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6. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach

Author

Broer, Simone L., van Disseldorp, Jeroen, Broeze, Kimiko A., Dolleman, Madeleine, Opmeer, Brent C., Bossuyt, Patrick, Eijkemans, Marinus J.C., Mol, Ben-Willem J., Broekmans, Frank J.M., Broer, S.L., van Disseldorp, J., Broeze, K.A., Dolleman, M., Opmeer, B.C., Anderson, R.A., Ashrafi, M., Bancsi, L., Caroppo, L. E., Copperman, A., Ebner, T., Eldar Geva, M., Erdem, M., Greenblatt, E.M., Jayaprakasan, K., Fenning, Raine, Klinkert, E.R., Kwee, J., Lambalk, C.B., La Marca, A., McIlveen, M., Merce, L.T., Muttukrishna, S., Nelson, S.M., Ng, H.Y., Popovic-Todorovic, B., Smeenk, J.M.J., Tomás, C., Van der Linden, P.J.Q., van Rooij, I.A., Vladimirov, I.K., Bossuyt, P.B., Eijkemans, M.J.C., Mol, B.W., and Frank, Broekmans

Published
2013
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22. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach

Author

Greenblatt, E. M., Smeenk, J. M. J., Mol, B. W., Broekmans, Frank, Ebner, T., Ng, H. Y., Broer, Simone L., van Disseldorp, Jeroen, Broeze, Kimiko A., Merce, L. T., Bossuyt, Patrick, Opmeer, Brent C., Mol, Ben-Willem J., Broekmans, Frank J. M., Van der Linden, P. J. Q., Copperman, A., Geva, Eldar M., van Rooij, I. A., Erdem, M., McIlveen, M., Tomas, C., La Marca, A., Eijkemans, Marinus J. C., Vladimirov, I. K., Popovic-Todorovic, B., Lambalk, C. B., Bossuyt, P. B., Caroppo, E., Bancsi, L., Ashrafi, M., Kwee, J., Eijkemans, M. J. C., Dolleman, Madeleine, Klinkert, E. R., Nelson, S. M., Fenning, Raine, Jayaprakasan, K., Anderson, R. A., Muttukrishna, S., Obstetrics and gynaecology, ICaR - Ischemia and repair, NCA - Brain mechanisms in health and disease, Other departments, Clinical Research Unit, APH - Amsterdam Public Health, Epidemiology and Data Science, 10 Public Health & Methodologie, and Obstetrics and Gynaecology

Subjects
Anti-Mullerian Hormone, medicine.medical_specialty, Ovarian reserve tests, Individual patient data meta-analysis, Cell Count, Fertilization in Vitro, Logistic regression, Ovarian Follicle, Obstetrics and gynaecology, Predictive Value of Tests, Pregnancy, medicine, AMH, Humans, Ovarian reserve, reproductive and urinary physiology, Gynecology, biology, urogenital system, business.industry, Obstetrics, Ovary, Obstetrics and Gynecology, Anti-Müllerian hormone, Prognosis, Antral follicle, medicine.disease, female genital diseases and pregnancy complications, AFC, ROC Curve, Human Reproduction Renal disorder [NCEBP 12], Reproductive Medicine, Meta-analysis, Predictive value of tests, IVF outcome prediction, biology.protein, Ovulation Prediction, Female, Follicle Stimulating Hormone, business, therapeutics, hormones, hormone substitutes, and hormone antagonists
Abstract

Item does not contain fulltext BACKGROUND Although ovarian reserve tests (ORTs) are frequently used prior to IVF treatment for outcome prediction, their added predictive value is unclear. We assessed the added value of ORTs to patient characteristics in the prediction of IVF outcome. METHODS An individual patient data (IPD) meta-analysis from published studies was performed. Studies on FSH, anti-Mullerian hormone (AMH) or antral follicle count (AFC) in women undergoing IVF were identified and authors were contacted. Using random intercept logistic regression models, we estimated the added predictive value of ORTs for poor response and ongoing pregnancy after IVF, relative to patient characteristics. RESULTS We were able to collect 28 study databases, comprising 5705 women undergoing IVF. The area under the receiver-operating characteristic curve (AUC) for female age in predicting poor response was 0.61. AFC and AMH each significantly improved the model fit (P-value

Published
2013

24. Inhibin A, Inhibin B and Activin A in Follicular Fluid of Infertile Women with Tubal Damage, Unexplained Infertility and Endometriosis1

Author

Muttukrishna S, J Asselin, Nigel P. Groome, David J. Cahill, Akande Av, Wardle Pg, and Stephen D. Keay

