Study of the correlation between the ovarian reserve markers and the oocyte yield after controlled ovarian hyperstimulation so as to improve fertility preservation protocols for patients with malignant and autoimmune diseases

Doctoral Dissertation uoadl:2895897 19 Read counter

Unit:
Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
2020-01-24
Year:
2020
Author:
Psarris Alexandros
Dissertation committee:
Λουτράδης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Ροδολάκης Αλέξανδρος, Καθηγητής, Ιατρική, ΕΚΠΑ
Δρακάκης Πέτρος, Καθηγητής, Ιατρική, ΕΚΠΑ
Καλλιανίδης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Στεφανίδης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ντόμαλη Αικατερίνη, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Θωμάκος Νικόλαος, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Μελέτη της συσχέτισης των δεικτών ωοθηκικής εφεδρείας με το αναπαραγωγικό δυναμικό των γυναικών που υποβάλλονται σε υποβοηθούμενη αναπαραγωγή με σκοπό τη βελτιστοποίηση των κλινικών πρωτόκολλων για διατήρηση γονιμότητας σε γυναίκες με γυναικολογικό καρκίνο και χρονιές παθήσεις
Languages:
Greek
Translated title:
Study of the correlation between the ovarian reserve markers and the oocyte yield after controlled ovarian hyperstimulation so as to improve fertility preservation protocols for patients with malignant and autoimmune diseases
Summary:
Objectives: The objective of our study is to evaluate the correlation between the known ovarian reserve markers and the oocyte yield after controlled ovarian hyperstimulation so as to improve fertility preservation protocols for patients with malignant and autoimmune diseases.
Materials and Methods: The study included the data from all women who were subjected to in vitro fertilization in the Assisted Reproduction Unit of the 1st Department of Obstetrics and Gynecology of Alexandra maternity hospital between 2015 and 2019. Furthermore, a retrospective analysis was conducted of the ivf cycles performed between 2013 and 2015. We documented the demographic data of our patients and measured FSH, LH, E2, PRL, TSH, ΑΜΗ, AFC as well as the results of the COH protocols. Statistical analysis included Pearson’s test, factor analysis, regression and ROC curve evaluation.
Results: Spearman’s test revealed a great number of statistically significant correlations between the ovarian reserve markers and the results of the COH protocol. The most important positive statistically significant correlation was observed between AMH and oocyte yield and between AFC and oocyte yield. A negative statistically significant correlation was observed between FSH and the number of oocytes as well. Factor analysis was unsuccessful in providing factors that can sufficiently substitute the variables that predict the number of oocytes after COH but managed to illustrate the most important variables of our study. ROC curves failed to determine specific cut off points between the markers of ovarian reserve and poor response. Regression analysis resulted in mathematical models that use AMH, AFC, FSH, BMI and age to predict the number of oocytes after controlled ovarian hyperstimulation.
Conclusions: Improving fertility preservation protocols for women with cancer and autoimmune diseases entails better prediction of the oocyte yield. Thus, clinicians can optimize ovarian stimulation protocols in order to safely achieve the maximum oocyte yield especially in women with increased risk for poor response or ovarian hyperstimulation syndrome. Our study demonstrated that using mathematical models that combine ovarian reserve markers, age and BMI to estimate oocyte yield after COH is a feasible approach.
Main subject category:
Health Sciences
Keywords:
AMH, AFC, FSH, Fertility Preservation
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
190
Number of pages:
180

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