Hormona anti-Mülleriana en felinos domésticos / Anti-Müllerian hormone in domestic felids

La hormona anti-Mülleriana (HAM) es una glicoproteína dimérica de 140 kDa que pertenece a la superfamilia del factor de crecimiento transformante ß. La HAM es producida por las células de Sertoli de los testículos fetales siendo responsable de la regresión de los conductos müllerianos durante la diferenciación sexual masculina. En la hembra la HAM circula a niveles casi indetectable al nacer, con un ligero aumento en los primeros años de vida hasta la pubertad cuando se expresa en las células de la granulosa de folículos preantrales y antrales pequeños del ovario. En hembras adultas, la HAM actúa como un regulador autocrino y paracrino inhibiendo el reclutamiento de folículos primordiales y reduciendo la respuesta a la hormona folículo estimulante. En el gato doméstico el número de estudios de HAM es muy escaso quedando aún abundantes aspectos por definir en la especie. También la validación de un único inmunoensayo que permita la comparación de valores séricos entre los trabajos es necesaria. El objetivo de esta revisión fue explicar aspectos básicos de la fisiología de la HAM y resumir las principales publicaciones en el gato doméstico. Finalmente, se proponen aplicaciones prácticas para esta hormona en la especie.(AU)

O hormônio anti-Mülleriano (HAM) é uma glicoproteína dimérica de 140 kDa que pertence a superfamília do fator de crescimento transformador ß. O HAM é produzido pelas células de Sertoli dos testículos fetais, sendo responsável pela regressão dos ductos de Müller durante a diferenciação sexual masculina. Na fêmea, o HAM circula a níveis quase indetectáveis ao nascimento, com um ligeiro aumento nos primeiros anos de vida até a puberdade, quando se expressa nas células da granulosa de folículos préantrais e antrais pequenos do ovário. Nas fêmeas adultas, o HAM atua como um regulador autócrino e parácrino inibindo o recrutamento de folículos primordiais e reduzindo a resposta ao hormônio folículoestimulante. No gato doméstico o número de estudos do HAM é muito escasso, faltando vários aspectos a serem definidos na espécie. Também é necessária a validação de um único imunoensaio que permita a comparação de valores séricos entre trabalhos. O objetivo desta revisão foi explicar aspectos básicos da fisiologia do HAM e resumir as principais publicações no gato doméstico. Finalmente, se propõe aplicações práticas para este hormônio na espécie.(AU)

Insuficiencia ovárica primaria en adolescentes: revisión de la literatura a propósito de un caso clínico / Primary ovarian insufficiency in adolescents: review of the literature regarding a clinical case

El objetivo de este manuscrito es realizar una revisión y actualización de la literatura de la insuficiencia ovárica primaria (IOP) en población adolescente, a partir del diagnóstico, manejo y seguimiento de un caso clínico. La insuficiencia ovárica primaria se define como la menopausia en una mujer antes de los 40 años, acompañada de amenorrea, hipogonadismo hipergonadotrópico e infertilidad. Su prevalencia varía entre 1 a 2%, y en mujeres menores de 20 años su prevalencia es un caso de cada 10,000. Aunque se sabe que muchas afecciones pueden llevar a una IOP, la más común es la causa idiopática. La presentación clínica es diversa, y varios trastornos diferentes pueden también, llevar a esta condición. CASO CLÍNICO: Se presenta el caso de una adolescente de 17 años, previamente sana, con historia de amenorrea secundaria, no embarazada, con examen físico general y ginecológico normal. Se solicita estudio analítico complementario resultando con niveles de hormona folículo estimulante (FHS), estradiol (E2) y hormona antimülleriana (AMH) compatibles con una insuficiencia ovárica como la observada en la posmenopausia. Se inicia terapia hormonal (TH) clásica con estradiol y progesterona, siendo posteriormente reemplazada por anticoncepción hormonal combinada (AHC) oral, coincidente con el inicio de vida sexual, con respuesta favorable y sangrados regulares. La IOP tiene graves consecuencias para la salud incluyendo trastornos psicológicos como angustia, síntomas depresivos o depresión, infertilidad, osteoporosis, trastornos autoinmunes, cardiopatía isquémica, y un mayor riesgo de mortalidad. La enfermedad de Hashimoto es el trastorno autoinmune más frecuente asociado a la IOP. Su tratamiento y diagnóstico deben establecerse de forma precoz para evitar consecuencias a largo plazo. La terapia con estrógenos es la base del tratamiento para eliminar los síntomas de la deficiencia de estrógenos, además de evitar las consecuencias futuras del hipogonadismo no tratado. También el manejo debe incluir los siguientes dominios: fertilidad y anticoncepción, salud ósea, problemas cardiovasculares, función psicosexual, psicológica y neurológica, informando a los familiares y a la paciente sobre la dimensión real de la IOP y la necesidad de tratamiento multidisciplinario en muchos casos. CONCLUSIÓN: El caso presentado, pese a ser infrecuente, permite abordar de manera sistematizada el diagnostico de IOP y evaluar alternativas de manejo plausibles para evitar graves consecuencias en la salud, así como conocer respuesta clínica y de satisfacción de la adolescente.

