Reduced embryo yield obtained from superstimulated ewes with low circulating AMH concentration is improved by lengthening the FSH treatment.

The aim of the present study was to evaluate: 1) the association between AMH, AFC, superovulatory response and embryo yield in sheep; and 2) the effect of FSH treatment length during superstimulation of the first follicular wave on ovarian response and embryo yield, particularly in ewes with low and high AMH. The experiment was performed on 63 Polled Dorset ewes that received an ovarian superstimulatory treatment during the first follicular wave (Day 0 protocol). Ewes were administered a total dose of 240 mg of FSH distributed in six (6-dose regimen, n = 30) or eight (8-dose regimen, n = 33) decreasing doses administered 12 h apart. On Day -9 (random stage of the estrous cycle) and Day 0 (day of the first FSH dose) ovarian ultrasonography was performed and blood samples were collected for AFC and AMH determinations, respectively. A weak positive correlation between AMH and small AFC (follicles <4 mm) was observed (r = 0.23; P = 0.07), and AMH concentration was positively correlated (r = 0.29; P < 0.05) with the number of corpora lutea (CL) determined at embryo collection (i.e., 6 d after insemination). The length of FSH treatment tended (P = 0.06) to affect the ovarian response, such that the number of CL was greater in 8-dose than 6-dose treated ewes, while no differences (P > 0.10) in embryo yield outcomes were observed. For further analysis, ewes were classified into low (<7 ng/mL) and high (>10 ng/mL) serum AMH. In high AMH ewes, there were no differences (P > 0.05) in the number of CL nor embryo yield between the 6-dose and 8-dose treatment (e.g., 7.8 ± 2.4 and 8.3 ± 2.5 transferable embryos, respectively; P = 0.92). Conversely, for low AMH ewes, fertilized ova and embryo yield were greater (P ≤ 0.05) for ewes receiving the 8-dose than the 6-dose superstimulatory treatment (e.g., 8.4 ± 2.8 vs. 2.7 ± 0.9 transferable embryos, respectively, P ≤ 0.05). In conclusion, embryo production in poor responding ewes with low low circulating AMH is improved by extending the superstimulatory treatment length from 6 to 8 FSH doses.

Effects of maternal antral follicle count in Bos taurus indicus cattle on the genetic merit of male offspring and antral follicle count of female offspring.

This study evaluated the effects of antral follicle count (AFC) in female cattle on offspring characteristics. Recently calved multiparous Bos indicus cows (Nelore; n = 222) were evaluated using ultrasonography on random days of their estrous cycle to determine the AFC and were classified into "low" (≤15 follicles), "intermediate" (≥16 and ≤ 29 follicles), and "high" (≥30 follicles) AFC groups. Weight and scrotal circumference (SC) of male offspring from these cows (n = 127) were determined from 20 to 27 months, and the data were added to a genetic evaluation program (economic total genetic merit, MGTe and TOP value) that uses the kinship matrix to evaluate the genetic relationship between animals. The AFC of female offspring from these cows (n = 95) was evaluated to analyze the relationship between the AFC of mothers and daughters. The effects of maternal AFC on the genetic merit of male and female offspring were analyzed using GLIMMIX and GLM, respectively. Correlations were assessed using the Pearson's coefficient. Male offspring of cows with high AFC had superior MGTe (P = 0.005) and TOP values (P = 0.01) than those from cows with low AFC. Additionally, the AFC of mothers was positively correlated with MGTe (R = 0.33; P < 0.0001) and negatively correlated with TOP values (R = -0.32; P < 0.0001). The SC (P = 0.01), but not body weight of the offspring (P = 0.46) was affected by maternal AFC. The daughters' AFC were correlated (R = 0.29; P = 0.004) with mothers' AFC and were influenced by maternal (P = 0.05) but not paternal (P = 0.77) effect. In conclusion, cows with high AFC produced males with greater MGTe, superior TOP values and higher SC. Maternal AFC did not influence the weight of male offspring but was correlated with the AFC of daughters.

Accuracy of ultrasound and visual inspection in antral follicular count in crossbred Holstein cows raised under grazing systems at high altitude.

The objective of this research was to investigate the diagnostic accuracy of post-mortem ultrasound in antral follicle count (AFC) determination and compare it with visual AFC in grazing crossbred Holstein cows, at high altitude in Ecuador. Pre-mortem blood from 80 cows was collected, and AFC and ovarian characteristics were analysed post-mortem by ultrasound and visual techniques. AFC counts were stratified as high, medium or low by terciles. Mean AMH concentration in pre-mortem blood was 280.1 ± 15.53 pg/mL. The AFC obtained by visual inspection (26.9 ± 9.49 follicles) was 23.8% higher than by ultrasound (20.5 ± 7.53 follicles) in all ovaries. Body condition score, age and weight of the cattle did not interact with the count technique. In the low AFC group, visual inspection and ultrasound provided similar AFC results. However, in the Medium- and High-AFC groups, AFC by ultrasound was 14.9% lower than AFC by visual inspection. We confirm that ultrasound can be used with great accuracy for AFC >3 mm (close to the resolution limit) in grazing crossbred Holstein cows at high altitude.

Self-made transvaginal ultrasound simulator: new training equipment in ultrasound evaluation of controlled ovarian stimulation and oocyte retrieval.

