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Salem AA, Taha DA, Nasr AA, El-Sagheer M, Daghash W, Taghian RA. Effect of vitamin E, D-limonene, and their combination on nulliparous rabbit reproductive performance. Anim Reprod Sci 2023; 259:107378. [PMID: 37989002 DOI: 10.1016/j.anireprosci.2023.107378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Oxidative status is important in reproductive performance and using two natural antioxidants is more beneficial than one in nulliparous rabbits. The goal, effect of vitamin E (VitE), D-limonene (DL), and VitE+DL on maternal LBW (MLBW), conception (CR), pregnancy (PR), and kindling rates (KR), gestation length (GL), total litter size at birth (TLSB) and weaning (TLSW), live kits at birth (LKB) and weaning (LKW), dead kits at birth (DKB) and weaning (DKW), kits mortality rate at weaning (KMRW), Kit weight at birth (KWB) and weaning (KWW), total kit weight at birth (TKWB) and weaning (TKWW), and concentrations of progesterone (P4) and Malondialdehyde (MDA), during first two pregnancies. A total of 24 healthy female WNZ rabbits were randomly selected and assigned into four groups (6/each). Control (animals injected with 1.0 mL propylene glycol), VitE (60 mg IM injection/animal, 2X/week pre-mating and 3X post-mating until mid-pregnancy, DL (20 mg IM injection/animal, 2X/week pre-mating and 1X at mating, and VitE+DL (IM injection/animal with the same doses and times applied in VitE and DL groups. All animals were treated during 1st pregnancy only. The results confirmed that animals treated with VitE+DL gained significant maternal LBW in 1st pregnancy, reduced dead kit number at birth and kit mortality rate at weaning, increased live kits and total kit weight at birth and weaning in the two pregnancies, and also increased significantly kit weight at birth and weaning in the treatments than controls in the two pregnancies, and DL was greater in 1st pregnancy. Progesterone concentrations in mid-pregnancy rose significantly in VitE+DL during 1st pregnancy and DL in 2nd pregnancy. Malondialdehyde concentrations dropped significantly in VitE and VitE+DL in mid-pregnancy in the two pregnancies. Eventually, the integration of VitE and DL displayed their unique properties for improving productive and reproductive performance in nulliparous rabbits.
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Affiliation(s)
- Anas A Salem
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt.
| | - Doaa A Taha
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt.
| | - Asmaa Ae Nasr
- Pathology Department, Institute of Veterinary Health, Assiut, Egypt.
| | - Mohamed El-Sagheer
- Poultry Production Department, Fac. of Agriculture, Assiut University, Egypt
| | - Wael Daghash
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt
| | - Raghda A Taghian
- Animal Production Department, Fac. of Agriculture, Assiut University, Assiut, Egypt
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Blavier F, Faron G, Cools W, Blockeel C, Santos-Ribeiro S, Done E, Ranisavljevic N, Rayssiguier R, Fuchs F, Gucciardo L. Corpus luteum score, a simple Doppler examination to prognose early pregnancies. Eur J Obstet Gynecol Reprod Biol 2021; 258:324-331. [PMID: 33524776 DOI: 10.1016/j.ejogrb.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/04/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In early pregnancies, miscarriages and inconclusive ultrasound scans considering location and viability are very common. In several previous studies, serum progesterone levels predicted viability of pregnancy and, in recent ones, failed Pregnancies of Unknown Location (PUL), completion of miscarriage and complications. Corpus luteum, secreting progesterone in early pregnancy, was less studied. Some publications showed correlations between corpus luteum aspects and diagnosis of miscarriage but it was not evaluated for other outcomes in early pregnancy, such as failed PUL, completion of miscarriage or complications. We aimed to assess if Doppler examination of corpus luteum could also predict all these outcomes: failed PUL, diagnosis and completion of miscarriages and complications. STUDY DESIGN A single operator prospectively described and/or collected pictures of Doppler signal in the wall of the corpus luteum at most consultations in our early pregnancy unit and established a three-level score. All suspected or confirmed non-viable pregnancies with this score or/and serum progesterone levels were registered retrospectively. With logistic regressions, AIC/BIC, likelihood ratios, ROC curves, Mann-Whitney and Fisher exact tests, we evaluated the ability of the score, alone, to predict failed PUL, diagnosis and completion of miscarriages and the complications, and, combined, to improve previously published predictions. RESULTS From 277 included pregnancies, 186 (67.1 %) miscarried. Of these, 159/186 (85.5 %) fully evacuated without surgery: 114/186 (61.3 %) within 20 days after the first diagnosis and 45/186 (24.2 %) after more than 20 days. Twenty-seven patients (14.5 %) underwent surgical evacuation, including ten complications, five haemorrhages and five suspected infections. Logistic regression correlated strongly the corpus luteum score with failed PUL (p < 0.0001) and miscarriages (p < 0.0001). Moreover, rates of complications and swift non-surgical completions of miscarriage were respectively 0 % and 92 % with scores of 0, versus 6 % and 44 % with scores of 1, versus 16 % and 0 % with scores of 2. Combined with serum progesterone levels, this score improved most predictions. Adding parity or history of miscarriage in predictive models even increased these performances. CONCLUSIONS Corpus luteum score, alone, can predict failed PUL, diagnosis and completion of miscarriages and their complications. Combining this score with other factors (mainly serum progesterone levels) improves most predictions.