The objective of this manuscript is to review and update the literature on primary ovarian insufficiency (POI) in an adolescent population, based on the diagnosis, management and follow-up of a clinical case. Primary ovarian insufficiency is defined as menopause in a woman before the age of 40, accompanied by amenorrhea, hypergonadotropic hypogonadism, and infertility. Its prevalence varies between 1 to 2%, and in women under 20 years of age its prevalence is one case in every 10,000. Although it is known that many conditions can lead to POI, the most common is the idiopathic cause. The clinical presentation is diverse, and several different disorders can also lead to this condition. CLINICAL CASE: The case of a 17-year-old adolescent, previously healthy, with a history of secondary amenorrhea, not pregnant, with a normal general physical and gynecological examination is presented. A complementary analytical study is requested, resulting in levels of follicle stimulating hormone (FHS), estradiol (E2) and anti-müllerian hormone (AMH) compatible with ovarian insufficiency such as that observed in postmenopause. Classic hormonal therapy (HT) with estradiol and progesterone was started, later being replaced by combined hormonal contraception (CHC), coinciding with the beginning of sexual life, with a favorable response and regular bleeding. POI has serious health consequences including psychological disorders such as distress, depressive symptoms or depression, infertility, osteoporosis, autoimmune disorders, ischemic heart disease, and an increased risk of mortality. Hashimoto's disease is the most common autoimmune disorder associated with POI. Its treatment and diagnosis must be established early to avoid long-term consequences. Estrogen therapy is the mainstay of treatment to eliminate the symptoms of estrogen deficiency, in addition to avoiding the future consequences of untreated hypogonadism. Management should also include the following domains: fertility and contraception, bone health, cardiovascular problems, psychosexual, psychological and neurological function, informing family members and the patient about the real dimension of POI and the need for multidisciplinary treatment in many cases. CONCLUSION: The case, although infrequent, allows a systematic approach to the diagnosis of POI and evaluate plausible management alternatives to avoid serious health consequences, as well as to know the clinical response and satisfaction of the adolescent.

Hormônio antimülleriano como marcador de fertilidade em fêmeas suínas / Anti-Müllerian hormone as a fertility marker in swine females

O hormônio antimülleriano é conhecido por seu papel na regressão dos ductos de Müller durante a fase de diferenciação sexual dos machos. Ainda assim, esse hormônio atua de forma ainda mais ampla no desenvolvimento de ambos os sexos. O hormônio antimülleriano é diferencialmente expresso em machos e fêmeas durante toda a vida. Nas fêmeas esse hormônio é produzido pelas células da granulosa dos folículos ovarianos e atua modulando os processos de secreção de gonadotrofinas, foliculogênese e esteroidogênese, sendo considerado um biomarcador confiável para fertilidade em diferentes espécies. Apesar de pouquíssimo estudado na espécie suína, alguns trabalhos vêm demonstrando a existência de associações entre os níveis séricos do hormônio antimülleriano e os fenótipos de maior fertilidade. De forma que, o objetivo desta revisão é fazer um levantamento do conhecimento já acumulado acerca da temática, demostrando a importância do desenvolvimento de novos estudos; tendo em vista que o aprofundamento do conhecimento sobre as funções do hormônio antimülleriano nas fêmeas da espécie suína pode contribuir para o melhor entendimento da fisiologia da espécie

The anti-Müllerian hormone (AMH) is known for its role in the regression of Muller ducts during the phase of sexual differentiation in males. Notwithstanding, this hormone acts more broadly on the development of both sexes. The AMH is differentially expressed both in males and females throughout life. In females, this hormone is produced by granulosa cells of ovarian follicles and modulates the gonadotropin secretion, folliculogenesis, and steroidogenesis, and is considered a reliable fertility biomarker in different species. Despite the lack of studies in the swine species, some reports demonstrated the association between serum levels of AMH and more fertile phenotypes. Therefore, this review aims to survey the current knowledge about this theme, demonstrating the importance of the development of new research, since the strengthening of the knowledge on the functions of the AMH in swine females may contribute to understanding the physiology of the species.

