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Article
COMPARISON OF ANTIMULLERIAN HORMONE LEVEL BETWEEN WOMEN WITH POLYCYSTIC OVARY SYNDROME AND NORMAL OVULATORY INFERTILE WOMEN OF REPRODUCTIVE AGE

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Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women. This syndrome is characterized by an increase in the number of small antral follicles that are between 5-8 mm in size. Antemüllerian hormone (AMH) is secreted mostly by this type of follicle and when it is much too high, the production of a healthy egg every cycle can be halted as it works by reducing the receptors of the ovary to follicle stimulating hormone (FSH).Objective: To compare the AMH level between women presented with PCOS with its level in normal ovulatory infertile women and to determine its correlation with the clinical, hormonal and ultrasonographic parameters in both groups.Methods: This is a prospective cross-sectional study done at Um-Albaneen Infertility Center in Al-Imamein Al-Kadhimein Medical City from march 2015 to January 2016. One hundred infertile women were recruited in this study, 50 women with PCOS and 50 women have other factors of infertility apart from PCOS and ovulatory dysfunction. Sera were taken from all the participants at day (2-3) of menstrual cycle and were investigated for AMH, FSH, luteinizing hormone (LH), androstenedione, testosterone and estradiol (E2) levels. The number of early antral follicles (2-9 mm in diameter) was estimated by transvaginal ultrasound scanning.Results: Level was significantly higher in PCOS women (42.6±23.8) compared to the normal ovulatory infertile women (16±7.5), P-value <0.001. There was positive correlation between AMH and LH, testosterone, androstenedione, number of antral follicles (antral follicle count) and ovarian volume. However, the correlation was negative with age, body mass index, estradiol, and FSH.Conclusion: AMH strongly correlated with testosterone level and the number of small antral follicles in PCOS women, so it can be considered as a good diagnostic marker for PCOS.Keywords: Antimullerian hormone, PCOS. Citation: Almoayad HA, Abdulrasul EA. Jumaa NA. Comparison of antimullerian hormone level between women with polycystic ovary syndrome and normal ovulatory infertile women of reproductive age. Iraqi JMS. 2017; Vol. 15(3): 234-241. doi: 10.22578/IJMS.15.3.4


Article
Effect of maternal age on the ovarian reserve markers, and pregnancy outcome in a sample of Kurdish women in Erbil city
تأثير عمر الأم على علامات احتياطي المبيض ونتائج الحمل لدى عينة من النساء الكورديات في مدينة أربيل

Authors: Namir G. Al-Tawil --- Shahla K. Alalaf --- Manar J. Hussein
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 1 Pages: 8-16
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The ovary has a biological age that does not always correspond to the chronological age; this may be of great importance for the evaluation of women reproductive outcome. This study aimed to determine the effect of maternal age on the pregnancy rate, and the ovarian reserve markers (antimullerian hormone, follicular stimulating hormone, and antral follicular count).Methods: A cross-sectional study was conducted in the in vitro fertilization center at the Maternity Teaching Hospital located in Erbil city, from January 1, 2015, to January 31, 2016. A convenience sample of 300 infertile women of different age groups was included in the study. Transvaginal ultrasound was conducted to determine antral follicular count, and blood test was done for determination of serum antimullerian hormone and follicular stimulating hormone. The study sample was divided into four age groups. Chi square test, ANOVA test, Pearson correlation, and logistic regression were used to determine the associations.Results: The biochemical pregnancy rate of the study population was 37% and the clinical pregnancy rate was 32%. The most common type of infertility among the studied sample was primary infertility (74%). Results showed a strong inverse significant correlation between antimullerian hormone and antral follicular count with age, but there was no statistically significant association between maternal age and serum follicular stimulating hormone.Conclusion: Maternal age is a significant factor that can affect ovarian reserve and causes ovarian aging. The pregnancy rate decreases with advanced maternal age.


Article
Effect of Obesity on Ovarian Reserve Parameters in mid-reproductive age Women
تأثير السمنه على احتياطي المبيض لدى النساء

Author: Zaid A. Almadfai زيد عبد المجيد المدفعي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2012 Volume: 54 Issue: 2 Pages: 186-189
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:The initiation and maintenance of reproductive functions are related to an optimal body weight in women. Body weight affectthe ovarian reserve which is basically an estimate of how many oocytes (eggs) are left in the ovaries.Objective: To study the relationship between obesity and serum and ultrasound markers of ovarian reserve in mid-reproductive age women (21- 35 years old).Patients and method:Twenty participants (“obese”) had a body mass index (BMI) of 30 to 35 Kg/m2 and another 20 participants (“non-obese”) had a BMI20-29 kg/m2. The obese women had a mean age of 27.9 years and the non-obese women had a mean age of29.5 years. Blood samples were collected from all participants, anthropometric measurements were calculated, and transvaginal ultrasonography was performed to measure the antral follicle count (AFC) during the early follicular phase. The blood samples were assayed for antimüllerian hormone (AMH), follicle-stimulating hormone (FSH) and estradiol (E2).Results: Therewas no significant difference between the two groups regarding ovarian reserve markers and there is no significant correlation between these markers and BMI, except forserum E2 in the obese group.Conclusion: Obesity has no effect on the levels of serum FSH, AMH, orAFCindicating that obesity is unlikely to affect ovarian reserve in the mid-reproductive age group. Keywords: Antimüllerian hormone (AMH),follicle stimulatingHormone (FSH), body mass index (BMI),obesity,antralfollicleCount (AFC), ovarian reserve

