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[PMID]:28796038
[Au] Autor:Jiang S; Kuang Y
[Ad] Endereço:Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
[Ti] Título:Clomiphene citrate is associated with favorable cycle characteristics but impaired outcomes of obese women with polycystic ovarian syndrome undergoing ovarian stimulation for in vitro fertilization.
[So] Source:Medicine (Baltimore);96(32):e7540, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to explore the effect of clomiphene citrate (CC) on the cycle characteristics and outcomes of obese women with polycystic ovarian syndrome (PCOS) undergoing ovarian stimulation for in vitro fertilization (IVF).This is a retrospective cohort study, and it was conducted at the tertiary-care academic medical center.This study included 174 obese PCOS patients undergoing IVF.In the study group (n = 90), CC and human menopausal gonadotropin (HMG) were administered simultaneously beginning on cycle day 3, while in control group (n = 84) HMG was used only. Both of the 2 groups used medroxyprogesterone acetate (MPA) for preventing premature luteinizing hormone (LH) surges. Ovulation was cotriggered by a GnRH agonist and hCG when dominant follicles matured.The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the number of top-quality embryos, maturation rate, fertilization rate, cleavage rate, incidence of premature LH surge, and OHSS.The study group received obviously lower total HMG dose [1650 (975-4800) vs 2025 (1350-3300) IU, P = 2.038E-4] but similar HMG duration. While the antral follicle count (AFC) is higher in study group, the number of oocytes retrieved and top-quality embryos are remarkably less [5 (0-30) vs 13 (0-42), P = 6.333E-5; 2 (0-14) vs 3.5 (0-15), P = .003; respectively]. The mature oocyte rate is higher in study group (P = .036). No significant differences were detected in fertilization rate and cleavage rate between 2 groups.CC has a positive influence on cycle characteristics, but might be correlated with the impaired IVF outcomes (less oocytes retrieved and top quality embryos, lower oocyte retrieval rate) in obese PCOS patients undergoing IVF, when HMG and MPA are used simultaneously.
[Mh] Termos MeSH primário: Clomifeno/uso terapêutico
Fármacos para a Fertilidade Feminina/uso terapêutico
Infertilidade Feminina/complicações
Infertilidade Feminina/tratamento farmacológico
Obesidade/complicações
Síndrome do Ovário Policístico/complicações
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Feminino
Fertilização In Vitro/métodos
Seres Humanos
Acetato de Medroxiprogesterona/administração & dosagem
Menotropinas/administração & dosagem
Oócitos/efeitos dos fármacos
Indução da Ovulação/métodos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Fertility Agents, Female); 1HRS458QU2 (Clomiphene); 61489-71-2 (Menotropins); C2QI4IOI2G (Medroxyprogesterone Acetate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170827
[Lr] Data última revisão:
170827
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007540


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[PMID]:28697910
[Au] Autor:Zhu X; Ye H; Fu Y
[Ad] Endereço:Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
[Ti] Título:Duphaston and human menopausal gonadotropin protocol in normally ovulatory women undergoing controlled ovarian hyperstimulation during in vitro fertilization/intracytoplasmic sperm injection treatments in combination with embryo cryopreservation.
