and a weighted mean difference (WMD) and 95% confidence interval (CI) were calculated. A total of 38 papers covering 8608 individuals were enrolled in this systematic review and meta-analysis. Antral follicle count (AFC) was significantly lower among Asians (WMD - 0.65; 95% CI - 1.28 to - 0.01; P = 0.04; I2 = 0.0%) and luteinizing hormone (LH) levels were higher in non-Asians (WMD 2.16 IU/L; 95% CI 0.20 to 4.12; P = 0.031; I2 = 9.3%) with vitamin D insufficiency/deficiency. Also, there was a negative correlation between vitamin D and LH/FSH ratio in women with normal body mass index (BMI) (Fisher's Z: - 0.18; 95% CI - 0.37 to - 0.008; P = 0.041; I2 = 51.5%). Although there were no significant associations between serum vitamin D levels and any of the intended ovarian reserve markers, subgroup analyses have found significant findings regarding AFC, LH, and LH/FSH ratio. In order to understand the underlying mechanisms of vitamin D in female reproduction, further attempts are needed.
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Affiliation(s)
- Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Rafiee
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Arshad MA, Majzoub A, Esteves SC. Predictors of surgical sperm retrieval in non-obstructive azoospermia: summary of current literature. Int Urol Nephrol 2020; 52:2015-2038. [PMID: 32519242 DOI: 10.1007/s11255-020-02529-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/29/2020] [Indexed: 12/20/2022]
Abstract
Intracytoplasmic sperm injection (ICSI), combined with surgical sperm retrieval (SR) techniques, is the sole option for patients with non-obstructive azoospermia to achieve fertility; however, with suboptimal results. Given the variability in clinical presentation, the potential role of factors that can predict the likelihood of successful testicular SR needs to be clarified. This article summarizes the current evidence concerning the variables predicting SR success in non-obstructive azoospermic patients with spermatogenic failure. For this, we used 60 articles, including 46 original papers and six meta-analyses. Clinical and laboratory factors, as well as adjuvant therapies and surgical retrieval methods, were the factors most commonly investigated. We found that Klinefelter syndrome, Y chromosome microdeletions in regions AZFa/b, and Sertoli cell-only histopathology were associated with reduced SR success. By contrast, testis volume > 12.5 ml, history of cryptorchidism, use of micro-TESE as the sperm retrieval method, and adjuvant therapy were associated with improved SR success. None of the predictors, alone or combined, provide definitive information about the chances of harvesting sperm in men with non-obstructive azoospermia, except for Y chromosome microdeletions in regions AZFa/b. In the latter, SR success is virtually nil. We conclude that SR outcomes in men with non-obstructive azoospermia are difficult to predict based on the existing variables. Although several predictors can be used for patient counseling, their clinical value is limited to either ensure SR success or discourage reproductive urologists from recommending SR to men with non-obstructive azoospermia seeking fertility. A notable exception includes the deletions involving the regions AZFa and/or AZFb of the Y chromosome; the affected patients should be counseled against undergoing SR.
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Affiliation(s)
- Muhammad A Arshad
- Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
- Nishter Hospital, Multan, Pakistan
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine- Qatar, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1464, Campinas, São Paulo, 13075-460, Brazil.
- Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil.
- Faculty of Health, Department of Clinical Sciences, Aarhus University, Aarhus, Denmark.
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Agabain E, Mohamed H, Elsheikh AE, Hamdan HZ, Adam I. Maternal serum anti-Müllerian hormone in Sudanese women with preeclampsia. BMC Res Notes 2017. [PMID: 28646929 PMCID: PMC5483251 DOI: 10.1186/s13104-017-2544-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives A case–control study was conducted at Omdurman Maternity Tertiary Hospital, Sudan, during the period from May to August 2014 to investigate AMH level in women with preeclampsia compared to healthy controls. The cases were women with preeclampsia and healthy pregnant women were the controls. The obstetrics and medical history was gathered using a questionnaire. AMH level was measured using ELISA. Results There was no significant difference between the two groups (40 in each arm of the study) in the age, parity and gestational age. Thirty-three of the 40 cases were patients with severe preeclampsia. There was no significant difference in median inter-quartile of the AMH level between the women with preeclampsia and the controls [0.700 (0.225–1.500) vs. 0.700 (0.400–1.275) ng/ml, P = 0.967]. In a linear regression model there was no association between the log of AMH and age, parity, gestational age, BMI, hemoglobin level and preeclampsia.
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Affiliation(s)
- Eiman Agabain
- Medical College, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Hameed Mohamed
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
| | | | | | - Ishag Adam
- Medical College, Qassim University, Buraydah, Kingdom of Saudi Arabia. .,Faculty of Medicine, University of Khartoum, P.O. Box 102, 11111, Khartoum, Sudan.