Hormônio antimülleriano como marcador de fertilidade em fêmeas suínas / Anti-Müllerian hormone as a fertility marker in swine females

O hormônio antimülleriano é conhecido por seu papel na regressão dos ductos de Müller durante a fase de diferenciação sexual dos machos. Ainda assim, esse hormônio atua de forma ainda mais ampla no desenvolvimento de ambos os sexos. O hormônio antimülleriano é diferencialmente expresso em machos e fêmeas durante toda a vida. Nas fêmeas esse hormônio é produzido pelas células da granulosa dos folículos ovarianos e atua modulando os processos de secreção de gonadotrofinas, foliculogênese e esteroidogênese, sendo considerado um biomarcador confiável para fertilidade em diferentes espécies. Apesar de pouquíssimo estudado na espécie suína, alguns trabalhos vêm demonstrando a existência de associações entre os níveis séricos do hormônio antimülleriano e os fenótipos de maior fertilidade. De forma que, o objetivo desta revisão é fazer um levantamento do conhecimento já acumulado acerca da temática, demostrando a importância do desenvolvimento de novos estudos; tendo em vista que o aprofundamento do conhecimento sobre as funções do hormônio antimülleriano nas fêmeas da espécie suína pode contribuir para o melhor entendimento da fisiologia da espécie(AU)

The anti-Müllerian hormone (AMH) is known for its role in the regression of Muller ducts during the phase of sexual differentiation in males. Notwithstanding, this hormone acts more broadly on the development of both sexes. The AMH is differentially expressed both in males and females throughout life. In females, this hormone is produced by granulosa cells of ovarian follicles and modulates the gonadotropin secretion, folliculogenesis, and steroidogenesis, and is considered a reliable fertility biomarker in different species. Despite the lack of studies in the swine species, some reports demonstrated the association between serum levels of AMH and more fertile phenotypes. Therefore, this review aims to survey the current knowledge about this theme, demonstrating the importance of the development of new research, since the strengthening of the knowledge on the functions of the AMH in swine females may contribute to understanding the physiology of the species.(AU)

AMH Polymorphisms and their association with traits indicative of sexual precocity in nelore heifers / Polimorfismos do AMH e suas associações com características indicadoras de precocidade sexual em novilhas nelore

Anti-Müllerian Hormone (AMH) is a protein expressed in the gonads and related to ovarian follicular development. The aim of this study was to investigate the presence of polymorphisms in the AMH gene in a Nelore herd to analyze the genetic constitution of this population and to perform association studies with early pregnancy occurrence (EPO) and age at first calving (AFC). Phenotypic data consisted of verification of early pregnancy and age at first calving of 197 unrelated heifers exposed to the mating season and aged between 15 and 17 months (precocious group) and 24 months (non-precocious group). The “precocious” group consisted of 67 heifers with age at first calving of 26.5 ± 0.59 months, and the “non-precocious” group was composed of 130 heifers with age at first calving of 36.4 ± 0.99 months. All five exons of the AMH gene were amplified by Polymerase Chain Reaction (PCR) and sequenced. A total of three SNPs were identified in this study, all of them located in exon 5 (rs527023314, rs722016629, and rs134387246), the latter one positioned in the stop codon. All three SNPs identified in exon 5 characterized synonymous mutations. Only SNP rs134387246 exhibited a significant value (P ≤ 0.10) for EPO and AFC. The association study of SNP rs134387246 revealed an over-dominance effect (P = 0.056), and no additive effect was observed (P = 0.67). A reduction of 2.5 months (75 days) in the age at first calving of heterozygous heifers for the SNP rs134387246 was observed. For the first time, polymorphisms of the AMH gene were described in Nelore heifers and associated with sexual precocity traits.

O hormônio Anti-Mülleriano (AMH) é uma proteína expressa nas gônadas e está relacionada ao desenvolvimento folicular ovariano. O objetivo desse trabalho foi investigar a presença de polimorfismos do gene AMH em um rebanho Nelore, analisar a constituição genética da população para o gene e estudar a associação entre os polimorfismos e as características ocorrência de prenhez precoce (OPP) e idade ao primeiro parto (IPP). Os dados fenotípicos consistiram da verificação da prenhez precoce e idade ao primeiro parto de 197 novilhas, não aparentadas, expostas à estação de monta com idade entre 15 e 17 meses (grupo precoce) ou 24 meses (grupo não precoce). O grupo denominado “precoce” foi composto por 67 novilhas com idade ao primeiro parto de 26.5±0.59 meses, e o segundo denominado “não precoce” composto por 130 novilhas com idade ao primeiro parto de 36.4±0.99 meses. Os cinco éxons do gene AMH foram amplificados por meio da técnica de Reação em Cadeia da Polimerase (PCR) e sequenciados. Um total de três SNPs foram identificados nesse estudo, todos localizados no éxon 5 (rs527023314, rs722016629 and rs134387246), sendo o último posicionado stop codon. Os três SNPs identificados caracterizaram mutações sinônimas. Somente o SNP rs134387246 exibiu associação significante (P ≤ 0.10) para ambas características (OPP e IPP). O estudo de associação do SNP rs134387246 revelou um efeito de sobre dominância (P=0,056), e ausência de ação gênica aditiva (P=0,67). Foi observada redução de 2,5 meses (75 dias) na idade ao primeiro parto de novilhas heterozigotas para o SNP rs134387246. Pela primeira vez na literatura, polimorfismos do gene AMH foram descritos em novilhas da raça Nelore e associados a características indicadoras de precocidade sexual.

