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https://www.readbyqxmd.com/read/29121350/individualized-fsh-dosing-based-on-ovarian-reserve-testing-in-women-starting-ivf-icsi-a-multicentre-trial-and-cost-effectiveness-analysis
#1
Theodora C van Tilborg, Simone C Oudshoorn, Marinus J C Eijkemans, Monique H Mochtar, Ron J T van Golde, Annemieke Hoek, Walter K H Kuchenbecker, Kathrin Fleischer, Jan Peter de Bruin, Henk Groen, Madelon van Wely, Cornelis B Lambalk, Joop S E Laven, Ben Willem J Mol, Frank J M Broekmans, Helen L Torrance
STUDY QUESTION: Is there a difference in live birth rate and/or cost-effectiveness between antral follicle count (AFC)-based individualized FSH dosing or standard FSH dosing in women starting IVF or ICSI treatment? SUMMARY ANSWER: In women initiating IVF/ICSI, AFC-based individualized FSH dosing does not improve live birth rates or reduce costs as compared to a standard FSH dose. WHAT IS KNOWN ALREADY: In IVF or ICSI, ovarian reserve testing is often used to adjust the FSH dose in order to normalize ovarian response and optimize live birth rates...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29121269/individualized-versus-standard-fsh-dosing-in-women-starting-ivf-icsi-an-rct-part-2-the-predicted-hyper-responder
#2
Simone C Oudshoorn, Theodora C van Tilborg, Marinus J C Eijkemans, G Jur E Oosterhuis, Jaap Friederich, Marcel H A van Hooff, Evert J P van Santbrink, Egbert A Brinkhuis, Jesper M J Smeenk, Janet Kwee, Corry H de Koning, Henk Groen, Cornelis B Lambalk, Ben Willem J Mol, Frank J M Broekmans, Helen L Torrance
STUDY QUESTION: Does a reduced FSH dose in women with a predicted hyper response, apparent from a high antral follicle count (AFC), who are scheduled for IVF/ICSI lead to a different outcome with respect to cumulative live birth rate and safety? SUMMARY ANSWER: Although in women with a predicted hyper response (AFC > 15) undergoing IVF/ICSI a reduced FSH dose (100 IU per day) results in similar cumulative live birth rates and a lower occurrence of any grade of ovarian hyperstimulation syndrome (OHSS) as compared to a standard dose (150 IU/day), a higher first cycle cancellation rate and similar severe OHSS rate were observed...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29100809/comments-on-the-eshre-recommendations-for-the-treatment-of-minimal-endometriosis-in-infertile-women
#3
Angelos Daniilidis, George Pados
According to ESHRE recommendations for women with stage I/II endometriosis, if a decision is made to proceed to laparoscopy then operative laparoscopy (excision or ablation of the endometriotic lesions) should be performed rather than only diagnostic laparoscopy, to increase ongoing pregnancy rates. Also, for infertile women with stage I/II endometriosis doctors may consider complete surgical removal of endometriosis to improve live birth rate prior to assisted reproductive treatment. This last recommendation is not well established...
October 23, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29046194/the-role-of-intravenous-access-during-oral-food-challenges-in-food-protein-induced-enterocolitis-syndrome
#4
Laura E Pena, Danielle Guffey, Charles G Minard, Sara Anvari, Carla M Davis
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E mediated food hypersensitivity syndrome characterized by profuse vomiting and diarrhea, which leads to lethargy, dehydration, and hypotension. Given the potential severity of reactions, resolution of FPIES is confirmed via oral food challenge (OFC) during which intravenous (IV) access is recommended to facilitate IV fluids (IVF) and steroid therapy. Risk factors for IV treatment are not well characterized...
