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von Wolff M, Reid G, Stute P, Schwartz ASK, Roumet M, Fink A. Ibuprofen delays ovulation by several hours: prospective controlled study in natural cycles with HCG-triggered ovulation. Reprod Biomed Online 2024; 49:103975. [PMID: 38954900 DOI: 10.1016/j.rbmo.2024.103975] [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: 12/29/2023] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 07/04/2024]
Abstract
RESEARCH QUESTION Does ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), delay ovulation? DESIGN Two-stage, proof-of-concept, controlled study, assessing the percentage of non-ovulated follicles 42 h after HCG injection in patients taking ibuprofen. The intervention group consisted of women undergoing natural cycle IVF treatment taking ibuprofen 3 × 400 mg per day. The control group consisted of women undergoing timed sexual intercourse or intrauterine insemination. The proportion of patients with non-ovulated follicles in the ibuprofen group was first compared against a reference of 50% using a one-sample binomial test, and second against the proportion observed in the control group using an adjusted logistic regression. RESULTS A total of 26 women were recruited in the ibuprofen intervention group. Twenty-five patients were recruited in the control group. The proportion of patients with delayed ovulation observed (22/26 [84.6%]; 95% CI 65.1% to 95.6%) was significantly higher than the reference of 50% (P < 0.001). In the control group, the proportion of patients with delayed ovulation was 20.0% ([5/25], 95% CI 6.8% to 40.7%). Compared with the ibuprofen group, a significantly increased probability of a delayed ovulation was found in the ibuprofen intervention group (adjusted OR 22.72, 95% CI 5.77 to 115; P < 0.001). Of the 22 women with delayed ovulation, oocytes were retrieved in 20 women (90.9%) and all oocytes were mature (metaphase II). CONCLUSIONS Women trying to conceive should avoid non-selective NSAIDs around the time of ovulation. Ibuprofen or other NSAID can be used to delay ovulation for several hours in assisted reproductive technology and other infertility treatments if required.
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Affiliation(s)
- Michael von Wolff
- Division of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Berne, Switzerland..
| | - Gregory Reid
- Department of Plastic Surgery, University hospital of Zürich, Zürich, Switzerland
| | - Petra Stute
- Division of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Berne, Switzerland
| | - Alexandra S Kohl Schwartz
- Division of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Berne, Switzerland.; Cantonal Hospital of Lucerne, Reproductive Medicine and Gynecological Endocrinology, Lucerne, Switzerland
| | - Marie Roumet
- CTU Bern, Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Anja Fink
- Division of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Berne, Switzerland
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2
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Villar L, Tralik B, Diamond MP, Allon M, Maldonado I, Dozortsev DI. Ovulation and birth after administration of progesterone trigger-two case reports. J Assist Reprod Genet 2023; 40:1037-1044. [PMID: 36808579 PMCID: PMC10239420 DOI: 10.1007/s10815-023-02750-x] [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: 01/05/2023] [Accepted: 02/07/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE To determine whether using progesterone as a trigger of a gonadotropin surge will induce ovulation and a competent corpus luteum. METHODS Patients were administered 5 or 10 mg of progesterone intramuscularly when the leading follicle reached preovulatory size. RESULTS We demonstrate that progesterone injections result in classical ultrasonographic hallmarks of ovulation about 48 h later and the formation of a corpus luteum competent to support pregnancy. CONCLUSION Our results support further exploration of using progesterone to trigger a gonadotropin surge in assisted human reproduction.
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Affiliation(s)
- Lina Villar
- CITMER Medicina Reproductiva, Mexico City, Mexico
| | - Beata Tralik
- Advanced Fertility Center of Texas, Houston, TX, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Michael Allon
- Advanced Fertility Center of Texas, Houston, TX, USA
| | | | - Dmitri I Dozortsev
- CITMER Medicina Reproductiva, Mexico City, Mexico.
- Advanced Fertility Center of Texas, Houston, TX, USA.
