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ovarian hyperstimulation

E A Elgindy, H Sibai, M I Mostafa, A Gibreel, E Darwish, H Maghraby
STUDY QUESTION: In ICSI patients with high risk of ovarian hyperstimulation syndrome (OHSS), are antagonist cycles triggered by gonadotropin releasing hormone (GNRH) agonist with a specialized luteal support regimen associated with comparable ongoing pregnancy rate (OPR) and less OHSS than those triggered by hCG? SUMMARY ANSWER: In antagonist ICSI cycles, GnRH agonist triggering with a specialized luteal support regimen is associated with comparable OPR to those triggered by hCG but may be less likely to be associated with OHSS...
March 19, 2018: Human Reproduction
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
Chen-Yu Huang, Guan-Yeu Chen, Miawh-Lirng Shieh, Hsin-Yang Li
BACKGROUND: The use of oral progestin has been shown to effectively prevent luteining hormone (LH) surge during ovarian stimulation with daily human menopausal gonadotropin injections. This study was aimed to investigate the efficacy of long-acting follicle stimulating hormone (long-acting FSH; corifollitropin alfa, Elonva®) use in progestin-primed ovarian stimulation for normal and high responders undergoing IVF/ICSI. METHODS: This is a retrospective and proof-of-concept study...
March 5, 2018: Reproductive Biology and Endocrinology: RB&E
C Choux, M Cavalieri, J Barberet, M Samson, B Bonnotte, P Fauque, P Sagot
Fertility preservation is routinely performed in cancerology but less systematically used in the field of immune diseases, even though the use of gonadotoxic treatments in young patients may be required and even though the disease itself can alter fertility. This review aimed to clarify the indications and methods of fertility preservation in this context. Cyclophosphamide is the only immunosuppressive drug requiring fertility preservation in women. In men, fertility preservation should be proposed before treatment with cyclophosphamide, methotrexate, mycophenolate mofetil or mTOR inhibitors...
February 27, 2018: La Revue de Médecine Interne
Barbara Lawrenz, Suzan Samir, Nicolas Garrido, Laura Melado, Nils Engelmann, Human M Fatemi
Ovarian stimulation in a gonadotropin-releasing hormone (GnRH) antagonist protocol with the use of GnRH agonist for final oocyte maturation is the state-of-the-art treatment in patients with an expected or known high response to avoid or at least reduce significantly the risk for development of ovarian hyperstimulation syndrome (OHSS). Due to a shortened LH surge after administration of GnRH agonist in most patients, the luteal phase will be characterized by luteolysis and luteal phase insufficiency. Maintaining a sufficient luteal phase is crucial for achievement of a pregnancy; however, the optimal approach is still under debate...
2018: Frontiers in Endocrinology
Xuan Huang, Li Chen, You-Bing Xia, Min Xie, Qin Sun, Bing Yao
AIMS: Electroacupuncture (EA) is an effective and safe therapeutic method widely used for treating clinical diseases. Previously, we found that EA could decrease serum hormones and reduce ovarian size in ovarian hyperstimulation syndrome (OHSS) rat model. Nevertheless, the mechanisms that contribute to these improvements remain unclear. MATERIALS AND METHODS: HE staining was used to count the number of corpora lutea (CL) and follicles. Immunohistochemical and ELISA were applied to examine luteal functional and structural regression...
March 15, 2018: Life Sciences
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
A Abbara, R Islam, S A Clarke, L Jeffers, G Christopoulos, A N Comninos, R Salim, S A Lavery, N L Vuong, P Humaidan, T W Kelsey, G H Trew, W S Dhillo
OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic condition, predominantly related to the hormone used to induce oocyte maturation during IVF treatment. Kisspeptin is a hypothalamic neuropeptide that has recently been demonstrated to safely trigger final oocyte maturation during IVF treatment even in women at high risk of OHSS. However to date, the safety of kisspeptin has not been compared to current hormonal triggers of oocyte maturation. DESIGN: We conducted a retrospective single-centre cohort study investigating symptoms and clinical parameters of early OHSS in women at high risk of OHSS (antral follicle count or total number of follicles on day of trigger ≥23) triggered with hCG (n=40), GnRH agonist (GnRHa; n=99), or kisspeptin (n=122) at Hammersmith Hospital IVF unit, London, UK (2013-2016)...
February 15, 2018: Clinical Endocrinology
Hortensia Ferrero, Patricia Diaz-Gimeno, Patricia Sebastian-Leon, Amparo Faus, Raul Gómez, Antonio Pellicer
Polycystic ovarian syndrome (PCOS) is a common reproductive disorder frequently associated with a substantial risk factor for ovarian hyperstimulation syndrome (OHSS). Dopamine receptor 2 (D2) agonists, like Cabergoline (Cb2), have been used to reduce the OHSS risk. However, lutein granulosa cells (LGCs) from PCOS patients treated with Cb2 still show a deregulated dopaminergic tone (decreased D2 expression and low dopamine production) and increased vascularization compared to non-PCOS LGCs. Therefore, to understand the PCOS ovarian physiology, it is important to explore the mechanisms that underlie syndrome based on the therapeutic effects of Cb2...
February 9, 2018: Reproduction: the Official Journal of the Society for the Study of Fertility
Keiji Kuroda, Kenji Ezoe, Keiichi Kato, Akiko Yabuuchi, Tomoya Segawa, Tamotsu Kobayashi, Asako Ochiai, Noriko Katoh, Satoru Takeda
AIM: Hypogonadotropic hypogonadism (HH) is a condition caused by the deficient secretion of pituitary gonadotropins, leading to diminished ovarian function. Several studies of in vitro fertilization (IVF) in women with HH revealed acceptable clinical pregnancy outcomes but high multiple pregnancy rates after multiple fresh embryo transfer (ET). The purpose of this study was to analyze the outcomes of combined freeze-all embryos and single vitrified-warmed ET in women with HH. METHODS: Of 91 infertile women with HH (basal luteinizing hormone and follicle-stimulating hormone levels <2...
February 13, 2018: Journal of Obstetrics and Gynaecology Research
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
Marzieh Aghahosseini, Ashraf Aleyasin, Venus Chegini, Victoria Chegini
Background: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication, which can cause high morbidity and mortality. Use of gonadotropin releasing hormone (GnRH) agonist instead of human chorionic gonadotropin (hCG) in GnRH antagonist cycles causes luteinizing hormone surge by GnRH stimulation which reduces the risk of OHSS by reducing the total amount of gonadotropin; however, there is no possibility of transferring fresh embryos. Objective: The current study aimed to evaluate the effect of hCG along with GnRH agonist administration in the occurrence of OHSS and pregnancy rate in females undergoing in vitro fertilization...
November 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
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
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