1
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Decanter C, Elefant E, Poirot C, Courbiere B. What reproductive follow-up for adolescent and young women after cancer? A review. Reprod Biomed Online 2024; 49:103891. [PMID: 38761433 DOI: 10.1016/j.rbmo.2024.103891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/02/2024] [Accepted: 02/09/2024] [Indexed: 05/20/2024]
Abstract
Fertility capacity has been shown to be one of the main concerns of young cancer survivors. Gonadotoxic treatments may lead to both premature ovarian failure and/or infertility. This review aimed to define which, and when, reproductive indicators should be followed-up to help doctors to counsel patients regarding their fertility and ovarian function, and to determine if a second stage of fertility preservation after the end of cancer treatment is clinically relevant. Longitudinal assessment of anti-Müllerian hormone (AMH) concentrations during cancer treatment indicates the degree of follicular depletion, and allows discrimination between low and high gonadotoxic treatments. Sustained low AMH concentrations after treatment, especially in the case of alkylating protocols, may reduce the duration of the conception window significantly, and expose the patient to the risk of premature ovarian failure. It remains unknown whether this may impact further fertility capacity because of the lack of systematic follow-up of adolescent and young adult (AYA) women after chemo-radiotherapy. It appears that dedicated reproductive follow-up of AYA women under cancer treatment is needed to refine fertility preservation strategies, and to determine if low AMH concentrations after treatment impact the chance of pregnancy in this specific survivor population.
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Affiliation(s)
- C Decanter
- CHU Lille, ART and Fertility Preservation Department, Lille, France; ONCOLille Cancer Institute, Lille, France.
| | - E Elefant
- Reference Centre for Teratogenic Agents, Hospital Armand Trousseau, Paris, France; Faculty of Medicine, Sorbonne University, Paris, France
| | - C Poirot
- Department of Haematology, Adolescents and Young Adults, Fertility Preservation, Assistance Publique des Hôpitaux de Paris, Saint Louis Hospital, Paris, France; Medecine Sorbonne University, Paris, France
| | - B Courbiere
- Department of Gynaecology-Obstetric and Reproductive Medicine-Fertility Preservation, AP-HM, Hôpital La Conception, Marseille, France; Aix-Marseille Université, Avignon Université, Avignon, France
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2
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Stenta T, Assis M, Ayers K, Tucker EJ, Halman A, Gook D, Sinclair AH, Elliott DA, Jayasinghe Y, Conyers R. Pharmacogenomic studies of fertility outcomes in pediatric cancer survivors - A systematic review. Clin Transl Sci 2024; 17:e13827. [PMID: 38924306 PMCID: PMC11199333 DOI: 10.1111/cts.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 06/28/2024] Open
Abstract
For the same age, sex, and dosage, there can be significant variation in fertility outcomes in childhood cancer survivors. Genetics may explain this variation. This study aims to: (i) review the genetic contributions to infertility, (ii) search for pharmacogenomic studies looking at interactions of cancer treatment, genetic predisposition and fertility-related outcomes. Systematic searches in MEDLINE Ovid, Embase Classic+Embase, and PubMed were conducted using the following selection criteria: (i) pediatric, adolescent, and young adult cancer survivors, below 25 years old at the time of diagnosis, (ii) fertility outcome measures after cancer therapy, (iii) genetic considerations. Studies were excluded if they were (i) conducted in animal models, (ii) were not published in English, (iii) editorial letters, (iv) theses. Articles were screened in Covidence by at least two independent reviewers, followed by data extraction and a risk of bias assessment using the Quality in Prognostic Studies tool. Eight articles were reviewed with a total of 29 genes. Outcome measures included sperm concentration, azoospermia, AMH levels, assessment of premature menopause, ever being pregnant or siring a pregnancy. Three studies included replication cohorts, which attempted replication of SNP findings for NPY2R, BRSK1, FANCI, CYP2C19, CYP3A4, and CYP2B6. Six studies were rated with a high risk of bias. Differing methods may explain a lack of replication, and small cohorts may have contributed to few significant findings. Larger, prospective longitudinal studies with an unbiased genome-wide focus will be important to replicate significant results, which can be applied clinically.
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Affiliation(s)
- Tayla Stenta
- Cancer Therapies, Stem Cell MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Michael Assis
- Cancer Therapies, Stem Cell MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of Obstetrics, Gynaecology and Newborn HealthRoyal Women's Hospital, University of MelbourneParkvilleVictoriaAustralia
| | - Katie Ayers
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Reproductive DevelopmentMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Elena J. Tucker
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Reproductive DevelopmentMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Andreas Halman
- Cancer Therapies, Stem Cell MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Debra Gook
- Department of Obstetrics, Gynaecology and Newborn HealthRoyal Women's Hospital, University of MelbourneParkvilleVictoriaAustralia
- Gynaecology, Royal Children‘s HospitalParkvilleVictoriaAustralia
- Reproductive Services, The Royal Women's HospitalParkvilleVictoriaAustralia
| | - Andrew H. Sinclair
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Reproductive DevelopmentMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - David A. Elliott
- Cancer Therapies, Stem Cell MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
| | - Yasmin Jayasinghe
- Department of Obstetrics, Gynaecology and Newborn HealthRoyal Women's Hospital, University of MelbourneParkvilleVictoriaAustralia
- Gynaecology, Royal Children‘s HospitalParkvilleVictoriaAustralia
| | - Rachel Conyers
- Cancer Therapies, Stem Cell MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Children's Cancer Centre, The Royal Children's HospitalParkvilleVictoriaAustralia
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3
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Athar F, Karmani M, Templeman N. Metabolic hormones are integral regulators of female reproductive health and function. Biosci Rep 2024; 44:BSR20231916. [PMID: 38131197 PMCID: PMC10830447 DOI: 10.1042/bsr20231916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
The female reproductive system is strongly influenced by nutrition and energy balance. It is well known that food restriction or energy depletion can induce suppression of reproductive processes, while overnutrition is associated with reproductive dysfunction. However, the intricate mechanisms through which nutritional inputs and metabolic health are integrated into the coordination of reproduction are still being defined. In this review, we describe evidence for essential contributions by hormones that are responsive to food intake or fuel stores. Key metabolic hormones-including insulin, the incretins (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1), growth hormone, ghrelin, leptin, and adiponectin-signal throughout the hypothalamic-pituitary-gonadal axis to support or suppress reproduction. We synthesize current knowledge on how these multifaceted hormones interact with the brain, pituitary, and ovaries to regulate functioning of the female reproductive system, incorporating in vitro and in vivo data from animal models and humans. Metabolic hormones are involved in orchestrating reproductive processes in healthy states, but some also play a significant role in the pathophysiology or treatment strategies of female reproductive disorders. Further understanding of the complex interrelationships between metabolic health and female reproductive function has important implications for improving women's health overall.
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Affiliation(s)
- Faria Athar
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Muskan Karmani
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicole M. Templeman
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
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Telfer EE, Grosbois J, Odey YL, Rosario R, Anderson RA. Making a good egg: human oocyte health, aging, and in vitro development. Physiol Rev 2023; 103:2623-2677. [PMID: 37171807 PMCID: PMC10625843 DOI: 10.1152/physrev.00032.2022] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 05/13/2023] Open
Abstract
Mammalian eggs (oocytes) are formed during fetal life and establish associations with somatic cells to form primordial follicles that create a store of germ cells (the primordial pool). The size of this pool is influenced by key events during the formation of germ cells and by factors that influence the subsequent activation of follicle growth. These regulatory pathways must ensure that the reserve of oocytes within primordial follicles in humans lasts for up to 50 years, yet only approximately 0.1% will ever be ovulated with the rest undergoing degeneration. This review outlines the mechanisms and regulatory pathways that govern the processes of oocyte and follicle formation and later growth, within the ovarian stroma, through to ovulation with particular reference to human oocytes/follicles. In addition, the effects of aging on female reproductive capacity through changes in oocyte number and quality are emphasized, with both the cellular mechanisms and clinical implications discussed. Finally, the details of current developments in culture systems that support all stages of follicle growth to generate mature oocytes in vitro and emerging prospects for making new oocytes from stem cells are outlined.
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Affiliation(s)
- Evelyn E Telfer
- Institute of Cell Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Discovery Brain Sciences, Biomedical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Johanne Grosbois
- Institute of Cell Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Discovery Brain Sciences, Biomedical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Yvonne L Odey
- Institute of Cell Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Discovery Brain Sciences, Biomedical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Roseanne Rosario
- Centre for Discovery Brain Sciences, Biomedical Sciences, University of Edinburgh, Edinburgh, United Kingdom
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Rosa IR, Barbosa CP, Ferrandez CA, Sonoda BDB, Christofolini DM, Trevisan CM, Laganà AS, Peluso C, Bianco B. Involvement of SYCP2L and TDRD3 gene variants on ovarian reserve and reproductive outcomes: a cross-sectional study. JBRA Assist Reprod 2023; 27:428-435. [PMID: 37417852 PMCID: PMC10712833 DOI: 10.5935/1518-0557.20220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/26/2022] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE Single nucleotide variants have been implicated in the response to fertility treatment and a pharmacogenomic approach may help to customize therapy based on patient genome. We aimed to evaluate the effect, individual and combined, of SYCP2L (rs2153157:G>A) and TDRD3 (rs4886238:G>A) variants on ovarian reserve, response to controlled ovarian stimulation (COS) and reproductive outcomes of women undergoing in vitro fertilization (IVF) treatment. METHODS This cross-sectional study included 149 normoovulatory women undergoing IVF. Genotyping was performed using the TaqMan real-time polymerase chain reaction method. Clinical parameters and reproductive outcomes were compared according to the genotypes of the variants studied. RESULTS Considering ovarian reserve, there were no significant differences among SYCP2L or TDRD3 genotypes in terms of FSH levels or AFC; however, AMH levels were significantly different in carriers of both variants. Regarding the SYCP2L rs2153157:G>A variant, lower AMH levels were observed in women carrying an AA genotype compared to women carrying a heterozygous genotype (p=0.01). Considering the TDRD3 rs4886238:G>A variant, women carrying an AA genotype presented higher AMH levels than carriers of GG and GA genotypes (p=0.025). Nevertheless, no difference was found regarding response to COS or reproductive outcomes. Considering the combined effect of the variants, women carrying the heterozygous genotype of both variants presented statistically increased AMH levels compared to SYCP2L rs2153157 AA genotype carriers and TDRD3 rs4886238 GG genotype carriers (p=0.042). CONCLUSIONS Individually and combined, the SYCP2L rs2153157 and TDRD3 rs4886238 variants have an effect on AMH level.
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Affiliation(s)
- Iasmim Ribeiro Rosa
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
| | - Caio Parente Barbosa
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
- Instituto Ideia Fértil, Santo André, Brazil
| | - Caroline Awoki Ferrandez
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
| | - Bianca Del Bel Sonoda
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
| | - Denise Maria Christofolini
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
- Instituto Ideia Fértil, Santo André, Brazil
| | - Camila Martins Trevisan
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico - Di Cristina -
Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal
Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Carla Peluso
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
| | - Bianca Bianco
- Discipline of Sexual and Reproductive Health and Populational
Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro
Universitário Saúde ABC, FMABC, Santo André, São Paulo,
Brazil
- Instituto Ideia Fértil, Santo André, Brazil
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6
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Flatt SB, Baillargeon A, McClintock C, Pudwell J, Velez MP. Premature ovarian insufficiency in female adolescent and young adult survivors of non-gynecological cancers: a population-based cohort study. Reprod Health 2023; 20:4. [PMID: 36593491 PMCID: PMC9808928 DOI: 10.1186/s12978-022-01559-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The risk of premature ovarian insufficiency (POI) is increased in adolescent and young adult (AYA) cancer survivors, with the prevalence depending on cancer diagnosis, treatment, and patient factors. Prior studies are limited by sample size and type of cancer included. The objective of this study was to assess the risk of POI in female AYA survivors of non-gynecologic cancers, using a population-based approach. METHODS This population-based retrospective cohort study comprises 21,666 females, 15-39 years old, diagnosed with a single non-gynecologic cancer in Ontario, Canada from 1995 to 2015. Through health administrative data linkage, participants were followed until their 40th birthday, December 31, 2018, bilateral oophorectomy, loss of health insurance eligibility or death. Each cancer survivor was matched to 5 females who were not diagnosed with cancer (unexposed, n = 108,330). Women with bilateral oophorectomy or a prior menopause diagnosis were excluded. POI was identified through use of the ICD-9 code for menopause (ICD9-627). Modified Poisson regression models were used to calculate the adjusted relative risk (aRR) of POI for AYA cancer survivors compared to unexposed individuals, adjusted for income, parity, age, and immigration status. RESULTS The occurrence of POI was higher in survivors of AYA cancer versus unexposed patients (5.4% vs. 2.2%). Survivors of AYA cancer had an increased risk of POI relative to unexposed patients (aRR 2.49; 95% CI 2.32-2.67). Risk varied by type of cancer: breast (4.32; 3.84-4.86), non-Hodgkin's lymphoma (3.77; 2.88-4.94), Hodgkin's lymphoma (2.37; 1.91-2.96), leukemia (14.64; 10.50-20.42), thyroid (1.26; 1.09-1.46) and melanoma (1.04; 0.82-1.32). Risk varied by age at time of cancer diagnosis, with a higher risk among females diagnosed at age 30-39 years (3.07; 2.80-3.35) than aged 15-29 years (1.75; 1.55-1.98). CONCLUSIONS AYA survivors of non-gynecologic cancers are at an increased risk of POI, particularly survivors of lymphomas, leukemia, breast, and thyroid cancer. The risk of POI is increased for those diagnosed with cancer at an older age. These results should inform reproductive counseling of female AYAs diagnosed with cancer.
