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At least 685 records · Page 38Linked to original sources
PubMed1985

High-dose human menopausal gonadotropin therapy for successful ovulation induction for in vitro fertilization in perimenopausal women.

Five women with elevated gonadotropin levels were treated with high doses of human menopausal gonadotropin (hMG) in order to induce an ovulatory response. Three of the five patients did not show any increase in circulating estradiol levels nor any change in the size of follicles (as observed by ultrasound), even after prolonged stimulation with up to 1200 IU of hMG. Two patients achieved an ovulatory response, however. They underwent laparoscopy with successful oocyte retrieval and fertilization. Both patients had evidence of pregnancy: one showed a transient hCG rise (chemical pregnancy), while the other continued to 12 weeks' gestational age when fetal demise was diagnosed.

Adult↗
PubMed1991

Pure FSH for ovulation induction in patients with polycystic ovary syndrome and resistant to clomiphene citrate therapy.

Twenty-nine infertile women with polycystic ovary disease which was resistant to therapy with clomiphene citrate underwent a combined treatment for follicle recruitment consisting of pure FSH during the first days of the cycle and HMG during the last days of the follicular phase. Sixty cycles were stimulated of which 83% were ovulatory. Eighteen pregnancies were achieved (36% of cycles, 62% of patients). The multiple pregnancy rate was 39%. Twelve cycles (20%) showed the ovarian hyperstimulation syndrome (OHS) although seven of these resulted in full term deliveries. There were no miscarriages among the patients studied.

Adult↗
PubMed1995

Predictive value of endometrial sonography in ovulation induction for intrauterine insemination.

This prospective study was undertaken to evaluate the prognostic value of the endometrial sonographic pattern on the day of human chorionic gonadotropin (hCG) administration in patients who underwent intrauterine insemination. The endometrial sonographic patterns were classified as homogenous, hyperechogenic (A), intermediate isoechogenic (B) and multiple-layered "triple-line" (C). Type A had no pregnancies, whereas type B had a 20% fecundity rate and type C had a 21.1% fecundity rate. The continuing pregnancy rate was 10% in type B, as compared to 19.3% in type C. The data suggest that the endometrial sonographic pattern on the day of hCG administration may be of predictive value regarding fecundity and continuing pregnancy in the intrauterine insemination cycle.

Adult↗
PubMed1983

Serum luteinizing hormone during ovulation induction with human menopausal gonadotropin for in vitro fertilization in normally menstruating women.

Sixteen cycles in 14 normally menstruating women, stimulated with human menopausal gonadotropin in order to recruit more than one follicle for a successful in vitro fertilization process, were adequately monitored to identify the appearance of the spontaneous luteinizing hormone (LH) surge. Daily serum LH determinations, increased to every 4 hours in the presumptive preovulatory period, showed that in these women the endogenous estrogen-triggered LH midcycle peak did not occur at the expected time. It is hypothesized that the mechanism responsible for this suppression is a negative feedback mediated by an increased circulating protein with an inhibin-like action.

Adult↗
PubMed1991

Transvaginal ultrasonic needle-guided aspiration of endometriotic cysts before ovulation induction for in vitro fertilization.

Controversy still exists concerning the optimal treatment of endometriomata in endometriosis and its related infertility. Forty-one women with endometriomata who failed to conceive during previous in vitro fertilization and embryo transfer (IVF-ET) cycles (protocol A) were readmitted for ovum pickup following transvaginal ultrasonic needle-guided aspiration of the endometriomata (protocol B). Following aspiration a significantly higher number of oocytes was recovered (P less than 0.0006); subsequently, more embryos were transferred, and significantly higher clinical pregnancy rates per cycle (P less than 0.0001) were achieved. This difference may be directly related to the reduction of extensive ectopic endometrial tissue (endometriomata) with improved ovarian response, follicular accessibility, and, most probably, improved oocyte quality.

Cysts↗
PubMedDate not supplied

[Ovulation induction using pulsatile GnRH in patients with hypothalamic amenorrhea: effects of changing the frequency and dosage on the luteal phase].

Effects of frequency and dose variation of GnRH administration by minipumps Zyklomat, were studied in five women during luteal phase. As controls were assumed the same patients; in fact they had been previously treated with pulsatile GnRH with constant dose and frequency all over the cycle. Then the patients received the same treatment but the dose and the frequency of infusion were changed in the luteal phase. Our data show an increase of mean levels of progesterone and oestradiol during the luteal phase and a better pregnancy rate when the frequency and the dose of GnRh administration were changed.