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Affiliation(s)
- Frederic Blavier
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium; Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France.
| | - Gilles Faron
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Wilfried Cools
- Interfaculty Centre for Data Processing and Statistics, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Christophe Blockeel
- Centre for Reproductive Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | | | - Elisa Done
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Noemie Ranisavljevic
- ART-PGD Department, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Romy Rayssiguier
- Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Florent Fuchs
- Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Leonardo Gucciardo
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
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Li S, Liu L, Meng T, Miao B, Sun M, Zhou C, Xu Y. Impact of Luteinized Unruptured Follicles on Clinical Outcomes of Natural Cycles for Frozen/Thawed Blastocyst Transfer. Front Endocrinol (Lausanne) 2021; 12:738005. [PMID: 34745005 PMCID: PMC8567098 DOI: 10.3389/fendo.2021.738005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/28/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the impact of luteinized unruptured follicles (LUF) on clinical outcomes of frozen/thawed embryo transfer (FET) of blastocysts. METHODS In this retrospective cohort study, 2,192 patients who had undergone blastocyst FET treatment with natural cycles from October 2014 to September 2017 were included. Using propensity score matching, 177 patients diagnosed with LUF (LUF group) were matched with 354 ovulating patients (ovulation group). The LUF group was further stratified by the average LH peak level of 30 IU/L. Clinical pregnancy rate and live birth rate were retrospectively analyzed between the LUF and ovulation groups, as well as between LUF subgroups. RESULTS After propensity score matching, general characteristics were similar in the LUF and ovulation groups. Clinical pregnancy rate in the LUF group was significantly lower than that in the ovulation group (47.46 vs. 58.76%, respectively, adjusted P = 0.01, OR 0.60, 95% CI 0.42-0.87). However, no significant difference was detected in live birth rate, although it was lower in the LUF group (43.50 vs. 50.00%, adjusted P = 0.19, OR 0.76, 95% CI 0.51-1.14). In the LUF subgroup analysis, both clinical pregnancy rate (43.02 vs. 62.30%, adjusted P = 0.02, OR 0.45, 95% CI 0.23-0.87) and live birth rate (37.21 vs. 59.02%, adjusted P = 0.01, OR 0.40, 95% CI 0.20-0.78) in the LH <30 IU/L subgroup were significantly lower than those in the LH ≥30 IU/L subgroup. CONCLUSION LUF negatively affected clinical outcomes of frozen/thawed embryo transfer of blastocysts, particularly when the LH surge was inadequate.
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Affiliation(s)
- Song Li
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lokwan Liu
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tian Meng
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Benyu Miao
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingna Sun
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Canquan Zhou
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanwen Xu
- Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Yanwen Xu,
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Medvediev MV, Malvasi A, Gustapane S, Tinelli A. Hemorrhagic corpus luteum: Clinical management update. Turk J Obstet Gynecol 2020; 17:300-309. [PMID: 33343977 PMCID: PMC7731611 DOI: 10.4274/tjod.galenos.2020.40359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 10/18/2020] [Indexed: 12/01/2022] Open
Abstract
Hemorrhagic corpus luteum (HCL) is an ovarian cyst formed after ovulation and caused by spontaneous bleeding into a corpus luteum (CL) cyst. When HCL rupture happens, a hemoperitoneum results. Clinical symptoms are mainly due to peritoneal irritation by the blood effusion. The differential diagnosis is extensive and standard management is not defined. The authors elaborated a comparison of the differential diagnosis and therapeutic modalities from the laparoscopic approach to nonsurgical, medical options because hemorrhage from HCL is often self-limiting. The authors reviewed all data implicated with the development of HCL, trying to give homogeneity to literature data. The authors analyzed extensive literature data and subdivided the medical approach into many topics. The wait-and-see attitude avoids unnecessary laparoscopic surgery using supportive therapies (antifibrinolytic, analgesics, liquid infusion, transfusions and antibiotic prophylaxis). Surgical therapy: operative management should be laparoscopic, with surgical options such as luteumectomy, ovarian wedge-shaped excision or oophorectomy. Prevention: the possibility to preserve fertility is essential, mainly in patients with bleeding disorders or undergoing anticoagulant therapy; therefore, they need estro-progestinics or GnRH analogues to prevent ovulation and avoid further episodes of HCL. This review will aid physicians in making an early diagnosis of HCL, to avoid unnecessary surgery, and use the most effective treatment.
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Affiliation(s)
- Mykhailo V Medvediev
- Dnipropetrovsk Medical Academy of Health Ministry of Ukraine, Dnipropetrovsk, Ukrain
| | - Antonio Malvasi
- Santa Maria Hospital, Gvm Care and Research, Clinic of Obstetrics and Gynaecology, Bari, Italy
| | - Sarah Gustapane
- Veris Delli Ponti Hospital, Clinic of Obstetrics and Gynecology, Scorrano, Lecce, Italy
| | - Andrea Tinelli
- Veris Delli Ponti Hospital, Chief of Clinic of Obstetrics and Gynecology, Scorrano, Lecce, Italy
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Luteal blood flow as a predictive factor for methotrexate treatment outcomes in women with unruptured tubal pregnancy. BMC Pregnancy Childbirth 2020; 20:190. [PMID: 32228498 PMCID: PMC7106736 DOI: 10.1186/s12884-020-02882-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blood flow in the corpus luteum is associated with luteal function. However, the impact of luteal blood flow on methotrexate (MTX) treatment in women with unruptured tubal pregnancy has not been reported. The aim of the present study was to observe the impact of luteal blood flow on the therapeutic effect of MTX in women with unruptured tubal pregnancy. METHODS A prospective observational study recruited 129 women with unruptured tubal pregnancy in the First Affiliated Hospital of Xi'an Jiaotong University from September 2016 to June 2018. One hundred and fifteen women were treated successfully with MTX, and women were divided into 2 groups according to luteal blood flow: the poor luteal blood flow group and the abundant luteal blood flow group. The therapeutic effects were compared between the two groups. RESULTS Women in the abundant luteal blood flow group had a significantly higher serum β-human chorionic gonadotropin (β-hCG) level 4 days, 1 week and 2 weeks after MTX treatment compared with women in the poor luteal blood flow group (P < 0.05). The average diameter of the ectopic mass 1 week, 2 weeks and 3 weeks after MTX treatment in women with abundant luteal blood flow was significantly larger (P < 0.05), and the time of serum β-hCG clearance and ectopic mass disappearance were significantly longer compared with those in women in the poor luteal blood flow group (P < 0.05). CONCLUSIONS Luteal blood flow might be a predictive factor for MTX treatment outcomes in women with unruptured tubal pregnancy, and those with abundant luteal blood flow need a longer recovery time.
