Ovarian reserve, cerebral palsy and hair tests - a round up from ESHRE 2020

Low ovarian reserve may be a useful marker of later health issues, research presented at the virtual 2020 meeting of the European Society of Human Reproduction and Embryology (ESHRE) suggests.

A Danish study of almost 20,000 women having a first cycle of IVF between 1995-2014 found young women with early ovarian ageing (measured by the number of eggs collected during IVF) had a 26 percent increased overall risk of age-related morbidity, with a 39 per cent increased risk of cardiovascular disease and a more than double the risk of osteoporosis.

Lead investigator Mette Wulf Christensen of Aarhus University, Denmark, said the data 'strongly support the hypothesis that low ovarian reserve may be a useful marker of later health problems'. She added: 'Identifying women at risk of early menopause may thus allow early preventive health initiatives in terms of a healthy lifestyle.'

The risk of cerebral palsy in IVF-conceived children has halved over two decades, in large part, say the researchers, because of the reduction in the rate of twin births following fertility treatment.

The large-scale Nordic population study, presented at ESHRE by Dr Anne Lærke Spangmose from Rigshospitalet, Copenhagen University Hospital, revealed the prevalence of cerebral palsy had declined consistently over the time period: from 12.5 cases per 1000 live born in 1990-1993 to 3.4 per 1000 in 2011-2014. Dr Spangmose noted that, in the Nordic countries (Denmark, Finalnd and Sweden), IVF twin rates have declined from almost 25 percent in the 1990s to less than five percent today, after a policy of single embryo transfer was introduced in the early 2000s.

'This study leaves no excuse: single embryo transfer should always be the gold standard in fertility treatment,' said Dr Spangmose.

'Biologically-relevant' levels of anti-Mullerian hormone (AMH) were detected successfully in human hair and correlated strongly with AMH levels in serum and antral follicle count (AFC), a poster presented at ESHRE demonstrated. The research raises the prospect of a non-invasive test for ovarian reserve.

The small, single study involved 152 women from whom hair and blood samples were routinely collected during hospital visits. AMH measured in serum from the same subjects and an ultrasound count of developing follicles in the ovary were used as control measures of ovarian reserve.

The hair test was able to detect a wide range of AMH levels within individuals from a similar age cohort, suggesting a greater accuracy than from a single blood sample. PhD student Sarthak Sawarkar, said: 'As hair offers a look at the long-term accumulation of hormones, this measurement may allow a better understanding of an individual's hormone levels - unlike blood-based assays, which can only measure the hormone at the moment of the testing.'