[So] Source:Fertil Steril;108(3):505-512.e2, 2017 Sep.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate endocrine characteristics and clinical outcomes in normal ovulatory patients undergoing controlled ovarian hyperstimulation (COH) with the use of a Duphaston and hMG protocol during in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments in combination with frozen-thawed embryo transfer (FET) compared with the characteristics and outcomes of patients undergoing an Utrogestan and hMG protocol. DESIGN: Prospective controlled study. SETTING: Tertiary care academic medical center. PATIENT(S): A total of 250 infertile patients undergoing IVF/ICSI treatments. INTERVENTION(S): Duphaston (20 mg/d) or Utrogestan (100 mg/d) was taken orally from cycle day 3 until the trigger day, with hMG (150-225 IU) administered when appropriate. When the dominant follicles reached maturity, 0.1 mg GnRH agonist was used as the trigger. Viable embryos were cryopreserved in both protocols for transfer at a later time. MAIN OUTCOME MEASURE(S): The primary outcome was the number of oocytes retrieved. Secondary outcomes included the incidence of premature LH surge, the number of viable embryos, and clinical pregnancy outcomes from FET cycles. RESULT(S): Consistent LH suppression was achieved during COH. None of the participants experienced a premature LH surge. The number of oocytes retrieved (8.22 ± 5.46 vs. 8.8 ± 5.62) was similar between the two groups. No between-group significant differences were observed in the number of mature oocytes (7.2 ± 4.72 vs. 6.98 ± 4.68), fertilized oocytes (6.16 ± 4.34 vs. 6.32 ± 4.23), and viable embryos (2.96 ± 2.22 vs. 3.4 ± 2.54). Furthermore, the clinical pregnancy rates (53.04% vs. 51.7%), early miscarriage rates (8.2% vs. 11.84%), implantation rates (38.68% vs. 35.71%), and cumulative pregnancy rates per woman (66.67% vs. 69.47%) were also similar. CONCLUSION(S): Duphaston administration during COH was similar to Utrogestan in the prevention of LH surge, embryonic characteristics, and pregnancy outcomes. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-IOR-15007265.
[Mh] Termos MeSH primário: Criopreservação/estatística & dados numéricos
Didrogesterona/administração & dosagem
Infertilidade/terapia
Menotropinas/administração & dosagem
Indução da Ovulação/estatística & dados numéricos
Resultado da Gravidez/epidemiologia
Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
China/epidemiologia
Terapia Combinada/estatística & dados numéricos
Quimioterapia Combinada
Feminino
Fertilização In Vitro
Seres Humanos
Infertilidade/sangue
Infertilidade/epidemiologia
Hormônio Luteinizante/sangue
Recuperação de Oócitos/estatística & dados numéricos
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
61489-71-2 (Menotropins); 9002-67-9 (Luteinizing Hormone); 90I02KLE8K (Dydrogesterone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE


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[PMID]:27922279
[Au] Autor:Ponzano A; Colangelo EC; Di Biase L; Romani F; Tiboni GM
[Ad] Endereço:a Department of Medicine and Aging Sciences , University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
[Ti] Título:Clinical experience with an ovarian stimulation protocol for intrauterine insemination adopting a gonadotropin releasing hormone antagonist at low dose.
[So] Source:Gynecol Endocrinol;33(3):208-211, 2017 Mar.
[Is] ISSN:1473-0766
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Studies testing the effectiveness of GnRH antagonists in controlled ovarian stimulation (COS) for intrauterine insemination (IUI) have provided controversial results. The present study was undertaken to evaluate, whether the use of a half of the conventional dose of the GnRH antagonist cetrorelix can be effective in increasing the successful rate of IUI cycles. Patients started COS with human menopausal gonadotropin (hMG) on day three of the menstrual cycle. Cetrorelix was started when at least one follicle of ≥14 mm, was detected at the ultrasound scan, according to the flexible multiple daily dose protocol, and continued until the trigger day with recombinant hCG. Patients adopting GnRH antagonist at low dose had a pregnancy rate (21.7%) that was significantly higher (p < 0.05) in comparison to women receiving hMG only (8.7%). These results suggest that adding a reduced dose of GnRH antagonist to the COS for IUI cycles significantly improves the outcome of the procedure.
