1.Value of serum estradiol concentration in predicting the clinical outcome of IVF-ET in patients receiving long protocol of GnRHa.
Hao NI ; Lei-ning CHEN ; Song QUAN ; Hong LI ; Rui HUA ; Rui-hua GAO ; Si-mei CHEN ; Chen LUO
Journal of Southern Medical University 2011;31(2):365-368
OBJECTIVETo investigate the value of serum estradiol increment and serum estradiol/follicles on the day of hCG administration in predicting the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET).
METHODSA retrospective analysis of the IVF-ET data was conducted involving 121 patients who received a long gonadotrophin-releasing hormone agonist (GnRHa) protocol. According to the increment of serum estradiol on the day of hCG administration (relative to the level on the day before hCG administration), the patients were divided into 3 groups (A1, A2 and A3) with a increment ratio below 30%, between 30% and 50%, and over 50%, respectively. In addition, according to the ratio of serum estradiol level on hCG day to mature follicle (diameter ≥ 14 mm) number, these patients were divided into three groups (B1, B2 and B3) with the ratio below 250 pg/ml, between 250 and 350 gp/ml, and over 350 pg/ml, respectively. The hormonal characteristics and clinical outcomes of the IVF-ET cycles were analyzed comparatively.
RESULTSBoth the clinical pregnancy rate (71.05%) and embryo implantation rate (52.63%) were significantly higher in group A3 than in groups A1 and A2 (P<0.05). The best clinical pregnancy rate (67.86%) and embryo implantation rate (49.14%) were significantly higher in group B2 than in groups B1 and B3 (P<0.05).
CONCLUSIONThe variation of serum estradiol shows an important impact on the clinical outcomes of IVF-ET in patients receiving long GnRH-a protocol. Favorable outcomes can be expected with a hCG day serum estradiol increment ratio above 50% and E(2)/follicle ratio between 250 and 350 pg/ml.
Embryo Transfer ; Estradiol ; blood ; Female ; Fertility Agents, Female ; administration & dosage ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; administration & dosage ; agonists ; Humans ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Treatment Outcome
2.Factors affecting the success of resynchronization protocols with or without progesterone supplementation in dairy cows.
Annette FORRO ; Georgios TSOUSIS ; Nicola BEINDORFF ; Ahmad Reza SHARIFI ; Christos BROZOS ; Heinrich BOLLWEIN
Journal of Veterinary Science 2015;16(1):121-126
The objective of this study was to investigate factors that influence the success of resynchronization protocols for bovines with and without progesterone supplementation. Cow synchronized and not found pregnant were randomly assigned to two resynchronization protocols: ovsynch without progesterone (P4) supplementation (n = 66) or with exogenous P4 administered from Days 0 to 7 (n = 67). Progesterone levels were measured on Days 0 and 7 of these protocols as well as 4 and 5 days post-insemination. Progesterone supplementation raised the P4 levels on Day 7 (p < 0.05), but had no overall effect on resynchronization rates (RRs) or pregnancy per artificial insemination (P/AI). However, cows with Body Condition Score (BCS) > 3.5 had increased P/AI values while cows with BCS < 2.75 had decreased P/AI rates after P4 supplementation. Primiparous cows had higher P4 values on Day 7 than pluriparous animals (p = 0.04) and tended to have higher RRs (p = 0.06). Results of this study indicate that progesterone supplementation in resynchronization protocols has minimal effects on outcomes. Parity had an effect on the levels of circulating progesterone at initiation of the protocol, which in turn influenced the RR.
Animals
;
Cattle/*physiology
;
Dinoprost/administration & dosage/*pharmacology
;
Estrus Synchronization/*drug effects/methods
;
Female
;
Fertility Agents/administration & dosage/pharmacology
;
Gonadotropin-Releasing Hormone/administration & dosage/*pharmacology
;
Insemination, Artificial/veterinary
;
Ovulation/drug effects
;
Pregnancy
;
Progesterone/administration & dosage/*pharmacology
;
Tromethamine/administration & dosage/*pharmacology
3.Effect of two different doses of letrozole in promoting ovulation in infertile women with polycystic ovarian syndrome.
