WO2007125317A1 - Fertility test based on measuring inhibin b, amh, and fsh - Google Patents
Fertility test based on measuring inhibin b, amh, and fsh Download PDFInfo
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- WO2007125317A1 WO2007125317A1 PCT/GB2007/001514 GB2007001514W WO2007125317A1 WO 2007125317 A1 WO2007125317 A1 WO 2007125317A1 GB 2007001514 W GB2007001514 W GB 2007001514W WO 2007125317 A1 WO2007125317 A1 WO 2007125317A1
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- WIPO (PCT)
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- nucleic acid
- acid molecule
- polypeptide
- assay
- fsh
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/74—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving hormones or other non-cytokine intercellular protein regulatory factors such as growth factors, including receptors to hormones and growth factors
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
- C12Q1/00—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
- C12Q1/68—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
- C12Q1/6813—Hybridisation assays
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/74—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving hormones or other non-cytokine intercellular protein regulatory factors such as growth factors, including receptors to hormones and growth factors
- G01N33/76—Human chorionic gonadotropin including luteinising hormone, follicle stimulating hormone, thyroid stimulating hormone or their receptors
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
- G01N2333/475—Assays involving growth factors
- G01N2333/495—Transforming growth factor [TGF]
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/36—Gynecology or obstetrics
- G01N2800/367—Infertility, e.g. sperm disorder, ovulatory dysfunction
Definitions
- the invention relates to a diagnostic test to determine the fertility of an animal subject.
- tests available to couples include semen analysis, and routine gynaecological procedures that include X-ray hysterosalpingogram or laparoscopy each of which will only be predicative in severe cases of failure to conceive.
- An important indicator of fertility is how long the woman has been trying to conceive.
- the control of reproduction is mediated by the combined effects of hormones which regulate the female ovulation and menstruation.
- the hypothalamus and pituitary gland secrete the hormones follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones control the growth of oocytes in the ovaries and the secretion of the female hormones oestradiol and progesterone by the ovaries.
- FSH follicle stimulating hormone
- LH luteinizing hormone
- FSH follicle stimulating hormone
- LH luteinizing hormone
- Two further hormones, inhibin B and anti-Mullerian hormone (AMH) are also associated with female reproductive biology.
- Bovine inhibin B is two subunit protein complex of a molecular weight of approximately 56kD. The subunits are around 44kD and 14kD. Bovine inhibin B has been isolated from a gonadal source and characterised. Antibodies to bovine inhibin B have been raised and used " to detect the protein in sera; see US5, 102, 807. The genes encoding human inhibin B subunits have been cloned and are described in EP0222491. The human hormone is also is a two subunit hormone referred to as ⁇ and ⁇ subunits. The processed ⁇ subunit is 134 amino acids and the ⁇ subunit is 350 amino acids in length. Inhibin B has also been isolated from porcine sources. It is also a two subunit hormone of 32kD (14 and 18kD subunits). The function of inhibin B is to suppress the secretion of FSH, and not LH, at the level of the pituitary gland.
- AMH is also referred to as Mullerian Inhibiting Substance and is expressed by prepubertal Sertoli cells and post natal granulosa cells and causes regression of the Mullerian duct.
- a cDNA encoding AMH has been cloned from fetal bovine testicular tissue; see Picard et al (1986) PNAS, 83, 5464-5468) and is a homodimer of two subunits the complex of approximately 62kD.
- the human hormone is a similar size.
- AHM is known to be a measure of ovarian reserve and has been suggested as a means to control female fertility; see WOO 1/08695.
- Monoclonal antibodies to AMH have also been produced and characterised; see US4, 792, 601.
- FSH is produced and secreted by the anterior pituitary gland. In the ovary FSH stimulates the growth of immature Graafian follicles to maturation and as the follicle matures it begins to release inhibin B which inhibits the secretion of FSH.
- FSH is a glycoprotein comprising two subunits; the ⁇ unit is 92 amino acids in length and the ⁇ subunit is 118 amino acids in length.
