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Roque Fernandez MA, Alvarez Lleo C, Gonzalez Mirasol E, Resta Serra M, Garcia Garrido C, Sanchez Toledo M, Amezcua Recover A. Progesterone elevation on the day of oocyte retrieval and live birth rate after in vitro fertilisation treatment. J OBSTET GYNAECOL 2021; 42:1396-1400. [PMID: 34907863 DOI: 10.1080/01443615.2021.1983780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The objective of this study was to evaluate if progesterone elevation (PE) on the day of oocyte retrieval is associated with IVF outcome. A prospective cohort study of 400 IVF-ICSI cycles, with fresh embryo transfer on day 2-3 was performed. We proposed a serum progesterone (P) level on percentile (p) 90 as a threshold.Pregnancy rates were not affected, however there were more miscarriages (25.7% vs 43.8%) and lower live birth rate (LBR) (28% vs 23.1%) in the PE group (not statistically significant). We also found a positive correlation between P levels and retrieved and mature oocytes, total embryos, and good quality embryos. This is the first study to analyse LBR based on P levels on the day of oocyte retrieval. PE is not associated with the IVF outcome, but there is a trend to lower ongoing pregnancy rate and LBR and more miscarriages. Our results also show that P levels have no negative effects on oocyte and embryo quality.Impact statementWhat is already known on this subject? The influence of PE during IVF cycle on pregnancy rates remains controversial.What do the results of this study add? This is the first study to analyse LBR based on P levels on the day of oocyte retrieval.What are the implications of these findings for clinical practice and/or further research? We demonstrated that pregnancy rates were not affected by PE at oocyte retrieval, but there is a trend to lower ongoing pregnancy rate and LBR and more miscarriages. Randomised controlled trials are needed to offer more evidence of these relationships.
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Affiliation(s)
| | - Cristina Alvarez Lleo
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain
| | - Esteban Gonzalez Mirasol
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain.,Medical Science Department, University of Castilla la Mancha, Ciudad Real, Spain
| | - Maria Resta Serra
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain
| | - Carmen Garcia Garrido
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain
| | - María Sanchez Toledo
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain
| | - Antonio Amezcua Recover
- Department of Obstetrics and Gynaecology, Albacete University Hospital Complex, Albacete, Spain.,Medical Science Department, University of Castilla la Mancha, Ciudad Real, Spain
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Tulic L, Tulic I, Bila J, Nikolic L, Dotlic J, Lazarevic-Suntov M, Kalezic I. Correlation of progesterone levels on the day of oocyte retrieval with basal hormonal status and the outcome of ART. Sci Rep 2020; 10:22291. [PMID: 33339878 PMCID: PMC7749108 DOI: 10.1038/s41598-020-79347-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/25/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to assess whether basal hormonal levels can predict the levels of progesterone (P4) on the day of oocyte retrieval (OR) and examine the impact of P4 levels on the day of OR on the outcome of assisted reproduction. One hundred sixty-four patients that were enrolled in the assisted reproduction procedure were classified according to their P4 levels on the OR day (< 2 ng/ml vs. ≥ 2 ng/ml). Patients who had P4 levels < 2 ng/ml had significantly higher follicle stimulating hormone (FSH) levels and significantly lower anti-Mullerian hormone (AMH) levels. More than half of patients with P4 levels < 2 ng/ml on the OR day got pregnant and delivered healthy infants. There was a significant correlation between lower FSH values and higher P4 values at OR and between higher AMH values and higher P4 values on the day of OR. Regression analysis showed that high FSH levels are the most important factor that can reliably imply lower P4 levels on OR day. Our study confirmed that lower basal FSH levels can predict the levels of P4 on the OR day. Moreover, lower levels of P4 on the day of OR are associated with a positive outcome in assisted reproduction.
