scholarly journals Progestin-Primed Ovarian Stimulation with Clomiphene Citrate Supplementation May Be More Feasible for Young Women with Diminished Ovarian Reserve Compared with Standard Progestin-Primed Ovarian Stimulation: A Retrospective Study

2021 ◽  
Vol Volume 15 ◽  
pp. 5087-5097
Author(s):  
Yue Lin ◽  
Qianqian Chen ◽  
Jing Zhu ◽  
Yili Teng ◽  
Xuefeng Huang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Young Women ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Clomiphene Citrate ◽  
Diminished Ovarian Reserve

scholarly journals Progestin-primed Ovarian Stimulation With Clomiphene Citrate Compared With the Standard Progestin-primed Ovarian Stimulation in Various Aged Women With Diminished Ovarian Reserve: a Retrospective Study

2021 ◽  
Author(s):  
Yue Lin ◽  
Qianqian Chen ◽  
Jing Zhu ◽  
Yili Teng ◽  
Xuefeng Huang ◽  
...  
Keyword(s):  
Oocyte Maturation ◽  
Young Women ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Positive Impact ◽  
Clomiphene Citrate ◽  
Diminished Ovarian Reserve ◽  
Lower Percentage ◽  
High Quality ◽  
Pituitary Suppression

Abstract Background: Clomiphene citrate (CC) supplementation in the progestin-primed ovarian stimulation (PPOS) protocol effectively alleviated profound pituitary suppression from progestin administration and reduced the gonadotropin (Gn) dose in the population of women with normal-ovarian-reserve or polycystic ovarian syndrome. Limited data are available about the role of CC in PPOS for women with diminished ovarian reserve (DOR). This study aimed to compare the efficiency of the PPOS protocol with CC supplementation and the standard PPOS protocol for various aged women with DOR.Methods: A total of 364 patients with DOR were recruited for this retrospective cohort study. They were divided into subgroups based on female age, ≤35 years and ＞35 years. The clinical characteristics and outcome were compared between the groups in subgroups.Results: In all patients with DOR, the PPOS protocol with CC supplementation was associated with a lower percentage of women with profound pituitary suppression (0.0% vs 18.6%, P ＜0.001 and 1.3% vs 11.0%, P ＝0.002) and a higher mean luteinizing hormone (LH) level during controlled ovarian stimulation (COS) than the standard PPOS protocol (P ＜0.05＝. In young women with DOR, more number of high-quality cleavage-stage embryos (1.96 vs. 1.38, P ＝0.018) was achieved in the PPOS protocol with CC supplementation. In elderly women with DOR, PPOS protocol with CC supplementation led to an increase in the incidence of LH levels above 10 IU/L on the trigger day (12.7% vs. 4.9%, P ＝0.028) and decrease in the rate of oocyte maturation (84.7% vs. 89.9%, P ＝0.034) compared to the standard PPOS protocol. No significant differences were observed in the Gn duration, total dosage of Gn, and pregnancy outcomes between the groups. Conclusions: CC is an effective adjuvant to alleviate pituitary suppression in the PPOS protocol. For young women with DOR, CC supplementation has a positive impact on the number of high-quality embryos in PPOS protocol. However, elderly patients with DOR would be at risk of developing premature LH surge and poor oocyte maturation rate after the PPOS protocol with CC supplementation was applied.

Differential cumulus cell gene expression in young women with diminished ovarian reserve

2007 ◽  
Vol 88 ◽  
pp. S66
Author(s):  
K. Greenseid ◽  
S. Jindal ◽  
M. Nihsen ◽  
J.M. Hurwitz ◽  
N.S. Santoro ◽  
...  
Keyword(s):  
Gene Expression ◽  
Young Women ◽  
Ovarian Reserve ◽  
Cumulus Cell ◽  
Diminished Ovarian Reserve ◽  
Cell Gene Expression ◽  
Cell Gene

scholarly journals Differential Granulosa Cell Gene Expression in Young Women with Diminished Ovarian Reserve

