RESUMO

OBJECTIVE: Late follicular phase progesterone elevation is a complication that affects approximately 38% of IVF cycles. There is a lack of consensus on the appropriate cut-off levels for progesterone on hCG day. Although premature progesterone rise occurs in all kinds of ovarian responses, there is a knowledge gap regarding the ovarian response with the highest risk of this phenomenon. Our study aims to assess the relative risk of each kind of ovarian response for premature progesterone rise and evaluate the prevalence of premature progesterone rise in each ovarian response. METHODS: A retrospective, cross-sectional, comparative and analytic study was performed at the Reproductive Endocrinology Department in Centro Médico Nacional 20 de Noviembre in Mexico City. All conventional-antagonist cycles were grouped according to their ovarian response and were evaluated from 2015 to 2020. Pearson's Squared-chi, Cramer's V, cross-table and the relative risk were calculated. RESULTS: The prevalence of premature progesterone rise oscillated from 20.8 to 67.9% for low and high ovarian responders, respectively. After calculating the relative risk, high ovarian responders had a 1.38 higher risk for premature progesterone rise than other groups. CONCLUSIONS: High ovarian responders have the highest risk for premature progesterone rise compared to normal and low ovarian responders. High ovarian responders have a 67.9% prevalence of premature progesterone rise.

Assuntos

Fertilização in vitro , Indução da Ovulação , Progesterona , Humanos , Feminino , Progesterona/sangue , Estudos Retrospectivos , Estudos Transversais , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Adulto , Fertilização in vitro/métodos , Fertilização in vitro/estatística & dados numéricos , Gravidez , Fase Folicular , México/epidemiologia

RESUMO

OBJECTIVE: The present study aims at evaluating the results obtained after in vitro fertilization in bad responders, using controlled ovarian hyperstimulation together with the use of gonadotrophin releasing hormone (GnRH) antagonist (cetrorelix acetate) in a short protocol. METHODS: This is an analytical, longitudinal, retrospective and controlled study involving patients who underwent in vitro fertilization (IVF) procedures in the assisted reproduction program of the Reproferty clinic, in the municipality of São José dos Campos/SP, from January 2012 to December 2016. We collected the data obtained from the medical records of patients considered to have undergone controlled ovarian hyperstimulation using GnRH antagonist (cetrorelix acetate) and Growth Hormone (GH) in a short cycle protocol. The patients considered controls were those submitted to the same hyperstimulation process, without using GH. RESULTS: There were significant differences in the following analyzed parameters: gonadotrophin regimen dose, stimulation duration, and estradiol levels on the day of HCG administration, number of follicles, number of retrieved oocytes, number of mature oocytes and number of good-quality embryos. On the other hand, the GH administration was not significant in the number of cycles that achieved transfer, the number of embryos transferred and the number of frozen cycles. In the case group, there was no increase in the number of cycles that reached pregnancy rate ßhCG+; however, the clinical pregnancy rates and live birth rates were significant. CONCLUSION: The present investigation demonstrated that GH administration as a supplement in poor responders improves the majority of the parameters to achieve a full term pregnancy in these patients.

Assuntos

Fertilização in vitro/métodos , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Hormônio do Crescimento , Antagonistas de Hormônios , Adulto , Feminino , Hormônio do Crescimento/administração & dosagem , Hormônio do Crescimento/uso terapêutico , Antagonistas de Hormônios/administração & dosagem , Antagonistas de Hormônios/uso terapêutico , Humanos , Indução da Ovulação/estatística & dados numéricos , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos

