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Ovarian Stimulation (ovarian + stimulation)
Selected AbstractsAge, FSH Dose and Follicular Aspiration Frequency Affect Oocyte Yield from Juvenile Donor LambsREPRODUCTION IN DOMESTIC ANIMALS, Issue 3 2007I Valasi Contents Experiments were conducted to determine the effects of lamb age, frequency of follicular aspirations, and hormone stimulation by fixed or variable FSH dose, on the number of collected oocytes and their maturational competence. In trial 1, the characteristics of follicular population (number and diameter of follicles) were studied in 40 lambs which were slaughtered at the age of 30 days (S1), 42 days (S2), 60 days (S3) and 5,6 months (S4), each n = 10. In trial 2, 27 lambs were divided into four groups. group MF lambs (n = 6) had follicular aspiration (OPU) in four monthly intervals commencing from the age of 8,9 weeks (sessions MF1, MF2, MF3 and MF4). In groups SF2, SF3 and SF4 (each n = 6), OPU was conducted once during the 12,13, 16,17 and 20,21 week of age, respectively. Ovarian stimulation was conducted with fixed FSH dose (3.52 mg/animal). In trial 3, 10 lambs (group MV) were treated as those of group MF apart from the FSH dose, which was administered according to the body weight in a dose of 0.27 mg/kg. The number and the size of follicles, the number and the quality of collected oocytes and the maturational competence of the oocytes were compared between and within groups. In trial 1, the total number and the number of small follicles were greater in groups S1 and S2 compared with those of S3 and S4 (p < 0.01). Similarly, the follicular population was greater in group MF1 than in group SF3 (p < 0.01). In sessions MF2, MF3, MV2, MV3 and MV4, more oocytes were collected in comparison with those from the respective once-aspirated age mates (groups SF2, SF3 and SF4). In total, more (p = 0.02) oocytes per donor were collected from group MV (15.2 ± 5.5) than from group MF (9.0 ± 3.2). An absolute maturational failure was observed in oocytes collected from groups SF2 and SF3. Maturational competence varied between 16.7% and 58.3% (p = 0.017) among sessions of group MF, but it was more uniform among sessions of group MV (range 12.5,42.9%, p > 0.05). Our results indicate that firstly, the number and the quality of harvested oocytes from juvenile lambs can be much improved if follicular stimulation regime is adjusted to the body weight. Secondly, in terms of follicular population and oocyte quality, 3 and 4-month-old lambs are naturally bad oocyte donors, but this characteristic can be reversed by a previous follicular ablation. [source] The influence of body weight on response to ovulation induction with gonadotrophins in 335 women with World Health Organization group II anovulatory infertilityBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2006AH Balen Objective, To assess the influence of body weight on the outcome of ovulation induction in women with World Health Organization (WHO) group II anovulatory infertility. Design, The combined results of two studies in which either a highly purified urinary follicle-stimulating hormone or highly purified urinary menotrophin were compared with recombinant follicle-stimulating hormone. Setting, Thirty-six fertility clinics. Population, A total of 335 women with WHO group II anovulatory infertility failing to ovulate or conceive on clomifene citrate. Methods, Ovarian stimulation using a low-dose step-up protocol. Main outcome measures, The effects of body weight on ovarian response, ovulation rate and pregnancy rate after one treatment cycle. Results, With increasing body mass index (BMI), a higher threshold dose of gonadotrophins was required and there were more days of stimulation; yet, despite a greater concentration of antral follicles, there were fewer intermediate and large follicles. There was no difference in the rates of ovulation and clinical pregnancy in relation to body weight. Conclusions, Body weight affects gonadotrophin requirements but not overall outcome of ovulation induction in women with anovulatory polycystic ovary syndrome and a BMI of less than 35 kg/m2. [source] Ovarian follicular development stimulated by leuprorelin acetate plus human menopausal gonadotropin in chimpanzeesJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2 2005Nobuhiko Yoshimoto Abstract:, We attempted ovarian stimulation using gonadotropins in 14 chimpanzees. Subjects were given a single administration of leuprorelin acetate, followed by repeated administration of human menopausal gonadotropin (hMG) for 16,21 days. During the dosing period, the ovarian follicle diameter and count were measured by transvaginal ultrasonography. The hormone administration induced the development of multiple follicles, and multiple oocytes were subsequently retrieved. However, the follicle count was decreased, suggesting atresia, in some subjects. Statistically, the final follicle diameter was dependent on the dosing duration and the hMG dose in the late stage, while the maximum follicle count during hMG administration was dependent on age and the