November 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28965552/development-of-in%C3%A2-vitro-maturation-techniques-for-clinical-applications
#5
REVIEW
Zhi-Yong Yang, Ri-Cheng Chian
In vitro maturation (IVM) refers to maturation in culture of immature oocytes at different stages that may or may not have been exposed to short courses of gonadotropins. The source of immature oocytes is an important feature for subsequent embryonic development, pregnancy, and healthy live births. IVM is an effective treatment that has already achieved significant outcomes of acceptable pregnancy and implantation rates and has led to the births of several thousand healthy babies. As the development of IVM treatment continues, an attractive possibility for improving the already successful outcome is to combine a natural-cycle in vitro fertilization (IVF) treatment with immature-oocyte retrieval followed by IVM of those immature oocytes...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28965550/in%C3%A2-vitro-fertilization-treatments-with-the-use-of-clomiphene-citrate-or-letrozole
#6
REVIEW
Jigal Haas, Robert F Casper
There has been increasing interest in combining the oral agents clomiphene citrate (CC) and letrozole with gonadotropins in IVF: for poor responders to reduce the amount of gonadotropins used, and in normal responders to reduce the incidence of ovarian hyperstimulation (OHSS). In normal responders, mild stimulation with the use of CC and gonadotropins was found to decrease the number of oocytes retrieved and result in good pregnancy rates, but in most studies the cumulative pregnancy rate was lower compared with conventional ovarian stimulation when frozen embryo transfers were considered...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28965549/mild-stimulation-for-in%C3%A2-vitro-fertilization
#7
REVIEW
Geeta Nargund, Adrija Kumar Datta, Bart C J M Fauser
It has been proven that the use of high gonadotropin dose does not necessarily improve the final outcome of IVF. Mild ovarian stimulation is based on the principle of optimal utilization of competent oocytes/embryos and endometrial receptivity. There is growing evidence that the pregnancy or live birth rates with mild-stimulation protocols are comparable to those with conventional IVF; the cumulative pregnancy outcome has been shown to be no different, despite having fewer numbers of oocytes or embryos available with milder ovarian stimulation...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28948397/neonatal-outcomes-and-congenital-malformations-in-children-born-after-human-menopausal-gonadotropin-and-medroxyprogesterone-acetate-treatment-cycles
#8
Jie Zhang, Xiaoyan Mao, Yun Wang, Qiuju Chen, Xuefeng Lu, Qingqing Hong, Yanping Kuang
PURPOSE: To investigate neonatal outcomes and congenital malformations in children born after in vitro fertilization (IVF) and vitrified embryo transfer cycles using human menopausal gonadotrophin and medroxyprogesterone acetate (hMG + MPA) treatment. METHODS: We performed a retrospective cohort study including 4596 live born babies. During January 2014-June 2016, children born after either hMG + MPA treatment, gonadotropin releasing hormone agonist short protocol, or mild ovarian stimulation were included...
December 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28911928/introduction-contemporary-approaches-to-alternative-ovarian-stimulation-strategies-for-in%C3%A2-vitro-fertilization
#9
Richard J Paulson
In the current practice of IVF, the vast majority of cycles use some form of controlled ovarian stimulation before egg retrieval to increase the number of embryos available for transfer or cryopreservation. However, the optimal stimulation regimen has not been established. This month's Views and Reviews presents five different approaches to alternative ovarian stimulation strategies. These include mild stimulation regimens, modified natural cycles, stimulation with oral agents, in vitro maturation (in the absence of stimulation), and finally, a proposal for patient-tailored ovarian stimulation...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28878823/a-de-novo-complex-chromosome-rearrangement-associated-with-multisystematic-abnormalities-a-case-report
#10
Chan Tian, Dan Li, Ping Liu, Liping Jiao, Xuefeng Gao, Jie Qiao
BACKGROUND: Complex chromosomal rearrangements (CCRs) are constitutional structural rearrangements that involve three or more chromosomes or that have more than two breakpoints. CASE PRESENTATION: Here, we describe a four-way CCR involving chromosomes 4, 5, 6 and 8. The patient had mild multisystematic abnormalities during his development, including defects in his eyes and teeth, exomphalos and asthenozoospermia. His wife had two spontaneous abortions during the first trimester...
