JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (1): 26-32.doi: 10.6040/j.issn.1671-7554.0.2016.1334

Previous Articles     Next Articles

Features of ovarian reserve and outcomes of assisted reproductive technology in elder patients with PCOS

YANG Dongzi, MAI Zhuoyao   

  1. Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong, China
  • Received:2016-10-18 Online:2017-01-10 Published:2017-01-10

Abstract: Patients with polycystic ovary syndrome(PCOS)older than 35yrs may possess a potential advantage of ovarian reserve compared with women of the same age. When assisted reproductive technology(ART)is performed, PCOS 山 东 大 学 学 报 (医 学 版)55卷1期 -杨冬梓,等.高龄多囊卵巢综合征患者的卵巢储备特点及其助孕结局 \=-patients younger than 40yrs usually have more retrieved oocytes than age-matched non-PCOS infertile patients. Nevertheless, age related decline in the quality of follicles and deficiency in fetal development adversely affect the outcomes of ART in PCOS patients thereafter. Data show that PCOS patients have the same tendency of age-related decline in terms of clinical pregnancy rate and live birth rate, as with non-PCOS population of the same age, while metabolic and endocrine factors unfavorably influence pregnancy outcomes.

Key words: Assisted reproductive technology, Ageing, Outcome, Polycystic ovary syndrome

CLC Number: 

