This thesis is engaged in the proposal of creation business plan for establishing IVF (in vintro fertilization) centre. With the regard for theoretical knowledges, analysis of contemporary situation in private enterprise and marketing research, this work brings the proposition of business plan for succesfull start of enterprise.

Within many communities and religions, including the LDS community, there is some controversy surrounding the use of stem cells – particularly embryonic stem cells (ESC). Much of this controversy arises from confusion and misconceptions about what stem cells actually are, where they come from , and when life begins. The theology of the Church of Jesus Christ of Latter-day Saints has interesting implications for the last of these considerations, and it becomes less a question of “when does life begin” and more an exploration of “when does personhood begin” or “when does the spirit enter the body.” With no official Church stance, statements from Church leaders vary on this topic, and this first section of the thesis explores the philosophical and practical meaning of personhood with a biological background intended for those not familiar with the origin or uses of stem cells.The second portion of the thesis explores possible cloning technologies. Recent events and advances address the possibility of cloning endangered and extinct species. The ethics of these types of cloning have considerations uniquely different from the type of cloning commonly practiced. Cloning of cheetahs (and other endangered or vulnerable species) may be ethically appropriate, given certain constraints. However, the ethics of cloning extinct species varies; for example, cloning mammoths and Neanderthals is more ethically problematic than conservation cloning, and requires more attention. Cloning Neanderthals in particular is likely unethical and such a project should not be undertaken. It is important to discuss and plan for the constraints necessary to mitigate the harms of conservation and extinct cloning, and it is imperative that scientific and public discourse enlighten and guide actions in the sphere of cloning.

Limited breeding success in captive breeding programs has necessitated the development of assisted reproductive technologies (ART) to preserve and increase genetic variation and population numbers of both captive and wild amphibian groups. ART has been shown to be successful in numerous anuran species, and current studies focus on the application of ART in ex-situ populations. The focus of this project is to show that linking in-situ and ex-situ amphibian populations through sperm cryopreservation, genome banking, and in-vitro fertilization is possible, with the goal of increasing gene diversity throughout groups in order to produce self-sustaining, wild populations in the future. Specific objectives include developing a sperm-cryopreservation methodology using sperm from the model species Anaxyrus fowleri, applying this protocol to the cryopreservation of spermatozoa from two other threatened anurans to determine protocol transmissibility, and linking in-situ and ex-situ populations of an endangered species using cryopreserved sperm form wild males to produce viable offspring.

No description available.

Que l’on parle de « technosemen », de « cyborg babies » ou de « techno-birth », force est de constater que le recours aux nouvelles technologies de reproduction participe d’une reconfiguration des processus biologiques. On assiste à une technicisation du corps qui entraine sa parcellisation et rend possibles son exploitation et sa commercialisation en pièces détachées. Or, la mise en valeur des substances biologiques est souvent accompagnée de leur rematérialisation dans l’imaginaire social. En nous intéressant à l’industrie du don de gamètes, nous cherchons à comprendre comment elle marchandise les substances reproductives en reconstituant le corps du donneur. La littérature est abondante sur la participation des nouvelles technologies de reproduction au renouveau identitaire et sociétal. Nous souhaitons donc décaler le regard et réfléchir sur la manière avec laquelle la sélection génétique opérée en clinique de reproduction nous révèle des schémas sociaux qui interviennent dans la dimension identitaire du corps. Dans le cadre de ce mémoire, il s’agira d’analyser les discours entourant le recrutement et la présentation des donneurs sur les sites internet de banques de gamètes au Canada et aux États-Unis. Nous montrerons que l’industrie du don de sperme et d’ovules, qui s’insère dans ce que l’on appelle la bioéconomie, participe à la reproduction d’une vision des formations sociales qui est à la fois genrée, racialisée et stratifiée par classes sociales. / Whether we talk about “technosemen”, “cyborg babies” or “techno-birth”, it all comes down to one thing: the use of the latest reproductive technologies is part of a redesign of the biological processes. What we are witnessing is that the body is being technified and ultimately broken down in such a way that it can be exploited and marketed in spare parts. However, because they’re being valued, the biological substances are often also rematerialized in the social consciousness. In looking at the gamete donation industry, we are trying to understand how it treats the reproductive substances as commodities in reconstructing the donor’s body. There is plenty of literature on how the new reproductive technologies are contributing to the identity and societal renewal. Our goal is therefore to look beyond and reflect on how much the genetic selection performed in fertility clinics says about the social patterns that enter in the identity dimension of the body. This thesis analyses the rhetoric used on the websites of sperm and egg banks in Canada and in the United States to recruit and present the donors. We will show that sperm and egg donations, which come within what is now called the bioeconomy, replicate a certain vision of social groups which are altogether classified by gender, race and social class.