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Affiliation(s)
- Sydney B. Flatt
- grid.410356.50000 0004 1936 8331School of Medicine, Queen’s University, 15 Arch St., Kingston, ON K7L 3L4 Canada ,grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | - Amanda Baillargeon
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | | | - Jessica Pudwell
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada
| | - Maria P. Velez
- grid.410356.50000 0004 1936 8331Department of Obstetrics and Gynecology, Queen’s University, 76 Stuart St., Victory 4, Kingston, ON K7L 2V7 Canada ,ICES Queen’s, 21 Arch St, Kingston, ON K7L 2V7 Canada
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7
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Kelsey T. Models and Biomarkers for Ovarian Ageing. Subcell Biochem 2023; 103:185-199. [PMID: 37120469 DOI: 10.1007/978-3-031-26576-1_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The human ovarian reserve is defined by the number of non-growing follicles (NGFs) in the ovary, with the age-related decline in NGF population determining age at menopause for healthy women. In this chapter, the concept of ovarian reserve is explored in detail, with a sequence of models described that in principle allow any individual to be compared to the general population. As there is no current technology that can count the NGFs in a living ovary, we move our focus to biomarkers for the ovarian reserve. Using serum analysis and ultrasound it is possible to measure anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and ovarian volume (OV) and to count numbers of antral follicles (AFC). These are compared, with ovarian volume being the closest to a true biomarker for a wide range of ages and with AMH and AFC being the most popular for post-pubertal and pre-menopausal ages. The study of genetic and subcellular biomarkers for the ovarian reserve has produced less concrete results. Recent advances are described and compared in terms of limitations and potential. The chapter concludes with an overview of the future study indicated by our current knowledge and by current controversy in the field.
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Affiliation(s)
- Tom Kelsey
- School of Computer Science, University of St Andrews, St Andrews, UK.
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8
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Więcek M, Gawlik J, Nowak Z, Gawlik A. Questions concerning fertility preservation during transition in girls with Turner syndrome: review of the literature. Endocr Connect 2022; 11:e220344. [PMID: 36191160 PMCID: PMC9641775 DOI: 10.1530/ec-22-0344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 11/08/2022]
Abstract
Loss of fertility is one of the most important concerns facing Turner syndrome (TS) patients as they transition into adult health care. Due to the limited and rapidly decreasing ovarian reserve, many TS patients require fertility preservation (FP) techniques to preserve their reproductive potential until they are ready to pursue procreation. One has to also remember about the additional risks connected with pregnancy in TS patients. In order to determine the optimal time for introducing FP techniques and decrease the chance of an unnecessary intervention, markers and procedures assessing ovarian reserve have been developed. The exposure to potential cardiovascular complications should be determined before FP to avoid unnecessary procedures in patients with potential contraindications to pregnancy. The aim of the present review is to answer the following three questions important for successful preservation of fertility and safe pregnancy in TS: which markers of ovarian reserve should be used as selection criteria for FP? Which methods of FP are the safest and most effective? Are there any cardiovascular contraindications to FP? For each of those questions, separate literature searches have been conducted. A total of 86 articles have been included in this review: 34 for the first question, 35 for the second, and 17 for the third. Ovarian reserve markers and cardiovascular contraindications to pregnancy should be established before FP; hoverer, there are no unambiguous indicators as to which patients should be disqualified from the FP and more evidence is needed in this subject.
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Affiliation(s)
- Małgorzata Więcek
- Department of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Jakub Gawlik
- Student Scientific Society at the Department of Pathophysiology, Jagiellonian University Medical College, Krakow, Poland
| | - Zuzanna Nowak
- Student Scientific Society at the Department of Pathophysiology, Jagiellonian University Medical College, Krakow, Poland
| | - Aneta Gawlik
- Department of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
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Chhabria S, Takle V, Sharma N, Kharkar P, Pansare K, Tripathi A, Tripathi A, Bhartiya D. Extremely Active Nano-formulation of Resveratrol (XAR™) attenuates and reverses chemotherapy-induced damage in mice ovaries and testes. J Ovarian Res 2022; 15:115. [PMID: 36271409 PMCID: PMC9585716 DOI: 10.1186/s13048-022-01043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/23/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Fertility preservation and restoration in cancer patients/survivors is the need of present times when increased numbers of patients get cured of cancer but face infertility as a serious side effect. Resveratrol has beneficial effects on chemoablated ovaries and testes in mice but has failed to enter the clinics because of extremely poor bioavailability. The present study was undertaken to evaluate the protective and curative effects of Extremely active Resveratrol (XAR™)- a nano-formulation of resveratrol with significantly improved bioavailability- on mouse ovary and testis after chemotherapy. Effects of XAR™ and FSH were compared on stimulation of follicle growth in adult mice ovaries. XAR™ (25 mg/kg) was administered for two days prior to chemotherapy to study the protective effects on the mouse gonads. XAR™ was also administered for 14 days post chemoablation to study the regenerative effects. Besides effect on numbers of primordial and growing follicles and spermatogenesis, the effect of XAR™ was also evaluated on the transcripts specific for ovarian/testicular stem/progenitor/germ cells, their proliferation, differentiation, meiosis, and the antioxidant indices. RESULTS Similar to FSH, XAR™ increased the numbers of primordial follicles (PF) as well as growing follicles. It protected the gonads from the adverse effects of chemotherapy and showed the ability to regenerate non-functional, chemoablated gonads. Besides stimulating follicle growth in adult ovaries similar to FSH, XAR™ also protected the testes from the adverse effects of chemotherapy and improved spermatogenesis. This was accompanied by improved anti-oxidant indices. CONCLUSIONS The results of the present study potentiate the use of XAR™ in pilot clinical studies to protect gonadal function during oncotherapy and also regenerate non-functional gonads in cancer survivors by improving antioxidant indices and stem cell-based tissue regeneration.
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Affiliation(s)
- Sagar Chhabria
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Vaishnavi Takle
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Nripen Sharma
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Prashant Kharkar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga, Mumbai, 400 019, India
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, Vile Parle (West), Mumbai, 400 056, India
| | - Kshama Pansare
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Anish Tripathi
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Ashish Tripathi
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India
| | - Deepa Bhartiya
- Epigeneres Biotech Pvt. Ltd., Sun Mill Compound, Ikon House, B-Block, Senapati Bapat Marg, Lower Parel, Mumbai, Maharashtra, 400013, India.
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10
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Rives N, Courbière B, Almont T, Kassab D, Berger C, Grynberg M, Papaxanthos A, Decanter C, Elefant E, Dhedin N, Barraud-Lange V, Béranger MC, Demoor-Goldschmidt C, Frédérique N, Bergère M, Gabrel L, Duperray M, Vermel C, Hoog-Labouret N, Pibarot M, Provansal M, Quéro L, Lejeune H, Methorst C, Saias J, Véronique-Baudin J, Giscard d'Estaing S, Farsi F, Poirot C, Huyghe É. What should be done in terms of fertility preservation for patients with cancer? The French 2021 guidelines. Eur J Cancer 2022; 173:146-166. [PMID: 35932626 DOI: 10.1016/j.ejca.2022.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/02/2022] [Accepted: 05/12/2022] [Indexed: 11/03/2022]
Abstract
AIM To provide practice guidelines about fertility preservation (FP) in oncology. METHODS We selected 400 articles after a PubMed review of the literature (1987-2019). RECOMMENDATIONS Any child, adolescent and adult of reproductive age should be informed about the risk of treatment gonadotoxicity. In women, systematically proposed FP counselling between 15 and 38 years of age in case of treatment including bifunctional alkylating agents, above 6 g/m2 cyclophosphamide equivalent dose (CED), and for radiation doses on the ovaries ≥3 Gy. For postmenarchal patients, oocyte cryopreservation after ovarian stimulation is the first-line FP technique. Ovarian tissue cryopreservation should be discussed as a first-line approach in case of treatment with a high gonadotoxic risk, when chemotherapy has already started and in urgent cases. Ovarian transposition is to be discussed prior to pelvic radiotherapy involving a high risk of premature ovarian failure. For prepubertal girls, ovarian tissue cryopreservation should be proposed in the case of treatment with a high gonadotoxic risk. In pubertal males, sperm cryopreservation must be systematically offered to any male who is to undergo cancer treatment, regardless of toxicity. Testicular tissue cryopreservation must be proposed in males unable to cryopreserve sperm who are to undergo a treatment with intermediate or severe risk of gonadotoxicity. In prepubertal boys, testicular tissue preservation is: - recommended for chemotherapy with a CED ≥7500 mg/m2 or radiotherapy ≥3 Gy on both testicles. - proposed for chemotherapy with a CED ≥5.000 mg/m2 or radiotherapy ≥2 Gy. If several possible strategies, the ultimate choice is made by the patient.
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Affiliation(s)
- Nathalie Rives
- Normandie Univ, UNIROUEN, Team "Adrenal and Gonadal Physiopathology" Inserm U1239 Nordic, Rouen University Hospital, Biology of Reproduction-CECOS Laboratory, Rouen, France
| | - Blandine Courbière
- Reproductive Medicine and Biology Department, Assistance Publique Hôpitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Thierry Almont
- Cancerology, Urology, Hematology Department, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France; General Cancer Registry of Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France
| | - Diana Kassab
- Methodology Unit, Association Française d'Urologie, Paris, Ile-de-France, France
| | - Claire Berger
- Department of Pediatric Hematology and Oncology, University-Hospital of Saint-Etienne, Hospital, Nord Saint-Etienne cedex 02, France 42055; Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, 15 rue Ambroise Paré, Saint-Etienne cedex 02, France 42023
| | - Michaël Grynberg
- Reproductive Medicine and Fertility Department, Hôpital Antoine-Beclère, Clamart, Île-de-France, France
| | - Aline Papaxanthos
- Reproductive Medicine and Biology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, Aquitaine, France
| | - Christine Decanter
- Medically Assisted Procreation and Fertility Preservation Department, Centre Hospitalier Régional Universitaire de Lille, Lille, Hauts-de-France, France
| | - Elisabeth Elefant
- Reference Center for Teratogenic Agents, Hôpital Armand-Trousseau Centre de Référence sur les Agents Tératogènes, Paris, Île-de-France, France
| | - Nathalie Dhedin
- Adolescents and Young Adults Unit, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
| | - Virginie Barraud-Lange
- Reproductive Medicine and Biology Department, Hôpital Cochin, Paris, Île-de-France, France
| | | | | | - Nicollet Frédérique
- Information and Promotion Department, Association Laurette Fugain, Paris, France
| | - Marianne Bergère
- Human Reproduction, Embryology and Genetics Directorate, Agence de la biomédecine, La Plaine Saint-Denis, France
| | - Lydie Gabrel
- Good Practices Unit - Guidelines and Medicines Directorate, Institut National du Cancer, Billancourt, Île-de-France, France
| | - Marianne Duperray
- Guidelines and Drug Directorate, Institut National du Cancer, Billancourt, Île-de-France, France
| | - Christine Vermel
- Expertise Quality and Compliance Mission - Communication and Information Directorate, Institut National du Cancer, Billancourt, Île-de-France, France
| | - Natalie Hoog-Labouret
- Research and Innovation, Institut National du Cancer, Billancourt, Île-de-France, France
| | - Michèle Pibarot
- OncoPaca-Corse Regional Cancer Network, Assistance Publique - Hôpitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Magali Provansal
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Laurent Quéro
- Cancerology and Radiotherapy Department, Hôpital Saint Louis, AP-HP, Paris, France
| | - Hervé Lejeune
- Reproductive Medicine and Biology Department, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Charlotte Methorst
- Reproductive Medicine and Biology Department, Centre Hospitalier des Quatre Villes - Site de Saint-Cloud, Saint-Cloud, France
| | - Jacqueline Saias
- Reproductive Medicine and Biology Department, Assistance Publique Hôpitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Jacqueline Véronique-Baudin
- Cancerology, Urology, Hematology Department, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France; General Cancer Registry of Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France
| | - Sandrine Giscard d'Estaing
- Reproductive Medicine and Biology Department, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Fadila Farsi
- Regional Cancer Network, Réseau Espace Santé Cancer, Lyon, Rhône-Alpes, France
| | - Catherine Poirot
- Adolescents and Young Adults Unit, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
| | - Éric Huyghe
- Urology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, Université Toulouse 3 Paul Sabatier, Toulouse, France.
