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Controlled ovarian hyperstimulation

Zeev Blumenfeld
The ovarian hyperstimulation syndrome (OHSS) is an iatrogenic syndrome, which may, infrequently, become severe and evenly fatal. Until the last decade, the worldwide popularity of assisted reproductive technology (ART) and ovulation induction/controlled ovarian hyperstimulation employed in ART for either in vivo fertilization or in vitro fertilization, in the last two decades, has been accompanied by an increase in the cases of OHSS. In the last decade, the substitution of the human chorionic gonadotropin trigger with the gonadotropin-releasing hormone agonist trigger has decreased the incidence of this syndrome but did not eliminate it completely...
2018: Vitamins and Hormones
R van Eekelen, R I Tjon-Kon-Fat, P M M Bossuyt, N van Geloven, M J C Eijkemans, A J Bensdorp, F van der Veen, B W Mol, M van Wely
STUDY QUESTION: What is the natural conception rate over the course of 12 months in couples with unexplained or mild male subfertility who are scheduled for fertility treatment and have a predicted unfavourable prognosis for natural conception? SUMMARY ANSWER: The natural conception rate over the course of 12 months in couples who were allocated to treatment was estimated to be 24.5% (95% CI: 20-29%). WHAT IS KNOWN ALREADY: After starting treatment, couples often perceive unsuccessful cycles as evidence of definitive failure even though they are still able to conceive naturally in between and after treatment...
March 12, 2018: Human Reproduction
Avi Ben-Haroush, Irit Ben-Aharon, Yechezkel Lande, Benjamin Fisch
BACKGROUND: Controlled ovarian hyperstimulation (COH) followed by oocyte retrieval is a leading option for fertility preservation before chemotherapy, yet this procedure causes excessive serum levels of estradiol (E2), which are often detrimental for cancer patients. Aromatase inhibitors are often used in breast cancer patients during COH to prevent elevated levels of E2. OBJECTIVES: To describe our experience with COH for oocyte cryopreservation in non-breast cancer patients using aromatase inhibitors...
March 2018: Israel Medical Association Journal: IMAJ
Tannaz Zamaniara, Robabeh Taheripanah, Sayyed Mohammad Hossein Ghaderian, Elnaz Zamaniara, Sara Sadat Afjeh Aghabozorgi
BACKGROUND: One of the major problems in IVF is the poor response of the ovary to gonadotropins. ESRI and FSHR are two effective genes on controlled ovarian hyperstimulation (COH). OBJECTIVES: Evaluating the correlation of alleles and genotypes of polymorphism (-29G/A) located in the FSH receptor gene and polymorphism (XbaI G/A) located in Estrogen receptor genes with the ovary's response would help to anticipate the results of ovulation in IVF cycles. METHODS: In the present study, two hundred (200) blood samples were taken from infertile women aged 20 to 39 who were under IVF therapy...
January 19, 2018: Human Antibodies
Lorraine Sheena Kasaven, Anastasia Goumenou, Kenneth Adegoke
Ovarian hyperstimulation syndrome (OHSS) is a well-recognised iatrogenic complication following controlled ovarian stimulation (COS). Mild to moderate cases are mostly managed conservatively. Severe cases of OHSS can be potentially fatal. For this reason, UK clinics providing licensed fertility treatment are obliged to follow Human Fertilisation and Embryology Authority guidelines for reporting severe incidents. We present an unusually severe complication of OHSS resulting in significant morbidity. A nulligravida woman aged 25, with a 4-year history of subfertility and multiple risk factors for the development of OHSS, underwent COS...
March 5, 2018: BMJ Case Reports
Fie Pilsgaard, Anna Garcia-Alix Grynnerup, Kristine Loessl, Leif Bungum, Anja Pinborg
Ovarian reserve can be determined by serum anti-Müllerian hormone (AMH) level and/or antral follicle count prior to controlled ovarian stimulation. The aim of controlled ovarian stimulation is to achieve an appropriate number of mature follicles and avoid complications such as ovarian hyperstimulation syndrome. Measurement of the ovarian reserve is very useful for the clinicians as it predicts the ovarian response to controlled ovarian stimulation. Further it assists in giving the patient realistic expectations regarding the treatment...
