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Mild ovarian stimulation

Rebecca J Gordon, Jennifer Bell, Wendy K Chung, Raphael David, Sharon E Oberfield, Sharon L Wardlaw
PURPOSE: Acromegaly in infancy is extremely rare. We describe a 32 year old woman who presented at 6 months of age with isolated macrocephaly, followed by accelerated linear growth. At 21 months of age, her head circumference was 55 cm (+5.5 SD), height was 97.6 cm (+4.4 SD) and weight was 20.6 kg (+6.2 SD). She had markedly elevated levels of growth hormone (GH) (135 ng/ml), IGF-1 (1540 ng/ml) and prolactin (370 ng/ml). A pituitary macroadenoma was surgically resected. Immunohistochemical staining was positive for GH...
September 8, 2016: Pituitary
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
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...
2016: Cochrane Database of Systematic Reviews
Alexandra J Bensdorp, Raissa Tjon-Kon-Fat, Harold Verhoeve, Carolien Koks, Peter Hompes, Annemieke Hoek, Jan Peter de Bruin, Ben Cohlen, Diederik Hoozemans, Frank Broekmans, Peter van Bomme, Jesper Smeenk, Ben W J Mol, Fulco van der Veen, Madelon van Wely
OBJECTIVE: To compare dropout rates in couples undergoing conventional in vitro fertilization with single embryo transfer (IVF-SET), in vitro fertilization in a modified natural cycle (IVF-MNC) or intrauterine insemination with ovarian stimulation (IUI-OS). STUDY DESIGN: Secondary analysis of a multicentre randomized controlled trial between January 2009 and February 2012. 602 couples with unexplained or mild male subfertility, allocated to IVF-SET (N=201), IVF-MNC (N=194) and IUI-OS (N=207)...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Qingyun Mai, Xiaokun Hu, Gang Yang, Yingyi Luo, Kejun Huang, Yuan Yuan, Canquan Zhou
BACKGROUND: Ovarian hyperstimulation syndrome is an iatrogenic complication of controlled ovarian stimulation. Early ovarian hyperstimulation syndrome occurs during luteal phase of controlled ovarian stimulation within 9 days after human chorionic gonadotropin trigger and reflects an acute consequence of this hormone on the ovaries. Late ovarian hyperstimulation syndrome occurs 10 or more days after human chorionic gonadotropin trigger and reflects increased endogenous human chorionic gonadotropin levels following pregnancy...
August 20, 2016: American Journal of Obstetrics and Gynecology
Hakan Yarali, Mehtap Polat, Sezcan Mumusoglu, Irem Yarali, Gurkan Bozdag
PURPOSE: The purpose of this study was to evaluate the best protocol to prepare endometrium for frozen embryo replacement (FER) cycles. METHODS: This study is a systematic review and meta-analysis. Following PubMed and OvidSP search, a total of 1166 studies published after 1990 were identified following removal of duplicates. Following exclusion of studies not matching our inclusion criteria, a total of 33 studies were analyzed. Primary outcome measure was live birth...
October 2016: Journal of Assisted Reproduction and Genetics
Dan Song, Yichao Shi, Yun Zhong, Qingxia Meng, Shunyu Hou, Hong Li
OBJECTIVE: Our study aims to provide evidence for evaluating the efficiency of mild controlled ovarian hyperstimulation (COH) protocol with clomiphene citrate on ovarian stimulation outcome and pregnancy outcome on poor ovarian respond patients undergoing in vitro fertilization treatment. METHODS: For the current study, a search was carried out for relevant randomized controlled trials (RCTs). This meta-analysis was performed on both COH and pregnancy outcomes following the mild COH protocols (CC/Gn/GnRH antagonist) and conventional COH protocols (Gn/GnRH agonist)...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ingilizova, E Kovachev, D Ivanov, I Kostov, S Ivanov
UNLABELLED: The current study presents the results of a retrospective and prospective observation of the maturity and morphological features of the oocytes and the way they are influenced by the therapeutic approaches and the protocol for controlled ovarian hypersimulation (COH) in patients with low ovarian reserve. MATERIALS AND METHODS: The study includes 184 oocytes, derived from 72 patients with low ovarian reserve involved in an infertility treatment program through in vitro fertilization from February 2011 to February 2014...