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3
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Carrillo Torres P, Goday Cibeira A, Hernández Dacruz B, Casals Soler G. Fecundación in vitro (FIV) en ciclo natural: del origen de la FIV a la práctica asistencial actual. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2021.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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4
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Yavuz A, Oner G, Tas M, Sonmezer M. The impact of indomethacin on the number of oocytes retrieved and IVF outcomes in patients with poor ovarian response. Eur J Obstet Gynecol Reprod Biol 2021; 264:266-270. [PMID: 34340097 DOI: 10.1016/j.ejogrb.2021.07.035] [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: 01/06/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this retrospective case-control study was to analyze the effect of administering indomethacin after triggering final oocyte maturation in patients with poor ovarian response (POR) on the cycle cancellation rate due to premature ovulation (PO), the number of oocytes retrieved and the clinical outcomes of IVF cycles. STUDY DESIGN A total of 214 patients with POR, diagnosed according to the Bologna criteria, who underwent fresh IVF cycle via flexible gonadotrophin-releasing hormone antagonist (GnRH-ant) protocol were enrolled in the study. The control group consisted of 100 patients, whereas the indomethacin group included 114 patients who received 100 mg rectal indomethacin administered twice within the same day (twelve hours apart) -starting at twelve hours after triggering. Cycle cancelation rates (CCR), number of oocytes retrieved (nOR), implantation rates (IR), biochemical pregnancy (BP) and clinical pregnancy loss rates (CPL), ongoing pregnancy rates (OPR) and live birth rates (LBR) were compared between the indomethacin and control groups. RESULTS The CCR rate was significantly lower in the indomethacin group (1.8%) compared to the control group (1.8% vs %12%, p = 0.01). In the control group, those with cycle cancellation were older than those without cycle cancellation (mean age 42.2 ± 2.3 years vs. 39.36 ± 4.3 years, p = 0.001) and had lower anti-Müllerian hormone levels and lower antral follicle count (0.59 ± 0.2 ng/mL vs 0.79 ± 0.2 ng/mL, p = 0.001 and 4 ± 0.6 vs 5.7 ± 1.7, p = 0.001, respectively). In multivariable analysis, when the dependent variable in the logistic regression model was coded as the absence of cycle cancellation, it was observed that only indomethacin had a statistically significant effect on cycle cancellation (β = -1.931, standard error = 0.832, Exp(B) = 0.145, p = 0.020). nOR was higher in the indomethacin group than control group but the difference did not reach significance (p = 0.07). Moreover, the IR, OPR and LBR, BP and CPL values were similar in the indomethacin and control groups (p > 0.05). CONCLUSIONS Based on data from this study, it can be concluded that indomethacin reduces cycle cancelation due to PO in patients with POR -without compromising implantation and pregnancy rates. However, further randomized controlled trials with larger sample sizes are required to clarify the definitive effect of indomethacin in the treatment of patients with POR.
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Affiliation(s)
- Adem Yavuz
- Department of Obstetrics and Gynecology, Omer Halisdemir University Faculty of Medicine, Nigde, Turkey.
| | - Gokalp Oner
- Department of Obstetrics and Gynecology, Acibadem Kayseri Hospital, Kayseri, Turkey
| | - Mustafa Tas
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Murat Sonmezer
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
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5
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Sominsky L, Younesi S, De Luca SN, Loone SM, Quinn KM, Spencer SJ. Ovarian follicles are resistant to monocyte perturbations-implications for ovarian health with immune disruption†. Biol Reprod 2021; 105:100-112. [PMID: 33709094 DOI: 10.1093/biolre/ioab049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2020] [Accepted: 03/10/2021] [Indexed: 02/03/2023] Open
Abstract
Monocytes and macrophages are the most abundant immune cell populations in the adult ovary, with well-known roles in ovulation and corpus luteum formation and regression. They are activated and proliferate in response to immune challenge and are suppressed by anti-inflammatory treatments. It is also likely they have a functional role in the healthy ovary in supporting the maturing follicle from the primordial through to the later stages; however, this role has been unexplored until now. Here, we utilized a Cx3cr1-Dtr transgenic Wistar rat model that allows a conditional depletion of circulating monocytes, to investigate their role in ovarian follicle health. Our findings show that circulating monocyte depletion leads to a significant depletion of ovarian monocytes and monocyte-derived macrophages. Depletion of monocytes was associated with a transient reduction in circulating anti-Müllerian hormone (AMH) at 5 days postdepletion. However, the 50-60% ovarian monocyte/macrophage depletion had no effect on ovarian follicle numbers, follicle atresia, or apoptosis, within 5-21 days postdepletion. These data reveal that the healthy adult ovary is remarkably resistant to perturbations of circulating and ovarian monocytes despite acute changes in AMH. These data suggest that short-term anti-inflammatory therapies that transiently impact on circulating monocytes are unlikely to disrupt ovarian follicle health, findings that have significant implications for fertility planning relative to the experience of an immune challenge or immunosuppression.