Adult↗
PubMed1990

Failure of ovulation induction with pulsatile gonadotropin-releasing hormone and human menopausal gonadotropins in isolated gonadotropin deficiency.

A 30-year-old woman with primary amenorrhea, hypothalamic hypogonadism, decreased sense of smell, and primary infertility failed to respond to pulsatile exogenous gonadotropin-releasing hormone. In addition, failure to respond to stimulation with human menopausal gonadotropins was consistent with concomitant ovarian failure. Perturbation of normal cellular migration during embryogenesis in the regions of the olfactory placode, yolk sac, hindgut, and gonadal ridge may explain both the hypothalamic defect and ovarian failure experienced by this woman. She demonstrates that gonadal failure need not be accompanied by elevated gonadotropin levels; nor do low gonadotropin levels necessarily indicate potentially responsive ovaries. These findings are consistent with the coexistence of isolated gonadotropin deficiency and ovarian failure in the same individual.

Adult↗
PubMed2006

Influence of ovarian hyperstimulation and ovulation induction on the cytoskeletal dynamics and developmental competence of oocytes.

This study was undertaken to determine the effects of gonadotrophin on cytoskeletal dynamics and embryo development and its role in improving the retrieval of developmentally competent oocytes. Female golden hamsters were injected with human chorionic gonadotrophin (hCG; 5-, 7.5- or 15-IU) on the day 4 of estrus, pregnant mare serum gonadotrophin (PMSG; 5-, 7.5- or 15-IU) on the day 1 of estrus, or 15-IU hCG at 56 hr post-15-IU PMSG injection in any cycle except estrus. Increasing the hCG dose decreased not only retrieval rate of 2-cell embryo but development to blastocyst after subsequent in vitro culture. Whereas, although increasing the PMSG dose induced increasing the number of 2-cell embryo and blastocyst, 15-IU PMSG injection caused retardation of development to blastocyst. No 2-cell embryos were retrieved by injecting both PMSG and hCG. The injections of 15-IU hCG and 7.5- or 15-IU PMSG inhibited the proliferation of trophectodermal and inner cell mass cells, respectively. Gonadotrophin injection didn't influence microtubular spindle formation, but 5- or 15-IU hCG, 15-IU PMSG, or PMSG and hCG injections induced aberrant cortical granule (CG) and microfilament distribution. After 15-IU hCG or PMSG and hCG injections, fewer oocytes had enriched cortical actin domains, and the expression of alpha-, beta- and gamma-actin genes was greatly increased. In conclusion, a high dose of gonadotrophins alters the microfilament and CG distribution, which in turn reduces the developmental competence of oocytes. Injecting a reduced dose of PMSG to initiate ovarian hyperstimulation without triggering ovulation contributes to the efficient retrieval of developmentally competent oocytes.

Actin Cytoskeleton↗
PubMed1996

Ovulation induction in the ovulatory woman.

Controlled ovarian hyperstimulation is frequently employed as empiric therapy for the treatment of unexplained infertility, mild male factor, cervical factor, and treated endometriosis. Prescribed in the form of either clomiphene citrate or gonadotropins, it is often combined with intrauterine insemination and offered to patients as a less expensive and less invasive alternative to the assisted reproductive technologies. Efficacy studies for these regimens are very important, as patients who would appear to be ideal candidates for this empiric therapy frequently do not suffer from absolute infertility; rather they are often subfertile, and may conceive spontaneously given enough time. Although there are few well-designed, controlled trials that assess the effectiveness of this form of therapy, the majority of the published data do suggest an improvement in pregnancy rates when compared to expectant management.

Clomiphene↗
PubMed1983

Vital initiation of pregnancy (VIP) using human menopausal gonadotropin and human chorionic gonadotropin ovulation induction: Phase I--1981.

Laparoscopies for oocyte aspiration in 31 cycles were performed on 25 patients receiving human menopausal gonadotropin and human chorionic gonadotropin. Sixty oocytes were aspirated, of which 48 were considered preovulatory. Ninety-seven percent (58 of 60) of the oocytes were found in the original aspirate, and the remaining oocytes were found in either the first or second follicle wash. The fertilization rate per preovulatory oocyte was 33% (16 of 48), whereas on a per cycle basis it was 39% (12 of 31). A total of 15 conceptuses (2-cell = 5; 3-cell = 3; 4-cell = 7) were transferred to 12 patients, and two pregnancies were established. These pregnancies were established by transfers of 3-cell and 4-cell conceptuses at approximately 47 hours after insemination. Both pregnancies resulted in term deliveries of normal infants.

