Association of Anti-Mullerian Hormone on the Quality of Human Oocytes in Some Patients Accessing in Vitro Fertilization (IVF) Treatment in a Private Fertility Center in Ghana
The quantity and quality of oocytes obtained after egg harvesting or retrieval have been regarded as a variable that influences fertilization and the development of viable embryos, determining the number of good embryos required for embryo transfer to achieve implantation (biochemical and clinical pregnancies), as well as the freezing of remaining embryos for future use. This study determined the effects of AMH on oocyte quantity and quality in response to controlled ovarian stimulation (COS) in women undergoing IVF treatment in Ghana. We performed a cohort prospective study at an IVF center in Ghana. Data analysis was performed according to five AMH ranges: group 1 ≤ 0.3 ng/mL (probably negligible response); Group 2 > 0.3 ≤ 2.19 ng/mL (expected lower response); Group 3 > 2.19 ≤ 4.00 ng/mL (possibly intermediate response); Group 4 > 4.00 and ≤6.79 ng/mL (normal response); and Group 5: ≥ 6.79 ng/mL (high response). The number of metaphase II oocytes obtained in each group was recorded. 426 patients were admitted. The data presented were limited to the first IVF cycles to minimize repeated-measures bias. Eight cycles were cancelled due to poor ovarian response. The remaining 418 retrieval cycles were divided into five subgroups according to AMH categories: group 1 ≤ 0.30 (n = 20), group 2 > 0.30 ≤ 2.19 (n = 132), group 3 > 2.19 ≤ 4.00 (n = 158), group 4 > 4.00 ≤ 6.79 (n = 73), and group 5 ≥ 6.79 (n = 35). AMH is the best ovarian reserve test (ORT) for predicting and individualizing gonadotropin dosing to achieve appropriate ovarian responsiveness and minimize both hyper- and poor-ovarian response. This study also demonstrated that anti-Müllerian hormone is a fairly robust metric for predicting cancellation and the number of oocytes that may be retrieved after stimulation in some Ghanaian women undergoing IVF treatment; however, it is a relatively poor predictor of oocyte quality.
References
[1]
Iussig, B. (2015) Morphological Selection of Oocytes. Current Trends in Clinical Embriology, 2, 103-114. https://doi.org/10.11138/cce/2015.2.3.103
[2]
Magli, M.C., Jones, G.M., Lundin, K. and van den Abbeel, E. (2012) Atlas of Human Embryology: From Oocytes to Preimplantation Embryos Human Reproduction, 27, 1-91. https://doi.org/10.1093/humrep/des229
[3]
Rienzi, L., Balaban, B., Ebner, T. and Mandelbaum, J. (2012) The Oocyte. Human Reproduction, 27, i2-i21. https://doi.org/10.1093/humrep/des200
[4]
Hennet, M.L. and Combelles, C.M.H. (2012) The Antral Follicle: A Microenvironment for Oocyte Differentiation. The International Journal of Developmental Biology, 56, 819-831. https://doi.org/10.1387/ijdb.120133cc
[5]
Dumesic, D.A., Meldrum, D.R., Katz-Jaffe, M.G., Krisher, R.L. and Schoolcraft, W.B. (2015) Oocyte Environment: Follicular Fluid and Cumulus Cells Are Critical for Oocyte Health. Fertility and Sterility, 103, 303-316. https://doi.org/10.1016/j.fertnstert.2014.11.015
[6]
Balaban, B. and Urman, B. (2006) Effect of Oocyte Morphology on Embryo Development and Implantation. Reproductive BioMedicine Online, 12, 608-615. https://doi.org/10.1016/s1472-6483(10)61187-x
[7]
Zaninovic, N., Gosden, R. and Veeck Gosden, L. (2005) Visualization of Meiotic Spindles and Chromosomes in Living Human Oocytes Using Conventional Hoffman Modulation Microscopy. Fertility and Sterility, 84, S368-S369. https://doi.org/10.1016/j.fertnstert.2005.07.964