RESUMO

OBJECTIVE: The aim of this study was to investigate which factors contribute to the incidence of immature oocytes (germinal vesicle -GV- and metaphase I -MI-) and how they impact the intracytoplasmic sperm injection (ICSI) outcomes of sibling mature oocytes. METHODS: Data from 3,920 cycles performed from June/2010 to August/2016 in a private university-affiliated IVF center were evaluated for the influence of controlled ovarian stimulation protocol (COS) on immature oocytes incidence and its effects on ICSI outcomes. RESULTS: MI (p=0.004) and GV (p=0.029) number were negatively correlated with gonadotropin dose. Patients stimulated by rFSH had increased GV/oocyte rate in both GnRH agonists (p<0.001) and antagonist (p=0.042) protocols, in comparison to rFSH associated with rLH protocol. MI and GV/oocyte rates were negatively correlated to fertilization (p<0.001), high-quality embryo on da p<0.001; GV/oocyte p=0.033) and pregnancy (MI/oocyte p=0.002; GV/oocyte p=0.013) rates. Cycles above a 10.5% MI/oocyte cut-off were correlated to higher response to ovarian stimulation, poor embryo development and almost two times lower pregnancy rate. Immature oocyte incidence is affected by COS and impacts on ICSI outcomes. CONCLUSION: Our evidence suggests that oocytes derived from a cohort with high incidence of maturation fail may have detrimental clinical outcomes.

Assuntos

Oócitos/citologia , Oócitos/fisiologia , Indução da Ovulação/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Metáfase , Recuperação de Oócitos , Indução da Ovulação/métodos

RESUMO

OBJECTIVE: To compare pregnancy rates from natural and artificial cycles of women submitted to frozen embryo transfers. METHODS: A systematic review was performed by PubMed search using the following algorithm: (endometrial [All Fields] AND preparation [All Fields]) AND (("freezing"[MeSH Terms] OR "freezing"[All Fields] OR "frozen"[All Fields]) AND thawed [All Fields]) and (natural cycles) AND (artificial cycle). Inclusion criteria: prospective and retrospective cohort studies. Exclusion criteria: use of hCG in the natural cycle, oocyte donors, and use of disused freezing techniques. Data were analyzed with the SPSS v.23 software and with a significance level of 5%. The meta-analysis was performed with RevMan 5.3 software. I² was calculated. RESULTS: 709 papers were retrieved. Five studies fulfilled the inclusion and exclusion criteria. From these studies, we analyzed 8,968 natural or artificial cycles. A contingency table compared the results of the natural and artificial cycles and the number of clinical pregnancies obtained in each selected paper. The I2 test resulted in high statistical heterogeneity (I2=77%). Studies by Morozov et al. (2007) and Zheng et al. (2015) obtained statistically significant results (p<0.03 and p<0.001): Morozov et al. (2007) found a higher pregnancy rate within natural cycles, and Zheng et al. (2015) found more positive outcomes when analyzing artificial cycles. The remaining selected studies did not show any statistical significance. CONCLUSION: There is insufficient scientific evidence to state that the artificial cycle yields better pregnancy rates than the natural cycle in women submitted to frozen embryo transfer. Limitations of this study include a small number of papers and heterogeneity among the studies.

Assuntos

Transferência Embrionária/estatística & dados numéricos , Ovulação/fisiologia , Taxa de Gravidez , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Criopreservação/métodos , Criopreservação/estatística & dados numéricos , Transferência Embrionária/métodos , Embrião de Mamíferos , Feminino , Congelamento , Humanos , Ciclo Menstrual/fisiologia , Indução da Ovulação/estatística & dados numéricos , Gravidez

