Menstrual Cycle Length: a Surrogate Measure of Reproductive Health Capable of Improving the Accuracy of Biochemical/sonographical Ovarian Reserve Test in Estimating the Reproductive Chances of Women Referred to ART

Overview

Journal Reprod Biol Endocrinol

Publisher Biomed Central

Specialties Endocrinology
Reproductive Medicine

Date 2015 Apr 18

PMID 25884482

Citations 18

Authors

Salvatore Gizzo

Alessandra Andrisani

Marco Noventa

Michela Quaranta

Federica Esposito

Decio Armanini

Michele Gangemi

Giovanni B Nardelli

Pietro Litta

Donato DAntona

Guido Ambrosini

Affiliations

Soon will be listed here.

Abstract

Background: Aim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.

Methods: A retrospective-observational-study in Padua' public tertiary level Centre was conducted. A total of 455 normo-ovulatory infertile women scheduled for their first fresh non-donor IVF/ICSI treatment. The mean menstrual cycle length (MCL) during the preceding 6 months was calculated by physicians on the basis of information contained in our electronic database (first day of menstrual cycle collected every month by telephonic communication by single patients). We evaluated the relations between MCL, ovarian response to stimulation protocol, oocytes fertilization ratio, ovarian sensitivity index (OSI) and pregnancy rate in different cohorts of patients according to the class of age and the estimated ovarian reserve.

Results: In women younger than 35 years, MCL over 31 days may be associated with an increased risk of OHSS and with a good OSI. In women older than 35 years, and particularly than 40 years, MCL shortening may be considered as a marker of ovarian aging and may be associated with poor ovarian response, low OSI and reduced fertilization rate. When AMH serum value is lower than 1.1 ng/ml in patients older than 40 years, MCL may help Clinicians discriminate real from expected poor responders. Considering the pool of normoresponders, MCL was not correlated with pregnancy rate while a positive association was found with patients' age.

Conclusions: MCL diary is more predictive than chronological age in estimating ovarian biological age and response to COH and it is more predictive than AMH in discriminating expected from real poor responders. In women older than 35 years MCL shortening may be considered as a marker of ovarian aging while chronological age remains most accurate parameter in predicting pregnancy.

Citing Articles

New AMH cutoff values for warning of decreased ovarian response based on MCL characteristics in young women: a retrospective study using a propensity score-matching analysis.

Lv J, Han Y, Wang X, Yuan L, Diao J, Fan Y BMC Pregnancy Childbirth. 2022; 22(1):962.

PMID: 36564774 PMC: 9789575. DOI: 10.1186/s12884-022-05294-7.

Systemic inflammation and menstrual cycle length in a prospective cohort study.

Harris B, Steiner A, Faurot K, Long A, Jukic A Am J Obstet Gynecol. 2022; 228(2):215.e1-215.e17.

PMID: 36244407 PMC: 9877159. DOI: 10.1016/j.ajog.2022.10.008.

Association Between the Ratio of Ovarian Stimulation Duration to Original Follicular Phase Length and Fertilization Outcomes: A Novel Index to Optimise Clinical Trigger Time.

Zhao X, Zhang X, Wu S, Tan J Front Endocrinol (Lausanne). 2022; 13:862500.

PMID: 35957813 PMC: 9361069. DOI: 10.3389/fendo.2022.862500.

Menstrual cycle characteristics as an indicator of fertility outcomes: evidence from prospective birth cohort study in China.

Xiping L, Xiaqiu W, Lirong B, Jin P, Hui K J Tradit Chin Med. 2022; 42(2):272-278.

PMID: 35473349 PMC: 9924698. DOI: 10.19852/j.cnki.jtcm.2022.02.010.

MOTHER Study: A ulticenter bservational, Retrospective Sudy to Determine Coorelation Between Physical Caracteristics and Ovarian Rserve Markers in Sub-fetile Women.

Ayyavoo C, Baxi A, Mandrupkar G, Malik S, Kannan J, Goenka D J Obstet Gynaecol India. 2021; 71(5):510-521.

PMID: 34602763 PMC: 8440784. DOI: 10.1007/s13224-020-01410-9.

References

van Zonneveld P, Scheffer G, Broekmans F, Blankenstein M, de Jong F, Looman C . Do cycle disturbances explain the age-related decline of female fertility? Cycle characteristics of women aged over 40 years compared with a reference population of young women. Hum Reprod. 2003; 18(3):495-501. DOI: 10.1093/humrep/deg138. View

Litta P, Cosmi E, Saccardi C, Esposito C, Rui R, Ambrosini G . Outpatient operative polypectomy using a 5 mm-hysteroscope without anaesthesia and/or analgesia: advantages and limits. Eur J Obstet Gynecol Reprod Biol. 2008; 139(2):210-4. DOI: 10.1016/j.ejogrb.2007.11.008. View

Saccardi C, Gizzo S, Ludwig K, Guido M, Scarton M, Gangemi M . Endometrial polyps in women affected by levothyroxine-treated hypothyroidism--histological features, immunohistochemical findings, and possible explanation of etiopathogenic mechanism: a pilot study. Biomed Res Int. 2013; 2013:503419. PMC: 3766560. DOI: 10.1155/2013/503419. View