Subjects
Infertility, endocrine system, medicine.medical_specialty, endocrine system diseases, medicine.medical_treatment, Immunology, Endometriosis, Biology, Andrology, Follicle, Internal medicine, Follicular phase, medicine, Immunology and Allergy, Ovarian follicle, reproductive and urinary physiology, Unexplained infertility, In vitro fertilisation, Obstetrics and Gynecology, medicine.disease, Follicular fluid, female genital diseases and pregnancy complications, medicine.anatomical_structure, Endocrinology, Reproductive Medicine, hormones, hormone substitutes, and hormone antagonists
Abstract

PROBLEM: To measure and compare concentrations of inhibin A, inhibin B, activin A and oestradiol in the follicular fluid of women with endometriosis, tubal damage and unexplained infertility with oocyte quality and fertilising capacity. Also, to assess whether impaired follicular function in women with endometriosis might be related to altered inhibin or activin concentrations and whether this correlated. METHOD OF STUDY: Follicular fluids were collected from individual follicles during oocyte retrieval for in vitro fertilisation (IVF) in natural cycles. Inhibin A. inhibin B and activin A were measured using two-site enzyme immunoassay, and oestradiol was assayed by fluoro-immunometric method. RESULTS: Follicular fluid inhibin A levels ere found to be significantly higher in women with endometriosis. Inhibin A was directly correlated with follicle size. There was no correlation between the levels of inhibin A, inhibin B, activin A and oocyte quality or fertilising capacity in the three groups of women. CONCLUSIONS: Follicular fluid concentration of inhibin A is elevated in follicles of women with endometriosis and is positively correlated with follicle maturation. However, we were unable to demonstrate any association between the follicular fluid concentrations of inhibin A. inhibin B, activin A or oestradiol and the quality and fertilisation capacity of oocytes in women with tubal damage, unexplained infertility or endometriosis.

Published
2000

26. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach

Author

Broer, S.L., Disseldorp, J. van, Broeze, K.A., Dolleman, M., Opmeer, B.C., Bossuyt, P., Eijkemans, M.J., Mol, B.W., Broekmans, F.J., Anderson, R.A., Ashrafi, M., Bancsi, L.F., Caroppo, E., Copperman, A., Ebner, T., Eldar Geva, M., Erdem, M., Greenblatt, E.M., Jayaprakasan, K., Fenning, R., Klinkert, E.R., Kwee, J., Lambalk, C.B., La Marca, A., McIlveen, M., Merce, L.T., Muttukrishna, S., Nelson, S.M., Ng, H.Y., Popovic-Todorovic, B., Smeenk, J.M.J., Tomas, C., Linden, P.J. van der, Rooij, I.A.L.M. van, et al., Broer, S.L., Disseldorp, J. van, Broeze, K.A., Dolleman, M., Opmeer, B.C., Bossuyt, P., Eijkemans, M.J., Mol, B.W., Broekmans, F.J., Anderson, R.A., Ashrafi, M., Bancsi, L.F., Caroppo, E., Copperman, A., Ebner, T., Eldar Geva, M., Erdem, M., Greenblatt, E.M., Jayaprakasan, K., Fenning, R., Klinkert, E.R., Kwee, J., Lambalk, C.B., La Marca, A., McIlveen, M., Merce, L.T., Muttukrishna, S., Nelson, S.M., Ng, H.Y., Popovic-Todorovic, B., Smeenk, J.M.J., Tomas, C., Linden, P.J. van der, Rooij, I.A.L.M. van, and et al.

Abstract

Item does not contain fulltext, BACKGROUND Although ovarian reserve tests (ORTs) are frequently used prior to IVF treatment for outcome prediction, their added predictive value is unclear. We assessed the added value of ORTs to patient characteristics in the prediction of IVF outcome. METHODS An individual patient data (IPD) meta-analysis from published studies was performed. Studies on FSH, anti-Mullerian hormone (AMH) or antral follicle count (AFC) in women undergoing IVF were identified and authors were contacted. Using random intercept logistic regression models, we estimated the added predictive value of ORTs for poor response and ongoing pregnancy after IVF, relative to patient characteristics. RESULTS We were able to collect 28 study databases, comprising 5705 women undergoing IVF. The area under the receiver-operating characteristic curve (AUC) for female age in predicting poor response was 0.61. AFC and AMH each significantly improved the model fit (P-value <0.001). Moreover, almost a similar accuracy was reached using AMH or AFC alone (AUC 0.78 and 0.76, respectively). Combining the two tests, however, did not improve prediction (AUC 0.80, P = 0.19) of poor response. In predicting ongoing pregnancy after IVF, age was the best single predictor (AUC 0.57), and none of the ORTs added any value. CONCLUSIONS This IPD meta-analysis demonstrates that AFC and AMH clearly add to age in predicting poor response. As single tests, AFC and AMH both fully cover the prediction of poor ovarian response. In contrast, none of the ORTs add any information to the limited capacity of female age to predict ongoing pregnancy after IVF. The clinical usefulness of ORTs prior to IVF will be limited to the prediction of ovarian response.

