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Molecular Diagnosis of Endometrial Receptivity
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Maria Ruiz-Alonso, Diana Valbuena, Carlos Simón
Sampling during an HRT cycle is preferred due to its simplicity and consistency. The classic protocol for endometrial preparation begins with the confirmation of ovarian quiescence by ultrasound. Then, estrogen is administered, beginning on the first or second day of menstruation. In Europe, popular preparations include estradiol valerate at a dose of 6 mg/day or estradiol hemihydrate patches delivering 150 μg/48 hours, while in the USA oral estrace at 200 mg/8 hours is favored. Between days 7 and 10 of HRT priming, when endogenous P is < 1 ng/mL and ultrasound assessment reveals a trilaminar endometrium > 6 mm, exogenous P administration is initiated. Vaginal micronized progesterone (or similar) at a dose of 400 mg/12h or 50 mg intramuscular progesterone daily is typically used in Europe or the USA, respectively. The day on which progesterone treatment begins is referred to as P+0, and the biopsy must be taken on day P+5, approximately 120 +/– 3 hours after the first P treatment (Figure 19.2).
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Cross-reactions between corticosteroids are discussed in Chapter 2.8. In a trial of the anti-inflammatory activity of some cream preparations containing steroids in volunteers, a 29-year-old woman developed some vesicles and redness on the 3rd day, only on the area of the forearm treated with 0.1% betamethasone valerate cream. Patch tests were positive to the cream and to betamethasone valerate 5% pet. Betamethasone itself was negative. There was also a positive reaction to hydrocortisone valerate (commercial preparation) but not to hydrocortisone base 5% pet. The author concluded that the contact allergic reactions were attributable to the side chains of the steroid compounds. Hydrocortisone valerate itself, however, was not tested (2).
Monitoring ovarian response in assisted reproduction (in vitro fertilization and intracytoplasmic sperm injection)
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
Matts Wikland, Torbjörn Hillensjö
In women with irregular cycles and in those with polycystic ovary syndrome, there is usually no spontaneous ovulation. Endometrial preparation can then be performed by hormone-replacement therapy (HRT). The most common stimulation is with estradiol valerate 6 mg/ day starting on cycle day 1 (22). Ultrasound is scheduled for between treatment days 10 and 14. When the endometrium has reached a thickness of at least 9 mm and displays a triple-line pattern, micronized progesterone is given intravaginally two to three times a day and the time of transfer can be determined. Occasionally, a higher dosage of estradiol valerate may be required. In anovulatory women, alternative ways to stimulate ovulation and endometrial receptivity can be applied, such as stimulation by a low dose of follicle-stimulating hormone (FSH) or human menopausal gonadotropin (hMG), by letrozole, or by clomiphene citrate. However, these cycles often require more monitoring than the HRT cycle.
Correlation between different endometrial preparation protocols and pregnancy outcome of frozen embryo transfer in patients with polycystic ovary syndrome: a retrospective study
Published in Gynecological Endocrinology, 2023
Yu Pan, Feng Li, Chun-Xia Yang, Yan Sun, Chen-Wang Zhang, Shen-Min Zhang, Tong-Min Xue
In the HRT group, routine vaginal ultrasonography and basic sex hormone tests were performed on the 2nd to 3rd day of the menstrual cycle. Estradiol valerate tablets (manufacturer: Bayer HealthCare Co., Ltd. Guangzhou Branch, China; NMPA approval number: J20130009; strength: 1 mg) were given orally at 2–3 mg/time, twice daily. The dosage was adjusted according to endometrial thickness, with a maximum dose of 4 mg. When estradiol valerate tablets were orally administered for > 10 days and endometrial thickness was > 7 mm, dydrogesterone tablets (manufacturer: Solvay Pharmaceuticals, Netherlands; approval number: JX20010415; strength: 10 mg) were added (20 mg/time orally, once daily) combined with 8% progesterone vaginal sustained-release gel (manufacturer: Merck Serono Limited; approval number: H20140552; strength: 90 mg) (90 mg vaginally, once daily) for endometrial transformation. Cleavage-stage embryos were transferred 4 days later, and medication for luteal support was continued until 10 weeks after pregnancy and gradually reduced.
Gut associated metabolites and their roles in Clostridioides difficile pathogenesis
Published in Gut Microbes, 2022
Andrea Martinez Aguirre, Joseph A. Sorg
A recent study that used1H-NMR on stool samples derived from recurring CDI patients that received FMT, through capsule or colonoscopy, found increased levels of acetate, butyrate, and propionate in recipients 12-weeks post-FMT.85 Interestingly, valerate, another SCFA was depleted in a chemostat C. difficile infection model.75 Similar to the other SCFA, valerate levels were restored upon FMT. The study also found that valerate inhibited in vitro C. difficile vegetative growth in a dose-dependent manner, and that introducing valerate orally in the form of 15 mM glycerol trivalerate into a C. difficile mouse model decreased total viable counts.75,85 It is important to note, though, that the glycerol trivalerate given to the mice was above physiologically relevant concentration since the authors found that chemostat FMT cultures only reached 4 mM valerate.
Retrospective analysis of the endometrial preparation protocols for frozen-thawed embryo transfers in women with endometrial polyps
Published in Human Fertility, 2022
Zengyan Wang, Yangxing Wen, Yujing Xiong, Yubin Li, Jia Huang, Yanwen Xu
In the women who underwent FET with the GnRHa-HRT protocol, 0.8–3.75 mg of GnRHa buserelin acetate (Suprefact®; Sanofi- Aventis, Seoul, Korea) was administered via subcutaneous injection in the midluteal phase (day 21). The women were initiated on oral oestradiol (E2) valerate (Progynova®; Bayer Schering Pharma AG, Berlin, Germany) at a daily dosage of 4–9 mg until the day of their pregnancy test. A transvaginal ultrasound was performed after 10–18 days of oestrogen treatment. If there was no dominant follicle or signs of ovulation, and the endometrial thickness reached at least 7 mm, FET was scheduled. Progesterone (P) in oil was intramuscularly (IM) administered at a dose of 60 mg/day before ET, depending on the cleavage stage of the embryos (embryo age + 1 day). E2 and P supplements were continued if pregnancy was confirmed until approximately 10 weeks of pregnancy. The FET with HRT protocol was similar to that with GnRHa, with the exception of the GnRHa buserelin acetate administration.