The role of gene polymorphisms and AMH level in prediction of poor ovarian response in Egyptian women undergoing IVF procedure.

OBJECTIVE: The aim of this study is to assess the role of AMH in prediction of poor ovarian response as well as the relation between ESR 2 (+ 1730G>A) (rs4986938) and FSHR p.Thr307Ala (c.919A>G, rs6165) SNPs and the poor ovarian response in Egyptian women undergoing IVF procedure. Discovering the genetic variants associated with ovarian response is an important step towards individualized pharmacogenetic protocols of ovarian stimulation. METHODS: We performed a prospective study on 216 young women with unexplained infertility. Ovarian stimulation was performed according to the GnRH antagonist protocol with a fixed daily morning dose of human menopausal gonadotrophin (HMG). The estrogen receptor (ESR2) (+ 1730G>A) (rs4986938) and FSH receptor p.Thr307Ala (c.919A>G, rs6165) single nucleotide polymorphisms (SNPs) were detected by real-time polymerase chain reaction. Serum FSH, Estradiol (E2) and anti-Müllerian hormone (AMH) levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: This study revealed that the low AMH level was highly significantly related to the poor ovarian response (p < 0.001). Furthermore, the frequency of the ESR2 (AA) genotype and the FSHR (Ala307Ala) genotypes were highly significantly associated with the poor ovarian response (p < 0.001). CONCLUSION: The AMH level in combination with the ESR2 and the FSHR gene polymorphisms predict the poor ovarian response to COH in Egyptian women. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02640976.

Mitochondrial DNA in Fresh versus Frozen Embryo Culture Media of Polycystic Ovarian Syndrome Patients Undergoing Invitro Fertilization: A Possible Predictive Marker of a Successful Pregnancy.

PURPOSE: Frozen embryos transfer (ET) may improve the live-birth and reduce rates of ovarian hyperstimulation in polycystic ovary syndrome (PCOS) patients. Morphological criteria are the classical way for embryo selection, yet recently, many biochemical and genetic markers have been developed. This study aimed to compare fresh and frozen ET using the mtDNA/gDNA ratio of embryo secretome and the possibility of using this ratio as a predictive marker of PCOS pregnancy rate. SUBJECTS AND METHODS: One hundred PCOS patients undergoing IVF were chosen according to Rotterdam criteria and divided into two groups. Group I (50 with fresh ET), group II (50 with frozen ET), and otherwise 33 apparently healthy women as a control group with fresh ET. We then carried out absolute quantification of embryo culture media mtDNA and gDNA by real-time PCR. RESULTS: mtDNA/gDNA ratio was significantly low in PCOS embryo culture media in comparison with control. Additionally, while the mtDNA/gDNA ratio was significantly high in pregnant PCOS embryo culture media, it was high, though not statistically significant, in the fresh ET than frozen ET group. mtDNA/gDNA ratio sensitivity and specificity in PCOS embryo culture media as a predictive value of pregnancy rate were (86% and 96%, respectively). CONCLUSION: mtDNA/gDNA ratio measurement in PCOS embryo culture media is a novel marker that can be clinically applied as a predictive value of the quality of the morphologically good embryo.

Association of altered serum levels of Chemerin, Paraoxonase-1 (PON1), Asymmetric Dimethyl arginine (ADMA) and obesitin the development of Polycystic Ovarian Syndrome (PCOS) in Egyptian women

Chemerinwas recently added to the adipokine family and was identified in human ovarian follicles and follicular fluid that suggests a direct correlation between chemerin and PCOS. Asymmetric dimethyl arginine (ADMA) is involved in endothelial dysfunctionthe atherogenic potential of ADMA has been investigated in young patients with PCOS. Oxidative stress is considered to be implicated in the pathophysiology of PCOS.Paraoxonase 1 (PON1) is an antioxidant enzyme and its concentration has been shown to be inversely associated with oxidative stress. Objectives: Evaluation of serum chemerin, ADMA, PON1in obese and non-obese polycystic ovarian patients to postulate their role in pathogenesis of PCOS. Methods: Ninetynuligravida women aged 20-35 (60 with PCOS and 30 controls) were recruited. Fasting blood was obtained on day 2 or 3 of the menstrual cycle. Clinical evaluation, hormonal profile, Chemerin, ADMA and PON1 were assessed. Results: There was a significant increase in serum chemerinlevels in PCOS obese group when compared with PCOS non obese patients and healthy controls non obese and obese respectively. Serum ADMA level was increased significantly in PCOS obese group as compared to the PCOS non obese group , control non obese and control obese. Paraoxonase was decreased stepwise significantly from the control non obese group and control obese group to PCOS non obese patients then PCOS obese patients to. Conclusions: it could be suggested that increased chemerin has a role in PCOS development andaltered ADMA and PON1 associated withobesity and oxidative stress may exacerbate the condition.