2016: Akusherstvo i Ginekologii︠a︡
Gautam N Allahbadia
For women of advanced age with abnormally increased FSH levels, standardized hormonal stimulation often represents a cost-intensive procedure with a low success rate. It is well established now that with mild ovarian stimulation, there is a greater percentage of good-quality eggs (although a smaller number) than with higher-dose conventional stimulation. Mild stimulation protocols reduce the mean number of days of stimulation, the total amount of gonadotropins used and the mean number of oocytes retrieved. The proportion of high-quality and euploid embryos seems to be higher compared with conventional stimulation protocols, and the pregnancy rate per embryo transfer is comparable...
October 2016: Journal of Obstetrics and Gynaecology of India
Robert L Rosenfield, David A Ehrmann
Polycystic ovary syndrome (PCOS) was hypothesized to result from functional ovarian hyperandrogenism (FOH) due to dysregulation of androgen secretion in 1989-1995. Subsequent studies have supported and amplified this hypothesis. When defined as otherwise unexplained hyperandrogenic oligoanovulation, two-thirds of PCOS cases have functionally typical FOH, characterized by 17-hydroxyprogesterone hyperresponsiveness to gonadotropin stimulation. Two-thirds of the remaining PCOS have FOH detectable by testosterone elevation after suppression of adrenal androgen production...
October 2016: Endocrine Reviews
Angela S Martin, Michael Monsour, Jennifer F Kawwass, Sheree L Boulet, Dmitry M Kissin, Denise J Jamieson
Objective To compare the risk of preeclampsia among spontaneously conceived pregnancies to those after hyperestrogenic ovarian stimulation (hyperestrogenic OS) with and without assisted reproductive technology (ART), and stimulation with non-hyperestrogenic aromatase inhibitor stimulation (non-hyperestrogenic OS). Methods Live-born singleton deliveries among women 20-49 years were identified in the 2004-2012 Truven Health MarketScan Commercial Claims and Encounters Databases using ICD-9 and CPT codes. Maternal characteristics were compared using Chi squared and Fisher exact tests...
October 2016: Maternal and Child Health Journal
W Decleer, K Osmanagaoglu, K Verschueren, F Comhaire, P Devroey
STUDY QUESTION: Does a 3-month adjuvant hormonal treatment of mild peritoneal endometriosis after laparoscopic surgery influence the outcome of IVF stimulation in terms of number of mature oocytes obtained per cycle? SUMMARY ANSWER: Complementary medical treatment of mild peritoneal endometriosis does not influence the number of oocytes per treatment cycle. WHAT IS KNOWN ALREADY: Endometriosis is a disease known to be related to infertility...
September 2016: Human Reproduction
D Fischer, C Reisenbüchler, S Rösner, J Haussmann, P Wimberger, M Goeckenjan
The polycystic ovary syndrome is a common endocrine disorder which influences outcome and potential risks involved with controlled ovarian stimulation for artificial reproductive techniques (ART). Concrete practical recommendations for the dosage of gonadotropins, the preferred protocol and preventive methods to avoid ovarian hyperstimulation syndrome (OHSS) are lacking. We present retrospective data of 235 individually calculated gonadotropin low-dose stimulations for ART in a single center from 2012 to 2014...
June 2016: Geburtshilfe und Frauenheilkunde
G Brichant, A Audebert, M Nisolle
Minimal and mild endometriosis (stages I/II) is frequently identified in subfertile patients, especially in case of unexplained infertility. The impact of those lesions on fecundity is still debatted and they have been considered as paraphysiological by some experts. In addition, they are heterogenous with variable spread, biological activity, induced inflammation and, sometimes, the presence of associated mild adhesions. Stages I/II endometriosis are the most frequent endometriotic lesions encountered in subfertile women...