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Sharma N, Saravanan M, Saravanan Mbbs L, Narayanan S. The role of color Doppler in assisted reproduction: A narrative review. Int J Reprod Biomed 2020; 17:779-788. [PMID: 31911960 PMCID: PMC6906874 DOI: 10.18502/ijrm.v17i10.5484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/06/2019] [Accepted: 05/12/2019] [Indexed: 11/24/2022] Open
Abstract
Color Doppler of perifollicular vascularity is a useful assessment tool to predict the growth potential and maturity of Graafian follicles. Power Angio is independent of the angle of insonation and morphometry and provides reliable clues to predict the implantation window of the endometrium. Color Doppler can be used for the prediction of ovarian hyperstimulation syndrome. It can also be used to identify the hyper responder and gonadotropin-resistant type of polycystic ovaries. The secretory scan of corpus luteum can accurately predict its vascularity and functional status. A corpus luteum with decreased blood flow is a very sensitive and specific indicator of threatened and missed abortions. Color Doppler and Power Angio need to be standardized and identical settings should be maintained if different patients, or if changes over time within the same patient are to be compared.
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Affiliation(s)
- Nidhi Sharma
- Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Mahalakshmi Saravanan
- Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Lakshmanan Saravanan Mbbs
- Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Sindujhaa Narayanan
- Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Han H, Mo X, Ma Y, Zhou Y, Zhang B. The Role of Blood Flow in Corpus Luteum Measured by Transvaginal Two-Dimensional and Three-Dimensional Ultrasound in the Prediction of Early Intrauterine Pregnancy Outcomes. Front Pharmacol 2019; 10:767. [PMID: 31354483 PMCID: PMC6637309 DOI: 10.3389/fphar.2019.00767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/13/2019] [Indexed: 12/01/2022] Open
Abstract
Objective: The purpose of this study was to explore the application of transvaginal two-dimensional and three-dimensional power Doppler ultrasound in pregnancy corpus luteum to predict the final outcome of early intrauterine pregnancy. Methods: This is a prospective observational cohort study. Six hundred early intrauterine pregnant women in Shanghai Changning Maternity and Infant Health Hospital were selected as the research objects from January 2015 to December 2015. According to the follow-up of 12 weeks, these pregnant women were divided into the normal pregnancy group (group A, n = 512) and the terminational pregnancy group (group B, n = 88). They all underwent both transvaginal two-dimensional ultrasound and three-dimensional power Doppler ultrasound to obtain relevant parameters of corpus luteum, namely, the average diameter of the corpus luteum (D), resistance index (RI), pulsatility index (PI), corpus luteum volume (V), vascularization index (VI), blood flow index (FI), and vascularized blood flow index (VFI). Among them, V, VI, FI, and VFI were calculated with the virtual organ computer-aided analysis method. Receiver operator characteristic (ROC) curves were drawn. The corresponding diagnostic cut-off, sensitivity, and specificity were calculated and compared. Results: Compared with group A, the D, V, VI, FI, and VFI of corpus luteum in group B were statistically significant lower while RI and PI were statistically significant higher (P < 0.05). The diagnostic cut-off values in the prediction of early intrauterine pregnancy outcomes were D: 14.48, RI: 0.56, PI: 0.81, V: 3.89, VI: 21.48, FI: 38.99, and VFI: 10.21 respectively, and the sensitivity and specificity were D (99.2%, 67.0%), RI (98.9%, 65.0%), PI (78.4%, 89.1%), V (95.1%, 78.4%), VI (74.%, 90.9%), FI (91.8%, 90.9%), and VFI (93.9%, 87.5%) respectively. The area under the ROC curve of the combined index (RI + FI) was 0.963, which was not significantly higher compared with any single index, and both the sensitivity and specificity were 94.3%. Conclusion: Both transvaginal two-dimensional and three-dimensional ultrasonography are of high diagnostic value in predicting the early intrauterine pregnancy outcomes.
