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https://www.readbyqxmd.com/read/28441461/sliding-scale-hcg-trigger-yields-equivalent-pregnancy-outcomes-and-reduces-ovarian-hyperstimulation-syndrome-analysis-of-10-427-ivf-icsi-cycles
#1
Vinay Gunnala, Alexis Melnick, Mohamad Irani, David Reichman, Glenn Schattman, Owen Davis, Zev Rosenwaks
OBJECTIVE: To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity. DESIGN: Retrospective cohort. SETTING: Academic medical center. PATIENTS: Fresh IVF cycles from 9/2004-12/2011. INTERVENTION: 10,427 fresh IVF-ICSI cycles met inclusion criteria...
2017: PloS One
https://www.readbyqxmd.com/read/28440715/gnrh-agonist-triggering-for-final-oocyte-maturation-in-gnrh-antagonist-ivf-cycles-induces-decreased-lh-pulse-rate-and-amplitude-in-early-luteal-phase-a-possible-luteolysis-mechanism
#2
Samer Tannus, Yechiel Burke, Christopher R McCartney, Shahar Kol
The use of GnRH agonist to trigger final oocyte maturation in GnRH-antagonist in vitro fertilization (IVF) cycles has been shown to significantly reduce or even eliminate the risk of ovarian hyperstimulation syndrome (OHSS) by inducing rapid luteolysis early in the luteal phase. The exact mechanism of this early luteolysis is still widely unknown. Since luteinizing hormone (LH) has a major role in corpus luteum support, we sought to explore the pattern of LH secretion early in the luteal phase. Ten high risk patients for developing OHSS and triggered with GnRH agonist were included...
April 25, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28440686/severe-ovarian-hyperstimulation-syndrome-after-combined-gnrh-agonist-and-low-dose-human-chorionic-gonadotropin-trigger-in-a-patient-with-a-single-kidney
#3
Nigel Pereira, Jovana P Lekovich, Isaac Kligman, Zev Rosenwaks
Ovarian hyperstimulation syndrome (OHSS) following gonadotropin-releasing hormone agonist (GnRH-a) trigger is rare. Here, we report a case of severe OHSS after combined GnRH-a and low-dose human chorionic gonadotropin (hCG) trigger in a patient with a single kidney. The patient is a 32-year-old women with a two-year history of infertility. The patient's history was significant for a single kidney, that is, she had donated a kidney to a family member three years ago. The patient underwent controlled ovarian stimulation (COS) for in vitro fertilization (IVF) and received a combined 2 mg GnRH-a and 1500 IU hCG ovulatory trigger...
April 25, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28437434/comparisons-of-gnrh-antagonist-protocol-versus-gnrh-agonist-long-protocol-in-patients-with-normal-ovarian-reserve-a-systematic-review-and-meta-analysis
#4
Ruolin Wang, Shouren Lin, Yong Wang, Weiping Qian, Liang Zhou
OBJECTIVE: To evaluate the effectiveness and safety of gonadotropin-releasing hormone antagonist (GnRH-ant) protocol and gonadotropin-releasing hormone agonist (GnRH-a) long protocol in patients with normal ovarian reserve. METHODS: We searched the PubMed (1992-2016), Cochrane Library (1999-2016), Web of Science (1950-2016), Chinese Biomedical Database (CBM, 1979-2016), and China National Knowledge Infrastructure (CNKI, 1994-2016). Any randomized controlled trials (RCTs) that compared GnRH-ant protocol and GnRH-a long protocol in patients with normal ovarian reserve were included, and data were extracted independently by two reviewers...
2017: PloS One
https://www.readbyqxmd.com/read/28403961/vascular-endothelial-growth-factor-antagonist-reduces-the-early-onset-and-the-severity-of-ovarian-hyperstimulation-syndrome
#5
S Jellad, A Haj Hassine, M Basly, A Mrabet, M Chibani, R Rachdi
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of controlled ovarian stimulation (COH) during assisted reproductive technology (ART) protocols. This syndrome is a result of ovarian expression of vascular endothelial growth factor (VEGF), which increases vascular permeability. OBJECTIVES: To evaluate the efficiency of prophylactic and therapeutic use of cabergoline in women with higher risk of developing OHSS. MATERIALS AND METHODS: In this prospective randomized study, 146 women undergoing in vitro fertilization (IVF) cycles with GnRH agonist protocols with a higher risk of OHSS diagnosed during the HCG day administration (more than 18 follicles observed larger than 12mm in diameter during COH and/or estradiol levels of 3000-3500pg/ml, previous episodes of OHSS)...