- Human FSH has been cloned and characterised, for example see US5, 156, 957.
- This disclosure relates to a test that combines the detection of each of inhibin B, AMH and FSH to provide a predictive test that allows a woman to forecast her ovarian reserve for the following two years. Women can therefore make an informed decision as to whether, or how long, they can potentially delay before trying to conceive. The test also allows the prediction of when a woman is to begin her menopause several years before this occurs giving them the opportunity to plan their lives accordingly.
- an assay to determine the fertility of a female animal subject comprising the detection of each of inhibin B, anti- Mullerian hormone and follicle stimulating hormone in an isolated biological sample to determine the concentration of the respective hormones to provide a data output and the analysis of the data out put to provide a measure of the fertility of said female subject.
- an assay to determine the fertility of a female animal subject comprising the steps of: i) providing an isolated biological sample from the subject; ii) detecting the presence in said biological sample of at least three polypeptides wherein said polypeptides are encoded by a nucleic acid molecule selected from the group consisting of: a) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 1; b) a nucleic acid molecule that hybridises the a nucleic acid molecule in (a) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with inhibin B; c) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 2; d) a nucleic acid molecule that hybridises the a nucleic acid molecule in (c) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with anti- mullerian hormone; e
- the output from the assay is analysed by application of the algorithm: Ln(100/[FSH])*ln([InB])*ln([AMH*10]) * 10/Age
- the assay provides an ovarian reserve index which is a measure of the fertility of the female subject.
- polypeptide is encoded by a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 1, Figure 2 and Figure 3.
- polypeptide is encoded by a nucleic acid molecule that consists of the nucleic acid sequence as represented in Figure 1, Figure 2 and Figure 3.
- polypeptides are detected by the binding of a ligand that specifically binds said polypeptide wherein the binding of said ligand is detected and is a direct or indirect measure of the presence of said polypeptide in said biological sample.
- said ligand is an antibody, or active binding part thereof, that specifically binds said polypeptide.
- said animal subject is a mammal; preferably said mammal is human.
- said biological sample comprises serum.
- said biological sample is a blood sample.
- a method to determine whether a female subject is likely to suffer premature menopause comprising the steps of: i) providing an isolated biological sample from the subject; ii) detecting the presence in said biological sample of at least three polypeptides wherein said polypeptides are encoded by a nucleic acid molecule selected from the group consisting of: a) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 1; b) a nucleic acid molecule that hybridises the a nucleic acid molecule in (a) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with inhibin
- nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 2; d) a nucleic acid molecule that hybridises the a nucleic acid molecule in (c) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with anti- mullerian hormone; e) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 3; f) a nucleic acid molecule that hybridises the a nucleic acid molecule in (a) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with follicle stimulating hormone; iii) collating the detection of each of said polypeptides into a data analysable form; and optionally iv) providing an output for the analysed data.
- the output from the assay is analysed by application of the algorithm:
- a method to determine whether a female subject would benefit from in vitro fertility treatment comprising the steps of: i) providing an isolated biological sample from the subject; ii) detecting the presence in said biological sample of at least three polypeptides wherein said polypeptides are encoded by a nucleic acid molecule selected from the group consisting of: a) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 1; b) a nucleic acid molecule that hybridises the a nucleic acid molecule in (a) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with inhibin B; c) a nucleic acid molecule comprising a nucleic acid sequence as represented in Figure 2; d) a nucleic acid molecule that hybridises the a nucleic acid molecule in (c) under stringent hybridisation conditions and that encodes a polypeptide that has the biological activity associated with anti-mul
- said output is compared to output from a female subject(s) that have a normal ovarian reserve index; preferably said output is compared to a female subject that successfully completed in vitro fertilisation.
- the output from the assay is analysed by application of the algorithm:
- kits comprising: an antibody that binds follicle stimulating hormone; an antibody that binds anti-Mullerian hormone and an antibody that binds inhibin B.
- said kit further comprises a storage container for the collection and storage of an isolated biological sample; and optionally a skin puncture device.
