Changes in intermediary metabolism of the eel, Anguilla japonica (Temminck & Schlegel) during artificial induction of sexualmaturation

published_or_final_versionZoologyDoctoralDoctor of Philosoph

Role of baseline antral follicle count and anti-Mullerian hormone in prediction of cumulative live birth in the first in vitro fertilisation cycle: a retrospective cohort analysis.

OBJECTIVE: This retrospective study determined for the first time the role of baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the first in-vitro fertilisation (IVF) cycle in predicting cumulative live birth from one stimulation cycle. METHODS: We studied 1,156 women (median age 35 years) undergoing the first IVF cycle. Baseline AFC and AMH level on the day before ovarian stimulation were analysed. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers after the same stimulation cycle. RESULTS: Serum AMH was significantly correlated with AFC. Both AMH and AFC showed significant correlation with age and ovarian response in the stimulated cycle and total number of transferrable embryos. Baseline AFC and serum AMH were significantly higher in subjects attaining a live birth than those who did not in the fresh stimulated cycle, as well as those attaining cumulative live birth. There was a significant trend of higher cumulative live birth rate in women with higher AMH or AFC. However, logistic regression revealed that both AMH and AFC were not significant predictors of cumulative live birth after adjusting for age and number of embryos available for transfer. Considering only one single predictor, the areas under the ROC curves for AMH (0.646, 95% CI 0.616-0.675) and age (0.648, 95% CI 0.618-0.677) were slightly higher than that for AFC (0.617, 95% CI 0.587-0.647) in predicting cumulative live birth. However, a model combining AMH (with or without AFC) and age of the women only classified an addition of less than 2% of subjects correctly compared to the model with age alone. CONCLUSION: Baseline AFC and serum AMH have only modest predictive performance on the occurrence of cumulative live birth, and may not give additional value on top of the women's age

Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.

OBJECTIVE: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF) treatment who had discordant baseline serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC). METHODS: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI) and cumulative live-birth rate for each classification category were compared. RESULTS: Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other. CONCLUSIONS: When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate

Number of retrieved oocytes in different subject groups classified according to the quartile of serum AMH and AFC.

<p>Values are expressed in median (interquartile range).</p>a,b,c,d<p> p<0.0001 (statistically significant. Mann-Whitney U test).</p><p>∧Only 1 case.</p><p>Number of retrieved oocytes in different subject groups classified according to the quartile of serum AMH and AFC.</p

Cumulative live birth rate in different subject groups classified according to the quartile of serum AMH and AFC.

<p>Values are expressed in median (interquartile range).</p>a<p> p = 0.012 (statistically significant, Fisher's Exact test).</p>b<p> p = 0.026 (statistically significant, Fisher's Exact test).</p>c<p> p = 0.002 (statistically significant, Fisher's Exact test).</p>d<p> p = 0.0497 (statistically significant, Fisher's Exact test).</p><p>Cumulative live birth rate in different subject groups classified according to the quartile of serum AMH and AFC.</p

Comparison of demographic and clinical characteristics of subjects with or without achieving live birth in the fresh IVF cycle.

<p>Continuous data are expressed as median (interquartile range).</p>*<p>statistically significant.</p><p>Mann-Whitney U test unless otherwise stated.</p

Receiver operator characteristic (ROC) curve analysis.

<p>Panal (A) shows the ROC curves of antral follicle count (AFC), serum AMH concentration and age of the women in predicting live birth from the fresh stimulation cycle, while Panal (B) shows those in predicting cumulative live birth from fresh and all frozen embryo transfers after the same index stimulation cycle.</p

Ovarian sensitivity index in different subject groups classified according to the quartile of serum AMH and AFC.

<p>Values are expressed in median (interquartile range).</p><p>∧Only 1 case.</p><p>Comparison I (between Groups 1, 2, 4 and 5):</p>a,b,c,d,e<p>p<0.05 (Kruskal-Wallis test with Conover post-hoc analysis).</p><p>Comparison II (between Groups 5, 6, 8 and 9):</p>f,g,h,i,j<p>p<0.05 (Kruskal-Wallis test with Conover post-hoc analysis).</p><p>Ovarian sensitivity index in different subject groups classified according to the quartile of serum AMH and AFC.</p