Saccardi C, Conte L, Fabris A, De Marchi F, Borghero A, Gizzo S . Hysteroscopic enucleation in toto of submucous type 2 myomas: long-term follow-up in women affected by menorrhagia. J Minim Invasive Gynecol. 2013; 21(3):426-30. DOI: 10.1016/j.jmig.2013.11.007. View

Mutlu M, Erdem M, Erdem A, Yildiz S, Mutlu I, Arisoy O . Antral follicle count determines poor ovarian response better than anti-Müllerian hormone but age is the only predictor for live birth in in vitro fertilization cycles. J Assist Reprod Genet. 2013; 30(5):657-65. PMC: 3663963. DOI: 10.1007/s10815-013-9975-3. View

Gizzo S, Capuzzo D, Zicchina C, Di Gangi S, Coronella M, Andrisani A . Could empirical low-dose-aspirin administration during IVF cycle affect both the oocytes and embryos quality via COX 1-2 activity inhibition?. J Assist Reprod Genet. 2014; 31(3):261-8. PMC: 3947072. DOI: 10.1007/s10815-014-0174-7. View

Hahn K, Wise L, Riis A, Mikkelsen E, Rothman K, Banholzer K . Correlates of menstrual cycle characteristics among nulliparous Danish women. Clin Epidemiol. 2013; 5:311-9. PMC: 3751379. DOI: 10.2147/CLEP.S46712. View

Patrelli T, Berretta R, Gizzo S, Pezzuto A, Franchi L, Lukanovic A . CA 125 serum values in surgically treated endometriosis patients and its relationships with anatomic sites of endometriosis and pregnancy rate. Fertil Steril. 2010; 95(1):393-6. DOI: 10.1016/j.fertnstert.2010.08.043. View

Burger H, Hale G, Dennerstein L, Robertson D . Cycle and hormone changes during perimenopause: the key role of ovarian function. Menopause. 2008; 15(4 Pt 1):603-12. DOI: 10.1097/gme.0b013e318174ea4d. View

10.

Broekmans F, Kwee J, Hendriks D, Mol B, Lambalk C . A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006; 12(6):685-718. DOI: 10.1093/humupd/dml034. View

11.

Neuber E, Rinaudo P, Trimarchi J, Sakkas D . Sequential assessment of individually cultured human embryos as an indicator of subsequent good quality blastocyst development. Hum Reprod. 2003; 18(6):1307-12. DOI: 10.1093/humrep/deg269. View

12.

Johnson N, Bagrie E, Coomarasamy A, Bhattacharya S, Shelling A, Jessop S . Ovarian reserve tests for predicting fertility outcomes for assisted reproductive technology: the International Systematic Collaboration of Ovarian Reserve Evaluation protocol for a systematic review of ovarian reserve test accuracy. BJOG. 2006; 113(12):1472-80. DOI: 10.1111/j.1471-0528.2006.01068.x. View

13.

Small C, Manatunga A, Klein M, Feigelson H, Dominguez C, McChesney R . Menstrual cycle characteristics: associations with fertility and spontaneous abortion. Epidemiology. 2005; 17(1):52-60. DOI: 10.1097/01.ede.0000190540.95748.e6. View

14.

Biasoni V, Patriarca A, Dalmasso P, Bertagna A, Manieri C, Benedetto C . Ovarian sensitivity index is strongly related to circulating AMH and may be used to predict ovarian response to exogenous gonadotropins in IVF. Reprod Biol Endocrinol. 2011; 9:112. PMC: 3162895. DOI: 10.1186/1477-7827-9-112. View

15.

Ferraretti A, La Marca A, Fauser B, Tarlatzis B, Nargund G, Gianaroli L . ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011; 26(7):1616-24. DOI: 10.1093/humrep/der092. View

16.

Beckers N, Macklon N, Eijkemans M, Fauser B . Women with regular menstrual cycles and a poor response to ovarian hyperstimulation for in vitro fertilization exhibit follicular phase characteristics suggestive of ovarian aging. Fertil Steril. 2002; 78(2):291-7. DOI: 10.1016/s0015-0282(02)03227-2. View

17.

Brodin T, Bergh T, Berglund L, Hadziosmanovic N, Holte J . Menstrual cycle length is an age-independent marker of female fertility: results from 6271 treatment cycles of in vitro fertilization. Fertil Steril. 2007; 90(5):1656-61. DOI: 10.1016/j.fertnstert.2007.09.036. View

18.

Li H, Lee V, Ho P, Ng E . Ovarian sensitivity index is a better measure of ovarian responsiveness to gonadotrophin stimulation than the number of oocytes during in-vitro fertilization treatment. J Assist Reprod Genet. 2013; 31(2):199-203. PMC: 3933607. DOI: 10.1007/s10815-013-0144-5. View

19.

Huber M, Hadziosmanovic N, Berglund L, Holte J . Using the ovarian sensitivity index to define poor, normal, and high response after controlled ovarian hyperstimulation in the long gonadotropin-releasing hormone-agonist protocol: suggestions for a new principle to solve an old problem. Fertil Steril. 2013; 100(5):1270-6. DOI: 10.1016/j.fertnstert.2013.06.049. View

20.

Broer S, Broekmans F, Laven J, Fauser B . Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update. 2014; 20(5):688-701. DOI: 10.1093/humupd/dmu020. View