- the kit is contained within a container.
- said container is sealed to protect the kit components.
- said kit is for the isolation of blood samples.
- Figure Ia is the nucleic acid sequence of human inhibin B
- Figure Ib is the amino acid sequence of inhibin B
- Figure 2a is the nucleic acid sequence of human AMH
- Figure 2b is the amino acid sequence of human AMH
- Figure 3a is the nucleic acid sequence of human FSH
- Figure 3b is the amino acid sequence of human FSH
- Figure 4a is a ROC curve illustrating measurement of FSH concentration and IFV cycle cancellation
- Figure 4b is a ROC curve illustrating measurement of estradiol concentration and cycle cancellation
- Figure 4c is a ROC curve illustrating measurement of inhibin B concentration on day 2 (post GnRH agonist administration) and cycle cancellation
- Figure 4d is a ROC curve illustrating measurement of inhibin B concentration on day 3 (post GnRH agonist administration) and cycle cancellation
- Figure 4e is a ROC curve illustrating measurement of AFC concentration and poor response to IVF treatment
- Figure 4f is a ROC curve illustrating mean ovarian volume and cycle cancellation
- Figure 4g is a ROC curve illustrating measurement AMH concentration and cycle cancellation.
- E2 levels to obtain a ratio the GAST test (Winslow et al. 1991).
- the difference in E2 levels between day 3 and 2 was calculated by subtracting the day 2 from the day 3 level (Padilla et al. 1990).
- buserelin 0.5mg
- rFSH 250IU Puregon®; Organon, Cambridge, UK
- rFSH 250IU Puregon®; Organon, Cambridge, UK
- hCG Pregnyl; Organon, Cambridge, UK
- transvaginal oocyte recovery performed -36 hours later.
- Embryo transfer was performed 2 or 3 days following oocyte recovery. Luteal support was provided with progesterone pessaries (Cyclogest, Alphapharma, Barnstaple, UK) 400mg/day.
- Cycle cancellation was recommended if 3 or less mature (>14mm) follicles developed in response to stimulation and the lead follicle was already 18mm or more. However some couples chose to proceed with oocyte collection against medical advice. If a couple were advised to cancel the cycle an intra-uterine insemination (IUI) was offered if appropriate (patent tubes and adequate sperm concentration and motility).
- IUI intra-uterine insemination
- a clinical pregnancy was defined as the presence of foetal cardiac activity on ultrasound between 6-8 weeks gestation.
- An ongoing pregnancy was defined as the presence of foetal cardiac activity beyond 12 weeks gestation.
- Hormonal Assays FSH, LH and E2 levels were determined using an automated multi-analysis system with chemiluminescence detection (Adiva Centaur; Bayer, Newbury, UK).
- FSH functional sensitivity was 0.3 IU/Land intra- and inter-assay variability were ⁇ 3%.
- estradiol functional sensitivity was 26 pmol/L and intra- and inter-assay variability were ⁇ 11 and 7% respectively.
- Inhibin B samples were assayed in duplicate using a commercial ELISA kit (Oxford Bio- Innovation Ltd, Oxford, UK) according to the manufacturer's protocol.
- the sensitivity of the assay is 15 pg/mL.
- the intra- and inter-assay variability were ⁇ 7%.
- Anti-Mullerian Hormone samples were assayed in duplicate using a commercial ELISA kit (Lnmunotech, Beckman Coulter UK Ltd, High Wycombe, Buckinghamshire, UK) according to the manufacturer's protocol.
- the sensitivity of the assay is 0.24ng/ml.
- the intra- and inter-assay variability were ⁇ 5 and 8% respectively.
- Table 1 Baseline, treatment and outcome characteristics
- P values are for comparison between cancelled and not cancelled patients.
- FSH levels were high in all groups with the overall mean being 10 IU/1. Many clinics would use a level of lOIU/1 to deicide on whether to proceed with treatment. This indicates that we were reasonably inclusive when making decisions on whether to proceed with treatment. It also emphasises that this is a unique group of patients and not a good prognosis group.