Aim: We sought to create and describe a self-made simulator designed and created for teaching purposes: a high-fidelity ultrasound phantom for demonstrating antral follicle count, ultrasound supervision of controlled of ovarian stimulation, and ultrasound-guided oocyte retrieval. Materials and methods: The uterus and ovaries of the ultrasound phantom were made from beef tongue, a male condom, latex gloves, cotton suture threads, bi-distilled water, and ultrasound gel. The components were placed in a pelvis created using three-dimensional (3D) printing. The phantom was presented to and evaluated by a group of 14 physicians pursuing a postgraduate course in reproductive medicine. Two training stations were structured: one to simulate antral follicle count and controlled ovarian stimulation and the other to simulate ultrasound-guided oocyte retrieval. Future specialists were requested to complete a feedback questionnaire evaluating the self-made simulator and the two practice stations. Results: The transvaginal ultrasound phantom was successfully created, making it possible to simulate antral follicle count, ultrasound control of ovarian hyperstimulation, and oocyte retrieval, and to capture ultrasound images. A review of the answers provided in the feedback questionnaire showed that the phantom had a good appearance and design, was realistic, helped to improve motor coordination, and could be a useful tool in the training of specialists in assisted reproduction. Conclusion: This phantom was designed to enable instruction and practice in the evaluation of ovarian follicles and ultrasound-guided oocyte retrieval in a supervised training environment. This self-made simulator is proposed as a training tool that could be included in the curricular structure of residency and postgraduate programs in reproductive medicine.

The mechanisms that control the preantral to early antral follicle transition and the strategies to have efficient culture systems to promote their growth in vitro.

Preantral to early antral follicles transition is a complex process regulated by endocrine and paracrine factors, as well as by a precise interaction among oocyte, granulosa cells and theca cells. Understanding the mechanisms that regulate this step of folliculogenesis is important to improve in vitro culture systems, and opens new perspectives to use oocytes from preantral follicles for assisted reproductive technologies. Therefore, this review aims to discuss the endocrine and paracrine mechanisms that control granulosa cell proliferation and differentiation, formation of the antral cavity, estradiol production, atresia, and follicular fluid production during the transition from preantral to early antral follicles. The strategies that promote in vitro growth of preantral follicles are also discussed.

Growth and differentiation factor - 9 (GDF-9) increases the in vitro growth rates of isolated goat early antral follicles / Fator de crescimento e diferenciação - 9 (GDF-9) aumenta a taxa de crescimento in vitro de folículos antrais iniciais caprinos isolados

Abstract This study aimed to investigate the effect of growth and differentiation factor 9 (GDF-9) during the in vitro culture of isolated caprine early antral follicles. The isolated and selected early antral follicles were individually cultured for 18 days, and the following treatments were tested: α-MEM+ (control treatment) or α-MEM+ supplemented with 200 ng/mL GDF-9. The following endpoints were evaluated: follicular growth and morphology, estradiol production, oocyte nuclear maturation, and relative expression of key genes related to steroidogenesis (CYP19A1, CYP17, and insulin receptor) and basement membrane remodeling (MMP-9 and TIMP-2). In both treatments, a decrease was observed in the percentage of morphologically intact follicles with a concomitant increase in the rates of extruded and degenerated follicles (P < 0.05). The GDF-9 treatment showed higher rates of extruded follicles only on day 6 of culture (P < 0.05). Follicle diameter increased progressively throughout the culture period (P < 0.05) with similar diameters between treatments at all culture times (P > 0.05). Growth and differentiation factor 9 increased the daily growth rate from the first to the second third of culture, with higher values (P < 0.05) than control in the second third. Oocyte maturation rate as well as estradiol levels and relative mRNA expression for CYP19A1, CYP17, MMP-9, TIMP-2, and insulin receptor genes were similar between treatments (P > 0.05). This study shows for the first time that GDF-9 added to a culture medium increased the follicle growth rate of goat early antral follicles cultured in vitro.

Resumo Este estudo teve como objetivo investigar o efeito do GDF-9 durante o cultivo in vitro de folículos antrais iniciais caprinos isolados. Os folículos antrais iniciais isolados e selecionados foram cultivados individualmente por 18 dias, e os seguintes tratamentos foram testados: α MEM+ (tratamento controle) ou α-MEM+ suplementado com 200 ng/mL de GDF-9 (tratamento GDF-9). Os seguintes parâmetros foram avaliados: crescimento e morfologia folicular, produção de estradiol, maturação nuclear do oócito e expressão relativa de genes-chave relacionados a esteroidogênese (CYP19A1, CYP17 e receptor de insulina) e remodelamento da membrana basal (MMP-9 e TIMP-2). Em ambos os tratamentos, observou-se diminuição na porcentagem de folículos morfologicamente intactos com aumento concomitante nas taxas de folículos extrusos e degenerados (P < 0,05). O tratamento GDF-9 apresentou maiores taxas de folículos extrusos apenas no 6º dia de cultivo (P < 0,05). O diâmetro do folículo aumentou progressivamente ao longo do período de cultivo (P < 0,05) com diâmetros semelhantes entre os tratamentos em todos os tempos de cultivo (P > 0,05). O GDF-9 aumentou a taxa de crescimento diário do primeiro para o segundo terço de cultivo, sendo maior (P < 0,05) que o controle no segundo terço. A taxa de maturação oocitária assim como os níveis de estradiol e a expressão relativa de RNAm para os genes CYP19A1, CYP17, MMP-9, TIMP-2 e receptor de insulina foram similares entre os tratamentos (P > 0,05). Em conclusão, este estudo mostra pela primeira vez que GDF-9 adicionado a um meio de cultivo aumentou a taxa de crescimento de folículos antrais iniciais caprinos cultivados in vitro.