AMH Polymorphisms and their association with traits indicative of sexual precocity in nelore heifers / Polimorfismos do AMH e suas associações com características indicadoras de precocidade sexual em novilhas nelore

Anti-Müllerian Hormone (AMH) is a protein expressed in the gonads and related to ovarian follicular development. The aim of this study was to investigate the presence of polymorphisms in the AMH gene in a Nelore herd to analyze the genetic constitution of this population and to perform association studies with early pregnancy occurrence (EPO) and age at first calving (AFC). Phenotypic data consisted of verification of early pregnancy and age at first calving of 197 unrelated heifers exposed to the mating season and aged between 15 and 17 months (precocious group) and 24 months (non-precocious group). The “precocious” group consisted of 67 heifers with age at first calving of 26.5 ± 0.59 months, and the “non-precocious” group was composed of 130 heifers with age at first calving of 36.4 ± 0.99 months. All five exons of the AMH gene were amplified by Polymerase Chain Reaction (PCR) and sequenced. A total of three SNPs were identified in this study, all of them located in exon 5 (rs527023314, rs722016629, and rs134387246), the latter one positioned in the stop codon. All three SNPs identified in exon 5 characterized synonymous mutations. Only SNP rs134387246 exhibited a significant value (P ≤ 0.10) for EPO and AFC. The association study of SNP rs134387246 revealed an over-dominance effect (P = 0.056), and no additive effect was observed (P = 0.67). A reduction of 2.5 months (75 days) in the age at first calving of heterozygous heifers for the SNP rs134387246 was observed. For the first time, polymorphisms of the AMH gene were described in Nelore heifers and associated with sexual precocity traits.(AU)

O hormônio Anti-Mülleriano (AMH) é uma proteína expressa nas gônadas e está relacionada ao desenvolvimento folicular ovariano. O objetivo desse trabalho foi investigar a presença de polimorfismos do gene AMH em um rebanho Nelore, analisar a constituição genética da população para o gene e estudar a associação entre os polimorfismos e as características ocorrência de prenhez precoce (OPP) e idade ao primeiro parto (IPP). Os dados fenotípicos consistiram da verificação da prenhez precoce e idade ao primeiro parto de 197 novilhas, não aparentadas, expostas à estação de monta com idade entre 15 e 17 meses (grupo precoce) ou 24 meses (grupo não precoce). O grupo denominado “precoce” foi composto por 67 novilhas com idade ao primeiro parto de 26.5±0.59 meses, e o segundo denominado “não precoce” composto por 130 novilhas com idade ao primeiro parto de 36.4±0.99 meses. Os cinco éxons do gene AMH foram amplificados por meio da técnica de Reação em Cadeia da Polimerase (PCR) e sequenciados. Um total de três SNPs foram identificados nesse estudo, todos localizados no éxon 5 (rs527023314, rs722016629 and rs134387246), sendo o último posicionado stop codon. Os três SNPs identificados caracterizaram mutações sinônimas. Somente o SNP rs134387246 exibiu associação significante (P ≤ 0.10) para ambas características (OPP e IPP). O estudo de associação do SNP rs134387246 revelou um efeito de sobre dominância (P=0,056), e ausência de ação gênica aditiva (P=0,67). Foi observada redução de 2,5 meses (75 dias) na idade ao primeiro parto de novilhas heterozigotas para o SNP rs134387246. Pela primeira vez na literatura, polimorfismos do gene AMH foram descritos em novilhas da raça Nelore e associados a características indicadoras de precocidade sexual.(AU)

Anti-Müllerian hormone (AMH) as a predictor of antral follicle population in heifers

Antral follicular population (AFP) and anti-Müllerian hormone (AMH) concentration are strongly associated. Thus, analyzing AMH concentration is a reliable method to predict animals with high AFP, an important feature to select donor cows for embryos and oocytes. However, not much is known about this parameter in heifers, particularly in crossbred animals. The aim of this study was to assess AFP in heifers and cows and its relation to serum AMH levels. Bos taurus indicus cows (36–60-months-old; n = 30) and heifers (12–14-months-old; n = 17) of the same breed were evaluated. A single procedure of follicular counting was performed by ultrasound for each animal. Random sampling was performed to analyze serum AMH concentration. Cows showed higher AFP than heifers; nonetheless, plasma AMH concentration did not differ between the categories. A high correlation of AFP with plasma AMH concentration was observed in Girolando heifers. Thus, it is suggested that AMH concentration could be a reliable and less invasive method for selecting heifers with high AFP.