Lasienë, K., Vitkus, A., Valanèiûtë, A. and Lasys, V. (2009) Morphological Criteria of Oocyte Quality. Medicina, 45, Article 509. https://doi.org/10.3390/medicina45070067
[10]
Holubcová, Z., Kyjovská, D., Martonová, M., Páralová, D., Klenková, T., Otevřel, P., et al. (2019) Egg Maturity Assessment Prior to ICSI Prevents Premature Fertilization of Late-Maturing Oocytes. Journal of Assisted Reproduction and Genetics, 36, 445-452. https://doi.org/10.1007/s10815-018-1393-0
[11]
Teplá, O., Topurko, Z., Mašata, J., Jirsová, S., Moosová, M., Fajmonová, E., et al. (2021) Relative Position of the Meiotic Spindle and Polar Body as a Marker of Oocyte Maturation Improves the Utilization and Pregnancy Rates. https://doi.org/10.21203/rs.3.rs-284509/v1
[12]
Ubaldi, F. and Rienzi, L. (2008) Morphological Selection of Gametes. Placenta, 29, 115-120. https://doi.org/10.1016/j.placenta.2008.08.009
[13]
Demyda-Peyrás, S., Hidalgo, M., Dorado, J., Anter, J., Género, E. and Moreno Millán, M. (2013) Short Communication: In Vitro Oocyte Maturation and Fertilization Rates in the Spanish Lidia Bovine Breed. Spanish Journal of Agricultural Research, 11, 356-361. https://doi.org/10.5424/sjar/2013112-3317
[14]
Borges, E., Braga, D.P.A.F., Setti, A., de Cássia Figueira, R. and Iaconelli Júnior, A. (2017) The Predictive Value of Serum Concentrations of Anti-Müllerian Hormone for Oocyte Quality, Fertilization, and Implantation. JBRA Assisted Reproduction, 21, Article No. 176. https://doi.org/10.5935/1518-0557.20170035
[15]
Broer, S.L., Dolleman, M., Opmeer, B.C., Fauser, B.C., Mol, B.W. and Broekmans, F.J.M. (2011) AMH and AFC as Predictors of Excessive Response in Controlled Ovarian Hyperstimulation: A Meta-Analysis. Human Reproduction Update, 17, 46-54. https://doi.org/10.1093/humupd/dmq034
[16]
van Rooij, I.A.J., de Jong, E., Broekmans, F.J.M., Looman, C.W.N., Habbema, J.D.F. and te Velde, E.R. (2004) High Follicle-Stimulating Hormone Levels Should Not Necessarily Lead to the Exclusion of Subfertile Patients from Treatment. Fertility and Sterility, 81, 1478-1485. https://doi.org/10.1016/j.fertnstert.2003.10.054
[17]
Fong, S.L., Baart, E., Martini, E., Schipper, I., Visser, J., Themmen, A., et al. (2008) Anti-Müllerian Hormone: A Marker for Oocyte Quantity, Oocyte Quality and Embryo Quality? Reproductive BioMedicine Online, 16, 664-670. https://doi.org/10.1016/s1472-6483(10)60480-4
[18]
Smeenk, J.M.J., Verhaak, C.M., Vingerhoets, A.J.J.M., Sweep, C.G.J., Merkus, J.M.W.M., Willemsen, S.J., et al. (2006) Stress and Outcome Success in IVF: The Role of Self-Reports and Endocrine Variables. Human Reproduction, 20, 991-996. https://doi.org/10.1093/humrep/deh739
[19]
Sanchez, F., Romero, S., De Vos, M., Verheyen, G. and Smitz, J. (2015) Human Cumulus-Enclosed Germinal Vesicle Oocytes from Early Antral Follicles Reveal Heterogeneous Cellular and Molecular Features Associated with in Vitro Maturation Capacity. Human Reproduction, 30, 1396-1409. https://doi.org/10.1093/humrep/dev083
[20]
Lin, Y., Chang, S., Lan, K., Huang, H., Chang, C., Tsai, M., et al. (2003) Human Oocyte Maturity in Vivo Determines the Outcome of Blastocyst Development in Vitro. Journal of Assisted Reproduction and Genetics, 20, 506-512. https://doi.org/10.1023/b:jarg.0000013651.37866.0c
[21]
Lehmann, P., Vélez, M.P., Saumet, J., Lapensée, L., Jamal, W., Bissonnette, F., et al. (2014) Anti-Müllerian Hormone (AMH): A Reliable Biomarker of Oocyte Quality in IVF. Journal of Assisted Reproduction and Genetics, 31, 493-498. https://doi.org/10.1007/s10815-014-0193-4
[22]
Coccia, M.E. and Rizzello, F. (2008) Ovarian Reserve. Annals of the New York Academy of Sciences, 1127, 27-30. https://doi.org/10.1196/annals.1434.011
