High serum anti-Müllerian hormone concentrations have a negative impact on fertilization and embryo development rates

Association of serum uric acid with women's ovarian reserve: observational study and Mendelian randomization analyses

OBJECTIVE

To investigate the association between serum uric acid and women's ovarian reserve.

DESIGN

Retrospective observational study and Mendelian randomization study.

SETTING

University-affiliated in vitro fertilization center.

PATIENTS

Observational analyses were undertaken using data from 8,257 women with infertility who finished their first in vitro fertilization treatments between May 2017 and December 2021. Mendelian randomization analyses were based on genome-wide association summary statistics from several biobanks of predominantly European ancestries.

INTERVENTIONS

Observational study involved testing log2 transformed serum uric acid levels (for linear, negative regression, and logistic regression analyses); original uric acid levels (for nonlinear association analyses). Mendelian randomization study involved testing genetically predicted uric acid levels.

MAIN OUTCOME MEASURES

Biomarkers including antimüllerian hormone, basal antral follicle count, follicle-stimulating hormone, luteinizing hormone, ratio of follicle-stimulating hormone to luteinizing hormone, estradiol; indices of ovarian response to stimulation including poor ovarian response according to different criteria and oocyte yield.

RESULTS

In retrospective observational study, all ovarian reserve-related outcomes demonstrated significant differences across serum uric acid quartiles. A two-fold uric acid increase was associated with increased antimüllerian hormone (adjusted β = 0.69; 95% confidence interval [CI], 0.43-0.95), antral follicle count (adjusted incidence rate ratio = 1.10, 95% CI, 1.05-1.14), luteinizing hormone (adjusted β = 0.53, 95% CI, 0.28-0.78), decreased risks of Bologna poor ovarian response (adjusted odds ratio = 0.97; 95% CI, 0.95-0.99) and groups 2-4 Poseidon poor ovarian response (group 2: 0.63, 0.56-0.71; group 3: 0.71, 0.65-0.78; group 4: 0.50, 0.46-0.55), whereas an increased risk of group 1 (1.26, 1.13-1.41). Nonlinear analyses showed a common inflection point at 320-340 μmol/L of uric acid. Interactions between uric acid and antimüllerian hormone and antral follicle count were presented in association with oocyte yield. Mendelian randomization results suggested a significant association between genetically predicted uric acid levels and antimüllerian hormone levels (β = 0.08; 95% CI, 0.04-0.12) but none for uric acid in relation to polycystic ovarian syndrome or other related hormones.

CONCLUSION

Higher uric acid levels were associated with better ovarian reserve and increased levels of antimüllerian hormone albeit an increased risk of unexpected poor ovarian response.

Associations between a normal-range free thyroxine concentration and ovarian reserve in infertile women undergoing treatment via assisted reproductive technology

BACKGROUND

Some recent studies have shown that female subclinical hypothyroidism (SCH) is associated with diminished ovarian reserve (DOR). In this study, we aimed to investigate whether serum-free thyroxine (fT4) concentrations within the reference range are associated with ovarian reserve in women.

METHODS

This cross-sectional study included 4933 infertile women with normal-range fT4 concentrations who received assisted reproductive technology treatment in our clinic. The data of women in different fT4 concentration tertiles (namely 12-15.33, 15.34-18.67, and 18.68-22 pmol/L) were compared with ovarian reserve markers, namely the anti-Müllerian hormone (AMH) concentration, the antral follicle count (AFC), and the number of aspirated oocytes. The primary outcomes were the AMH concentration and the risk of DOR, diagnosed as an AMH concentration < 1.1 ng/mL.

RESULTS

The average ages of women in the low-normal, middle-normal, and high-normal fT4 tertiles were 33.20 (standard deviation [SD]: 5.11), 32.33 (SD: 5.13), and 31.61 (SD: 5.10) years, respectively (p < 0.0001). AMH concentrations (adjusted mean: 3.32 [95% confidence interval {CI}: 3.16 to 3.50] vs. 3.51 [3.40 to 3.62] vs. 3.64 [3.50 to 3.80] ng/mL, p = 0.022) were significantly different between the fT4 concentration tertiles. The risk of DOR was significantly increased in the low-normal (adjusted odds ratio: 1.61 [95% CI: 1.01 to 2.58]) and middle-normal (1.47 [95% CI: 1.00 to 2.16]) tertiles compared with the high-normal tertile. Subgroup analysis showed that AMH concentrations were significantly different among the fT4 concentration tertiles in women aged < 35 years (adjusted mean: 3.94 [95% CI: 3.70 to 4.20] vs. 4.25 [4.11 to 4.39] vs. 4.38 [4.18 to 4.58], p = 0.028), whereas this difference was not significant in women aged ≥ 35 years (p = 0.534). The general additive models using fT4 as a continuous variable indicated that a lower fT4 concentration within the normal range was significantly associated with a lower AMH concentration (p = 0.027), a lower AFC (p = 0.018), a lower number of aspirated oocytes (p = 0.001), and a higher risk of DOR (p = 0.007).

CONCLUSION

Low-normal fT4 concentrations are associated with lower ovarian reserve in infertile women.

Sol-Gel Synthesis of New TiO2 Ball/Activated Carbon Photocatalyst and Its Application for Degradation of Three Hormones: 17α-EthinylEstradiol, Estrone, and β-Estradiol

Many approaches have been investigated to eliminate pharmaceuticals in wastewater treatment plants during the last decades. However, a lack of sustainable and efficient solutions exists for the removal of hormones by advanced oxidation processes. The aim of this study was to synthesize and test new photoactive bio composites for the elimination of these molecules in wastewater effluents. The new materials were obtained from the activated carbon (AC) of Arganian spinosa tree nutshells and titanium tetrachloride by the sol gel method. SEM analysis allowed one to confirm the formation of TiO₂ particles homogeneously dispersed at the surface of AC with a controlled titanium dioxide mass ratio, a specific TiO₂ anatase structure, and a highly specific surface area, evidenced by ATG, XRD, and BET analysis, respectively. The obtained composites were revealed to quantitatively absorb carbamazepine (CBZ), which is used as a referred pharmaceutical, and leading to its total elimination after 40 min under irradiation with the most effective material. TiO₂ high content disfavors CBZ adsorption but improves its degradation. In the presence of the composite, three hormones (17α-ethinylestradiol, estrone, and β-estradiol) are partially adsorbed onto the composite and totally degraded after 60 min under UV light exposure. This study constitutes a promising solution for the efficient treatment of wastewater contaminated by hormones.