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Ultrasonographic Monitoring of Follicle Growth in Controlled Ovarian Hyperstimulation
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Controlled ovarian hyperstimulation (COH) is achieved by daily subcutaneous injections of recombinant or urinary gonadotropins (Gn). The dose is individualized, and the aim is to recruit 5–15 follicles. USS is used to assess the number and average diameter of the developing follicles for timing of egg retrieval. The estimated pregnancy rate per cycle using standard COH is approximately 30% [2], but when using minimal ovarian stimulation, the pregnancy rate per cycle is lower, approximately 10% [3]. This is why the accuracy of follicular ultrasound monitoring is very important for the ultimate outcome. In addition, ovaries might overrespond to the stimulation protocol, causing ovarian hyperstimulation syndrome (OHSS), which can be a life-threatening condition [4], and hence, the importance of having a reliable and secure tool to monitor superovulation. Martins et al. [5] performed a literature search up to April 2013 for randomized controlled trials (RCTs) on this topic. Studies that compared different methods for monitoring COH, including ultrasound assessment of follicles (alone or combined with hormonal assessment), in at least one group were included in the meta-analysis. The objective of the meta-analysis was to evaluate the efficacy and safety of monitoring COH using ultrasonography. Of the 1515 records found, only six studies fulfilled the inclusion criteria and were analyzed.
In Vitro Fertilization and Embryo Transfer
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Recently, a new technique of superovulation in patients undergoing the IVF procedure has been introduced. Initial induction and multiple follicle growth are induced with standard clomiphene citrate and then from day 7 of the cycle an intermittent pulsatile pump that injects 20 μg of Gn-RH is introduced. Preliminary results with this new technique are encouraging, but to evaluate results more data are needed.20
Helping a woman afflicted with endometriosis to conceive
Published in Seema Chopra, Endometriosis, 2020
To address the need of assisted reproduction over expectant management in women with mild or minimal endometriosis, and no other detectable cause, surgical reduction of the disease followed by 3–6 cycles of Superovulation (SO) + IUI is likely to give the best chance of live birth without the need for IVF [5]. This was supported by the results of a randomized controlled trial that showed superovulation with gonadotropins and intrauterine insemination has an odds ratio of 5.6 (95% CI, 1.8–17.4) for live birth [5,24].
The role of FGF-4 and FGFR-2 on preimplantation embryo development in experimental maternal diabetes
Published in Gynecological Endocrinology, 2022
Filiz Yilmaz, Serap Cilaker Micili, Guven Erbil
The study was a prospective experimental study. The weights of the mice were measured at the beginning and end of the experiment. Female mice (weighting 25–30 g, aged 7–8 weeks) were randomly divided into two groups: control (n = 15) and diabetic (n = 13). Two diabetic female mice died and were excluded from the study. After in the diabetic group mice were confirmed to be diabetic, all mice were induced for superovulation with 10 IU PMSG (pregnant mare serum gonadotropin; Folligon, Intervet) followed by 10 IU hCG (human chorionic gonadotropin; Chorulon, Intervet) over 48 h [16]. One of the basic techniques of reproductive biotechnology in experimental animals is the induction of superovulation, increasing the number of eggs [17]. After HCG injection, females were placed in cages with males and left to copulate, and the vaginal plug was evaluated the next day. Vaginal plug means copulation, and its presence defines the first day of pregnancy. Female mice in both groups were sacrificed under ether anesthesia on the third and fourth day of pregnancy, and their uterus and fallopian tubes were removed [18]. We collected the blastocysts by flushing the oviducts and uteri with M2 medium (Sigma) supplemented with 4 mg/ml bovine serum albumin (BSA; BioVision) [19]. The recovered embryos were counted and examined under the stereomicroscope for developmental stage classification and morphological analysis [21,28].
IVF protocol efficacy in women with expected suboptimal response depending on ovary stimulation mode
Published in Gynecological Endocrinology, 2021
K. V. Ob’edkova, I. Y. Kogan, V. C. Muller, N. I. Tapilskaya, I. O. Krikhely, L. Kh. Dzhemlikhanova, Z. K. Abdulkadirova, I. D. Mekina, E. A. Lesik, E. A. Komarova, M. A. Ishchuk, A. M. Gzgzian
The randomization was performed by ‘envelope’ technique (2:2 blocks) into one of two groups. The basic clinical group (Group I) included 25 women who underwent superovulation stimulating by recombinant corifollitropin alfa 150 mcg (Elonva – N.V. Organon) combined with highly purified menotropins150/150 IU (Meriofert – IBSA) within a protocol comprising administration of gonadotropin releasing hormone (GnRH) antagonists. The comparison group (Group II) included 26 women receiving ovary stimulation of similar layout by recombinant follitropin/lutropin alfa 300/150 IU (Pergoveris – Merck Serono). In course of superovulation stimulation ultrasound monitoring of folliculogenesis and endometrium growth was performed. On the 5th day of stimulation gonadotropin dose correction was made along with a decision whether to apply GnRH antagonists (Orgalutran – N.V. Organon, Cetrotid – Merck Serono) to prevent a luteinizing hormone (LH) preterm peak when one or several leading follicles had achieved 12 mm size. The indication for administering a final oocyte maturity trigger was achieving 17 mm size by at least two follicles. As a final oocyte maturity trigger, recombinant chorionic gonadotropine alfa was applied (Ovitrelle – Merck Serono, Figure 1).
Effect of embryo vitrification on the expression of brain tissue proteins in mouse offspring
Published in Gynecological Endocrinology, 2020
Wenjing Zhu, Jingxuan Zheng, Yangxing Wen, Yubin Li, Canquan Zhou, Zengyan Wang
Fifty specific-pathogen-free ICR mice were selected as research subjects. All the specific-pathogen-free ICR mice were purchased from the Animal Center of Sun Yat-sen University. The superovulation female mice were 6–8 weeks old; the mating male mice and pseudopregnancy female mice were more than 10 weeks old. The experiment comprised three groups. The vitrification group included mice born using embryos obtained after vitrification and thawing. Superovulation, IVF, embryo vitrification, and embryo transfer methods were similar to those described in previous studies [9,13]. Embryos were thawed and transferred after vitrification for a period of 1–3 months. Considering that all the experiments were conducted in a short time, there was no grouping according to the period of vitrification. The IVF group consisted of mice born after superovulation, IVF, and the transfer of embryos into pseudopregnant female mice. The control group consisted of mice conceived naturally. The experimental procedure and groupings are shown in Supplementary Figure S1.