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11
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Gromski PS, Patil RS, Chougule SM, Bhomkar DA, Jirge PR, Nelson SM. Ethnic discordance in serum anti-Müllerian hormone in European healthy control, Indian healthy control and Indian infertile women: a population study from India and Europe. Reprod Biomed Online 2022; 45:979-986. [DOI: 10.1016/j.rbmo.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
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12
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Lipovac M, Aschauer J, Imhof H, Herrmann C, Sima M, Weiß P, Imhof M. The effect of micronutrient supplementation on serum anti-Mullerian hormone levels: a retrospective pilot study. Gynecol Endocrinol 2022; 38:310-313. [PMID: 35147056 DOI: 10.1080/09513590.2022.2028770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The anti-Müllerian-hormone (AMH) is secreted by the granulosa cells of the oocytes and can be used as a marker of the ovarian reserve; helpful to estimate female fertility or the menopause onset. Although various factors may influence AMH levels, the correlation with nutritional factors needs more research. OBJECTIVE To evaluate the effect of a micronutrient supplementation on female AMH levels. METHODS This retrospective analysis includes a total of 244 women, who attended the Karl Landsteiner Institute, Korneuburg, Austria from January 2013 to June 2019 due to an unfulfilled desire for a child. All women were treated with an oral micronutrient preparation consisting the dosage of one soft capsule and one tablet per day for 3 months. The soft capsule contains omega-3 fatty acids and the tablet is a standardized combination of coenzyme Q10, vitamin E, folic acid, selenium, catechins from green tea extract, and glycyrrhizin from licorice extract. Serum AMH levels before and after 3 months were compared. In addition, available clinical data such as ovulation frequency, endometrium thickness, and luteal phase duration were analyzed. RESULTS The mean age of the women was 37.3 ± 1.8 years, the mean body mass index of 24.3 ± 4.6 k/m2. The mean serum AMH levels and endometrial thickness values were significantly higher after micronutrient supplementation as compared to baseline (1.42 ± 0.86 versus 1.86 ± 0.82 ng/mL and 6.10 ± 1.76 versus 7.29 ± 1.65 mm, respectively). In addition, ovulation frequency and luteal phase duration significantly improved in more than 60%. CONCLUSION Proposed micronutrient supplementation had a positive effect on serum AMH levels, endometrial thickness, ovulation frequency, and luteal phase duration. It could be a simple, risk-free therapeutic option to improve female fertility. More research is warranted to prove this effect.
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Affiliation(s)
- Markus Lipovac
- IMI Fertility Center, Vienna, Austria
- Karl Landsteiner Institute for Cell-Based Therapy in Gynecology, Korneuburg, Austria
| | | | | | | | | | | | - Martin Imhof
- IMI Fertility Center, Vienna, Austria
- Karl Landsteiner Institute for Cell-Based Therapy in Gynecology, Korneuburg, Austria
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13
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Alinia T, Khodakarim S, Tehrani FR, Sabour S. Age at Natural Menopause; A Data Mining Approach (Data from the National Health and Nutrition Examination Survey 2013-2014). Int J Prev Med 2021; 12:180. [PMID: 37663399 PMCID: PMC10472079 DOI: 10.4103/ijpvm.ijpvm_647_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background The timing of the age at which menopause occurs varies among female populations. This variation is attributed to genetic and environmental factors. This study aims to investigate the determinants of early and late-onset menopause. Methods We used data from the National Health and Nutrition Examination Survey 2013-2014 for 762 naturally menopause women. Data on sociodemographic, lifestyle, examination, and laboratory characteristics were examined. We used random forest (RF), support vector machine (SVM), and logistic regression (LR) to identify important determinants of early and late-onset menopause. We compared the performance of models using sensitivity, specificity, Brier score, and area under the receiver operating characteristic (AUROC). The top determinants were assessed by using the best performing models, using the mean decease in Gini. Results Random forest outperformed LR and SVM with overall AUROC 99% for identifying related factors of early and late-onset menopause (Brier score: 0.051 for early and 0.005 for late-onset menopause). Vitamin B12 and age at menarche were strongly related to early menopause. Also, methylmalonic acid (MMA), vitamin D, body mass index (BMI) were among the top highly ranked factors contributing to early menopause. Features such as age at menarche, MMA, sex hormone-binding globulin (SHBG), BMI, vitamin B12 were the most important covariate for late-onset menopause. Conclusions Menarche age and BMI are among the important contributors of early and late-onset menopause. More research on the association between vitamin D, vitamin B12, SHBG, and menopause timing is required which will produce invaluable information for better prediction of menopause timing.
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Affiliation(s)
- Tahereh Alinia
- Student Research Committee, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Allied Medical Sciences, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Tehran, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran
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14
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Decanter C, Delepine J, Behal H, Manier S, Bruno B, Barbatti M, Robin C, Labreuche J, Morschhauser F, Pigny P. Longitudinal study of AMH variations in 122 Adolescents and Young Adults (AYA) and non-AYA lymphoma patients to evaluate the chemo-induced ovarian toxicity to further personalise fertility preservation counselling. Hum Reprod 2021; 36:2743-2752. [PMID: 34417822 DOI: 10.1093/humrep/deab189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/02/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the influence of age and chemotherapy regimen on the longitudinal blood anti-Müllerian hormone (AMH) variations in a large series of adolescents and young adult (AYA) (15-24 years old) and non-AYA (25-35 years old) lymphoma patients? SUMMARY ANSWER In case of alkylating regimen treatment, there was a deep and sustained follicular depletion in AYA as well as non-AYA patients; however in both groups, the ovarian toxicity was extremely low in cases of non-alkylating treatments. WHAT IS KNOWN ALREADY AMH is now well-recognised to be a real-time indicator of ovarian follicular depletion and recovery in women treated by chemotherapy. Its longitudinal variations may discriminate between highly and minimally toxic protocols regarding ovarian function. It has been shown, in different cancer types, that age, type of chemotherapy regimen and pre-treatment AMH levels are the main predictors of ovarian recovery. Large studies on longitudinal AMH variations under chemotherapy in lymphoma patients are few but can provide the opportunity to assess the degree of follicle loss at a young age. STUDY DESIGN, SIZE, DURATION This prospective cohort study was conducted in the Fertility Observatory of the Lille University Hospital. Data were collected between 2007 and 2016. Non-Hodgkin or Hodgkin lymphoma patients (n = 122) between 15 and 35 years old were prospectively recruited before commencing chemotherapy. Patients were treated either by a non-alkylating protocol (ABVD group; n = 67) or by an alkylating regimen (alkylating group; n = 55). PARTICIPANTS/MATERIALS, SETTING, METHODS Serial AMH measurements were performed at baseline (AMH0), 15 days after the start of chemotherapy (AMH1), 15 days before the last chemotherapy cycle (AMH2), and at time 3, 6, 9, 12, 18 and 24 months from the end of chemotherapy. The whole study population was divided into two groups according to age: AYA (15-24; n = 65) and non-AYA (25-35; n = 57). All patients received a once monthly GnRH agonist injection during the whole treatment period. A linear mixed model was used to account for the repeated measures of single patients. MAIN RESULTS AND THE ROLE OF CHANCE At baseline, non-AYA patients had higher BMI and lower AMH levels than AYA patients. All AYA and non-AYA patients having received ABVD protocols had regular cycles at 12 months of follow-up. In case of alkylating regimens, amenorrhoea was more frequent in non-AYA patients than in AYA patients at 12 months (37% vs 4%, P = 0.011) and at 24 months (24% vs 4%, P = 0.045). We distinguished a similar depletion phase from AMH0 to AMH2 between ABVD and alkylating groups but significantly different recovery phases from AMH2 to AMH + 24 months. AMH recovery was fast and complete in case of ABVD protocols whatever the age: AMH reached pre-treatment values as soon as the 6th month of follow-up in the AYA group (mean (95% CI) in log AMH M0 vs M6: 3.07 (2.86 to 3.27) vs 3.05 (2.78 to 3.31), P = 1.00) and in the non-AYA group (mean (95% CI) in log AMH M0 vs M6: 2.73 (2.40 to 3.05) vs 2.47 (2.21 to 2.74), P = 1.00). In contrast, no patients from the alkylating group returned to pre-treatment AMH values whatever the age of patients (AYA or non-AYA). Moreover, none of the AMH values post-chemotherapy in the non-AYA group were significantly different from AMH2. Conversely in the AYA group, AMH levels from 6 months (mean (95% CI) in log AMH: 1.79 (1.47 to 2.11), P < 0.001) to 24 months (mean (95% CI) in log AMH: 2.16 (1.80 to 2.52), P ≤ 0.001) were significantly higher than AMH2 (mean (95% CI) in log AMH: 1.13 (0.89 to 1.38)). Considering the whole study population (AYA and non-AYA), pre-treatment AMH levels influenced the pattern of the AMH variation both in alkylating and ABVD protocols (interaction P-value = 0.005 and 0.043, respectively). Likewise, age was significantly associated with the pattern of the recovery phase but only in the alkylating group (interaction P-value =0.001). BMI had no influence on the AMH recovery phase whatever the protocol (interaction P-value = 0.98 in alkylating group, 0.72 in ABVD group). LIMITATIONS, REASONS FOR CAUTION There was a large disparity in subtypes of protocols in the alkylating group. The average duration of chemotherapy for patients treated with alkylating protocols was longer than that for patients treated with ABVD. WIDER IMPLICATIONS OF THE FINDINGS These results make it possible to develop strategies for fertility preservation according to age and type of protocol in a large series of young lymphoma patients. In addition, it was confirmed that young age does not protect against ovarian damage caused by alkylating agents. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by Agence Régionale de Santé Hauts de France and Agence Onco Hauts-de-France who provided finances for AMH dosages (n° DOS/SDES/AR/FIR/2019/282). There are no competing interests. TRIAL REGISTRATION NUMBER DC-2008-642 and CNIL DEC2015-112.
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Affiliation(s)
- C Decanter
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.,EA 4308 Gamétogénèse et qualité du gamète, Lille University Hospital, Lille, France
| | - J Delepine
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.,EA 4308 Gamétogénèse et qualité du gamète, Lille University Hospital, Lille, France
| | - H Behal
- Department of Biostatistics of the Lille University Hospital, ULR 2694-METRICS: Health Technologies Evaluation and Medical Practices, Lille, France
| | - S Manier
- Department of Hematology, Lille University Hospital, Lille, France
| | - B Bruno
- Department of Pediatric Hematology-Oncology Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - M Barbatti
- Department of Pediatric Hematology-Oncology Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - C Robin
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - J Labreuche
- Department of Biostatistics of the Lille University Hospital, ULR 2694-METRICS: Health Technologies Evaluation and Medical Practices, Lille, France
| | - F Morschhauser
- Department of Hematology, Lille University Hospital, Lille, France
| | - P Pigny
- Department of Biochemistry and Hormonology, Metabolism, Nutrition and Oncology, Lille University Hospital, Lille, France
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15
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Tal R, Seifer DB, Tal R, Granger E, Wantman E, Tal O. AMH Highly Correlates With Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve Independent of Age. J Clin Endocrinol Metab 2021; 106:2754-2766. [PMID: 33729496 DOI: 10.1210/clinem/dgab168] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Antimüllerian hormone (AMH) level is strongly associated with ovarian response in assisted reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBRs) in women with diminished ovarian reserve (DOR). OBJECTIVE To examine the association between serum AMH and CLBR among women with DOR undergoing ART. METHODS Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. A total of 34 540 index retrieval cycles of women with AMH <1 ng/mL. The main outcome measure was cumulative live birth. RESULTS A total of 34 540 (25.9%) cycles with AMH <1 ng/mL out of 133 442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data were stratified according to AMH and, age and regression analysis of AMH and CLBR was performed for each age stratum. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (odds ratio [OR] 1.39, 95% CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age stratum. CONCLUSION Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.
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Affiliation(s)
- Reshef Tal
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | - David B Seifer
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | - Renana Tal
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | - Emily Granger
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | | | - Oded Tal
- School of Business, Conestoga College, Kitchener, ON N2G 4M4, Canada
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Filippi F, Meazza C, Somigliana E, Podda M, Dallagiovanna C, Massimino M, Raspagliesi F, Terenziani M. Fertility preservation in childhood and adolescent female tumor survivors. Fertil Steril 2021; 116:1087-1095. [PMID: 34238574 DOI: 10.1016/j.fertnstert.2021.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the proportion of female childhood and adolescent tumor survivors who could benefit from oocyte cryopreservation. DESIGN Case series of female childhood and adolescent tumor survivors referred for fertility counseling. SETTING A referral cancer center and an infertility unit of an academic hospital. PATIENT(S) Young female childhood and adolescent tumor survivors who received gonadotoxic treatments. INTERVENTION(S) Patients were prescribed tests of ovarian reserve and a personalized counseling was given. Oocyte cryopreservation was considered in subjects aged ≥18 years who were diagnosed with diminished ovarian reserve (DOR) (antimüllerian hormone level <2 ng/mL or total antral follicle count ≤10). MAIN OUTCOME MEASURE(S) Rate of women with DOR who stored their oocytes. RESULT(S) Ninety out of 126 evaluated women completed the assessments. We documented preserved ovarian reserve, DOR, and premature ovarian insufficiency in 36 (40%), 35 (39%), and 19 (21%) cases, respectively. Overall, 13 subjects with DOR were eligible for oocyte cryostorage, of whom 9 (69%) underwent the procedure. Considering the whole cohort of evaluated young women (n = 90), the rate of those who had egg freezing was 10%. Finally, nine women started seeking pregnancy after the counseling (six with DOR), and seven of them became pregnant. When the data were analyzed separately according to most gonadotoxic treatments, considerable differences emerged but the evidence did not support the idea that counseling should be restricted to particular subgroups of women. CONCLUSION(S) Ovarian reserve impairment is common in female childhood and adolescent tumor survivors. Postcancer oocyte cryopreservation may be part of the armamentarium of fertility preservation options.