Des facteurs masculins sont identifiés dans près de la moitié des cas d’infertilité. À ce jour, les tests évaluant la fertilité masculine demeurent peu prédictifs de la survenue d’une grossesse. Dans le but de pallier cette lacune, nous avons mis au point deux nouveaux tests mesurant l’intégrité de l’ADN et le temps de survie des spermatozoïdes. Nous avons effectué une étude prospective portant sur 42 couples infertiles suivis en fécondation in vitro (FIV). Le spermogramme a été effectué selon les critères de l’Organisation Mondiale de la Santé (OMS) et le temps de survie des spermatozoïdes exposés à un détergent cationique a été mesuré en observant la mobilité sous microscope. L’intégrité de l’ADN des spermatozoïdes a été vérifiée par la nouvelle méthode de marquage radioenzymatique et par analyse de la structure de la chromatine (SCSA). Tous les tests ont été réalisés sur la partie des échantillons de sperme non utilisée par la clinique de fertilité. Le projet a été approuvé par le comité d’éthique du Centre Hospitalier Universitaire de Montréal (CHUM) et les patients ont préalablement signé un formulaire de consentement éclairé. L’analyse des paramètres du spermogramme et de l’intégrité de l’ADN n’a montré aucune différence statistiquement significative entre les données chez les couples avec ou sans grossesse. Cependant, le taux de grossesse biochimique était statistiquement plus élevé chez les couples dont le temps de survie des spermatozoïdes était long (>250 s) comparativement à ceux dont ce temps était court (≤250 s): 66% vs 27% respectivement (p<0,05). Les taux de grossesse clinique et d’implantation étaient aussi plus élevés, mais les différences n’atteignaient pas le seuil de signification statistique. Nos résultats confirment que le spermogramme et la mesure de la fragmentation de l’ADN des spermatozoïdes ne sont pas de bons facteurs prédictifs des résultats de la FIV. Par contre, le test de survie des spermatozoïdes serait un meilleur indicateur de la possibilité d’une grossesse en FIV. L’amélioration de sa spécificité et un plus grand nombre de sujets sont nécessaires avant de proposer son application en clinique de fertilité. / Male factors are known to be involved in almost half of the couples consulting for infertility. To date, the tests for evaluating male fertility are poor predictors of pregnancy. We developed two new tests to evaluate sperm function: a sperm survival test and a new method to measure sperm DNA integrity. This prospective study was conducted on 42 infertile couples undergoing in vitro fertilization (IVF). Assessment of sperm parameters was done according to the World Health Organization (WHO) criteria, and sperm survival upon exposure to a cationic detergent was measured by observing motility under the microscope. Sperm DNA integrity was verified by our new radioenzymatic method as well as by the sperm chromatin structure analysis (SCSA) method. All testing was performed on a remainder aliquot of the semen samples. The study was approved by the ethics committee of the Centre Hospitalier Universitaire de Montréal (CHUM), and informed consent was obtained before inclusion. Neither conventional semen analysis, nor sperm DNA fragmentation showed statistically significant difference between conception and non-conception cycles. However, the biochemical pregnancy rate was statistically higher in couples where the sperm survival time was long (>250 s) compared to short (≤250 s): 66% vs. 27% respectively, (p < 0.05). The clinical pregnancy rate and implantation rate were also higher but the differences did not reach statistical significance. Our study confirms that conventional semen analysis and the assay for sperm DNA integrity are not reliable indicators of IVF outcome. In contrast, our new sperm survival test seems to be a better predictor of the pregnancy rate after IVF. Improvement of its specificity and a larger cohort of patients are necessary before proposing its regular application in IVF clinics.