Anti-Müllerian hormone (AMH) as a predictor of antral follicle population in heifers

Antral follicular population (AFP) and anti-Müllerian hormone (AMH) concentration are strongly associated. Thus, analyzing AMH concentration is a reliable method to predict animals with high AFP, an important feature to select donor cows for embryos and oocytes. However, not much is known about this parameter in heifers, particularly in crossbred animals. The aim of this study was to assess AFP in heifers and cows and its relation to serum AMH levels. Bos taurus indicus cows (36–60-months-old; n = 30) and heifers (12–14-months-old; n = 17) of the same breed were evaluated. A single procedure of follicular counting was performed by ultrasound for each animal. Random sampling was performed to analyze serum AMH concentration. Cows showed higher AFP than heifers; nonetheless, plasma AMH concentration did not differ between the categories. A high correlation of AFP with plasma AMH concentration was observed in Girolando heifers. Thus, it is suggested that AMH concentration could be a reliable and less invasive method for selecting heifers with high AFP.(AU)

Anti-Müllerian hormone in type 2 and gestational diabetes during the second half of pregnancy: relationship with sexual steroid levels and metabolic parameters.

Hyperandrogenemia and hyperinsulinemia are observed in women with diabetes during pregnancy. The effect of diabetes on anti-Müllerian hormone (AMH) levels during pregnancy is unclear. The aim of this study was to determine the AMH levels in women with type 2 diabetes (T2D) and gestational diabetes (GD) compared to healthy (C) pregnant women during the second half of gestation. A prospective study of 69 pregnant women with T2D (N: 21), GD (N: 24) and C (N: 24) were followed up during the second half of pregnancy. Clinical assessments and blood samples were collected at 26.7 (25-27.8); 34 (32-34.9) and 37.5 (37-40) weeks of gestation. AMH, sexual steroids, insulin, homeostatic model assessment of insulin resistance, HbA1c levels were measured. AMH levels were similar between T2D, GD and C (p = .07). A decline of AMH levels during the second half of gestation was observed in the three groups (p < .0001). AMH levels were negatively associated with age (p < .001). A positive association between AMH and testosterone (p < .05) was found in all groups. A progressive decline of AMH levels is observed in diabetic and healthy women during the second half of pregnancy. Testosterone levels are an independent factor that influences AMH levels during pregnancy. However, AMH levels are not affected by the presence of diabetes during gestation.

Avaliação da reserva ovariana na predição do mau prognóstico reprodutivo: quando e como investigar / Ovarian reserve evaluation in the prediction of poor reproductive prognosis: when and how to investigate?

Muitas vezes, torna-se um grande desafio para o ginecologista a identificação daquelas com maior ou menor chance de concepção. Vários marcadores laboratoriais e ultrassonográficos, conhecidos conjuntamente como testes de avaliação da reserva ovariana, são estudados há décadas com a intenção de se buscar uma ferramenta para a predição do potencial reprodutivo. E, embora ainda se busquem os marcadores ideais para aplicação clínica, mais difícil do que os definir é definir quando eles estão indicados. Este artigo de atualização, assinado pela Comissão Nacional Especializada em Ginecologia Endócrina da Febrasgo, pretende oferecer ao leitor as ferramentas necessárias para o uso racional dos testes de avaliação da reserva ovariana no cotidiano.(AU)

Often, it becomes a great challenge for the gynecologist to identify women with a greater or lesser chance of conception. Several laboratory and ultrasound markers, known jointly as ovarian reserve evaluation tests, have been studied for decades with the intention of seeking a tool for the prediction of reproductive potential. And, while the ideal markers for clinical application are still sought, defining them is as harder as defining when they are indicated. This update article, signed by the National Specialized Committee on Gynecologic Endocrinology, Febrasgo, intends to offer the reader the necessary tools for the rational use of ovarian reserve evaluation tests in daily practice.(AU)

Hormônio antimülleriano pode uma realidade usada em seres humanos ser transferida a bovinos e búfalos / Antimüllerian Hormone can a reality in humans translate to bovine and buffalos