January 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28382684/thromboembolism-and-in-vitro-fertilization-ndash-a-systematic-review
#6
Maria Sennström, Karin Rova, Margareta Hellgren, Ragnhild Hjertberg, Eva Nord, Lars Thurn, Pelle G Lindqvist
INTRODUCTION: There is no accepted consensus on thromboprophylaxis in relation to in-vitro fertilization (IVF). We aimed to study the frequency of thromboembolism and to assess thromboprophylaxis in relation to IVF. MATERIAL AND METHODS: We performed a systematic review. All study designs were accepted except single case reports. Language of included articles was restricted to English. RESULTS: Of 338 articles, 21 relevant articles (9 cohort studies, 6 case-control studies, 3 case series, and 3 reviews of case series) were identified...
April 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28379469/in-vivo-intrabursal-administration-of-bioactive-lipid-sphingosine-1-phosphate-enhances-vascular-integrity-in-a-rat-model-of-ovarian-hyperstimulation-syndrome-ohss
#7
Mariana Di Pietro, Natalia Pascuali, Leopoldina Scotti, Griselda Irusta, Diana Bas, María May, Marta Tesone, Dalhia Abramovich, Fernanda Parborell
STUDY QUESTION: Can the bioactive lipid sphingosine-1 phosphate (S1P) act as an endothelial barrier-enhancing molecule and, in turn, restore the vascular integrity and homeostasis in a rat model of ovarian hyperstimulation syndrome (OHSS). STUDY ANSWER: In vivo administration of S1P may prevent the early onset of OHSS and decrease its severity. WHAT IS KNOWN ALREADY: Although advances in the prediction and treatment of OHSS have been made, complete prevention has not been possible yet...
April 1, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28371633/ovarian-torsion-and-spontaneous-ovarian-hyperstimulation-syndrome-in-a-twin-pregnancy-a-case-report
#8
Núria Gil Navarro, Emma Garcia Grau, Sílvia Pina Pérez, Laia Ribot Luna
INTRODUCTION: Ovarian hyperstimulation syndrome (OHSS) is extremely rare in spontaneous pregnancies. Spontaneous OHSS can result from glycoprotein hormones stimulating follicle-stimulating hormone receptors (FSHR). PRESENTATION OF CASE: We report a twin pregnancy in which ovarian torsion and hemoperitoneum complicating OHSS were treated with left adnexectomy and aspiration. The only trigger for spontaneous OHSS in this case was high levels of chorionic gonadotropin hormone...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28367300/renal-and-hepatic-functions-after-a-week-of-controlled-ovarian-hyperstimulation-during-in-vitro-fertilization-cycles
#9
Ilaria Romito, Ferdinando Antonio Gulino, Antonio Simone Laganà, Salvatore Giovanni Vitale, Attilio Tuscano, Gianluca Leanza, Giulia Musmeci, Vito Leanza, Agnese Maria Chiara Rapisarda, Marco Antonio Palumbo
BACKGROUND: One the main aspects of in vitro fertilization (IVF) cycle is to avoid any possible systemic damage on women undergoing a controlled ovarian hyperstimulation (COH). The aim of this work is to evaluate renal and hepatic function blood tests in patients undergoing controlled ovarian hyperstimulation during IVF cycles. MATERIALS AND METHODS: We performed a prospective cohort analysis. All patients re- ceived a long stimulation protocol with gonadotropin-releasing hormone (GnRH) analogues by daily administration, since the twenty-first day of the previous ovarian cycle followed by COH with recombinant follicle-stimulating hormone (FSH)...