RESUMO

OBJECTIVE: Transdermal testosterone has been used in different doses and in different stimulation protocols in poor responders. The aim of the present study is to compare the luteal estradiol/GnRH antagonists protocol versus long GnRH agonists in poor responder patients according to the Bologna criteria, in which transdermal testosterone has been used prior to the stimulation with gonadotropins. METHODS: In this retrospective analysis, a total of 141 poor responder patients according to the Bologna criteria were recruited. All patients were treated with transdermal testosterone preceding ovarian stimulation with gonadotropins during 5 days. In 53 patients we used the conventional antagonist protocol (Group 1). In 88 patients (GrH pituitary suppression was achieved by leuprolide acetate according to the conventional long protocol (Group 2). We analyzed the ovarian stimulation parameters and IVF outcomes. RESULTS: Comparing groups 1 and 2, there were no significant differences between cancellation rates and number of oocytes retrieved. However the total gonadotropin dose used and the mean length of stimulation were significantly lower in group 1 when compared to group 2. There were no significant differences in pregnancy outcomes; however, there was a slight increase in the implantation rate in group 1 vis-a-vis group 2, although statistical significance was not achieved. CONCLUSION: TT in poor responder patients can be effective both with the conventional agonist's long protocol and with the conventional antagonist's protocol. However, short regimes with previous estradiol antagonists in the luteal phase facilitate ovarian stimulation by shortening the days of treatment and the consumption of gonadotropins.

Assuntos

Estradiol , Hormônio Liberador de Gonadotropina , Hormônios , Indução da Ovulação , Testosterona , Administração Cutânea , Adulto , Estradiol/administração & dosagem , Estradiol/uso terapêutico , Feminino , Hormônio Liberador de Gonadotropina/agonistas , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Hormônios/administração & dosagem , Hormônios/uso terapêutico , Humanos , Fase Luteal , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Estudos Retrospectivos , Testosterona/administração & dosagem , Testosterona/uso terapêutico

RESUMO

OBJECTIVE: To compare the results obtained with two different GnRH agonist dosages: 0.3mg versus 0.4mg to trigger ovulation in oocyte donor cycles. METHODS: Experimental controlled randomized trial including 40 patients from a private practice center. The patients were randomized into two groups. Group A received a single dose of Triptorelin 0.3mg (Decapeptyl®) 36hours before pick-up. Group B patients received Triptorelin 0.4mg (Decapeptyl®) before pick-up to final oocyte maturation. We evaluated the total number of oocytes collected, the number of mature oocytes and total days of ovarian stimulation. RESULTS: The average of total collected oocytes were 16 (Group A) versus 15 (Group B), and the mean number of mature oocytes were 13 versus 12 respectively. The only variable showing a difference was the percentage of mature oocytes, which was greater in Group A, resulting in 84.6%, in contrast with those treated with 0.4mg of Triptorelin (78.6%), although these differences were not statistical significant (p=0.35). Days of stimulation did not differ between groups. No cases of empty follicle syndrome were reported. CONCLUSIONS: We found that an increase from 0.3 to 0.4mg of triptorelin in an oocyte donation program might not improve outcomes. Nevertheless, more studies might be necessary, not only in oocyte donors but in sterile women as well, to evaluate how GnRH agonist dosage could affect the results among other factors.

Assuntos

Hormônio Liberador de Gonadotropina/agonistas , Doação de Oócitos , Oócitos/citologia , Indução da Ovulação , Pamoato de Triptorrelina , Adulto , Feminino , Humanos , Doação de Oócitos/métodos , Doação de Oócitos/estatística & dados numéricos , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Pamoato de Triptorrelina/administração & dosagem , Pamoato de Triptorrelina/uso terapêutico , Adulto Jovem

RESUMO

OBJECTIVE: This study aimed to identify a possible correlation between serum levels of anti-Müllerian hormone (AMH) and oocyte quality, embryo developmental competence, and implantation potential. METHODS: 4488 oocytes obtained from 408 patients undergoing ICSI cycles were evaluated. Oocyte dimorphisms, embryo quality on days two and three, blastocyst formation competence, fertilization rates, implantation rates, and pregnancy rates were correlated with serum levels of AMH using Pearson's correlation coefficient and regression analysis. RESULTS: A positive correlation was observed between serum levels of AMH and number of retrieved oocytes (CC: 0.600, p<0.001), fertilization rate (CC:0.595, p=0.048), and number of obtained embryos (CC:0.495, p<0.001). AMH did not affect the quality of cleavage stage embryos or the chance of blastocyst formation. However, AMH levels affected oocyte quality (OR:0.75, CI 0.44-0.96, p<0.001), and implantation (CC:0,116, p=0.031) and pregnancy (OR:1.22, CI:1.03-1.53, p<0.001) rates. CONCLUSION: Serum levels of AMH are a useful predictor of ovarian response to COS, oocyte quality, and fertilization. However, AMH levels may also compromise clinical outcomes; lower AMH levels did not impair embryo development.