Antral follicle count, productive and reproductive parameters in Bos indicus and Bos indicus-taurus prepubertal heifers with early puberty induction / Contagem de folículos antrais, parâmetros produtivos e reprodutivos em novilhas pré-púberes Bos indicus e Bos indicus-taurus com indução precoce de puberdade

Prepubertal Nelore (G-N = 15) and crossbred Nelore x Aberdeen Angus heifers (G-NA = 15) were used for this study. AFC, live weight, body condition score (BCS), ovary and dominant follicle (DF) diameters were determined in each animal. Puberty induction was performed by insertion of a 4th use progesterone device (D0) which was removed on D12. Also, 1 mg estradiol benzoate was administered, and estrus intensity was classified (D12). At D21, the presence and diameter of the corpus luteum (CL) were registered. AFC was highly repeatable, regardless of hormone induction in both G-N (r=0.79) and G-NA (r=0.90). The mean AFC was greater in G-N compared to G-NA (24.2±8.5 vs. 17.7±9.0 follicles). A variation in BCS throughout the study occurred in G-NA, but not in G-N. The average weight gain (AWG) was greater in G-NA compared to G-N (0.69±0.33 vs. 0.40±0.29kg/day). The G-NA resulted in a larger diameter of DF at D12 than G-N (11.6±2.7 vs. 9.3±1.5mm). In conclusion, AFC was greater in Nelore heifers, although in both breeds this count was highly repeatable during puberty induction. Crossbred heifers had greater BCS and AWG with greater diameter of DF, indicating higher precocity when compared to Nelore heifers.

Novilhas pré-púberes Nelore (G-N=15) e mestiças Nelore x Aberdeen Angus (G-NA=15) foram utilizadas neste estudo. CFA, peso vivo, escore de condição corporal (ECC), diâmetros do ovário e folículo dominante (FD) foram determinados em cada animal. A indução da puberdade foi realizada pela inserção de um dispositivo de progesterona de quarto uso (D0), que foi retirado no D12. Além disso, 1mg de benzoato de estradiol foi administrado e a intensidade do estro foi classificada (D12). No D21, foram registrados a presença e o diâmetro do corpo lúteo (CL). A CFA foi altamente repetível, independentemente da indução hormonal em G-N (r=0,79) e G-NA (r=0,90). A CFA média foi maior em G-N em comparação com G-NA (24,2±8,5 vs. 17,7±9,0 folículos). Uma variação no ECC ao longo do estudo ocorreu em G-NA, mas não em G-N. O ganho de peso médio (GPM) foi maior em G-NA em comparação com G-N (0,69±0,33 vs. 0,40±0,29kg/dia). O G-NA resultou em um diâmetro maior de FD em D12 do que o G-N (11,6±2,7 vs. 9,3±1,5mm). Em conclusão, a CFA foi maior em novilhas Nelore, embora em ambas as raças essa contagem tenha sido altamente repetível durante a indução da puberdade. Novilhas mestiças apresentaram maior ECC e GPM com maior diâmetro de FD, indicando maior precocidade quando comparadas às novilhas Nelore.

Evaluation of three classification methods of antral follicle count and fertility to the timed artificial insemination in cattle.

The controversial data about antral follicle count (AFC) may be partially explained by the different criteria used to determine what is high, intermediate and low AFC. This study evaluated different classification methods for AFC groups, relating them to the conception rate, dominant follicle size and body condition score (BCS) in cows submitted to timed artificial insemination (TAI). Nelore cows (Bos indicus; n = 935), received a reproductive program consisting of TAI and natural breeding. Conception rate, BCS and dominant follicle size during TAI were evaluated by three AFC methodologies: i) mean and standard deviation: low (≤ 15 follicles); intermediate (≥ 16 to ≤ 44 follicles) or high (≥ 45 follicles); ii) quartiles: low (≤ 15 follicles); intermediate (≥ 16 to ≤ 39 follicles), or high (≥ 40 follicles); and iii) AFC score: I (low; ≤ 15 follicles); II (intermediate; ≥ 16 to ≤ 30 follicles); III (high; ≥ 31 to ≤ 44 follicles) or IV (very high; ≥ 45 follicles). Data were analyzed by a GLIMMIX and Tukey test or binary logistic regression model (P ≤ 0.05). The conception rate to TAI was influenced (P < 0.05) by AFC in the three methods classification, being the highest conception rate observed in the low AFC group regardless of method utilized: Mean (low 61.73%a, intermediate 54.02%ab and high 49.48%b), Quartiles (low 61.73%a, intermediate 53.59%ab and 51.46%b) and Score (I 61.73%a, II 54.80%ab, III 53.23%ab and IV 49.48%b). There were variations (P < 0.05) in the conception rate within the 2.50 to 2.75 BCS range for all AFC classification methods, with the low AFC females presenting the best results, regardless of the method used. Also, females with low AFC showed larger (P < 0.05) diameters of dominant follicles at the TAI regardless of method. The different methodologies used (Mean, Quartile and Score) to AFC classification showed a consistency between the main findings, and we believe that this standardization will facilitate the interpretation of data involving AFC.

Relationship between the concentration of anti-Müllerian hormone and antral follicle count in pasture-managed Holstein cows in the high tropics.