May 2016: Revue Médicale de Liège
Yan Meng, Yi Qian, Cun Huang, Wei Wu, Jiayin Liu
OBJECTIVE: To investigate the suitable fresh embryo transfer strategy for mild ovarian stimulation with clomiphene citrate in vitro fertilization-embryo transfer (IVF-ET). METHODS: The data of the 286 patients for IVF-ET from 1st January, 2013 to 30th June, 2015 in Clinical Center of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed to find the difference of clinical pregnancy rate in different endometrial thickness groups...
December 15, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Keiichi Kato, Naoki Aoyama, Nami Kawasaki, Hiroko Hayashi, Tang Xiaohui, Takashi Abe, Tomoko Kuroda
Forty-six reciprocal and six Robertsonian translocation carrier couples who experienced recurrent pregnancy loss underwent fluorescence in situ hybridization-based preimplantation genetic diagnosis (PGD) for the presence of the two translocated chromosomes. Out of 52 couples, 17 (33%) were undergoing infertility treatment. In total, 239 PGD cycles as oocyte retrieval (OR) were applied. The transferrable rate of negatively diagnosed embryos at the cleavage stage was 26.3%; 71 embryos were transferred as single blastocysts...
August 2016: Journal of Human Genetics
Şafak Hatırnaz, Ebru Hatırnaz, Murat Bakacak, Mehmet Sühha Bostancı, Melahat Atasever
BACKGROUND: Repeated in vitro Fertilization (IVF) failure together with Ovarian Hyperstimulation Syndrome (OHSS) is one of the distressing situations leading couples to search for alternative treatment options. For such patients with Polycystic Ovarian Syndrome (PCOS) who have experienced Ovarian Hyperstimulation Syndrome, mild ovarian stimulation with in vitro oocyte maturation could be a promising alternative. Testicular Sperm Aspiration (TESA) of spermatozoa from a known obstructive azoospermic patient is a limiting factor for IVM (in vitro maturation) but the couple reported here accepted mild IVF -IVM with TESA...
October 2015: Journal of Reproduction & Infertility
Annie S Leung, Michael H Dahan
The treatment of minimal or mild endometriosis prior to non-in-vitro fertilization (IVF) assisted reproduction to improve pregnancy outcomes is controversial. Ovulation suppression may be offered to women who do not wish to conceive to suppress advancement of the disease. There is little evidence to suggest improvements in fertility associated ovarian suppression prior to non-IVF infertility treatments. The use of intrauterine insemination without ovulation induction offers little benefit, with low pregnancy rates in most studies...
December 2016: Minerva Ginecologica
M Toftager, J Bogstad, T Bryndorf, K Løssl, J Roskær, T Holland, L Prætorius, A Zedeler, L Nilas, A Pinborg
STUDY QUESTION: Is the risk of severe ovarian hyperstimulation syndrome (OHSS) similar in a short GnRH antagonist and long GnRH agonist protocol in first cycle IVF/ICSI patients less than 40 years of age?. SUMMARY ANSWER: There is an increased risk of severe OHSS in the long GnRH agonist group compared with the short GnRH antagonist protocol. WHAT IS KNOWN ALREADY?: In the most recent Cochrane review, the GnRH antagonist protocol was associated with a similar live birth rate (LBR), a similar on-going pregnancy rate (OPR), and a lower incidence of OHSS (odds ratio (OR) = 0...
June 2016: Human Reproduction
Richard J Paulson, Bart C J M Fauser, Lan T N Vuong, Kevin Doody
One of the barriers to access to fertility care is the relative complexity of fertility treatments. If these can be simplified, more patients may be able to take advantage of these treatments. In this overview, we review the potential benefits of simplifying ovarian stimulation by the means of four distinct methods: 1) using mild stimulation for IVF cycles; 2) using in vitro maturation to allow for the retrieval of oocytes that are not yet fully mature yet have the potential to result in live births; 3) conducting IVF in modified natural cycles which use no exogenous FSH stimulation; and 4) allowing embryo culture to take place in a novel intravaginal incubation system...
May 2016: Fertility and Sterility
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