  • R588
[1] McCartney CR, Marshall JC. Clinical practice. Polycystic ovary syndrome[J]. N Engl J Med, 2016, 375(1): 54-64.
[2] 沈文娟, 张跃辉, 匡洪影, 等. 多囊卵巢综合征治疗的研究现状[J]. 中华妇产科杂志, 2012, 47(1): 67-70.
[3] Somigliana E, Paffoni A, Busnelli A, et al. Age-related infertility and unexplained infertility: an intricate clinical dilemma[J]. Hum Reprod, 2016, 31(7): 1390-1396.
[4] Broekmans FJ, Knauff EA, te Velde ER, et al. Female reproductive ageing: current knowledge and future trends[J]. Trends Endocrinol Metab, 2007, 18(2): 58-65.
[5] Richardson MC, Guo M, Fauser BC, et al. Environmental and developmental origins of ovarian reserve[J]. Hum Reprod Update, 2014, 20(3): 353-369.
[6] te Velde ER, Scheffer GJ, Dorland M, et al. Developmental and endocrine aspects of normal ovarian aging[J]. Mol Cell Endocrinol, 1998, 145(1-2): 67-73.
[7] Qiao J, Wang ZB, Feng HL, et al. The root of reduced fertility in aged women and possible therapentic options: current status and future perspects[J]. Mol Aspects Med, 2014, 38: 54-85. doi: 10.1016/j.mam.2013.06.001.
[8] Rabinowitz M, Ryan A, Gemelos G, et al. Origins and rates of aneuploidy in human blastomeres[J]. Fertil Steril, 2012, 97(2): 395-401.
[9] Monniaux D, Clement F, Dalbies-Tran R, et al. The ovarian reserve of primordial follicles and the dynamic reserve of antral growing follicles: what is the link?[J] Biol Reprod, 2014, 90(4): 85. doi: 10.1095/biolreprod.113.117077.
[10] Jeppesen JV, Anderson RA, Kelsey TW, et al. Which follicles make the most anti-Mullerian hormone in humans? Evidence for an abrupt decline in AMH production at the time of follicle selection[J]. Mol Hum Reprod, 2013, 19(8): 519-527.
[11] Cui Y, Shi Y, Cui L, et al. Age-specific serum antimüllerian hormone levels in women with and without polycystic ovary syndrome[J]. Fertil Steril, 2014, 102(1): 230-236.
[12] Aksglaede L, Sorensen K, Boas M, et al. Changes in anti-Mullerian hormone(AMH)throughout the life span: a population-based study of 1027 healthy males from birth(cord blood)to the age of 69 years[J]. J Clin Endocrinol Metab, 2010, 95(12): 5357-5364.
[13] Wellons MF, Bates GW, Schreiner PJ, et al. Antral follicle count predicts natural menopause in a population-based sample: the Coronary Artery Risk Development in Young Adults Womens Study[J]. Menopause, 2013, 20(8): 825-830.
[14] Hansen KR, Hodnett GM, Knowlton N, et al. Correlation of ovarian reserve tests with histologically determined primordial follicle number[J]. Fertil Steril, 2011, 95(1): 170-175.
[15] Xita N, Tsatsoulis A. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical, and genetic association studies[J]. J Clin Endocrinol Metab, 2006, 91(5): 1660-1666.
[16] Webber LJ, Stubbs S, Stark J, et al. Formation and early development of follicles in the polycystic ovary[J]. Lancet, 2003, 362(9389): 1017-1021.
[17] Hudecova M, Holte J, Olovsson M, et al. Long-term follow-up of patients with polycystic ovary syndrome: reproductive outcome and ovarian reserve[J]. Hum Reprod, 2009, 24(5): 1176-1183.
[18] Catteau-Jonard S, Jamin SP, Leclerc A, et al. Anti-Mullerian hormone, its receptor, FSH receptor, and androgen receptor genes are overexpressed by granulosa cells from stimulated follicles in women with polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2008, 93(11): 4456-4461.
[19] Tehrani FR, Solaymani-Dodaran M, Hedayati M, et al. Is polycystic ovary syndrome an exception for reproductive aging?[J]. Hum Reprod, 2010, 25(7): 1775-1781.
[20] Wiser A, Shalom-Paz E, Hyman JH, et al. Age-related normogram for antral follicle count in women with polycystic ovary syndrome[J]. Reprod Biomed Online, 2013, 27(4): 414-418.
[21] Webber LJ, Stubbs SA, Stark J, et al. Prolonged survival in culture of preantral follicles from polycystic ovaries[J]. J Clin Endocrinol Metab, 2007, 92(5): 1975-1978.
[22] Schmidt J, Brannstrom M, Landin-Wilhelmsen K, et al. Reproductive hormone levels and anthropometry in postmenopausal women with polycystic ovary syndrome(PCOS): a 21-year follow-up study of women diagnosed with PCOS around 50 years ago and their age-matched controls[J]. J Clin Endocrinol Metab, 2011, 96(7): 2178-2185.
[23] Wild S, Pierpoint T, Jacobs H, et al. Long-term consequences of polycystic ovary syndrome: results of a 31 year follow-up study[J]. Hum Fertil(Camb), 2000, 3(2): 101-105.
[24] May-Panloup P, Boucret L, Chao de la Barca JM, et al. Ovarian ageing: the role of mitochondria in oocytes and follicles[J]. Hum Reprod Update, 2016, 22(6):725-743.
[25] Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence[J]. Hum Reprod Update, 2011, 17(1): 17-33.
[26] Dumesic DA, Abbott DH. Implications of polycystic ovary syndrome on oocyte development[J]. Semin Reprod Med, 2008, 26(1): 53-61.
[27] Dumesic DA, Padmanabhan V, Abbott DH. Polycystic ovary syndrome and oocyte developmental competence[J]. Obstet Gynecol Surv, 2008, 63(1): 39-48.