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Affiliation(s)
- Huijuan Han
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China
| | - Xinhai Mo
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuqin Ma
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuqing Zhou
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China
| | - Bo Zhang
- Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Faustmann G, Meinitzer A, Magnes C, Tiran B, Obermayer-Pietsch B, Gruber HJ, Ribalta J, Rock E, Roob JM, Winklhofer-Roob BM. Progesterone-associated arginine decline at luteal phase of menstrual cycle and associations with related amino acids and nuclear factor kB activation. PLoS One 2018; 13:e0200489. [PMID: 29990354 PMCID: PMC6039037 DOI: 10.1371/journal.pone.0200489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/27/2018] [Indexed: 11/18/2022] Open
Abstract
Background/Objectives Given their role in female reproduction, the effects of progesterone on arginine and related amino acids, polyamines and NF-κB p65 activation were studied across the menstrual cycle. Methods Arginine, ornithine and citrulline as well as putrescine, spermidine, spermine, and N-acetyl-putrescine were determined in plasma, NF-κB p65 activation in peripheral blood mononuclear cells and progesterone in serum of 28 women at early (T1) and late follicular (T2) and mid (T3) and late (T4) luteal phase. Results Arginine and related amino acids declined from T1 and T2 to T3 and T4, while progesterone increased. At T3, arginine, ornithine, and citrulline were inversely related with progesterone. Changes (ΔT3-T2) in arginine, ornithine, and citrulline were inversely related with changes (ΔT3-T2) in progesterone. Ornithine and citrulline were positively related with arginine, as were changes (ΔT3-T2) in ornithine and citrulline with changes (ΔT3-T2) in arginine. At T2, NF-κB p65 activation was positively related with arginine. Polyamines did not change and were not related to progesterone. All results described were significant at P < 0.001. Conclusions This study for the first time provides data, at the plasma and PBMC level, supporting a proposed regulatory node of arginine and related amino acids, progesterone and NF-κB p65 at luteal phase of the menstrual cycle, aimed at successful preparation of pregnancy.
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Affiliation(s)
- Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Christoph Magnes
- Institute for Biomedicine and Health Sciences, HEALTH, Joanneum Research Forschungsgesellschaft m.b.H., Graz, Austria
| | - Beate Tiran
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | | | - Hans-Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Josep Ribalta
- Unitat de Recerca de Lipids I Arteriosclerosi, Facultat de Medicina, Universitat Rovira I Virgili, Facultat Medicina i Ciències de la Salut, Reus, Spain
| | - Edmond Rock
- Unité de Nutrition Humaine, Centre Auvergne Rhône-Alpes, Institut National de la Recherche Agronomique, Saint-Gènes-Champanelle, France
| | - Johannes M. Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | - Brigitte M. Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
- * E-mail:
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Devoto L, Henríquez S, Kohen P, Strauss JF. The significance of estradiol metabolites in human corpus luteum physiology. Steroids 2017; 123:50-54. [PMID: 28502859 DOI: 10.1016/j.steroids.2017.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/21/2017] [Accepted: 05/03/2017] [Indexed: 12/29/2022]
Abstract
The human corpus luteum (CL) is a temporary endocrine gland derived from the ovulated follicle. Its formation and limited lifespan is critical for steroid hormone production required to support menstrual cyclicity, endometrial receptivity for successful implantation, and the maintenance of early pregnancy. Endocrine and paracrine-autocrine molecular mechanisms associated with progesterone production throughout the luteal phase are critical for the development, maintenance, regression, and rescue by hCG which sustains CL function into early pregnancy. However, the signaling systems driving the regression of the primate corpus luteum in non-conception cycles are not well understood. Recently, there has been interest in the functional roles of estradiol metabolites (EMs), mostly in estrogen-producing tissues. The human CL produces a number of EMs, and it has been postulated that the EMs acting via paracrine-autocrine pathways affect angiogenesis or LH-mediated events. The present review describes advances in understanding the role of EMs in the functional lifespan and regression of the human CL in non-conception cycles.
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Affiliation(s)
- Luigi Devoto
- Institute for Maternal and Child Research (IDIMI), Chile; Department of Obstetrics and Gynecology, Faculty of Medicine, San Borja-Arriaran Clinical Hospital, University of Chile, Santiago, Chile.
| | | | - Paulina Kohen
- Institute for Maternal and Child Research (IDIMI), Chile
| | - Jerome F Strauss
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States
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Gómez-Seco C, Alegre B, Martínez-Pastor F, Prieto JG, González-Montaña JR, Alonso ME, Domínguez JC. Evolution of the corpus luteum volume determined ultrasonographically and its relation to the plasma progesterone concentration after artificial insemination in pregnant and non-pregnant dairy cows. Vet Res Commun 2017; 41:183-188. [DOI: 10.1007/s11259-017-9685-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
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Hiramoto K, Yamate Y, Sato EF. Gp91phox NADPH oxidase modulates litter size by regulating mucin1 in the uterus of mice. Syst Biol Reprod Med 2017; 63:130-139. [PMID: 28301257 DOI: 10.1080/19396368.2017.1282063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Active oxygen derived from gp91phox is critical for gestation. However, no reports have evaluated the relationship between reactive oxygen species (ROS) and the number of births in a given pregnancy. In this study, we examined the influence of ROS produced by gp91phox activity on the number of births using C57BL/6j (control) and gp91phox-knockout (gp91phox-/-) mice. The number of births in gp91phox-/- mice was found to be lower than that in control mice. We observed sequential increases in gp91phox, ROS, nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3), caspase-1, and interleukin-18 (IL-18), followed by increased expression of mucin1 (MUC1), in control mice. However, none of these markers were upregulated in gp91phox-/- mice. In addition, in control mice administered IL-18 or MUC1 inhibitors, the number of births decreased to a number similar to that of gp91phox-/- mice. These results suggest that ROS derived from gp91phox activity altered the inflammatory system and produced IL-18, which subsequently increased the expression of MUC1, thereby modulating fetal development. ABBREVIATIONS IL-1 β: interleukin-1β; IL-18: interleukin-18; NLRP3: nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3; IgA: immunoglobulin A; MUC1: mucin1.