[Mh] Termos MeSH primário: Fármacos para a Fertilidade Feminina/administração & dosagem
Hormônio Liberador de Gonadotropina/análogos & derivados
Hormônio Liberador de Gonadotropina/antagonistas & inibidores
Antagonistas de Hormônios/administração & dosagem
Infertilidade Feminina/terapia
Inseminação Artificial
Indução da Ovulação
[Mh] Termos MeSH secundário: Adulto
Gonadotropina Coriônica/genética
Gonadotropina Coriônica/metabolismo
Gonadotropina Coriônica/uso terapêutico
Feminino
Fármacos para a Fertilidade Feminina/uso terapêutico
Hormônio Liberador de Gonadotropina/administração & dosagem
Hormônio Liberador de Gonadotropina/uso terapêutico
Antagonistas de Hormônios/uso terapêutico
Hospitais Universitários
Seres Humanos
Infertilidade Masculina
Itália
Masculino
Menotropinas/uso terapêutico
Ovulação/efeitos dos fármacos
Gravidez
Taxa de Gravidez
Proteínas Recombinantes/uso terapêutico
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chorionic Gonadotropin); 0 (Fertility Agents, Female); 0 (Hormone Antagonists); 0 (Recombinant Proteins); 33515-09-2 (Gonadotropin-Releasing Hormone); 61489-71-2 (Menotropins); OON1HFZ4BA (cetrorelix)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE
[do] DOI:10.1080/09513590.2016.1252327


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[PMID]:27865446
[Au] Autor:Zhu X; Ye H; Fu Y
[Ad] Endereço:Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
[Ti] Título:Use of Utrogestan during controlled ovarian hyperstimulation in normally ovulating women undergoing in vitro fertilization or intracytoplasmic sperm injection treatments in combination with a "freeze all" strategy: a randomized controlled dose-finding study of 100 mg versus 200 mg.
[So] Source:Fertil Steril;107(2):379-386.e4, 2017 Feb.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the clinical characteristics in a Utrogestan and hMG protocol with the use of different doses of Utrogestan in normally ovulating women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments. DESIGN: Prospective controlled study. SETTING: Tertiary-care academic medical center. PATIENT(S): A total of 150 infertile patients undergoing IVF/ICSI treatments. INTERVENTION(S): Utrogestan and hMG were administered simultaneously beginning on cycle day 3. The dose of Utrogestan was 100 mg/d in the study group and 200 mg/d in the control group. When the dominant follicles reached mature, 0.1 mg GnRH agonist was used for trigger. Viable embryos were cryopreserved in both protocols for later transfer. MAIN OUTCOME MEASURE(S): The primary outcome measure was the incidence of premature LH surge. Secondary outcomes included the embryo results and clinical pregnancy outcomes. RESULT(S): Consistent LH suppression was achieved during controlled ovarian hyperstimulation with Utrogestan at 100 mg, and the number of patients with profound LH suppression (LH <1.2 IU/L) in the low-dose group was significantly less than that in the high-dose group. The number of oocytes retrieved in the low-dose group was similar to that in the high-dose group (9.87 ± 5.77 vs. 10.25 ± 5.43). No significant differences were observed in the number of mature oocytes, viable embryos, clinical pregnancy rate, or implantation rate. CONCLUSION(S): Utrogestan at 100 mg is as effective as Utrogestan at 200 mg in reducing premature LH surge during controlled ovarian hyperstimulation. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-OOC-14005277.
[Mh] Termos MeSH primário: Criopreservação
Fármacos para a Fertilidade Feminina/administração & dosagem
Fertilização In Vitro
Infertilidade/terapia
Indução da Ovulação/métodos
Ovulação/efeitos dos fármacos
Progesterona/administração & dosagem
Injeções de Esperma Intracitoplásmicas
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Esquema de Medicação
Quimioterapia Combinada
Transferência Embrionária
Feminino
Fertilidade/efeitos dos fármacos
Fármacos para a Fertilidade Feminina/efeitos adversos
Fertilização In Vitro/efeitos adversos
Seres Humanos
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Hormônio Luteinizante/sangue
Menotropinas/administração & dosagem
Recuperação de Oócitos
Indução da Ovulação/efeitos adversos
Gravidez
Resultado da Gravidez
Taxa de Gravidez
Progesterona/efeitos adversos
Estudos Prospectivos
Injeções de Esperma Intracitoplásmicas/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Biomarkers); 0 (Fertility Agents, Female); 4G7DS2Q64Y (Progesterone); 61489-71-2 (Menotropins); 9002-67-9 (Luteinizing Hormone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


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[PMID]:27638053
[Au] Autor:Di Stefano AF; Rusca A; Radicioni MM; Loprete L; Binelli D; Caccia G; Cometti B
[Ad] Endereço:CROSS Research S.A., Via F. A. Giorgioli, 6864, Arzo, Switzerland. andrea.distefano@croalliance.com.