2011 ◽  
Vol 18 (9) ◽  
pp. 892-899 ◽  
Author(s):  
Keri Greenseid ◽  
Sangita Jindal ◽  
Joshua Hurwitz ◽  
Nanette Santoro ◽  
Lubna Pal
Keyword(s):  
Gene Expression ◽  
Granulosa Cell ◽  
Young Women ◽  
Ovarian Reserve ◽  
Diminished Ovarian Reserve ◽  
Cell Gene Expression ◽  
Cell Gene

P–689 IL–6/IL–10 ratio as predictor of poor ovarian response in women undergoing in-vitro fertilization

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A M Fabrega. Reolid ◽  
M Horta. Foronda ◽  
B Lled. Bosch ◽  
J A Orti. Salcedo ◽  
B Moline. Renau ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Study Design ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Young Patients ◽  
Ovarian Response ◽  
Phase Reaction ◽  
Serum Cytokines ◽  
Potential Biomarker ◽  
Tnf Α

Abstract Study question Are serum cytokines levels associated with ovarian response in IVF cycles? Summary answer The IL–6/IL–10 ratio is higher in patients with low ovarian response. What is known already Previous studies reported differences in the levels of IL–2, Il–6, IL–8, IL–10 and VEGF in follicular fluid between young patients with low ovarian response and normoresponder women. In addition, it is known that IL–6 plays an important role as a mediator of fever and acute phase reaction and IL–10 is the cytokine with the greatest anti-inflammatory power. Although there seems to be some evidence about the possible effect of the immune system on ovarian function and implantation, the role it plays in ART remains unknown. Our aim was to investigate the effect of cytokines in ovarian reserve and response. Study design, size, duration One hundred and fifty-two patients were included in a retrospective study between February 2016 and December 2020. Serum cytokines IL–2, IL–4, IL- 6, IL–8, IL–10, VEGF, IFN↖, TNF α, IL–1 α, IL–1 β, MCP–1 and EGF were measured previously to the ovarian stimulation cycle. Patients with altered karyotype, mutation or premutation in the FMR1 gene or endometriosis or with any other factor that could alter the ovarian reserve or response were excluded from the study. Participants/materials, setting, methods To measure the levels of the different cytokines, a sandwich immunoassay with specific antibodies for the cytokines IL–2, IL–4, IL–6, IL–8, IL–10, VEGF, IFN↖, TNF α, IL -1 α, IL–1 β, MCP–1 and EGF were used. The statistical analysis was performed with R Statistical Software, version 4.0.3 and the Software Statistical Product and Service Solutions, version 20.0 (SPSS, Chicago, IL, EE.UU.). Main results and the role of chance We found that the ratio between IL–6 and IL–10 cytokines is higher in those patients in whom four or fewer oocytes have been recovered after ovarian puncture (2.15 versus 1.55; p = 0.035; Mann-Whitney test). If we establish 0.9 as a cut-off point for the IL–6 / IL–10 ratio, we observed that above this value the risk of having a low response to ovarian stimulation is more than 3 times greater than below this value (22.9% versus 6.0%; p = 0.007; Fischer exact test). There were no statistically significant differences between both groups in terms of age (p = 0.136), dose of gonadotropin administered (p = 0.415) and duration of ovarian stimulation (p = 0.706). In addition, performing hierarchical cluster analysis with the analyzed cytokines and the associated variables to ovarian reserve and response, we observed that the antral follicle count, the total oocytes recovered and the MII recovered are grouped in the same cluster as the cytokines IL–2, IL–4, IL–6, IL–10, IL–1α, IL–1B, IFNγ y TNFα. We determined the number of clusters based on the tree diagram and k-means method. Limitations, reasons for caution The retrospective study design and the sample size could be a limitation. The study was performed in patients with suspected implantation failure. Wider implications of the findings: The ratio between IL–6 and IL–10 could be used as a potential biomarker to predict the ovarian response and provide real expectations regarding the success of IVF cycle. The action of IL–6 could be reduced by blocking its receptor using humanized monoclonal antibodies as Tocilizumab. Trial registration number Not applicable

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