ABSTRACT
BACKGROUND: Premature ovarian failure (POF) is generally irreversible. However, developing follicles up to the antral stage are reported in POF and anti-Müllerian hormone (AMH) might be a good indicator of follicular presence. This study analysed serum AMH, ovarian histology and AMH immunoexpression in POF patients. METHODS: A cross-sectional study of 48 POF patients in an Endocrinology Department setting. Patients had an ovarian biopsy simultaneously with serum AMH sampling and/or ovarian AMH immunostaining. RESULTS: Mean serum AMH was 1.04 +/- 1.66 ng/ml. Serum AMH was significantly higher in women with 15 or more follicles at ovarian histology (P = 0.001). Comparison of ovarian AMH immunostaining from POF patients and 10 normal controls revealed a normal AMH expression in POF pre-antral follicles, but a decreased expression at the early antral stages. Serum AMH was undetectable in 77% of the patients with 0-5 AMH immunopositive follicles and detectable in 100% of the patients with more than 15 AMH immunopositive follicles. CONCLUSIONS: AMH levels in POF patients could identify women with persistent follicles. The decrease of AMH immunoexpression in POF antral follicles could suggest a defect of antral development.
Subject(s)
Glycoproteins/blood , Primary Ovarian Insufficiency/blood , Testicular Hormones/blood , Adolescent , Adult , Anti-Mullerian Hormone , Cross-Sectional Studies , Female , Humans , Immunohistochemistry , Ovarian Follicle/anatomy & histology , Ovarian Follicle/chemistryABSTRACT
Defining markers that could reliably predict good oocyte quality could improve the management of infertile patients. Although a few potentially important predictors of oocyte quality have been identified, their application in assisted reproductive technologies (ART) is discussed.
Subject(s)
Oocytes/physiology , Ovary/physiology , Ovulation Induction , Biomarkers , Estradiol/blood , Female , Humans , Luteinizing Hormone/blood , Progesterone/blood , Reproductive Techniques, AssistedABSTRACT
A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub-mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for sub-mucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.