[23]
Gleicher, N., Weghofer, A. and Barad, D.H. (2011) Defining Ovarian Reserve to Better Understand Ovarian Aging. Reproductive Biology and Endocrinology, 9, Article No. 23. https://doi.org/10.1186/1477-7827-9-23
[24]
Tal, R. and Seifer, D.B. (2017) Ovarian Reserve Testing: A User’s Guide. American Journal of Obstetrics and Gynecology, 217, 129-140. https://doi.org/10.1016/j.ajog.2017.02.027
[25]
Tremellen, K.P., Kolo, M., Gilmore, A. and Lekamge, D.N. (2005) Anti‐Müllerian Hormone as a Marker of Ovarian Reserve. Australian and New Zealand Journal of Obstetrics and Gynaecology, 45, 20-24. https://doi.org/10.1111/j.1479-828x.2005.00332.x
[26]
Howie, R. and Kay, V. (2018) Controlled Ovarian Stimulation for In-Vitro Fertilization. British Journal of Hospital Medicine, 79, 194-199. https://doi.org/10.12968/hmed.2018.79.4.194
[27]
Pilsgaard, F., Grynnerup, A.G.‐., Løssl, K., Bungum, L. and Pinborg, A. (2018) The Use of Anti‐Müllerian Hormone for Controlled Ovarian Stimulation in Assisted Reproductive Technology, Fertility Assessment and ‐Counseling. Acta Obstetricia et Gynecologica Scandinavica, 97, 1105-1113. https://doi.org/10.1111/aogs.13334
[28]
Tshzmachyan, R. and Hambartsoumian, E. (2020) The Role of Letrozole (LE) in Controlled Ovarian Stimulation (COS) in Patients at High Risk to Develop Ovarian Hyper Stimulation Syndrome (OHSS). A Prospective Randomized Controlled Pilot Study. Journal of Gynecology Obstetrics and Human Reproduction, 49, Article 101643. https://doi.org/10.1016/j.jogoh.2019.101643
[29]
Uppangala, S., Fernandes, G., Salian, S.R., Kumar, P., Talevi, R., Kalthur, G., et al. (2020) Reduced Ovarian Response to Controlled Ovarian Stimulation Is Associated with Increased Oxidative Stress in the Follicular Environment. Reproductive Biology, 20, 402-407. https://doi.org/10.1016/j.repbio.2020.04.005
[30]
Wang, F., Niu, W., Kong, H., Guo, Y. and Sun, Y. (2017) The Role of AMH and Its Receptor SNP in the Pathogenesis of PCOS. Molecular and Cellular Endocrinology, 439, 363-368. https://doi.org/10.1016/j.mce.2016.09.023
[31]
Broer, S.L., Broekmans, F.J.M., Laven, J.S.E. and Fauser, B.C.J.M. (2014) Anti-Müllerian Hormone: Ovarian Reserve Testing and Its Potential Clinical Implications. Human Reproduction Update, 20, 688-701. https://doi.org/10.1093/humupd/dmu020
[32]
Homburg, R. and Crawford, G. (2014) The Role of AMH in Anovulation Associated with PCOS: A Hypothesis. Human Reproduction, 29, 1117-1121. https://doi.org/10.1093/humrep/deu076
[33]
Ebner, T. (2009) Extracytoplasmic Markers of Human Oocyte Quality. Journal of Mammalian Ova Research, 26, 18-25. https://doi.org/10.1274/jmor.26.18
[34]
Maggiulli, R., Ubaldi, F. and Rienzi, L.F. (2012) Oocyte Insemination and Culture. In: Ginsburg, E. and Racowsky, C., Eds., In Vitro Fertilization, Springer, 83-98. https://doi.org/10.1007/978-1-4419-9848-4_6
[35]
Rienzi, L.F., Maggiulli, R. and Ubaldi, F.M. (2019) Oocyte Denuding. In: Nagy, Z., Varghese, A. and Agarwal, A. Eds., In Vitro Fertilization, Springer International Publishing, 133-145. https://doi.org/10.1007/978-3-319-43011-9_14
[36]
Ebner, T., Sommergruber, M., Moser, M., Shebl, O., Schreier-Lechner, E. and Tews, G. (2006) Basal Level of Anti-Müllerian Hormone Is Associated with Oocyte Quality in Stimulated Cycles. Human Reproduction, 21, 2022-2026. https://doi.org/10.1093/humrep/del127
[37]
Walls, M., Junk, S., Ryan, J.P. and Hart, R. (2012) IVF versus ICSI for the Fertilization of In-Vitro Matured Human Oocytes. Reproductive BioMedicine Online, 25, 603-607. https://doi.org/10.1016/j.rbmo.2012.08.001
