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Hamdi M, Elmowafy E, Abdel-Bar HM, ElKashlan AM, Al-Jamal KT, Awad GAS. Hyaluronic acid-entecavir conjugates-core/lipid-shell nanohybrids for efficient macrophage uptake and hepatotropic prospects. Int J Biol Macromol 2022; 217:731-747. [PMID: 35841964 DOI: 10.1016/j.ijbiomac.2022.07.067] [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: 01/25/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/05/2022]
Abstract
Drug covalently bound to polymers had formed, lately, platforms with great promise in drug delivery. These drug polymer conjugates (DPC) boosted drug loading and controlled medicine release with targeting ability. Herein, the ability of entecavir (E) conjugated to hyaluronic acid (HA) forming the core of vitamin E coated lipid nanohybrids (EE-HA LPH), to target Kupffer cells and hepatocyte had been proved. The drug was associated to HA with efficiency of 93.48 ± 3.14 % and nanohybrids loading of 22.02 ± 2.3 %. DiI labelled lipidic nanohybrids improved the macrophage uptake in J774 cells with a 21 day hepatocytes retention post intramuscular injection. Finally, in vivo biocompatibility and safety with respect to body weight, organs indices and histopathological alterations were demonstrated. Coating with vitamin E and conjugation of E to HA (a CD44 ligand), could give grounds for prospective application for vectored nano-platform in hepatitis B.
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Affiliation(s)
- Mohamed Hamdi
- Department of Pharmaceutics, Faculty of Pharmacy, University of Sadat City, Egypt
| | - Enas Elmowafy
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Egypt
| | - Hend Mohamed Abdel-Bar
- Department of Pharmaceutics, Faculty of Pharmacy, University of Sadat City, Egypt; Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, United Kingdom.
| | - Akram M ElKashlan
- Department of Biochemistry, Faculty of Pharmacy, University of Sadat City, Egypt
| | - Khuloud T Al-Jamal
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, United Kingdom
| | - Gehanne A S Awad
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Egypt
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The Impact of Bariatric Surgery on Assisted Reproductive Technology Outcomes: A Systematic Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:915-923. [PMID: 35526831 DOI: 10.1016/j.jogc.2022.04.010] [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: 12/28/2021] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE There is a paucity of literature on the impact of bariatric surgery on artificial reproductive technology (ART) outcomes. This topic should be examined, given that most bariatric surgery candidates are of reproductive age and those with obesity are significantly more likely to experience poor fertility outcomes. This systematic review aimed to determine if bariatric surgery impacts ART outcomes and if effects vary between females and males. DATA SOURCES MEDLINE, EMBASE, SCOPUS, and the Cochrane Central Register of Controlled Trials were searched for English studies published between January 1978 and May 2021. STUDY SELECTION Studies with participants who had had bariatric surgery and subsequently underwent ART (i.e., in vitro fertilization or intracytoplasmic sperm injection) were eligible for inclusion. Screening, data abstraction, and risk of bias assessment were conducted independently and in duplicate. DATA EXTRACTION AND SYNTHESIS Of the 279 articles screened for eligibility, 25 were sought for full text review, and 7 were included for analysis. Four studies (57%) examined ART interventions in females, while 3 (43%) examined interventions in males. Data on cumulative live birth rate (CLBR) was extracted for all 7 studies (N = 169). There were 50 live births with CLBRs ranging from 0.0% to 80.0%. Changes to female secondary outcomes were varied. Data on male secondary outcomes were contradictory: 1 study indicated improved sperm parameters following bariatric surgery, while 2 showed decreased parameters, with certain participants seeing improvements after several months. CONCLUSION Bariatric surgery prior to ART may have an impact on CLBRs; however, high-quality research is needed to delineate the direct effects of bariatric surgery on ART outcomes. Various sex-specific outcomes should be considered prior to recommending ART after bariatric surgery. Future research should determine the optimal type of bariatric surgery and timing of ART following bariatric surgery.