hMG dose in the early stage. Five subjects showed mild ovarian hyperstimulation syndrome (OHSS)-like symptoms with a high serum estradiol (E2) concentration. These results suggest that leuprorelin acetate plus hMG administration successfully stimulates the development of multiple ovarian follicles for oocyte retrieval and that the serum E2 concentration is predictive of OHSS-like symptoms in chimpanzees. [source] New frontiers of assisted reproductive technology (Chien Tien Hsu Memorial Lecture 2007)JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009P. C. Ho Abstract Many significant advances have been made in assisted reproductive technology since the birth of the first baby conceived with in vitro fertilization and embryo transfer. The development of recombinant gonadotropins and gonadotropin releasing hormone antagonists helps to simplify the ovarian stimulation. Excessive ovarian stimulation should be avoided because of the risks of ovarian hyperstimulation syndrome and reduction in endometrial receptivity. Maturation of oocytes in vitro has been developed in some centers. It is still uncertain whether techniques such as assisted hatching, blastocyst transfer and pre-implantation aneuploidy screening can improve the live birth rates in assisted reproduction. The introduction of pre-implantation genetic diagnosis for selection of human lymphocyte antigens (HLA) compatible embryos for treatment of siblings has raised ethical concerns. There is a higher risk of obstetric complications and congenital abnormalities even in singleton pregnancies achieved with assisted reproduction. Because of the risks of multiple pregnancies, elective single embryo transfer is increasingly used in good-prognosis patients. With a good freezing program, the cumulative pregnancy rate (including the pregnancies from subsequent replacement of frozen-thawed embryos) is not adversely affected. Improvement in cryopreservation techniques has made it possible to cryopreserve slices of ovarian tissue or oocytes, thus helping women who have to receive sterilizing forms of anti-cancer treatment to preserve their fertility. It is important that the development of the new techniques should be based on good scientific evidence. Ethical, legal and social implications should also be considered before the introduction of new techniques. [source] Adnexal torsion during pregnancy: Report of four cases and review of the literatureJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4pt2 2008Dimitris Hasiakos Abstract Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. It is frequently associated with ovarian stimulation for in vitro fertilization (IVF) or with ovarian masses, mainly of functional origin. The clinical, laboratory and imaging findings are non-specific. The authors present four cases with adnexal torsion diagnosed during the first trimester of pregnancy. The clinical picture, the mode of diagnosis, and the therapeutic approach are discussed. In two cases, the adnexa was removed, because there was extensive hemorrhage and ischemia. In the other two cases, unwinding of the adnexa was carried out and the ovary was preserved. The diagnosis of adnexal torsion is difficult, especially during pregnancy, and occasionally remains a diagnostic dilemma. It necessitates a prompt surgical intervention, because any delay leads to irreversible ovarian necrosis, so that adnexectomy is ultimately required. [source] In-vitro Fertilization and Embryo Transfer and Cellular Immunity: Study on Cytokines and T Lymphocyte subpopulations in IVF-ET CyclesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2002Mitsutaka Murakami Objectives: To determine whether peripheral T lymphocyte subpopulations and cytokines change during in-vitro fertilization and embryo transfer (IVF-ET) cycles and to evaluate them with regard to pregnancy status and types of infertility. Methods: Peripheral T lymphocyte subpopulations and cytokines in 33 consecutive cycles of IVF-ET were examined. All the women were stimulated with purified FSH and hCG after pituitary suppression with GnRH agonist. Peripheral blood samples were collected before FSH administration, on the day of hCG administration, the day of ET (day 2), day 6 and day 15. We measured plasma estradiol and progesterone levels and plasma interferon-,, interleukin-4 (IL-4), IL-10 and IL-12 levels. Peripheral T lymphocyte subpopulations, T helper type 1 and 2 cells (Th1 and Th2) and T cytotoxic type 1 and 2 cells (Tc1 and Tc2), were analyzed with three-color flowcytometry. Results: There were no changes in the plasma levels of the cytokines or in the proportions of Th1 and Th2 and the proportions of Tc1 and Tc2 in peripheral blood lymphocytes during the IVF-ET cycles. In women with endometriosis, the ratios of Tc1 to CD8+ lymphocytes and the Tc1 to Tc2 ratios before FSH administration were much higher than in women without endometriosis. The ratios of Tc1 to CD8+ lymphocytes were significantly lower in the patients with endometriosis who became pregnant. Conclusions: Peripheral cellular immunity does not change during IVF-ET cycles. In women with