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Birdir C, Fryze J, Vasiliadis H, Nicolaides KH, Poon LC. Maternal serum anti-Müllerian hormone at 11-13 weeks' gestation in the prediction of preeclampsia. J Matern Fetal Neonatal Med 2014; 28:865-8. [PMID: 24953352 DOI: 10.3109/14767058.2014.937418] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the potential value of maternal serum anti-Müllerian hormone (AMH) at 11-13 weeks' gestation in the prediction of preeclampsia (PE). METHODS The serum concentration of AMH was measured at 11-13 weeks' gestation in cases of PE (n = 50) and normotensive controls (n = 150). Backward stepwise multiple regression analysis was used to determine which of the factors amongst the maternal characteristics and gestation were significant predictors of the serum AMH in the control group and from the regression model the value in each case and control was expressed as a multiple of the expected median (MoM). RESULTS In normotensive pregnancies, the maternal serum concentration of AMH is higher in Afro-Caribbean than in Caucasian women and in smokers than in non-smokers. In the PE group, the median serum concentration of AMH was significantly higher than in the controls (2.140 ng/L, IQR 1.968-2.273 versus 2.062 ng/L, IQR 1.938-2.181; p = 0.025), but the median MoM value of AMH was not significantly different between the PE group and the controls (1.040, IQR 0.941-1.081 versus 0.995, IQR 0.939-1.065, p = 0.147). CONCLUSIONS Maternal serum AMH is not an effective early predictor for PE.
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Affiliation(s)
- Cahit Birdir
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital , London , UK and
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Expression of INHβA and INHβB proteins in porcine oocytes cultured in vitro is dependent on the follicle size. ZYGOTE 2013; 23:205-11. [PMID: 24134883 PMCID: PMC4413872 DOI: 10.1017/s0967199413000439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current study aimed to investigate differential expression of inhibin βA (INHβA) and inhibin βB (INHβB) in porcine oocytes before or after in vitro maturation (IVM) isolated from follicles of various sizes. Porcine oocytes isolated from large, medium and small follicles (40 from each) were used to study the INHβA and INHβB protein expression pattern using western blot analysis before or after 44 h of oocyte IVM. An increased expression of INHβA was found in oocytes collected from large and medium follicles compared with small follicles before or after IVM (P < 0.001, P < 0.05, respectively). Similarly, higher INHβB levels were observed in oocytes recovered from large follicles compared with small (P < 0.01). As INHβA and INHβB are expressed in both porcine follicular somatic cells and oocytes, it can be assumed that these transforming growth factor beta (TGFβ) superfamily factors are involved in the regulation of molecular bi-directional pathways during follicle and oocyte development, and can be recognized as markers of follicle and oocyte maturation. Moreover, the current study clearly demonstrated that inhibin expression is substantially associated with porcine follicle growth and development.
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Sahmay S, Guralp O, Aydogan B, Cepni I, Oral E, Irez T. Anti-Müllerian hormone and polycystic ovary syndrome: assessment of the clinical pregnancy rates in in vitro fertilization patients. Gynecol Endocrinol 2013; 29:440-3. [PMID: 23461296 DOI: 10.3109/09513590.2013.769519] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study is to investigate the role of serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and antral follicle count (AFC) for the prediction of clinical pregnancy rates (CPR) in women with polycystic ovary syndrome (PCOS) undergoing IVF treatment. DESIGN Prospective cohort study. SETTING University hospital. PATIENTS One hundred and fifty consecutive women with PCOS. INTERVENTIONS All women underwent controlled ovarian stimulation with long agonist protocol followed by IVF procedure. Outcomes of pregnant and non-pregnant groups were compared. MAIN OUTCOME MEASURE CPR; AMH, FSH and AFC means and percentiles. RESULTS Fifty-one (34%) clinical pregnancies were observed in 150 women. Mean AMH was 6.7 ± 2.8 and 7.1 ± 4.3 ng/mL in pregnant and non-pregnant women, respectively (p = 0.594). The CPR were 27.8%, 35.0% and 37.8% in <25%, 25%-75% and >75% AMH percentiles, respectively (p = 0.656). There were also no significant difference in mean FSH and AFC between pregnant and non-pregnant women (p = 0.484 and p = 0.165, respectively). CONCLUSION AMH, FSH and AFC are not predictive for CPR in women with PCOS undergoing IVF treatment. Mean AMH values were not significantly different between pregnant and non-pregnant women. Although CRP increased in parallel with the raise in AMH percentiles, this remained insignificant.
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Affiliation(s)
- Sezai Sahmay
- Cerrahpasa School of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF unit, Istanbul University, Istanbul, Turkey.
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Glina S, Vieira M. Prognostic factors for sperm retrieval in non-obstructive azoospermia. Clinics (Sao Paulo) 2013; 68 Suppl 1:121-4. [PMID: 23503961 PMCID: PMC3583147 DOI: 10.6061/clinics/2013(sup01)13] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 09/06/2012] [Indexed: 11/18/2022] Open
Abstract
Testicular sperm retrieval techniques associated with intracytoplasmic sperm injection have changed the field of male infertility treatment and given many azoospermic men the chance to become biological fathers. Despite the current use of testicular sperm extraction, reliable clinical and laboratory prognostic factors of sperm recovery are still absent. The objective of this article was to review the prognostic factors and clinical use of sperm retrieval for men with non-obstructive azoospermia. The PubMed database was searched for the Medical Subject Headings (MeSH) terms azoospermia, sperm retrieval, and prognosis. Papers on obstructive azoospermia were excluded. The authors selected articles that reported successful sperm retrieval techniques involving clinical, laboratory, or parenchyma processing methods. The selected papers were reviewed, and the prognostic factors were discussed. No reliable positive prognostic factors guarantee sperm recovery for patients with non-obstructive azoospermia. The only negative prognostic factor is the presence of AZFa and AZFb microdeletions.