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Affiliation(s)
- Francesca Filippi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy
| | - Edgardo Somigliana
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy
| | - Chiara Dallagiovanna
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy
| | - Francesco Raspagliesi
- Gynecological Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy
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Peregrin-Alvarez I, Fletcher NM, Saed GM, Roman RA, Detti L. Anti-Müllerian Hormone (AMH) regulates BRCA1 and BRCA2 gene expression after ovarian cortex transplantation. Gynecol Endocrinol 2021; 37:349-352. [PMID: 33084436 DOI: 10.1080/09513590.2020.1828328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To test whether recombinant anti-Müllerian hormone (rAMH) could exert an inhibitory function on BRCA1/2 expression in human ovarian cortex. METHODS Pilot study on ovariectomized nude mice xenotransplanted with human vitrified/warmed ovarian cortex and treated with rAMH via infusion pump. Twelve nude mice were ovariectomized and Alzet pumps delivering 1.23 mcg rAMH/day to reach a serum concentration of 17.5 ng/mL, or placebo (controls), were inserted intraabdominally. Previously vitrified/warmed 2x2 mm ovarian cortex fragments were transplanted on day 7 and then harvested on day 14 after pump placement. PCR analyses determined mRNA levels for BRCA1 and BRCA2 in the human ovarian cortex. RESULTS In mice treated with rAMH, BRCA1 expression was significantly lower (0.196 fg/µg RNA, IQR 0.158, 0.236) than in controls (0.544 fg/µg RNA, IQR 0.458, 0.554; p = .030), while BRCA2 expression remained similar in rAMH mice (5.355 fg/µg RNA, IQR 4.479, 6.230) and in controls (4.011 fg/µg RNA, IQR 3.650, 4.182; p = .327). CONCLUSION Administration of rAMH in the peri-transplant period caused downregulation of BRCA1, but not of BRCA2 expression, in human ovarian cortex. These results help our understanding of DNA repair mechanism in the ovarian cortex and identify AMH's possible protective effect on ovarian reserve in BRCA1 mutation carriers.
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Affiliation(s)
- Irene Peregrin-Alvarez
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nicole M Fletcher
- The C. S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ghassan M Saed
- The C. S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI, USA
| | - Robert A Roman
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Laura Detti
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA
- Women's Health Institute, Department of Ob-Gyn Subspecialty Women's Care, Cleveland Clinic, Women's Health Institute, Cleveland, OH, USA
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18
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Wang J, Yao T, Zhang X, Chen Q, Gong S, Jiang L, Yao H, Hu X. Age-specific reference intervals of serum anti-Müllerian hormone in Chinese girls. Ann Clin Biochem 2021; 58:350-357. [PMID: 33657846 DOI: 10.1177/00045632211002879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed to establish anti-Mullerian hormone age-specific reference intervals and determine the correlation between the anti-Mullerian hormone concentration and age, body mass index and concentrations of follicle-stimulating hormones and luteinizing hormone in healthy Chinese girls. METHODS Serum anti-Mullerian hormone concentrations of 1702 healthy girls (0-12 years), recruited between March 2018 and December 2019, were determined using the Beckman Access 2 automated chemiluminescence immunoassay. Single-year-specific medians of anti-Mullerian hormone and effects of age, body mass index, follicle-stimulating hormone and luteinizing hormone on anti-Mullerian hormone concentration were analysed. RESULTS The anti-Mullerian hormone median level continued increasing from birth, reached its peak at age 9 at 4.45 ng/mL (interquartile range [IQR] 2.58-6.90) and then gradually decreased. At age 12, the median reached 1.98 ng/mL (IQR 1.05-3.46). Age-specific reference intervals for anti-Mullerian hormone were established in healthy Chinese girls aged 0-12 years. Anti-Mullerian hormone concentrations showed a moderately positive correlation with age (r = 0.33, P < 0.001). In contrast, follicle-stimulating hormone (r = -0.29, P < 0.001) concentrations were weakly negatively correlated with the serum anti-Mullerian hormone concentration. CONCLUSION We established single-year-specific reference intervals for anti-Mullerian hormone in Chinese girls using the Beckman chemiluminescent platform. This reference range can help clinicians accurately understand anti-Mullerian hormone secretion in healthy girls and promote its clinical use.
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Affiliation(s)
- Jin Wang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Yao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinxin Zhang
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China
| | - Qi Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuo Gong
- Sinopharm Hubei Medical Device Co., Ltd, Wuhan, China
| | - Li Jiang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hui Yao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xijiang Hu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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19
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Anderson RA, Nelson SM. Anti-Müllerian Hormone in the Diagnosis and Prediction of Premature Ovarian Insufficiency. Semin Reprod Med 2021; 38:263-269. [PMID: 33429444 DOI: 10.1055/s-0040-1722319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The menopause and its pathological version, premature ovarian insufficiency (POI), are characterized by the cessation of follicle growth in the ovary, with consequent lack of estrogen production and amenorrhea. The measurement of a specific product of ovarian follicles would therefore be expected to be a valuable biomarker in women with POI, and to be of likely clinical value in the diagnosis and perhaps prediction of POI. Anti-Müllerian hormone (AMH) is produced by the granulosa cells of growing follicles and is therefore likely to be of value in this context. Current data indicate that measurement of AMH is an accurate indicator of POI in many situations and has diagnostic validity and may facilitate more timely diagnosis. AMH seems to be of limited value in predicting age at natural menopause, even with multiple measurements, and there are scarce data regarding prediction of POI, other than when it is imminent, and in some contexts where there is an immediate iatrogenic threat to ovarian function. AMH therefore appears to have considerable value as a diagnostic test for POI, but apart from highlighting broadly those at increased risk, it has inadequate precision to be able to predict accurately the timing of onset of impending POI.
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Affiliation(s)
- Richard A Anderson
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow, United Kingdom.,NIHR Bristol Biomedical Research Centre, Bristol, United Kingdom
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20
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Seshadri S, Morris G, Serhal P, Saab W. Assisted conception in women of advanced maternal age. Best Pract Res Clin Obstet Gynaecol 2020; 70:10-20. [PMID: 32921559 DOI: 10.1016/j.bpobgyn.2020.06.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/14/2020] [Indexed: 11/18/2022]
Abstract
A delay in childbearing to later in life has increased the number of women of advanced maternal age (AMA) opting for assisted reproduction. Women should be made aware that there are age-related changes to fertility, including a decline in oocyte reserve and quality, in addition to an increase in the number of oocyte chromosomal aberrations. Success rates of assisted reproductive technology (ART) cycles decrease with advanced maternal age. There are different fertility options for women of AMA, including fertility preservation (oocyte or embryo freezing), in vitro fertilisation (IVF treatment) with or without preimplantation genetic screening and oocyte or embryo donation. Detailed counselling needs to be offered to these women with regard to the risks, success rates, ethical and legal implications of these fertility treatment options. Women of AMA should be screened for underlying medical conditions that could have an impact on maternal and neonatal morbidity and mortality.
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Affiliation(s)
- S Seshadri
- The Centre for Reproductive and Genetic Health (CRGH), London, UK.
| | - G Morris
- St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - P Serhal
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
| | - W Saab
- The Centre for Reproductive and Genetic Health (CRGH), London, UK
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21
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Gut microbial metabolism of dietary fibre protects against high energy feeding induced ovarian follicular atresia in a pig model. Br J Nutr 2020; 125:38-49. [PMID: 32600501 DOI: 10.1017/s0007114520002378] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To investigate the effects of dietary fibre on follicular atresia in pigs fed a high-fat diet, we fed thirty-two prepubescent gilts a basal diet (CON) or a CON diet supplemented with 300 g/d dietary fibre (fibre), 240 g/d soya oil (SO) or both (fibre + SO). At the 19th day of the 4th oestrus cycle, gilts fed the SO diet showed 112 % more atretic follicles and greater expression of the apoptotic markers, Bax and caspase-3, and these effects were reversed by the fibre diet. The abundance of SCFA-producing microbes was decreased by the SO diet, but this effect was reversed by fibre treatment. Concentrations of serotonin and melatonin in the serum and follicular fluid were increased by the fibre diet. Overall, dietary fibre protected against high fat feeding-induced follicular atresia at least partly via gut microbiota-related serotonin-melatonin synthesis. These results provide insight into preventing negative effects on fertility in humans consuming a high-energy diet.
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22
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Ye M, Yeh J, Kosteria I, Li L. Progress in Fertility Preservation Strategies in Turner Syndrome. Front Med (Lausanne) 2020; 7:3. [PMID: 32039223 PMCID: PMC6993200 DOI: 10.3389/fmed.2020.00003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022] Open
Abstract
Growth retardation and gonadal dysgenesis are two of the most important clinical manifestations of Turner syndrome (TS). As premature ovarian failure generally occurs early in life in women with TS, these patients should be counseled and evaluated as early as possible for discussion of optimal and individualized fertility preservation strategies. Infertility seriously affects the quality of life of women with TS. For those who have ovarian reserve, the theoretical options for future fertility in TS patients include cryopreservation of oocytes, ovarian tissues, and embryos. For those who have already lost their ovarian reserve, oocyte or embryo donation, gestational surrogacy, and adoption are strategies that allow fulfillment of desire for parenting. This review describes the etiologies of infertility and reviews the fertility preservation strategies for women with TS.
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Affiliation(s)
- Mudan Ye
- Department of Gynecology and Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - John Yeh
- Department of Gynecology, Obstetrics and Reproductive Biology, Harvard Medical School, Boston, MA, United States
| | - Ioanna Kosteria
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Agia Sophia Children's Hospital, Athens, Greece
| | - Li Li
- Department of Gynecology and Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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23
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Guo R, Pankhurst MW. Accelerated ovarian reserve depletion in female anti-Müllerian hormone knockout mice has no effect on lifetime fertility†. Biol Reprod 2019; 102:915-922. [DOI: 10.1093/biolre/ioz227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/12/2019] [Accepted: 12/12/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Anti-Müllerian hormone (AMH) inhibits the activation of primordial follicles in the ovary. This causes an increased rate of ovarian reserve depletion in Amh−/− mice. The depletion of the ovarian reserve is responsible for the onset of menopause but age-related infertility occurs in advance of ovarian reserve depletion. To determine whether accelerated loss of primordial follicles leads to earlier onset infertility, Amh−/− and Amh+/+ females were paired with Amh+/+ stud males and birth rates were recorded across the females’ reproductive lifespan. The number of primordial follicles remaining in the ovaries of Amh−/− and Amh+/+ females were quantified in two cohorts at 11–12 and 12–13 months of age. As expected, the ovarian reserve in the Amh−/− females became depleted approximately 1 month earlier than Amh+/+ females. However, no difference was observed in the cumulative number of births over the lifespan, nor were there any differences in mean littersize at any age. It is possible that the reproductive lifespan of mice is too short for sufficient divergence of primordial follicles numbers to cause differences in Amh−/− and Amh+/+ female fertility. An alternative explanation contradicts current thinking; the function of AMH may be unrelated to the longevity of the reproductive lifespan in female mice.
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Affiliation(s)
- Ruikang Guo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Michael W Pankhurst
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
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24
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Nelson SM, Aijun S, Ling Q, Tengda X, Wei X, Yan D, Yanfang W, Zenghui T, Xinqi C, Fraser A, Clayton GL. Ethnic discordance in serum anti-Müllerian hormone in healthy women: a population study from China and Europe. Reprod Biomed Online 2019; 40:461-467. [PMID: 32094052 DOI: 10.1016/j.rbmo.2019.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 12/23/2022]
Abstract
RESEARCH QUESTION Chinese women are known to have an earlier age of natural menopause than their European counterparts, but whether they also have a lower functional ovarian reserve is unknown. This study was designed to assess whether there are ethnic differences in anti-Müllerian hormone (AMH) concentrations in women of reproductive age. DESIGN Women in China and Europe with regular menstrual cycles, not on hormonal contraception and with no medical history of note, were recruited to provide a day 2-5 early follicular phase sample. AMH concentration was determined using the Roche Elecsys assay. Decline in AMH was modelled with linear, quadratic and quadratic with interaction on age equations to assess the impact of ethnicity. RESULTS A total of 887 European and 461 Chinese women participated in the study. Despite the Chinese population being slightly younger (34.1 ± 8.4 years) than their European counterparts (34.8±8.9 years), their median AMH was lower, at 1.87 ng/ml (interquartile range [IQR] 0.28-3.64) compared with 2.11 ng/ml (IQR 0.73-3.96), with evidence of increasing discordance from age 25 years. In all regression models of the age-related decline in AMH, there was evidence of a difference between Chinese and European women. Although AMH was 28.1% (95% confidence interval [CI] 18.2-36.7%) lower in the Chinese population at age 30, this decline increased to 79.4% (95% CI 75.4- 82.9%) at age 45. CONCLUSIONS There were independent effects of age and ethnicity on serum AMH concentrations, with Chinese women having a substantially lower AMH in adult life than their European counterparts from age 25 onwards.
