Krocina, Improves in Vitro Fertilization Outcomes in Patients With Diminished Ovarian Reserve: A Randomized Controlled Trial
Bahareh KarimiSedighe HosseiniZahra Shams MofaraheMarefat Ghaffari NovinMahsa KazemiMohsen NorouzianNazanin HajizadehLatif GachkarBita PourkavehTahereh GhelijiHamid Nazarian
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Background: Diminished ovarian reserve (DOR) is a clinical syndrome with reproductive and endocrine disorders. This study aimed to examine the effect of crocin on oxidative stress, gene expression, oocyte maturation, and embryo quality in DOR patients who underwent a controlled ovarian hyperstimulation (COH) cycle.Methods: As a clinical trial, this study involved 34 DOR patients trying to conceive by assisted reproductive technique who were divided into two groups (17 each): An intervention group receiving crocin (15 mg, once daily, for 12 weeks) and a control group receiving a placebo (tablets with the same form of the drug). Pre- and post-intervention, demographic information was gathered, and hormonal levels (follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)) were measured. In the subsequent COH cycle, oocyte maturation, embryo quality, level of both superoxide dismutase (SOD) and reactive oxygen species (ROS) in follicular fluid, expression of GDF9, BMP15, and Nrf2 genes in granulosa cells were measured.Results: The collected data as a comparison between groups showed alteration of criteria in the intervention group as follows: Significant reduction of FSH (P<0.01), increased level of SOD in the follicular fluid (P<0.0001), decreased level of oxidative stress in the granulosa cells (P<0.0001), increased expression of Nrf2 gene (P<0.08), and of GDF9, BMP15 genes (P<0.0001) in the granulosa cells. The rate of oocyte maturation and embryo quality were significantly higher in the intervention group compared to the control group (P<0.05 and P<0.005, respectively).Conclusion: Our study discussed how the Krocina supplement can slow down the progression of the disease by reducing the level of FSH, and oxidative stress, increasing the maturation rate of oocytes, and increasing the quality of embryos in women with DOR. Further research is needed to investigate the effect of crocin in improving fecundity for women with DOR.Keywords:
Ovarian Reserve
Objective To evaluate the therapeutic effects of one visit root canal therapy(RCT) and several visit RCT for cracked teeth.Methods Cracked teeth with pulposis or apical disease were randomized to receive one visit RCTor several visit RCT,their responses were compared.Results The long-term therapeutic effects of one visit RCT were batter than those of several visit RCT,but the differences were not significant.The concomitant symptoms were significantly less and treatment time was significantly shorter in one visit RCT group as compared with several visit RCT group.Conclusion One visit RCT is recommended for the RCT of cracked teeth.
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The existing quantity of follicles and their response to stimulation at a particular age predicts the ovarian reserve. In vitro fertilization is emerging as a common method of treatment of infertility. This technique is not 100% accurate and puts the patient and the couple in both physical and financial burden. It is important to predict the outcome of a cycle of IVF to counsel a patient prior to proceeding. The ovarian reserve is the main functional component which might guide the outcome. There may be many factors affecting ovarian reserve but the age of the patient is the most important one. Various markers have been utilized to determine ovarian reserve in women which are endocrine, radiological or dynamic tests. No perfect marker has been identified yet but some have proven to be better than the other. This review will discuss the different methods of testing ovarian reserve and the current research that might help the clinician to predict outcome prior to initiating IVF. Keywords: Ovarian reserve, anti mullerian hormone, antral follicle count, basal follicle stimulating hormone, ovarian volume
Ovarian Reserve
Antral follicle
Anti-Müllerian hormone
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Ovarian Reserve
Antral follicle
Anti-Müllerian hormone
Ovarian Cortex
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Women undergoing IVF are routinely subjected to one or more tests of ovarian reserve. The results of these tests are also being extrapolated to women attending infertility clinics and those planning to delay childbearing. This debate examines the predictive power of currently available tests of ovarian reserve and questions the value of subjecting women to ovarian reserve tests. We propose that in the absence of an agreement on (i) a definition of poor ovarian reserve, (ii) the population to be tested and (iii) which interventions are effective in women with poor ovarian reserve, routine ovarian reserve testing is unhelpful.
