This study was performed to analyze retrospectively outcomes of stimulated in vitro fertilization (IVF) cycles where the gonadotropin-releasing hormone (GnRH) antagonist was omitted on ovulation triggering day. A total of 92 consecutive IVF cycles were included in 65 women who are undergoing ovarian stimulation with recombinant FSH. A GnRH antagonist, cetrorelix 0.25 mg/day, was started when leading follicle reached 14 mm in diameter until the day of hCG administration (Group A, 66 cycles) or until the day before hCG administration (Group B, 26 cycles). The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and the number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in Group B compared to Group A (2.7+/-0.8 vs. 3.2+/-0.9 ampoules). There was no premature luteinization in the subjects. The proportion of mature oocytes (71.4% vs. 61.7%) and fertilization rate of mature (86.3+/-19.7% vs. 71.8+/-31.7%) was significantly higher in Group B. There were no significant differences in embryo quality and clinical pregnancy rates. Our results suggest that cessation of the GnRH antagonist on the day of hCG administration during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising IVF results.
Adult ; Chorionic Gonadotropin/administration & dosage ; Drug Administration Schedule ; Estradiol/blood ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone/administration & dosage/blood ; Gonadotropin-Releasing Hormone/*antagonists & inhibitors ; Hormone Antagonists/*administration & dosage ; Humans ; Ovulation Induction/*methods ; Recombinant Proteins/therapeutic use ; Retrospective Studies

OBJECTIVETo analyze the clinical characteristics and cycle outcome of Chinese women with gonadotropin-releasing hormone (GnRH) antagonist treatment during controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET).

METHODSA retrospective review was conducted in patients who completed 54 consecutive cycles of IVF-ET with GnRH antagonist treatment for luteinizing hormone (LH) surge prevention. Descriptive statistics were recorded for the patients' age, GnRH treatment duration (days) and dose, timing and duration of GnRH antagonist treatment, serum E2 and LH level on the day of antagonist use and hCG injection, number of oocytes retrieved, and clinical pregnancy rate.

RESULTSThe clinical pregnancy rate was 46.2% per ET cycle for GnRH antagonist group and 56.8% in GnRH agonist group, showing no significant difference between the two protocols. The age of the patients with GnRH antagonist averaged 35.7-/+3.8 years. Gn and GnRH antagonist treatment lasted for 8.5-/+1.6 and 4.5-/+1.1 days, respectively. On the day of ovulation triggered by hCG, the serum estradiol level was 1616.7-/+721.1 pg/ml, and a mean of 7.4-/+4.6 oocytes was collected per retrieval. The number of the embryos transferred was 2.4-/+0.6, with an implantation rate of 27.7%, resulting in a clinical pregnancy rate of 50.0% in the fixed protocol (antagonist initiation on day 4 or 5 of stimulation) and 37.5% in the flexible protocol (antagonist treatment initiated for a follicle of 12-15 mm, on day 6 to 9 of stimulation).

CONCLUSIONSGnRH antagonists treatment results in good outcomes and can be safe, short, convenient and effective for Chinese women undergoing COH for IVF. GnRH antagonist treatment can be initiated on day 4 to 9 of Gn stimulation to obtain comparable pregnancy rate.

Adult ; China ; Embryo Transfer ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone, Human ; administration & dosage ; Gonadotropin-Releasing Hormone ; administration & dosage ; antagonists & inhibitors ; Hormone Antagonists ; administration & dosage ; Humans ; Ovarian Hyperstimulation Syndrome ; drug therapy ; prevention & control ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Time Factors

OBJECTIVETo investigate the efficacy, convenience and costs of recombinant follitropin alpha administered by a prefilled pen device and conventional syringe in Chinese women undergoing controlled ovarian stimulation for in vitro fertilization (IVF).

METHODSA total of 184 patients undergoing IVF treatment were enrolled in this study. According to a long-term recombinant follicle-stimulating hormone (rFSH) protocol, ovarian stimulation was performed with the prefilled pen and conventional syringe at random in these subjects, and the dose of follitropin, number of oocytes and embryo parameters and IVF-ET outcome were compared between the two groups.