2017: Molecular Cytogenetics
https://www.readbyqxmd.com/read/28874259/outcomes-from-a-university-based-low-cost-in%C3%A2-vitro-fertilization-program-providing-access-to-care-for-a-low-resource-socioculturally-diverse-urban-community
#11
Christopher N Herndon, Yanett Anaya, Martha Noel, Hakan Cakmak, Marcelle I Cedars
OBJECTIVE: To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. DESIGN: Retrospective cohort study. SETTING: Academic infertility center. PATIENT(S): Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28701212/is-the-oocyte-quality-affected-by-endometriosis-a-review-of-the-literature
#12
REVIEW
Ana Maria Sanchez, Valeria Stella Vanni, Ludovica Bartiromo, Enrico Papaleo, Eran Zilberberg, Massimo Candiani, Raoul Orvieto, Paola Viganò
Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period causing infertility and pelvic pain. The disease, especially at the ovarian site has been shown to have a detrimental impact on ovarian physiology. Indeed, sonographic and histologic data tend to support the idea that ovarian follicles of endometriosis patients are decreased in number and more atretic. Moreover, the local intrafollicular environment of patients affected is characterized by alterations of the granulosa cell compartment including reduced P450 aromatase expression and increased intracellular reactive oxygen species generation...
July 12, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28645286/the-myths-surrounding-mild-stimulation-in-vitro-fertilization-ivf
#13
REVIEW
Raoul Orvieto, Valeria Stella Vanni, Norbert Gleicher
So-called mild controlled ovarian hyperstimulation (mCOH) has in recent years increased in popularity, claiming to be safer and more patient-friendly, while also improving in vitro fertilization (IVF) outcomes. We here challenge the International Society for Mild Approaches in Assisted Reproduction (ISMAAR) definition of mild stimulation, and especially address four fundamental issues, where our review found conventional COH (cCOH) advantageous over mCOH. They are: prevalence of severe ovarian hyperstimulation syndrome (OHSS), oocyte/embryo quality, pregnancy/live birth rates, and cost...
June 24, 2017: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/28598138/unexplained-infertility-live-birth-s-prognostic-factors-to-determine-the-art-management
#14
Alexandra Ohannessian, Anderson Loundou, Audrey Gnisci, Odile Paulmyer-Lacroix, Jeanne Perrin, Blandine Courbiere
BACKGROUND: The purpose of this retrospective observational study was to identify prognostic factors that lead to a live birth (LB) in couples with unexplained infertility in order to define the best ART strategy. METHODS: Prognostic factors of couples with unexplained infertility managed initially with gonadotropin intrauterine inseminations (IUI) at a single university fertility center were analyzed. Infertility was not considered "unexplained" in case of mild male infertility and suspicion of diminished ovarian reserve (FSH>10IU/L)...
June 9, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28508683/effectiveness-of-mild-ovarian-stimulation-versus-gnrh-agonist-protocol-in-women-undergoing-assisted-reproductive-technology-a-meta-analysis
#15
Yuan Fan, Xiaowei Zhang, Zhidong Hao, Huanfei Ding, Quanyu Chen, Li Tian
OBJECTIVE: our meta-analysis was conducted to evaluate the effectiveness of the mild ovulation induction protocol using CC/gonadotropin/GnRH antagonist compared to the conventional GnRH agonist protocol in women undergoing ART. METHOD: Six electronic databases were searched from their date of establishment until August 2016. Outcomes in our analysis were calculated in terms of relative risk (RR) and weighted mean differences (WMD) and standard mean differences (SMD) with 95% confidence intervals (CI) using random effect models or fixed effect models...
October 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28506514/a-novel-cooling-method-and-comparison-of-active-rewarming-of-mildly-hypothermic-subjects
#16
Mark L Christensen, Grant S Lipman, Dennis A Grahn, Kate M Shea, Joseph Einhorn, H Craig Heller
OBJECTIVE: To compare the effectiveness of arteriovenous anastomosis (AVA) vs heated intravenous fluid (IVF) rewarming in hypothermic subjects. Additionally, we sought to develop a novel method of hypothermia induction. METHODS: Eight subjects underwent 3 cooling trials each to a mean core temperature of 34.8±0.6 (32.7 to 36.3°C) by 14°C water immersion for 30 minutes, followed by walking on a treadmill for 5 minutes. Core temperatures (Δtes) and rates of cooling (°C/h) were measured...