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Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Simin Younesi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Simone N De Luca
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Sophie M Loone
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Kylie M Quinn
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.,ARC Centre of Excellence for Nanoscale Biophotonics, RMIT University, Melbourne, Victoria, Australia
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6
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Nyachieo A, Siristatidis CS, Vaidakis D. Nonsteroidal anti-inflammatory drugs for assisted reproductive technology. Cochrane Database Syst Rev 2019; 10:CD007618. [PMID: 31628860 PMCID: PMC6800564 DOI: 10.1002/14651858.cd007618.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite substantial improvements in the success of treatments through assisted reproduction technologies (ART), live birth rates remain constantly low, and practitioners are seeking aetiologic treatments to improve the outcomes.Local inflammatory response is believed to contribute to implantation failure, where prostaglandins may increase uterine contractions and decrease uterine receptivity, decreasing the possibility of an IVF cycle leading to successful embryo transfer. In this context, nonsteroidal anti-inflammatory drugs (NSAIDs) have been employed to inhibit the negative prostaglandin effect. They are often offered in clinical practice to improve ART outcomes, but current robust evidence on their efficacy is lacking. OBJECTIVES To evaluate the effectiveness and safety of nonsteroidal anti-inflammatory drugs as co-treatments in infertile women undergoing assisted reproduction, in terms of improving live birth and miscarriage rates. SEARCH METHODS We designed the search using standard Cochrane methods and performed it on databases from their inception to 20 February 2019.We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL via the Cochrane Central Register of Studies Online, MEDLINE, Embase, CINAHL, and the trial registers for ongoing and registered trials, grey literature and treatment guidelines. We handsearched reference lists of relevant systematic reviews and RCTs, and PubMed and Google for any recent trials. There were no restrictions by language or country of origin. SELECTION CRITERIA All RCTs on the use of NSAIDs as co-treatment during an ART cycle compared with no use or the use of placebo or any other similar drug, along with the comparison of any NSAID to another. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. Our primary outcomes were live birth/ongoing pregnancy and miscarriage. We performed statistical analysis using Review Manager 5. We assessed evidence quality using GRADE methods. MAIN RESULTS We found 11 RCTs (1884 women) suitable for inclusion in the review. Most studies were at unclear or high risk of bias. The main limitations in the overall quality of the evidence were high risk of bias, unexplained heterogeneity and serious imprecision and indirectness.There were no data on our primary outcome - live birth per woman randomised - in any review comparisons.NSAIDs vs. placebo/no treatmentWe are uncertain of an effect on ongoing pregnancy when NSAIDs were compared to placebo/no treatment (risk ratio (RR) 1.06, 95% confidence interval (CI) 0.71 to 1.59; 4 studies, 1159 participants; I² = 53%; very low quality evidence). Results suggest that if the chance of ongoing pregnancy following placebo or no treatment is assumed to be 15%, the chance following the use of NSAIDs is estimated to be between 12% and 24%. Subgroup analysis according to the type of NSAID yielded similar results.We are also uncertain of an effect on miscarriage rates when NSAIDs were compared to placebo/no treatment (RR 0.62, 95% CI 0.33 to 1.16; 4 studies, 525 participants; I² = 43%; very low quality evidence). Results suggest that if the chance of miscarriage following placebo or no treatment is assumed to be 21%, the chance following the use of NSAIDs is estimated to be between 7% and 27%. The results were similar when two studies were excluded due to high risk of bias.Concerning the secondary outcomes, we are uncertain of an effect on clinical pregnancy rates (RR 1.23, 95% CI 1.00 to 1.52; 6 