[Ti] Título:Pharmacokinetics and Pharmacodynamics of Follicle-Stimulating Hormone in Healthy Women Receiving Single and Multiple Doses of Highly Purified Human Menotrophin and Urofollitrophin.
[So] Source:Clin Drug Investig;36(12):1031-1044, 2016 Dec.
[Is] ISSN:1179-1918
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: Highly purified human menotrophin and urofollitrophin preparations obtained from human urine via a novel patented purification method have been tested over a timeframe of 14 years in the studies presented in this article. The objective of the studies was to investigate the pharmacokinetics and the pharmacodynamics of follicle-stimulating hormone (FSH) after single subcutaneous and intramuscular doses and multiple subcutaneous doses of the tested preparations in healthy fertile pituitary-suppressed women. DESIGNS: We performed five open, randomised, crossover, single-dose bioequivalence and/or bioavailability studies and one open, multiple-dose, pharmacokinetics and pharmacodynamics study. STUDY SUBJECTS AND TREATMENTS: The six studies included 121 healthy fertile women taking their usual combined oral contraceptives for 3 months before the study: Study 1: 300 international units (IU) of highly purified menotrophin as single subcutaneous and intramuscular doses. Study 2: 300 IU of highly purified menotrophin (test formulation vs. comparator) as single subcutaneous doses. Study 3: 300 IU of highly purified urofollitrophin (hp-FSH) (test formulation vs. comparator) as single subcutaneous doses. Study 4: 300 IU (2 × 150 IU vs. 4 × 75 IU) of hp-FSH as single subcutaneous doses. Study 5: 225 and 445 IU of hp-FSH as single subcutaneous doses. Study 6: daily 225 IU of hp-FSH as subcutaneous doses for 5 consecutive days. MAIN OUTCOME MEASURES: The main outcome measures were the FSH pharmacokinetic parameters, estradiol concentrations, and the number and size of the follicles. RESULTS: FSH after single subcutaneous and intramuscular injections of menotrophin or urofollitrophin attained a systemic peak (maximum) concentration (C ) that was on average consistent throughout the first four studies and ranged from 4.98 to 7.50 IU/L. The area under the plasma concentration-time curve (AUC) from administration to the last observed concentration time t (AUC ) ranged from 409.71 to 486.16 IU/L·h and the elimination half-life (t ) ranged from 39.02 to 53.63 h. After multiple doses of urofollitrophin (225 IU) for 5 days, FSH attained a mean C of 14.93 ± 2.92 IU/L and had an AUC during the time interval τ between two consecutive doses at steady state (AUC ) of 322.59 ± 57.92 IU/L·h, which was similar to the mean AUC after a single subcutaneous dose of 225 IU of urofollitrophin in study 5 (306.82 ± 68.37 IU/L·h). CONCLUSIONS: In our studies, the intramuscular and subcutaneous routes of menotrophin were equivalent; both menotrophin and urofollitrophin were bioequivalent to their marketed reference; FSH kinetic parameters following injection of urofollitrophin were dose proportional and independent from the administered concentration; and multiple doses of FSH increased estradiol levels and enhanced growth of follicles with a good dose-response correlation. Local tolerability was excellent throughout the six studies.
[Mh] Termos MeSH primário: Hormônio Foliculoestimulante/farmacocinética
Menotropinas/administração & dosagem
Urofolitropina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Disponibilidade Biológica
Anticoncepcionais Orais Combinados
Estudos Cross-Over
Relação Dose-Resposta a Droga
Estradiol/sangue
Feminino
Meia-Vida
Seres Humanos
Injeções Subcutâneas
Menotropinas/farmacocinética
Equivalência Terapêutica
Urofolitropina/farmacocinética
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Contraceptives, Oral, Combined); 0 (Urofollitropin); 4TI98Z838E (Estradiol); 61489-71-2 (Menotropins); 9002-68-0 (Follicle Stimulating Hormone)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160918
[St] Status:MEDLINE


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[PMID]:27581117
[Au] Autor:Fragoulakis V; Pescott CP; Smeenk JM; van Santbrink EJ; Oosterhuis GJ; Broekmans FJ; Maniadakis N
[Ad] Endereço:Department of Health Services Organization and Management, National School of Public Health, 196 Alexandras Avenue, Athens, 11521, Greece. vfragoulakis@esdy.edu.gr.
