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https://www.readbyqxmd.com/read/28169189/ovarian-stimulation-protocols-for-ivf-is-more-better-than-less
#1
REVIEW
Michael M Alper, Bart C Fauser
Conventional ovarian stimulation protocols for IVF are designed to achieve maximum oocyte yields. Conventional protocols, however, are associated with patient discomfort, increased risk of ovarian hyperstimulation syndrome and higher costs. In recent years, mild stimulation protocols have risen in popularity. These protocols typically use lower doses (≤150 IU/day), shorter duration of exogenous gonadotrophins, or both, compared with conventional protocols, with the goal of limiting the number of retrieved oocytes to less than eight...
January 24, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28122315/intrauterine-insemination-no-more-mr-n-i-c-e-guy
#2
Minna E Geisler, Mark Ledwidge, Margaret Bermingham, Mary McAuliffe, Moya B McMenamin, John J Waterstone
OBJECTIVE: To determine the per cycle chance of a live birth and to identify factors that may support a more individualised application of IUI in view of National Institute for Health and Care Excellence (NICE) updated guideline on fertility 2013. STUDY DESIGN: A retrospective, cohort study of 851 couples (1688 cycles) with unexplained, mild endometriosis, one patent Fallopian tube (with ovulation occurring in the corresponding ovary), mild male factor or ovulatory dysfunction, who initiated their first cycle of IUI/COH during the study period 2009-2013 and completed up to 3 cycles...
January 18, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28119950/optimizing-inflammatory-bowel-disease-for-successful-in-vitro-fertilization
#3
Jason J Pan, Mora Cannon, Edward Kane, Gauree Konijeti
We present a nulliparous woman with mild to moderate ulcerative colitis (UC) and multiple failed cycles of in vitro fertilization (IVF) in whom we achieved a successful, viable pregnancy following clinical and endoscopic UC remission. Infertile patients with inflammatory bowel disease who have failed multiple cycles of IVF should try to achieve clinical remission and mucosal healing (absence of erosions or ulcers) prior to reattempting conception. Furthermore, deficiencies in vitamin B12, vitamin D, and iron should be addressed...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28112384/surgery-for-tubal-infertility
#4
REVIEW
Su Jen Chua, Valentine A Akande, Ben Willem J Mol
BACKGROUND: Surgery remains an acceptable treatment modality for tubal infertility despite the rise in usage of in vitro fertilisation (IVF). Estimated livebirth rates after surgery range from 9% for women with severe tubal disease to 69% for those with mild disease; however, the effectiveness of surgery has not been rigorously evaluated in comparison with other treatments such as IVF and expectant management (no treatment). Livebirth rates have not been adequately assessed in relation to the severity of tubal damage...
January 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27998009/endometriosis-associated-infertility-aspects-of-pathophysiological-mechanisms-and-treatment-options
#5
REVIEW
Tom Tanbo, Peter Fedorcsak
Endometriosis is a common condition in women of reproductive age. In addition to pain, endometriosis may also reduce fertility. The causes of infertility in women with endometriosis may range from anatomical distortions due to adhesions and fibrosis to endocrine abnormalities and immunological disturbances. In some cases, the various pathophysiological disturbances seem to interact through mechanisms so far not fully understood. Whether surgery should be offered as a treatment option in endometriosis-associated infertility has become controversial, partly due to its modest or undocumented effect...