endometriosis, the peripheral Tc1 subpopulation is more predominant before ovarian stimulation, suggest- ing that the ratio of Tc1 before ovarian stimulation could be an indicator of fecundity for women with endometriosis. [source] Ovarian reserve tests and their utility in predicting response to controlled ovarian stimulation in rhesus monkeysAMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2010Julie M. Wu Abstract Controlled ovarian stimulation (COS) is an alternative to natural breeding in nonhuman primates; however, these protocols are costly with no guarantee of success. Toward the objective of predicting COS outcome in rhesus monkeys, this study evaluated three clinically used ovarian reserve tests (ORTs): day 3 (d3) follicle-stimulating hormone (FSH) with d3 inhibin B (INHB), the clomiphene citrate challenge test (CCCT), and the exogenous FSH Ovarian Reserve Test. A COS was also performed and response was classified as either successful (COS+) or unsuccessful (COS,) and retrospectively compared with ORT predictions. FSH and INHB were assessed for best hormonal index in conjunction with the aforementioned tests. INHB was consistently more accurate than FSH in all the ORTs used. Overall, a modified version of the CCCT using INHB values yielded the best percentage of correct predictions. This is the first report of ORT evaluation in rhesus monkeys and may provide a useful diagnostic test before costly follicle stimulations, as well as predicting the onset of menopause. Am. J. Primatol. 72:672,680, 2010. © 2010 Wiley-Liss, Inc. [source] Evaluation of antral follicle growth in the macaque ovary during the menstrual cycle and controlled ovarian stimulation by high-resolution ultrasonographyAMERICAN JOURNAL OF PRIMATOLOGY, Issue 5 2009Cecily V. Bishop Abstract To date, ultrasonography of monkey ovaries is rare and typically of low resolution. The objectives of this study were to use state-of-the-art, high-resolution, transabdominal ultrasonography with real-time Doppler capabilities to: (1) determine whether one can reliably detect in real time the large dominant follicle, the corpus luteum (CL), and small (<2,mm) antral follicles on the ovaries of rhesus monkeys during the natural menstrual cycle; and (2) predict the follicular response of rhesus ovaries to controlled ovarian stimulation (COS) protocols. Rhesus monkeys were selected for transabdominal ultrasonography using a GE Voluson 730 Expert Doppler System at discrete stages of the menstrual cycle. Subsequently, serial ultrasound scanning was employed to observe growth of antral follicles and the CL. Finally, females were scanned to assess follicular growth during COS. The dominant structure and small antral follicles (<2,mm) were reliably visualized in real time. The follicle destined to ovulate could be identified by size differential by day 3 of the follicular phase. The number of small antral follicles present before onset of COS protocol correlated positively with the number of metaphase II-stage oocytes collected after treatment. The results of this study demonstrate that the population dynamics of antral follicle pools can be noninvasively evaluated in monkeys during natural and pharmacologic ovarian cycles. Am. J. Primatol. 71:384,392, 2009. © 2009 Wiley-Liss, Inc. [source] Choice in fertility preservation in girls and adolescent women with cancer,CANCER, Issue S7 2006Jeffrey Nisker MD Abstract With the cure rate for many pediatric malignancies now between 70% and 90%, infertility becomes an increasingly important issue. Strategies for preserving fertility in girls and adolescent women occur in two distinct phases. The first phase includes oophorectomy (usually unilateral) and cryopreservation of ovarian cortex slices or individual oocytes; ultrasound-guided needle aspiration of oocytes, with or without in vitro maturation (IVM), followed by cryopreservation; and ovarian autografting to a distant site. The second phase occurs if the woman chooses to pursue pregnancy, and includes IVM of the oocytes, followed by in vitro fertilization (IVF) and transfer of any created embryos to the woman's uterus (or to a surrogate's uterus if the cancer patient's uterus has been surgically removed or the endometrium destroyed by radiotherapy). For ovarian autografting, the woman would undergo menotropin ovarian stimulation and retrieval of matured oocytes (likely by laparotomy, but possibly by ultrasound-guided needle aspiration if the ovary is positioned in an inaccessible location). The ethical challenges with each of these phases are many of fertility preservation and include issues of informed choice (consent or refusal). The lack of proven benefit with these strategies and the associated potential physical and psychological harms require careful attention to the key elements of informed choice, which include decisional capacity, disclosure, understanding and voluntariness, and to the benefits of in-depth counseling to promote free and informed choice at a time that is emotionally difficult for the decision makers. Cancer 2006. © 2006 American Cancer Society. [source] | ||||||||||