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Affiliation(s)
- Keiichi Hiramoto
- a Department of Pharmaceutical Sciences , Suzuka University of Medical Science , Suzuka , Mie , Japan
| | - Yurika Yamate
- a Department of Pharmaceutical Sciences , Suzuka University of Medical Science , Suzuka , Mie , Japan
| | - Eisuke F Sato
- a Department of Pharmaceutical Sciences , Suzuka University of Medical Science , Suzuka , Mie , Japan
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Giugliano E, Cagnazzo E, Vesce F, Giugliano B, Caserta D, Moscarini M, Caldarelli C, Stellin G, Marci R. Doppler velocimetry of the ovarian artery as a tool to detect LH surge in stimulated cycles. Gynecol Endocrinol 2014; 30:627-31. [PMID: 24983776 DOI: 10.3109/09513590.2014.911276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Our aim was to assess the velocimetric pattern of the ovarian artery as a possible marker of LH surge in stimulated cycles. A total of 130 women undergoing ovarian stimulation for intrauterine insemination were randomized in two groups. Each woman was stimulated with 75 IU of recombinant FSH starting from the third day of the cycle. Velocimetric indices of the dominant ovarian artery were compared between patients with spontaneous LH surge and those needing HCG administration to trigger dominant follicle rupture. The pulsatility index and the ratio between peak systolic flow and lowest diastolic flow were significantly higher in women that had a spontaneous triggering of ovulation. These parameters had a high and very significant positive correlation with the dosage of luteinizing hormone. Threshold values of 2.60 for PI and 7.68 for S/D had a high sensitivity and specificity to predict LH surge. These velocimetric results demonstrated that an increased resistance in the dominant ovarian artery is correlated to LH surge in stimulated cycles. It may represent a sign of relevant clinical utility in timing of intrauterine insemination and/or natural intercourse.
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Affiliation(s)
- Emilio Giugliano
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara , Ferrara , Italy
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13
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Bishop CV, Molskness TA, Xu F, Belcik JT, Lindner JR, Slayden OD, Stouffer RL. Quantification of dynamic changes to blood volume and vascular flow in the primate corpus luteum during the menstrual cycle. J Med Primatol 2014; 43:445-54. [PMID: 24948037 DOI: 10.1111/jmp.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 01/28/2023]
Abstract
BACKGROUND The objective of the current study was to determine changes to vascular parameters of nonhuman primate dominant ovarian structures by dynamic contrast-enhanced ultrasound (DCE-US). MATERIALS AND METHODS Dynamic contrast-enhanced ultrasound with intravenous microbubble infusion was performed on the rhesus macaque ovary bearing the pre-ovulatory follicle and corpus luteum (CL) sequentially during the natural luteal phase (n = 8) and GnRH antagonist (antide)-induced luteal regression (n = 6). RESULTS Changes in luteal blood volume (BV) and vascular flow (VF) were observed between stages of the luteal phase Luteal BV was highest in early stage CL, before decreasing 2.5-fold in late stage CL (P < 0.06); in contrast, luteal VF peaked at mid luteal stage (P < 0.01). Two females identified with luteal insufficiency trended toward lower peak BV, compared to typical CLs. Another female was identified with a luteal cyst on the contralateral ovary, and a CL that regressed before P levels declined. After 72 hours of antide exposure, BV was reduced 2.3-fold (P = 0.03). CONCLUSIONS DCE-US provides a sensitive, non-invasive measurement of the dynamics of blood volume and flow in dominant ovarian structures.
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Affiliation(s)
- Cecily V Bishop
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
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14
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Tamura H, Takasaki A, Taketani T, Tanabe M, Lee L, Tamura I, Maekawa R, Aasada H, Yamagata Y, Sugino N. Melatonin and female reproduction. J Obstet Gynaecol Res 2013; 40:1-11. [PMID: 24118696 DOI: 10.1111/jog.12177] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Melatonin (N-acetyl-5-methoxytryptamine) is secreted during the dark hours at night by the pineal gland. After entering the circulation, melatonin acts as an endocrine factor and a chemical messenger of light and darkness. It regulates a variety of important central and peripheral actions related to circadian rhythms and reproduction. It also affects the brain, immune, gastrointestinal, cardiovascular, renal, bone and endocrine functions and acts as an oncostatic and anti-aging molecule. Many of melatonin's actions are mediated through interactions with specific membrane-bound receptors expressed not only in the central nervous system, but also in peripheral tissues. Melatonin also acts through non-receptor-mediated mechanisms, for example serving as a scavenger for reactive oxygen species and reactive nitrogen species. At both physiological and pharmacological concentrations, melatonin attenuates and counteracts oxidative stress and regulates cellular metabolism. Growing scientific evidence of reproductive physiology supports the role of melatonin in human reproduction. This review was conducted to investigate the effects of melatonin on female reproduction and to summarize our findings in this field.