- P values are for comparison between cancelled and not cancelled patients.
- Ratio E2 rise day 3 0.60 ⁇ 2.0 54 64 1.5 0.6 to 3
- Table 3 depicts ROC AUCs, sensitivity, specificity, LRs and statistical significance for the ovarian reserve markers studied in relation to cycle cancellation.
- the variables that were predictive of cycle cancellation included the day 3 estradiol level, inhibin B (both day 2 and 3 levels), AMH and mean ovarian volume.
- the exceptions were the baseline FSH, ratio of E2 rise (GAST) and, unexpectedly, the AFC.
- Table 4 depicts the various ovarian reserve markers studied as predictors of a poor response to simulation. The cut-off used to assess each factor was the same as that determined by the ROC curve for cycle cancellation. Inhibin B (day 2 and 3 levels), AMH and mean ovarian volume were all good predictors of both cycle cancellation and a poor response to stimulation. Although the E2 rise (GAST) and the AFC were not predictive of cycle cancellation they were predictive of a poor response. Just as baseline FSH levels were not predictive of cycle cancellation, neither were they predictive of a poor response.
- the mean baseline FSH level for the cycle studied was 8.3 (SD ⁇ 2.3) [Table 2].
- the highest baseline FSH in this study was 14.2 IU/1.
- the mean baseline inhibin B level was 58 pg/mL (SD ⁇ 55).
- the mean inhibin B level on day 3 was 116 pg/mL (SD ⁇ 88).
- the mean sum of inhibin B was 173 pg/mL (SD ⁇ 135).
- Table 4
- Inhibin B levels were not able to predict pregnancy. Baseline, day 3 and the inhibin sum were all unable to discriminate between those who did and did not become pregnant (P >0.5 for all). [Table 6]
- the mean ovarian volume was 8.OmL (SD ⁇ 3.9).
Abstract
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Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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GB0821417A GB2451396A (en) | 2006-04-27 | 2007-04-26 | Fertility test based on measuring inhibin B, AMH, and FSH |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
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US79517506P | 2006-04-27 | 2006-04-27 | |
GB0608305.9 | 2006-04-27 | ||
GB0608305A GB0608305D0 (en) | 2006-04-27 | 2006-04-27 | Hormone Test |
US60/795,175 | 2006-04-27 |
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WO2007125317A1 true WO2007125317A1 (en) | 2007-11-08 |
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PCT/GB2007/001514 WO2007125317A1 (en) | 2006-04-27 | 2007-04-26 | Fertility test based on measuring inhibin b, amh, and fsh |
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WO (1) | WO2007125317A1 (en) |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20090275060A1 (en) * | 2008-05-05 | 2009-11-05 | Cornell University | Determination of serum anti-mullerian hormone as a diagnostic test for spay in companion animals |
CN104730247A (en) * | 2015-03-12 | 2015-06-24 | 广州市丰华生物工程有限公司 | Kit suitable for rapidly detecting AMH and INHB by using double-tagging time resolution fluorescence immunoassay method and use method of kit |
US9260759B2 (en) * | 2007-03-22 | 2016-02-16 | The General Hospital Corporation | Pyrazoloanthrone and derivatives thereof for the treatment of cancers expressing MISRII |
CN109799349A (en) * | 2019-03-13 | 2019-05-24 | 石家庄洹众生物科技有限公司 | A kind of fluorescence immunoassay test strips for combining quantitative detection Ovary reserve many index |
CN111596076A (en) * | 2020-06-04 | 2020-08-28 | 昆明天沃生物科技有限公司 | Method for detecting sheep fertility |
CN111596074A (en) * | 2020-06-04 | 2020-08-28 | 昆明天沃生物科技有限公司 | Method for detecting fertility of cattle |
