title: Menstrual cycle length: a surrogate measure of reproductive health capable of improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.
abstract: BACKGROUND
  Aim of the study was to investigate whether menstrual cycle length may be considered as a surrogate measure of reproductive health, improving the accuracy of biochemical/sonographical ovarian reserve test in estimating the reproductive chances of women referred to ART.
  
  
  METHODS
  A retrospective-observational-study in Padua' public tertiary level Centre was conducted. A total of 455 normo-ovulatory infertile women scheduled for their first fresh non-donor IVF/ICSI treatment. The mean menstrual cycle length (MCL) during the preceding 6 months was calculated by physicians on the basis of information contained in our electronic database (first day of menstrual cycle collected every month by telephonic communication by single patients). We evaluated the relations between MCL, ovarian response to stimulation protocol, oocytes fertilization ratio, ovarian sensitivity index (OSI) and pregnancy rate in different cohorts of patients according to the class of age and the estimated ovarian reserve.
  
  
  RESULTS
  In women younger than 35 years, MCL over 31 days may be associated with an increased risk of OHSS and with a good OSI. In women older than 35 years, and particularly than 40 years, MCL shortening may be considered as a marker of ovarian aging and may be associated with poor ovarian response, low OSI and reduced fertilization rate. When AMH serum value is lower than 1.1 ng/ml in patients older than 40 years, MCL may help Clinicians discriminate real from expected poor responders. Considering the pool of normoresponders, MCL was not correlated with pregnancy rate while a positive association was found with patients' age.
  
  
  CONCLUSIONS
  MCL diary is more predictive than chronological age in estimating ovarian biological age and response to COH and it is more predictive than AMH in discriminating expected from real poor responders. In women older than 35 years MCL shortening may be considered as a marker of ovarian aging while chronological age remains most accurate parameter in predicting pregnancy.
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. ginecologia_padova@libero.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. alessandra.andrisani@unipd.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Andrisani
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. marco.noventa@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Noventa
authors.affiliation: Department of Obstetrics and Gynaecology, University of Verona, Piazzale Ludovico Scuro 10 street, 37134, Verona, Italy. michela40mq@gmail.com.
authors.forename: Michela
authors.initials: M
authors.lastname: Quaranta
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. fede.esp@hotmail.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Esposito
authors.affiliation: Department of Medicine-Endocrinology, University of Padua, Giustiniani 2 street, 35128, Padua, Italy. decio.armanini@unipd.it.
authors.forename: Decio
authors.initials: D
authors.lastname: Armanini
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. michele.gangemi@unipd.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Gangemi
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. giovannibattista.nardelli@unipd.it.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Nardelli
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. pietro.litta@unipd.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. donato.dantona@unipd.it.
authors.forename: Donato
authors.initials: D
authors.lastname: D'Antona
authors.affiliation: Department of Woman and Child Health, University of Padua, Gynecologic and Obstetric Clinic, Giustiniani 3 street, 35128, Padua, Italy. guido.ambrosini@unipd.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Ambrosini
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology; D065851:Ovarian Reserve; D010053:Ovary / Q000187:drug effects; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D060728:Reproductive Health; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D054304:Anti-Mullerian Hormone