Etiology of OHSS and use of dopamine agonists
A review of the role played by VEGF on OHSS etiologyand the protective effect of dopamine agonists.
March 2012
All the papers from the March 2012 issue of Fertility and Sterility.
Agonist and antagonist coast
GnRH antagonist cycles are associated with a lower risk of OHSS and should be the protocol of choice in high-risk patients; and coasting is a useful protocol for prevention of OHSS.
Agonist trigger: what is the best approach? Agonist trigger with vitrification of oocytes or embryos
Agonist triggering combined with oocyte vitrification and ET in a subsequent natural cycle avoids ovarian hyperstimulation syndrome in patients at risk and shows excellent cycle outcome.
Agonist trigger: what is the best approach? Agonist trigger and low dose hCG
Low-dose hCG supplementation after GnRHa trigger secures the reproductive outcome and minimizes the risk of OHSS in the high-risk IVF patient.
Agonist trigger: what is the best approach? Agonist trigger with aggressive luteal support
Intensive luteal phase support is effective in improving pregnancy rates after GnRHa trigger.
Can FSH co-trigger prevent OHSS?
FSH co-trigger after ovarian stimulation has been shown to improve oocyte competence and a recent report suggested that the FSH co-trigger can completely prevent OHSS.
Preventing severe OHSS has many different facets
Dopamine agonists, decreased FSH and hCG doses, coasting, agonist trigger, paracentesis, metformin, low-dose aspirin, anticoagulation, and possibly FSH co-trigger are measures that prevent or reduce the severity of OHSS.
Committee opinion: role of tubal surgery in the era of assisted reproductive technology
This Practice Committee guideline provides recommendations regarding the use of surgical procedures for the treatment of tubal disease.
Mild induced testicular and epididymal hyperthermia alters sperm chromatin integrity in men
We report on how mild induced testicular and epididymal hyperthermia in men caused drastic and reversible effects on sperm chromatin integrity which appeared before any changes in sperm output.
Nitric oxide synthase and tyrosine nitration in idiopathic asthenozoospermia: an immunohistochemical study
We confirm a pathogenic role of nitric oxide in the reduction of sperm functionality.
A randomized assessor-blind trial comparing highly purified hMG and recombinant FSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer
A randomized, assessor-blind, multicenter trial with compulsory single-blastocyst transfer documented that highly purified hMG is noninferior to rFSH regarding ongoing pregnancy in GnRH antagonist cycles.
The relationship between follicle development and progesterone receptor membrane component-1 expression in women undergoing in vitro fertilization
Eighteen percent of women undergoing IVF overexpressed PGRMC1, which was associated with a 30% reduction in follicle development and the number of mature oocytes but not ongoing pregnancy rates.
Outcomes of singleton births after blastocyst versus nonblastocyst transfer in assisted reproductive technology
Retrospective cohort analysis of 4,202 births resulting from blastocyst versus nonblastocyst transfer demonstrated no significant difference in maternal and perinatal outcomes, although blastocyst transfer may increase preeclampsia and placenta previa.
Thyroid function during controlled ovarian hyperstimulation as part of in vitro fertilization
We report that ovarian hyperstimulation as part of in vitro fertilization led to significant elevations in TSH, often above pregnancy-appropriate targets. These findings were particularly evident in participants with preexisting hypothyroidism.
High expression of luteinizing hormone receptors messenger RNA by human cumulus granulosa cells is in correlation with decreased fertilization
This is the first demonstration that LH receptor expression increases during antral follicular growth, is highest in preovulatory follicles, and correlates with fertility treatment outcome.
Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis
We present a systematic review and meta-analysis performed to evaluate the effect of acupuncture on pregnancy rates in women undergoing IVF.
Pre-emptive effect of ibuprofen versus placebo on pain relief and success rates of medical abortion: a double-blind, randomized, controlled study
Pre-emptive use of ibuprofen had a statistically significant beneficial effect on the need for pain relief during a mifepristone and misoprostol regimen for medical abortion. Ibuprofen did not adversely affect the outcome of medical abortion.
A randomized, phase II study describing the efficacy, bleeding profile, and safety of two low-dose levonorgestrel-releasing intrauterine contraceptive systems and Mirena
Two new low-dose LNG-IUSs provided effective contraception with a similar bleeding profile to Mirena and were significantly easier and less painful to place compared with Mirena.
Severe maternal morbidity in ectopic pregnancy is not associated with maternal factors but may be associated with quality of care
We report that severe maternal morbidity from hemorrhage in women with ectopic pregnancy is not associated with patient-related risk factors.
Birth outcomes after spontaneous or assisted conception among infertile Australian women aged 28 to 36 years: a prospective, population-based study
More than 40% of Australian women aged 28 to 36 years with a history of infertility can achieve births without using fertility treatment, indicating they are subfertile rather than infertile.
Temporal trends in clomiphene citrate use: a population-based study
Increased incidence rates of clomiphene citrate use among women aged 30 to 44 years over the past decade indicate a growing demand for fertility treatments in this population.
Physiologic activation of nuclear factor kappa-B in the endometrium during the menstrual cycle is altered in endometriosis patients
Healthy endometrium has variable constitutive nuclear factor kB activity. Altered p65 activity in secretory endometrium from endometriosis patients may modulate endometrial dysfunctions associated with endometriosis pathophysiology.