O hormônio antimülleriano (AMH) nas fêmeas é produzido especificamente pelas células da granulosa dos folículos em crescimento e controla a velocidade do crescimento folicular ao inibir a enzima aromatase. Este hormônio tem sido explorado em várias aplicações biotecnológicas, sendo a mais bem estudada a relação positiva entre a sua concentração circulante e a população folicular antral (PFA) no ovário, tornando o AMH um indicador confiável desta característica em humanos e em outras espécies. O AMH também mostrou ser um indicador prognóstico positivo do rendimento de embriões em programas de ovulação múltipla e transferência de embriões (MOET) em bovinos, porém sua utilidade para identificar fêmeas doadoras de oócitos para produção de embriões in vitro (IVEP) ainda está em discussão. Em búfalos, apenas poucos estudos foram realizados até o momento, porém devido a baixa reserva folicular ovariana na espécie e a grande variabilidade individual, que criam um desafio para ART (Assisted Reproduction Technology) na espécie, o AMH surge com grande potencial de se tornar alternativa eficiente para a identificação precoce de doadores de oócitos para IVEP. Estudos sobre AMH demonstraram claramente sua utilidade como parte do "pacote de biotecnologia reprodutiva" em algumas espécies, especialmente em seres humanos. Em animais de produção, como bovinos, e principalmente no búfalo, estudos adicionais são necessários para definir a utilidade da AMH não apenas como um bom preditor da AFP, mas também como uma ferramenta chave em programas de biotecnologia reprodutiva em todo o mundo.

The antimüllerian hormone (AMH) in females ias specifically produced by the granulosa cells of growing follicles and controls the speed of follicular growth by inhibit the enzyme aromatase. This has been recently explored in several biotechnological applications with the most well studied being the positive relationship between circulating concentration of circulating AMH and the antral follicular population (PFA) in the ovary,where AMH is becoming accepted as a reliable indicator of this characteristic in both humans and other species. AMH has also been shown to be a positive prognostic indicator of embryo yield in multiple ovulation and embryo transfer (MOET) in cattle, however its utility for identifying good oocyte donors for in vitro embryo production (IVEP) in bovines is still under debate. In buffaloes, only limited studies have been completed, however with the low ovarian follicular reserve in the species and the great individual variability creating a challenge for ART (Assisted Reproduction Technology) the enormous potential of AMH as an efficient alternative of early identification of oocyte donors for IVEP has been suggested. In summary, studies on AMH have clearly demonstrated its utility as part of the "reproductive biotechnology package" in some species, especially in humans and in farm animals such as cattle. In the buffalo, further studies are needed to define the usefulness of AMH not only as a good predictor of AFP but also as a key tool in buffalo reproductive biotechnology programs worldwide.

Hormônio antimülleriano pode uma realidade usada em seres humanos ser transferida a bovinos e búfalos / Antimüllerian Hormone can a reality in humans translate to bovine and buffalos

O hormônio antimülleriano (AMH) nas fêmeas é produzido especificamente pelas células da granulosa dos folículos em crescimento e controla a velocidade do crescimento folicular ao inibir a enzima aromatase. Este hormônio tem sido explorado em várias aplicações biotecnológicas, sendo a mais bem estudada a relação positiva entre a sua concentração circulante e a população folicular antral (PFA) no ovário, tornando o AMH um indicador confiável desta característica em humanos e em outras espécies. O AMH também mostrou ser um indicador prognóstico positivo do rendimento de embriões em programas de ovulação múltipla e transferência de embriões (MOET) em bovinos, porém sua utilidade para identificar fêmeas doadoras de oócitos para produção de embriões in vitro (IVEP) ainda está em discussão. Em búfalos, apenas poucos estudos foram realizados até o momento, porém devido a baixa reserva folicular ovariana na espécie e a grande variabilidade individual, que criam um desafio para ART (Assisted Reproduction Technology) na espécie, o AMH surge com grande potencial de se tornar alternativa eficiente para a identificação precoce de doadores de oócitos para IVEP. Estudos sobre AMH demonstraram claramente sua utilidade como parte do "pacote de biotecnologia reprodutiva" em algumas espécies, especialmente em seres humanos. Em animais de produção, como bovinos, e principalmente no búfalo, estudos adicionais são necessários para definir a utilidade da AMH não apenas como um bom preditor da AFP, mas também como uma ferramenta chave em programas de biotecnologia reprodutiva em todo o mundo.(AU)

