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Journal of Assisted Reproduction and... Jan 1997It seems, therefore, that in PCOS patients stimulated for IVF with HMG, follicular-phase LH levels have an adverse effect on follicle and oocyte numbers as well as on... (Review)
Review
It seems, therefore, that in PCOS patients stimulated for IVF with HMG, follicular-phase LH levels have an adverse effect on follicle and oocyte numbers as well as on oocyte quality. Moreover, an inappropriately raised LH appears to have a deleterious effect on the pregnancy outcome by being associated with a greater possibility for miscarriage. On the other hand, the administration of GnRH-a in the long desensitization protocol seems to reverse the detrimental effect of increased LH concentrations on follicular and oocyte development, whereas the beneficial effect on oocyte maturity, although significant, appears to be less profound. Furthermore, GnRH-a administration is associated with a decreased risk for early abortion.
Topics: Female; Fertilization in Vitro; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Menotropins; Oocytes; Ovarian Follicle; Polycystic Ovary Syndrome; Pregnancy; Pregnancy Outcome
PubMed: 9013299
DOI: 10.1007/BF02765740 -
Fertility and Sterility Feb 1987The value of multiple parameters in the prediction of fertile cycles was prospectively evaluated in 52 menotropin-induced cycles. The periovulatory pattern of estradiol... (Comparative Study)
Comparative Study
The value of multiple parameters in the prediction of fertile cycles was prospectively evaluated in 52 menotropin-induced cycles. The periovulatory pattern of estradiol (E2) was found to correlate with conceptional cycles. E2 levels greater than 500 pg/ml on the day of human chorionic gonadotropin administration (day 0) with a further increase on day +1 (high ascending pattern--A1) were found to have a 51% predictive value for fertile cycles. Twelve of the 17 fertile cycles had an A1, type of response (71%), whereas the overall incidence of an A1 pattern was 42% (22 of 52). No pregnancies have occurred with preovulatory follicles less than or equal to 14 mm in diameter. The number of preovulatory follicles, E2 level on day 0, and midluteal progesterone had no predictive value for fertile cycles.
Topics: Anovulation; Chorionic Gonadotropin; Drug Therapy, Combination; Estradiol; Female; Humans; Infertility, Female; Menotropins; Menstrual Cycle; Ovulation Induction; Pregnancy; Prospective Studies
PubMed: 3102283
DOI: 10.1016/s0015-0282(16)49997-8 -
Fertility and Sterility Mar 1991
Topics: Female; Fertilization in Vitro; Gamete Intrafallopian Transfer; Humans; Infertility; Insemination, Artificial; Menotropins; Ovulation; Superovulation
PubMed: 1900477
DOI: 10.1016/s0015-0282(16)54170-3 -
Scientific Reports Mar 2018Medroxyprogesterone 17-acetate (MPA) combined with human menopausal gonadotropin (hMG) has been effectively used for ovarian stimulation in clinical practice. However,...
Medroxyprogesterone 17-acetate (MPA) combined with human menopausal gonadotropin (hMG) has been effectively used for ovarian stimulation in clinical practice. However, the molecular mechanism of MPA + hMG treatment in follicular development is poorly described. Here we performed a study to investigate the impact of MPA + hMG on ovarian stimulation utilizing a mouse model in vivo. Forty female BALB/C mice were randomly divided into four groups of 10 each and treated during ciestrus stage and continued for 5 days: control group, MPA group, hMG group, and MPA + hMG group. Morphological and molecular biology methods were used for detecting serum hormones and ovarian function. MPA + hMG group exhibited increasing follicle stimulating hormone (FSH), antral follicle, FSH receptor (FSHR) and phosphorylated mammal target of rapamycin (p-mTOR), and decreasing luteinizing hormone (LH), estradiol (E2), progesterone (P), corpus luteum, phosphoinositide 3-kinase (PI3K), Akt and mTOR compared with control group. In contrast, MPA + hMG group showed reduced FSH, LH, E2, P, corpus luteum, LH receptor (LHR), and activated PI3K,/Akt/mTOR pathway compared with hMG group (P < 0.05). Collectively, these data definitively established that MPA plus hMG may modulate the hormone, hormone receptor and PI3K/Akt/mTOR signaling pathway to influence follicular development in the mouse ovary. Our study provides overwhelming support for MPA + hMG as an effective treatment for infertility in women.
Topics: Animals; Disease Models, Animal; Female; Hormones; Humans; Medroxyprogesterone Acetate; Menopause; Menotropins; Mice; Mice, Inbred BALB C; Ovarian Follicle; Ovulation Induction; Random Allocation; Signal Transduction; Treatment Outcome
PubMed: 29535409
DOI: 10.1038/s41598-018-22797-6 -
Fertility and Sterility Apr 1993To examine the relationship of baseline and preovulatory serum E2, P, and LH levels and age with pregnancy outcome in polycystic ovarian syndrome (PCOS) patients...
Age and follicular phase estradiol are better predictors of pregnancy outcome than luteinizing hormone in menotropin ovulation induction for anovulatory polycystic ovarian syndrome.