Mei-Qiong YANG ; Song QUAN ; Hong LI ; Ya-Li SONG ; Fu-Qi XING
Journal of Southern Medical University 2008;28(11):2060-2061
OBJECTIVETo investigate the effect of two different doses of letrozole in promoting ovulation in infertile women with polycystic ovarian syndrome (PCOS).
METHODSSeventy-six PCOS infertile women undergoing intrauterine insemination (IUI) or with anovulation were divided into two groups and received oral letrozole at the daily dose of 2.5 (n=36) or 5.0 mg (n=40) from the 3rd to the 7th day of the menstrual cycle. Three days after discontinuation of the medication (the 10th day of the menstrual cycle ), ultrasound scanning was performed to monitor the follicle development. When the diameter of the biggest follicle reached 14 mm, the presence of luteinizing hormone (LH) was monitored; when LH positivity was detected, blood samples were drawn to test follicle-stimulating hormone (FSH), LH, estradiol (E2) and testosterone (T) levels. Human chorionic gonadotropin (hCG, 10 000 U) was then injected to induce ovulation.
RESULTSThe ovulation rate, stimulation follicle days, diameter of the biggest follicle on the day of LH positivity and the thickness of endometrium were all similar between the two groups (P>0.05). But in women receiving 5.0 mg letrozole, both the number of mature follicles and pregnancy rate were significantly higher than those in women having the half dose (P<0.05). The levels of FSH, LH, E2, and T on the third day of menstruation and on the day of HCG injection were similar between the two groups (P<0.05).
CONCLUSIONLetrozole at the dose of 5.0 mg/day produces higher pregnancy rate and more mature follicles in fertile women with PCOS.
Adult ; Aromatase Inhibitors ; administration & dosage ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; etiology ; Insemination, Artificial ; Nitriles ; administration & dosage ; Ovulation Induction ; methods ; Polycystic Ovary Syndrome ; complications ; Triazoles ; administration & dosage
4.Clinical analysis of 4 treatments for woman polycystic ovarian syndrome with infertility.
Xiao-bo SHI ; Li-yuan ZHOU ; Shu-xin FU ; Jian-lin CHEN
Journal of Central South University(Medical Sciences) 2006;31(3):359-362
OBJECTIVE:
To investigate the therapeutic effects of 4 different treatments for woman polycystic ovarian syndrome (PCOS) with infertility.
METHODS:
One hundred and twenty women PCOS with infertility were divided into 4 Groups : patients in Group 1 were directly treated with clomiphene (CC)/CC + human menopausal gonadotropin (HMG) + human chorionic gonadotropin (HCG) to accelerate ovulation; patients in Group 2 were treated with the same way as Group 1 after taking marvolon for 2 cycles; patients in Group 3 took marvolon for 2 cycles and metformin for 8 weeks, and then were treated the same as Group 1; patients in Group 4 were treated with laparosocopy. The body mess index (BMI), emmenia period, weight, volume of ovary, LH, and T were measured before and after the treatment in all patients. The cycle ovulatory rate and occurrence rate of luteinized unruptued follicle syndrome (LUFS) within 2 months and the pregnancy rate within 6 months after the treatment were also observed.
RESULTS:
In all patients, BMI, emmenia period, serum T, and serum LH decreased significantly (P <0.05 or 0.01). The body mess indexes were significantly lower in Group 2 and Group 3 than those in Group 4 and Group 1, and Group 4 was also lower than Group 1 (P < 0.05 or 0.01). There was no difference in emmenia period between the 4 groups (P = 0.289). The volumes of ovary were enlarged in Group 1, and they were shrunk in the residual groups, which was significantly lower in Group 4 than in Group 2 and 3 (P < 0.01). The cycle ovulation rates were 53%, 72 %, 78 %, and 76%; the pregnancy rates within 6 months were 20%, 47%, 50%, and 57%, respectively; and they were significantly higher in the Group 2, 3 and 4 than in Group 1 (P <0.01). The occurrence rates of LUFS were 32%, 16%, 15%, and 13%, and they were significantly lower in Group 2, 3 and 4 than in Group 1 (P <0. 01).