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Affiliation(s)
| | - Sun Aijun
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Qui Ling
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Xu Tengda
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Xue Wei
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Deng Yan
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Wang Yanfang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Tian Zenghui
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Chen Xinqi
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking, China
| | - Abigail Fraser
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma L Clayton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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25
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Lunding SA, Pors SE, Kristensen SG, Bøtkjær JA, Ramløse M, Jeppesen JV, Flachs EM, Pinborg A, Macklon KT, Pedersen AT, Andersen CY, Andersen AN. Ovarian cortical follicle density in infertile women with low anti-Müllerian hormone. J Assist Reprod Genet 2019; 37:109-117. [PMID: 31758514 DOI: 10.1007/s10815-019-01633-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To evaluate the association between anti-Müllerian hormone (AMH) and follicle density in infertile women with diminished ovarian reserve (DOR) versus women with normal ovarian reserve? METHODS Case-control study comparing follicle densities in ovarian cortex from 20 infertile women with DOR (AMH ≤ 5 pmol/L) and 100 controls with presumed normal ovarian reserve. RESULTS For all women > 25 years, the follicle densities correlated positively with AMH levels. For each single picomole per liter increase in AMH the follicle density increased by 6% (95% CI 3.3-8.5%) when adjusted for age. This was similar for women with DOR and controls. The follicle density was 1.8 follicles/mm3 cortical tissue in women with DOR versus 7.0 in age-paired controls (p = 0.04). The women with DOR had a median AMH of 1.8 pmol/L versus 14.4 pmol/L in the age-paired control group (p < 0.001). The ratio of AMH/follicle density was 1:1 (1.8/1.8) in women with DOR and 2:1 (14.4/7.0) in the age-paired controls. Analyses for gonadotropin receptor polymorphisms could not explain the characteristics of women with DOR. The proportion of secondary follicles was higher in women with DOR compared with controls (4.6% versus 1.4%, p = 0.0003). Pooling all patients, the follicle density decreased significantly by 7.7% for every year added (p < 0.0001). The women with DOR had lower follicle densities than the controls, but the slopes were equal in the two cohorts. CONCLUSIONS Follicle density and AMH concentrations correlate also when AMH is low. However, AMH is only a reliable marker for the true ovarian reserve when age is included in the estimation and women with DOR may have more follicles than their AMH levels imply.
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Affiliation(s)
- Stine Aagaard Lunding
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Susanne Elisabeth Pors
- Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stine Gry Kristensen
- Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jane Alrø Bøtkjær
- Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maja Ramløse
- Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Janni Vikkelsø Jeppesen
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Anja Pinborg
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Kirsten Tryde Macklon
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Anette Tønnes Pedersen
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anders Nyboe Andersen
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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26
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Sutherland JM, Frost ER, Ford EA, Peters AE, Reed NL, Seldon AN, Mihalas BP, Russel DL, Dunning KR, McLaughlin EA. Janus kinase JAK1 maintains the ovarian reserve of primordial follicles in the mouse ovary. Mol Hum Reprod 2019; 24:533-542. [PMID: 30247637 DOI: 10.1093/molehr/gay041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/24/2018] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Is the Janus kinase and signal transducer and activator of transcription (JAK-STAT) signalling pathway involved in ovarian follicle development and primordial follicle activation? SUMMARY ANSWER JAK1 is a key factor involved in the regulation of primordial follicle activation and maintenance of the ovarian reserve. WHAT IS KNOWN ALREADY A series of integrated, intrinsic signalling pathways (including PI3K/AKT, mTOR and KITL) are responsible for regulating the ovarian reserve of non-growing primordial follicles and ultimately female fertility. The JAK-STAT signal transduction pathway is highly conserved with established roles in cell division and differentiation. Key pathway members (specifically JAK1, STAT3 and SOCS4) have been previously implicated in early follicle development. STUDY DESIGN, SIZE, DURATION A laboratory animal study was undertaken using the C57Bl/6 inbred mouse strain as a model for human ovarian follicle development. To determine which Jak genes were most abundantly expressed during primordial follicle activation, mRNA expression was analysed across a developmental time-course, with ovaries collected from female mice at post-natal days 1 (PND1), 4 (PND4), 8 (PND8), as well as at 6 weeks (6WK) and 7 months (7MTH) (n ≥ 4). Functional analysis of JAK1 was performed on PND2 mouse ovaries subjected to in vitro explant culture treated with 12.5 μM Ruxolitinib (JAK inhibitor) or vehicle control (DMSO) for 48 h prior to histological assessment (n ≥ 4). PARTICIPANTS/MATERIALS, SETTING, METHODS The expression and localization of the JAK family during ovarian follicle development in the C57Bl/6 inbred mouse strain were evaluated using quantitative PCR, immunoblotting and immunolocalisation. Functional studies were undertaken using the JAK inhibitor Ruxolitinib to investigate the underpinning cellular mechanisms via biochemical in vitro inhibition and histological assessment of intact neonate ovaries. All experiments were replicated at least three times using tissue from different mice unless otherwise stated. MAIN RESULTS AND THE ROLE OF CHANCE Jak1 is the predominant Jak mRNA expressed in the C57Bl/6 mouse ovary across all developmental time-points assessed (P ≤ 0.05). Forty-eight hour inhibition of JAK1 with Ruxolitinib of PND2 ovaries in vitro demonstrated concomitant acceleration of primordial follicle activation and apoptosis (P ≤ 0.001) and upregulation of downstream JAK-STAT pathway members STAT3 and suppressors of cytokine signalling 4 (SOCS4). LARGE-SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Results are shown in one species, the C57Bl/6 mouse strain as an established model of human ovary development. Ruxolitinib also inhibits JAK2, with decreased efficacy. However, Jak2 mRNA had limited expression in the mouse ovary, particularly at the neonatal stages of follicle development, thus any effect of Ruxolitinib on primordial follicle activation was unlikely to be mediated via this isoform. WIDER IMPLICATIONS OF THE FINDINGS This study supports a key role for JAK1 in the maintenance and activation of primordial follicles, with potential for targeting the JAK-STAT pathway as a method of regulating the ovarian reserve and female fertility. STUDY FUNDING AND COMPETING INTEREST(S) This project has been funded by the Australian National Health and Medical Research Council (G1600095) and The Hunter Medical Research Institute Bob and Terry Kennedy Children's Research Project Grant in Pregnancy & Reproduction (G1501433). All authors declare no conflict of interests.
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Affiliation(s)
- Jessie M Sutherland
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Emily R Frost
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Emmalee A Ford
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Alexandra E Peters
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Natalie L Reed
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Alexandra N Seldon
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Bettina P Mihalas
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Darryl L Russel
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Kylie R Dunning
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Australian Research Council, Centre of Excellence for Nanoscale BioPhotonics
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia.,School of Biological Sciences, University of Auckland, Auckland, New Zealand
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27
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Ishii R, Tachibana N, Okawa R, Enomoto M, Asami M, Toriumi R, Hamada M, Horikawa M, Akiba Y, Taketani Y. Different anti-Műllerian hormone (AMH) levels respond to distinct ovarian stimulation methods in assisted reproductive technology (ART): Clues to better ART outcomes. Reprod Med Biol 2019; 18:263-272. [PMID: 31312105 PMCID: PMC6613008 DOI: 10.1002/rmb2.12270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 01/12/2023] Open
Abstract
PURPOSE We asked whether the relationship between anti-Műllerian hormone (AMH) value and the response to ovarian stimulation (OS) might be AMH value-related and differ for each regimen, aiming at getting clues as to how to choose OS protocols according to AMH levels. We further addressed how AMH value connects with ART outcome. METHODS A total of 1112 women undergoing egg retrieval in ART were included. We adopted four OS protocols, that is, clomiphene, clomiphene + low-dose gonadotropins (Gns), GnRH (Gn-releasing hormone) + Gns (short), and GnRH antagonist. RESULTS Anti-Műllerian hormone showed a stronger correlation with egg number compared with age over a wide age range. When patients were stratified into four groups by AMH value (<1, 1-2, 2-3, and 3≦ ng/mL), the relationship between AMH and egg number differed among differential OS regimes. The number of eggs rose as AMH and total doses of Gn increased. When analyzed for each AMH group, egg number, but not AMH, was associated with pregnancy rate. CONCLUSION Different AMH levels exhibit characteristic responses to distinct OS regimens. To improve ART outcomes, personalized OS should be selected so as to maximize egg number, which seems to be a more precise variable than AMH for predicting pregnancy.
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Affiliation(s)
- Rena Ishii
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | | | - Riho Okawa
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | - Megumi Enomoto
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | - Mai Asami
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | - Rena Toriumi
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
- Department of Obstetrics and GynecologyKyorin University School of MedicineTokyoJapan
| | - Michiko Hamada
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | - Michiharu Horikawa
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
- Artemis Women's HospitalLenia Medical CorporationTokyoJapan
| | - Yoko Akiba
- Women’s Clinic Oizumi GakuenLenia Medical CorporationTokyoJapan
| | - Yuji Taketani
- Artemis Women's HospitalLenia Medical CorporationTokyoJapan
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28
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Ruth KS, Soares ALG, Borges MC, Eliassen AH, Hankinson SE, Jones ME, Kraft P, Nichols HB, Sandler DP, Schoemaker MJ, Taylor JA, Zeleniuch-Jacquotte A, Lawlor DA, Swerdlow AJ, Murray A. Genome-wide association study of anti-Müllerian hormone levels in pre-menopausal women of late reproductive age and relationship with genetic determinants of reproductive lifespan. Hum Mol Genet 2019; 28:1392-1401. [PMID: 30649302 PMCID: PMC6452199 DOI: 10.1093/hmg/ddz015] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 12/29/2022] Open
Abstract
Anti-Müllerian hormone (AMH) is required for sexual differentiation in the fetus, and in adult females AMH is produced by growing ovarian follicles. Consequently, AMH levels are correlated with ovarian reserve, declining towards menopause when the oocyte pool is exhausted. A previous genome-wide association study identified three genetic variants in and around the AMH gene that explained 25% of variation in AMH levels in adolescent males but did not identify any genetic associations reaching genome-wide significance in adolescent females. To explore the role of genetic variation in determining AMH levels in women of late reproductive age, we carried out a genome-wide meta-analysis in 3344 pre-menopausal women from five cohorts (median age 44-48 years at blood draw). A single genetic variant, rs16991615, previously associated with age at menopause, reached genome-wide significance at P = 3.48 × 10-10, with a per allele difference in age-adjusted inverse normal AMH of 0.26 standard deviations (SD) (95% confidence interval (CI) [0.18,0.34]). We investigated whether genetic determinants of female reproductive lifespan were more generally associated with pre-menopausal AMH levels. Genetically-predicted age at menarche had no robust association but genetically-predicted age at menopause was associated with lower AMH levels by 0.18 SD (95% CI [0.14,0.21]) in age-adjusted inverse normal AMH per one-year earlier age at menopause. Our findings provide genetic support for the well-established use of AMH as a marker of ovarian reserve.
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Affiliation(s)
- Katherine S Ruth
- Genetics of Complex Traits, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Ana Luiza G Soares
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maria-Carolina Borges
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan E Hankinson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Peter Kraft
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Jack A Taylor
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Anna Murray
- Genetics of Complex Traits, University of Exeter Medical School, University of Exeter, Exeter, UK
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McCormack CD, Leemaqz SY, Furness DL, Dekker GA, Roberts CT. Anti-Müllerian hormone levels in recurrent embryonic miscarriage patients are frequently abnormal, and may affect pregnancy outcomes. J OBSTET GYNAECOL 2019; 39:623-627. [DOI: 10.1080/01443615.2018.1552669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Catherine D. McCormack
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Department of Obstetrics, Women’s and Children’s Hospital, North Adelaide, Australia
| | - Shalem Y. Leemaqz
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Denise L. Furness
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gustaaf A. Dekker
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Claire T. Roberts
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
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Beydoun HA, Hossain S, Beydoun MA, Weiss J, Zonderman AB, Eid SM. Anti-Müllerian Hormone Levels and Cardiometabolic Disturbances by Weight Status Among Men in the 1999 to 2004 National Health and Nutrition Examination Survey. J Endocr Soc 2019; 3:921-936. [PMID: 31020056 PMCID: PMC6469951 DOI: 10.1210/js.2018-00414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/12/2019] [Indexed: 12/27/2022] Open
Abstract
Context Serum anti-Müllerian hormone level (AMH) and body mass index may be jointly associated with cardiometabolic risk. Objectives Examine the contribution of AMH to cardiometabolic disturbances by weight status among US adult men. Design Cross-sectional analysis using data from the 1999 to 2004 waves of the National Health and Nutrition Examination Survey. Setting Multistage probability sampling of the noninstitutionalized US population. Participants US men aged ≥18 years. Final analytic sample sizes ranged from 517 to 1063 participants. Main Outcome and Exposure Measures Cardiometabolic disturbances (metabolic syndrome and its components, insulin resistance, diabetes, and chronic inflammation) and AMH were obtained from trained staff and nurses in a mobile examination center or during in-home visits. Results AMH was directly associated with insulin resistance among obese men [OR 1.08 (95% CI 1.00, 1.15); P = 0.046; N = 146], whereas AMH was inversely associated with waist circumference (WC) among obese men [OR 0.95 (95% CI 0.91, 0.99); P = 0.049; N = 146]. An inverse relationship was also observed between categorical AMH and diabetes status [medium vs low AMH; OR 0.19 (95% CI 0.043, 0.84); P = 0.030; N = 145] among obese men, with a strong inverse relationship also detected among overweight men [high vs low AMH; OR 0.011 (95% CI 0.0004, 0.27); P = 0.007; N = 193]. An inverse relationship between continuous AMH and diabetes [OR 0.75 (95% CI: 0.59, 0.93); P = 0.011; N = 193] was also detected among overweight men. Conclusions AMH was associated with specific cardiometabolic risk factors, including WC, diabetes status, and insulin resistance, in overweight and obese US men.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Jordan Weiss
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Somigliana E, Terenziani M, Filippi F, Bergamini A, Martinelli F, Mangili G, Peccatori F, Vercellini P. Chemotherapy-related damage to ovarian reserve in childhood cancer survivors: interpreting the evidence. J Assist Reprod Genet 2019; 36:341-348. [PMID: 30362055 PMCID: PMC6420530 DOI: 10.1007/s10815-018-1345-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/12/2018] [Indexed: 01/23/2023] Open
Abstract
Chemotherapy during childhood damages ovarian reserve and can affect future fertility. However, recent large epidemiological studies showed that the detrimental impact on fertility is less severe if women seek for pregnancy at a younger age. To explain this observation, we hypothesize that the detrimental effects of previous chemotherapy on the ovarian reserve may be attenuated in young adults for two main reasons. Firstly, recent evidence showed that the amount of ovarian reserve is not a critical factor for effective natural conceptions. Provided that the residual ovarian reserve allows regular ovulatory cycles, the chances of pregnancy are similar in women with intact or reduced ovarian reserve. Secondly, ovarian reserve depletion appears to be a phenomenon that is inversely related to the residual ovarian reserve rather than to age. From a mathematical perspective, this kind of regulation intrinsically attenuates the effects of an early loss of a significant amount of primordial follicles. In conclusion, the detrimental effects of chemotherapy on natural fertility may be less severe if women with a history of chemotherapy during childhood seek for pregnancy early. This information should be part of the counseling.