Cell Separation↗
PubMed2005

Embryo quality based on ovulation induction: defining the differences.

Patients undergoing IVF, with or without intracytoplasmic sperm injection, were treated with either recombinant human FSH or urine-derived FSH. Response to ovarian stimulation was monitored by ultrasound examinations and measurement of serum oestradiol concentrations. To define any differences in embryo quality and hence assisted reproductive technology success rates, a retrospective analysis of 811 recombinant FSH versus 555 urinary FSH cycles was undertaken. Embryo quality was assessed as embryo cell number and degree of fragmentation. Implantation and ongoing pregnancy rates were also compared. Use of recombinant FSH resulted in a higher percentage of mature oocytes, improved embryo cleavage, with more embryos available for freezing and higher implantation rates compared with urinary FSH. Oocyte and embryo quality were superior when recombinant FSH was used for ovarian stimulation compared with urinary FSH.

Adult↗
PubMedDate not supplied

Simultaneous intra- and extrauterine pregnancy after multiple ovulation induction.

Superovulation was induced by combined treatment with a GnRH analog, hMG and hCG in a 31 years old nulligravida with a diagnosis of unexplained infertility. She developed a mild hyperstimulation syndrome for which she received conservative treatment in hospital, and she was discharged only after we demonstrated a gestation sac in utero with evident fetal heart beat and beta hCG assays were positive. One week later the patient was readmitted urgently with acute abdominal pain. Laparoscopy revealed a left tubal pregnancy with corpus luteum on the right ovary and free blood in the pouch of Douglas. Salpingotomy was therefore performed with dilatation and curettage of the uterine cavity. Histological examination confirmed the presence of contemporary intra- and extrauterine pregnancy. Based on this first communication, a high index of clinical suspicion for an extrauterine pregnancy is warranted in all patients undergoing superovulation even after a pregnancy in utero has been demonstrated.

Adult↗
PubMed2003

Effect of ovarian cysts detected on the beginning day of ovulation induction to the success rates in ART cycles.

AIM: In the present study, we examined the outcome of assisted reproductive technology cycles in patients with or without baseline ovarian cysts following gonadotrophin-releasing hormone analogs administration. MATERIALS AND METHODS: Three-hundred and fifty-six patients who had undergone assisted reproductive technology treatment were enrolled in the study. The patients, all of who had undergone cyst aspiration prior to ovarian stimulation, were grouped into two groups according to the absence or presence of ovarian cysts. These two groups were compared on the basis of the clinical pregnancy rates, the baseline E2 levels, the total follicle stimulating hormone ampules used, the total number of days of induction, the maximum E2 levels, the number of oocytes retrieved, the fertilization rates and the number of embryos available for transfer per controlled ovarian hyperstimulation cycle. RESULTS: The number of ampules used for induction was significantly higher in the cyst group 37.2 +/- 13.0, 32.1 +/- 11.7, respectively, (P = 0.001). The number of total induction days was also longer in the cyst group 9.7 +/- 2.2, 8.9 +/- 1.6, respectively, (P = 0.001). There was no difference between the mean E2 levels measured on the human chorionic gonadotropin administration days (P = 0.339). There was also no difference in terms of the number of oocyte retrieved (P = 0.846). The number of embryos transferred did not differ statistically between the groups (P = 0.233). Finally, there was no significant difference between the groups according to the clinical pregnancy rates 25.3%, 30.7%, respectively, (P = 0.218). CONCLUSION: Baseline ovarian cysts have a negative impact on the quality of ovarian hyperstimulation procedure; however, they have no negative effect on the pregnancy rates in IVF cycles.

Adult↗
PubMedDate not supplied

Comparison of different follicle-stimulating hormone and luteinizing hormone ratios for ovulation induction during in vitro fertilization.

Five normally menstruating women were treated in an attempt to induce development of multiple follicles. They were randomly divided into two groups. The first group, consisting of three women, was treated with a combination of follicle stimulating hormone (FSH) and human menopausal gonadotropin (hMG) (combination FSH/hMG). The second group, two women, was treated with hMG only. Following a nonconceptual cycle, the treatments were exchanged. The increment patterns of serum estradiol during the follicular phase and progesterone levels in both groups were identical. Ultrasonographic scanning revealed similar number and size of the growing follicles, which subsequently terminated in the same oocyte recovery rate in both groups (7.6 +/- 3.4 oocytes/procedure in the combination FSH/hMG and 8.0 +/- 2.5 in the hMG-only group). Fertilization and cleavage rates were also similar. These data indicate that high FSH/LH levels in different ratios do not alter ovarian response and oocyte fertilization potential.