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Affiliation(s)
- Hiroshi Tamura
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube, Japan
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15
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Polisca A, Zelli R, Troisi A, Orlandi R, Brecchia G, Boiti C. Power and pulsed Doppler evaluation of ovarian hemodynamic changes during diestrus in pregnant and nonpregnant bitches. Theriogenology 2013; 79:219-24. [DOI: 10.1016/j.theriogenology.2012.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/05/2012] [Accepted: 08/10/2012] [Indexed: 11/15/2022]
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16
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Tamura H, Takasaki A, Taketani T, Tanabe M, Kizuka F, Lee L, Tamura I, Maekawa R, Asada H, Yamagata Y, Sugino N. Melatonin as a free radical scavenger in the ovarian follicle. Endocr J 2013; 60:1-13. [PMID: 23171705 DOI: 10.1507/endocrj.ej12-0263] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This review summarizes new findings related to beneficial effects of melatonin (N-acetyl-5-methoxytryptamine) on reproductive physiology. Recently many researchers have begun to study the local role of melatonin as an antioxidant. We focused on intra-follicular role of melatonin in the ovary. Melatonin, secreted by the pineal gland, is taken up into the follicular fluid from the blood. Reactive oxygen species (ROS) are produced within the follicles, during the ovulatory process. Melatonin reduces oxidative stress as an antioxidant, and contribute to oocyte maturation, embryo development and luteinization of granulosa cells. Our clinical study demonstrated that melatonin treatment for infertile women increases intra-follicular melatonin concentrations, reduces intra-follicular oxidative damage, and elevates fertilization and pregnancy rates. Melatonin treatment also improves progesterone production by corpus luteum in infertile women with luteal phase defect. Melatonin treatment could become a new cure for improving oocyte quality and luteal function in infertile women.
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Affiliation(s)
- Hiroshi Tamura
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan.
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Abstract
Luteal phase insufficiency is one of the reasons for implantation failure and has been responsible for miscarriages and unsuccessful assisted reproduction. Luteal phase defect is seen in women with polycystic ovaries, thyroid and prolactin disorder. Low progesterone environment is created iatrogenically due to interventions in assisted reproduction. Use of gonadotrophin-releasing hormone analogs to prevent the LH surge and aspiration of granulosa cells during the oocyte retrieval may impair the ability of corpus luteum to produce progesterone. Treatment of the underlying disorder and use of progestational agents like progesterone/human chorionic gonadotrophin have been found to be effective in women with a history of recurrent miscarriage. There has been no proved beneficial effect of using additional agents like ascorbic acid, estrogen, prednisolone along with progesterone. Despite their widespread use, further studies are required to establish the optimal treatment. Literature review and analysis of published studies on luteal phase support.
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Affiliation(s)
- Duru Shah
- Gynaecworld and Gynaecworld Assisted Fertility Unit Mumbai, Gynaecworld, Mumbai, India
| | - Nagadeepti Nagarajan
- Gynaecworld and Gynaecworld Assisted Fertility Unit Mumbai, Gynaecworld, Mumbai, India
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18
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Bollwein H, Lüttgenau J, Herzog K. Bovine luteal blood flow: basic mechanism and clinical relevance. Reprod Fertil Dev 2013; 25:71-9. [DOI: 10.1071/rd12278] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The introduction of transrectal colour Doppler sonography (CDS) has allowed the evaluation of luteal blood flow (LBF) in cows. Because appropriate angiogenesis plays a decisive role in the functioning of the corpus luteum (CL), studies on LBF may provide valuable information about the physiology and pathophysiology of the CL. Studies on cyclic cows have shown that progesterone concentrations in blood plasma can be more reliably predicted by LBF than by luteal size (LS), especially during the regression phase of the CL. In contrast with non-pregnant cows, a significant increase in LBF is seen in pregnant cows during the third week after insemination. However, because there are high interindividual variations in LBF between animals, LBF is not useful for the early diagnosis of pregnancy. Determination of LBF is more sensitive than LS for detecting the effects of acute systemic inflammation and exogenous hormones on the CL. Cows with low progesterone levels have smaller CL during the mid-luteal phase, but LBF related to LS did not differ between cows with low and high progesterone levels. In conclusion, LBF determined by CDS provides additional information about luteal function compared with LS and plasma progesterone concentrations, but its role concerning fertility in the cow is yet to be clarified.
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Kizuka F, Tokuda N, Takagi K, Adachi Y, Lee L, Tamura I, Maekawa R, Taketani T, Tamura H, Suzuki T, Owada Y, Sugino N. Involvement of bone marrow-derived vascular progenitor cells in neovascularization during formation of the corpus luteum in mice. Biol Reprod 2012; 87:55. [PMID: 22674393 DOI: 10.1095/biolreprod.112.099960] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Neovascularization is necessary for formation of the corpus luteum (CL) and includes angiogenesis and vasculogenesis. Vasculogenesis is the formation of new blood vessels by bone marrow-derived endothelial progenitor cells. Here we investigated whether vasculogenesis occurs in neovascularization during CL formation. Mice transplanted with bone marrow from transgenic mice expressing green fluorescent protein (GFP) were injected with equine chorionic gonadotropin and human chorionic gonadotropin (hCG) to induce ovulation and subsequent CL formation. Immunohistochemistry was performed on the ovaries obtained before hCG injection and at 6, 12, and 24 h after hCG injection using antibodies for CD34 or CD31 (an endothelial cell marker), platelet-derived growth factor receptor beta (PDGFR-beta, a pericyte marker), F4/80 (a macrophage marker), and GFP (a bone marrow-derived cell marker). Cells immunostained for CD34, PDGFR-beta, F4/80, and GFP were present in the theca cell layer of the preovulatory follicle before hCG injection. Each of these cell types invaded the granulosa cell layer after hCG injection, and a number of them were observed in the CL 24 h after hCG injection. Fluorescence-based immunohistochemistry or double immunohistochemical staining revealed that a few CD34/CD31-positive cells and PDGFR-beta-positive cells were also positive for GFP in the preovulatory follicle and CL, and that many of the GFP-positive cells recruited to the CL during CL formation were F4/80-positive macrophages. In conclusion, bone marrow-derived vascular progenitor cells and macrophages contribute to neovascularization during CL formation.