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Serum anti-müllerian hormone, follicle stimulating hormone and antral follicle count measurement cannot predict pregnancy rates in IVF/ICSI cycles. J Assist Reprod Genet 2012; 29:589-95. [PMID: 22492221 DOI: 10.1007/s10815-012-9754-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 03/16/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To investigate whether serum anti-müllerian hormone (AMH), follicle stimulating hormone (FSH), or antral follicle count (AFC) are predictive for clinical pregnancy in in vitro fertilization (IVF) patients. METHODS Serum AMH, inhibin B, FSH, luteinizing hormone (LH), estradiol (E2), prolactin, and thyroid stimulating hormone (TSH) levels and AFC of 189 women under 40 years of age were investigated. Pregnant and non-pregnant women were compared. RESULTS Forty-seven (24.8 %) clinical pregnancies were observed in 189 women. There was no significant difference in terms of mean age, duration of infertility, body mass index, AMH, LH, FSH, E2, TSH, Inhibin B, AFC and total oocyte number between women who did and who did not become pregnant. Additionally, there was no significant difference in clinical pregnancy rates between the quartiles of AMH, FSH and AFC. (P values were 0.668, 0.071, and 0.252, respectively.) CONCLUSION Serum AMH and FSH, and AFC cannot predict clinical pregnancy in IVF patients under 40; the pregnancy rate tends to increase as AMH increases, although this remains non-significant.
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Moawad A, Elmawgood HA, Shaeer M. Early follicular anti-mullerian hormone as a predictor of ovarian response during ICSI cycles. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2010. [DOI: 10.1016/j.mefs.2010.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hugon J, Ouzounian S, Christin-Maître S. [Müllerian inhibitor substance: from gene to protein, its role in clinical practice]. ANNALES D'ENDOCRINOLOGIE 2010; 71:83-8. [PMID: 20137781 DOI: 10.1016/j.ando.2010.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Revised: 01/04/2010] [Accepted: 01/11/2010] [Indexed: 10/19/2022]
Abstract
Müllerian inhibiting substance (MIS) has been discovered by Alfred Jost at the beginning of the fifties. MIS is a glycoprotein belonging to the TGF-beta family. Its various functions differ between males and females and according to the age of the individual. In male, the protein is synthesized by Sertoli's cells and induces the disappearance of Müllerian's ducts, the development of the male genital tract. Its role in adult males remains quite unknown. In female, the protein is secreted by granulosa cells and plays a role during folliculogenesis as it regulates the initial and cyclic recruitment of ovarian follicles. MIS is also a good marker of follicular reserve and ovarian function. Therefore, it plays a role in different areas such as assisted medical reproduction and oncology. This protein represents a potential major diagnosis as well as prognostic tool in reproduction.
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Affiliation(s)
- J Hugon
- Service d'endocrinologie, hôpital Saint-Antoine, 184 rue du Faubourg-Saint-Antoine, Paris, France.
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Carpi A, Sabanegh E, Mechanick J. Controversies in the management of nonobstructive azoospermia. Fertil Steril 2009; 91:963-70. [DOI: 10.1016/j.fertnstert.2009.01.083] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 01/12/2009] [Accepted: 01/16/2009] [Indexed: 02/06/2023]
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Fréour T, Mirallié S, Colombel A, Bach-Ngohou K, Masson D, Barrière P. Anti-mullerian hormone: clinical relevance in assisted reproductive therapy. ANNALES D'ENDOCRINOLOGIE 2007; 67:567-74. [PMID: 17194966 DOI: 10.1016/s0003-4266(06)73008-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Anti-Müllerian Hormone (AMH) is a member of the transforming Growth Factor-B (TGF-B) family synthesized exclusively by the gonads of both sexes. Over the last four years, numerous studies have examined the clinical usefulness of serum AMH levels as a predictor of ovarian response and pregnancy in assisted reproductive technology cycles. Assessment of ovarian reserve in women undergoing assisted reproduction is useful in optimising the treatment protocol. Availability of a reliable measure of ovarian reserve is essential. Currently, serum AMH level seems to be more strongly related to the ovarian reserve and to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B or estradiol, which are more commonly used markers. Our study involving 69 women undergoing a cycle of in vitro fertilisation (IVF) or intracytoplamic sperm injection (ICSI) treatment, confirmed these results. We have shown in this study that AMH is significantly correlated with the number of eggs collected and is of great interest as a negative predictive value for the success of assisted reproductive technology (ART). Further studies are needed to determine AMH cut-off values.
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Affiliation(s)
- T Fréour
- Service de Médecine de la reproduction, Laboratoire de Biochimie Spécialisée, CHU de Nantes, France.
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