Assuntos

Hormônio Antimülleriano/sangue , Implantação do Embrião/fisiologia , Oócitos/fisiologia , Indução da Ovulação/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Resultado da Gravidez/epidemiologia , Adulto Jovem

RESUMO

OBJECTIVE: To assess Body Mass Index (BMI) effects on the results obtained from ICSI cycles. METHODS: We studied 266 ICSI cycles performed between January 2014 and December 2016. The patients were grouped according to their BMI in: Normal (18.5-24.9), Overweight (25.0-29.9) and Obese (>30). We compared the following variables between the groups: number of antral follicles, ovarian stimulation length, gonadotropin dose used, maximum estradiol level, follicles developed/antral follicles, retrieved oocytes/developed follicles and mature/retrieved oocytes, normal fertilization rate, embryo achieved/normal fertilized oocytes, clinical pregnancy and implantation rates. We used the Kruskal-Wallis and the Chi square tests. p<0.05 was considered significant. RESULTS: Normal, Overweight and Obese patients presented comparable values for number of antral follicles (11.6±5.4, 12.5±5.5, 12.2±5.7), ovarian stimulation length (7.5±1.4, 7.6±1.1, 7.8±1.3) and gonadotropin dose used (2043±489, 1940±536, 2109±605). Obese patients had lower values of estradiol (1560±610, 1511±635, 1190±466; p=0.018), developed follicles (81%, 76%, 70%; p<0.0001), and retrieved oocytes (91%, 90%, 84%; p=0.0017); and not significantly lower values of mature oocytes (82%, 82%, 77%; p=0.26). The groups had comparable fertilization rates (72%, 73%, 69%) and embryo achieved rates (67%, 63%, 72%). The normal group had higher, but not significantly higher pregnancy and implantation rates (43%, 40%, 38%, p=0.53; and 33%, 26%, 23%; p=0.11), and significantly higher ongoing pregnancy rates (37%, 33%, 33%, p=0.042). CONCLUSION: Increased BMI patients had impaired ovarian response and lower pregnancy rates in ICSI cycles.

Assuntos

Recuperação de Oócitos/estatística & dados numéricos , Sobrepeso/epidemiologia , Indução da Ovulação/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Índice de Massa Corporal , Feminino , Humanos , Obesidade/epidemiologia , Gravidez , Estudos Retrospectivos

RESUMO

OBJECTIVE: To evaluate the double-stimulation protocol efficacy over conventional ovarian stimulation in recovering a more adequate number of oocytes and increase the number of embryos to be transferred or to be genetically analyzed. METHODS: A retrospective and comparative study with 13 patients who underwent unsuccessful in vitro fertilization (IVF) cycles with a conventional antagonist ovarian stimulation protocol and repeat the attempt with a double stimulation protocol. The following variables were analyzed: number of oocytes collected, mature oocytes collected, fertilization rate, blastocyst rate, biopsied blastocyst rate and euploidy rate. RESULTS: The double stimulation protocol had a significant higher number of oocytes collected (p=0.007) and mature oocytes to be injected (p=0.01). There was no statistically significant difference in fertilization (p=0.78) and blastocyst (p=0.59) rates. CONCLUSION: Double stimulation favors patients who are at risk of incurring several attempts of IVF to achieve pregnancy.