studies, 1570 participants; I² = 49%; low-quality evidence); on ectopic pregnancy (RR 0.56, 95% CI 0.05 to 5.89; 1 study, 72 participants); on multiple pregnancy (RR 2.00, 95% CI 0.18 to 21.67; 1 study, 180 participants); and on side effects (RR 1.39, 95% CI 0.02 to 119.35; 3 studies, 418 participants; I² = 79%). The evidence suggests that if the chance of clinical pregnancy following placebo or no treatment is assumed to be 30%, the chance following the use of NSAIDs is estimated to be between 31% and 45%. If the chance of ectopic pregnancy following placebo or no treatment is assumed to be 5%, the chance following the use of NSAIDs is estimated to be between 0.3% and 31%. If the chance of multiple pregnancy following placebo or no treatment is assumed to be 1%, the chance following the use of NSAIDs is estimated to be between 0.2 % and 24%.There were no cases of congenital anomalies during antenatal ultrasound screening of the women in one study.NSAID vs. another NSAIDOnly one study compared piroxicam with indomethacin: we are uncertain of an effect on ongoing pregnancy (RR 1.12, 95% CI 0.63 to 2.00; 1 study, 170 participants; very low quality evidence); and on miscarriage (RR 1.00, 95% CI 0.44 to 2.28; 1 study, 170 participants; very low quality evidence). The evidence suggests that if the chance of ongoing pregnancy following indomethacin is assumed to be 20%, the chance following the use of piroxicam is estimated to be between 13% and 40%; while for miscarriage, the evidence suggests that if the chance following indomethacin is assumed to be 12%, the chance following the use of piroxicam is estimated to be between 5% and 27%.Similar results were reported for clinical pregnancy (RR 1.07, 95% CI 0.71 to 1.63; 1 study, 170 participants; very low quality evidence).There were no data for the other outcomes specified in this review.NSAID vs. aspirinNo study reported this comparison. AUTHORS' CONCLUSIONS Currently we are uncertain of an effect of the routine use of NSAIDs as co-treatments in infertile women undergoing assisted reproduction in order to improve ongoing pregnancy and miscarriage rates. This is based on available data from RCTs, where very low quality evidence showed that there is no single outcome measure demonstrating a benefit with their use. Further large, well-designed randomised placebo-controlled trials reporting on live births are required to clarify the exact role of NSAIDs.
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Affiliation(s)
- Atunga Nyachieo
- Institute of Primate ResearchReproductive health and BiologyPOBox 24481‐00502KarenNairobiKenya
- University of NairobiDepartment of BiochemistryNairobiKenya
| | - Charalampos S Siristatidis
- Medical School, National and Kapodistrian University of AthensAssisted Reproduction Unit, 3rd Department of Obstetrics and GynaecologyAttikon University HospitalRimini 1AthensChaidariGreece12462
| | - Dennis Vaidakis
- University of Athens3rd Department of Obstetrics and Gynecology'Attikon' Hospital, ChaidariAthensGreece
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Abstract
Natural Cycle IVF (NC-IVF) with and without modifications is being increasingly performed. NC-IVF and conventional gonadotropin-stimulated IVF (cIVF) should not be understood as competing treatments, but as complementary treatments with different target groups and to some extent other indications. NC-IVF is particularly interesting for couples who wish to save money, wish a treatment with as few risks as possible and for women who would like to avoid selection and cryopreservation of embryos. NC-IVF therefore contributes to the concept of individualized and patient-oriented therapy. The time to pregnancy is slightly longer than with conventional IVF. NC-IVF is particularly suitable for younger women and for women with a very low ovarian reserve. In this article, the principles of NC-IVF, i.e. monofollicular IVF without gonadotropin stimulation, are described and the technical differences to cIVF, advantages and disadvantages, perinatal outcome and indications for NC-IVF are highlightened.
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Affiliation(s)
- Michael von Wolff
- University Women's Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, Inselspital, University Hospital, Berne, Switzerland.
