Pharmacogenomics in IVF: A New Era in the Concept of Personalized Medicine

Kalinderi, Kallirhoe; Asimakopoulos, Byron; Nikolettos, Nikos; Manolopoulos, Vangelis G.

doi:10.1177/1933719118765970

Cited by 7 publications

(3 citation statements)

References 115 publications

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“…Several studies have been reported in past on the same lines demonstrating the association of the genotype with less oocytes retrieved, lower follicle-to-oocyte index, more resistant to FSH action and requiring stronger stimulus. [ 20 21 22 ]…”

Section: Discussionmentioning

confidence: 99%

High-Risk Genotypes Associated with Poor Response to Controlled Ovarian Stimulation in Indian Women

Udumudi¹,

Lava²,

Hegde³

2023

Journal of Human Reproductive Sciences

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A BSTRACT Background: Infertility is a global burden and has become exceedingly common in the preceding years; controlled ovarian stimulation (COS) is a pre-requisite for couples opting to conceive via in vitro fertilisation (IVF). Based on the number of oocytes retrieved upon COS, a patient may be classified as a good responder or poor responder. The genetic aspect of response to COS has not been elucidated in the Indian population. Aims: This study aimed to establish a genomic basis for COS in IVF in the Indian population and to understand its predictive value. Settings and Design: The patient samples were collected at both Hegde Fertility Centre and GeneTech laboratory. The test was carried out at GeneTech, a diagnostic research laboratory based in Hyderabad, India. Patients with infertility without any history of polycystic ovary syndrome and hypogonadotropic hypogonadism were included in the study. Detailed clinical, medical and family history was obtained from patients. The controls had no history of secondary infertility or pregnancy losses. Materials and Methods: A total of 312 females were included in the study comprising 212 women with infertility and 100 controls. Next-generation sequencing technology was employed to sequence multiple genes associated with response to COS. Statistical Analysis Used: Statistical analysis using odds ratio was carried out to understand the significance of the results obtained. Results: Strong association of c.146G>T of AMH , c.622-6C>T of AMHR2 , c.453-397T>C and c.975G>C of ESR1 , c.2039G>A of FSHR and c.161+4491T>C of LHCGR with infertility and response to COS was established. Further, combined risk analysis was carried out to establish a predictive risk factor for patients with a combination of the genotypes of interest and biochemical parameters commonly considered during IVF procedures. Conclusion: This study has enabled the identification of potential markers pertaining to response to COS in the Indian population.

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Section: Discussionmentioning

confidence: 99%

High-Risk Genotypes Associated with Poor Response to Controlled Ovarian Stimulation in Indian Women

Udumudi¹,

Lava²,

Hegde³

2023

Journal of Human Reproductive Sciences

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“…Nonadherence behaviors during treatment in clinical trials compromise study power, reduce treatment effect size, and weaken overall study findings. In this era of popularity of personalized medicine, more research is focused on tailoring infertility pharmacotherapies to women based on their genetic characteristics to optimize treatment outcomes ( 69 ). Still, the benefits of these therapies are dependent upon women’s adherence to the regimen.…”

Section: Discussionmentioning

confidence: 99%

Women’s Reports of Barriers to and Facilitators of Oral Medication Adherence During Ovarian Stimulation: A Mixed Methods Pilot Study

Mahoney¹,

Russell²

2021

JRI

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Background: Adherence to lifestyle modification recommendations remains problematic for women undergoing fertility treatment, raising concerns about the extent to which women adhere to prescribed medication regimens. Limited data have shown suboptimal oral medication adherence rates of 19% to 74%. The objective of this study was to explore what women perceive as barriers to and facilitators of oral medication adherence during fertility treatment cycles. Methods: An exploratory mixed methods pilot study was conducted among a sample of 30 women who were actively taking one to two cycles of letrozole or clomiphene citrate for ovarian stimulation in conjunction with intrauterine insemination cycles. Medication adherence barriers were measured using a 20-item survey. Medication adherence facilitators and personal experiences with fertility treatment were assessed with structured interviews. Medication adherence was assessed with electronic event monitoring. Results: The overall medication adherence median was 0.97 with a range of 0.75 to 1.00, and nine women (50%) demonstrated perfect adherence. The most commonly reported barriers were recently feeling sad, down, or blue (53%), and taking medication more than once per day (40%). Women with higher barrier scores had significantly lower medication adherence scores (p=0.02) compared to women with lower total barrier scores. Facilitators included using physical aides as reminders (60%) and establishing a daily routine (50%). No significant correlation was found between medication adherence scores and facilitators. Conclusion: The dynamic interplay between perceived barriers and facilitators and women’s medication-taking patterns could influence whether or not medication regimens are followed correctly.

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“…The potential of pharmacogenomics to introduce a new era in IVF treatment has recently been summarized (Kalinderi et al, 2019). Much remains to be explored further, but it is to be expected that additional genomic information generated from large data sets will give rise to much improved individualized infertility care.…”

Section: Ethnic and Biomarker Contextmentioning

confidence: 99%