Assuntos

Blastocisto/fisiologia , Fertilização in vitro/estatística & dados numéricos , Ciclo Menstrual/psicologia , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos

RESUMO

OBJECTIVE: This study aimed to compare the outcomes of controlled ovarian stimulation (COS) with corifollitropin alfa versus daily recombinant follicle-stimulating hormone (rRFSH) or highly purified human menopausal gonadotropin (HP-HMG) in patients undergoing in vitro fertilization (IVF) cycles based on gonadotropin-releasing hormone (GnRH) antagonist protocols. The primary endpoints were total number of oocytes and mature oocytes. METHODS: This retrospective study looked into 132 controlled ovarian stimulation cycles from IVF or oocyte cryopreservation performed in a private human reproduction center between January 1 and December 31, 2014. Enrollment criteria: women aged < 40 years submitted to COS with corifollitropin alfa 100µg or 150µg (n = 26) and rFSH or HP-HMG in the first seven days of treatment with daily doses of 150-225 IU (n = 106); all subjects were on GnRH antagonist protocols. RESULTS: The groups had similar mean ages and duration of stimulation. The mean number ± standard deviation of total aspirated oocytes and MII oocytes was 11.9±10 and 10.3±7.9 in the corifollitropin alfa group, and 10.9±7.2 and 8.6±5.7 in the group on rFSH or HMG (p>0.05). There were no significant differences in fertilization (76.9% vs. 76.8%, p=1.0), biochemical pregnancy (66.7% vs. 47.2%, p=0.1561) or embryo implantation rates (68.7% vs. 50%, p=0.2588) between the groups using corifollitropin alfa and rFSH or HMG, respectively. CONCLUSIONS: Corifollitropin alfa seems to be as effective as rFSH or HP-HMG when used in the first seven days of ovulation induction for patients undergoing assisted reproduction in GnRH antagonist protocols.

Assuntos

Hormônio Foliculoestimulante Humano/uso terapêutico , Hormônio Foliculoestimulante/uso terapêutico , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Menotropinas/uso terapêutico , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Adulto , Feminino , Humanos , Cooperação do Paciente , Gravidez , Resultado da Gravidez , Estudos Retrospectivos

Assuntos

Humanos , Masculino , Feminino , Gravidez , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Fertilização in vitro/estatística & dados numéricos , Coeficiente de Natalidade/tendências , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Sêmen , Doadores de Tecidos , Fertilização in vitro/métodos , Modelos Lineares , Fatores de Risco , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Transferência Embrionária/estatística & dados numéricos , Infertilidade Masculina

RESUMO

OBJECTIVE: To assess the association between the use of medically assisted reproduction (MAR) and birth defects (BD) in newborns and terminations of pregnancy in pregnant women registered in Barcelona in the period 1992 to 2007. METHODS: We studied 1905 cases and 2722 controls in a retrospective population-based case-control study. Cases comprised any newborn presenting at least one major BD, as well as any pregnancy terminated because of BD. Controls were newborns without BD. Exposure was MAR. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by means of logistic regression to assess the association. RESULTS: The MAR was demonstrated to be associated with BD, after adjusting for probable confounders (aOR = 1.8; 95% CI = 1.4 to 2.5). Regarding MAR modalities, this association was statistically significant only for assisted reproduction techniques (ART) (aOR = 2.7; 95% CI = 1.8 to 4.1). In the stratified analysis by structural BD categories, frequencies for all categories were increased after ART with the exception of head-face-neck-eye defects, none after artificial insemination, and digestive-abdominal wall defects in ovulation induction. CONCLUSIONS: This study demonstrated a strong association between ART and BD, with an almost threefold increased risk for overall BD after ART, as compared with natural conception. Increased associations were also observed for almost all structural BD categories.