CONCLUSION
The effects of marvolon or marvolon and metformin are the same as those of laparoscopy not only in controlling the symptoms of PCOS, but also in increasing the cycle ovulation rate, pregnancy rate within 6 months, and decreasing the occurrence rate of LUFS. The symptoms of PCOS can be controlled better, but the cycle ovulation rate and pregnancy rate within 6 months can not be improved when clomiphene is used alone.
Adult
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Chorionic Gonadotropin
;
administration & dosage
;
Clomiphene
;
administration & dosage
;
Drug Therapy, Combination
;
Female
;
Fertility Agents, Female
;
administration & dosage
;
Humans
;
Infertility, Female
;
etiology
;
therapy
;
Insulin Resistance
;
Laparoscopy
;
Metformin
;
administration & dosage
;
Ovulation Induction
;
methods
;
Polycystic Ovary Syndrome
;
complications
5.Effects of Ficus asperifolia on normal rat estrus cyclicity.
Esther NGADJUI ; Pierre WATCHO ; Telesphore Benoit NGUELEFACK ; Albert KAMANYI
Asian Pacific Journal of Tropical Biomedicine 2013;3(1):53-57
OBJECTIVETo evaluate Ficus asperifolia (Moraceae) (F. asperifolia) effecting on regular estrus cycle of Wistar rats.
METHODSAir-dried fruits of F. asperifolia were extracted using water. Prior to the test, vaginal smear was monitored daily for a 3-week period to select females with normal (regular) estrous cycle. Those with regular estrus cycle weighing between 150-170 g were randomized into three sets of 15 animals each. Each set was then divided into three groups: Group 1 (control) was orally administered with distilled water (10 mL/kg body weight) once a day for 1 week starting from the proestrus stage. Groups 2 and 3 were respectively treated with 100 and 500 mg/kg body weight of the plant aqueous extract. The two other sets of 15 animals each were similarly treated as the first set for 3 weeks and 6 weeks respectively. Estrus cycle pattern was monitored before and during plant extract application whereas lipid profile, ovary, uterus and liver growth indices were determined at the end of each treatment.
RESULTSF. asperifolia did not disrupt (0%) the order of appearance of normal estrus cycle stages, namely, proestrus, estrus, metestrus and diestrus. Short-term treatment (1 week duration) exhibited high frequency of appearance of proestrus and estrus stages while mid- (3 weeks) and long-term (6 weeks) treatments revealed constancy in the frequency of all stages irrespective to animal groups. The plasma and organ lipid profile, as well as ovary, uterus and liver growth remained unchanged when compared to distilled water-treated animals. Following long-term administration of plant extract (6 weeks), no adverse effect was noticed.
CONCLUSIONSOur data partially support the use of F. asperifolia in common medicine.
Administration, Oral ; Animals ; Estrus ; drug effects ; Female ; Fertility Agents, Female ; pharmacology ; Ficus ; chemistry ; Plant Extracts ; chemistry ; pharmacology ; Rats ; Rats, Wistar ; Time Factors
6.Infertility in polycystic ovary syndrome treated with acupuncture and clomiphene: a randomized controlled trial.
Duosheng JIANG ; Yingchun ZHANG ; Xianqun WU ; Song WU
Chinese Acupuncture & Moxibustion 2015;35(2):114-118
OBJECTIVETo explore the best therapy for infertility caused by polycystic ovary syndrome (PCOS).