Justificativa: Falhas recorrentes de implantação (FRI) são uma fonte de grande frustração para pacientes e especialistas que, frequentemente buscam intervenções com o objetivo de atingir resultados favoráveis. A prevalência exata dessa condição é de difícil estimativa, uma vez que existem diversas definições para caracterizá-la. Diversas intervenções que visam a melhora dos resultados reprodutivos dessas pacientes já foram propostas. Entretanto, nenhuma revisão sistematizada abordou, simultaneamente, todas as potenciais estratégias para esse grupo de mulheres. Dessa forma, a eficácia e a segurança dessas intervenções não são bem definidas. Devido ao alto número de intervenções descritas para esse fim, julgamos que uma metanálise que as contemple de forma abrangente é importante para casais, especialistas e pesquisadores do assunto. Objetivos: Avaliar a eficácia e segurança das intervenções que visam a melhora do resultado reprodutivo das pacientes com FRI submetidas a um novo tratamento de reprodução assistida. Métodos de busca: As buscas por estudos randomizados e controlados, publicados e em andamento, foram realizadas nas principais bases de dados eletrônicas. Adicionalmente, as listas de referências de estudos incluídos e revisões semelhantes foram avaliadas pelos autores. A última busca eletrônica foi realizada em fevereiro de 2018. Critérios de Elegibilidade: Foram considerados elegíveis apenas os estudos verdadeiramente randomizados que comparassem quaisquer intervenções destinadas a esse grupo depacientes. No presente estudo, consideramos como FRI a história de duas ou mais falhas prévias. Extração e análise de dados: Dois autores realizaram, individualmente, a seleção de estudos, extração de dados e análise do risco de viés. Discordâncias foram resolvidas em consulta a um terceiro autor. Os pesquisadores de estudos potencialmente elegíveis foram contatados sempre que necessário para obtenção de informações adicionais. Resultados: Foram identificados 2794 registros; desses, 62 estudos foram incluídos, representando uma população de 9308 pacientes, submetidas a 26 intervenções diferentes. Informações sobre 24 intervenções e 8461 pacientes foram submetidas à análise quantitativa. Não há evidências de alta ou moderada qualidade de que alguma dessas intervenções seja realmente eficaz para a melhora dos resultados reprodutivos de pacientes com FRI. As seguintes intervenções se mostraram benéficas: assisted hatching, injúria endometrial, histeroscopia, uso de FSH urinário + recombinante para estimulação endometrial e administração intrauterina de hCG. Porém as evidências são de baixa qualidade, o que nos traz incerteza em relação aos seus reais efeitos. Todas as outras intervenções identificadas não permitiram nenhuma outra conclusão adicional, uma vez que as evidências foram avaliadas como de muito baixa qualidade ou não foram encontrados estudos randomizados que as tivessem avaliado. Conclusões: Evidências de ensaios clínicos randomizados não sustentam o uso de nenhuma intervenção para a melhora dos resultados reprodutivos de pacientes com FRI. Todos os achados foram julgados como de baixa ou muito baixa qualidade, o que nos traz incerteza quanto aos seus reais efeitos na prática clínica. Deve-se estar ciente de que o emprego de tais intervenções impõe despesas e riscos adicionais para as pacientes. Além disso, a falta de critérios universalmente aceitos para odiagnóstico de falha recorrente de implantação é uma importante limitação para o avanço do conhecimento sobre essa condição / Background: Recurrent implantation failure (RIF) is a source of deep frustration to couples and clinicians, who often look for interventions to improve the reproductive outcomes. Its exact prevalence is difficult to determine because there are several definitions used to describe the condition. Several interventions aiming to improve reproductive outcomes for such patients have been studied. However, there are no systematic reviews that focus on all potential interventions for improving reproductive outcomes in women with RIF undergoing assisted reproduction techniques. The efficacy and safety of these interventions are not clear. Because of the large number of potential interventions for this condition, it would be very difficult to be aware of the current evidence for all of them. We believe this systematic review is important for subfertile couples, clinicians and researchers. Objectives: To assess the efficacy and safety of interventions designed to improve reproductive outcomes in women with RIF undergoing ART. Search methods: We searched for randomised controlled trials (RCT) in electronic databases (Cochrane Gynaecology and Fertility Group (CGF), The Cochrane Central Register of Controlled Trials, MEDLINE Ovid, EMBASE Ovid, PsycINFO, PsycINFO Ovid, CINAHL, LILACS), trials registers (ClinicalTrials.gov, ISRCTN registry, The WHO International Clinical Trials Registry Platform, World Health Organization International Clinical Trials Registry Platform) and grey literature (OpenGrey); in addition, we handsearched the reference lists of included studies and similar reviews. We performed the last electronic search on 22 Feb 2018.Selection criteria: We considered eligible only truly randomised controlled trials comparing any intervention designed to improve outcomes in women with repeat implantation failure (RIF) compared to other intervention, placebo or no treatment. For study selection, we defined RIF as two or more previous failures Data collection and analysis: Two authors independently performed study selection, data extraction, and assessment of the risk of bias. Any disagreements were solved by consulting a third review author. Study\'s authors were contacted whenever needed to solve any queries. Results: the search retrieved 2794 records; from those, sixty-two studies were included, comprising 9308 participants, submitted to 26 different interventions. Data from 24 interventions and 8461 participants were pooled for quantitative analysis. We found no high or even moderate quality evidence that any of the tested interventions are really effective to improve reproductive outcomes of women with RIF undergoing a new IVF treatment. We observed low-quality evidence of benefit for women with RIF with the following interventions: assisted hatching, endometrial Injury, hysteroscopy, the use of human + recombinant FSH for ovarian stimulation and intrauterine hCG administration. All the other listed interventions did not allow any further conclusion: either very low-quality evidence or no evidence from RCTs. Conclusions: Evidence from RCTs does not support the use of any specific intervention for improving reproductive outcomes in women with RIF. All evidences were deemed of low to very low quality, which makes us uncertain of their real effectiveness on clinical practice. One should be aware that the employment of such interventions imposes additional expenses and risks. Additionally, the lack of universally accepted criteria for recurrent implantation failure is an important limitation for the advance of knowledge regarding this condition.More studies are needed to evaluate their real effect. Maybe even more importantly is to create universally accepted criteria for defining implantation failure; only them one will be able to test interventions for this specific group

Experimentos anteriores realizados em nosso laboratório indicam que o sucesso gestacional é afetado pela poluição atmosférica. O presente estudo teve como objetivo avaliar os efeitos biológicos associados a uma curva dose resposta das partículas de exaustão do diesel (PED) sobre o desenvolvimento embrionário inicial e o potencial de implantação, utilizando-se como modelo a fertilização in vitro e o cultivo embrionário de camundongos. No Experimento 1, encontrou-se um efeito negativo dose-dependente sobre o desenvolvimento embrionário inicial, o processo de eclosão, a alocação das células e a morfologia da massa celular interna (MCI) dos blastocistos. A análise post-hoc revelou que o desenvolvimento precoce do embrião não foi afetado pelas concentrações de 0,2 µg/cm2 ou 2 µg/cm2, mas foi significativamente afetado pela concentração de 20 µg/cm2 de PED. O processo de eclosão foi prejudicado pelas concentrações de 2 µg/cm2 e 20 µg/cm2. A alocação das células da MCI e a relação entre as células da MCI e do trofectoderma foram significativamente afetadas por todas as concentrações. Adicionalmente, observou-se um efeito negativo sobre a morfologia da MCI para as concentrações de 2 µg/cm2 e 20 µg/cm2. O Experimento 2, apesar de não mostrar efeito significativo sobre o potencial de implantação, evidenciado pela capacidade de adesão dos blastocistos e crescimento trofoblástico, revelou que a morfologia da MCI no dia 8 de cultivo, as taxas de viabilidade e de apoptose celular e a expressão de Oct4 e Cdx2 foram significativamente afetadas. O teste HSD-Tukey demonstrou que a presença de PED (0,2 µg/cm2 e 2 µg/cm2) durante o desenvolvimento embrionário aumentou significativamente a taxa de células em apoptose dos embriões tanto no dia 5 quanto no dia 8 de cultivo e, embora a proporção de células viáveis no dia 8 tenha sido prejudicada por ambas as concentrações, apenas a exposição a 2 µg/cm2 de PED diminuiu a viabilidade celular no dia 5. Por outro lado, tanto a concentração de 0,2 µg/cm2 como a de 2 µg/cm2 tiveram um efeito negativo significativo sobre a qualidade da MCI no dia 8 e a taxa de expressão de Oct4 nos blastocistos e aumentaram a porcentagem de células desses blastocistos expressando Cdx2, adicionalmente, a razão Oct4/Cdx2 dos embriões expostos a 0,2 µg/cm2 e 2 µg/cm2 foi significativamente menor. Frente