Does colorectal endometriosis alter intestinal functions? A prospective manometric and questionnaire-based study
This study investigated whether rectosigmoid DIE influences intestinal and defecatory functions through anorectal manometry and a questionnaire. Some defecatory disorders were reported while there was no report of motility or sensitive dysfunctions.
Peroxisome proliferating activating receptor gamma–independent attenuation of interleukin 6 and interleukin 8 secretion from primary endometrial stromal cells by thiazolidinediones
Thiazolidinediones reduce the concentration of inflammatory cytokines IL-6 and IL-8 secreted from primary cultured endometrial stromal cells through a PPARg–independent mechanism.
Fertility preservation for social indications: a cost-based decision analysis
Neither oocyte cryopreservation nor ovarian tissue cryopreservation appears to be cost-effective for healthy women planning delayed childbearing.
Which patients pursue fertility preservation treatments? A multicenter analysis of the predictors of fertility preservation in women with breast cancer
Several factors are associated with undergoing fertility preservation treatment. Understanding these factors may be helpful to better target counseling and possibly tailor treatments so that fertility preservation treatment options can be maximized.
Follicle-stimulating hormone receptor gene polymorphisms are not associated with ovarian reserve markers
This study evaluated the association between FSH receptor gene variants and current markers of ovarian reserve. No associations of FSH receptor genotypes with markers of ovarian reserve were detected.
LHX1 mutation screening in 96 patients with müllerian duct abnormalities
We sequenced LHX1 and identified a novel variation, c.1070–1081del, in 1 of 77 incomplete m€ullerian fusion patients and 1 of 105 control individuals from a Han Chinese population.
Mayer-Rokitansky-Küster-Hauser syndrome: a review of 245 consecutive cases managed by a multidisciplinary approach with vaginal dilators
Mayer-Rokitansky-Kuster-Hauser syndrome management by a multidisciplinary approach, including psychologists, results in no need for surgical intervention.
Sexuality after sigmoid vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser syndrome
The analysis of 59 Mayer-Rokitansky-Kuster-Hauser syndrome patients shows that sigmoid vaginoplasty provides nearly normal sexuality often tainted with psychologic distress.
Lifestyle behaviors in women undergoing in vitro fertilization: a prospective study
Women undergoing an assisted reproductive technology cycle reported some surprising lifestyle habits, including a 12% prevalence of taking herbs while cycling.
CD11c+HLADR+ dendritic cells are present in human ovarian follicular fluid, and their maturity correlates with serum estradiol levels in response to gonadotropins
Dendritic cells make up a significant fraction of hematopoietic cells in human follicular fluid. The ovarian response to gonadotropins in in vitro fertilization cycles correlates with the maturity of these cells.
Transient expression of progesterone receptor and cathepsin-l in human granulosa cells during the periovulatory period
Human chorionic gonadotropin/luteinizing hormone modulates progesterone receptor and cathepsin-L expression in human preovulatory granulosa cells, suggesting that both peptides are critical in human ovulation.
Oocyte mitochondrial bioenergy potential and oxidative stress: within-/between-subject, in vivo versus in vitro maturation, and age-related variations in a sheep model
Mitochondrial activity in oocytes from hormonally stimulated donor sheep shows within- and betweensubject and maturation procedure- and age-related variations. Reactive oxygen species (ROS) level increases in aged oocytes. High mitochondria-ROS colocalization identifies in vivo matured oocytes.
Uncoupling oxidative phosphorylation with 2,4-dinitrophenol promotes development of the adhesion phenotype
The adhesion phenotype, which is normally expressed in response to hypoxia, is reproduced in a normoxic environment by uncoupling oxidative phosphorylation with 2,4-dinitrophenol.
Recombinant H2 relaxin inhibits apoptosis and induces cell proliferation in cultured leiomyoma cells without affecting those in cultured normal myometrial cells
Human relaxin selectively inhibits apoptosis by downregulating caspase-3 expression and induces proliferation in cultured human leiomyoma cells without affecting apoptosis or proliferation in normal myometrial cells.
Phospholipase C-ζ-induced Ca2+ oscillations cause coincident cytoplasmic movements in human oocytes that failed to fertilize after intracytoplasmic sperm injection
PLCz-induced Ca2+ oscillations in human oocytes that failed to fertilize after intracytoplasmic sperm injection cause small, discrete movements in the cytoplasm that provide a noninvasive measure of the pattern of Ca2+ transients during activation.
Developmental programming: prenatal testosterone excess disrupts anti-Müllerian hormone expression in preantral and antral follicles
Prenatal T leads to changes in anti-Mullerian hormone protein expression that likely accounts for the increased follicular recruitment and persistence found in this animal model of PCOS.
11-deoxy prostaglandin F2α, a thromboxane A2 receptor agonist, partially alleviates embryo crowding in Lpar3(−/−) females
11-deoxy prostaglandin F2a, a thromboxane A2 receptor (TP) agonist, partially alleviates embryo crowding and increases litter size in the Lpar3(/) females.
Effects of low molecular weight heparin and heparin-binding epidermal growth factor on human trophoblast in first trimester
This study shows that LMWH plays a role in the protection of the trophoblast by regulating proliferation, invasion, and differentiation. The HB-EGF is an important factor in the effects of LMWH on trophoblast function.