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Affiliation(s)
- Fumie Kizuka
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube, Japan
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20
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QIU JUNJUN, LIU MANHUA, ZHANG ZHONGXIN, CHEN LIPING, YANG QICHANG, LIU HONGBING. Transvaginal color Doppler sonography predicts ovarian interstitial fibrosis and microvascular injury in women with ovarian endometriotic cysts. Acta Obstet Gynecol Scand 2012; 91:605-12. [DOI: 10.1111/j.1600-0412.2012.01370.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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21
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van Diepen HA, Pansier J, Oude Wesselink P, van Drie A, van Duin M, Mulders S. Non-invasive translational Cynomolgus model for studying folliculogenesis and ovulation using color Doppler ultrasonography. J Med Primatol 2011; 41:18-23. [PMID: 22084982 DOI: 10.1111/j.1600-0684.2011.00514.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In women, different events of folliculogenesis can be measured and evaluated using ultrasound (US) technology. The availability of a non-invasive translational non-human primate model to study these processes would represent a major contribution to further advance R&D efforts toward novel therapies in assisted reproduction. METHODS In our study, follicular growth and ovulation was measured in six cyclic Cynomolgus monkeys using abdominal Doppler US. RESULTS The mean follicular diameter on cycle day -6 (cycle day 0=day of ovulation) was 3.7mm that increased to 6.8mm on cycle day -1. After ovulation, the mean diameter decreased to 4.6mm, confirming ovulation. The mean percentage of follicular size reduction after ovulation was 31%. CONCLUSION Ultrasonography in combination with color-flow Doppler imaging was shown to be a useful, non-invasive translational method to measure ovarian follicular growth and occurrence and timing of follicular rupture in Cynomolgus monkeys.
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Affiliation(s)
- Harry A van Diepen
- Women's Health Department, Merck Research Laboratories, Oss, The Netherlands.
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22
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Qiu JJ, Liu YL, Liu MH, Chen LP, Xu DW, Zhang ZX, Yang QC, Liu HB. Ovarian interstitial blood flow changes assessed by transvaginal colour Doppler sonography: predicting ovarian endometrioid cyst-induced injury to ovarian interstitial vessels. Arch Gynecol Obstet 2011; 285:427-33. [DOI: 10.1007/s00404-011-1971-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 06/23/2011] [Indexed: 10/18/2022]
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23
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Lüttgenau J, Beindorff N, Ulbrich S, Kastelic J, Bollwein H. Low plasma progesterone concentrations are accompanied by reduced luteal blood flow and increased size of the dominant follicle in dairy cows. Theriogenology 2011; 76:12-22. [DOI: 10.1016/j.theriogenology.2010.12.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 11/29/2010] [Accepted: 12/26/2010] [Indexed: 10/18/2022]
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24
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Impact of luteinized unruptured follicles on endometrial receptivity. ACTA ACUST UNITED AC 2011; 31:181. [DOI: 10.1007/s11596-011-0248-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Indexed: 11/26/2022]
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25
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Luteal blood flow increases during the first three weeks of pregnancy in lactating dairy cows. Theriogenology 2011; 75:549-54. [DOI: 10.1016/j.theriogenology.2010.09.024] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 09/16/2010] [Accepted: 09/20/2010] [Indexed: 12/25/2022]
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26
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Takasaki A, Tamura I, Kizuka F, Lee L, Maekawa R, Asada H, Taketani T, Tamura H, Shimamura K, Morioka H, Sugino N. Luteal blood flow in patients undergoing GnRH agonist long protocol. J Ovarian Res 2011; 4:2. [PMID: 21219663 PMCID: PMC3024996 DOI: 10.1186/1757-2215-4-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 01/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blood flow in the corpus luteum (CL) is closely related to luteal function. It is unclear how luteal blood flow is regulated. Standardized ovarian-stimulation protocol with a gonadotropin-releasing hormone agonist (GnRHa long protocol) causes luteal phase defect because it drastically suppresses serum LH levels. Examining luteal blood flow in the patient undergoing GnRHa long protocol may be useful to know whether luteal blood flow is regulated by LH. METHODS Twenty-four infertile women undergoing GnRHa long protocol were divided into 3 groups dependent on luteal supports; 9 women were given ethinylestradiol plus norgestrel (Planovar) orally throughout the luteal phase (control group); 8 women were given HCG 2,000 IU on days 2 and 4 day after ovulation induction in addition to Planovar (HCG group); 7 women were given vitamin E (600 mg/day) orally throughout the luteal phase in addition to Planovar (vitamin E group). Blood flow impedance was measured in each CL during the mid-luteal phase by transvaginal color-pulsed-Doppler-ultrasonography and was expressed as a CL-resistance index (CL-RI). RESULTS Serum LH levels were remarkably suppressed in all the groups. CL-RI in the control group was more than the cutoff value (0.51), and only 2 out of 9 women had CL-RI values < 0.51. Treatments with HCG or vitamin E significantly improved the CL-RI to less than 0.51. Seven of the 8 women in the HCG group and all of the women in the vitamin E group had CL-RI < 0.51. CONCLUSION Patients undergoing GnRHa long protocol had high luteal blood flow impedance with very low serum LH levels. HCG administration improved luteal blood flow impedance. This suggests that luteal blood flow is regulated by LH.
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Affiliation(s)
- Akihisa Takasaki
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan.