The antimüllerian hormone (AMH) in females ias specifically produced by the granulosa cells of growing follicles and controls the speed of follicular growth by inhibit the enzyme aromatase. This has been recently explored in several biotechnological applications with the most well studied being the positive relationship between circulating concentration of circulating AMH and the antral follicular population (PFA) in the ovary,where AMH is becoming accepted as a reliable indicator of this characteristic in both humans and other species. AMH has also been shown to be a positive prognostic indicator of embryo yield in multiple ovulation and embryo transfer (MOET) in cattle, however its utility for identifying good oocyte donors for in vitro embryo production (IVEP) in bovines is still under debate. In buffaloes, only limited studies have been completed, however with the low ovarian follicular reserve in the species and the great individual variability creating a challenge for ART (Assisted Reproduction Technology) the enormous potential of AMH as an efficient alternative of early identification of oocyte donors for IVEP has been suggested. In summary, studies on AMH have clearly demonstrated its utility as part of the "reproductive biotechnology package" in some species, especially in humans and in farm animals such as cattle. In the buffalo, further studies are needed to define the usefulness of AMH not only as a good predictor of AFP but also as a key tool in buffalo reproductive biotechnology programs worldwide.(AU)

Utilidad de la determinación de la reserva ovárica como predictor de la posibilidad de embarazo espontáneo: revisión sistemática / Usefulness of determining ovarian reserve as a predictor of the possibility of spontaneous pregnancy: a systematic review

ANTECEDENTES: En la actualidad, muchos especialistas determinan la reserva ovárica para aconsejar a sus pacientes acerca de su futuro reproductivo. OBJETIVO: Definir, a través de una revisión sistemática, si existe evidencia que justifique la determinación de la reserva ovárica como predictor de la posibilidad de embarazo espontáneo. MÉTODO: Realizamos una revisión sistemática usando las palabras claves "ovarian reserve" y "spontaneous pregnancy" en las bases MEDLINE y EMBASE, entre los años 2000 y 2015. RESULTADOS: Sólo tres artículos cumplieron con los criterios de selección. Si bien difieren en la forma de determinar la reserva ovárica y la población analizada, ninguno de los estudios encontró que la determinación de la reserva ovárica tuviera utilidad clínica en predecir la posibilidad de un embarazo espontáneo. CONCLUSIÓN: No existe evidencia que justifique la determinación de reserva ovárica, en forma rutinaria, para aconsejar a las parejas acerca de sus posibilidades de embarazo espontáneo.

BACKGROUND: Many specialists use ovarian reserve tests to determine their patient's reproductive potential. OBJECTIVE: To determine whether the ovarian reserve determine the possibility of spontaneous pregnancy. METHOD: We searched in MEDLINE and EMBASE, articles published between 2000 and 2015, with the keywords "spontaneous pregnancy" and "ovarian reserve". RESULTS: Only three articles complied with the selection criteria. Although the studies have different approaches to evaluate ovarian reserve and study subjects, none of them found that that ovarian-reserve testing have clinical utility in predicting the chance of a spontaneous pregnancy. CONCLUSION: There is no utility to assess ovarian reserve routinely in order to predict chances of spontaneous pregnancy.

Immunolocalization of growth, inhibitory, and proliferative factors involved in initial ovarian folliculogenesis from adult common squirrel monkey (Saimiri collinsi).

We performed an immunohistochemical (IHC) study to determine the follicular expression of growth differentiation factor 9 (GDF-9), anti-Müllerian hormone (AMH), Kit Ligand (KL), and c-Kit in squirrel monkey ovary. Ovarian tissue fragments from 4 squirrel monkeys were collected by laparotomy and processed for classical histology and IHC. Additionally, follicle development was assessed by Ki67 immunostaining to evaluate proliferative status of granulosa cells. A total of 4025 follicles were examined (1475 for classical histology and 2550 for immunohistochemistry). More than 80% of the evaluated follicles were morphologically normal. The GDF-9 protein was detectable in oocyte cytoplasm from primordial (100%), primary (99.1%), and secondary (100%) follicles. The AMH was not expressed in primordial follicles but just in few primary follicles (13.8%). On the other hand, it was highly expressed in granulosa cells from secondary follicles (67.9%). c-Kit, KL receptor, was found in the oolemma of primordial (100%), primary (100%), and secondary (100%) follicles. The KL expression was observed in oocytes and granulosa cells from primordial (94.9%), primary (91.6%) and secondary follicles (100%). Ki67 immunostaining was observed in granulosa cells from primary (5.7%) and secondary (54.8%) follicles but not in primordial follicles. In conclusion, we described the localization of GDF-9, KL, c-Kit, and Ki67 proteins and confirmed the presence of AMH protein in preantral follicles from squirrel monkey. Our results offer contribution for understanding of folliculogenesis in neotropical nonhuman primates. Moreover, these markers can be used to assess follicular viability and functionality after cryopreservation, transplantation, or in vitro culture of ovarian tissue.

Protocolo largo con análogos de GnRH versus protocolo corto con antagonistas: ¿existen diferencias en cuanto a los resultados de los ciclos de FIV-ICSI? / Protocol with GnRH analogues vs antagonists of GnRH: exist differences in the results of the IVF-ICSI cycles?

