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Poor ovarian respond

Kayhan Yakin, Ozgur Oktem, Basak Balaban, Bulent Urman
PURPOSE: The ESHRE Working Group on Poor Ovarian Response defined a set of variables to define poor responders, named as the Bologna Criteria, but several concerns have been raised regarding their applicability and prognostic significance. In order to evaluate the clinical relevance of the criteria, we retrospectively analyzed the ovarian response and live birth rates in women who had consecutive IVF attempts, according to their fulfillment of the criteria. METHODS: The study group comprised 1153 and 288 women who had two and three consecutive ovarian stimulation (OS) cycles between May 2010 and January 2017, respectively...
November 27, 2018: Archives of Gynecology and Obstetrics
Jeanne M Quinn, Molly M Greenwade, Marguerite L Palisoul, Gregory Opara, Katina Massad, Lei Guo, Peinan Zhao, Hollie Beck-Noia, Ian S Hagemann, Andrea R Hagemann, Carolyn K McCourt, Premal H Thaker, Matthew A Powell, David G Mutch, Katherine C Fuh
Ovarian cancer (OvCa), one of the deadliest malignancies in female cancer patients, is characterized by recurrence and poor response to cytotoxic chemotherapies. Fewer than 30% of patients with resistant disease will respond to additional chemotherapy treatments. This study aims to determine whether and how inhibition of the receptor tyrosine kinase AXL can restore sensitivity to front-line platinum and taxane therapy in OvCa. AXL staining was quantified in a patient tissue microarray and correlated with chemoresponse of patients...
November 26, 2018: Molecular Cancer Therapeutics
Yu Xiao, Yong Wang, Min Wang, Kai Liu
BACKGROUND: To investigate the impact of follicular flushing on the number of oocytes retrieved and embryo quality and to determine the optimal number of flushings for poor ovarian responders (PORs) undergoing in vitro fertilization (IVF). METHODS: This retrospective study included 291 IVF cycles in 224 patients who were PORs and had no more than three dominant follicles on retrieval day. During oocyte retrieval, follicular fluid was aspirated and examined for an oocyte...
November 16, 2018: BMC Women's Health
Afsoon Zarei, Mohammad Ebrahim Parsanezhad, Maryam Azizi Kutenaei, Bahia Namavar Jahromi, Parastoo Soheil Esfahani, Pardis Bakhshaei
Objectives: We sought to determine the effects of the delayed start protocol with gonadotropin-releasing hormone (GnRH) antagonists in poor responders undergoing in vitro fertilization (IVF). Methods: This randomized clinical trial was conducted during a 15-month period from April 2014 to July 2015 in clinics in Shiraz, Iran. A total of 42 poor responders with primary infertility were randomly assigned to the controlled ovarian stimulation group utilizing the delayed start protocol (n = 21) or the traditional group (n = 21) using GnRH antagonist, Cetrotide...
November 2018: Oman Medical Journal
Ahmed M Maged, Radwa M Fahmy, Hamsa Rashwan, Maryam Mahmood, Sarah M Hassan, Hala Nabil, Ayman Hany, Rehab Lotfy, Yossra S Lasheen, Sherif Dahab, Mohamed Darwish
OBJECTIVE: To assess the effects of body mass index (BMI) on the outcome of IVF cycles among poor responders. METHODS: A prospective cohort study in Egypt enrolled 185 poor responders who underwent intracytoplasmic sperm injection via an antagonist protocol between 2012 and 2017. Participants were classified into three groups by BMI (calculated as weight in kilograms divided by the square of height in meters): 18.5-24.9 (normal, n=48); 25-29.9 (overweight, n=54); 30 or higher (obese, n=83)...
November 8, 2018: International Journal of Gynaecology and Obstetrics
Maruška Čuš, Veljko Vlaisavljević, Katja Repnik, Uroš Potočnik, Borut Kovačič
PURPOSE: The aim of this study was to investigate whether single nucleotide polymorphisms (SNPs) in selected genes, responsible for hormonal regulation of folliculogenesis, are associated with response to controlled ovarian hyperstimulation (COH) and clinical characteristics of women enrolled in in vitro fertilization (IVF) programs. METHODS: In a cross-sectional study, 60 (IVF) patients underwent COH by using gonadotropin-releasing hormone (GnRH) antagonist and recombinant follicle-stimulating hormone (rFSH) protocol...
November 8, 2018: Journal of Assisted Reproduction and Genetics
Yoshiyuki Kobayashi, Tsutomu Tabata, Mayu Omori, Eiji Kondo, Toru Hirata, Kenta Yoshida, Masayuki Sekine, Atsuo Itakura, Takayuki Enomoto, Tomoaki Ikeda
BACKGROUND: In recent years, the incidence of malignant disease in pregnancy has been increasing, but there are few large-scale surveys of malignant disease in pregnancy in Japan. The aim of this study was to survey malignant disease occurring during pregnancy in Japan. METHODS: Malignant disease in pregnancy was defined as diagnosis or treatment for malignant disease, except in situ carcinoma during pregnancy, or within 1-year postpartum. First, a primary survey questionnaire of the incidence of malignant disease in pregnancy and the number of deliveries over the course of 2014 was sent to 510 medical centers in Japan...
October 27, 2018: International Journal of Clinical Oncology
Léa Delbos, Elsa Parot-Schinkel, Hady El Hachem, Guillaume Legendre, Philippe Descamps, Lisa Boucret, Véronique Ferré-L'Hotellier, Pauline Jeanneteau, Cécile Dreux, Catherine Morinière, Pascale May-Panloup, Pierre-Emmanuel Bouet
BACKGROUND: To date, there is no consensus on the ideal management strategy of patients with poor ovarian response (POR) to controlled ovarian stimulation (COS) for in vitro fertilization (IVF). Currently, these patients are given the choice of: (1) canceling the cycle; (2) proceeding with COS regardless of the poor response, and performing the oocyte retrieval and transfer of embryos when available; or (3) conversion to an intrauterine insemination (IUI). When the decision to proceed with the COS cycle is taken, it is not clear whether IVF or conversion to IUI is the best choice...
October 17, 2018: Trials
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)...
October 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
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