Assuntos

Anormalidades Congênitas/epidemiologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Fertilização in vitro/estatística & dados numéricos , Humanos , Recém-Nascido , Inseminação Artificial/estatística & dados numéricos , Modelos Logísticos , Masculino , Idade Materna , Análise Multivariada , Obesidade/epidemiologia , Razão de Chances , Indução da Ovulação/estatística & dados numéricos , Paridade , Gravidez , Gravidez em Diabéticas/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos

RESUMO

BACKGROUND: The objective was to present a new ovarian response prediction index (ORPI), which was based on anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response. METHODS: A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH x AFC)/Patient age). RESULTS: The regression analysis demonstrated significant (P<0.0001) positive correlations between the ORPI and the total number of oocytes and of MII oocytes collected. The logistic regression revealed that the ORPI values were significantly associated with the likelihood of pregnancy (odds ratio (OR): 1.86; P=0.006) and collecting greater than or equal to 4 oocytes (OR: 49.25; P<0.0001), greater than or equal to 4 MII oocytes (OR: 6.26; P<0.0001) and greater than or equal to 15 oocytes (OR: 6.10; P<0.0001). Regarding the probability of collecting greater than or equal to 4 oocytes according to the ORPI value, the ROC curve showed an area under the curve (AUC) of 0.91 and an efficacy of 88% at a cut-off of 0.2. In relation to the probability of collecting greater than or equal to 4 MII oocytes according to the ORPI value, the ROC curve had an AUC of 0.84 and an efficacy of 81% at a cut-off of 0.3. The ROC curve for the probability of collecting greater than or equal to 15 oocytes resulted in an AUC of 0.89 and an efficacy of 82% at a cut-off of 0.9. Finally, regarding the probability of pregnancy occurrence according to the ORPI value, the ROC curve showed an AUC of 0.74 and an efficacy of 62% at a cut-off of 0.3. CONCLUSIONS: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients.

Assuntos

Hormônio Antimülleriano/metabolismo , Folículo Ovariano/citologia , Ovário/citologia , Ovário/metabolismo , Adulto , Fatores Etários , Contagem de Células , Feminino , Humanos , Masculino , Indução da Ovulação/métodos , Indução da Ovulação/normas , Indução da Ovulação/estatística & dados numéricos , Análise de Regressão , Reprodutibilidade dos Testes , Injeções de Esperma Intracitoplásmicas , Adulto Jovem

RESUMO

Determinar a correlaçäo entre o volume ovariano medido pela ultra-sonografia transvaginal (USTV) com o cancelamento da induçäo da ovulaçäo nos ciclos de fertilizaçäo in vitro (FIV) devido à má resposta. Estudamos a resposta de 117 pacientes submetidas a induçäo da ovulaçäo para FIV. As pacientes foram divididas em dois grupos: Grupo I = volume ovariano < 3cm cubicos e Grupo II = volume ovariano >ò 3cm cubicos. As pacientes do grupo I obtiveram uma maior taxa de cancelamento da induçäo da ovulaçäo devido a má resposta (52 por cento) que as pacientes do grupo II (21 por cento) (p<0,001). As pacientes do grupo I tiveram menor número de folículos recrutados (4,66) que a do grupo II (9,5) (P<0,01). Näo houve diferença estatisticamente significativa entre idade, número de dias de induçäo da ovulaçäo e número de ampolas de gonadotrofinas utilizadas. Nossos resultados sugerem uma importante associaçäo da reserva ovariana com o volume ovariano. Os ovários com dimensöes < 3cm cubicos de volume estäo associados ao maior índice de cancelamento da induçäo da ovulaçäo devido à má resposta.

Assuntos

Humanos , Feminino , Adulto , Fertilização in vitro/métodos , Indução da Ovulação/efeitos adversos , Indução da Ovulação/estatística & dados numéricos , Valor Preditivo dos Testes , Gonadotropinas , Infertilidade

RESUMO

The objective was to evaluate the exponential response of serum estradiol to controlled ovarian hyperstimulation (COH) in an in vitro fertilization-embryo transfer (IVF-ET) program through measurement of logarithm of serum estradiol area under the curve (LOG-OUC). One hundred three patients undergone conventional IVF-ET with pituitary suppression were studied. For to calculate the LOG-AUC estradiol, trapezoidal formula and ten-fold logarithm definitions were employed. The estradiol synthesis have notorious logarithmic changes during all COH. There was significant difference between estradiol AUC for initial and final phases of controlled ovarian hyperstimulation. As conclusion LOG-AUC of estradiol can be used for to evaluate the ovarian response to superovulation, its prognostic value for following IVF-ET intent is discussed.