December 20, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27960134/individualised-gonadotrophin-ovulation-induction-in-women-with-normogonadotrophic-anovulatory-infertility-a-prospective-observational-study
#6
Mette Petri Lauritsen, Anne Loft, Anja Pinborg, Nina la Cour Freiesleben, Arieh Cohen, Jørgen Holm Petersen, Anne Lis Mikkelsen, Marianne Rich Bjerge, Anders Nyboe Andersen
OBJECTIVE: The aim of this study was to evaluate an individualised gonadotrophin starting dose regimen for women with anovulatory infertility. STUDY DESIGN: We included 71 normogonadotrophic anovulatory infertile women in a prospective, observational study. All underwent one ovulation induction cycle in a flexible, low-dose step-up protocol. The gonadotrophin starting dose (75-150IU/day) was individualised according to a nomogram incorporating menstrual cycle pattern (oligo- or amenorrhoea), BMI, and mean ovarian volume...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27933606/relaxin-like-peptides-in-male-reproduction-a-human-perspective
#7
REVIEW
Richard Ivell, Alexander I Agoulnik, Ravinder Anand-Ivell
The relaxin family of peptide hormones and their cognate G-protein coupled receptors are becoming physiologically well characterized in the cardiovascular system and particularly in female reproductive processes. Much less is known about the physiology and pharmacology of these peptides in male reproduction, particularly as regards the human. H2-relaxin is involved in prostate function and growth, while INSL3 is a major product of the testicular Leydig cells and in the adult appears to modulate steroidogenesis and germ cell survival...
December 9, 2016: British Journal of Pharmacology
https://www.readbyqxmd.com/read/27905697/management-of-infertile-women-with-pelvic-endometriosis-a-literature-review
#8
Elisabeth Guinard, Pierre Collinet, Catherine Lefebvre, Geoffroy Robin, Chrystele Rubod
INTRODUCTION: Endometriosis is a condition that affects women's fertility. Several mechanisms are involved in this process: anatomical changes, mechanical, immune or inflammatory factors, ovarian reserve alterations. There are different types of strategies to treat endometriosis-related infertility: medical treatment, surgical treatment and / or techniques of medically assisted procreation. EVIDENCE ACQUISITION: We tried to consider various therapeutic strategies depending on the stage of the disease in order to offer appropriate management to patients with endometriosis who wish to become pregnant: we reviewed 58 articles between 1985 to 2016 searching in medline using the key words "endometriosis and infertility" and "infertility and endometriosis treatment"...
December 1, 2016: Minerva Ginecologica
https://www.readbyqxmd.com/read/27901279/dopamine-agonists-for-preventing-ovarian-hyperstimulation-syndrome
#9
REVIEW
Huilin Tang, Selma Mourad, Suo-Di Zhai, Roger J Hart
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). It is characterised by enlarged ovaries and an acute fluid shift from the intravascular space to the third space, resulting in bloating, increased risk of venous thromboembolism and decreased organ perfusion. Most cases are mild, but forms of moderate or severe OHSS appear in 3% to 8% of in vitro fertilisation (IVF) cycles. The dopamine agonist cabergoline was introduced as a secondary prevention intervention for OHSS in women at high risk of OHSS undergoing ART treatment...
30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27884883/bilateral-ureteric-obstruction-during-in-vitro-fertilisation-therapy-in-a-patient-with-complex-surgically-managed-crohn-s-disease
#10
Christopher Charles Khoo, Nikhil Ahluwalia, Jan Grace, Arun Sahai
A 37-year-old woman receiving in vitro fertilisation (IVF) treatment presented with lethargy, fevers and anuria. Her background included complex surgically managed Crohn's disease and mild right-sided hydronephrosis (with no evidence of obstruction on MAG3 renogram). On examination, she had a distended abdomen with generalised tenderness. Blood tests revealed an acute kidney injury and confirmed sepsis. She was found to have bilateral ureteric obstruction with worsening of the right-sided hydronephrosis and new-onset left-sided hydronephrosis secondary to bilateral ovarian masses, diagnosed as mild ovarian hyperstimulation syndrome (OHSS)...