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Affiliation(s)
- L Tulic
- Department of In Vitro Fertilization, Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Koste Todorovica 26, 11000, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.
| | - I Tulic
- Department of In Vitro Fertilization, Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Koste Todorovica 26, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - J Bila
- Department of In Vitro Fertilization, Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Koste Todorovica 26, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Lj Nikolic
- Department of Biochemistry, Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovica 26, 11000, Belgrade, Serbia
| | - J Dotlic
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.,Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovica 26, 11000, Belgrade, Serbia
| | - M Lazarevic-Suntov
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovica 26, 11000, Belgrade, Serbia
| | - I Kalezic
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovica 26, 11000, Belgrade, Serbia
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Kaponis A, Chronopoulou E, Decavalas G. The curious case of premature luteinization. J Assist Reprod Genet 2018; 35:1723-1740. [PMID: 30051348 DOI: 10.1007/s10815-018-1264-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 07/11/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Premature luteinization (PL) affects 12.3-46.7% of fresh in vitro fertilization cycles, and there is accumulating evidence confirming its negative effect on success rates. However, despite its clinical significance, PL is poorly understood and defined. This narrative review aims to provide a fresh look at the phenomenon of PL by summarizing the existing evidence and re-evaluating fundamental issues. METHODS A thorough electronic search was conducted covering the period from 1978 until January 2018 in PubMed, Embase, and Medline databases, and references of relevant studies were cross-checked. Meeting proceedings of the European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine were also hand searched. RESULTS In the curious case of PL, one should go back to the beginning and re-consider every step of the way. The pathogenesis, definition, measurement methods, clinical implications, and management strategies are discussed in detail, highlighting controversies and offering "food for thought" for future directions. CONCLUSIONS Authors need to speak the same language when studying PL in order to facilitate comparisons. The terminology, progesterone cut-off, measurement methods and days of measurement should be standardized and globally accepted; otherwise, there can be no scientific dialog. Future research should focus on specific patient profiles that may require a tailored approach. Progesterone measurements throughout the follicular phase possibly depict the progesterone exposure better than an isolated measurement on the day of hCG. Adequately powered randomized controlled trials should confirm which the best prevention and management plan of PL is, before introducing any strategy into clinical practice.
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Affiliation(s)
- Apostolos Kaponis
- Department of Obstetrics and Gynaecology, Patras University School of Medicine, General University Hospital of Patras, Rio, 26504, Patras, Greece
| | - Elpiniki Chronopoulou
- Department of Obstetrics and Gynaecology, Patras University School of Medicine, General University Hospital of Patras, Rio, 26504, Patras, Greece.
| | - George Decavalas
- Department of Obstetrics and Gynaecology, Patras University School of Medicine, General University Hospital of Patras, Rio, 26504, Patras, Greece
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Liu J, Shen C, Fan W, Chen Y, Zhang A, Feng Y, Li Z, Kuang Y, Wang Z. Low levels of PRSS37 protein in sperm are associated with many cases of unexplained male infertility. Acta Biochim Biophys Sin (Shanghai) 2016; 48:1058-1065. [PMID: 27649891 DOI: 10.1093/abbs/gmw096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/01/2016] [Indexed: 11/13/2022] Open
Abstract
PRSS37, a putative trypsin-like serine protease, is highly conserved during mammalian evolution as revealed by multiple sequence alignment. Mice deficient for Prss37 gene exhibit male infertility, but their mating behavior, spermatogenesis, sperm morphology, and motility remain unaffected, similar to a situation called unexplained male infertility (UMI) in men (human being). Here, we demonstrated that PRSS37 is restrictively expressed in human testis, where it is mainly located in the elongating and elongated spermatids during spermiogenesis as shown by immunohistochemical analysis of normal human testicular sections. In mature sperm, PRSS37 appears in the acrosome region and diminishes during acrosome reaction. Further examination reveals that PRSS37 contents in sperm from patients with UMI are dramatically lower than those in sperm from men with proven fertility or from sperm donors. Sperm with low PRSS37 contents exhibit abnormal activation of the proacrosin/acrosin system and premature proteolysis of ADAM2, which may impair the functional competence of human sperm in vivo However, the in vitro fertilization outcomes of sperm with low PRSS37 contents are not affected. Together, these data implicate an important role of PRSS37 for male fertility. PRSS37 can be used as a potential molecular biomarker for evaluating sperm fertilization capability in vivo but not in vitro.
