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Poor ovarian respond

Pinxiu Huang, Minling Tang, Aiping Qin
BACKGROUND: Poor ovarian response (POR) to ovarian hyperstimulation is one of the biggest challenges in assisted reproduction technology. The objective of this study was to compare the efficacy of progestin-primed ovarian stimulation (PPOS) with a GnRH antagonist (GnRH-ant) in poor ovarian response (POR) patients. MATERIALS AND METHODS: This retrospective analysis included a total of 186 cycles of POR patients between 2014 and 2016. The patients were divided into two groups according to the method of stimulation protocol, as follows: 63 cycles were PPOS, and 123 cycles were GnRH-ant...
October 12, 2018: Journal of gynecology obstetrics and human reproduction
Mei-Hong Cai, Xiao-Yan Liang, Yao-Qiu Wu, Rui Huang, Xing Yang
AIM: The purpose was to explore whether the 6 weeks of growth hormone (GH) pretreatment could increase the live birth rate of poor ovarian responders (POR). METHODS: This self-controlled, retrospective study was performed among 380 POR who had GH adjuvant (GH+) at a university-affiliated hospital in Guangzhou, China, from October 2010 to April 2016. Growth hormone was injected daily beginning with the previous menstruation and maintained until ovum pickup, for approximately 6 weeks...
October 1, 2018: Journal of Obstetrics and Gynaecology Research
Chia-Jung Li, San-Nung Chen, Li-Te Lin, Chyi-Uei Chern, Peng-Hui Wang, Zhi-Hong Wen, Kuan-Hao Tsui
Mitochondrial dysfunction is related to reproductive decline in humans, with consequences for in vitro fertilization (IVF). We assessed whether dehydroepiandrosterone (DHEA) could regulate mitochondrial homeostasis and mitophagy of cumulus cells (CCs) in poor ovarian responders (PORs). A total of 66 women who underwent IVF treatment at the Reproductive Medicine Center of Kaohsiung Veterans General Hospital were included in this study. Twenty-eight normal ovarian responders (NOR) and 38 PORs were enrolled. PORs were assigned to receive DHEA supplementation ( n = 19) or not ( n = 19) before IVF cycles...
September 20, 2018: Journal of Clinical Medicine
Chyi-Uei Chern, Kuan-Hao Tsui, Salvatore Giovanni Vitale, San-Nung Chen, Peng-Hui Wang, Antonio Cianci, Hsiao-Wen Tsai, Zhi-Hong Wen, Li-Te Lin
BACKGROUND: Dehydroepiandrosterone (DHEA) is now widely used as an adjuvant for in vitro fertilization (IVF) cycles in poor ovarian responders (PORs). Several studies showed that DHEA supplementation could improve IVF outcomes of PORs. However, most of the PORs do not respond to DHEA clinically. Therefore, the aim of this study is to confirm the beneficial effects of DHEA on IVF outcomes of PORs and to investigate which subgroups of PORs can best benefit from DHEA supplementation. METHODS: This retrospective cohort study was performed between January 2015 and December 2017...
September 17, 2018: Reproductive Biology and Endocrinology: RB&E
Elena Labarta, Diego Marin, José Remohí, Ernesto Bosch
RESEARCH QUESTION: Is minimal ovarian stimulation (MOS) as effective as conventional ovarian stimulation (COS) in ovarian response and embryo quality in the same 46 poor-responder patients according to the Bologna criteria? DESIGN: An intra-patient comparison of patients undergoing both protocols. Ovaries were stimulated with either a gonadotrophin-releasing hormone antagonist protocol and a combination of recombinant FSH and highly purified human menotrophin (HP-HMG) daily (COS), or with the use of clomiphene citrate 50 mg daily and 150 IU of HP-HMG or recombinant FSH every other day from simulation day 4 (MOS)...
August 23, 2018: Reproductive Biomedicine Online
Sterre T Paijens, Ninke Leffers, Toos Daemen, Wijnand Helfrich, H Marike Boezen, Ben J Cohlen, Cornelis Jm Melief, Marco de Bruyn, Hans W Nijman
BACKGROUND: This is the second update of the review first published in the Cochrane Library (2010, Issue 2) and later updated (2014, Issue 9).Despite advances in chemotherapy, the prognosis of ovarian cancer remains poor. Antigen-specific active immunotherapy aims to induce tumour antigen-specific anti-tumour immune responses as an alternative treatment for ovarian cancer. OBJECTIVES: Primary objective• To assess the clinical efficacy of antigen-specific active immunotherapy for the treatment of ovarian cancer as evaluated by tumour response measured by Response Evaluation Criteria In Solid Tumors (RECIST) and/or cancer antigen (CA)-125 levels, response to post-immunotherapy treatment, and survival differences◦ In addition, we recorded the numbers of observed antigen-specific humoral and cellular responsesSecondary objective• To establish which combinations of immunotherapeutic strategies with tumour antigens provide the best immunological and clinical results SEARCH METHODS: For the previous version of this review, we performed a systematic search of the Cochrane Central Register of Controlled Trials (CENTRAL; 2009, Issue 3), in the Cochrane Library, the Cochrane Gynaecological Cancer Group Specialised Register, MEDLINE and Embase databases, and clinicaltrials...