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McCartan AJS, Curran DW, Mrsny RJ. Evaluating parameters affecting drug fate at the intramuscular injection site. J Control Release 2021; 336:322-335. [PMID: 34153375 DOI: 10.1016/j.jconrel.2021.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/18/2022]
Abstract
Intramuscular (IM) injections are a well-established method of delivering a variety of therapeutics formulated for parenteral administration. While the wide range of commercial IM pharmaceuticals provide a wealth of pharmacokinetic (PK) information following injection, there remains an inadequate understanding of drug fate at the IM injection site that could dictate these PK outcomes. An improved understanding of injection site events could improve approaches taken by formulation scientists to identify therapeutically effective and consistent drug PK outcomes. Interplay between the typically non-physiological aspects of drug formulations and the homeostatic IM environment may provide insights into the fate of drugs at the IM injection site, leading to predictions of how a drug will behave post-injection in vivo. Immune responses occur by design after e.g. vaccine administration, however immune responses post-injection are not in the scope of this article. Taking cues from existing in vitro modelling technologies, the purpose of this article is to propose "critical parameters" of the IM environment that could be examined in hypothesis-driven studies. Outcomes of such studies might ultimately be useful in predicting and improving in vivo PK performance of IM injected drugs.
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Affiliation(s)
- Adam J S McCartan
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, Avon BA2 7AY, UK
| | - David W Curran
- CMC Analytical, GlaxoSmithKline, Collegeville, PA 19426, USA
| | - Randall J Mrsny
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, Avon BA2 7AY, UK.
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Sifer C, Herbemont C, Adda-Herzog E, Sermondade N, Dupont C, Cedrin-Durnerin I, Poncelet C, Levy R, Grynberg M, Hugues JN. Clinical predictive criteria associated with live birth following elective single embryo transfer. Eur J Obstet Gynecol Reprod Biol 2014; 181:229-32. [PMID: 25171268 DOI: 10.1016/j.ejogrb.2014.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/30/2014] [Accepted: 08/04/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We aimed to define clinical criteria from the patients related to the occurrence of live birth in case of elective single embryo transfer (eSET). STUDY DESIGN We analyzed retrospectively 409 eSET at day 2/3 between March 2005 and July 2012, proposed in case of (i) woman's age <37 years, (ii) first/second IVF0 cycle, (iii) ≥2 good quality embryos obtained (3-5/6-10 blastomeres at day 2/3 and <20% fragmentation), including one top embryo (4/8 cells). In all, 124/409 live births (30.3%) were obtained, separating patients into groups of women who had birth or not. Different clinical parameters of interest were compared between each group, using appropriate statistical tests at p<0.05 significance level. RESULTS By comparing Body Mass Index (BMI), we report a statistically higher BMI among women who did not deliver (24.6 vs. 23.4kg/m(2); p=0.014). Using an analysis by BMI categories, we also precise a threshold of BMI≥30kg/m(2), negatively associated with the occurrence of live birth. CONCLUSION BMI appears to be the only clinical parameter statistically associated with delivery following eSET strategy in a good prognosis infertile population.
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Affiliation(s)
- Christophe Sifer
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France.
| | - Charlène Herbemont
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France
| | - Elodie Adda-Herzog
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France
| | - Nathalie Sermondade
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France
| | - Charlotte Dupont
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France
| | - Isabelle Cedrin-Durnerin
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France
| | - Christophe Poncelet
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France
| | - Rachel Levy
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France
| | - Michael Grynberg
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France
| | - Jean-Noël Hugues
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France
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WILSHER S, ALLEN WR. Factors influencing equine chorionic gonadotrophin production in the mare. Equine Vet J 2011; 43:430-8. [DOI: 10.1111/j.2042-3306.2010.00309.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Effect of route of superovulatory gonadotrophin administration on the embryo recovery rate of Boer goat does. Small Rumin Res 2009. [DOI: 10.1016/j.smallrumres.2009.