ان استهلال وصون الوظائف الإنجابية مرتبطه بوزن الجسمالمثاليفي النساء.الهدف:دراسة العلاقةبينالسمنة علاماتاحتياطي المبيض فيالنساء في سنمنتصفالإنجابية(21 --35 سنة).المرضى وطرق العمل:عشرون مشاركه( ذوسمنة),مؤشر كتلةالجسم(BMI) ( 30-35)كغمم2. والمشاركات20 اخريات ("غيرالبدناء") كان مؤشر كتله الجسم اقل من 30 كغمم2. كانت متوسط العمرفي النساء البدينات27.5 سنه و غير البدينات29.5 سنه. تم جمع عينات الدم من جميع المشاركاتو تم قياس الطول و الوزن , و اجري التصوير بالموجات فوق الصوتيه عبر المهبل لقياس عدد الجريبات الغاريه خلال المرحله الجرابيه المبكره. تم قياس معايير الدم لهرمون انتي موليرين و هرمون المحرض للجريب والاسترادايول النتائج : لم يكن هناك فرق معنوي بين المجموعتين البدناء و غير البدناء في ما يتعلق باحتياطي المبيض و لا يوجد اي ارتباط بين هذا العلامات و مؤشر كتله الجسم ما عدا الارتباط المعنوي لنسبه هرمون الاسترادايول لمؤشر كتلة الجسم في مجموعه النساء البديناتالاستنتاج: نستنج من ذلك ان السمنه ليس لها علاقه بمعايير احيتياطي المبيض في النساء في سن منتصف الانجابية .مفتاح الكلمات: السمنة ,احتياطي المبيض , FSH,AMH


Article
Anti-mullerian hormone and antral follicle count in polycystic ovary syndrome and non-polycystic ovary syndrome women
مضاد هرمون موليرين و عد جريب الغارات في متلازمة المبيض المتعدد الاكياس ومتلازمة المبيض غير المتعدد الاكياس

Authors: Jwan J. Namik --- Shahla K. Alalaf --- Namir G. Al Tawil
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 3 Pages: 292-299
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Although the ultimate pathogenesis of polycystic ovary syndrome remains obscure, the distinctive feature is the failure of follicular maturation resulting in an ovulation and accumulation of preantral and small antral follicles which contribute significantly to the production of the anti-mullerian hormone. This study aimed to compare anti-mullerian hormone concentration and antral follicle count in polycystic ovary syndrome and non-polycystic ovary syndrome women regarding clinical, hormonal and ultrasound parameter in both groups.Methods: A cross-sectional study with comparison group study was conducted in the fertility and gynecology outpatient clinic in the Maternity Teaching Hospital, Erbil, Kurdistan region, Iraq from April 1st, 2015, to December 31st, 2015. The study involved a total of 100 infertile women aged 18 - 39 years; 50 polycystic ovary syndrome women based on the Rotterdam criteria and 50 infertile non-polycystic ovary syndrome selected as a comparison group. Anti-mullerian hormone and antral follicle count in both groups were compared.Results: A strong, inverse and significant correlation was found between anti-mullerian hormone and age in each of the two study groups. A weak correlation was detected between anti-mullerian hormone with body mass index, luteinizing hormone, follicular stimulating hormone, and total testosterone, in each of the two study groups. A significant inverse correlation was detected between anti-mullerian hormone and luteinizing hormone/follicular stimulating hormone ratio in the non-polycystic ovary syndrome group (P <0.001). There was a statistically strong, significant and positive correlation between anti-mullerian hormone and antral follicle count in each of the study groups.Conclusion: Anti-mullerian hormone and antral follicle count are higher in polycystic ovary syndrome group than in non-polycystic ovary syndrome group. Elevated levels of the anti-mullerian hormone were associated and related to increased number of follicles in women with polycystic ovary syndrome.