Ovarian Reserve
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Ovarian Reserve
Anti-Müllerian hormone
Antral follicle
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Background: Fertility rates have started declining in India in the last few decades. The total fertility rate, which was 3.5 in 93-94 declined to 2.5 in 2005-6. Researchers attribute this fertility transition to concomitant socio-economic development. Decreasing ovarian reserve is an important contributor for age related infertility. Objectives: The objective of this study was to assess the association of ovarian reserve with socio-economic status (SES) with the available clinical ovarian reserve markers in reproductive age women. Materials and Methods: A total of 160 married women in the age group of 20-35 years, belonging to all three socio-economic strata were assessed for ovarian reserve using the clinical ovarian reserve parameters Antimullerian hormone (AMH), Antral follicle count (AFC) and follicular stimulating hormone (FSH). Analysis of variance was used to see the association of ovarian reserve with SES. Results: Both the ovarian parameters AMH and AFC have shown a significant association with SES (P = 0.000 for AMH and P = 0.023 for AFC). The association between FSH and SES was not significant (P = 0.147). Conclusions: Higher SES in this study was seen to be associated with better ovarian reserve as assessed by the available clinical ovarian reserve markers.
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Antral follicle
Anti-Müllerian hormone
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Measures of ovarian reserve, particularly anti-Müllerian hormone, have been increasingly and inaccurately utilized as "fertility tests." It is important to understand the available measures of ovarian reserve and how to appropriately interpret and integrate their use into clinical practice. The objectives of this article are to review the process of reproductive aging, define ovarian reserve, describe the available measures of ovarian reserve, and discuss the clinical utility of these measures. A literature search was performed using the electronic database PubMed. Relevant guidelines, systematic reviews, and original research articles investigating ovarian reserve parameters and their clinical utility were reviewed. The fecundity of women gradually declines with increasing reproductive age as oocyte quantity and quality decline. Ovarian reserve is defined as the quantity of oocytes remaining in the ovary. Ovarian reserve can be measured indirectly with the use of serum blood tests or ultrasound imaging. Measures of ovarian reserve are clinically useful in several circumstances, particularly for use during fertility treatment and cycles of assisted reproductive technology. However, measures of ovarian reserve are poor predictors of reproductive potential and should not be used as "fertility tests." Measures of ovarian reserve are poor predictors of reproductive potential and should not be used as "fertility tests." Age remains a stronger predictor of reproductive success than measures of ovarian reserve.
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Anti-Müllerian hormone
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To detect clinical parameters impacting ovarian reserve, data were analyzed from 573 patients who had an anti-Müllerian hormone (AMH) measurement for infertility treatment. No impact was found on the age at menarche but a significant diminished ovarian reserve was observed when a patient's mother was menopausal before age 50. These data suggest that ovarian reserve must be monitored in such patients to offer them fertility preservation when at risk of premature ovarian insufficiency (POI).
Ovarian Reserve
Menarche
Anti-Müllerian hormone
Premature ovarian insufficiency
Premature ovarian failure
Premature Menopause
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Ovarian Reserve
Antral follicle
Anti-Müllerian hormone
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Objective: Subfertility is commonly observed in patients with rheumatoid arthritis (RA). Although the causes are not well established, the alteration of the ovarian reserve is thought to contribute to the lower chances of pregnancy. This cross-sectional study aimed to evaluate the ovarian reserve in patients with RA. Materials and methods: Two parameters associated with ovarian reserves such as the antral follicle count (AFC) and the anti-müllerian hormone (AMH) were assessed in 38 patients with RA. We also analyzed the correlation of these parameters with the medication used to treat this pathology and with the illness severity. Results: The AMH levels in women with RA were comparable to those found on healthy individuals although the RA patients were more likely to have a low AFC. Ovarian reserve and RA were neither influenced by parameters of disease activity nor by the use of medication. Conclusion: The ovarian reserve in women with RA was similar to that found in healthy individuals.
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Anti-Müllerian hormone
Antral follicle
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