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hsu CC, Kuo HC, Hsu CT, Gu Q. The absorption and uptake of recombinant human follicle-stimulating hormone through vaginal subcutaneous injections--a pharmacokinetic study. Reprod Biol Endocrinol 2009; 7:107. [PMID: 19807931 PMCID: PMC2764710 DOI: 10.1186/1477-7827-7-107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 10/07/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Follicle stimulating hormone (FSH) has been routinely used for ovulation induction. Because of rapid clearance of the hormone, FSH is commonly administered by daily intramuscular or subcutaneous injections in in-vitro fertilization (IVF). To reduce the number of visits to the clinic, an intermittent vaginal injection of rhFSH every 3 days employing the concepts of mesotherapy and uterine first-pass effect was invented and has successfully been applied in women receiving IVF treatment. This study was designed to monitor the pharmacokinetic pattern of rhFSH administered vaginally. METHODS Twelve healthy women with regular ovulatory cycles were recruited. All volunteers received gonadotrophin-releasing hormone agonist to suppress pituitary function and were assigned to receive single dose recombinant human FSH (rhFSH, Puregon 300) either using conventional abdominal subcutaneous injection or vaginal subcutaneous injection in a randomized cross-over study. Serum samples were collected at pre- scheduled time intervals after injections of rhFSH to determine immunoreactive FSH levels. Pharmacokinetic parameters characterizing rate [maximal plasma concentrations (Cmax) and time of maximal plasma concentrations (tmax)] and extent [area under the plasma concentration-time curve (AUC) and clearance] of absorption of rhFSH were compared. RESULTS Vaginal injection of rhFSH was well tolerated and no drug-related adverse reaction was noted. Our analysis revealed that tmax was significantly earlier (mean 6.67 versus 13.33 hours) and Cmax was significantly higher (mean 17.77 versus 13.96 IU/L) in vaginal versus abdominal injections. The AUC(0-infinity) was 1640 versus 1134 IU hour/L in vaginal and abdominal injections, respectively. Smaller plasma elimination rate constant (0.011 versus 0.016 hour-1), longer mean residence time (106.58 versus 70.47 hours), and slower total body clearance (292.2 versus 400.1 mL/hour) were also found in vaginal injection. CONCLUSION The vaginal injection mode elicited a rapid and highly extended absorption of rhFSH injected compared to conventional abdominal injection. These data indicate that the rate and extent of FSH absorption from the injection site can vary depending on the route of the FSH administration.
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Affiliation(s)
- Chao-Chin Hsu
- Department of Obstetrics & Gynecology, National Cheng Kung University Hospital, Tainan, 701, Taiwan
- Department of Obstetrics & Gynecology, China Medical University, 91 Hsueh-Shih Rd, Tai-Chung, 404, Taiwan
| | - Hsin-Chih Kuo
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Tien Hsu
- Department of Pathology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
| | - Qing Gu
- Cambridge Bay Assisted Conception Unit, Chang Hai Hospital, Shanghai, China
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8
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Abstract
Ovulation is the result of an integrated action of the hypothalamus, pituitary and ovaries. During the process, gonadal steroids, peptides and growth factors are produced and influence the synthesis and release of gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH). These latter compounds play a crucial role in folliculogenesis and are frequently used in the management of infertility.
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9
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Nyachieo A, Spiessens C, Mwenda JM, Debrock S, D’Hooghe TM. Improving ovarian stimulation protocols for IVF in baboons: Lessons from humans and rhesus monkeys. Anim Reprod Sci 2009; 110:187-206. [DOI: 10.1016/j.anireprosci.2008.08.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 08/18/2008] [Accepted: 08/21/2008] [Indexed: 10/21/2022]
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10
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Ng EHY, Yeung WSB, Ho PC. The significance of antral follicle count in controlled ovarian stimulation and intrauterine insemination. J Assist Reprod Genet 2005; 22:323-8. [PMID: 16247713 DOI: 10.1007/s10815-005-6785-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Accepted: 03/14/2005] [Indexed: 10/25/2022] Open
Abstract
PURPOSE This retrospective study evaluated the role of antral follicle count (AFC) in predicting ovarian response and successful outcome of stimulated insemination cycles. METHODS One-hundred and fifty infertile women with bilateral patent tubes receiving a standard regime of human menopausal gonadotrophin (HMG) in their first cycle were evaluated. Multiple regression analysis was used to evaluate the effects of different parameters on ovarian responses and multiple logistic regression analysis was applied to determine which parameters gave the maximum discrimination to predict clinical pregnancy. RESULTS Body mass index was the only significant parameter to predict the number of follicles > or =14 mm whereas AFC was the only significant parameter to predict the HMG duration. Only the number of follicles > or =14 mm significantly improved the chance of clinical pregnancy with an odds ratio of 1.8. CONCLUSION AFC was related to the HMG duration but was not predictive of number of follicles and clinical pregnancy of stimulated insemination cycles.