[Ti] Título:Economic Evaluation of Three Frequently Used Gonadotrophins in Assisted Reproduction Techniques in the Management of Infertility in the Netherlands.
[So] Source:Appl Health Econ Health Policy;14(6):719-727, 2016 Dec.
[Is] ISSN:1179-1896
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: Subfertility represents a multidimensional problem associated with significant distress and impaired social well-being. In the Netherlands, an estimated 50,000 couples visit their general practitioner and 30,000 couples seek medical specialist care for subfertility. We conducted an economic evaluation comparing recombinant human follicle-stimulating hormone (follitropin alfa, r-hFSH, Gonal-F ) with two classes of urinary gonadotrophins-highly purified human menopausal gonadotrophin (hp-HMG, Menopur ) and urinary follicle-stimulating hormone (uFSH, Fostimon )-for ovarian stimulation in women undergoing in vitro fertilization (IVF) treatment in the Netherlands. METHODS: A pharmacoeconomic model was developed, simulating each step in the IVF protocol from the start of therapy until either a live birth, a new IVF treatment cycle or cessation of IVF, following a long down-regulation protocol. A decision tree combined with a Markov model details progress through each health state, including ovum pickup, fresh embryo transfer, up to two subsequent cryo-preserved embryo transfers, and (ongoing) pregnancy or miscarriage. A health insurer perspective was chosen, and the time horizon was set at a maximum of three consecutive treatment cycles, in accordance with Dutch reimbursement policy. Transition probabilities and costing data were derived from a real-world observational outcomes database (from Germany) and official tariff lists (from the Netherlands). Adverse events were considered equal among the comparators and were therefore excluded from the economic analysis. A Monte Carlo simulation of 5000 iterations was undertaken for each strategy to explore uncertainty and to construct uncertainty intervals (UIs). All cost data were valued in 2013 Euros. The model's structure, parameters and assumptions were assessed and confirmed by an external clinician with experience in health economics modelling, to inform on the appropriateness of the outcomes and the applicability of the model in the chosen setting. RESULTS: The mean total treatment costs were estimated as €5664 for follitropin alfa (95 % UI €5167-6151), €5990 for hp-HMG (95 % UI €5498-6488) and €5760 for uFSH (95 % UI €5256-6246). The probability of a live birth was estimated at 36.1 % (95 % UI 27.4-44.3 %), 33.9 % (95 % UI 26.2-41.5 %) and 34.1 % (95 % UI 25.9-41.8 %) for follitropin alfa, hp-HMG and uFSH, respectively. The costs per live birth estimates were €15,674 for follitropin alfa, €17,636 for hp-HMG and €16,878 for uFSH. Probabilistic sensitivity analysis indicated a probability of 72.5 % that follitropin alfa is cost effective at a willingness to pay of €20,000 per live birth. The probabilistic results remained constant under several analyses. CONCLUSION: The present analysis shows that follitropin alfa may represent a cost-effective option in comparison with uFSH and hp-HMG for IVF treatment in the Netherlands healthcare system.
[Mh] Termos MeSH primário: Fertilização In Vitro/economia
Hormônio Foliculoestimulante Humano/economia
Hormônio Foliculoestimulante/economia
Subunidade alfa de Hormônios Glicoproteicos/economia
Infertilidade Feminina/terapia
Menotropinas/economia
[Mh] Termos MeSH secundário: Análise Custo-Benefício
Farmacoeconomia
Feminino
Fármacos para a Fertilidade Feminina/economia
Fármacos para a Fertilidade Feminina/uso terapêutico
Fertilização In Vitro/efeitos dos fármacos
Hormônio Foliculoestimulante/uso terapêutico
Hormônio Foliculoestimulante Humano/uso terapêutico
Alemanha
Subunidade alfa de Hormônios Glicoproteicos/uso terapêutico
Seres Humanos
Menotropinas/uso terapêutico
Modelos Econômicos
Países Baixos
Gravidez
Proteínas Recombinantes/economia
Proteínas Recombinantes/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents, Female); 0 (Follicle Stimulating Hormone, Human); 0 (Glycoprotein Hormones, alpha Subunit); 0 (Recombinant Proteins); 0 (follitropin alfa); 61489-71-2 (Menotropins); 9002-68-0 (Follicle Stimulating Hormone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160902
[St] Status:MEDLINE


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[PMID]:27490046
[Au] Autor:Lu X; Hong Q; Sun L; Chen Q; Fu Y; Ai A; Lyu Q; Kuang Y
[Ad] Endereço:Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
[Ti] Título:Dual trigger for final oocyte maturation improves the oocyte retrieval rate of suboptimal responders to gonadotropin-releasing hormone agonist.