Objetivo: Valorar si existen diferencias en los resultados de los ciclos de FIV-ICSI en función del protocolo de estimulación empleado. Método: Estudio retrospectivo descriptivo de pacientes infértiles que fueron sometidas a ciclos de FIV-ICSI en el Hospital Universitario La Paz, entre los meses de enero y septiembre de 2010, comparando un protocolo largo de estimulación con análogos de GnRH vs un protocolo corto con antagonistas de GnRH. Las variables analizadas fueron: tasa de gestación, necesidad de cancelación del ciclo, dosis total de gonadotropinas requerida durante la estimulación, niveles de estradiol sérico el día de la administración de la hCG, número de folículos puncionados, complejos obtenidos, número de ovocitos maduros y de embriones conseguidos. Resultados: No hubo diferencias estadísticamente significativas en los resultados de los ciclos en función del protocolo de estimulación empleado, en ninguna de las variables analizadas. Conclusiones: Este estudio no encontró diferencias en los resultados de los ciclos de FIV-ICSI con relación al uso de análogos o antagonistas de GnRH. Es necesarios más estudios con mayores tamaños muestrales para definir qué tipo de pacientes serían subsidiarias de recibir cada tratamiento para conseguir resultados óptimos.

Aims: To assess if there exist any differences in the results of the IVF-ICSI cycles depending on the stimulation protocol employed. Methods: Retrospective descriptive study of infertile patients who underwent IVF-ICSI cycles at La Paz University Hospital, between January and September 2010, comparing sitmulation protocol with GnRH agonists vs antagonists of GnRH. The variables analyzed were pregnancy rate, cancellation rate, total dose of gonadotropin required for stimulation, serum estradiol levels on the day of hCG administration, number of follicles punctured, complexes obtained, number of mature oocytes and of embryos obtained. Results: No statistically significant differences where found in the results of cycles depending on the protocol of stimulation used in any of the variables analyzed. Conclusions: This study didn't find any difference in the outcome of IVF-ICSI cycles in relation to the use of GnRH agonists or antagonists. We need more studies with larger sample sizes to determine which is the best treatment to each patient in order to achieve optimal results.

State of the art of assisted human reproduction

Background: Infertility is a disease observed in approximately 10% of the reproductive age population (20-44 years old), and is defined as the failure to conceive after twelve months of regular sexual intercourse, without contraception; in women older than 35 years old, this period is reduced to 6 months. The main causes of infertility are tubal, ovarian and uterine and sperm abnormalities, endometriosis, and those with undetermined causes. Over the past 30 years, several techniques were developed to overcome these factors including gamete cryopreservation, controlled ovarian stimulation, intra-uterine insemination, in vitro fertilization, intracytoplasmatic sperm injection). Review: Despite advances in assisted reproductive technologies (ART), treatment success is still strongly dependent on oocyte and sperm quality, and resulting embryo viability. The most promising advance on oocyte quality assessment is the evaluation of the ovarian reserve by the quantification of the anti-müllerian hormone (AMH). Since ovarian reserve is closely related to oocyte quality, AMH levels could be an indicator of both oocyte production capacity and the potential of these oocytes to generate a viable embryo. On the other hand, despite the development of techniques to overcome male factor infertility, attention has been paid on the semen evaluation, since routine sperm evaluation techniques are known to be ineffective, especially in those cases of unexplained infertility. Therefore, techniques were developed to assess acrosome and membrane integrity, mitochondrial potential, DNA integrity, and fertilizing capacity of sperm. However, further studies are necessary to evaluate sperm DNA integrity without damaging the cell, allowing the injection of a spermatozoon with an intact DNA when using ICSI. Regarding embryo quality, even with a good quality oocyte (as assessed by the current techniques) and an apparently normal sperm, there are still chances of generating an embryo with genetic abnormalities. In such cases, and in cases of recurrent failures, women over 35 years of age, and couples with a pre-existing genetic risk, the preimplantation genetic diagnosis (PGD) appears to be an important tool to improve the odds of pregnancy and avoid abortions or the conception of fetuses with genetic abnormalities. The technique of PGD, usually performed with PCR or FISH, has gained a powerful tool with the development of the Comparative Genomic Hybridization (CGH). However, recent studies aiming to identify markers of oocyte and sperm quality and embryo viability are in course using mass spectroscopy. With this sensitive technique applied to body fluids (i.e., blood, follicular fluid, seminal plasma), granulosa cells, sperm, and culture media, researches are being conducted to non-invasively identify biomarkers that will help understand reproductive mechanisms and to efficiently predict the outcome of ARTs. Conclusion: Significant advances in ART have been observed in the last few years, yet, failures still occur with high frequency. This review will focus on techniques to assess oocyte quality, sperm function and embryo viability, aiming to provide tools for a precise prognosis when treating infertile couples.