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Affiliation(s)
- Ernest Hung Yu Ng
- Department of Obstetrics and Gynecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
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Abstract
Many clinical trials have been carried out to find the optimal gonadotrophin starting dose for IVF. The consensus for patients undergoing first treatment and <40 years old is a range stretching from 150 to 250 IU/day. The varying ovarian response to gonadotrophins may be due to factors such as age, basal FSH, number of antral follicles and body mass index, all of which should be taken into account before choosing the type of protocol and the amount of gonadotrophins to use. Increasing the dose of recombinant FSH does not compensate for the age-related decline in retrievable oocytes. Higher doses of gonadotrophins are required in overweight patients, but enhanced protocols are thought to only marginally improve live birth rates in obese women. The actual role of LH in controlled ovarian stimulation is still a matter of debate. A therapeutic 'window' of LH concentrations, below which oestradiol production is inadequate and above which LH may be detrimental to follicular development has been described.
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Affiliation(s)
- Andrea Borini
- Tecnobios Procreazione, Centre for Reproductive Health, Bologna, Italy.
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12
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Steinkampf MP, Hammond KR, Nichols JE, Slayden SH. Effect of obesity on recombinant follicle-stimulating hormone absorption: subcutaneous versus intramuscular administration. Fertil Steril 2003; 80:99-102. [PMID: 12849809 DOI: 10.1016/s0015-0282(03)00566-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether recombinant follicle-stimulating hormone (rFSH) should be administered intramuscularly (i.m.) or subcutaneously (s.c.) to obese women. DESIGN Randomized, single-center, two-way crossover study. SETTING Academic clinical research center. SUBJECT(S) Nineteen healthy women of reproductive age with body mass indices of 19.9 kg/m(2)-42.8 kg/m(2). INTERVENTION(S) Leuprolide acetate 3.75 mg i.m. to achieve pituitary down-regulation as determined by serum E(2) levels. Subjects were then given a single dose of 300 IU rFSH either i.m. or s.c.. Multiple blood sampling was performed over the next two weeks, and after retreatment with leuprolide, a second 300 IU rFSH dose was given via the other administration route. MAIN OUTCOME MEASURE(S) Serum samples were analyzed in duplicate for follicle-stimulating hormone (FSH) using a standard radioimmunoassay in a single run. Maximum concentrations (C(max)), times to C(max) (T(max)), and extent of absorption (area under curve [AUC]) with i.m. vs. s.c. administration were compared using paired analysis. RESULT(S) Maximal concentrations were achieved within 24 hours with both s.c. and i.m. routes. No significant differences were found in C(max), T(max), or AUC with s.c. vs. i.m. administration. A decline of AUC occurred among subjects of higher body mass index (BMI) with rFSH given either s.c. or i.m.. Subcutaneous administration achieved AUCs comparable to i.m. administration in both normal-weight and obese subjects. CONCLUSION(S) Our data indicate that the s.c. administration of rFSH is appropriate for women regardless of body mass.
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Affiliation(s)
- Michael P Steinkampf
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama 35249-7333, USA.
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13
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Ulloa-Aguirre A, Timossi C. Biochemical and functional aspects of gonadotrophin-releasing hormone and gonadotrophins. Reprod Biomed Online 2003; 1:48-62. [PMID: 12804199 DOI: 10.1016/s1472-6483(10)61901-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reproductive function in mammals is governed by the hypothalamic-pituitary-gonadal axis, which conforms a functional unit. Sexual maturation and the subsequent development of reproductive competence depend on the precise and coordinated function of this axis. The components of the reproductive axis communicate each other through endocrine signals. The hypothalamus synthesizes gonadotrophin-releasing hormone or GnRH, which in turn stimulates synthesis and secretion of the pituitary gonadotrophins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The ovarian follicles and the interstitial and Sertoli cells of the testis are the targets for these pituitary signals. Under gonadotrophic stimulation, the gonads produce and secrete several steroid and non-steroid (polypeptide) factors, which in turn regulate in different ways the function of the hypothalamic-pituitary axis. An episodic and pulsatile mode of secretion of hormonal signals characterize (as in other endocrine systems) the function of the reproductive axis, particularly that of the hypothalamic-pituitary unit. The target cell response, and consequently the harmonic function of the corresponding gland, will depend on the adequate dynamics of this pulsatile secretion. The function of each component of the reproductive axis is strongly influenced by locally-produced signals acting either in a paracrine or autocrine manner; these particular signals represent fine-tuning regulation systems that eventually amplify or restrain the magnitude of response to a particular endocrine signal, providing additional mechanisms for tissue homeostasis and a better functional plasticity of the target gland. The design and rational use of novel therapeutic strategies for an optimal exogenously-controlled reproductive function largely depend on the detailed knowledge of the hypothalamic-pituitary-gonadal axis function and the structure and mechanism of action of those factors and signals involved in its regulation.