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8
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Bou Nemer L, Shi H, Carr BR, Word RA, Bukulmez O. Effect of single-dose ibuprofen on follicular fluid levels of interleukins in poor responders undergoing in vitro fertilization. Syst Biol Reprod Med 2018; 65:48-53. [DOI: 10.1080/19396368.2018.1557761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Laurice Bou Nemer
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility and the Cecil H and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Haolin Shi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility and the Cecil H and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce Richard Carr
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility and the Cecil H and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ruth Ann Word
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility and the Cecil H and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orhan Bukulmez
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility and the Cecil H and Ida Green Center for Reproductive Biological Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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9
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Cheng HY, Li HY. Successful prevention of follicular rupture at 45 h after hCG and GnRHa triggering by emergent administration of indomethacin: A case report. Taiwan J Obstet Gynecol 2018; 57:760-762. [PMID: 30342668 DOI: 10.1016/j.tjog.2018.08.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To report the management and prevention of pre-operative ovulation before oocyte retrieval with emergent administration of indomethacin. CASE REPORT During in vitro fertilization (IVF) treatment, the patient described here mistakenly administered 6500 IU of hCG and 0.2 mg of triptorelin (GnRHa) 9 h earlier than scheduled triggering. To avoid emergent oocyte retrieval in the midnight, indomethacin was given (150 mg/day, there times a day) from 2 h after incorrect hCG and GnRHa injection to the night before ovum pickup. The oocyte retrieval was performed at originally scheduled time. The result showed that pre-operative ovulation was effectively prevented and we successfully collected the expected number Andersen et al., 1995 of oocytes at 45 h after triggering. CONCLUSION The presented case demonstrates that indomethacin can be used safely and effectively as an emergent prescription to prevent and postpone ovulation till up to 45 h after hCG and GnRHa triggering.
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Affiliation(s)
- Hsin-Yi Cheng
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taiwan
| | - Hsin-Yang Li
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taiwan; National Yang-Ming University, School of Medicine, Taipei, Taiwan.
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10
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Choi Y, Wilson K, Hannon PR, Rosewell KL, Brännström M, Akin JW, Curry TE, Jo M. Coordinated Regulation Among Progesterone, Prostaglandins, and EGF-Like Factors in Human Ovulatory Follicles. J Clin Endocrinol Metab 2017; 102:1971-1982. [PMID: 28323945 PMCID: PMC5470773 DOI: 10.1210/jc.2016-3153] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/06/2017] [Indexed: 01/12/2023]
Abstract
CONTEXT In animal models, the luteinizing hormone surge increases progesterone (P4) and progesterone receptor (PGR), prostaglandins (PTGs), and epidermal growth factor (EGF)-like factors that play essential roles in ovulation. However, little is known about the expression, regulation, and function of these key ovulatory mediators in humans. OBJECTIVE To determine when and how these key ovulatory mediators are induced after the luteinizing hormone surge in human ovaries. DESIGN AND PARTICIPANTS Timed periovulatory follicles were obtained from cycling women. Granulosa/lutein cells were collected from in vitro fertilization patients. MAIN OUTCOME MEASURES The in vivo and in vitro expression of PGR, PTG synthases and transporters, and EGF-like factors were examined at the level of messenger RNA and protein. PGR binding to specific genes was assessed. P4 and PTGs in conditioned media were measured. RESULTS PGR, PTGS2, and AREG expressions dramatically increased in ovulatory follicles at 12 to 18 hours after human chorionic gonadotropin (hCG). In human granulosa/lutein cell cultures, hCG increased P4 and PTG production and the expression of PGR, specific PTG synthases and transporters, and EGF-like factors, mimicking in vivo expression patterns. Inhibitors for P4/PGR and EGF-signaling pathways reduced hCG-induced increases in PTG production and the expression of EGF-like factors. PGR bound to the PTGS2, PTGES, and SLCO2A1 genes. CONCLUSIONS This report demonstrated the time-dependent induction of PGR, AREG, and PTGS2 in human periovulatory follicles. In vitro studies indicated that collaborative actions of P4/PGR and EGF signaling are required for hCG-induced increases in PTG production and potentiation of EGF signaling in human periovulatory granulosa cells.