Adult↗
PubMed1993

Ovulation induction with low-dose follicle-stimulating hormone in women with the polycystic ovary syndrome.

Fifty infertile women with the polycystic ovary syndrome (PCOS) were treated for 66 cycles with low-dose FSH stimulation starting with 75 IU FSH for two weeks before eventual stepwise increases in the gonadotropin dose occurred. An unifollicular response was observed in 35 (53%) cycles and in 20 (30%) cycles there were two-three mature follicles. A multifollicular response (> 3 mature follicles) resulted in 11 (17%) cycles. One of the 66 cycles was complicated with the ovarian hyperstimulation syndrome. Twelve (22%) pregnancies were obtained following 55 completed cycles. All ongoing pregnancies were singleton gestations. The obese PCOS women required a longer period of stimulation and a higher amount of gonadotropin to achieve follicular maturation. However, there was no difference in cycle cancellation or pregnancy rate between obese and non-obese PCOS women. Thus low-dose FSH administration seems a safe stimulation regimen with a satisfactory conception rate in PCOS women.

Adult↗
PubMed1993

[Comparison of ovulation induction protocols for in vitro fertilization].

In a retrospective study we evaluated 4 controlled ovarian hyperstimulation (COH) protocols for in vitro fertilization (IVF) treatment. Treatment cycles 4 through 8 were analyzed in patients, who in 3 previous attempts reached the stage of embryo transfer (ET) but did not conceive. The 426 recorded cycles included all indications for IVF, but not the male factor. The age range was 25-46 years. Patients underwent from 4 cycles (169 women) to 8 cycles (27 women). The COH protocols used included established combinations of menotropins, clomiphene citrate/hMG, and short and long protocols of GnRH analogs followed by hMG. There were no statistically significant differences in patient age, etiology and duration of infertility, or distribution of the various COH protocols among the groups of patients. No single protocol was significantly superior to any other when the pregnancy rate per cycle was assessed. The results did not justify changing a COH protocol which had lead to ET but not to pregnancy, for another protocol.

Adolescent↗
PubMed2000

Prevalence of gestational diabetes mellitus in polycystic ovarian syndrome (PCOS) patients pregnant after ovulation induction with gonadotrophins.

Our aims were: 1. To investigate if women with PCOS who become pregnant using gonadotrophins have a higher incidence of gestational diabetes mellitus (GDM) compared to spontaneously pregnant matched control women, 2. To compare the prevalence of GDM in PCOS women with that in women with hypo/eugonadotrophic hypogonadism and in unexplained infertility and 3. To investigate differences in pregnancy outcomes between the groups. This was a retrospective case-control study. Women with PCOS were matched with a control by age, BMI, and ethnicity. There were 60 women with PCOS, 11 with hypogonadotrophic hypogonadism, 6 with eugonadotrophic hypogonadism, and 12 with unexplained infertility. Control women were those who attended a major public hospital for antenatal care and delivery We found no difference in the prevalence of GDM between the PCOS (22%) and the controls (17%) or between the PCOS and other groups. Women with GDM (diet or insulin controlled) had a significantly higher BMI than women without GDM (p = 0.019). There was no difference in pregnancy outcomes between the groups. There was a significant dependence of babies' birthweight on mother's BMI (p<0.001).

Adult↗
PubMed1994

The use of recombinant FSH for ovulation induction.

Recombinant human FSH (recFSH) was tested in a phase II study in 50 couples superovulated for IVF. Rec FSH alone was used in 10 women (Group 1). Intranasal buserelin spray (150 micrograms x 4 daily) was used in a flare-up protocol (10 women; Group 2) or in a desensitization protocol (10 women; Group 3) in combination with rec FSH. Desensitization using Triptorelin depot (3.75 mgIM) followed by rec FSH was given to 10 women (Group 4), while the same agonist was used subcutaneously (200 micrograms/daily) in Group 5 (10 women). In the five groups rec FSH induced multiple follicular growth. Significantly more ampoules rec FSH were required when a GnRH agonist was used. I all groups 9 to 11 mature oocytes were retrieved per cycle. In 6 couples there was an absence of fertilization due to severe sperm anomalies (5 couples); one couple suffered from idiopathic infertility. Fertilization and cleavage was normal in 44 couples. Forty-three transfers of 2.3 to 2.8 embryos yielded 10 pregnancies. Nine healthy babies were born. Superovulation for IVF was successful and safe by using rec FSH alone or in combination with various GnRHa dosages and protocols.

Buserelin↗