April 2017: International Journal of Fertility & Sterility
https://www.readbyqxmd.com/read/28367298/the-effect-of-coasting-on-intracytoplasmic-sperm-injection-outcome-in-antagonist-and-agonist-cycle
#10
Z Candan İltemir Duvan, Müberra Namlı Kalem, Yuksel Onaran, Esra Aktepe Keskin, Aylin Ayrım, Aslıhan Pekel, Hasan Kafalı, Nilgün Turhan
BACKGROUND: Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. MATERIALS AND METHODS: In a retrospective cohort study, 117 ICSI cycles were per- formed and coasting was applied due to hyperresponse, between 2006 and 2011...
April 2017: International Journal of Fertility & Sterility
https://www.readbyqxmd.com/read/28351814/combining-several-interventions-to-reduce-the-incidence-of-ohss-a-prospective-cohort-study
#11
Mohamed Elmahdy, Eman A Abdelsalam, Hassan A Maghraby
OBJECTIVE: To assess the outcome of using low-dose aspirin, dopamine agonist and triggering ovulation by low dose of HCG in combination with GnRH agonist in fixed GnRH antagonist protocol in patients at risk of OHSS. STUDY DESIGN: This prospective cohort study was conducted on 50 infertile women who were at high risk of OHSS. They received low dose aspirin from first day of stimulation, cabergoline 0.5mg daily from the day of HCG for 8days and low dose of HCG (2500 IU) in combination with GnRH agonist for final oocyte maturation in fixed GnRH antagonist protocol...
May 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28350328/vitamin-d-decreases-serum-vegf-correlating-with-clinical-improvement-in-vitamin-d-deficient-women-with-pcos-a-randomized-placebo-controlled-trial
#12
Mohamad Irani, David B Seifer, Richard V Grazi, Sara Irani, Zev Rosenwaks, Reshef Tal
Vascular endothelial growth factor (VEGF) has been suggested to play a role in the pathophysiology of polycystic ovary syndrome (PCOS) and may contribute to increased risk of ovarian hyperstimulation syndrome (OHSS) in affected individuals. Vitamin D (VitD) supplementation improves multiple clinical parameters in VitD-deficient women with PCOS and decreases VEGF levels in several other pathologic conditions. Unveiling the basic mechanisms underlying the beneficial effects of vitamin D on PCOS may enhance our understanding of the pathophysiology of this syndrome...
March 28, 2017: Nutrients
https://www.readbyqxmd.com/read/28349525/glucocorticoid-supplementation-during-ovarian-stimulation-for-ivf-or-icsi
#13
REVIEW
Theodoros Kalampokas, Zabeena Pandian, Stephen D Keay, Siladitya Bhattacharya
BACKGROUND: Ovarian response to stimulation during in-vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) plays an important role in determining live birth rates. Adjuvant treatments during ovarian stimulation that have different modes of action have been used to improve ovarian response to stimulation and outcome of IVF. Glucocorticoids (GCs) are a class of steroid hormones that have been used either alone or in combination with other stimulatory regimens in order to improve folliculogenesis and pregnancy rates...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28349510/fresh-versus-frozen-embryo-transfers-in-assisted-reproduction
#14
REVIEW
Kai Mee Wong, Madelon van Wely, Femke Mol, Sjoerd Repping, Sebastiaan Mastenbroek
BACKGROUND: In general, in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) implies a single fresh and one or more frozen-thawed embryo transfers. Alternatively, the 'freeze-all' strategy implies transfer of frozen-thawed embryos only, with no fresh embryo transfers. In practice, both strategies can vary technically including differences in freezing techniques and timing of transfer of cryopreservation, that is vitrification versus slow freezing, freezing of two pro-nucleate (2pn) versus cleavage-stage embryos versus blastocysts, and transfer of cleavage-stage embryos versus blastocysts...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28345956/modulation-of-steroidogenesis-by-vitamin-d3-in-granulosa-cells-of-the-mouse-model-of-polycystic-ovarian-syndrome
#15
Shabnam Bakhshalizadeh, Fardin Amidi, Ashraf Alleyassin, Masoud Soleimani, Reza Shirazi, Maryam Shabani Nashtaei
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder of women of reproductive age characterized by polycystic ovarian morphology, anovulation or oligomenorrhea, and hyperandrogenism. It is shown that disruption in the steroidogenesis pathway caused by excess androgen in PCOS is a critical element of abnormal folliculogenesis and failure in dominant follicle selection. Vitamin D plays an important role in the regulation of ovulatory dysfunction and can influence genes involved in steroidogenesis in granulosa cells...
