Study of Ovarian Aging and Reserve in Young Women (SOAR)

在过去的三十年里，女性生育第一个孩子的平均年龄一直在增加 美国，让我们了解卵巢老化及其对卵巢储备的负面影响-a 衡量卵巢产生受精卵子的能力--日益重要。然而，我们 对育龄妇女中可能影响卵巢储备的其他因素知之甚少 衰老本身。这项名为《年轻女性卵巢老化和储备研究》的提案旨在 解决我们对影响卵巢的因素--特别是可改变的因素--的认识上的重大差距 储备，并可能加速其减少在年轻女性。为了实现这一目标，我们将利用正在进行的 NIEHS环境、生活方式和纤维瘤研究(SELF)，该研究跟踪了1,696名非洲人- 美国女性的年龄在23-34岁之间，为期五年。在这群年轻女性中，我们 将通过跟踪三种不同的卵巢储备指标来评估卵巢储备的变化： 苗勒氏激素(AMH)、卵泡早期促卵泡激素(FSH)和有腔卵泡计数 (AFC)。除了收集调查数据外，我们还将进行口服葡萄糖耐量试验(OGTT)和 人体测量和生物电阻抗分析(BIA)测量以更准确地确定 糖代谢和肥胖对卵巢储备的作用。我们的研究结果将用于临床。 重要的是，我们目前有有限的纵向数据，咨询妇女的风险因素减少 卵巢储备。我们的研究设计是创新的，因为我们将使用卵巢储备的重叠测量方法 以及基于群体的轨迹建模，以确定与卵巢储备减少相关的因素。 具体地说，我们将确定人口、健康行为、生殖和环境因素 随着时间的推移(目标1)与AMH降低(作为卵巢储备的一种衡量标准)相关，确定 肥胖的各种指标与卵巢储备减少之间的关系(目标2)，并确定 糖代谢紊乱与卵巢储备减少之间的关系(目标3)。建议的前景 纵向队列研究将确定卵巢改变的自然病史和相关因素 随着时间的推移而保留。此外，它将通过生成最大的纵向数据集来增加极其有限的数据 到目前为止，美国关于AMH和卵巢储备的数据，这将使所有女性受益。

The average age for a woman to have her first child has been increasing for the last three decades in the United States, making our understanding of ovarian aging and its negative effect on the ovarian reserve—a measure of the capacity of the ovary to produce eggs capable of fertilization—increasingly important. Yet, we know very little about other factors in reproductive-age women that might affect the ovarian reserve, beyond aging itself. This proposal, titled Study of Ovarian Aging and Reserve in Young Women (SOAR), seeks to address the significant gap in our knowledge of factors—particularly modifiable factors—that affect ovarian reserve and might accelerate its decrease in young women. To achieve this goal, we will leverage the ongoing NIEHS Study of Environment, Lifestyle and Fibroids (SELF), which is following a cohort of 1,696 African- American women between the ages of 23-34 years over a five-year period. In this group of young women, we will assess changes in the ovarian reserve by tracking three different measures of the ovarian reserve: anti- Müllerian hormone (AMH), early follicular phase follicle-stimulating hormone (FSH), and antral follicle count (AFC). In addition to collecting survey data, we will also perform oral glucose tolerance testing (OGTT) and anthropometric and bioelectrical impedance analysis (BIA) measurements to more precisely determine the roles of glucose metabolism and obesity on the ovarian reserve. The results of our study will be clinically significant as we currently have limited longitudinal data for counseling women on risk factors for decreased ovarian reserve. Our study design is innovative in that we will use overlapping measures of the ovarian reserve and group-based trajectory modeling to determine correlates associated with decreased ovarian reserve. Specifically, we will determine the demographic, health-behavior, reproductive, and environmental factors associated with decreased AMH (as a measure of the ovarian reserve) over time (Aim 1), determine the association between various measures of obesity and decreased ovarian reserve (Aim 2), and determine the association between glucose dysregulation and decreased ovarian reserve (Aim 3). The proposed prospective longitudinal cohort study will determine the natural history of and factors associated with the change in ovarian reserve over time. Further, it will add to the extremely limited data by generating the largest set of longitudinal data on AMH and ovarian reserve in the United States to date, which will benefit all women.