[28] Wood JR, Dumesic DA, Abbott DH, et al. Molecular abnormalities in oocytes from women with polycystic ovary syndrome revealed by microarray analysis[J]. J Clin Endocrinol Metab, 2007, 92(2): 705-713.
[29] Heijnen EM, Eijkemans MJ, Hughes EG, et al. A meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome[J]. Hum Reprod Update, 2006, 12(1): 13-21.
[30] Sigala J, Sifer C, Dewailly D, et al. Is polycystic ovarian morphology related to a poor oocyte quality after controlled ovarian hyperstimulation for intracytoplasmic sperm injection? Results from a prospective, comparative study[J]. Fertil Steril, 2015, 103(1): 112-118.
[31] Child TJ, Abdul-Jalil AK, Gulekli B, et al. In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome[J]. Fertil Steril, 2001, 76(5): 936-942.
[32] Jonard S, Dewailly D. The follicular excess in polycystic ovaries, due to intra-ovarian hyperandrogenism, may be the main culprit for the follicular arrest[J]. Hum Reprod Update, 2004, 10(2): 107-117.
[33] Hughesdon PE. Morphology and morphogenesis of the stein-leventhal ovary and of so-called “hyperthecosis”[J]. Obstet Gynecol Surv, 1982, 37(2): 59-77.
[34] Dewailly D, Catteau-Jonard S, Reyss AC, et al. The excess in 2-5 mm follicles seen at ovarian ultrasonography is tightly associated to the follicular arrest of the polycystic ovary syndrome[J]. Hum Reprod, 2007, 22(6): 1562-1566.
[35] Durlinger AL, Gruijters MJ, Kramer P, et al. Anti-Mullerian hormone inhibits initiation of primordial follicle growth in the mouse ovary[J]. Endocrinology, 2002, 143(3): 1076-1084.
[36] Carlsson IB, Scott JE, Visser JA, et al. Anti-Mullerian hormone inhibits initiation of growth of human primordial ovarian follicles in vitro[J]. Hum Reprod, 2006, 21(9): 2223-2227.
[37] Stubbs SA, Hardy K, Da Silva-Buttkus P, et al. Anti-müllerian hormone protein expression is reduced during the initial stages of follicle development in human polycystic ovaries[J]. J Clin Endocrinol Metab, 2005, 90(10): 5536-5543.
[38] Hsueh AJ, Kawamura K, Cheng Y, et al. Intraovarian control of early folliculogenesis[J]. Endocr Rev, 2015, 36(1): 1-24.
[39] Bhide P, Dilgil M, Gudi A, et al. Each small antral follicle in ovaries of women with polycystic ovary syndrome produces more antimullerian hormone than its counterpart in a normal ovary: an observational cross-sectional study[J]. Fertil Steril, 2015, 103(2): 537-541.
[40] Das M, Gillott DJ, Saridogan E, et al. Anti-mullerian hormone is increased in follicular fluid from unstimulated ovaries in women with polycystic ovary syndrome[J]. Hum Reprod, 2008, 23(9): 2122-2126.
[41] Dewailly D, Robin G, Peigne M, et al. Interactions between androgens, FSH, anti-mullerian hormone and estradiol during folliculogenesis in the human normal and polycystic ovary[J]. Hum Reprod Update, 2016, 22(6):709-724.
[42] Grossman MP, Nakajima ST, Fallat ME, et al. Mullerian-inhibiting substance inhibits cytochrome P450 aromatase activity in human granulosa lutein cell culture[J]. Fertil Steril, 2008, 89(5 Suppl): 1364-1370.
[43] Pierre A, Peigne M, Grynberg M, et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome[J]. Hum Reprod, 2013, 28(3): 762-769.
[44] Grynberg M, Pierre A, Rey R, et al. Differential regulation of ovarian anti-mullerian hormone(AMH)by estradiol through alpha- and beta-estrogen receptors[J]. J Clin Endocrinol Metab, 2012, 97(9): E1649-E1657.
[45] Catteau-Jonard S, Pigny P, Reyss AC, et al. Changes in serum anti-mullerian hormone level during low-dose recombinant follicular-stimulating hormone therapy for anovulation in polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2007, 92(11): 4138-4143.
[46] Xi W, Yang Y, Mao H, et al. Circulating anti-mullerian hormone as predictor of ovarian response to clomiphene citrate in women with polycystic ovary syndrome[J]. J Ovarian Res, 2016, 9: 3.
[47] Koninger A, Sauter L, Edimiris P, et al. Predictive markers for the FSH sensitivity of women with polycystic ovarian syndrome[J]. Hum Reprod, 2014, 29(3): 518-524.
[48] Mumford SL, Legro RS, Diamond MP, et al. Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2016, 101(9): 3288-3296.
[49] Ellakwa HE, Sanad ZF, Hamza HA, et al. Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility[J]. Int J Gynaecol Obstet, 2016, 133(1): 59-63.
[50] Hudecova M, Holte J, Moby L, et al. Androgen levels, insulin sensitivity, and early insulin response in women with polycystic ovary syndrome: a long-term follow-up study[J]. Fertil Steril, 2011, 95(3): 1146-1148.
[51] Guido M, Belosi C, Selvaggi L, et al. The effect of age on the ovarian response to gonadotropin and on pregnancy rate in polycystic ovary syndrome[J]. Gynecol Endocrinol, 2003, 17(3): 215-221.
[52] Mellembakken JR, Berga SL, Kilen M, et al. Sustained fertility from 22 to 41 years of age in women with polycystic ovarian syndrome[J]. Hum Reprod, 2011, 26(9): 2499-2504.
[53] Kalra SK, Ratcliffe SJ, Dokras A. Is the fertile window extended in women with polycystic ovary syndrome? Utilizing the society for assisted reproductive technology registry to assess the impact of reproductive aging on live-birth rate[J]. Fertil Steril, 2013, 100(1): 208-213.