RESULTSThe total rFSH dose, cost, and frequency of hospital visits were significantly lower in the pen protocol group, but the residual rFSH amount was higher. Compared with conventional injections, the prefilled pen was associated with significantly lowered rate of local redness, high rate of local bruise, more frequent follitropin dose modulation and lower serum oestradiol levels on HCG day. No significant difference was found in the endometrial thickness, numbers of oocytes retrieved, MII oocytes, transferred embryo, or the clinical pregnancy rates between the two groups. The ratio of MII oocytes, good quality embryo rates and implantation rates was significantly higher in the pen group with lower incidences of moderate and severe ovarian hyperstimulation syndrome.

CONCLUSIONThe prefilled pen provides an easy, safe, effective and more patient-friendly means for controlled ovarian stimulation procedure in Chinese women, but more attention should be given to protocol optimization and patient education.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Follicle Stimulating Hormone ; administration & dosage ; Humans ; Infertility, Female ; therapy ; Ovulation Induction ; instrumentation ; methods ; Recombinant Proteins ; administration & dosage

OBJECTIVETo investigate the subchronic toxicity of soy isoflavones (SIF) in male rats.

METHODFifty Sprague-Dawley rats were randomly divided into 5 groups, 10 rats per group. SIF were given to rats in different groups by gavage at dose of 0, 0.2, 0.5, 1.5, and 4.5 g/kg bw, respectively for 13 weeks. Clinical manifestations, body weight, and food consumption were observed weekly. At the end of the study, urinalysis, hematology, clinical chemistry, total testosterone, and follicle-stimulating hormone were tested, and histopathological examinations were performed.

RESULTSNo mortality, ophthalmic abnormalities or treatment-related clinical signs were identified during the study. As compared with the control group, significantly lower body weights and food consumption were observed in 1.5 and 4.5 g/kg bw groups. In clinical chemistry tests, triglyceride was significantly decreased and high-density lipoprotein cholesterol was significantly increased in all SIF-treated groups. Total testosterone levels were significantly lower in 0.50, 1.50, and 4.5 g/kg bw dose groups than in the control group. Microscopic examination showed that the mammary glands exhibited hyperplasia and excreted latex in rats of the 4.5 g/kg bw group. No changes attributable to treatment of SIF in other parameters were found.

CONCLUSIONSIF at high dosages caused significant endocrine disruption in male rats. The no observed adverse effect level (NOAEL) of SIF to male rats in this study is considered to be 0.20 g/kg bw.

Animals ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Follicle Stimulating Hormone ; blood ; Isoflavones ; administration & dosage ; chemistry ; toxicity ; Male ; Rats ; Rats, Sprague-Dawley ; Soybeans ; chemistry ; Thyroxine ; blood ; Triiodothyronine ; blood

AIMTo explore the causes of the difference in spermatogenic suppression between responders and non-responders in Chinese men treated with levonorgestrel (LNG) implants plus testosterone undecanoate (TU) injectable.

METHODSThe 16 Chinese volunteers treated were divided into two groups in regard to the sperm count during the treatment period, 7 men in the responder group (Group R), including 6 azoospermia and one severe oligozoospermia, and the remaining 9 in the non-responder group (Group N), including 4 oligozoospermia and 5 with sperm counts greater than 20 x 10(6)/mL. The differences in serum profiles of FSH, LH, T, LNG and T/LH ratio were compared between the two groups and the correlation between the seminal fluid parameters and serum reproductive hormones was analyzed.

RESULTSThe serum FSH level was lower in Group R than that in Group N (P<0.05), while the serum LH and LNG levels were higher in Group R than those in Group N (P<0.05). The sperm density (P<0.01, r=0.235), motility(P<0.01, r=0.326) and vitality (P<0.01, r=0.219) showed significantly positive correlation with the serum FSH level.