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Affiliation(s)
- A Ulloa-Aguirre
- Research unit in Reproductive Medicine, Gynecology and Obstetrics Hospital, Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, DF, Mexico.
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Trinchard-Lugan I, Khan A, Porchet HC, Munafo A. Pharmacokinetics and pharmacodynamics of recombinant human chorionic gonadotrophin in healthy male and female volunteers. Reprod Biomed Online 2002; 4:106-15. [PMID: 12470572 DOI: 10.1016/s1472-6483(10)61927-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The pharmacokinetics and pharmacodynamics of recombinant human chorionic gonadotrophin (rHCG) were investigated in three studies of healthy volunteers. After single intravenous doses of 25, 250 and 1000 microg, rHCG and urinary HCG (uHCG) showed linear pharmacokinetics described by a bi-exponential model, although the area under the curve (AUC) for uHCG was ~29% lower than for rHCG. After intramuscular or subcutaneous administration (absolute bioavailability, 40-50% for both), rHCG pharmacokinetics could be described by a first-order absorption, one-compartment model. During multiple subcutaneous dosing, the amount of HCG increased by approximately1.7-fold. A comparison of liquid and freeze-dried rHCG and freeze-dried uHCG showed pharmacokinetic bioequivalence. In down-regulated male subjects, single doses of 125 microg rHCG, given intravenously, intramuscularly or subcutaneously, produced comparable increases in serum testosterone, inhibin and 17beta-oestradiol, with little further increase during repeated subcutaneous administration (in female subjects, this produced a sustained comparable increase in serum androstenedione and testosterone concentrations). In conclusion, the pharmacokinetics and pharmacodynamics of rHCG are similar to those of uHCG and are not affected by the use of different formulations. In healthy subjects, rHCG produces pharmacodynamic responses consistent with HCG physiology and is suitable for use in the same clinical indications as uHCG. The secured source and high purity of rHCG may offer important advantages.
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Affiliation(s)
- I Trinchard-Lugan
- Serono International SA, 12, chemin des Aulx, 1228 Plan-les-Ouates, Geneva, Switzerland.
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Gocial B, Keye WR, Fein SH, Nardi RV. Subcutaneously administered Repronex in female patients undergoing in vitro fertilization is as effective and well tolerated as intramuscular menotropin treatment. Repronex SC, IVF Study Group. Fertil Steril 2000; 74:73-9. [PMID: 10899500 DOI: 10.1016/s0015-0282(00)00605-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the efficacy and safety of Repronex SC as compared with Repronex IM and Pergonal IM in patients undergoing IVF. DESIGN Open-label, randomized, parallel-group, multicenter study. SETTING Fifteen academic and private fertility clinics with IVF experience. PATIENT(S) Premenopausal women with regular ovulatory menstrual cycles undergoing IVF for infertility attributable to tubal factors, endometriosis (stage I or II), or unknown factors. INTERVENTION(S) Down-regulation with leuprolide acetate followed by up to 12 days of treatments with gonadotropins, hCG administration, oocyte retrieval, and embryo transplant. MAIN OUTCOME MEASURE(S) Mean number of oocytes retrieved, chemical, clinical, and continuing pregnancies, incidence of oocyte retrieval and embryo transfer, and peak serum E2 concentrations. RESULT(S) There were no significant differences among the treatment groups except for a higher percentage of continuing pregnancies in the Repronex SC group. Gonadotropin therapy was well tolerated in all three treatment groups. The Repronex SC group had a significantly higher incidence of transient mild/moderate injection site reactions during the first few days of therapy. CONCLUSION(S) Repronex SC is comparable in therapeutic effectiveness and safety to Repronex IM and Pergonal IM in patients undergoing IVF and provides an alternative route of injection for self-administration of gonadotropin.