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Affiliation(s)
- Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
- Obstet-Gynecol Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122, Milan, Italy.
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - Francesca Filippi
- Obstet-Gynecol Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Bergamini
- Obstet-Gynecol Department, San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Martinelli
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - Giorgia Mangili
- Obstet-Gynecol Department, San Raffaele Scientific Institute, Milan, Italy
| | - Fedro Peccatori
- Fertility and Procreation Unit, Division of Gynaecologic Oncology, European Institute of Oncology, Milan, Italy
| | - Paolo Vercellini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Obstet-Gynecol Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Tang Z, Yang Y, Wang X, Meng W, Li X. Meta-analysis of the diagnostic value of Wisteria floribunda agglutinin-sialylated mucin1 and the prognostic role of mucin1 in human cholangiocarcinoma. BMJ Open 2019; 9:e021693. [PMID: 30700476 PMCID: PMC6352767 DOI: 10.1136/bmjopen-2018-021693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Serum carbohydrate antigen 19-9 (CA19-9) is a widely used tumour marker for cholangiocarcinoma (CCA). However, it is not a necessarily good CCA marker in terms of diagnostic accuracy. The purpose of this study is to evaluate the diagnostic value of Wisteria floribundaagglutinin-sialylated Mucin1 (WFA-MUC1) and the prognostic role of Mucin1 (MUC1) in human CCA. DESIGN Meta-analysis. DATA SOURCES Studies published in PubMed, Web of Science, The Cochrane Library and the China National Knowledge Infrastructure up to 11 October 2017. ELIGIBILITY CRITERIA We included reports assessing the diagnostic capacity of WFA-MUC1 and the prognostic role of MUC1 in CCA. The receiver operating characteristic curve (ROC) of WFA-MUC1 and/or CA19-9 was described, and the HRs including 95% CI and the corresponding p value for MUC1 can be extracted. DATA EXTRACTION AND SYNTHESIS Two independent researchers extracted data and assessed risk of bias. The diagnostic sensitivity and specificity data of WFA-MUC1 were extracted and analysed as bivariate data. Pooled HRs and its 95% CI for MUC1 were calculated with a random-effects meta-analysis model on overall survival of resectable CCA. RESULTS Sixteen reports were included in this study. The pooled sensitivity and specificity of WFA-MUC1 were 0.76 (95% CI 0.71 to 0.81) and 0.72 (95% CI 0.59 to 0.83) in serum, 0.85 (95% CI 0.81 to 0.89) and 0.72 (95% CI 0.64 to 0.80) in bile and 0.72 (95% CI 0.50 to 0.87) and 0.85 (95% CI 0.70 to 0.93) in tissue, respectively. The summary ROC (SROC) were 0.77 (95% CI 0.73 to 0.81) in serum, 0.88 (95% CI 0.85 to 0.90) in bile and 0.86 (95% CI 0.83 to 0.89) in tissue, respectively. Furthermore, the pooled sensitivity and specificity and the SROC of CA19-9 in serum were 0.67 (95% CI 0.61 to 0.72), 0.86 (95% CI 0.75 to 0.93) and 0.75 (95% CI 0.71 to 0.79), respectively. The pooled HRs for MUC1 was 2.20 (95% CI 1.57 to 3.01) in CCA and 4.17 (95% CI 1.71 to 10.17) in mass-forming intrahepatic CCA. CONCLUSIONS Compared with CA19-9, WFA-MUC1 was shown to possess stronger diagnostic capability. MUC1 could serve as a prognosis factor for poor outcomes of CCA, particularly, mass-forming intrahepatic CCA.
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Affiliation(s)
- Zengwei Tang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Yuan Yang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Xiaolu Wang
- Department of General Surgery, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | - Wenbo Meng
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
- Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, China
| | - Xun Li
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
- The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China
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Hamza RT, Mira MF, Hamed AI, Ezzat T, Sallam MT. Anti-Müllerian hormone levels in patients with turner syndrome: Relation to karyotype, spontaneous puberty, and replacement therapy. Am J Med Genet A 2018; 176:1929-1934. [PMID: 30088853 DOI: 10.1002/ajmg.a.40473] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/12/2017] [Accepted: 06/21/2018] [Indexed: 11/10/2022]
Abstract
Most girls with Turner syndrome (TS) suffer from incomplete sexual development, premature ovarian failure, and infertility due to abnormal ovarian folliculogenesis. Serum anti-Müllerian hormone (AMH) levels reflect the ovarian reserve in females, even in childhood. Thus, we aimed to assess serum AMH levels in girls with TS and its relation to karyotype, spontaneous puberty, and growth hormone (GH) therapy. Fifty TS were compared to 50 age- and sex-matched controls. All subjects were subjected to history, anthropometric assessment, Tanner pubertal staging and measurement of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and AMH. Karyotype results were obtained from patients' records. Serum AMH was measurable in 12 TS patients (24%). The lowest frequency of measurable AMH was in patients with a karyotype of 45,X. The measurable AMH was associated with spontaneous breast development (p = .003) and spontaneous menarche (p = .001). AMH correlated negatively with FSH (r = -.846, p = .000) and LH (r = -.83, p = .034). GH therapy increased the odds of having measurable AMH in TS girls (p = .002). In conclusion, AMH was associated with karyotype, spontaneous pubertal development, LH, and FSH in TS girls and may serve as a useful marker of ovarian function and ongoing follicular development in prepuberty.
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Affiliation(s)
- Rasha T Hamza
- Departments of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa F Mira
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amira I Hamed
- Departments of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Treiz Ezzat
- Departments of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud T Sallam
- Department of Clinical and Chemical Pathology, National Research Center, Cairo, Egypt
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Gai HF, An JX, Qian XY, Wei YJ, Williams JP, Gao GL. Ovarian Damages Produced by Aerosolized Fine Particulate Matter (PM 2.5) Pollution in Mice: Possible Protective Medications and Mechanisms. Chin Med J (Engl) 2018; 130:1400-1410. [PMID: 28584201 PMCID: PMC5463468 DOI: 10.4103/0366-6999.207472] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Ambient aerosol fine particulate matter (PM2.5) is associated with male reproductive toxicity in experiments and may have adverse effects in the female. However, studies evaluating the protective effects and precise mechanisms of aspirin, Vitamin C, Vitamin E, or ozone against toxic effects of PM2.5 are sparse. This study was conducted to investigate the possible protective effects and mechanisms of aspirin, Vitamin C, Vitamin E, or ozone on fertility in female mice treated with PM2.5. Methods: Eighty-four ICR mice were divided into six groups: control group, PM2.5 group, PM2.5 + aspirin group, PM2.5 + Vitamin C group, PM2.5 + Vitamin E group, and PM2.5 + ozone group. PM2.5 was given by intratracheal instillation every 2 days for 3 weeks. Aspirin, Vitamin C, and Vitamin E were given once a day by oral gavage for 3 weeks, and ozone was administered by intraperitoneal injection once a day for 3 weeks. The levels of anti-Müllerian hormone (AMH), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and 8-hydroxy-2’-deoxyguanosine (8-OHdG) were measured using enzyme-linked immunosorbent assay. Western blotting analysis was used to analyze the expressions of Bcl-2, Bax, and caspase-3 in ovaries. Changes in histological structure were examined by light microscope and electron microscopy was used to detect ultramicrostructure. Results: The results demonstrated that PM2.5 decreased AMH levels (P < 0.001); however, aspirin (P < 0.001), Vitamin C (P < 0.001), Vitamin E (P = 0.001), and ozone (P = 0.002) alleviated the decrease. Changes of IL-6, TNF-α, 8-OHdG, Bax/Bcl-2, and caspase-3 in PM2.5 group were increased compared to control group (P < 0.001), while in PM2.5 + aspirin, PM2.5 + Vitamin C, PM2.5 + Vitamin E, and PM2.5 + ozone groups, they were statistically decreased compared to PM2.5 group (P < 0.001 or P < 0.05). Conclusions: PM2.5 cause the damage of ovaries, and aspirin, Vitamin C, Vitamin E, and ozone antagonizes the damage. The protective mechanism is probably due to its ability to blunt the inflammatory and oxidative stress caused by PM2.5, which subsequently suppressing the expression of apoptotic regulatory protein and reducing the incidence of ovary apoptosis.
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Affiliation(s)
- Hui-Fang Gai
- Department of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261000; Department of Obstetrics and Gynecology, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
| | - Jian-Xiong An
- Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
| | - Xiao-Yan Qian
- Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
| | - Yong-Jie Wei
- Laboratory of Environmental Criteria and Risk Assessment and Environmental Standards Institute, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - John P Williams
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Guo-Lan Gao
- Department of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261000; Department of Obstetrics and Gynecology, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
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Rasool S, Shah D. Fertility with early reduction of ovarian reserve: the last straw that breaks the Camel's back. FERTILITY RESEARCH AND PRACTICE 2017; 3:15. [PMID: 29046817 PMCID: PMC5637249 DOI: 10.1186/s40738-017-0041-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/25/2017] [Indexed: 01/29/2023]
Abstract
Diminished fertility and poor ovarian response pose a conundrum to the experts in the field of reproductive medicine. There is limited knowledge about the risk factors of diminished ovarian reserve other than the iatrogenic ones. One of the leading causes of infertility in women today is diminished ovarian reserve (DOR). DOR is characterized by a low number of eggs in a woman's ovaries and/or with poor quality of the remaining eggs, which boils down to impaired development of the existing eggs, even with assisted reproductive techniques. A good number of such women with low ovarian reserve may conceive with their own eggs, if they are given individualized treatment that is tailored for their profile. Such patients should be counseled appropriately for an aggressive approach towards achieving fertility. The sooner the treatment is started, the better the chances of pregnancy.
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Affiliation(s)
- Sabahat Rasool
- Gynaecworld, Kwality House, 1st Floor, Kemps Corner, Mumbai, India
| | - Duru Shah
- Scientific Director & Fertility Expert, Gynaecworld, Kwality House, 1st Floor, Kemps Corner, Mumbai, India
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Tal R, Seifer DB. Ovarian reserve testing: a user's guide. Am J Obstet Gynecol 2017; 217:129-140. [PMID: 28235465 DOI: 10.1016/j.ajog.2017.02.027] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/08/2017] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
Ovarian reserve is a complex clinical phenomenon influenced by age, genetics, and environmental variables. Although it is challenging to predict the rate of an individual's ovarian reserve decline, clinicians are often asked for advice about fertility potential and/or recommendations regarding the pursuit of fertility treatment options. The purpose of this review is to summarize the state-of-the-art of ovarian reserve testing, providing a guide for the obstetrician/gynecologist generalist and reproductive endocrinologist. The ideal ovarian reserve test should be convenient, be reproducible, display little if any intracycle and intercycle variability, and demonstrate high specificity to minimize the risk of wrongly diagnosing women as having diminished ovarian reserve and accurately identify those at greatest risk of developing ovarian hyperstimulation prior to fertility treatment. Evaluation of ovarian reserve can help to identify patients who will have poor response or hyperresponse to ovarian stimulation for assisted reproductive technology. Ovarian reserve testing should allow individualization of treatment protocols to achieve optimal response while minimizing safety risks. Ovarian reserve testing may inform patients regarding their reproductive lifespan and menopausal timing as well as aid in the counselling and selection of treatment for female cancer patients of reproductive age who receive gonadotoxic therapy. In addition, it may aid in establishing the diagnosis of polycystic ovary syndrome and provide insight into its severity. While there is currently no perfect ovarian reserve test, both antral follicular count and antimüllerian hormone have good predictive value and are superior to day-3 follicle-stimulating hormone. The convenience of untimed sampling, age-specific values, availability of an automated platform, and potential standardization of antimüllerian hormone assay make this test the preferred biomarker for the evaluation of ovarian reserve in women.
