Association between diminished ovarian reserve and luteal phase deficiency

Abstract

Objective: To determine the association between biomarkers of ovarian reserve and luteal phase deficiency (LPD). Design: Secondary analysis of a prospective time-to-conceive cohort study. Setting: Not applicable. Patient(s): Women attempting conception, aged 30-44 years, without known infertility. Intervention(s): Measurement of early follicular phase serum levels of antim€ ullerian hormone, FSH, inhibin B, and E 2. Main Outcome Measure(s): The primary outcome was LPD, defined by luteal bleeding (LB) (R1 day of LB) or a short luteal phase length (%11 days). Result(s): Overall, 755 women provided information on 2,171 menstrual cycles and serum for measurement of at least one biomarker of ovarian reserve. There were 2,096 cycles from 754 women in the LB cohort, of which 40% experienced LB. After adjusting for age, race, previous miscarriages, and previous pregnancies, diminished ovarian reserve (DOR) was not significantly associated with LB. Low early follicular phase FSH levels increased the odds of LB (odds ratio [OR] 1.84; 95% confidence interval [CI] 1.25-2.71), as did high early follicular phase E 2 levels (OR 1.59; 95% CI 1.26-2.01). A total of 608 cycles from 286 women were included in the analysis of luteal phase length, of which 13% had a short luteal phase. After adjusting for age, there was no significant association between DOR and a short luteal phase. The risk of a short luteal phase decreased with increasing inhibin B (OR 0.61; 95% CI 0.45-0.81). Conclusion(s): Although DOR is not associated with LPD, hormone dysfunction in the early follicular phase may contribute to LPD in women of older reproductive age. (Fertil Steril Ò 2019;112:378-86. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Altered T lymphocyte subtypes and cytokine profiles in follicular fluid associated with diminished ovary reserve

“…DOR is characterized with the loss of ovarian normal reproductive potential. 18,19 The condition is a high morbidity syndrome of women with normal aging and may results in decreased ovarian response, low pregnancy rates and poor IVF outcomes. 20 Previous study showed that smoking, toxic chemicals, radiation, environmental and genetic change, endometriosis and ovarian surgery may lead to DOR, but the cause was still unknown in many cases.…”

Towards Personalized Antioxidant Use in Female Infertility: Need for More Molecular and Clinical Studies

“…Even though age-related decrease in the uterine and placental function were also described in some women, ART outcomes of aging women obtained with the use of oocytes from young donors are excellent [ 50 ], suggesting that uterine aging only represents a marginal problem in humans. Moreover, in a large cohort study, and after adjusting for age, no significant association between DOR and a short luteal phase was detected [ 51 ].…”

“…On the other hand some studies described age-unrelated problems of uterine receptivity leading to recurrent implantation failure (RIF). RIF usually refers to failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of 3 fresh or frozen cycles in woman under the age of 40 years [ 51 , 52 ]. There is little information about the possible role of oxidative stress in the etiology of RIF.…”

Melatonin: Multi-Target Mechanism Against Diminished Ovarian Reserve Based on Network Pharmacology

“…Infertility affects a significant proportion of humanity and is regarded as a global public health issue by the World Health Organization (1,2). Diminished ovarian reserve (DOR), defined as a reduction in both oocyte quality and quantity, is one of the most common causes of female infertility and poor ovarian response to controlled ovarian stimulation with a rapidly increasing occurrence rate (3,4). In addition, women with DOR have exceedingly high rates of recurrent pregnancy loss and no euploid embryos (5)(6)(7).…”