We evaluated the relationship between plasma levels of anti-Müllerian hormone (AMH) and the number of antral follicles at the restart of the follicular wave in crossbred Holstein cows reared under extensive grazing systems over 2500 m above sea level. The study included 140 cows from 15 farms that were in average at the 75.3 ± 2.10 d post partum. Animals were synchronized according to the following regime: day 0 = intravaginal progesterone releasing device (IPD) + estradiol benzoate (EB); day 7: withdrawal of IPD + prostaglandin; and day 8: EB, for restart of the follicular wave on day 11. On this day 11, antral follicle counts (AFCs) were made by transrectal ultrasound, and a plasma sample was taken for the determination of AMH. The mean AMH plasma level was 0.06 ± 0.03 ng/ml and the mean AFC was 17.26 ± 0.38 follicles. A strong positive linear correlation was found between these two variables (r = 0.783, r = 0.613, P < 0.0001). Cows were categorized according to AMH concentration as high (>0.09 ng/ml), intermediate (0.09-0.05 ng/ml) or low (<0.05 ng/ml). Cows with high AMH presented a higher AFC (25.0 ± 2.21 follicles) than those with low AMH (14.08 ± 2.68 follicles; P < 0.001. Our results suggest that the cut-off value of AMH = 0.09 ng/ml may be useful for selecting donors in multiple ovulation embryo transfer programs involving cows with these characteristics. Our data further suggest that AMH plasma concentration correlates with AFC and can be used as an endocrine biomarker of the number of antral follicles present at a given moment of the estrous cycle in crossbred Holstein cows raised at altitudes above 2500 m.

Expression of bta-miR-222 and LHCGR in bovine cultured granulosa cells: Impact of follicle deviation and regulation by FSH/insulin in vitro.

Final antral follicle development and future ovulation are mediated by gonadotropin-induced changes with spatio-temporally regulated expression of genes. Here, we aimed to quantify the relative mRNA abundance of bta-miR-222 and its predicted target, LHCGR, in granulosa cells (GCs) from follicles, after follicle deviation, as well as from GCs cultured in vitro with follicle stimulating hormone (FSH) and/or insulin. Thus, to study the impact of follicle deviation, Nelore heifers (n = 10; Bos taurus indicus) were hormonally synchronized and slaughtered 3 days after ovulation. Then, GCs from the dominant follicle (DF) and its respective subordinate follicle (SF) were recovered for RT-qPCR. For in vitro analysis, small follicles (2-5 mm) were dissected from bovine ovaries collected from a local abattoir. The GCs were isolated and cultured in serum-free medium, or treated with insulin (1 ng/mL or 10 ng/mL) alone or in combination with human recombinant FSH (1 ng/mL), for 6 days. Our findings showed that the relative mRNA abundance of LHCGR in GCs was higher in the DF compared to the SF (p = 0.01). Inversely, bta-miR-222 expression was lower in the DF compared to the SF (p = 0.01). Furthermore, GCs cultured with FSH and insulin together resulted in a higher abundance of LHCGR and a lower abundance of bta-miR-222 (p ≤ 0.05) when compared to GCs cultured with insulin alone. In conclusion, we found that the LHCGR upregulation in GCs from the DF is inversely related to bta-miR-222 expression. We also suggest the involvement of FSH in bta-miR-222 suppression in healthy bovine GCs.

Comparing Two- and Three-dimensional Antral Follicle Count in Patients with Endometriosis.

Background: The purpose of the study was to compare three-dimensional (3D) ultrasound semiautomatic antral follicle count (AFC) with two-dimensional (2D) ultrasound real-time AFC to evaluate patients with deep endometriosis and/or endometrioma submitted to ovarian stimulation (OS). Methods: This was a retrospective cohort study assessing all women with documented diagnosis of deep endometriosis who underwent OS for assisted reproduction treatment. The primary outcome was the difference between AFC by semiautomatic 3D follicle count using 3D volume datasets and 2D ultrasound count with the number of oocytes retrieved at the end of the cycle. The 3D ultrasound AFC was obtained using sonography-based automated volume count (SonoAVC), and the 2D ultrasound AFC data was collected from the electronic medical record. Results: Total of 36 women had deep endometriosis documented by magnetic resonance imaging, laparoscopy, or ultrasonography and 3D ovarian volume datasets stored from their first exam. The differences between the 2D and 3D AFC and the number of oocytes retrieved at the end of the stimulation were compared, showing no significant statistical difference between both methods (P = 0.59). Correlations were similar using both methods when compared to the number of oocytes retrieved (2D [r = 0.83, confidence interval (CI) = 0.68-0.9, P < 0.001]); (3D [r = 0.81, CI = 0.46-0.83, P < 0.001]). Conclusion: 3D semiautomatic AFC can be used to access the ovarian reserve in patients with endometriosis.

Evaluation of Protocols of Controlled Ovarian Stimulation in Obtaining Mature Oocytes (MII): Retrospective Study on Assisted Reproductive Technology Procedures.

OBJECTIVE: To understand which of the controlled ovarian stimulation (COS) protocols used in different patients are associated with greater amounts of oocytes retrieved. METHODS: The study population was divided into three groups, considering AMH and AFC to obtain the Ovarian Response Predictor Index (ORPI); they were grouped into: G1-Low Reserve (ORPI <0.5); G2-Normal Reserve (ORPI:0.5-0.9); and G3-High Reserve (ORPI≥0.9). 246 cycles were selected in which COS was used: recombinant FSH - follitropin alfa or beta (Protocol 1) or corifollitropin alfa (Protocol 2), both associated with urinary HMG and the GnRH antagonist, with the trigger performed using recombinant hCG or GnRH agonist. RESULTS: The number of oocytes obtained was higher in protocol 1 in all groups, with higher counts seen in G1 than in G2 or G3. The number of days required in COS for protocol 2 was greater than for protocol 1 in all groups. The total dose of recombinant FSH alfa or beta / urinary HMG used in protocol 1 was inversely proportional to the ovarian reserve. The lower the ORPI, the greater the average number of international units administered. In protocol 2, there was a need to supplement with higher doses of urinary HMG when compared to protocol 1. The dosage of the GnRH antagonist was dependent on the number of COS days until the trigger was used. In obtaining MII oocytes, the percentages were similar regardless of the trigger used. CONCLUSIONS: The use of follitropin leads to greater numbers of retrieved oocytes than corifollitropin alfa in all ORPIs. The dose of recombinant FSH used with urinary HMG increases inversely proportional to the ORPI value. The fixed dose of recombinant FSH deposit requires a sharp increase in the dose of urinary HMG.