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Affiliation(s)
- Jianbing Liu
- State Key Laboratory of Medical Genomics, Research Center for Experimental Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200025, China
- Model Organism Division, E-Institutes of Shanghai Universities, SJTUSM , Shanghai 200025, China
| | - Chunling Shen
- State Key Laboratory of Medical Genomics, Research Center for Experimental Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200025, China
| | - Weimin Fan
- Reproductive Medical Center of Ruijin Hospital , Shanghai 200025, China
| | - Yan Chen
- Model Organism Division, E-Institutes of Shanghai Universities, SJTUSM , Shanghai 200025, China
| | - Aijun Zhang
- Reproductive Medical Center of Ruijin Hospital , Shanghai 200025, China
| | - Yun Feng
- Reproductive Medical Center of Ruijin Hospital , Shanghai 200025, China
| | - Zheng Li
- Shanghai Human Sperm Bank of Shanghai Renji Hospital , Shanghai 200025, China
| | - Ying Kuang
- Shanghai Research Center for Model Organisms , Shanghai 201203, China
| | - Zhugang Wang
- State Key Laboratory of Medical Genomics, Research Center for Experimental Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200025, China
- Model Organism Division, E-Institutes of Shanghai Universities, SJTUSM , Shanghai 200025, China
- Shanghai Research Center for Model Organisms , Shanghai 201203, China
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Progesterone level at oocyte retrieval predicts in vitro fertilization success in a short-antagonist protocol: a prospective cohort study. Fertil Steril 2014; 101:676-82. [DOI: 10.1016/j.fertnstert.2013.11.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 11/14/2013] [Accepted: 11/14/2013] [Indexed: 11/22/2022]
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In vitro fertilization at a public hospital in Nigeria. Int J Gynaecol Obstet 2012; 118:56-60. [PMID: 22503520 DOI: 10.1016/j.ijgo.2012.01.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 01/17/2012] [Accepted: 03/19/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the results of an in vitro fertilization program newly established within a conventional infertility program at a university hospital in Nigeria. METHODS From June 1, 2007, to June 30, 2011, following unsuccessful conventional treatments, 600 couples were offered in vitro fertilization with (if needed) intracytoplasmic sperm injection in batches of 30 couples. The outcomes measured were duration of ovarian stimulation and rate of ovarian hyperstimulation syndrome; numbers of follicles aspirated, oocytes retrieved, oocytes fertilized, and embryos transferred; and clinical pregnancy rate. RESULTS The mean duration of stimulation was 11.8 ± 1.6 days and 1% of the women had severe ovarian hyperstimulation syndrome. The mean number of follicles aspirated was 8 ± 2.8; of oocytes retrieved 6 ± 3.2; and fertilized 3 ± 1.8. The maximum number of embryos transferred per woman was 3. The rates of clinical pregnancy and multiple pregnancy were 30% and 6.0%. The rates of abortion and ectopic pregnancy were 6.6% and 0.6%. The preterm delivery rate was 2.5%. CONCLUSION Successfully conducting an assisted reproduction program at a public health facility is feasible in a low-resource country. Treating couples in batches was cost effective, with a low complication rate.
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Sperm chromatin structure assay results after swim-up are related only to embryo quality but not to fertilization and pregnancy rates following IVF. Asian J Androl 2011; 13:862-6. [PMID: 21841807 DOI: 10.1038/aja.2011.77] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to investigate whether the sperm chromatin structure assay (SCSA) results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitro fertilization (IVF). A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index (DFI) subgroups and high DNA stainability (HDS) subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.