CN112908475A (en) * | 2021-04-22 | 2021-06-04 | 北京大学第三医院(北京大学第三临床医学院) | System for assessing ovarian reserve function in a subject |
CN114913972A (en) * | 2021-12-10 | 2022-08-16 | 北京大学第三医院(北京大学第三临床医学院) | System for predicting the number of oocytes obtained during ovarian stimulation of a subject |
-
2007
- 2007-04-26 WO PCT/GB2007/001514 patent/WO2007125317A1/en active Application Filing
- 2007-04-26 GB GB0821417A patent/GB2451396A/en not_active Withdrawn
Non-Patent Citations (4)
Title |
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BELVILLE C ET AL: "Mutations of the Anti-Mullerian Hormone Gene in Patients with Persistent Mullerian Duct Syndrome: Biosynthesis, Secretion and Processing of the Abnormal Proteins and Analysis Using a three-Dimensional Model", MOLECULAR ENDOCRINOLOGY, BALTIMORE, MD, US, vol. 18, no. 3, 2004, pages 708 - 721, XP003004133, ISSN: 0888-8809 * |
MUTTUKRISHNA SHANTHI ET AL: "Inhibin B and anti-Mullerian hormone: markers of ovarian response in IVF/ICSI patients?", BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY NOV 2004, vol. 111, no. 11, November 2004 (2004-11-01), pages 1248 - 1253, XP002450392, ISSN: 1470-0328 * |
PASTOR ET AL: "Pilot study investigating the age-related decline in ovarian function of regularly menstruating normal women", FERTILITY AND STERILITY, ELSEVIER SCIENCE INC, NEW YORK, NY, US, vol. 84, no. 5, November 2005 (2005-11-01), pages 1462 - 1469, XP005151603, ISSN: 0015-0282 * |
VAN ROOIJ ET AL: "Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: A longitudinal study", FERTILITY AND STERILITY, ELSEVIER SCIENCE INC, NEW YORK, NY, US, vol. 83, no. 4, April 2005 (2005-04-01), pages 979 - 987, XP005526625, ISSN: 0015-0282 * |
Cited By (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9260759B2 (en) * | 2007-03-22 | 2016-02-16 | The General Hospital Corporation | Pyrazoloanthrone and derivatives thereof for the treatment of cancers expressing MISRII |
US20090275060A1 (en) * | 2008-05-05 | 2009-11-05 | Cornell University | Determination of serum anti-mullerian hormone as a diagnostic test for spay in companion animals |
US9513300B2 (en) * | 2008-05-05 | 2016-12-06 | Cornell University | Determination of serum anti-mullerian hormone as a diagnostic test for spay in companion animals |
CN104730247A (en) * | 2015-03-12 | 2015-06-24 | 广州市丰华生物工程有限公司 | Kit suitable for rapidly detecting AMH and INHB by using double-tagging time resolution fluorescence immunoassay method and use method of kit |
CN109799349A (en) * | 2019-03-13 | 2019-05-24 | 石家庄洹众生物科技有限公司 | A kind of fluorescence immunoassay test strips for combining quantitative detection Ovary reserve many index |
CN111596076A (en) * | 2020-06-04 | 2020-08-28 | 昆明天沃生物科技有限公司 | Method for detecting sheep fertility |
CN111596074A (en) * | 2020-06-04 | 2020-08-28 | 昆明天沃生物科技有限公司 | Method for detecting fertility of cattle |
CN112908475A (en) * | 2021-04-22 | 2021-06-04 | 北京大学第三医院(北京大学第三临床医学院) | System for assessing ovarian reserve function in a subject |
CN114913972A (en) * | 2021-12-10 | 2022-08-16 | 北京大学第三医院(北京大学第三临床医学院) | System for predicting the number of oocytes obtained during ovarian stimulation of a subject |
CN114913972B (en) * | 2021-12-10 | 2023-12-01 | 北京大学第三医院(北京大学第三临床医学院) | System for predicting the number of oocytes obtained during ovarian stimulation of a subject |
Also Published As
Publication number | Publication date |
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GB2451396A (en) | 2009-01-28 |
GB0821417D0 (en) | 2008-12-31 |
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