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37
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Garavaglia E, Sala C, Taccagni G, Traglia M, Barbieri C, Ferrari S, Candiani M, Panina-Bordignon P, Toniolo D. Fertility Preservation in Endometriosis Patients: Anti-Müllerian Hormone Is a Reliable Marker of the Ovarian Follicle Density. Front Surg 2017; 4:40. [PMID: 28791295 PMCID: PMC5524724 DOI: 10.3389/fsurg.2017.00040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/10/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the ovarian reserve via measurement of follicular density and anti-Müllerian hormone (AMH) in endometriosis patients participating to a clinical program of cortical ovarian cryopreservation. DESIGN Retrospective analysis of serum AMH levels and prospective investigation of ovarian follicle number. SETTING University Hospital. PATIENTS Two hundred and two women with endometriosis and 400 controls. INTERVENTIONS Blood samples and ovarian biopsies. MAIN OUTCOME MEASURES Correlation of serum AMH levels and the number of non-growing follicles in the biopsied cortical tissues in endometriosis and control subjects, including age, type of AMH kit, and the laboratory performing the analysis as covariates. RESULTS AMH levels were shown to decrease with age in untreated endometriosis patients (P < 1.0 × 10-5) but they were significantly lower in endometriosis compared to controls only in patients over 36 years old (P = 2.7 × 10-4). The AMH decrease was faster in endometriosis compared to controls (beta = 0.27, P = 4.0 × 10-4). Primordial follicle number decreased with the reduction of AMH levels in both cases and controls (beta = 0.3; P = 0.04). CONCLUSION AMH is a reliable marker of ovarian reserve in endometriosis patients, and it can predict follicular density in women undergoing ovarian tissue cryopreservation.
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Affiliation(s)
| | - Cinzia Sala
- Genetics of Common Disorders, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | | | - Michela Traglia
- Genetics of Common Disorders, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Barbieri
- Genetics of Common Disorders, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Ferrari
- Obstetrics and Gynaecology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynaecology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Paola Panina-Bordignon
- Reproductive Sciences, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Toniolo
- Genetics of Common Disorders, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
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Balduzzi A, Dalle JH, Jahnukainen K, von Wolff M, Lucchini G, Ifversen M, Macklon KT, Poirot C, Diesch T, Jarisch A, Bresters D, Yaniv I, Gibson B, Willasch AM, Fadini R, Ferrari L, Lawitschka A, Ahler A, Sänger N, Corbacioglu S, Ansari M, Moffat R, Dalissier A, Beohou E, Sedlacek P, Lankester A, De Heredia Rubio CD, Vettenranta K, Wachowiak J, Yesilipek A, Trigoso E, Klingebiel T, Peters C, Bader P. Fertility preservation issues in pediatric hematopoietic stem cell transplantation: practical approaches from the consensus of the Pediatric Diseases Working Party of the EBMT and the International BFM Study Group. Bone Marrow Transplant 2017; 52:1406-1415. [PMID: 28737775 DOI: 10.1038/bmt.2017.147] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/31/2017] [Accepted: 06/04/2017] [Indexed: 12/14/2022]
Abstract
Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy. Semen collection should be routinely offered to all postpubertal boys at the diagnosis of any disease requiring therapy that could potentially impair fertility. Testicular tissue collection might be offered to postpubertal boys; nevertheless, its use has been unsuccessful to date. Oocyte collection after hormonal hyperstimulation should be offered to postpubertal girls facing gonadotoxic therapies that could be delayed for the 2 weeks required for the procedure. Ovarian tissue collection could be offered to pre-/post-pubertal girls. Pregnancies have been reported after postpubertal ovarian tissue reimplantation; however, to date, no pregnancy has been reported after the reimplantation of prepubertal ovarian tissue or in vitro maturation of pre-/post-pubertal ovarian tissue. Possible future advances in reproductive medicine could change this scenario. Health authorities should prioritize fertility preservation projects in pediatric transplantation to improve patient care and quality of life.
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Affiliation(s)
- A Balduzzi
- Clinica Pediatrica, Università degli Studi di Milano Bicocca, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy
| | - J-H Dalle
- Hemato-Immunology Department, Robert-Debre Hospital, APHP and Paris-Diderot University, Paris, France
| | - K Jahnukainen
- Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M von Wolff
- Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynecology, Inselspital Bern, University Hospital, Bern, Switzerland
| | - G Lucchini
- Bone Marrow Transplant Department, Great Ormond Street Hospital, London, UK
| | - M Ifversen
- Department of Pediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - K T Macklon
- The Fertility Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Poirot
- Adolescent and Young Adult Hematology Unit, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Paris, France
| | - T Diesch
- Department of Pediatric Hematology/Oncology, University Children's Hospital of Basel, Basel, Switzerland
| | - A Jarisch
- Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - D Bresters
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - I Yaniv
- Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - B Gibson
- Department of Paediatric Haematology, Royal Hospital for Children, Scotland, UK
| | - A M Willasch
- Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - R Fadini
- Centro di Medicina della Riproduzione Biogenesi, Istituti Clinici Zucchi, Monza, Italy
| | - L Ferrari
- Department of Gynecology and Obstetrics, Ospedale San Gerardo di Monza, Monza, Italy
| | - A Lawitschka
- St Anna Children's Hospital, UKKJ, MUW, Vienna, Austria
| | - A Ahler
- Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynaecology, University Hospital, Basel, Switzerland
| | - N Sänger
- Division of Reproductive Medicine, Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospital, JW Goethe University, Frankfurt, Germany
| | - S Corbacioglu
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital, University of Regensburg, Regensburg, Germany
| | - M Ansari
- Department of Pediatrics, Hémato-Oncologie Pédiatrique, CANSEARCH Research Laboratory, Université de Médecine de Genève, Geneva, Switzerland
| | - R Moffat
- Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynaecology, University Hospital, Basel, Switzerland
| | - A Dalissier
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - E Beohou
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - P Sedlacek
- Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - A Lankester
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - C D De Heredia Rubio
- Pediatric Oncology and Hematology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - K Vettenranta
- Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - A Yesilipek
- Bahcesehir University School of Medicine, Department of Pediatrics, Pediatric Stem Cell Transplantation Unit, Istanbul, Turkey
| | - E Trigoso
- Paediatric Oncology Unit, Paediatric Transplant Unit, Polytechnic and University Hospital 'LA FE', Valencia, Spain
| | - T Klingebiel
- Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - C Peters
- St Anna Children's Hospital, UKKJ, MUW, Vienna, Austria
| | - P Bader
- Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
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Chen T, Wu H, Xie R, Wang F, Chen X, Sun H, Chen L. Serum Anti-Müllerian Hormone and Inhibin B as Potential Markers for Progressive Central Precocious Puberty in Girls. J Pediatr Adolesc Gynecol 2017; 30:362-366. [PMID: 28161677 DOI: 10.1016/j.jpag.2017.01.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/02/2017] [Accepted: 01/20/2017] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To investigate the potential of serum anti-Müllerian hormone (AMH) and inhibin B (INHB) levels as markers for pubertal progression rate in girls with central precocious puberty (CPP). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A total of 148 girls were enrolled, including 65 girls with premature thelarche and 83 girls with CPP, grouped on the basis of the results of gonadotropin-releasing hormone stimulation tests. Girls with CPP underwent a 6-month follow-up, and were further divided into 2 subgroups: the progressive CPP (P-CPP) group (n = 55) and the slowly P-CPP (SP-CPP) group (n = 28). Serum AMH and INHB levels were assessed in all enrolled girls. Using receiver operating characteristic curves, we analyzed the diagnostic performance of AMH and INHB to differentiate the 2 forms of CPP. RESULTS Our data showed that AMH and INHB offer the potential to act as markers that distinguish SP-CPP from P-CPP. Compared with the SP-CPP group, girls with P-CPP showed lower AMH levels and higher INHB levels. On the basis of the receiver operating characteristics analysis, the area under the curve was 0.92 for the combination of AMH and INHB, with 80% sensitivity and 89.3% specificity. CONCLUSION Our results suggest that serum AMH and INHB levels provide a promising method in differentiating SP-CPP from P-CPP.
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Affiliation(s)
- Ting Chen
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Haiying Wu
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Rongrong Xie
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fengyun Wang
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiuli Chen
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hui Sun
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Linqi Chen
- Department of Endocrinology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
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Moini A, Hedayatshodeh M, Hosseini R, Rastad H. Association between parity and ovarian reserve in reproductive age women. Eur J Obstet Gynecol Reprod Biol 2016; 207:184-187. [DOI: 10.1016/j.ejogrb.2016.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 09/23/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
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Kang E, Wu J, Gutierrez NM, Koski A, Tippner-Hedges R, Agaronyan K, Platero-Luengo A, Martinez-Redondo P, Ma H, Lee Y, Hayama T, Van Dyken C, Wang X, Luo S, Ahmed R, Li Y, Ji D, Kayali R, Cinnioglu C, Olson S, Jensen J, Battaglia D, Lee D, Wu D, Huang T, Wolf DP, Temiakov D, Belmonte JCI, Amato P, Mitalipov S. Mitochondrial replacement in human oocytes carrying pathogenic mitochondrial DNA mutations. Nature 2016; 540:270-275. [PMID: 27919073 DOI: 10.1038/nature20592] [Citation(s) in RCA: 197] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 11/02/2016] [Indexed: 12/17/2022]
Abstract
Maternally inherited mitochondrial (mt)DNA mutations can cause fatal or severely debilitating syndromes in children, with disease severity dependent on the specific gene mutation and the ratio of mutant to wild-type mtDNA (heteroplasmy) in each cell and tissue. Pathogenic mtDNA mutations are relatively common, with an estimated 778 affected children born each year in the United States. Mitochondrial replacement therapies or techniques (MRT) circumventing mother-to-child mtDNA disease transmission involve replacement of oocyte maternal mtDNA. Here we report MRT outcomes in several families with common mtDNA syndromes. The mother's oocytes were of normal quality and mutation levels correlated with those in existing children. Efficient replacement of oocyte mutant mtDNA was performed by spindle transfer, resulting in embryos containing >99% donor mtDNA. Donor mtDNA was stably maintained in embryonic stem cells (ES cells) derived from most embryos. However, some ES cell lines demonstrated gradual loss of donor mtDNA and reversal to the maternal haplotype. In evaluating donor-to-maternal mtDNA interactions, it seems that compatibility relates to mtDNA replication efficiency rather than to mismatch or oxidative phosphorylation dysfunction. We identify a polymorphism within the conserved sequence box II region of the D-loop as a plausible cause of preferential replication of specific mtDNA haplotypes. In addition, some haplotypes confer proliferative and growth advantages to cells. Hence, we propose a matching paradigm for selecting compatible donor mtDNA for MRT.
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Affiliation(s)
- Eunju Kang
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Jun Wu
- Gene Expression Laboratory, Salk Institute for Biological Studies, 10010 North Torrey Pines Road, La Jolla, California 92037, USA
| | - Nuria Marti Gutierrez
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Amy Koski
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Rebecca Tippner-Hedges
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Karen Agaronyan
- Department of Cell Biology School of Osteopathic Medicine, Rowan University, 2 Medical Center Drive, Stratford, New Jersey 08084, USA
| | - Aida Platero-Luengo
- Gene Expression Laboratory, Salk Institute for Biological Studies, 10010 North Torrey Pines Road, La Jolla, California 92037, USA
| | - Paloma Martinez-Redondo
- Gene Expression Laboratory, Salk Institute for Biological Studies, 10010 North Torrey Pines Road, La Jolla, California 92037, USA
| | - Hong Ma
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Yeonmi Lee
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Tomonari Hayama
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Crystal Van Dyken
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Xinjian Wang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA
| | - Shiyu Luo
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA
| | - Riffat Ahmed
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Ying Li
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Dongmei Ji
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Reproductive Medical Centre, Anhui Medical University, No 218, Jixi Rd, Shushan District, Heifei, Anhui 230022, China
| | - Refik Kayali
- IviGen Los Angeles, 406 Amapola Avenue, Suite 215, Torrance, California 90501, USA
| | - Cengiz Cinnioglu
- IviGen Los Angeles, 406 Amapola Avenue, Suite 215, Torrance, California 90501, USA
| | - Susan Olson
- Research Cytogenetics Laboratory, Oregon Health &Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA
| | - Jeffrey Jensen
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
| | - David Battaglia
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
| | - David Lee
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
| | - Diana Wu
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
| | - Taosheng Huang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA
| | - Don P Wolf
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA
| | - Dmitry Temiakov
- Department of Cell Biology School of Osteopathic Medicine, Rowan University, 2 Medical Center Drive, Stratford, New Jersey 08084, USA
| | - Juan Carlos Izpisua Belmonte
- Gene Expression Laboratory, Salk Institute for Biological Studies, 10010 North Torrey Pines Road, La Jolla, California 92037, USA
| | - Paula Amato
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
| | - Shoukhrat Mitalipov
- Center for Embryonic Cell and Gene Therapy, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Division of Reproductive &Developmental Sciences, Oregon National Primate Research Center, Oregon Health &Science University, 505 NW 185th Avenue, Beaverton, Oregon 97006, USA.,Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA.,Knight Cardiovascular Institute, Oregon Health &Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA.,Department of Biomedical Engineering, Oregon Health &Science University, 3303 SW Bond Avenue, Portland, Oregon 97239, USA
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Presence of Germ Cells in Disorders of Sex Development: Implications for Fertility Potential and Preservation. J Urol 2016; 197:937-943. [PMID: 27840018 DOI: 10.1016/j.juro.2016.08.108] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE We sought to determine the presence of germ cells in the gonads of patients with disorders of sex development to establish whether preservation of germ cells for future fertility potential is possible. We hypothesized that germ cells are present but vary by age and diagnosis. MATERIALS AND METHODS We reviewed histology from patients with disorders of sex development who underwent gonadectomy/biopsy from 2002 to 2014 at a single institution for pathological classification of the gonad, composition of gonadal stroma and germ cell presence. RESULTS A total of 44 patients were identified and germ cells were present in 68%. The presence and average number of germ cells per mm2 were analyzed by gonad type and diagnosis. By gonad type all ovotestes, most testes, ovaries and dysgenetic testes, and 15% of streak gonads had germ cells present. By diagnosis germ cells were present in all patients with complete androgen insensitivity syndrome, Denys-Drash syndrome, SRY mutation, mixed gonadal dysgenesis, ovotesticular conditions and StAR (steroid acute regulatory protein) deficiency, in some patients with persistent müllerian duct syndrome, XO/XY Turner syndrome and disorders of sex development not otherwise specified, and in none with complete or partial gonadal dysgenesis. Germ cells were present in the gonads of 88% of patients 0 to 3 years old, 50% of those 4 to 11 years old and 43% of those older than 12 years. CONCLUSIONS Germ cells were present in the majority of our cohort and the presence decreased with age. This novel, fertility driven evaluation of germ cell quantity in a variety of disorders of sex development suggests that fertility potential may be greater than previously thought. Further studies must be done to evaluate a larger population and examine germ cell quality to determine the viability of these germ cells.