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Yding Andersen C, Bungum L, Nyboe Andersen A, Humaidan P. Preovulatory progesterone concentration associates significantly to follicle number and LH concentration but not to pregnancy rate. Reprod Biomed Online 2011; 23:187-95. [PMID: 21665546 DOI: 10.1016/j.rbmo.2011.04.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 04/07/2011] [Accepted: 04/07/2011] [Indexed: 10/18/2022]
Abstract
Using data from a large prospective randomized controlled trial that evaluated the effect of recombinant LH (rLH)co-administration for ovarian stimulation, the present study assessed whether progesterone concentration on the day of human chorionic gonadotrophin (HCG) administration was associated with pregnancy outcome. Progesterone concentration was measured on stimulation day 1 and on the day of HCG administration in 475 patients who underwent IVF/intracytoplasmic sperm injection treatment following ovarian stimulation with gonadotrophin-releasing hormone (GnRH) agonist and recombinant FSH with or without rLH administration from day 6 of stimulation. There was no significant association between the late-follicular-phase progesterone concentration and the clinical pregnancy rate. However, progesterone concentration was strongly associated with the number of follicles and retrieved oocytes. Late-follicular-phase LH concentration also showed a significant positive association with progesterone concentration (P = 0.018). Administration of rLH during ovarian stimulation did not affect progesterone concentration. The present study does not support an association between progesterone concentration on the day of HCG administration and the probability of clinical pregnancy in women undergoing ovarian stimulation with GnRH agonists and gonadotrophins for assisted reproduction treatment.Instead, late-follicular-phase progesterone concentration appears to be governed by the number of preovulatory follicles and LH concentration.
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Affiliation(s)
- Claus Yding Andersen
- Laboratory of Reproductive Biology, University Hospital of Copenhagen, University of Copenhagen, Section 5712, Blegdamsvej 9, DK-2100 Copenhagen, Copenhagen, Denmark.
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Ozdegirmenci O, Dilbaz S, Cinar O, Aydin S, Beydilli G, Cakir L, Guven ESG, Akyol M, Haberal A. Can serum oestradiol be a predictor of quality of oocytes and embryos, maturation of oocytes and pregnancy rate in ICSI cycles? Gynecol Endocrinol 2011; 27:279-85. [PMID: 20540672 DOI: 10.3109/09513590.2010.491168] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [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 influence of ratios of oestradiol (E2) to either number of follicles ≥ 14 mm on the day of human chorionic gonadotropin administration (E2/fol) or the number of oocytes retrieved (E2/o) during oocyte pick up and total serum E2 levels on the day of embryo transfer (ETE2) on the outcome of ICSI cycles. The assessed outcomes were number of oocytes retrieved (NRO), number of mature oocytes (NMO), number of fertilised oocytes (NFO), number of transferred embryos (NTE), qualities of oocytes (OQS), qualities of embryos (EQS) and pregnancy rates (PR). Two hundred and twenty-seven ICSI-ET cycles admitted to our IVF clinic during a 2-year period with normal ovarian reserve receiving long luteal GnRH agonist protocol were included. The E2/fol levels correlated positively with NRO (r = 0.202, p = 0.002), NMO (r = 0.199, p = 0.003) and NFO (r = 0.159, p = 0.018). However, we observed negative correlations between E2/o and NMO (r = -0.329, p <0.001), NFO (r = -0.219, p = 0.001), EQ5 (r = -0.203, p = 0.040). Oocyte quality scores were not affected from either E2/fol or E2/o levels. Implantation, clinical and ongoing PRs were comparable between groups categorised due to E2/fol, E2/o and ETE2. It seems that high E2/fol ratio may have beneficial effects on NRO, NMO and NFO while E2/o may adversely affect these parameters. Neither of the E2 levels is associated with pregnancy rates in women with normal ovarian reserve.
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Affiliation(s)
- Ozlem Ozdegirmenci
- In Vitro Fertilization Clinic, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
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Wiser A, Hourvitz A, Yinon Y, Levron J, Dor J, Elizur S. Recombinant human luteinizing hormone supplementation may improve embryo quality in in vitro fertilization/intracytoplasmic sperm injection cycles with gonadotropin-releasing hormone antagonist protocol. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/ojog.2011.12007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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