METHODSOne hundred and twenty patients were randomized into three groups, a clomi-phene group (group A), an acupuncture-moxibustion + Chinese medicine group (group B) and a clomiphene + acupuncture-moxibustion+ Chinese medicine group (group C), 40 cases in each one. In the group A, since the 5th day of menstruation, clomiphene was prescribed for oral administration. In the group B, on the 5th day of menstruation, warm needling therapy was applied at Zhongji (CV 3), Guanyuan (CV 4), Guilai (ST 29), etc. Additionally, the Chinese herbal medication for tonifying the kidney and activating blood circulation was provided. In the group C, the therapy as the group B was combined on the basis of the treatment as the group A. The treatment lasted continuously for 3 menstrual cycles. The endometrial thickness, endometrial type and cervical mucus score on human chorionic gon adotropin (HCG) day, and ovulatory cycle rate, clinical pregnancy rate and abortion rate after treatment were observed in the patients of the three groups.
RESULTS1) HCG day cervical mucus score, endometrial thickness and endometrial morphology (A type rate): the results in the group C were better than those in the group A (all P<0.01); the results in the group B were better than those in the group A (all P<0.05). The difference in the endometrial thickness was not significant in comparison between the group C and the group B (P>0.05). The cervical mucus score and endometrial morphology (A type rate) in the group C were better than those in the group B (both P<0.05). 2) The ovulatory cycle rates in the group A and group (C were higher than that in the group B (both P<0.05), the pregnancy rate in the group C was higher than that in the other groups (both P<0.05), and the early abortion rate in the group C was lower than that in the group A and group B (both P<0.01). 3) Follicle diameter from 18 mm to 20 mm and endometrial thickness: the differences were not significant between the normal pregnancy patients and the early abortion patients (both P>0.05). The endometrial morphology A type rate in the normal pregnancy patients was higher than that in the early abortion patients (P<0.05).
CONCLUSIONThe combined therapy of acupuncture, herbal medicine and clomiphene improves the pregnancy rate and reduces early abortion rate by effectively improving HCG day cervical mucus, endometrial thickness and morphology. The efficacy is apparently superior to the simple medication with clomiphene and the combined application of acupuncture and herbal medicine.
Acupuncture Therapy ; Administration, Oral ; Adult ; Chorionic Gonadotropin ; metabolism ; Clomiphene ; administration & dosage ; Combined Modality Therapy ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; etiology ; metabolism ; therapy ; Moxibustion ; Polycystic Ovary Syndrome ; Pregnancy ; Pregnancy Rate ; Young Adult
7.Observation on clinical efficacy of activating renal blood circulation and ovarian stimulation formula in treating ovulation failure infertility.
Xiao-Di FAN ; Kun MA ; Jing SHAN ; Xuan-Ting JIN
China Journal of Chinese Materia Medica 2013;38(1):119-122
OBJECTIVETo discuss the clinical efficacy of the activating renal blood circulation and ovarian stimulation formula in treating ovulation failure infertility.
METHODEighty-six cases were randomly divided into two groups: the treatment group and the control group. The treatment group is administered with the activating renal blood circulation and ovarian stimulation formula (composed of 15 g Cuscutae Semen, 15 g Dipsaci Asperoidis Radix, 15 g Lycii Fructus, 15 g Spatholobi Caulis, 10 g Ligustri Lucidi Fructus, 15 g Lycopi Herba, 10 g Typhae Polleu, 10 g Angelicae Sinensis Radix, 15 g Cyathulae Radix etc.), whereas the control group was given clomiphene.
RESULTThe treatment group showed a pregnancy rate of 58.14%, with an ovulation rate of 68.6%. While the control group showed a pregnancy rate of 36.67%, with an ovulation rate of 70%.
CONCLUSIONThe comparison between the two groups showed that the activating renal blood circulation and ovarian stimulation formula was significantly different from clomiphene in statistical analysis (P < 0.05), without notable difference in the ovulation rate. Before and after the treatment, there is no significant difference in diameter of dominant follicles between the two groups, with remarkable difference in endometrium (P < 0.05).
Adult ; Anovulation ; drug therapy ; physiopathology ; Blood Circulation ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; blood supply ; drug effects ; Middle Aged ; Ovulation ; drug effects
8.A multi-center, randomized, double-blind clinical study on Bushen Huoxue in treatment of ovulatory dysfunction caused infertility.