Published
2013

27. Effect of antihypertensive therapy with alpha-methyldopa on uterine artery Doppler in pregnancies with hypertensive disorders.

Author

Khalil A, Harrington K, Muttukrishna S, Jauniaux E, Khalil, A, Harrington, K, Muttukrishna, S, and Jauniaux, E

Abstract

Objectives: Antihypertensive drugs lower blood pressure by direct vascular effects or central vasodilatory mechanisms. Their effect on uterine artery Doppler resistance indices in hypertensive disorders of pregnancy is uncertain. This study aimed to evaluate the impact of antihypertensive therapy with alpha-methyldopa on maternal uterine artery Doppler pulsatility index (PI) and resistance index (RI) in women presenting with hypertensive disorders of pregnancy. Methods: This was a cross-sectional study of 51 women with pre-eclampsia, 29 with gestational hypertension and 80 matched normotensive controls. Uterine artery PI and RI were measured at recruitment (between 24 and 40 weeks' gestation) and, in the hypertensive groups, 24-48 h after starting alpha-methyldopa. Differences between mild and severe, and between early- and late-onset pre-eclampsia were compared using the Mann-Whitney test. The Wilcoxon rank sum test was used to compare measurements before and after treatment. Results: Prior to treatment, uterine artery PI and RI were significantly higher in women with pre-eclampsia compared with those with gestational hypertension and controls (P < 0.0001). The median uterine artery PI multiple of the median (MoM) was significantly higher (P < 0.0001) in early-onset than in late-onset pre-eclampsia (1.83 (range, 0.88-3.65) vs. 1.19 (range, 0.91-1.72)) and in severe compared with mild disease (2.26 (range, 2.02-3.65) vs. 1.29 (range, 0.88-2.9)). Uterine artery PI- and RI-MoMs in both pre-eclampsia and gestational hypertension, before and after 34 weeks' gestation, were not affected by alpha-methyldopa treatment. Conclusions: Antihypertensive therapy using alpha-methyldopa in women presenting with hypertensive disorders of pregnancy has no significant effect on uterine artery resistance to blood flow, suggesting that it does not impair uteroplacental circulation in these cases. [ABSTRACT FROM AUTHOR]

Published
2010
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29. Prediction of an excessive response in in vitro fertilization from patient characteristics and ovarian reserve tests and comparison in subgroups: an individual patient data meta-analysis

Author

Broer, Simone L., primary, Dólleman, Madeleine, additional, van Disseldorp, Jeroen, additional, Broeze, Kimiko A., additional, Opmeer, Brent C., additional, Bossuyt, Patrick M.M., additional, Eijkemans, Martinus J.C., additional, Mol, Ben Willem, additional, Broekmans, Frank J.M., additional, Broer, S.L., additional, Dólleman, M., additional, van Disseldorp, J., additional, Broeze, K.A., additional, Opmeer, B.C., additional, Bossuyt, P.M.M., additional, Eijkemans, M.J.C., additional, Mol, B.W., additional, Broekmans, F.J.M., additional, Aflatoonian, A., additional, Anderson, R.A., additional, Ashrafi, M., additional, Bancsi, L., additional, Caroppo, E., additional, Copperman, A.B., additional, Ebner, T., additional, Eldar-Geva, T., additional, Erdem, M., additional, Freour, T., additional, Gnoth, C., additional, Greenblatt, E.M., additional, Jayaprakasan, K., additional, Raine-Fenning, N., additional, Klinkert, E., additional, Kwee, J., additional, La Marca, A., additional, Lambalk, C.B., additional, McIlveen, M., additional, Mohiyiddeen, L., additional, Merce, L.T., additional, Muttukrishna, S., additional, Nardo, L.G., additional, Nelson, S.M., additional, Ng, H.Y., additional, Popovic-Todorovic, B., additional, Smeenk, J.M.J., additional, Tomás, C., additional, Van der Linden, P.J.Q., additional, van Rooij, I.A., additional, and Vladimirov, I.K., additional

Published
2013
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