Increased intrafollicular androgen levels affect human granulosa cell secretion of anti-müllerian hormone and inhibin-B

Wang

et al. 2014

J Assist Reprod Genet

Purpose To evaluate basal testosterone (T) levels in women undergoing in vitro fertilization (IVF) cycles and examine the association between basal T levels and ovarian response or IVF pregnancy outcome. Methods We retrospectively analyzed 1413 infertile Chinese women undergoing their first IVF treatment at our institution's reproductive center from March 2011 to May 2013. The basal testosterone (T) levels in women undergoing in vitro fertilization (IVF) and the relationship between basal T levels and ovarian response or IVF pregnancy outcome were determined. These patients did not have polycystic ovary syndrome (PCOS) or endometriosis, and were treated with a long luteal down-regulation protocol. Subjects were divided into 2 groups according to basal testosterone (T) levels: Group 1, basal T values <20 ng/dl (n=473), and Group 2, basal T values >20 ng/dl (n=940). We evaluated the association of basal T levels with ovarian response and IVF outcome in the two groups. Results In this study, BMI, basal follicle-stimulating hormone (FSH) levels, basal luteinizing hormone (LH) levels, antral follicle count (AFC), days of stimulation, total gonadotrophin dose, basal FSH/LH ratio, and the number of follicles >14 mm were significantly different (P<0.05) between the two groups. Basal T level positively correlated with ovarian reserve function, number of follicles >14 mm on human chorionic gonadotrophin (HCG) day, and total gonadotropin dose. However, basal T levels play no role in predicting IVF pregnancy outcome. Conclusion Basal T level can be used as a good predictor for ovarian response and the number of large follicles on HCG day. Additionally, we may use basal T level as a marker to predict FSH dosage. In general women, lower level of T might relate with potential poor ovarian response. However, based on our data, basal T levels do not predict pregnancy outcome.

Section: Discussionmentioning

confidence: 99%

Basal serum testosterone levels correlate with ovarian response but do not predict pregnancy outcome in non-PCOS women undergoing IVF

Wang

et al. 2014

J Assist Reprod Genet

“…DHEA supplementation results in an increased ovarian IGF-1 expression, which is reduced in poor responders [15]. The role of androgens in follicular development was described in multiple studies [33][34][35][36][37]. Increasing intra follicular androgens results in an increased AMH expression by the granulosa cells and inhibin-B production [35].…”

Section: Mechanism(s) Of Actionmentioning

confidence: 99%

“…The role of androgens in follicular development was described in multiple studies [33][34][35][36][37]. Increasing intra follicular androgens results in an increased AMH expression by the granulosa cells and inhibin-B production [35]. Androgen receptors have been described in the following: ovarian stroma, theca and granulosa cells, and primary follicles [34].…”

Section: Mechanism(s) Of Actionmentioning

confidence: 99%

“…Androgen receptors have been described in the following: ovarian stroma, theca and granulosa cells, and primary follicles [34]. Fratterelli et al suggested that a day three-testosterone levels below 20 ng/dl are associated with poorer IVF pregnancy rate [35]. In a follow up study from the same group, there was an association with IVF parameters but not with increased pregnancy [36].…”

Section: Mechanism(s) Of Actionmentioning

confidence: 99%

See 1 more Smart Citation

Is there a role for DHEA supplementation in women with diminished ovarian reserve?

Fouany

Sharara

2013

J Assist Reprod Genet

Purpose Poor ovarian reserve and poor ovarian response presents a challenge to IVF centers. Dehydroepiandrosterone (DHEA) supplementation is increasingly being used by many IVF centers around the world in poor responders despite the lack of convincing data. We therefore examined the rationale for the use of DHEA in poor responders, address the relevant studies, present new data, and address its potential mechanisms of action. Methods All published articles on the role of DHEA in infertile women from 1990 to April 2013 were reviewed. Results Several studies have suggested an improvement in pregnancy rates with the use of DHEA. Potential mechanisms include improved follicular steroidogenesis, increased IGF-1, acting as a pre-hormone for follicular testosterone, reducing aneuploidy, and increasing AMH and antral follicle count. While the role of DHEA is intriguing, evidencebased recommendations are lacking. Conclusions While nearly 25 % of IVF programs use DHEA currently, large randomized prospective trials are sorely needed. Until (and if) such trials are conducted, DHEA may be of benefit in suitable, well informed, and consented women with diminished ovarian reserve.

“…Была установлена отрицательная корреляция между AMГ и Э2 в сыворотке крови в день введения хориони-ческого гонадотропина человека (ХГЧ) [27]. Другие исследования, изучающие взаимосвязь между концентрациями Э2 и AMГ в фоллику-лярной жидкости зрелых фолликулов, показа-ли аналогичные результаты [28]. В спонтанном менструальном цикле отмечается статистиче-ски значимое снижение АМГ за 5 дней до ову-ляции [29].…”

unclassified

Aromatase P450 activity in the natural menstrual cycle and during controlled ovarian stimulation

Yakovlev

Павлович

2017

Z.akus.zen.bolezn

The Aim of the study was to assess modern considerations about the role of aromatase P450 enzyme in female reproductive system and the effect of its activity on the protocols of in vitro fertilization (IVF). Materials: foreign and Russian literature data from 1978 to 2016. Methods:review and synthesis of publications has been performed. Conclusions: Ovarian aromatase is the key steroidogenesis enzyme of the female reproductive system. Its activity depends on many factors, both of intraovarian and extragonadal origin. The ovarian follicular response and oocyte quality in IVF may depend on aromatase activity.