May 11, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28429340/controlled-prospective-observational-study-on-the-efficiency-and-tolerability-of-a-combination-of-potential-nrf2-inducing-antioxidants-and-micronutrients-as-pre-treatment-for-icsi-in-dyspermic-patients-with-previous-failure
#17
MULTICENTER STUDY
R Rago, M Gallo, A Dal Lago, E Licata, G Paciotti, M Amodei, C Meneghini, C Fabiani, G Dani, C Liberanome, D Antonaci, R Corno, D Miriello, G Giuffrida, B Giammusso
OBJECTIVE: To evaluate the efficiency of pre-treatment in dyspermic males in IVF couples with a combination of micronutrients, for the purpose of improving the fertilization rate, the implantation rate and the outcome of the pregnancy. PATIENTS AND METHODS: This controlled prospective clinical study was performed in two medically assisted reproduction centers. 59 males with mild oligo-astheno-teratospermia (OAT) were admitted to the study. All of them had a history of previous in vitro fertilization (IVF) attempts with female partners aged < 40 diagnosed having tubal or idiopathic infertility...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28358705/mild-versus-conventional-ovarian-stimulation-for-poor-responders-undergoing-ivf-icsi
#18
RANDOMIZED CONTROLLED TRIAL
Charalampos Siristatidis, George Salamalekis, Konstantinos Dafopoulos, George Basios, Paraskevi Vogiatzi, Nikolaos Papantoniou
BACKGROUND/AIM: Mild stimulation protocols have been implemented to be offered to subfertile patients who respond poorly to ovarian stimulation. We aimed to compare the efficacy of mild versus conventional gonadotropin-releasing hormone (GnRH)-agonist and antagonist protocols in poor responders undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycles. PATIENTS AND METHODS: A total of 58 poorly-responding patients were divided into two groups: mild group (n=33), receiving clomiphene citrate 100 mg and 0...
March 2017: In Vivo
https://www.readbyqxmd.com/read/28333271/impact-of-thyroid-autoimmunity-in-euthyroid-women-on-live-birth-rate-after-iui
#19
D Unuane, B Velkeniers, B Bravenboer, P Drakopoulos, H Tournaye, J Parra, M De Brucker
Study question: Does thyroid autoimmunity (TAI) predict live birth rate in euthyroid women after one treatment cycle in IUI patients? Summary answer: TAI as such does not influence pregnancy outcome after IUI treatment. What is known already: The role of TAI on pregnancy outcome in the case of IVF/ICSI is largely debated in the literature. This is the first study to address this issue in the case of IUI. Study design, size, duration: This was a retrospective cohort study...
April 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333222/ivf-or-iui-as-first-line-treatment-in-unexplained-subfertility-the-conundrum-of-treatment-selection-markers
#20
COMPARATIVE STUDY
R I Tjon-Kon-Fat, P Tajik, M H Zafarmand, A J Bensdorp, P M M Bossuyt, G J E Oosterhuis, R van Golde, S Repping, M D A Lambers, E Slappendel, D Perquin, M J Pelinck, J Gianotten, J W M Maas, M J C Eijkemans, F van der Veen, B W Mol, M van Wely
STUDY QUESTION: Are there treatment selection markers that could aid in identifying couples, with unexplained or mild male subfertility, who would have better chances of a healthy child with IVF with single embryo transfer (IVF-SET) than with IUI with ovarian stimulation (IUI-OS)? SUMMARY ANSWER: We did not find any treatment selection markers that were associated with better chances of a healthy child with IVF-SET instead of IUI-OS in couples with unexplained or mild male subfertility...
May 1, 2017: Human Reproduction
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