Kun MA ; Yan-feng LIU ; Jun-qin HE ; Min LI ; Jing SHAN
China Journal of Chinese Materia Medica 2015;40(20):3911-3915
OBJECTIVEThe multi-center, randomized, double-blind, double-simulated and positive-control trial was used to verify the contribution degree of Bushen Huoxue for the treatment of ovulatory dysfunction caused infertility, which provided scientific basis for clinical treatment.
METHODAccording to diagnostic, inclusion and exclusion criteria, we observed 349 patients which were divided into the treated group (n = 177, treated with Bushen Huoxue ricipe) and control group (n = 172, treated with clomiphene). Ovulation rate, pregnancy rate, clinical effective rate of traditional Chinese medicine, endometrium and diameter of dominant follicle were observed. Serum reproductive endocrine hormones were assayed before and after treatment.
RESULTThe treated group showed ovulation rate of 69.34%, with pregnancy rate of 41.35%. The clinical effective rate of treated group and control group were 91.73% and 80.77%. There was remarkable difference in endometrium (P < 0.05) and remarkbale difference in sex hormones PRL and E₂in treated group at prior-treatment and post-treatment (P < 0.05). No adverse effects were found in the experiment. Security indicators did not show abnormal change.
CONCLUSIONThe comparison between the two groups showed that the treated group was significantly different from control group in the pregnancy rate (P < 0.05), without notable difference in ovulation rate. There was significant difference in clinical effective rate between the treated group and control group. Both the two groups could contribute to the mature development and discharge of the follicles. The growth of endometrium and endometrial receptivity in the treated group were higher than control group. The treated group has regulatory effect on PRL and E₂.
Adult ; Double-Blind Method ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Ovary ; drug effects ; physiopathology ; Ovulation ; drug effects ; Pregnancy ; Treatment Outcome ; Young Adult
9.Minimal Stimulation Using Gonadotropin Combined with Clomiphene Citrate or Letrozole for Intrauterine Insemination.
Bo Hyon YUN ; Seung Joo CHON ; Joo Hyun PARK ; Seok Kyo SEO ; SiHyun CHO ; Young Sik CHOI ; Seok Hyun KIM ; Byung Seok LEE
Yonsei Medical Journal 2015;56(2):490-496
PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.
Adult
;
Aromatase Inhibitors/administration & dosage
;
Clomiphene/*administration & dosage/therapeutic use
;
Drug Administration Schedule
;
Drug Combinations
;
Female
;
Fertility Agents, Female/administration & dosage/therapeutic use
;
Fertilization in Vitro
;
Gonadotropins/*administration & dosage
;
Humans
;
Infertility, Female/*drug therapy
;
Insemination, Artificial/*statistics & numerical data
;
Nitriles/*administration & dosage
;
Ovulation Induction/methods/*statistics & numerical data
;
Pregnancy
;
Pregnancy Rate
;
Treatment Outcome
;
Triazoles/*administration & dosage
10.Minimal Stimulation Using Gonadotropin Combined with Clomiphene Citrate or Letrozole for Intrauterine Insemination.
Bo Hyon YUN ; Seung Joo CHON ; Joo Hyun PARK ; Seok Kyo SEO ; SiHyun CHO ; Young Sik CHOI ; Seok Hyun KIM ; Byung Seok LEE
Yonsei Medical Journal 2015;56(2):490-496
PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.
Adult
;
Aromatase Inhibitors/administration & dosage
;
Clomiphene/*administration & dosage/therapeutic use
;
Drug Administration Schedule
;
Drug Combinations
;
Female
;
Fertility Agents, Female/administration & dosage/therapeutic use
;
Fertilization in Vitro
;
Gonadotropins/*administration & dosage
;
Humans
;
Infertility, Female/*drug therapy
;
Insemination, Artificial/*statistics & numerical data
;
Nitriles/*administration & dosage
;
Ovulation Induction/methods/*statistics & numerical data
;
Pregnancy
;
Pregnancy Rate
;
Treatment Outcome
;
Triazoles/*administration & dosage