September 10, 2018: Cochrane Database of Systematic Reviews
Giovanna Sighinolfi, Sesh Kamal Sunkara, Antonio La Marca
The theory of a multicyclic development of follicles during the menstrual cycle prompted new approaches to ovarian stimulation, such as starting gonadotrophins for ovarian stimulation at any time during the menstrual cycle or using double stimulation during it, with stimulation in both the follicular and luteal phases. Because of the asynchrony between endometrial receptivity and embryo development with a 'non-conventional start' stimulation, all the oocytes/embryos are generally cryopreserved and transferred subsequently...
August 11, 2018: Reproductive Biomedicine Online
Graziela Zibetti Dal Molin, Carina Meira Abrahão, Robert L Coleman, Fernando Cotait Maluf
Background: Ovarian carcinosarcoma is a rare malignancy associated with a high rate of cancer-related mortality even at early stages. Guidelines for systemic treatment have been difficult to establish because the disease is commonly excluded from prospective clinical trials. Ovarian carcinosarcoma is usually managed as high-grade epithelial ovarian cancer despite major histologic differences. Owing to the rarity and poor prognosis of ovarian carcinosarcoma, salvage treatments and their efficacy have been poorly described...
2018: Gynecologic Oncology Research and Practice
Hoyoung Lee, Tae-Young Choi, Eun Hyoung Shim, Jiae Choi, Jong Kil Joo, Bo Sun Joo, Myeong Soo Lee, Jun-Yong Choi, Ki-Tae Ha, Sooseong You, Kyu Sup Lee
INTRODUCTION: Women with infertility who have a poor ovarian responder (POR), characterized by a low number of retrieved oocytes after ovulation induction, often have a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer (IVF-ET), due to the few transferred embryos. Acupuncture is a form of Korean Traditional Medicine. It involves the insertion of a microscopic needle at a specific point in the body, known as an acupuncture point or an acupoint. In this study, our purpose is to investigate how acupuncture affects the retrieval of mature oocytes after ovulation induction in patients with POR...
August 2018: Medicine (Baltimore)
Yun Wang, Yanping Kuang, Qiuju Chen, Renfei Cai
BACKGROUND: Progress in vitrification techniques has allowed reproductive physicians to consider new strategies for using progestin as an alternative to a GnRH analogue to improve in vitro fertilisation (IVF). However, the role of progestin in blocking luteinising hormone (LH) surges and its potential in clinical practice are unclear, especially for poor responders. We designed a prospective randomised controlled trial (RCT) to compare the efficacy of a gonadotropin-releasing hormone (GnRH) antagonist and progestin in blocking LH surges and premature ovulation in poor responders...
August 22, 2018: Trials
Konstantinos Sfakianoudis, Mara Simopoulou, Nikolaos Nitsos, Anna Rapani, Agni Pantou, Terpsithea Vaxevanoglou, Georgia Kokkali, Michael Koutsilieris, Konstantinos Pantos
Poor responders are described as those In Vitro Fertilization (IVF) patients who are failing to respond to controlled ovarian stimulation protocols. Extensive research has focused on crafting the optimal treatment. However, it appears that each approach fails to be established as effective or guaranteed towards successful management. Platelet-Rich Plasma (PRP) is a novel, highly promising approach that has been successfully applied for an array of medical issues. In this case series, we present 3 poor responder patients with the common denominator of: failed IVF attempts, poor oocyte yield, and poor embryo quality...
August 22, 2018: Gynecologic and Obstetric Investigation
Stéphanie Mendret-Pellerin, Florence Leperlier, Arnaud Reignier, Tiphaine Lefebvre, Paul Barrière, Thomas Fréour
Does corifollitropin alfa associated with hp-HMG protocol from the beginning of ovarian stimulation perform better than high dose rFSH alone for ovarian stimulation with GnRH antagonist in poor responders? This retrospective, monocentric, case-control pilot study was conducted in 65 poor responders (Bologna criteria) undergoing 2 consecutive IVF cycles. All patients underwent a first ovarian stimulation cycle with high dose rFSH (≥300 IU/day) alone in antagonist protocol, unfortunately leading to poor ovarian response and no pregnancy...
August 21, 2018: Human Fertility: Journal of the British Fertility Society
Song-Po Pan, Kuang-Han Chao, Chu-Chun Huang, Ming-Yih Wu, Mei-Jou Chen, Chin-Hao Chang, Jehn-Hsiahn Yang, Yu-Shih Yang, Shee-Uan Chen
Previous studies indicated that progesterone can be withdrawn at the time of the first positive β-hCG test without compromising the clinical pregnancy outcome in normal ovarian responder. However, the effect of early stop of progesterone supplementation for patients with poor ovarian response (POR) has not been investigated. This study retrospectively collected data from patients with POR in 156 IVF/ICSI fresh embryo transfer (ET) cycles in single tertiary center from January 2010 to June 2016. All the patients met ESHRE consensus, the Bologna criteria, of POR and had hCG injection for luteal phase support (LPS) on day 2, 5 and 8 after ovum pick-up...