OBJECTIVE
To examine the relationship of baseline and preovulatory serum E2, P, and LH levels and age with pregnancy outcome in polycystic ovarian syndrome (PCOS) patients undergoing hMG ovulation induction.
DESIGN
Retrospective analysis of all available data over 2 years.
SETTING
Tertiary referral ovulation induction clinic.
SUBJECTS
Forty-four anovulatory PCOS patients with 25 ovulatory nonconception and 50 conception cycles after hMG ovulation induction.
MAIN OUTCOME MEASURES
Ovulation (midluteal serum P > 25 nmol/L [7.86 ng/mL]); pregnancy (serum beta-hCG > 30 mIU/mL 16 days after ovulating injection); pregnancy outcome: pregnancy termination < 20 weeks' or > or = 20 weeks' amenorrhea.
RESULTS
Of the endocrine parameters considered, none was significantly different in nonconceptive and conceptive ovulatory cycles. Miscarriage was associated with low basal serum E2: median value for pregnancies ending < 20 weeks, 105 pmol/L (28.6 pg/mL) and for > or = 20 weeks 150 pmol/L (40.9 pg/mL). It was also significantly associated with age. For patients > 29.5 years of age, (29.5 years, population mean age) a baseline E2 < or = 140 pmol/L (38.2 pg/mL) had sensitivity 92%, specificity 54%, positive predictive value 65%, and negative predictive value 87% for the prediction of miscarriage. The nature of the previous cycle, the day of the cycle on which therapy commenced, and a past history of miscarriage were not related either to pregnancy outcome or to basal serum E2.
Topics: Abortion, Spontaneous; Adult; Estradiol; Female; Follicular Phase; Humans; Luteinizing Hormone; Maternal Age; Menotropins; Ovulation Induction; Polycystic Ovary Syndrome; Pregnancy; Retrospective Studies
PubMed: 8458487
DOI: 10.1016/s0015-0282(16)55850-6 -
Fertility and Sterility Feb 1988In an effort to overcome possible interference by endogenous gonadotropin-ovarian hormone dynamics, desensitization of the pituitary gonadotropins by a...
In an effort to overcome possible interference by endogenous gonadotropin-ovarian hormone dynamics, desensitization of the pituitary gonadotropins by a gonadotropin-releasing hormone agonist (GnRHa) was achieved in 12 women with repeatedly failed attempts at multiple follicular stimulation. Eight women were scheduled for in vitro fertilization (IVF) and embryo transfer (ET), and 4 for gamete intrafallopian transfer (GIFT). Stimulation failure was characterized by premature luteinization, poor estradiol (E2) response, or inadequate follicular growth. The agonist was administered by nasal spray 500 to 600 micrograms/day beginning on days 21 to 23 of the menstrual cycle. A rapid desensitization occurred by 7.6 +/- 0.6 days (mean +/- standard error [SE]) following the initial dose. Gonadotropin stimulation was begun when pituitary and ovarian suppression was judged to be adequate. In response to gonadotropin stimulation, a continuous rise of E2 was observed in all patients with a mean of 989 +/- 46 pg/ml on the day of hCG. A cohort of synchronized follicles was recruited and matured. The mean number of growing follicles per patient was significantly higher (P less than 0.0001) in combined therapy than in previously failed cycles (8.0 +/- 0.3 versus 3.2 +/- 0.1). All the patients underwent oocyte retrieval and 94.3% of the harvested oocytes were preovulatory. A high fertilization rate (89.7%) of the inseminated oocytes occurred in IVF patients.
Topics: Adult; Buserelin; Embryo Transfer; Female; Fertilization in Vitro; Humans; Menotropins; Ovulation Induction; Reproductive Techniques
PubMed: 3123277
DOI: 10.1016/s0015-0282(16)59718-0 -
Fertility and Sterility Aug 1976The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from...
The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from inadequate cervical mucus, was found. Hormone investigations revealed that these patients could be divided into two groups: those with low sex steroid profiles despite apparent ovulation, and a second group with normal sex steroid profiles. All patients were treated with ovulation-inducing agents in an attempt to produce "controlled" ovarian hyperstimulation and an improved cervical mucus. Four of six patients conceived. The rationale behind the use of ovulation-inducing agents in this situation is discussed.
Topics: Adult; Cervix Mucus; Clomiphene; Estradiol; Female; Fertility Agents, Female; Humans; Infertility, Female; Menotropins
PubMed: 955130
DOI: 10.1016/s0015-0282(16)42020-0 -
Fertility and Sterility Nov 2003To determine the cost of achieving pregnancy with different gonadotropin preparations. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVE
To determine the cost of achieving pregnancy with different gonadotropin preparations.
DESIGN
Cost-minimization analysis of a prospective randomized clinical trial.
SETTING
Twenty-two centers in six countries.
PATIENT(S)
Women 18 to 36 years of age with infertility for more than 1 year who were undergoing IVF or ICSI.