[54] Hwang YI, Cha SW, Song IO, et al. Fertility of patients with polycystic ovary syndrome undergoing in vitro fertilization by age[J]. Int J Gynaecol Obstet, 2016, 35(1):91-95.
[55] Delvigne A, Rozenberg S. Epidemiology and prevention of ovarian hyperstimulation syndrome(OHSS): a review[J]. Hum Reprod Update, 2002, 8(6): 559-577.
[56] Koivunen R, Pouta A, Franks S, et al. Fecundability and spontaneous abortions in women with self-reported oligo-amenorrhea and/or hirsutism: Northern Finland Birth Cohort 1966 Study[J]. Hum Reprod, 2008, 23(9): 2134-2139.
[57] West S, Vahasarja M, Bloigu A, et al. The impact of self-reported oligo-amenorrhea and hirsutism on fertility and lifetime reproductive success: results from the Northern Finland Birth Cohort 1966[J]. Hum Reprod, 2014, 29(3): 628-633.
[58] Dicker D, Goldman JA, Ashkenazi J, et al. Age and pregnancy rates in in vitro fertilization[J]. J In Vitro Fert Embryo Transf, 1991, 8(3): 141-144.
[59] Dor J, Seidman DS, Ben-Shlomo I, et al. Cumulative pregnancy rate following in-vitro fertilization: the significance of age and infertility aetiology[J]. Hum Reprod, 1996, 11(2): 425-428.
[60] Gonzalez-Foruria I, Penarrubia J, Borras A, et al. Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization[J]. Fertil Steril, 2016, 106(2): 342-347.
[61] Shea LO, Hughes C, Mocanu EV. Advanced maternal age and assisted reproductive technologies in an irish population[J]. Ir Med J, 2015, 108(8): 243-246.
[62] Yan J, Wu K, Tang R, et al. Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET)[J]. Sci China Life Sci, 2012, 55(8): 694-698.
[1] DING Xiangyun, YU Qingmei, ZHANG Wenfang, ZHUANG Yuan, HAO Jing. Correlation of the expression of insulin-like growth factor II in granulosa cells and ovulation induction outcomes of 84 patients with polycystic ovary syndrome [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 60-66.
[2] FENG Zhiyu, YANG Yanliang, GUO Rui, XU Huihui, ZHANG Jian, GUO Kai, WANG Guangzhen, WANG Hui. Diagnosis and surgical treatment of pulmonary artery sling complicated with tracheal stenosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 48-51.
[3] GAO Jianbu, YANG Shouzhong, LI Yudong, QIAO Chong, ZHANG Songyu. Trend survey of inpatient use of drugs for acute myocardial infarction during 10 years in a hospital of Nanyang City [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 66-69.
[4] ZHANG Suping, WANG Ze, ZHOU Yali, LI Jing, LU Xilan, BAI Hongwei, SHI Yuhua. Clinical effects of body mass index on ovulation induction treatment with letrozole among women with polycystic ovary syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 81-85.
[5] LI Mei. Quality of oocytes and embryos of elder women [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 16-21.
[6] CHEN Zijiang. Clinical concern of the second pregnancy under the two-child policy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 1-4.
[7] DENG Xiaohui, XU Yaxuan. Fertility evaluation and assisted reproduction in elder women [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 5-10.
[8] SHI Yuhua, LI Jing. Strategies for infertility treatment in elderly women [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 22-25.
[9] JIA Yueyue, LIU Hongbin, LI Jingbo, LI Jing, ZHANG Jiangtao, SUN Mei, SHI Yuhua. Expression of microRNA-200b in granulosa cells of PCOS patients and its significance [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 63-68.
[10] LI Jingbo, LIU Hongbin, JIA Yueyue, WANG Ze, SUN Mei, SHI Yuhua. Expression and clinical significance of microRNA-183 in polycystic ovary syndrome with insulin resistance [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 69-74.
[11] ZHANG Lin, LI Jing, WANG Ze, ZHANG Jiangtao, MA Zengxiang, SHI Yuhua. Impact of thyroid-stimulating hormone on blood glucose and serum lipids in patients with polycystic ovary syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 80-84.
[12] HONG Haijie, SUN Wenjuan, ZHANG Yuan, XU Yongping. Influencing factors of adverse outcomesin term neonates delivered by elective caesarean [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 56-61.
[13] DONG Yanlei, ZHU Lin. Reproductive outcomes of different laparoscopic operations for ectopic pregnancy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 65-67.
[14] FENG Zhiyu, GUO Rui, YANG Yanliang, LI Haiming, DONG Mingliang, XU Huihui, LIU Yimin, GUO Kai, WANG Guangzhen, WANG Hui. Initial palliative repair of pulmonary atresia with ventricular septal defect by rehabilitating right ventricle to pulmonary artery connection [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(11): 41-45.
[15] WANG Likui, SANG Hongai, MA Yuyan, XU Yintao, WANG Linlin. Clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus: a study of 66 cases with 67 pregnancies [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(12): 69-72.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!