Assuntos

Estradiol/sangue , Fertilização in vitro , Ovário/fisiologia , Indução da Ovulação/métodos , Superovulação/sangue , Adulto , Intervalos de Confiança , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/terapia , Ovário/efeitos dos fármacos , Indução da Ovulação/estatística & dados numéricos , Superovulação/efeitos dos fármacos

Assuntos

Humanos , Feminino , Gravidez , Adulto , Hormônios/uso terapêutico , Injeções Intramusculares , Leuprolida/uso terapêutico , Estudos Prospectivos , Técnicas Reprodutivas , Hormônios/efeitos adversos , Indução da Ovulação/estatística & dados numéricos , Indução da Ovulação/métodos , Leuprolida/administração & dosagem

Assuntos

Humanos , Feminino , Gravidez , Adulto , Técnicas Reprodutivas/estatística & dados numéricos , Hormônios/uso terapêutico , Estudos Prospectivos , Leuprolida/uso terapêutico , Injeções Intramusculares , Hormônios/efeitos adversos , Leuprolida/administração & dosagem , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos

Assuntos

Humanos , Feminino , Adolescente , Adulto , Fertilização , Indução da Ovulação/métodos , Infertilidade Feminina/terapia , Infertilidade/tratamento farmacológico , Estudos Multicêntricos como Assunto , Hormônio Foliculoestimulante/administração & dosagem , Hormônio Foliculoestimulante/uso terapêutico , Indução da Ovulação/estatística & dados numéricos , Infertilidade/terapia , Leuprolida/administração & dosagem , Leuprolida/efeitos adversos , Leuprolida/uso terapêutico , Menotropinas/administração & dosagem , Menotropinas/uso terapêutico , Gravidez/estatística & dados numéricos

Assuntos

Estudo Comparativo , Humanos , Feminino , Adolescente , Adulto , Fertilização/efeitos dos fármacos , Indução da Ovulação/métodos , Infertilidade/tratamento farmacológico , Infertilidade Feminina/terapia , Estudos Multicêntricos como Assunto , Indução da Ovulação/estatística & dados numéricos , Infertilidade/terapia , Leuprolida/administração & dosagem , Leuprolida/efeitos adversos , Leuprolida/uso terapêutico , Hormônio Foliculoestimulante/administração & dosagem , Hormônio Foliculoestimulante/uso terapêutico , Menotropinas/administração & dosagem , Menotropinas/uso terapêutico , Gravidez/estatística & dados numéricos

RESUMO

En pacientes que no responden a la terapia con citrato de clomifeno, se utiliza un protocolo basado en dosis bajas de clomifeno y gonadotrofina menopáusica humana (HMG). Se obtiene 51.2 por ciento de ovulación en 35 ciclos. Las pacientes obesas tienen una baja respuesta al esquema de inducción de ovulación lo mismo que las pacientes con una relación LH/FSH mayor de 2.68. No se presentan síntomas de hiperestimulación ovárica. En las pacientes que ovulan se utiliza 50 mg/día por 5 dosis de clomifeno y un promedio de 2.2 ampollas de 75 UI de HMG por ciclo en promedio. El promedio del tamaño del folículo al momento de ovulación es de 18.66 +o- 4.9mm. El 60 por ciento de las pacientes ovulan 24-48 horas posterior a la aplicación de HCG; restante lo hacen a las 24 horas o menos. Se discute la utilidad y las indicaciones de protocolos alternos en pacientes "resistentes" al clomifeno

Assuntos

Humanos , Feminino , Adulto , Clomifeno , Clomifeno/uso terapêutico , Indução da Ovulação/estatística & dados numéricos , Indução da Ovulação/instrumentação , Indução da Ovulação/métodos , Indução da Ovulação