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ABSTRACT
Recent studies suggests that one in six couples may encounter difficulty in achieving clinical pregnancy after more than 12 months of regular unprotected sexual intercourse. Increasingly, couples are turning to Assisted Reproductive Technology (ART) for conception. Unfortunately, many of these women do not achieve clinical pregnancy and several factors such as hormonal imbalance, abnormal ovarian response, oxidative stress and senescence have been implicated. The aim of this study was to evaluate ovarian response to gonadotropin stimulation and the adverse effect of oxidative stress and senescence on pregnancy outcome in women who enlisted in ART. A total of 46 women (mean age: 33.8±2.9 years; range 30-39, body mass index (BMI) range: 19-29.9) attending the Invitro-fertilization (IVF) clinic at the National Hospital Abuja were recruited for this study. Blood specimens were collected four times at various stages during IVF treatment. Serum anti-mullerian hormone (AMH), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH) were determined using Electrochemilluminscence assay principle (ECLIA), lipid profile was determined using spectrophotometry, total anti-oxidant status (TAS) was determined using spectrophotometry method while Inhibin B was determined using ELISA technique. Twenty-two subjects 22/46(47.8%) were high responders, 11/46(23.9%) were normal responders, while 13/46(28.3%) were low responders to gonadotrophin stimulation after down regulation. Marked antioxidant decrease were observed between Day3 of menses and 36 hours after human chorionic gonadotropin (HCG) injection (p< 0.001) and between Day 14 after down regulation and 36 hours after HCG injection (p<0.002). There were variations in Inhibin B hormone and the variations were observed between Day 3 of menses and Day 14 after down regulation (p<0.001), and between Day 3 of menses and after gonadotropin stimulation (p<0.004). The age of the couples appear not to have had significant impact on oocyte production and pregnancy outcome. There was a positive correlation (r=0.443, p < 0.002) between AMH and number of oocytes produced. A total of 16/46 (34.8%) of participants were clinically pregnant while 30/46 (65.2%) did not achieve pregnancy. Oxidative stress and AMH serum levels appear to have effect on pregnancy outcome. Biomarkers of oxidative stress and AMH serum levels is suggested to be included in routine panel pre-IVF screening so as to improve pregnancy outcome in IVF treated women.