a esses resultados, presumi-se que as PED poderiam estar envolvidas nos mecanismos que levariam à diminuição do sucesso reprodutivo observado em camundongos expostos à poluição atmosférica ambiental / Previous experiments conducted in our laboratory demonstrate that successful pregnancy is affected by air pollution. The aim of this study was to evaluate the biological effects associated with a dose-response curve of the diesel exhaust particles (DEP) on early embryonic development and implantation potential, using mice in vitro fertilization and culture embryo as model. In Experiment 1, we found a negative dose-dependent effect on the embryonic development, hatching process, cell allocation and morphology of inner cell mass (ICM) of blastocysts. A post-hoc analysis revealed that the early development of the embryo was not affected by concentrations of 0.2 g/cm2 or 2g/cm2, but was significantly affected by the concentration of 20 g/cm2 of DEP. The hatching process was impaired by concentrations of 2 g/cm2 and 20 g/cm2. Cell allocation of ICM and the ratio between cells of ICM and trophectoderm were significantly affected by all concentrations. Addicionaly, we observed a negative effect on ICM morphology was observed for the 2 µg/cm2 and the 20 µg/cm2 concentrations. Experiment 2, despite showing no significant effect on implantation potential, as evidenced by the adhesion ability and trophoblast outgrowth, revealed that ICM morphology on day 8 of culture, rates of cell viability and apoptosis, and expression of Oct4 and Cdx2 were significantly affected. The Tukey HSD test showed that presence of DEP (0.2 g/cm2 and 2 g/cm2) during embryonic development increased significantly the rate of apoptotic cells in embryos as on day 5 as on day 8 of culture, although the proportion of viable cells on day 8 was impaired by both concentrations, only exposure to 2 g/cm2 PED decreased cell viability on day 5. On the other hand, both the concentration of 0.2 g/cm2 such as 2 g/cm2 had a significant negative effect on the quality of ICM on the day 8 and the rate of expression of Oct4 on blastocysts, and increased the percentage of cells from these embryos expressing Cdx2, also, Oct4/Cdx2 ratio were significantly lower in the blastocysts derived from embryos exposed to 0.2 g/cm2 and 2 g/cm2¬ concentrations. Given these results, the suggestion is that DEP could be involved in the mechanisms that lead to decreased reproductive success observed in mice exposed to environmental pollution

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Treatment success in IVF-ICSI is mainly limited by female age, but differences in ovarian reserve (OR; the remaining pool of oocytes and their quality) between individuals modify treatment prerequisites among women of similar age. OR may be assessed by OR tests (ORTs). The main aims of this work were to study menstrual cycle length (MCL), basal levels of circulating gonadotrophins, antral follicle count (AFC) and serum Anti-Müllerian hormone (AMH) levels and their associations with and prognostic capacities regarding IVF-ICSI outcome in large cohorts of unselected women. Age-adjusted MCL was positively and linearly associated with pregnancy rates (PRs), live-birth rates (LBRs) and ovarian response to controlled ovarian hyperstimulation. An MCL of &gt;34 days almost doubled the LBR compared with an MCL of &lt;26 days. The grouped variable ‘combined FSH and LH levels’ was superior to both individual gonadotrophin levels and the LH:FSH ratio. The highest mean PR was seen in connection with a combination of FSH &lt;6.7 U/l with LH &gt;4.9 U/l; PRs were lowest when FSH-LH levels were opposite to this (high-low) and intermediate when FSH-LH levels were low-low or high-high. Associations with LBR and ovarian response were similar as those for PR. AFCs and serum AMH levels were positively and log-linearly associated with PR, LBR and ovarian response. Success rates levelled out above AFC 30 or AMH 5 ng/ml. Treatment outcome was superior among women with polycystic ovaries. Among the studied ORTs, logAFC and logAMH concentration correlated most strongly. After multivariate testing, entering all studied ORTs, AMH and female age remained independently associated with LBR. AMH + AFC + age predicted both poor and excessive ovarian responses with high accuracy. Adjusting for age and oocyte yield, all ORTs remained significant for LBR, implying that ORTs also capture information on oocyte quality. In conclusion, measures of OR are strongly associated with PR, LBR and ovarian response in a log-linear fashion, and partly reflect oocyte quality. The OR spectrum is continuous, from small ‘oligofollicular’ ovaries (the low extreme) to polycystic ovaries (the high extreme). Among the studied ORTs, AMH together with age provide the most powerful basal estimate for IVF/ICSI outcome.