Different anti‐Műllerian hormone (AMH) levels respond to distinct ovarian stimulation methods in assisted reproductive technology (ART): Clues to better ART outcomes

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.

Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally

“…The pooled estimate among schoolgirls in Uganda, a more homogenous subgroup, was 13% (95% CI 7-21%, 5 studies, I 2 96.4%, S1 File). Higher use was present in areas where there was a history of a programme that had offered reusable pads, such as in refugee camps [42,53] or in schools [8]. Fifteen longitudinal studies followed participants after distributing RMPs, with a median follow-up time of six months (range 2-18 months) (Table 2).…”

“…Maharashtra, p = 0.520; 10% vs. 16% in Tamil Nadu, p = 0.253) and similar or higher compared to single-use pad-users (10% vs. 12% respectively in Chhattisgarh, p = 0.774; 24% vs. 18% in Maharashtra, p = 0.044; 10% vs. 7% in Tamil Nadu, p = 0.288) [8]. In qualitative studies, some users mentioned that reusable pads or period underwear felt thin and were concerned it would cause leakage [22,33], whereas others reported they felt more secure against leaking with RMPs than single-use pads (S1 File) [28,53,58].…”

“…However, a study in Thailand noted that washing and drying RMPs was easier than finding places to dispose of used single-use pads in a refugee camp setting [28]. Although drying outside in the sun is recommended for RMPs [61], there was reluctance as others might see the RMPs, thus some participants reported hiding it under another piece of laundry [53,62]. Some participants complained RMPs required long drying times [24,31,59] of 4 hours to two days, which could result in wearing them while still damp (range 10-14% reported in two studies) [24,37].…”

“…A small Indian study (~20 at follow up 12-24 months) among boarding-school girls who received both RMPs and menstrual cups noted a lower percentage of pain and discomfort when RMPs were used (17%) than when menstrual cups were used (60%). Two Ugandan studies compared inadequate menstrual practices among RMP-users and single-use pad and cloth-users (adequate menstrual practices: access to clean absorbents, adequate frequency of changing of the absorbent, washing of the body with water and soap, adequate disposal and privacy for managing menstruation) [25,53]: in a refugee camp, adequate menstrual hygiene management practices were 50% among RMP-users compared to 65% among single-use pad users and 78% among cloth-users [53]. In a school-based Ugandan study, adequate menstrual hygiene management practices were 11% among RMP-users compared to 9% among users of other materials [25] (Table 5).…”

Roles of kisspeptin in IVF/ICSI-treated infertile women and in human granulosa cells

“…Our results were consistent with a previous study showing that AMH levels had a positive correlation with the number of RO. 48 Remarkably, although AMH in Phase I as well as kisspeptin in Phase II and Phase III had positive correlations with the outcomes of IVF/ICSI treatment, the relationships were different in some aspects. First, AMH showed positive correlations with the number of RO, MII, and 2PN in both successful and unsuccessful subjects with higher correlation coefficient values ( R = 0.627 − 0.890) while kisspeptin levels in Phase II/III showed positive correlations with the number of RO, MII, and 2PN only in the successful group with lower correlation coefficient values ( R = 0.445 − 0.728).…”