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27
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28
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Daya S. Luteal support: progestogens for pregnancy protection. Maturitas 2009; 65 Suppl 1:S29-34. [PMID: 19913373 DOI: 10.1016/j.maturitas.2009.09.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 09/14/2009] [Indexed: 12/18/2022]
Abstract
Following ovulation, the granulosa cells undergo luteinization and form part of the corpus luteum; this then secretes progesterone that causes secretory transformation of the endometrium so that implantation can occur. The ideal time for implantation is 6-10 days after the luteinizing hormone (LH) surge; implantation occurring outside this optimal window is associated with a higher likelihood of miscarriage. Before the placenta takes over progesterone production, the progesterone produced by the corpus luteum also provides the necessary support to early pregnancy. A defect in corpus luteum function is not only associated with implantation failure but also with miscarriage. In assisted reproduction, both the use of gonadotropin-releasing hormone analogues to prevent the LH surge and aspiration of granulosa cells during the oocyte retrieval may impair the ability of the corpus luteum to produce sufficient progesterone. This may be treated effectively with progestational agents such as progesterone or dydrogesterone, which have a very similar pharmacological profile. Studies indicate that an estrogen may be given during the luteal phase to optimise the estrogen:progestogen ratio to facilitate implantation, although the available evidence is inconsistent in its strength for this hypothesis. In addition to assisted reproduction, progestational agents have shown beneficial effects in the management of patients with recurrent spontaneous miscarriage of unknown cause. In conclusion, despite the wide-spread use and many years of clinical experience, the amount of data from well-controlled clinical trials is currently limited. Further studies are therefore required to establish the optimal treatment situation and type and dose of progestational agent.
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Affiliation(s)
- Salim Daya
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
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29
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Takasaki A, Tamura H, Miwa I, Taketani T, Shimamura K, Sugino N. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertil Steril 2009; 93:1851-8. [PMID: 19200982 DOI: 10.1016/j.fertnstert.2008.12.062] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 12/15/2008] [Accepted: 12/16/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow. DESIGN A prospective observational study. SETTING University hospital and city general hospital. PATIENT(S) Sixty-one patients with a thin endometrium (endometrial thickness [EM] <8 mm) and high radial artery-resistance index of uRA (RA-RI >or=0.81). INTERVENTION(S) Vitamin E (600 mg/day, n = 25), l-arginine (6 g/day, n = 9), or sildenafil citrate (100 mg/day, intravaginally, n = 12) was given. MAIN OUTCOME MEASURE(S) EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound. RESULT(S) Vitamin E improved RA-RI in 18 (72%) out of 25 patients and EM in 13 (52%) out of 25 patients. L-arginine improved RA-RI in eight (89%) out of nine patients and EM in six (67%) patients. Sildenafil citrate improved RA-RI and EM in 11 (92%) out of 12 patients. In the control group (n = 10), who received no medication to increase uRA-blood flow, only one (10%) patient improved in RA-RI and EM. The effect of vitamin E was histologically examined in the endometrium (n = 5). Vitamin E improved the glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein expression in the endometrium. CONCLUSION(S) Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium.
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Affiliation(s)
- Akihisa Takasaki
- Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Kifunecho, Shimonoseki, Japan
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Takasaki A, Tamura H, Taniguchi K, Asada H, Taketani T, Matsuoka A, Yamagata Y, Shimamura K, Morioka H, Sugino N. Luteal blood flow and luteal function. J Ovarian Res 2009; 2:1. [PMID: 19144154 PMCID: PMC2633338 DOI: 10.1186/1757-2215-2-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 01/14/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blood flow in the corpus luteum (CL) is associated with luteal function. The present study was undertaken to investigate whether luteal function can be improved by increasing CL blood flow in women with luteal phase defect (LFD). METHODS Blood flow impedance in the CL was measured by transvaginal color-pulsed-Doppler-ultrasonography and was expressed as a resistance index (RI). The patients with both LFD [serum progesterone (P) concentrations < 10 ng/ml during mid-luteal phase] and high CL-RI (>/= 0.51) were given vitamin-E (600 mg/day, n = 18), L-arginine (6 g/day, n = 14) as a potential nitric oxide donor, melatonin (3 mg/day, n = 13) as an antioxidant, or HCG (2,000 IU/day, n = 10) during the subsequent menstrual cycle. RESULTS In the control group (n = 11), who received no medication to increase CL blood flow, only one patient (9%) improved in CL-RI and 2 patients (18%) improved in serum P. Vitamin-E improved CL-RI in 15 patients (83%) and improved serum P in 12 patients (67%). L-arginine improved CL-RI in all the patients (100%) and improved serum P in 10 patients (71%). HCG improved CL-RI in all the patients (100%) and improved serum P in 9 patients (90%). Melatonin had no significant effect. CONCLUSION Vitamin-E or L-arginine treatment improved luteal function by decreasing CL blood flow impedance. CL blood flow is a critical factor for luteal function.
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Affiliation(s)
- Akihisa Takasaki
- Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Kifunecho 3-1-37, Shimonoseki, 751-0823, Japan
| | - Hiroshi Tamura
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Ken Taniguchi
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Hiromi Asada
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Toshiaki Taketani
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Aki Matsuoka
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Yoshiaki Yamagata
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
| | - Katsunori Shimamura
- Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Kifunecho 3-1-37, Shimonoseki, 751-0823, Japan
| | - Hitoshi Morioka
- Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Kifunecho 3-1-37, Shimonoseki, 751-0823, Japan
| | - Norihiro Sugino
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan
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