Evaluation of three classification methods of antral follicle count and fertility to the timed artificial insemination in cattle

The controversial data about antral follicle count (AFC) may be partially explained by the different criteria used to determine what is high, intermediate and low AFC. This study evaluated different classification methods for AFC groups, relating them to the conception rate, dominant follicle size and body condition score (BCS) in cows submitted to timed artificial insemination (TAI). Nelore cows (Bos indicus; n = 935), received a reproductive program consisting of TAI and natural breeding. Conception rate, BCS and dominant follicle size during TAI were evaluated by three AFC methodologies: i) mean and standard deviation: low (≤ 15 follicles); intermediate (≥ 16 to ≤ 44 follicles) or high (≥ 45 follicles); ii) quartiles: low (≤ 15 follicles); intermediate (≥ 16 to ≤ 39 follicles), or high (≥ 40 follicles); and iii) AFC score: I (low; ≤ 15 follicles); II (intermediate; ≥ 16 to ≤ 30 follicles); III (high; ≥ 31 to ≤ 44 follicles) or IV (very high; ≥ 45 follicles). Data were analyzed by a GLIMMIX and Tukey test or binary logistic regression model (P ≤ 0.05). The conception rate to TAI was influenced (P < 0.05) by AFC in the three methods classification, being the highest conception rate observed in the low AFC group regardless of method utilized: Mean (low 61.73%a, intermediate 54.02%ab and high 49.48%b), Quartiles (low 61.73%a, intermediate 53.59%ab and 51.46%b) and Score (I 61.73%a, II 54.80%ab, III 53.23%ab and IV 49.48%b). There were variations (P < 0.05) in the conception rate within the 2.50 to 2.75 BCS range for all AFC classification methods, with the low AFC females presenting the best results, regardless of the method used. Also, females with low AFC showed larger (P < 0.05) diameters of dominant follicles at the TAI regardless of method. The different methodologies used (Mean, Quartile and Score) to AFC classification showed a consistency between the main findings, and we believe that this standardization will facilitate the interpretation of data involving AFC.(AU)

Increased antral follicle population and in vitro embryo production in pregnant Holstein / Aumento da população folicular antral e produção in vitro de embriões em fêmeas gestantes da raça Holandesa

This study used Holstein cattle to evaluate the following: I) the productive and reproductive characteristics of cows with low, intermediate and high antral follicle counts (AFCs) that were subjected to artificialin semination (AI) and comparison of AFC variability at the time of AI (nonpregnant) and at two time points during pregnancy (30 and 60 days), and II) whether the pregnancy status and different pregnancy periods in heifers improves the efficiency at in vitro embryo production (IVEP). In study I, 75 high-milk production cows with body condition scores (BCSs) of 2.75 to 4.75 and ages of 23 to 99 months were selected. Onthe day of estrus, AFCs (follicles ≥ 3 mm), BCS, body weight, and diameters of the dominant follicle, ovaries and the corpus luteum were evaluated. Posteriorly, AFC was monitored in pregnant cows at 30 days (n =35) and at 60 days for comparison of AFC before pregnancy versus different periods. In study II, heifers (n = 9) with BCS of 2.5 to 3.5 and ages of 10 to 16 months were selected for ovum pick-up and an IVEP program before AI (nonpregnant) as well as at 0 to 30, 31 to 60, and > 60 days of pregnancy. Statistical analysis was performed using PROC GLM and binary logistic regression model (P ≤ 0.05). In study I, AFC was not associated with variations in productive and reproductive parameters. However, AFCs in the low group increased following pregnancy (AI: 14.82 ± 1.36, 30 days: 23.45 ± 2.31 and 60 days: 35.18 ± 3.17 follicles). AFCs increased from AI to 60 days in the intermediate group but did not vary among time points in the high group. AFCs varied among AFC groups in AI and at 30 days of pregnancy but not at 60 days. In study II, the mean of total oocytes (17.43 ± 4.52 vs. 41.67 ± 3.79) and viable oocytes (13.77 ± 3.63 vs. 30.56± 3.45) increased from AI (nonpregnant) to the first 30 days of pregnancy. [...](AU)

Este estudo utilizou fêmeas da raça Holandesa para avaliar: i) variação da contagem de folículos antrais na gestação; ii) resultado da produção in vitro de embriões em doadoras antes e depois da gestação. No estudo I, 75 vacas de alta produção de leite com escores de condição corporal (ECC) de 2,75 a 4,75 e idades de 23 a 99 meses foram selecionadas. No dia do estro a CFA foi avaliada (folículos ≥ 3 mm) além do escore corporal, peso corporal e diâmetros do folículo dominante, ovários e corpo lúteo. Posteriormente, a CFA foi monitorada nas vacas gestantes (n = 35) aos 30 e 60 dias. No estudo II, novilhas (n = 9) com ECC de 2,5 a 3,5 e idades de 10 a 16 meses foram selecionadas para obtenção de oócitos antes e depois da gestação, no primeiro, segundo e acima dos dois meses de gestação. A análise estatística foi realizada usando PROC GLM e modelo de regressão logística binária (P ≤ 0,05). No estudo I, a CFA não foi associada a variações nos parâmetros produtivos e reprodutivos. No entanto, as vacas de baixa CFA apresentaram aumento no número de folículos após início da gestação (IA: 14,82 ± 1,36, 30 dias: 23,45 ± 2,31 e 60 dias:35,18 ± 3,17 folículos). A CFA aumentou da IA para 60 dias no grupo de CFA intermediária, mas não variou ao longo do tempo no grupo de alta CFA. A CFA variou entre os grupos comparando-se o momento da IA e 30 dias de gestação. No estudo II, entre a IA e o primeiro mês de gestação, houve aumento do total de oócitos (17,43 ± 4,52 vs. 41,67 ± 3,79), bem como de oócitos viáveis (13,77 ± 3,63 vs. 30,56 ± 3,45). O número médio de embriões produzidos aumentou durante a gestação, [...](AU)