2018: PloS One
Rakotobe Andriamaro Andriantsirombaka, Graziella Badull, Ramarolahy Rija, Marcienne Aimée, Leonardo Formigli
Our In-Vitro Fertilisation Centre is situated in a large developing country, Madagascar, with very bad roads and low income patients. Therefore we try to find ways to reduce as much as possible the number of attempts to obtain a pregnancy. Poor or no response to ovarian stimulation in In Vitro Fertilization (IVF) cycles is a great challenge. Here we describe a method whereby we shift from IVF to Oocyte Donation (OD) during the same cycle for patients whose ovaries do not respond properly to ovulation stimulation...
June 2018: African Journal of Reproductive Health
F Fabregues, I González-Foruria, J Peñarrubia, F Carmona
STUDY QUESTION: Is the length of the anogenital distance (AGD) a biomarker of ovarian reserve and response to controlled ovarian stimulation (COS)? SUMMARY ANSWER: Shorter AGD is associated with presence of poor ovarian response. WHAT IS KNOWN ALREADY: Organ development during prenatal life is influenced by the prevailing intrauterine environment, and it has been suggested that nutritional, environmental and toxic factors could affect ovarian reserve set prenatally...
September 1, 2018: Human Reproduction
S J Morin, G Patounakis, C R Juneau, S A Neal, R T Scott, E Seli
STUDY QUESTION: Do infertile women aged <38 years with quantitative evidence of diminished ovarian reserve and/or poor response to stimulation also exhibit poor oocyte quality as measured by blastulation rates, aneuploidy rates, and live birth rates? SUMMARY ANSWER: Young women with evidence of accelerated follicular depletion, either by precycle ovarian reserve testing or postcycle evidence of low oocyte yield, exhibit equivalent blastulation rates, aneuploidy rates and live birth rates per euploid embryo transfer as age-matched controls with normal precycle and postcycle parameters...
July 11, 2018: Human Reproduction
Julia Rehnitz, Diego D Alcoba, Ilma S Brum, Jens E Dietrich, Berthe Youness, Katrin Hinderhofer, Birgitta Messmer, Alexander Freis, Thomas Strowitzki, Ariane Germeyer
BACKGROUND: Fragile-X-Mental-Retardation-1- (FMR1)-gene is supposed to be a key gene for ovarian reserve and folliculogenesis. It contains in its 5'-UTR a triplet-base-repeat (CGG), that varies between 26 and 34 in general population. CGG-repeat-lengths with 55-200 repeats (pre-mutation = PM) show instable heredity with a tendency to increase and are associated with premature-ovarian-insufficiency or failure (POI/POF) in about 20%. FMR1-mRNA-expression in leucocytes and granulosa cells (GCs) increases with CGG-repeat-length in PM-carriers, but variable FMR1-expression profiles were also described in women with POI without PM-FMR1 repeat-length...
July 7, 2018: Reproductive Biology and Endocrinology: RB&E
Michael Carducci, Montaser Shaheen, Ben Markman, Sara Hurvitz, Daruka Mahadevan, Dusan Kotasek, Oscar B Goodman, Erik Rasmussen, Vincent Chow, Gloria Juan, Gregory R Friberg, Erick Gamelin, Florian D Vogl, Jayesh Desai
Background Aurora kinase overexpression or amplifications are associated with high proliferation, poor prognosis, and therapeutic resistance in human tumors. AMG 900 is an investigational, oral, selective pan-Aurora kinase inhibitor. Methods This first-in-human trial included dose-escalation and dose-expansion phases ( : NCT00858377). Dose escalation evaluated the safety, tolerability, and pharmacokinetics of AMG 900 in advanced solid tumors and determined the maximum tolerated dose (MTD) with/without granulocyte colony-stimulating factor (G-CSF) prophylaxis...
July 7, 2018: Investigational New Drugs
Ling-Jun Zhao, Ping Wang, Ying He
RATIONALE: Ovarian malignancy is associated with one of the highest rates of death among gynecological reproductive system malignancies. While progress has been made in surgical and postoperative adjuvant treatment approaches, the early atypical clinical manifestations, quick progression, and lack of the effective early screening means imply that the prognosis remains poor. Bilateral ovarian cancers are common, but different types of primary bilateral ovarian carcinomas are extremely rare...
July 2018: Medicine (Baltimore)
Rodney F Minchin, Neville J Butcher
BACKGROUND: Arylamine N-acetyltransferase 1 (NAT1) is a drug metabolizing enzyme that has been associated with cancer cell proliferation in vitro and with survival in vivo. NAT1 expression has been associated with the estrogen receptor and it has been proposed as a prognostic marker for estrogen receptor positive cancers. However, little is known about the distribution of NAT1 mRNA across an entire patient population or its effects on outcomes. To address this, gene expression data from breast cancer patient cohorts were investigated to identify sub-populations based on the level of NAT1 expression...
July 3, 2018: BMC Genomics
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