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Lavery SA, Islam R, Hunt J, Carby A, Anderson RA. The medical and ethical challenges of fertility preservation in teenage girls: a case series of sickle cell anaemia patients prior to bone marrow transplant. Hum Reprod 2016; 31:1501-7. [DOI: 10.1093/humrep/dew084] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/23/2016] [Indexed: 11/13/2022] Open
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Abstract
PURPOSE OF REVIEW This review summarizes recent technological developments in the measurement of anti-Müllerian hormone (AMH) and presents an update of the relative performance characteristics of both AMH and antral follicle count (AFC) in predicting the ovarian response to controlled stimulation. RECENT FINDINGS The introduction of two automated AMH immunoassays appears to have resolved the majority of preanalytical and analytical limitations of the manual assays thereby facilitating the delivery of consistent and accurate results. However, as they exhibit different calibration from preexisting assays, derivation of new reference ranges and clinical thresholds for prediction of ovarian response categories will be required. Randomized controlled trials have highlighted the superiority of AMH to AFC in ovarian response prediction and provide a sound basis for its ongoing assessment for stratification and personalization of treatment. SUMMARY Trial evidence combined with full automation of AMH assay measurement suggests that the future for ovarian response prediction will be AMH focused. Sonography will continue to be invaluable for the identification of tubal, ovarian and endometrial pathologies, but the days of counting follicles are numbered.
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Perry JRB, McMahon G, Day FR, Ring SM, Nelson SM, Lawlor DA. Genome-wide association study identifies common and low-frequency variants at the AMH gene locus that strongly predict serum AMH levels in males. Hum Mol Genet 2016; 25:382-8. [PMID: 26604150 PMCID: PMC4706112 DOI: 10.1093/hmg/ddv465] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/20/2015] [Accepted: 11/09/2015] [Indexed: 12/27/2022] Open
Abstract
Anti-Müllerian hormone (AMH) is an essential messenger of sexual differentiation in the foetus and is an emerging biomarker of postnatal reproductive function in females. Due to a paucity of adequately sized studies, the genetic determinants of circulating AMH levels are poorly characterized. In samples from 2815 adolescents aged 15 from the ALSPAC study, we performed the first genome-wide association study of serum AMH levels across a set of ∼9 m '1000 Genomes Reference Panel' imputed genetic variants. Genetic variants at the AMH protein-coding gene showed considerable allelic heterogeneity, with both common variants [rs4807216 (P(Male) = 2 × 10(-49), Beta: ∼0.9 SDs per allele), rs8112524 (P(Male) = 3 × 10(-8), Beta: ∼0.25)] and low-frequency variants [rs2385821 (P(Male) = 6 × 10(-31), Beta: ∼1.2, frequency 3.6%)] independently associated with apparently large effect sizes in males, but not females. For all three SNPs, we highlight mechanistic links to AMH gene function and demonstrate highly significant sex interactions (P(Het) 0.0003-6.3 × 10(-12)), culminating in contrasting estimates of trait variance explained (24.5% in males versus 0.8% in females). Using these SNPs as a genetic proxy for AMH levels, we found no evidence in additional datasets to support a biological role for AMH in complex traits and diseases in men.
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Affiliation(s)
- John R B Perry
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK,
| | - George McMahon
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK and
| | - Felix R Day
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Susan M Ring
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK and
| | - Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow G31 2ER, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK and
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Somigliana E, Lattuada D, Colciaghi B, Filippi F, La Vecchia I, Tirelli A, Baffero GM, Paffoni A, Persico N, Bolis G, Fedele L. Serum anti-Müllerian hormone in subfertile women. Acta Obstet Gynecol Scand 2015; 94:1307-12. [DOI: 10.1111/aogs.12761] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 08/17/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Edgardo Somigliana
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Debora Lattuada
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Barbara Colciaghi
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Francesca Filippi
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Irene La Vecchia
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Amedea Tirelli
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Giulia M. Baffero
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
- University of Milan; Milan Italy
| | - Alessio Paffoni
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Nicola Persico
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
| | - Giorgio Bolis
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
- University of Milan; Milan Italy
| | - Luigi Fedele
- Department of Obstetrics and Gynecology; “Fondazione IRCCS Ca' Granda” Hospital; Milan Italy
- University of Milan; Milan Italy
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Jeffery A, Streeter AJ, Hosking J, Wilkin TJ, Nelson SM. Anti-Müllerian hormone in children: a ten-year prospective longitudinal study (EarlyBird 39). J Pediatr Endocrinol Metab 2015; 28:1153-62. [PMID: 26030784 DOI: 10.1515/jpem-2014-0517] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/09/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is produced by Sertoli cells of the testes and granulosa cells of the ovary. There are limited prospective longitudinal data assessing AMH concentrations throughout childhood in both sexes. OBJECTIVE This study aimed to examine AMH throughout childhood with particular reference to the relationship of AMH to pubertal development in both sexes. DESIGN This is a prospective longitudinal non-intervention cohort study with annual sampling for participants aged 5-14 years. SETTING Community cohort study. PARTICIPANTS A total of 307 healthy children (170 boys) recruited at 5 years from randomly selected schools in Plymouth, UK, participated in this study. Data sets are complete in 76% of the children at 14 years of age. MAIN OUTCOME MEASURE(S) Annual measures of serum AMH, follicle stimulating hormone (FSH) and luteinising hormone (LH), Tanner stage (TS). RESULTS Boys: AMH was stable from 5 to 7 years, increased slightly from 8 to 10 years, then declined at TS2. This decline was preceded by rising FSH and the appearance of LH. AMH correlated inversely with gonadotrophic hormones during puberty. Girls: AMH increased slightly between 6 and 10 years, peaking during the final prepubertal year before returning to near baseline levels at TS3. Inverse correlations between AMH and FSH were apparent during the prepubertal years. CONCLUSIONS Our longitudinal data clarified the development of individual AMH levels over a 10-year period. We described modest late prepubertal peaks in both boys and girls, and confirmed the pubertal decline in boys. The inverse association of AMH with gonadotrophins in young females supports its role as a marker of ovarian function, while the precise role for AMH in relation to testicular function in young males remains unclear.
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McLaughlin M, Kelsey TW, Wallace WHB, Anderson RA, Telfer EE. An externally validated age-related model of mean follicle density in the cortex of the human ovary. J Assist Reprod Genet 2015; 32:1089-95. [PMID: 26043911 PMCID: PMC4531872 DOI: 10.1007/s10815-015-0501-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/18/2015] [Indexed: 12/30/2022] Open
Abstract
Purpose The ability to accurately estimate a woman’s ovarian reserve by non-invasive means is the goal of ovarian reserve prediction. It is not known whether a correlation exists between model-predicted estimates of ovarian reserve and data generated by direct histological analysis of ovarian tissue. The aim of this study was to compare mean non-growing follicle density values obtained from analysis of ovarian cortical tissue samples against ovarian volume models. Methods Non-growing follicle density values were obtained from 13 ovarian cortical biopsies (16-37 years). A mean non-growing follicle density was calculated for each patient by counting all follicles in a given volume of biopsied ovarian cortex. These values were compared to age-matched model generated densities (adjusted to take into consideration the proportion of ovary that is cortex) and the correlation between data sets tested. Results Non-growing density values obtained from fresh biopsied ovarian cortical samples closely matched model generated data with low mean difference, tight agreement limits and no proportional error between the observed and predicted results. Conclusion These findings validate the use of the adjusted population and ovarian volume models, to accurately predict mean follicle density in the ovarian cortex of healthy adult women.
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Affiliation(s)
- M McLaughlin
- Institute of Cell Biology and Centre for Integrative Physiology, University of Edinburgh, Edinburgh, EH8 9XD, UK
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Warren L, Murawski M, Wilk K, Zieba DA, Bartlewski PM. Suitability of antral follicle counts and computer-assisted analysis of ultrasonographic and magnetic resonance images for estimating follicular reserve in porcine, ovine and bovine ovaries ex situ. Exp Biol Med (Maywood) 2015; 240:576-84. [PMID: 25432987 PMCID: PMC4935271 DOI: 10.1177/1535370214560971] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/08/2014] [Indexed: 11/17/2022] Open
Abstract
This study was conducted to determine if correlations exist between the numbers of microscopic follicles comprising ovarian follicular reserve (OFR) and antral follicle counts (AFCs), and to assess the usefulness of computerized analyses of ovarian ultrasonograms and magnetic resonance (MR) images for estimating OFR in excised porcine, ovine and bovine ovaries. As a pre-requisite to these analyses, we characterized and compared ovarian cortical histomorphology and follicle populations in the three species varying in prolificacy and overall reproductive longevity, and hence the total number of microscopic and antral follicles. Ultrasonographic and MR images were obtained at the scanner settings optimized to provide opposing contrasts between antral follicles and the ovarian stroma. Commercially available ImageProPlus® analytical software was used to calculate numerical pixel values (NPVs) and pixel heterogeneity (standard deviation of the pixel values) along the computer-generated lines (4-6) placed in the area corresponding to the ovarian cortex. The numbers of primordial (r = 0.38, P < 0.01) and intermediate follicles (r = 0.37, P < 0.01) were correlated with the numbers of antral follicles in bovine ovarian sections. The numbers of primordial (r = 0.28, P < 0.05), intermediate (r = 0.31, P < 0.01) and primary follicles (r = 0.27, P < 0.05) correlated directly with mean NPVs of the ultrasonographic ovarian images in cattle. There was a negative correlation between primary follicle numbers and NPVs of MR images (3D FAST-SPOILED GRADIENT ECHO) of the porcine ovarian cortex (r = -0.31, P < 0.05). To summarize, the numbers of primordial and intermediate follicles could only be estimated from AFCs in cows. Using ultrasound NPVs, the numbers of primordial, intermediate and primary follicles could be directly estimated in bovine ovaries and the quantitative image attributes of MR images were useful for quantifying porcine primary follicles. The bovine ovarian model is compatible with human situation and hence future studies should be undertaken to ascertain the usefulness of AFCs and ultrasonographic image analyses for estimating OFR in women.
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Affiliation(s)
- Lisa Warren
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road, Guelph, ON N1G 2W1, Canada
| | - Maciej Murawski
- Department of Animal Biotechnology, University of Agriculture in Kraków, 1B Rędzina Street, 30-274 Kraków, Poland
| | - Karolina Wilk
- Department of Animal Biotechnology, University of Agriculture in Kraków, 1B Rędzina Street, 30-274 Kraków, Poland
| | - Dorota A Zieba
- Department of Animal Biotechnology, University of Agriculture in Kraków, 1B Rędzina Street, 30-274 Kraków, Poland
| | - Pawel M Bartlewski
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road, Guelph, ON N1G 2W1, Canada
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Hagen CP, Mouritsen A, Mieritz MG, Tinggaard J, Wohlfart-Veje C, Fallentin E, Brocks V, Sundberg K, Jensen LN, Anderson RA, Juul A, Main KM. Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls. J Clin Endocrinol Metab 2015; 100:880-90. [PMID: 25485726 DOI: 10.1210/jc.2014-3336] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT In adult women, Anti-Müllerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated. OBJECTIVE This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. DESIGN AND SETTING This was a population-based cohort study involving the general community. PARTICIPANTS Included in the study were 121 healthy girls 9.8-14.7 years of age. MAIN OUTCOME MEASURES Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. RESULTS AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118). CONCLUSIONS Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.
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Affiliation(s)
- Casper P Hagen
- Department of Growth and Reproduction (C.P.H., A.M., M.G.M., J.T., C.W.-V., A.J., K.M.M.), Department of Radiology, (E.F.), Department of Fetal Medicine and Ultrasound (V.B., K.S., L.N.J.), Rigshospitalet Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark; and Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
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