Increased antral follicle population and in vitro embryo production in pregnant Holstein / Aumento da população folicular antral e produção in vitro de embriões em fêmeas gestantes da raça Holandesa

This study used Holstein cattle to evaluate the following: I) the productive and reproductive characteristics of cows with low, intermediate and high antral follicle counts (AFCs) that were subjected to artificialin semination (AI) and comparison of AFC variability at the time of AI (nonpregnant) and at two time points during pregnancy (30 and 60 days), and II) whether the pregnancy status and different pregnancy periods in heifers improves the efficiency at in vitro embryo production (IVEP). In study I, 75 high-milk production cows with body condition scores (BCSs) of 2.75 to 4.75 and ages of 23 to 99 months were selected. Onthe day of estrus, AFCs (follicles ≥ 3 mm), BCS, body weight, and diameters of the dominant follicle, ovaries and the corpus luteum were evaluated. Posteriorly, AFC was monitored in pregnant cows at 30 days (n =35) and at 60 days for comparison of AFC before pregnancy versus different periods. In study II, heifers (n = 9) with BCS of 2.5 to 3.5 and ages of 10 to 16 months were selected for ovum pick-up and an IVEP program before AI (nonpregnant) as well as at 0 to 30, 31 to 60, and > 60 days of pregnancy. Statistical analysis was performed using PROC GLM and binary logistic regression model (P ≤ 0.05). In study I, AFC was not associated with variations in productive and reproductive parameters. However, AFCs in the low group increased following pregnancy (AI: 14.82 ± 1.36, 30 days: 23.45 ± 2.31 and 60 days: 35.18 ± 3.17 follicles). AFCs increased from AI to 60 days in the intermediate group but did not vary among time points in the high group. AFCs varied among AFC groups in AI and at 30 days of pregnancy but not at 60 days. In study II, the mean of total oocytes (17.43 ± 4.52 vs. 41.67 ± 3.79) and viable oocytes (13.77 ± 3.63 vs. 30.56± 3.45) increased from AI (nonpregnant) to the first 30 days of pregnancy. [...]

Este estudo utilizou fêmeas da raça Holandesa para avaliar: i) variação da contagem de folículos antrais na gestação; ii) resultado da produção in vitro de embriões em doadoras antes e depois da gestação. No estudo I, 75 vacas de alta produção de leite com escores de condição corporal (ECC) de 2,75 a 4,75 e idades de 23 a 99 meses foram selecionadas. No dia do estro a CFA foi avaliada (folículos ≥ 3 mm) além do escore corporal, peso corporal e diâmetros do folículo dominante, ovários e corpo lúteo. Posteriormente, a CFA foi monitorada nas vacas gestantes (n = 35) aos 30 e 60 dias. No estudo II, novilhas (n = 9) com ECC de 2,5 a 3,5 e idades de 10 a 16 meses foram selecionadas para obtenção de oócitos antes e depois da gestação, no primeiro, segundo e acima dos dois meses de gestação. A análise estatística foi realizada usando PROC GLM e modelo de regressão logística binária (P ≤ 0,05). No estudo I, a CFA não foi associada a variações nos parâmetros produtivos e reprodutivos. No entanto, as vacas de baixa CFA apresentaram aumento no número de folículos após início da gestação (IA: 14,82 ± 1,36, 30 dias: 23,45 ± 2,31 e 60 dias:35,18 ± 3,17 folículos). A CFA aumentou da IA para 60 dias no grupo de CFA intermediária, mas não variou ao longo do tempo no grupo de alta CFA. A CFA variou entre os grupos comparando-se o momento da IA e 30 dias de gestação. No estudo II, entre a IA e o primeiro mês de gestação, houve aumento do total de oócitos (17,43 ± 4,52 vs. 41,67 ± 3,79), bem como de oócitos viáveis (13,77 ± 3,63 vs. 30,56 ± 3,45). O número médio de embriões produzidos aumentou durante a gestação, [...]

Antral follicle count and anti-Müllerian hormone to classify low-prognosis women under the POSEIDON criteria: a classification agreement study of over 9000 patients.