[38]
Balaban, B., Ata, B., Isiklar, A., Yakin, K. and Urman, B. (2008) Severe Cytoplasmic Abnormalities of the Oocyte Decrease Cryosurvival and Subsequent Embryonic Development of Cryopreserved Embryos. Human Reproduction, 23, 1778-1785. https://doi.org/10.1093/humrep/den127
[39]
Hossein, M.S., Jeong, Y.W., Kim, S., Kim, J.J., Park, S.W., Jeong, C.S., et al. (2008) Protocol for the Recovery of in Vivo Matured Canine Oocytes Based on Once Daily Measurement of Serum Progesterone. Cloning and Stem Cells, 10, 403-408. https://doi.org/10.1089/clo.2008.0001
[40]
De Santis, L., Cino, I., Rabellotti, E., Calzi, F., Persico, P., Borini, A., et al. (2005) Polar Body Morphology and Spindle Imaging as Predictors of Oocyte Quality. Reproductive BioMedicine Online, 11, 36-42. https://doi.org/10.1016/s1472-6483(10)61296-5
[41]
Kilani, S. and Chapman, M.G. (2011) The Use of Polarized Light Microscopy in IVF. Expert Review of Obstetrics & Gynecology, 6, 241-246. https://doi.org/10.1586/eog.11.17
[42]
Sun, M., Li, Z. and Gui, J. (2010) Dynamic Distribution of Spindlin in Nucleoli, Nucleoplasm and Spindle from Primary Oocytes to Mature Eggs and Its Critical Function for Oocyte‐to‐Embryo Transition in Gibel Carp. Journal of Experimental Zoology Part A: Ecological Genetics and Physiology, 313, 461-473. https://doi.org/10.1002/jez.618
[43]
Trebichalská, Z., Kyjovská, D., Kloudová, S., Otevřel, P., Hampl, A. and Holubcová, Z. (2021) Cytoplasmic Maturation in Human Oocytes: An Ultrastructural Study. Biology of Reproduction, 104, 106-116. https://doi.org/10.1093/biolre/ioaa174
[44]
Combelles, C.M.H. and Rawe, V.Y. (2013) Determinants of Oocyte Quality: Impact on in Vitro Fertilization Failures. In: Oogenesis, Springer London, 307-327. https://doi.org/10.1007/978-0-85729-826-3_21
[45]
Alves, B.G., Alves, K.A., Lúcio, A.C., Martins, M.C., Silva, T.H., Alves, B.G., et al. (2014) Ovarian Activity and Oocyte Quality Associated with the Biochemical Profile of Serum and Follicular Fluid from Girolando Dairy Cows Postpartum. Animal Reproduction Science, 146, 117-125. https://doi.org/10.1016/j.anireprosci.2014.02.019
[46]
Balaban, B. (2017) Analysis of Fertilization. In: Taylor and Francis Group, Eds., Handbook of In Vitro Fertilization, CRC Press, 169-180.
[47]
Balaban, B., Barut, T. and Urman, B. (2012) Assessment of Oocyte Quality. In: Nagy, Z., Varghese, A. and Agarwal, A., Eds., Practical Manual of in Vitro Fertilization, Springer, 105-119. https://doi.org/10.1007/978-1-4419-1780-5_13
[48]
Bokhove, M. and Jovine, L. (2018) Structure of Zona Pellucida Module Proteins. In: Current Topics in Developmental Biology, Elsevier, 413-442. https://doi.org/10.1016/bs.ctdb.2018.02.007
[49]
Familiari, G., Relucenti, M., Heyn, R., Micara, G. and Correr, S. (2006) Three‐Dimensional Structure of the Zona Pellucida at Ovulation. Microscopy Research and Technique, 69, 415-426. https://doi.org/10.1002/jemt.20301
[50]
Litscher, E.S. and Wassarman, P.M. (2020) Zona Pellucida Genes and Proteins and Human Fertility. Trends in Developmental Biology, 13, 21-33.
[51]
Carlson, B.M. (2018) Human Embryology and Developmental Biology-Inkling Enhanced E-Book. Elsevier Health Sciences.
[52]
Homburg, R., Hendriks, M.L., Konig, T.E., Anderson, R.A., Balen, A.H., Brincat, M., et al. (2012) Clomifene Citrate or Low-Dose FSH for the First-Line Treatment of Infertile Women with Anovulation Associated with Polycystic Ovary Syndrome: A Prospective Randomized Multinational Study. Human Reproduction, 27, 468-473. https://doi.org/10.1093/humrep/der401