Article
The Role of Antimullerian Hormone in the Diagnosis of Poly Cystic Ovarian Syndrom.
دور انتي موليرين هورمون في تشخيص متلازمة المبيض المتعدد الأكياس

Author: Hanan A. Al-Taee حنان عبد الجبار الطائي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2013 Volume: 55 Issue: 4 Pages: 374-379
Publisher: Baghdad University جامعة بغداد

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Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder, affecting up to 10% of women of reproductive age. The cardinal features of PCOS are hyperandrogenism (HA) and oligo-anovulation. Many work teams recently have relate the severity of PCOS with Anti mullerian hormone (AMH) or antral follicle count (AFC). Objective: 1) to confirm if there is an increase of serum AMH in this group of patients with PCOS, 2) to relate the AMH level to the follicle status at ultrasound (U/S) in this group, and 3) to search if AMH or AFC can serve as surrogate for the definition of PCOS. Patients and methods: Twenty five (control) and another 45 participants (with PCOS) were selected for this study. The control women had a mean age of 32.5 year (yr) and the patients group women had a mean age of 28.4 yr. Blood samples were collected from all participants, anthropometric measurements were calculated, and transvaginal U/S was performed to measure the AFC during the early follicular phase. The blood samples were assayed for AMH, follicle-stimulating hormone (FSH), Luteinizing Hormone (LH) and estradiol (E2) and total testosterone (TT).Results: Basal serum hormonal levels of LH, AMH and TT as well as AFC were significantly higher in the study group than in controls. While basal serum levels of E2 and FSH show no significant difference between the two groups. Body mass index (BMI) is significantly higher in PCOS patients. Basal serum levels of AMH show significant positive correlation with both AFC and basal serum TT levels.The area under the receiver operating characteristic curve (ROCAUC ) for AMH and AFC show significant sensitive and specificities Conclusion: serum AMH and AFC appear as a sensitive and specific parameter that would probably help in the diagnosis of PCOS. Both criteria need to be incorporated into the Rotterdam definition for PCOS, and it indicates PCOS only if associated with HA and/or oligo-anovulation. Key words: Antimullerian hormone(AMH) , antral follicle count(AFC) ,Poly Cystic Ovarian Syndrom(PCOS) .

المفدمة: متلازمة المبيض المتعدد التكيسات هو من أكثر اضطرابات الغدد الصماء شيوعا و يؤثر على ما يصل الى 10% من النساء في سن الإنجاب. من الملامح المعرفة لمتلازمة تكيس المبايض هي فرط الاندروجينية و نسبة الاباضة الضئيلة. كثير من الدراسات الحديثة تؤكد على ارتباط شدة متلازمة تكيسات المبيض بنسبة انتي موليرين هورمون (AMH) و عدد الجريبات الغارية(AFC). هدف الدراسة :1-لمعرفة ما أن كان هناك ارتفاعا في نسبة انتي موليرين هورمون عند مرضى متلازمة تكيس المبيض. 2-ايجاد علاقة تربط عدد الجريبات الغارية مع انتي موليرين هورمون عند مرضى متلازمة تكيس المبايض.3-البحث في امكانية ان يكون انتي موليرين هورمون و عدد الجريبات الغارية بمثابة بديل لتعريف متلازمة تكيس المبيض. المرضى و طرق العمل:تم اختيار 25 امرأة كفريق قياس سيطرة للعمل بمتوسط عمر 32,5 سنة و 45 أمرأة مصابة بمتلازمة تكيس المبيض بمتوسط عمر 28,4 سنة كفريق عمل. تم جمع عينات الدم من جميع المشاركين و اجري سونار مهبلي لقياس عدد الجريبات الغارية في المرحلة الجرابية المبكرة. تم قياس هورمون المنبه للجريب و هرمون اللتونه وانتي موليرين هرمون و هرمون الاسترادايول و هرمون التستستيرون.النتائج :هناك ازدياد معنوي واضح في هورمون انتي موليرين و عدد الجريبات الغارية و هورمون التستستيرون عند فريق المرضى مقارنة بفريق السيطرة. كان هناك ارتباطا معنويا ايجابيا بالانتي موليرين هورمون مع كل من عدد الجريبات الغارية و هورمون التستستيرون في فريق متلازمة تكيس المبايض. عندما اجري الاحصاء باستخدام Receiver Operating Characteristic Curve (area under the curve) اظهر الانتي موليرين هورمون و عدد الجريبات الغارية حساسية و خصوصية ذات قيمة معنوية في تعريف مرضى متلازمة تكيس المبيض.الاستنتاج :انتي موليرين هورمون و عدد الجريبات الغارية من شأنها ان تساعد على الارجح في تشخيص متلازمة تكيس المبيض و تحتاج ان تدرج في تعريف روتردام لمتلازمة تكيس المبيض شريطة مصاحبتها لافراط الاندروجينية او مع الاباضة الضعيفة.مفتاح الكلمات: انتي موليرين هورمون, عدد الجريبات الغارية, متلازمة المبيض المتعدد التكيسات

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