STUDY QUESTION: What is the agreement between antral follicle count (AFC) and anti-Müllerian hormone (AMH) levels when used to patient classification according to the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria? SUMMARY ANSWER: Our study indicates a strong agreement between the AFC and the AMH levels in classifying POSEIDON patients; thus, either can be used for this purpose, although one in four women will have discordant values when both biomarkers are used. WHAT IS KNOWN ALREADY: According to the POSEIDON criteria, both AFC and AMH may be used to classify low-prognosis patients. Proposed AFC and AMH thresholds of 5 and 1.2 ng/ml, respectively, have their basis in published literature; however, no study has yet determined the reproducibility of patient classification in comparing one biomarker with the other, nor have their thresholds ever been validated within this patient population. STUDY DESIGN, SIZE, DURATION: A population-based cohort study involving 9484 consecutive patients treated in three fertility clinics in Brazil, Turkey and Vietnam between 2015 and 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were infertile women between 22 and 46 years old in their first in vitro fertilization/intracytoplasmic sperm injection cycle of standard ovarian stimulation with exogenous gonadotropins whose baseline ovarian reserves had been assessed by both AFC and AMH. Details of pre- and post-treatment findings were input into a coded research file. Two indicators of interest were created to classify patients according to the POSEIDON criteria based upon AFC and AMH values. Patients who did not fit any of the four POSEIDON groups were classified as non-POSEIDON. AFC was determined in the early follicular phase using two-dimensional (2D) transvaginal ultrasonography, whereas AMH values were based on the modified Beckman Coulter generation II enzyme-linked immunosorbent assay. Agreement rates were computed between AFC and AMH to classify patients using Cohen's kappa statistics. Logistic regression analyzes were carried out to examine the association between ovarian markers and low (<4) and suboptimal (4-9) oocyte yield. MAIN RESULTS AND THE ROLE OF CHANCE: The degree of agreement in classifying patients according to POSEIDON groups was strong overall (kappa = 0.802; 95% CI: 0.792-0.811). A total of 73.8% of individuals were classified under the same group using both biomarkers. The disagreement rates were ∼26% and did not diverge when AFC or AMH was used as the primary biomarker criterion. Significant regression equations were found between ovarian markers and oocyte yield (P < 0.0001). For low oocyte yield, the optimal AFC and AMH cutoff values were 5 and 1.27 ng/ml with sensitivities of 0.61 and 0.66, specificities of 0.81 and 0.72, and AUC receiver operating characteristics of 0.791 and 0.751, respectively. For suboptimal oocyte yield respective AFC and AMH cutoffs were 12 and 2.97 ng/ml with sensitivities of 0.74 and 0.69, specificities of 0.76 and 0.66 and AUCs of 0.81 and 0.80. LIMITATIONS, REASONS FOR CAUTION: Our study relied on 2D transvaginal sonography to quantify the AFC and manual Gen II assay for AMH determination and classification of patients. AMH data must be interpreted in an assay-specific manner. Treatment protocols varied across centers potentially affecting patient classification. WIDER IMPLICATIONS OF THE FINDINGS: Three of four patients will be classified the same using either AFC or AMH values. Both biomarkers provide acceptable and equivalent accuracy in predicting oocyte yield further supporting their use and proposed thresholds in daily clinical practice for patient classification according to the POSEIDON criteria. However, the sensitivity of POSEIDON thresholds in predicting low oocyte yield is low. Clinicians should adopt the biomarker that may best reflect their clinical setting. STUDY FUNDING/COMPETING INTEREST(S): Unrestricted investigator-sponsored study grant (MS200059_0013) from Merck KGaA, Darmstadt, Germany. The funder had no role in study design, data collection, analysis, decision to publish or manuscript preparation. S.C.E. declares receipt of unrestricted research grants from Merck and lecture fees from Merck and Med.E.A. H.Y. declares receipt of payment for lectures from Merck and Ferring. L.N.V. receives speaker fees and conferences from Merck, Merck Sharp and Dohme (MSD) and Ferring and research grants from MSD and Ferring. T.M.H. received speaker fees and conferences from Merck, MSD and Ferring. The remaining authors have nothing to disclose. TRIAL REGISTRATION NUMBER: not applicable.

Which ovarian reserve marker relates to embryo quality on day 3 and blastocyst; age, AFC, AMH?

OBJECTIVE: The aim of the present prospective study was to evaluate which ovarian reserve marker would be more reliable as the quality of the A + B embryos (day 3 and blastocyst). METHODS: We ran a prospective study with 124 infertile women, aged 24-48 years, from 2017 to 2018. The patients were divided into 3 groups according to age and the subgroups were compared for AMH, AFC, number of A+B embryos. New division of the 3 groups was performed based on the AMH, and the subgroups were compared for age, AFC and number of A+B embryos. Finally, we divided the patients into 3 groups, based on the AFC, and we compared the subgroups for age, AMH and number of A+B embryos. P<0.05 was considered statistically significant. RESULTS: When the 124 patients were divided according to age, we found a significant fall in an A+B embryo quality (day3; blastocyst) after 35 years (p<0.038; p<0.035), and more severely after 37 years (p<0.032; p<0.027). When the 124 patients were divided according to AMH, there was a significant fall in A+B embryo quality (day 3; blastocyst), with AMH<1ng/ml (p<0.023; p<0.021). When the 124 patients were divided according to AFC, there was a significant fall in A+B embryo quality (day 3; blastocyst) with AFC<7 (p<0.025; p<0.023). These markers had significant associations with embryo quality (p<0.005). CONCLUSION: Age, AFC and AMH have significant associations with A +B embryo quality on day 3 and blastocyst.

Contagem de folículos antrais: relação com a eficiência das biotécnicas e fertilidade / Antral follicle count: relationship with the efficiency of biotechniques and fertility

A implementação das biotécnicas reprodutivas juntamente com os programas de melhoramento genético tem contribuído expressivamente para uma rápida disseminação de indivíduos melhoradores, tanto pelo uso da inseminação artificial, quanto pela produção in vivo e in vitro de embriões. No entanto, a eficiência destes programas está condicionada a uma série de fatores que podem afetar de maneira significativa a performance reprodutiva tanto em bovinos de corte, como de leite. Neste contexto, a contagem de folículos antrais (CFA) se destaca como um dos fatores de maior influência e ainda pouco compreendido. Empregando a ultrassonografia, fêmeas podem ser classificada em baixa, intermediária ou alta CFA, devido à alta variabilidade desta contagem no rebanho. Além disso, a alta repetibilidade desta característica possibilita realizar esta classificação em diferentes momentos da vida reprodutiva da fêmea. De maneira geral, doadoras de alta CFA tem proporcionado maiores rendimentos embrionários tanto na técnica in vivo quanto in vitro. Entretanto, fêmeas de baixa CFA têm apresentado maiores diâmetros foliculares e maior taxa de prenhez quando submetidas à IATF. Embora a CFA atue como um fator de grande influência, sua herdabilidade é baixa e não há relação com características zootécnicas de programas de melhoramento. Finalmente, a CFA tem se destacado como uma importante ferramenta de seleção de matrizes e que tem contribuído significativamente para um maior sucesso nos programas reprodutivos.