November 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27836979/a-mild-ovarian-stimulation-strategy-in-women-with-poor-ovarian-reserve-undergoing-ivf-a-multicenter-randomized-non-inferiority-trial
#11
M A Youssef, M van Wely, H Al-Inany, T Madani, N Jahangiri, S Khodabakhshi, M Alhalabi, M Akhondi, S Ansaripour, R Tokhmechy, L Zarandi, A Rizk, M El-Mohamedy, E Shaeer, M Khattab, M H Mochtar, F van der Veen
STUDY QUESTION: In subfertile women with poor ovarian reserve undergoing IVF does a mild ovarian stimulation strategy lead to comparable ongoing pregnancy rates in comparison to a conventional ovarian stimulation strategy? SUMMARY ANSWER: A mild ovarian stimulation strategy in women with poor ovarian reserve undergoing IVF leads to similar ongoing pregnancy rates as a conventional ovarian stimulation strategy. WHAT IS KNOWN ALREADY: Women diagnosed with poor ovarian reserve are treated with a conventional ovarian stimulation strategy consisting of high-dose gonadotropins and pituitary downregulation with a long mid-luteal start GnRH-agonist protocol...
January 2017: Human Reproduction
https://www.readbyqxmd.com/read/27825533/no-need-for-luteal-phase-support-in-ivf-cycles-after-mild-stimulation-proof-of-concept-study
#12
Anna Pia Ferraretti, Paul Devroey, M Cristina Magli, Luca Gianaroli
This is a pilot study performed in a private IVF unit. The objective of the study was to investigate whether luteal support is required in IVF cycles after mild stimulation with clomiphene citrate and low FSH doses. The study included 15 patients with good prognosis (defined as ≤38 years old with normal ovarian reserve and normovulatory cycles, body mass index <29 kg/m(2), no previous cycles, no severe endometriosis, no history of recurrent miscarriage, no endocrine/autoimmune diseases and no surgical semen extraction from the partner) undergoing IVF with mild stimulation...
February 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/27803584/gonadotropin-releasing-hormone-agonist-trigger-is-a-better-alternative-than-human-chorionic-gonadotropin-in-pcos-undergoing-ivf-cycles-for-an-ohss-free-clinic-a-randomized-control-trial
#13
Deepika Krishna, Snehal Dhoble, Gautham Praneesh, Suvarna Rathore, Amit Upadhaya, Kamini Rao
OBJECTIVE: The objective of this study is to evaluate if gonadotropin-releasing hormone agonist (GnRHa) trigger is a better alternative to human chorionic gonadotropin (hCG) in polycystic ovary syndrome (PCOS) of Indian origin undergoing in vitro fertilization (IVF) cycles with GnRH antagonist for the prevention of ovarian hyperstimulation syndrome (OHSS). DESIGN: Prospective randomized control trial. SETTING: Tertiary care center. MATERIALS AND METHODS: A total of 227 patients diagnosed with PCOS, undergoing IVF in an antagonist protocol were recruited and randomly assigned into two groups: Group A (study group): GnRHa trigger 0...
July 2016: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/27664205/iui-and-ivf-for-unexplained-subfertility-where-did-we-go-wrong
#14
R I Tjon-Kon-Fat, A J Bensdorp, I Scholten, S Repping, M van Wely, B W J Mol, F van der Veen
IUI is a first-line treatment for couples with unexplained or mild male subfertility and has become one of the most widely used fertility-enhancing treatments. The results of a recent trial comparing IVF to IUI, demonstrating similar live birth rates, have been used to build a case supporting the effectiveness of IUI. Yet, this conclusion might be somewhat premature, as the superiority of neither IUI nor IVF over no treatment has ever been proven. The evidence on the effectiveness and safety of IUI and IVF has been evaluated in two Cochrane reviews which both suggested that there is insufficient evidence to conclude that IUI or IVF is effective compared to sexual intercourse in couples with unexplained subfertility...
December 2016: Human Reproduction
https://www.readbyqxmd.com/read/27662901/myeloperoxidase-as-a-potential-target-in-women-with-endometriosis-undergoing-ivf
#15
Nalini Santanam, Nathaniel Zoneraich, Sampath Parthasarathy
As infertility is intimately associated with endometriosis, the levels of myeloperoxidase (MPO), a leukocyte enzyme and an oxidative stress marker, were determined in a case-control prospective study of 68 women with and without endometriosis undergoing in vitro fertilization in the outpatient fertility center within a tertiary care academic medical center. Measured values included plasma and follicular fluid (FF) concentrations of MPO, plasma estradiol, as well as oocyte quality, fertilization, implantation, and pregnancy rates in these women...