CONCLUSIONThe blood LNG and T levels, the degree of FSH inhibition and/or the sensitivity of the pituitary-testis axis to exogenous steroids, as well as the individual spermatogenetic potential and the functional status of the Leydig cells may be factors bringing about individual differences in spermatogenic suppression in Chinese men treated with LNG and TU.

Adult ; Contraceptive Agents, Male ; administration & dosage ; Drug Implants ; Follicle Stimulating Hormone ; blood ; Humans ; Injections ; Levonorgestrel ; administration & dosage ; pharmacokinetics ; Leydig Cells ; physiology ; Luteinizing Hormone ; blood ; Male ; Sperm Count ; Spermatogenesis ; drug effects ; Testosterone ; administration & dosage ; analogs & derivatives ; blood

In order to obtain the long-acting FSH preparation, the single strand long-acting analogous gene FSHbeta-CTP-alpha was successfully constructed by the C-terminal peptide(CTP) of carboxyl-terminal region of human chorionic gonadotropin with the goat FSHalpha-subunit and beta-subunit genes, then it was inserted into pPIC9K vector. The recombinant plasmid pPIC9K FSHbeta-CTP-alpha was transformed into Pichia pastoris GS115 by electroporation. The multi-copy inserts His+Mut+ were gained by the screening of phenotype and hyper-resistance to G418. After methanol induction, the supernatant was analysised by SDS-Polyacrylamide Gen Electrophoresis and Western blot. The results show that the transformants of FSHbeta-CTP-alpha could express the objective protein successfully and the molecular weight is about 29 kD. The concentration of supernatant was detected by Radio-immunoassay and the average expression of multi-inserts is 91.849 mIU/mL and the low-inserts is 37.419 mIU/mL. The expression of multi-inserts is higher than the low-inserts significantly. This research lay the foundation for studying the structure of FSH and the production of long-acting FSH preparation.
Animals ; Delayed-Action Preparations ; chemical synthesis ; Electroporation ; Female ; Follicle Stimulating Hormone ; analogs & derivatives ; genetics ; Genetic Vectors ; Goats ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; administration & dosage ; biosynthesis ; genetics

OBJECTIVETo compare the difference in clinical efficacy on polycystic ovary syndrome (PCOS) between electroacupuncture (EA) and dyne-35 and to explore the effect mechanism.

METHODSSixty-five patients were randomized into an EA group (33 cases) and a western medication group (32 cases). In the EA group, the selected acupoints were Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3), etc. After the arrival of qi, electric stimulation was attached to the acupoints for 30 min. The treatment was given 3 times a week. In the western medication group, dyne-35 was prescribed on the 5th day of natural menstruation or withdrawal bleeding, one tablet a day, continuously for 21 days. The treatment cycle was 3 months in the two groups. The menstrual condition, body mass, body mass index (BMI), serum testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH were compared before and after treatment in the two groups. The clinical efficacy was assessed in the two groups.

RESULTSThe total effective rate was 90.6% (29/32) in the EA group and was 93.3% (28/30) in the western medication group. The efficacy was similar in the two groups (P > 0.05). After treatment, the levels of LH and LH/FSH were all reduced significantly in the two groups (all P < 0.01). After treatment, T level in serum was reduced apparently in the western medication group (P < 0.05). Before and after treatment, the differences in body mass and BMI in the EA group were more significant than those in the western medication group (P < 0.01, P < 0.05).

CONCLUSIONEA is the effective method for PCOS, similar to that of dyne-35. The effect of it for weight loss is superior to dyne-35 and no apparent adverse reactions happen. The effect mechanism of EA is related to the regulation of serum sexual hormone levels and their ratio, as well as to the regulation of body lipid metabolism.

Acupuncture Points ; Adolescent ; Adult ; Cyproterone Acetate ; administration & dosage ; Drug Combinations ; Electroacupuncture ; Ethinyl Estradiol ; administration & dosage ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Polycystic Ovary Syndrome ; blood ; drug therapy ; therapy ; Young Adult

OBJECTIVETo study the influence and therapeutic effect of the Chinese herbal drug Shengjing Granule on varicocele in rats.