June 2017: Systems Biology in Reproductive Medicine
https://www.readbyqxmd.com/read/28333033/freeze-all-cycle-in-reproductive-medicine-current-perspectives
#16
Matheus Roque, Marcello Valle, Alessandra Kostolias, Marcos Sampaio, Selmo Geber
The freeze-all strategy has emerged as an alternative to fresh embryo transfer (ET) during in vitro fertilization (IVF) cycles. Although fresh ET is the norm during assisted reproductive therapies (ART), there are many concerns about the possible adverse effects of controlled ovarian stimulation (COS) over the endometrium. The supra-physiologic hormonal levels that occur during a conventional COS are associated with modifications in the peri-implantation endometrium, which may be related to a decrease in pregnancy rates and poorer obstetric and perinatal outcomes when comparing fresh to frozen-thawed embryo transfers...
February 1, 2017: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/28325095/concomitant-use-of-fsh-and-low-dose-recombinant-hcg-during-the-late-follicular-phase-versus-conventional-controlled-ovarian-stimulation-for-intracytoplasmic-sperm-injection-cycles
#17
Carla Andrade Rebello Iaconelli, Amanda Souza Setti, Daniela Paes Almeida Ferreira Braga, Luiz Guilherme Louzada Maldonado, Assumpto Iaconelli, Edson Borges, Tsutomu Aoki
The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n = 178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n = 152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group...
March 22, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28322539/a-review-on-ovarian-hyperstimulation-syndrome-ohss-management-strategies
#18
Ashley M Eskew, Kenan R Omurtag
Ovarian hyperstimulation syndrome (OHSS) is one of the most frequent, serious and potentially lethal iatrogenic complications of controlled ovarian stimulation. Despite extensive research, the exact pathogenesis of this syndrome remains less clear, but there appears to be a relationship of increased vascular permeability mediated by HCG and other downstream mediators. Adequate experience with ovulation induction therapy and identifying patients with known risk factors are essential in preventing OHSS. As this is a completely iatrogenic disease numerous strategies have been investigated to help decrease the risk of OHSS and their effects on pregnancy and live birth rate...
March 21, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28322538/controlled-ovarian-stimulation-and-triggers-in-in-vitro-fertilization-protocol-personalization-key-to-optimize-outcomes
#19
Jacqueline Y Maher, Mindy S Christianson
The past four decades have delivered many advancements to improve in vitro fertilization (IVF) outcomes. These include a delicate balance of controlled ovarian hyperstimulation (COH) without causing ovarian hyperstimulation syndrome (OHSS), a safe oocyte retrieval, fertilization and embryo culture, endometrial growth and receptivity to promote implantation, and luteal support to maintain the pregnancy. Contemporary IVF practice includes both the classic COH protocols as well as protocols for poor responders and those for specific patient populations...
March 21, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28319428/two-cases-of-first-onset-intrahepatic-cholestasis-of-pregnancy-associated-with-moderate-ovarian-hyperstimulation-syndrome-after-ivf-treatment-and-review-of-the-literature
#20
Mehmet Firat Mutlu, Koray Aslan, Ismail Guler, Ilknur Mutlu, Mehmet Erdem, Nuray Bozkurt, Ahmet Erdem
Intrahepatic cholestasis of pregnancy (ICP) is an uncommon disorder, which generally occurs in the second and third trimester of pregnancy with symptoms of pruritus. The cause of ICP is unknown but genetic, hormonal and environmental factors contribute to its pathogenesis. The aetiology of ICP is unclear but elevation in oestrogen levels thought to cause ICP is typically seen in the third trimester of pregnancy, and for this reason it is not usually considered in the differential diagnosis of pruritus and liver function disorders in the first trimester of the pregnancy...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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