February 24, 2018: Acta Obstetricia et Gynecologica Scandinavica
Jawa Ashmita, Swarankar Vikas, Garg Swati
Background: Premature progesterone rise (PPR) has long been implicated as contributing to implantation failure. Despite the use of gonadotropin-releasing hormone (GnRH) analogues, subtle increases in serum progesterone ( P 4 ) levels beyond a threshold progesterone concentration were observed on the day of trigger in controlled ovarian hyperstimulation cycles. Aims: The purpose of the study was to evaluate the incidence of PPR on the day of trigger in conventional IVF/ICSI cycles and its impact on clinical pregnancy rate...
October 2017: Journal of Human Reproductive Sciences
Haiyang Fu, Jianhua Sun, Yong Tan, Huifang Zhou, Wanli Xu, Junling Zhou, Dong Chen, Cong Zhang, Xuanxuan Zhu, Ying Zhang, Xiaoliang Wu, Zhaoqing Xi
AIMS: Acupuncture is frequently recommended as a complementary therapy for infertility. However, whether acupuncture can prevent early ovarian hyperstimulation syndrome has not been examined and its potential mechanisms are not well understood. MAIN METHODS: Forty rats were randomized into four groups: Control, Ovarian Stimulation Model, Acupuncture, and Human Chorionic Gonadotropin (HCG). Serum estradiol, progesterone, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were measured by enzyme-linked immunosorbent assay...
February 5, 2018: Life Sciences
Selin Özaltın, Serkan Kumbasar, Kadir Savan
OBJECTIVES: To investigate the complications of the oocyte retrieval procedure currently used in in vitro fertilisation. MATERIAL AND METHODS: We examined 1.031 patients who underwent oocyte retrieval in the IVF unit of our hospital for complications developed during and after the procedure. RESULTS: No complications developed related to sedation or general anaesthesia. Vaginal bleeding was observed in 3.1% of the patients. There was no intra-abdominal bleeding or pelvic organ injuries requiring surgery...
2018: Ginekologia Polska
Omer Yiginer, Mehmet Dogan, Ismet Gun, Huseyin Tayfun Kutlu, Gokhan Degirmencioglu, İlkin Guliyev, Alptug Tokatli, Fethi Kilicaslan
BACKGROUND: The frequency of arrhythmic death developing without a structural cardiac disease is higher in women. Also female gender is an independent risk factor regarding developing Torsades des Pointes. Several studies have been conducted on the effects of physiological and therapeutic sex hormones on cardiac conduction system. AIM: In this study we aim to examine the effect of hormonal changes occurring during in vitro fertilization treatment and especially supraphysiological E2 levels on ventricular repolarization parameters...
February 5, 2018: Kardiologia Polska
Manish Banker, Azadeh Patel, Ashwini Deshmukh, Sandeep Shah
Introduction: Intrauterine insemination (IUI) is one of the most commonly performed procedure of assisted reproductive technology, for the treatment of infertility. Controlled ovarian hyperstimulation is an important first step while performing IUI. This study aims at establishing a relationship between stimulation protocol and pregnancy outcome following IUI. Methods: This is a retrospective study of 1001 cycles of IUI in which the patients were divided into two groups: Group A Clomiphene citrate (CC only) and Group B Clomiphene citrate and Gonadotropin or Gonadotropin alone(CC+GN OR GN alone)...
February 2018: Journal of Obstetrics and Gynaecology of India
Sarah F Lensen, Jack Wilkinson, Jori A Leijdekkers, Antonio La Marca, Ben Willem J Mol, Jane Marjoribanks, Helen Torrance, Frank J Broekmans
BACKGROUND: During a cycle of in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI), women receive daily doses of gonadotropin follicle-stimulating hormone (FSH) to induce multifollicular development in the ovaries. Generally, the dose of FSH is associated with the number of eggs retrieved. A normal response to stimulation is often considered desirable, for example the retrieval of 5 to 15 oocytes. Both poor and hyper-response are associated with increased chance of cycle cancellation...
February 1, 2018: Cochrane Database of Systematic Reviews
Nikita Naredi, S K Singh, Prasad Lele, N Nagraj
Background: Prevention of severe Ovarian Hyperstimulation Syndrome (OHSS), a potentially fatal complication of controlled ovarian hyperstimulation has been the aim of all fertility experts. Various pharmacologic and non-pharmacologic interventions have been instituted but the results have been conflicting. These preventive strategies were administered in isolation or as a combination of few aiming to eliminate this iatrogenic sequel. This study aimed to eliminate severe OHSS by multipronged approach incorporating almost all preventive modalities available in patients at high risk for this dreadful complication...