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Affiliation(s)
- B Gocial
- Penn Reproductive Associates, USA
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Voortman G, Mannaerts BM, Huisman JA. A dose proportionality study of subcutaneously and intramuscularly administered recombinant human follicle-stimulating hormone (Follistim*/Puregon) in healthy female volunteers. Fertil Steril 2000; 73:1187-93. [PMID: 10856481 DOI: 10.1016/s0015-0282(00)00542-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess pharmacokinetics (PK) and pharmacodynamics (PD) of subcutaneous (s.c.) administration of recombinant FSH in comparison with the intramuscular (i.m.) route. DESIGN Open, group-comparative, randomized, multiple-dose study. SETTING Phase I Clinical Research Unit.Volunteer(s): Forty-six healthy female volunteers. INTERVENTION(S) All volunteers were treated with Lyndiol contraceptive pills for 6 weeks to suppress pituitary function. After 3 weeks of Lyndiol, volunteers were randomized to 75 IU, 150 IU, or 225 IU s.c. or 150 IU i.m. of recombinant FSH, administered once daily for 7 days. Serum samples were collected to determine immunoreactive FSH, LH, and E(2) levels. Ultrasonography was performed for measurement of follicular growth. MAIN OUTCOME MEASURE(S) FSH pharmacokinetic parameters, number, and size of follicles. RESULT(S) The s.c. doses tested showed dose-proportional pharmacokinetics. Subcutaneous and i.m. administration of 150 IU of recombinant FSH were bioequivalent. For the 75-IU group almost no follicles >/=10 mm were found. The mean (+/-SD) number of follicles >/=8 mm on the day of maximum stimulation in the 150 IU and 225 IU s. c. and 150 IU i.m. groups were 14.0 +/- 7.1, 14.3 +/- 8.2, and 6.5 +/- 4.7. CONCLUSION(S) Pharmacokinetics of recombinant FSH were dose proportional within the dose range studied (75-225 IU). Subcutaneous and i.m. administration of 150 IU was bioequivalent with respect to pharmacokinetics, but after s.c. administration the number of growing follicles and estradiol response were higher.
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Affiliation(s)
- G Voortman
- Research and Development, NV Organon, Oss, The Netherlands.
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Engstrom JL, Giglio NN, Takacs SM, Ellis MC, Cherwenka DI. Procedures used to prepare and administer intramuscular injections: a study of infertility nurses. J Obstet Gynecol Neonatal Nurs 2000; 29:159-68. [PMID: 10750682 DOI: 10.1111/j.1552-6909.2000.tb02036.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe the procedures infertility nurses use to prepare and administer intramuscular injections of fertility medications. DESIGN Descriptive survey. PARTICIPANTS Nurses listed as members of the Nurses Professional Group of the American Society for Reproductive Medicine (N = 645) were surveyed. Completed questionnaires were returned by 219 of the nurses. MAIN OUTCOME MEASURES Volume of diluent, needle selection, site selection, internal rotation of the extremity distal to the injection site, and use of the z-track technique. RESULTS There was wide variation in the gauge and length of needles used to administer the medications, with most nurses using a 22 g, 1-1/2-in needle for all medications. Most nurses changed the needle between preparing and administering medications; however, filter needles were seldom used. There was wide variation in the volume of diluent used to reconstitute medications. Most of the nurses used the dorsogluteal site for injections. Although almost all of the nurses indicated that they routinely rotated injection sites, they infrequently used sites other that the dorsogluteal site. Most nurses did not rotate the extremity distal to the injection site when administering injections and even fewer used the z-track technique. CONCLUSIONS This study demonstrated wide variation in the procedures used by infertility nurses to prepare and administer intramuscular injections of fertility medications. Many nurses did not use procedures that can reduce the pain and tissue trauma associated with intramuscular injections.
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Affiliation(s)
- J L Engstrom
- University of Illinois at Chicago, Maternal-Child Nursing, 60612, USA.
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Fauser BC, Van Heusden AM. Manipulation of human ovarian function: physiological concepts and clinical consequences. Endocr Rev 1997; 18:71-106. [PMID: 9034787 DOI: 10.1210/edrv.18.1.0290] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- B C Fauser
- Department of Obstetrics and Gynecology, Dijkzigt Academic Hospital, Rotterdam, The Netherlands
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