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Affiliation(s)
- Yohan Choi
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
| | - Kalin Wilson
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
| | - Patrick R Hannon
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
| | - Katherine L Rosewell
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
| | - Mats Brännström
- Department of Obstetrics and Gynecology, University of Gothenburg, 405 30 Gothenburg, Sweden
- Stockholm IVF, 112 81 Stockholm, Sweden
| | - James W Akin
- Bluegrass Fertility Center, Lexington, Kentucky 40503
| | - Thomas E Curry
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
| | - Misung Jo
- Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky 40536
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11
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Sunkara SK, LaMarca A, Polyzos NP, Seed PT, Khalaf Y. Reply: Rapid changes in practice make analysis of historical databases irrelevant for contemporary counselling. Hum Reprod 2017; 32:964-965. [DOI: 10.1093/humrep/dex039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Shaulov T, Vélez MP, Buzaglo K, Phillips SJ, Kadoch IJ. Outcomes of 1503 cycles of modified natural cycle in vitro fertilization: a single-institution experience. J Assist Reprod Genet 2015; 32:1043-8. [PMID: 26041679 DOI: 10.1007/s10815-015-0502-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/24/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE A retrospective cohort study was conducted in a single academic center to determine if modified natural cycle in vitro fertilization (mnIVF) is an acceptable treatment for the infertile couple. METHODS Cycles performed between July 2005 and December 2011 were included. In our center's mnIVF protocol, a GnRH antagonist, gonadotrophin, as well as Indocid are given on a daily basis from detection of a dominant follicle until ovulation induction. The primary outcomes were clinical pregnancy rates (CPR) per cycle started and per embryo transfer (ET). Outcomes were stratified by female patient age (≤35 years and ≥36 years). They were further stratified in each age group by ovarian response status according to the 2011 Bologna criteria. RESULTS A total of 1503 cycles of mnIVF, performed in 782 patients, were analyzed. CPRs were 13.7 % per started cycle and 32.5 % per ET. Stratification by ovarian response status (normal or poor) in each age group showed similar CPRs in patients ≤35 years (p = 0.373), and divergent CPRs per ET in patients ≥36 years old (26.26 vs 6.25 %). CONCLUSION MnIVF is an acceptable treatment option for patients considering IVF, particularly for women ≤35 years old and for women ≥36 years old with normal ovarian response.
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Affiliation(s)
- Talya Shaulov
- Obstetrics and Gynecology, University of Montreal Hospital Centre, 1058 Rue Saint-Denis, Montreal, QC, Canada, H2X 3J4,
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13
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Bodri D, Kawachiya S, Kondo M, Kato R, Matsumoto T. Oocyte retrieval timing based on spontaneous luteinizing hormone surge during natural cycle in vitro fertilization treatment. Fertil Steril 2014; 101:1001-7.e2. [DOI: 10.1016/j.fertnstert.2014.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 12/19/2013] [Accepted: 01/10/2014] [Indexed: 11/29/2022]
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14
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Comparison of results of cycles treated with modified mild protocol and short protocol for ovarian stimulation. Int J Reprod Med 2014; 2014:367474. [PMID: 25763398 PMCID: PMC4334054 DOI: 10.1155/2014/367474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 07/07/2014] [Accepted: 07/12/2014] [Indexed: 11/28/2022] Open
Abstract
The ovarian stimulation has been applied in order to increase the number of oocytes to compensate for the poor results of in vitro fertilization, allowing the selection of one or more embryos to be transferred. Our aim is to compare the results obtained in IVF/ICSI cycles using the short protocol for controlled ovarian stimulation to the results from the modified mild protocol used in our department. A total of 240 cycles were conducted from January 2010 to December 2011. When comparing both protocols, it could be observed that there was a significant difference in the quantity of gonadotropins doses in the mild protocol and in the short protocol. No significant difference was observed regarding pregnancy rates per cycle, 22% and 26.2%, in short and mild protocols, respectively. The protocols of controlled ovarian stimulation are often associated with high risk of complications such as ovarian hyperstimulation syndrome, excessive emotional stress, high rates of treatment dropouts, and abdominal discomfort. With the data obtained in this study, one can conclude that there are less risks and complications for the patient when using the mild stimulation protocol. It was also observed that in this group there was a slightly higher rate.
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