September 22, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27651720/factors-affecting-clinical-pregnancy-rates-after-iui-for-the-treatment-of-unexplained-infertility-and-mild-male-subfertility
#16
Melahat Atasever, Müberra Namlı Kalem, Şafak Hatırnaz, Ebru Hatırnaz, Ziya Kalem, Zeynep Kalaylıoğlu
OBJECTIVE: The aim of the present retrospective study was to evaluate intrauterine insemination (IUI) clinical experiences and to define the variables for predicting success. MATERIAL AND METHODS: The present study was an observational trial performed in a private IVF center on subfertile couples who had applied for treatment between 2002 and 2012, in which the data of 503 IUI cases were retrospectively reviewed. Couples who had been diagnosed with unexplained and mild male subfertility were included...
2016: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/27645154/adenomyosis-in-infertile-women-prevalence-and-the-role-of-3d-ultrasound-as-a-marker-of-severity-of-the-disease
#17
J M Puente, A Fabris, J Patel, A Patel, M Cerrillo, A Requena, J A Garcia-Velasco
BACKGROUND: Adenomyosis is linked to infertility, but the mechanisms behind this relationship are not clearly established. Similarly, the impact of adenomyosis on ART outcome is not fully understood. Our main objective was to use ultrasound imaging to investigate adenomyosis prevalence and severity in a population of infertile women, as well as specifically among women experiencing recurrent miscarriages (RM) or repeated implantation failure (RIF) in ART. METHODS: Cross-sectional study conducted in 1015 patients undergoing ART from January 2009 to December 2013 and referred for 3D ultrasound to complete study prior to initiating an ART cycle, or after ≥3 IVF failures or ≥2 miscarriages at diagnostic imaging unit at university-affiliated private IVF unit...
September 20, 2016: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/27628955/in-vitro-fertilization-versus-mild-stimulation-intrauterine-insemination-in-women-aged-40-and-older
#18
Laurice Bou Nemer, Vanessa N Weitzman, Kristopher L Arheart, Marcelo J Barrionuevo, Daniel R Christie, Youssef Mouhayar, David I Hoffman, Wayne S Maxson, Steven J Ory
INTRODUCTION: The objective of this study was to compare clinical pregnancy rates (PRs) and pregnancy outcomes (POs) in patients undergoing in vitro fertilization (IVF) and a specific controlled ovarian hyperstimulation (mild-stimulation or mini-stim) and intrauterine insemination (IUI) protocol in women older than 40. METHODS: It is a retrospective chart review of 770 cycles of all women aged 40 and older who underwent a first cycle of either IVF or mini-stim IUI between the years 2007 and 2012 at a single infertility center...
September 14, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27627604/endometriosis-has-no-negative-impact-on-outcomes-of-in-vitro-fertilisation-in-women-with-poor-ovarian-response
#19
X Yang, R Huang, M Cai, X Liang
OBJECTIVE: To compare the in vitro fertilisation (IVF) outcomes of poor ovarian responders among women with laparoscopically diagnosed minimal-mild endometriosis (Group A), moderate-severe endometriosis (Group B) and those without endometriosis (Group C). The comparisons were made separately for age groups younger than 35 years and 35 years or older. DESIGN: Retrospective study. SETTING: A university-affiliated hospital in Guangzhou, China...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27577848/volume-expanders-for-the-prevention-of-ovarian-hyperstimulation-syndrome
#20
REVIEW
Mohamed A Youssef, Selma Mourad
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially fatal complication of ovarian stimulation which affects 1% to 14% of all in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles. A number of clinical studies with conflicting results have reported on the use of plasma expanders such as albumin, hydroxyethyl starch (HES), mannitol, polygeline and dextran as a possible intervention for the prevention of OHSS. Women with very high estradiol levels, high numbers of follicles or oocytes retrieved, and women with polycystic ovary syndrome (PCOS), are at particularly high risk of developing OHSS...
August 31, 2016: Cochrane Database of Systematic Reviews
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