January 2018: Medical Journal, Armed Forces India
Roberto Negro
BACKGROUND AND OBJECTIVE: Infertility is a common disease that in about one third of cases has a female cause and often requires assisted reproduction technologies (ART) to conceive. Also thyroid autoimmunity (TAI), with or without hypothyroidism, is a common disease, particularly in females, and referral for endocrine consultation is not infrequent. DISCUSSION: In the last 15 years a remarkable amount of studies has been published that investigated the pathophysiology of women suffering from TAI, who undergo ART...
January 30, 2018: Endocrine, Metabolic & Immune Disorders Drug Targets
Süleyman Akarsu, Sibel Demir, Funda Gode, Ahmet Zeki Işık
Objective: The aim of this study was to compare the effect of corifollitropin alfa (CFA) and recombinant follicle-stimulating hormone (rFSH) in poor-responder patients undergoing antagonist cycles. Materials and Methods: The study was a retrospective analysis of the treatment results of 214 poor responder patients who had been admitted to the In Vitro Fertilization Unit of İzmir Medical Park Hospital between November 2014 and November 2016. Intracytoplasmic sperm injections were performed in 38 patients (group 1) with CFA, and the remaining 176 (group 2) with rFSH for controlled ovarian hyperstimulation...
December 2017: Turkish Journal of Obstetrics and Gynecology
P-E Bouet, G Legendre, L Delbos, C Dreux, P Jeanneteau, V Ferré-L'Hotellier, L Boucret, P Descamps, P May-Panloup
In women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF), a poor ovarian response, defined as three of fewer mature follicles, can lead to cancellation of the cycle. However, in women with at least one patent tube and normal semen parameters, conversion to intrauterine insemination (IUI) is considered an option, offering reasonable pregnancy rates at a lower cost and without the complications associated with oocyte retrieval. Studies have shown that in cycles with only one mature follicle, IVF should be canceled...
January 17, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Dapeng Chu, Lei Fu, Wenhui Zhou, Yuan Li
The purpose of this study was to compare the efficacy of different open cryo-carriers: the CryoloopTM, CryotopTM, and CryoleafTM, in embryo survival and clinical outcome in patients with frozen embryo transfer (FET) cycle. We analyzed the embryo survival rate and clinical outcome in 325 patients of 348 FET cycles vitrified with the CryoloopTM (160 cycles), CryotopTM (105 cycles), or CryoleafTM (83 cycles). No significant differences were observed in embryo survival rate (98.8% vs. 100% vs. 97.7%, p > 0...
January 20, 2018: Systems Biology in Reproductive Medicine
Emaduldin Seyam, Enas Hefzy
OBJECTIVE: The aim of this work was to investigate the value of laparoscopic ovarian drilling (LOD) compared with GnRH antagonist flexible protocol combined with cabergoline (Cb), as a prophylaxis against the re-development of ovarian hyperstimulation syndrome (OHSS) in women with clomiphene citrate-resistant polycystic ovary disease (CCR-PCOD) who had severe OHSS before in a previous ICSI cycle. STUDY DESIGN: It is a prospective controlled study, where 250 CCR-PCOD women (n = 250) with a history of severe OHSS before, had been recruited for the study...
January 15, 2018: Gynecological Endocrinology
Sha Yu, Hui Long, Hannah Ya-Ning Chang, Yali Liu, Hongyuan Gao, Jing Zhu, Xinxin Quan, Qifeng Lyu, Yanping Kuang, Ai Ai
STUDY QUESTION: Can dydrogesterone (DYG) be used as an alternative progestin in a progesterone primed ovarian stimulation (PPOS) protocol? SUMMARY ANSWER: DYG can be used as an appropriate alternative progestin in a PPOS protocol. WHAT IS KNOWN ALREADY: PPOS is a new ovarian stimulation regimen based on a freeze-all strategy that uses progestin as an alternative to a GnRH analog for suppressing a premature LH surge during the follicular phase...
December 29, 2017: Human Reproduction
J Zech, A Brandao, M Zech, K Lugger, S Neururer, H Ulmer, E Ruttmann
Elective cryopreservation of cultured embryos has become a treatment option for women at risk for ovarian hyperstimulation syndrome (OHSS). The aim of our study was to investigate the outcome of elective cryopreservation and consecutive frozen-thawed embryo transfer (FET) in a large IVF clinic in Austria. A total of 6104 controlled ovarian hyperstimulation cycles (COH) were performed on 2998 patients including 200 patients (6.7%) who were undergoing elective cryopreservation and FET due to high risk of OHSS...
December 24, 2017: Reproductive Biology
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