Email this article Predictive value of ovarian hormone-producing function assessment in poor responders undergoing assisted reproductive technologies
- Authors: Merkulova A.I.1, Dzhemlikhanova L.K.1,2, Niauri D.A.1,2, Gzgzyan A.M.1,2, Kogan I.Y.1,2, Krikheli I.O.2, Tapilskaya N.I.2,3, Tkachenko N.N.2, Mekina I.D.2, Lesik E.A.2, Komarova E.M.2
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Affiliations:
- Saint Petersburg State University
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Saint Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation
- Issue: Vol 68, No 6 (2019)
- Pages: 7-18
- Section: Current public health problems
- URL: https://journals.rcsi.science/jowd/article/view/16343
- DOI: https://doi.org/10.17816/JOWD6867-18
- ID: 16343
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Abstract
Hypothesis/aims of study. The management of poor responders to ovarian stimulation for in vitro fertilization (IVF) has always been a challenge. It is difficult for both doctors and patients to make decision to proceed to oocyte donation or abandon fertility treatment. More predictors of successful IVF treatment in poor responders are needed. The aim of this study was to assess hormonal ovarian function in poor responders undergoing ovarian stimulation and to identify predictors of the chance of clinical pregnancy after IVF cycle.
Study design, materials and methods. The study included 45 infertile patients undergoing ovarian stimulation with poor ovarian response according to the Bologna criteria. All patients underwent standard IVF or IVF/ICSI protocol using gonadotropin releasing hormone antagonists. Letrozole (5 mg/day) was administered during the first 5 days of stimulation in standard antagonist FSH/hMG protocol to 13 of the patients included in the study, with standard antagonist FSH/hMG protocol being only administered to other 32 patients. Serum and follicular fluid were collected at the time of follicle aspiration, and the concentrations of total testosterone, estradiol and androstenedione were determined.
Results. Follicular fluid concentrations of testosterone and androstenedione were higher and serum estradiol level was lower in the letrozole group. The serum concentrations of testosterone and androstenedione were comparable in both groups, while the serum estradiol/testosterone ratio was lower in the letrozole group. The threshold level of estradiol/testosterone ratio × 1000 on the day of oocyte retrieval above which pregnancy and implantation rates were increased was 1532.68 (odds ratio — 7.0 (95% CI 1.39–35.35), р = 0.02).
Conclusion. Evaluating of the serum estradiol / testosterone ratio has been shown to determine aromatase activity of ovarian preovulatory follicles and to predict IVF outcome in poor responders undergoing assisted reproductive technology.
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##article.viewOnOriginalSite##About the authors
Alexandra I. Merkulova
Saint Petersburg State University
Author for correspondence.
Email: merkulova.alexandra@gmail.com
ORCID iD: 0000-0001-5555-2425
SPIN-code: 5109-0816
MD, Postgraduate student. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty
Russian Federation, Saint PetersburgLyailya Kh. Dzhemlikhanova
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: dzhemlikhanova_l@mail.ru
ORCID iD: 0000-0001-6842-4430
SPIN-code: 1691-6559
MD, PhD, Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; the Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgDariko A. Niauri
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: d.niauri@mail.ru
ORCID iD: 0000-0003-1556-248X
SPIN-code: 4384-9785
MD, PhD, DSci (Medicine), Professor, the Head of the Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Leading Researcher. The Gynecological Department with the Operation Unit
Russian Federation, Saint PetersburgAlexander M. Gzgzyan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: agzgzyan@mail.ru
ORCID iD: 0000-0003-3917-9493
SPIN-code: 6412-4801
MD, PhD, DSci (Medicine), Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; the Head of the Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgIgor Yu. Kogan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450
MD, PhD, DSci (Medicine), Professor, Corresponding Member of RAS. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Director
Russian Federation, Saint PetersburgInna O. Krikheli
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikrikhely@gmail.com
ORCID iD: 0000-0002-5439-1727
SPIN-code: 7356-6189
MD, PhD, Senior Researcher
Russian Federation, Saint PetersburgNatalya I. Tapilskaya
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation
Email: tapnatalia@yandex.ru
ORCID iD: 0000-0001-5309-0087
SPIN-code: 3605-0413
MD, PhD, DSci (Medicine), Professor, Leading Researcher; Professor. The Department of Obstetrics and Gynecology with the Course of Pediatric and Adolescent Gynecology
Russian Federation, Saint PetersburgNatalia N. Tkachenko
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: liberin@mail.ru
ORCID iD: 0000-0001-6189-3488
SPIN-code: 9633-6701
PhD, the Head of the Laboratory of Endocrinology
Russian Federation, Saint PetersburgIrina D. Mekina
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: iagmail@ott.ru
ORCID iD: 0000-0002-0813-5845
SPIN-code: 4682-8590
PhD, Senior Researcher. The Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgElena A. Lesik
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: iagmail@ott.ru
PhD, Senior Researcher. The Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgEvgenia M. Komarova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: iagmail@ott.ru
ORCID iD: 0000-0002-9988-9879
SPIN-code: 1056-7821
PhD, Researcher. The Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgReferences
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