METHODSA total of 80 male Sprague-Dawley rats were equally randomized into a sham operation group and 3 varicocele model groups, and the latter 3 again subdivided into a model, a Shengjing and a Clomifene group. Fifteen days after the modeling, the Shengjing and the Clomifene groups were intragastrically given Shengling Granule and Clomifene at the dose of 4 g/(kg x d) and 20 mg/(kg x d), respectively, while the model and sham operation groups were on normal diet. Thirty days later, the effects of Shengjing Granule were assessed by determining such serum sexual hormones as FSH, LH and T and observing the morphological changes of the testes of different groups of rats under the light microscope.

RESULTSThe testis constitution was better and the levels of FSH and LH were significantly lower in the Shengjing group than in the model and Clomifene groups (P<0.05) but markedly higher in the Clomifene group than in the other three. The T level showed no obvious difference among the Shengjing, Clomifene and sham operation groups but was significantly higher in the three groups than in the model group (P<0.05).

CONCLUSIONShengjing Granule can not only protect the testis from but also repair varicocele-induced injury, probably with a better efficacy than Clomifene.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Follicle Stimulating Hormone ; blood ; Luteinizing Hormone ; blood ; Male ; Organ Size ; drug effects ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Testis ; drug effects ; growth & development ; Treatment Outcome ; Varicocele ; drug therapy

The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone (GnRH) agonist in GnRH agonist long protocol for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with GnRH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group (41.2% vs. 43.7%). The mean luteinizing hormone (LH) level on follicle-stimulating hormone (FSH) starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin (hCG) administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group (12.90±5.82 vs. 13.52±6.97). There was no significant difference in clinical pregnancy rate between the two groups (50.5% vs. 54.5%). It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.
Adult ; Down-Regulation ; Female ; Fertilization in Vitro ; methods ; Follicle Stimulating Hormone ; blood ; Humans ; Live Birth ; Luteinizing Hormone ; blood ; Pituitary Gland ; drug effects ; secretion ; Pregnancy ; Sperm Injections, Intracytoplasmic ; methods ; Triptorelin Pamoate ; administration & dosage ; pharmacology ; therapeutic use

This study is to explore the effects of quercetin (QUE) on the 3 week-old mice ovarian development and relative hormone levels. The 3 week-old mice were exposed to QUE (45, 25, and 5 mg x kg(-1) x hd(-1)) by gavage for 50 days. The estrous cycle during 50 days and the changes of hormone level such as FSH, LH, etc were monitored. Moreover, the ovaries were removed after sacrifice. The organ index was measured, and the ratios of different stages of follicles were analyzed by HE staining. Furthermore, the proportion of PCNA positive cells during all stages was detected by immunohistochemistry. The results showed that QUE could increase body weight of mice and reduce the anogenital distance (AGD) to some extent, and was able to disrupt mice's estrous cycle, but it could not extend or reduce the cycle regularity. It increased ovarian organ index with a dose-dependent manner. The proportion of the primordial follicle and secondary follicles rose obviously, and that of mature follicles', atretic follicles' and corpus luteums' reduced, while primordial follicle had no change. Immunohistochemistry analysis showed that QUE could effectively increase the percentage of proliferating cells in all kinds of follicles. Serum hormone assay showed that there were significant changes of FSH and LH levels. In summary, QUE showed an estrogen-like effect on mice's ovarian development. The weight of ovary, the proportion of all kinds of follicles, the development of ovarian cells and the level of plasma hormone in mice were altered obviously by oral administration of QUE.
Animals ; Body Weight ; drug effects ; Dose-Response Relationship, Drug ; Estrous Cycle ; drug effects ; Female ; Follicle Stimulating Hormone ; blood ; Luteinizing Hormone ; blood ; Mice ; Ovarian Follicle ; drug effects ; metabolism ; Ovary ; drug effects ; growth & development ; Phytoestrogens ; administration & dosage ; pharmacology ; Proliferating Cell Nuclear Antigen ; metabolism ; Quercetin ; administration & dosage ; pharmacology ; Random Allocation