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At least 487 records · Page 27Linked to original sources
PubMed2004

Ovulation induction using laparoscopic ovarian drilling in women with polycystic ovarian syndrome: predictors of success.

BACKGROUND: Although laparoscopic ovarian drilling (LOD) has been widely used to induce ovulation in women with polycystic ovarian syndrome (PCOS), predicting the clinical response to this treatment remains to be elucidated further. This study was carried out to identify factors that may help to predict the outcome of LOD. METHODS: This retrospective study included 200 patients with anovulatory infertility due to PCOS who underwent LOD between 1990 and 2002. The influence of the various patients' pre-operative characteristics on the ovulation and pregnancy rates after LOD was evaluated. In addition, women were divided into two or three categories according to the severity of each of the various clinical and biochemical parameters of PCOS. The success rates were compared between the categories of each factor using contingency table analyses. Multiple logistic regression analysis was used to identify independent predictors of success of LOD. RESULTS: Women with body mass index (BMI) > or = 35 kg/m2, serum testosterone concentration > or = 4.5 nmol/l, free androgen index (FAI) > or = 15 and/or with duration of infertility > 3 years seem to be poor responders to LOD. In LOD responders, serum LH levels > 10 IU/l appeared to be associated with higher pregnancy rates. CONCLUSION: Marked obesity, marked hyperandrogenism and/or long duration of infertility in women with PCOS seem to predict resistance to LOD. High LH levels in LOD responders appear to predict higher probability of pregnancy.

Adult↗
PubMed1989

Male sex preselection: swim-up technique and insemination of women after ovulation induction.

Insemination of women with sperm treated by the swim-up technique resulted in 81% male offspring. This was achieved even in women taking ovulation-inducing drugs, in whom the albumin gradient separation technique not only is not effective in male preselection but in which the female sex is favored. Confirmation of these initial data is needed as well as an investigation of the swim-up's efficacy of producing male offspring in women not taking ovulation-inducing drugs.

Clomiphene↗
PubMed1984

Human in vitro fertilization employing individualized ovulation induction by human menopausal gonadotropins.

One hundred six women suffering from obstructive tubal disease not corrected by previous surgery were treated in an in vitro fertilization (IVF) program. Ovulation was induced by 3 amps of human menopausal gonadotropin (HMG)/day starting on the third day of the cycle for 5 days. In most of the patients the regimen was continued for another 1-3 days, depending on the individual's ovarian response (mean, 20 +/- 5 amps/cycle). Monitoring consisted of daily follicular ultrasonography and serum estradiol measurements. Human chorionic gonadotropin (HCG), 10,000 IU, was administered when more than two large (1.5 to 1.8 cm in diameter) follicles were visualized. Using this regimen, a mean of five follicles per woman was aspirated, from which a mean of 3.9 ova was recovered. The oocytes were pre-incubated for 8 or 24 hr, according to the morphological degree of mucification and dispersal of the oocyte-corona-cumulus complex. Following exposure to washed spermatozoa for 16 hr, a 68% fertilization rate was obtained. Oocytes were transferred into the uterus 48 hr after laparoscopy. Ninety-nine transfers (93% of the women) of 1-8 embryos (mean, 2.9/woman) were performed and resulted in 16 clinical pregnancies. No pregnancies occurred in 14 women transferred with one to three oocytes in the pronuclear stage and only one pregnancy (7.1%) was obtained in 14 women transferred with one cleaved oocyte. Over 70% of the women were transferred with two or more cleaved oocytes: in this group the pregnancy/transfer rate was 21%. Of the pregnant women 5 of 16 (31%) aborted between 6 and 10 weeks of gestation and 1 (6%) had an ectopic pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Ovulation induction by pulsatile intravenous administration of Gn-RH to patients with hypothalamic amenorrhea].

Intravenous pump administration (Zyklomat, Ferring) of GnRH (Lutrelef, Ferring) has been used to induce ovulation in 16 patients suffering from hypothalamic amenorrhea between January 1989 and December 1991. One to 6 cycles were performed for a total of 47 cycles. GnRH pulses were set at 20 micrograms/pulse every 90 min up during the follicular phase and decreased to 1 pulse/120 min during the 3-5 days following ovulation. Thereafter, the luteal phase was supported by 1000 IU HCG/48 h up to the end of the 5th week. Response to the treatment was monitored with seriC E2, P and LH and vaginal echography. Cycles (N = 3) were cancelled when E2 did not reach at least 0.25 nmol/l after 30 days. An E2 level > 0.8 nmol/l, associated with a mature follicle (> 20 mm), and the presence of a LH peak or an increased progesterone level were used to determine the day of ovulation. In case of normozoospermy (N = 9), sexual intercourse was recommended to the patients (27 cycles), whereas an intrauterine insemination was performed in case of a male factor (N = 7, 20 cycles). Results can be summarized as follows: 39 (83%) cycles were ovulatory and led to 9 (19%) clinical and 6 (13%) biochemical pregnancies. Five (8.5%) pregnancies aborted and 5 (11%) came to full term. After exclusion of the male factors, the pregnancy rate reaches 26%/initiated cycle, 28%/ovulatory cycle and 56%/patient. No patient developed a hyperstimulation syndrome or a multiple pregnancy. Three cycles (6.3%) were interrupted due to 2 superficial phlebitis and 1 pump failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Ovulation induction in clomiphene-resistant anovulatory women with normal dehydroepiandrosterone sulfate levels: beneficial effects of the addition of dexamethasone during the follicular phase.

OBJECTIVE: To evaluate the effect on ovulation of a 10-day course of dexamethasone (DEX) initiated concurrently with a 5-day course of clomiphene citrate (CC) in CC-resistant patients with normal DHEAS levels. DESIGN: Retrospective review. SETTINGS: Patients from the clinical practice of the authors at the Medical College of Georgia, Augusta, Georgia. PATIENTS: Thirteen oligomenorrheic women with normal DHEAS levels who failed to ovulate on a graduated regimen of CC up to a dose of 150 mg for 5 days. INTERVENTIONS: Ten-day course of DEX initiated concurrently with a 5-day course of CC; ovulation and pregnancy outcomes recorded. MAIN OUTCOME MEASURE: Pregnancy. RESULTS: Eleven of 13 women had evidence of ovulation. Five clinical pregnancies were achieved. CONCLUSION: These initial data support improvements in follicular development with an overlapping follicular phase regimen of CC and DEX in patients with normal DHEAS levels and a previous poor response.

Adult↗