The implementation of reproductive biotechniques and genetic improvement programs has significantly contributed to a fast dissemination of animals with high genetic, both by artificial insemination and in vivo and in vitro embryo production. However, the efficiency of these programs is conditioned to several factors that can considerably affect the reproductive performance in both beef and dairy cattle. In this context, the antral follicle count (AFC) stands out as one of the most influential and still poorly understood factors. Females can be classified as low, intermediate, or high AFC by ultrasonography due to the high variability of this count in the herd. In addition, the high repeatability of this characteristic allows high confidence in carrying out this classification at different times of the reproductive life. In general, high AFC donors have provided higher embryo yields both in vivo and in vitro. However, females with low AFC have shown larger follicular diameters and higher pregnancy rate when submitted to TAI. Although AFC is a factor of great influence, its heritability is low and there is no relationship with zootechnical characteristics of breeding programs. Finally, AFC has emerged as an important tool to female’s selection and has significantly contributed to greater success in breeding programs.

Synchronization of stage of follicle development before OPU improves embryo production in cows with large antral follicle counts.

In the present study, there was an evaluation of in vitro embryo production (IVEP) in Bos indicus donor cows with small or large antral follicle counts (AFCs) when there was synchronization of follicular dynamics among cows before ovum pick-up (OPU). Donor cows classified as having small or large AFC were submitted to OPU/IVEP program (Experiment-I) or had follicular-stage synchronization imposed before OPU/IVEP (Experiment-II). In Experiment-I, the cows with a large AFC had a greater (P < 0.01) mean of embryos developing to the blastocyst stage compared to those with a small AFC. In Experiment-II, percentage of viable oocytes/OPU were not affected (P = 0.33) by synchronization of follicular dynamics, but the AFC had an effect (P < 0.0001). There was an interaction (P = 0.01) indicating the larger AFC, with or without imposing of a synchronization treatment regimen, resulted in the most desirable outcome. The number of embryos was affected (P < 0.001) by follicular-stage synchronization and AFC, with there being an interaction (P = 0.002) with the most desirable results for the large AFC-synchronized group. Number of pregnancies was greater (P ≤ 0.02) for recipient females with embryos from synchronized donors and with a large AFC. There was an interaction (P = 0.03) with there being a greater pregnancy percentage for cows with synchronized follicular stages and the large AFC. Bos indicus donor with a large AFC when associated with the synchronization of stage of follicular dynamics pre-OPU results in improvement of the efficacy of IVEP.

Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation.

BACKGROUND: To determine if a modified ovarian sensitivity index (MOSI), based on initial follicular measurements and the initial follicle-stimulating hormone (FSH) dose, can predict the production of high-quality embryos for successful implantation during in vitro fertilization (IVF). METHODS: This study consisted of two phases: 1) a retrospective study and 2) a prospective observational study. For the first phase, 363 patients charts were reviewed, of which 283 had embryos transferred. All women underwent a standardized antagonist-based IVF protocol. At the first follow-up (Day 3/4), the number and size of the follicles were determined. MOSI was calculated as ln (number follicles (≥6 mm) × 1000 / FSH initial dose). Afterward, the number and quality of the ova, embryo development, and the number and quality of the blastocysts were determined. Embryo implantation was confirmed by ß-hCG. For the second phase, 337 IVF cycles were followed to determine MOSI's accuracy. RESULTS: MOSI could predict the production of ≥4 high-quality embryos by Day 2 (AUC = 0.69, 95%CI:0.63-0.75), ≥2 blastocysts (AUC = 0.74, 95%CI:0.68-0.79), and ≥ 35% rate of blastocyst formation (AUC = 0.65, 95%CI:0.58-0.72). Using linear regression, MOSI was highly associated with the number of ova captured (ß = 5.15), MII oocytes (ß = 4.31), embryos produced (ß = 2.90), high-quality embryos (ß = 0.98), and the blastocyst formation rate (ß = 0.06, p < 0.01). Using logistic regression, MOSI was highly associated with achieving ≥4 high-quality embryos (odds ratio = 2.80, 95%CI:1.90-4.13), ≥2 blastocysts (odds ratio = 3.40, 95%CI:2.33-4.95), and ≥ 35% blastocysts formation rate (odds ratio = 1.96, 95%CI:1.31-2.92). This effect was independent of age, BMI, and antral follicle count. For implantation, MOSI was significantly associated with successful implantation (odds ratio = 1.79, 95%CI:1.25-2.57). For the prospective study, MOSI was highly accurate at predicting ≥6 high-quality embryos on Day 2 (accuracy = 68.5%), ≥6 blastocysts (accuracy = 68.0%), and a blastocyst formation rate of ≥35% (accuracy = 61.4%). CONCLUSION: MOSI was highly correlated with key IVF parameters that are associated with achieved pregnancy. Using this index with antagonist cycles, clinicians may opt to stop an IVF cycle, under the assumption that the cycle will fail to produce good blastocysts, preventing wasting the patient's resources and time.