INTERVENTION(S)
Highly purified hMG or recombinant FSH.
RESULT(S)
Mean cost of achieving an ongoing pregnancy. The mean cost per patient treatment cycle was estimated to be pound 2423 with highly purified hMG (95% CI, pound 2356 to pound 2495) and pound 2745 with recombinant FSH (95% CI, pound 2658 to pound 2830). The ongoing pregnancy rate was 22% with highly purified hMG and 19% with recombinant FSH. The cost per ongoing pregnancy was pound 10781 with highly purified hMG (95% CI, pound 9056 to pound 12919) and pound 14284 with recombinant FSH (95% CI, pound 11883 to pound 17891).
CONCLUSION(S)
Highly purified hMG and recombinant FSH are equally effective, but highly purified hMG is less expensive per cycle. Using highly purified hMG instead of recombinant FSH would translate into a 13% increase in the number of cycles that could be offered.
Topics: Adult; Clinical Trials, Phase III as Topic; Cost Control; Cost-Benefit Analysis; Drug Costs; Female; Fertility Agents, Female; Fertilization in Vitro; Follicle Stimulating Hormone; Health Resources; Humans; Menotropins; Multicenter Studies as Topic; Pregnancy; Randomized Controlled Trials as Topic; Recombinant Proteins; Sperm Injections, Intracytoplasmic; Treatment Outcome
PubMed: 14607557
DOI: 10.1016/s0015-0282(03)02185-x -
Journal of Endocrinological... May 2015Gonadotropins are protein hormones which are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. There... (Review)
Review
Human recombinant follicle stimulating hormone (rFSH) compared to urinary human menopausal gonadotropin (HMG) for ovarian stimulation in assisted reproduction: a literature review and cost evaluation.
BACKGROUND
Gonadotropins are protein hormones which are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. There is still a lively debate on which type of gonadotropin medication should be used, either human menopausal gonadotropin or recombinant follicle-stimulating hormone. The objective of the study was to perform a systematic review of the recent literature to compare recombinant follicle-stimulating hormone to human menopausal gonadotropin with the aim to assess any differences in terms of efficacy and to provide a cost evaluation based on findings of this systematic review.
METHODS
The review was conducted selecting prospective, randomized, controlled trials comparing the two gonadotropin medications from a literature search of several databases. The outcome measure used to evaluate efficacy was the number of oocytes retrieved per cycle. In addition, a cost evaluation was performed based on retrieved efficacy data.
RESULTS
The number of oocytes retrieved appeared to be higher for human menopausal gonadotropin in only 2 studies while 10 out of 13 studies showed a higher mean number of oocytes retrieved per cycle for recombinant follicle-stimulating hormone. The results of the cost evaluation provided a similar cost per oocyte for both hormones.
CONCLUSIONS
Recombinant follicle-stimulating hormone treatment resulted in a higher oocytes yield per cycle than human menopausal gonadotropin at similar cost per oocyte.
Topics: Female; Follicle Stimulating Hormone, Human; Humans; Menotropins; Outcome Assessment, Health Care; Ovulation Induction
PubMed: 25480425
DOI: 10.1007/s40618-014-0204-4 -
International Journal of Molecular... Sep 2020Different Follicle Stimulating Hormone (FSH) formulation and Luteinizing Hormone (LH) are used in Assisted Reproductive Technology (ART) to induce follicles development...
Different Follicle Stimulating Hormone (FSH) formulation and Luteinizing Hormone (LH) are used in Assisted Reproductive Technology (ART) to induce follicles development and oocytes maturation, but it is still under debate which protocol is to be preferred. In the present study, the different effects on cumulus cells (CCs) of three controlled ovarian stimulation (COS) protocols, based on urinary FSH, recombinant FSH, or human Menopausal Gonadotropin (hMG) administration, were assessed. CCs were obtained from 42 normal-responders women undergoing COS, randomly divided into three groups according to the used gonadotropin formulation. Differences were found in the expression of genes belonging to the endocannabinoid system (the receptors , and , and the enzymes involved in the metabolisms of anandamide, and , and 2-acylglycerol, and ); consistently, changes in lipid (α, and ) and carbohydrate ( and ) metabolisms, in CCs' macromolecules composition (highlighted by Fourier Transform Infrared Microspectroscopy, FTIRM), and in the number of retrieved oocytes were found. For the first time, statistically significant evidence on the differences related to each COS protocol on the endocannabinoid system, metabolism and macromolecular composition of CCs was found, representing a proof of concept to be further confirmed in a larger cohort of patients.
Topics: Adult; Arachidonic Acids; Cells, Cultured; Cohort Studies; Cumulus Cells; Endocannabinoids; Female; Follicle Stimulating Hormone, Human; Gene Expression; Humans; Menotropins; Oocyte Retrieval; Ovulation Induction; Polyunsaturated Alkamides; Recombinant Proteins; Signal Transduction; Spectroscopy, Fourier Transform Infrared; Urofollitropin
PubMed: 32992491
DOI: 10.3390/ijms21197124