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

在过去的三十年里，妇女生育第一个孩子的平均年龄一直在增加， 美国，使我们了解卵巢老化及其对卵巢储备的负面影响-- 衡量卵巢产生受精卵的能力越来越重要。但我们 对育龄妇女可能影响卵巢储备的其他因素知之甚少， 老化本身。这项名为“年轻女性卵巢衰老和储备研究”（SOAR）的提案旨在 解决我们对影响卵巢功能的因素，特别是可改变的因素的认识上的重大差距， 储备，并可能加速其减少年轻妇女。为了实现这一目标，我们将利用正在进行的 NIEHS环境，生活方式和肌瘤研究（SELF），该研究跟踪了1，696名非洲人的队列， 年龄在23-34岁之间的美国女性在五年内。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：抗- 苗勒管激素（AMH）、卵泡早期卵泡刺激素（FSH）和窦卵泡计数 （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）， 人体测量和生物电阻抗分析（BIA）测量，以更精确地确定 糖代谢和肥胖对卵巢储备功能的影响。我们的研究结果将临床 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，我们将使用卵巢储备的重叠措施， 以及基于组的轨迹建模以确定与卵巢储备减少相关的相关性。 具体而言，我们将确定人口统计学、健康行为、生殖和环境因素 与AMH（作为卵巢储备的衡量标准）随时间推移而下降相关（目的1），确定 肥胖和卵巢储备功能下降的各种指标之间的关联（目的2），并确定 葡萄糖调节异常与卵巢储备功能下降之间的关系（Aim 3）。拟议的前景 一项纵向队列研究将确定卵巢癌的自然史和与卵巢癌变化相关的因素。 随着时间的推移。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。 迄今为止，美国AMH和卵巢储备的数据将使所有女性受益。

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.