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

Reproductive Biology and Endocrinology

Guido Ambrosini²  Donato D’Antona²  Pietro Litta²  Giovanni B Nardelli²  Michele Gangemi²  Decio Armanini³  Federica Esposito²  Michela Quaranta¹  Marco Noventa²  Alessandra Andrisani²  Salvatore Gizzo² 

[1] Department of Obstetrics and Gynaecology, University of Verona, Piazzale Ludovico Scuro 10 street, Verona, 37134, Italy;Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, Padua, 35128, Italy;Department of Medicine-Endocrinology, University of Padua, Giustiniani 2 street, Padua, 35128, Italy

关键词: Infertility;    Pregnancy rate;    Fertilization rate;    Ovarian response;    Ovarian reserve;    Ovarian sensitivity index;    Estimation of reproductive chances;    Menstrual cycle length;   

Others  :  1172007
DOI  :  10.1186/s12958-015-0024-1

 received in 2015-01-21, accepted in 2015-03-31,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Gizzo et al.; licensee BioMed Central.

【 图 表 】

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