[So] Source:Fertil Steril;106(6):1356-1362, 2016 Nov.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify the risk factors for suboptimal response to GnRH agonist (GnRH-a) trigger and evaluate the effect of hCG on the outcome of patients with suboptimal response to GnRH-a. DESIGN: A retrospective data analysis. SETTING: A tertiary-care academic medical center. PATIENT(S): A total of 8,092 women undergoing 8,970 IVF/intracytoplasmic sperm injection (ICSI) treatment cycles. INTERVENTION(S): All women underwent hMG + medroxyprogesterone acetate (MPA)/P treatment cycles during IVF/ICSI, which were triggered using a GnRH-a alone or in combination with hCG (1,000, 2,000, or 5,000 IU). Viable embryos were cryopreserved for later transfer. MAIN OUTCOME MEASURE(S): The rates of oocyte retrieval, mature oocytes, fertilization, and the number of oocytes retrieved, mature oocytes, and embryos frozen. RESULT(S): In total, 2.71% (243/8,970) of patients exhibited a suboptimal response to GnRH-a. The suboptimal responders (LH ≤15 mIU/mL) had a significantly lower oocyte retrieval rate (48.16% vs. 68.26%), fewer mature oocytes (4.10 vs. 8.29), and fewer frozen embryos (2.32 vs. 3.54) than the appropriate responders. Basal LH levels served as the single most valuable marker for differentiating suboptimal responders with the areas under the receiver operating curve of 0.805. Administering dual trigger (GnRH-a and hCG 1,000, 2,000, 5,000 IU) significantly increased oocyte retrieval rates (60.04% vs. 48.16%; 68.13% vs. 48.16%; and 65.76% vs. 48.16%, respectively) in patients with a suboptimal response. CONCLUSION(S): Basal LH level was useful predictor of the suboptimal response to GnRH-a trigger. Administrating dual trigger including 1,000 IU hCG for final oocyte maturation could improve the oocytes retrieval rate of GnRH-a suboptimal responder.
[Mh] Termos MeSH primário: Gonadotropina Coriônica/administração & dosagem
Fármacos para a Fertilidade Feminina/administração & dosagem
Hormônio Liberador de Gonadotropina/agonistas
Infertilidade/terapia
Acetato de Medroxiprogesterona/administração & dosagem
Menotropinas/administração & dosagem
Recuperação de Oócitos
Oócitos/efeitos dos fármacos
Indução da Ovulação/métodos
Ovulação/efeitos dos fármacos
Progesterona/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Área Sob a Curva
Biomarcadores/sangue
Gonadotropina Coriônica/efeitos adversos
Criopreservação
Quimioterapia Combinada
Feminino
Fertilidade/efeitos dos fármacos
Fármacos para a Fertilidade Feminina/efeitos adversos
Fertilização In Vitro
Seres Humanos
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Hormônio Luteinizante/sangue
Acetato de Medroxiprogesterona/efeitos adversos
Menotropinas/efeitos adversos
Oócitos/metabolismo
Indução da Ovulação/efeitos adversos
Valor Preditivo dos Testes
Progesterona/efeitos adversos
Curva ROC
Estudos Retrospectivos
Injeções de Esperma Intracitoplásmicas
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Chorionic Gonadotropin); 0 (Fertility Agents, Female); 33515-09-2 (Gonadotropin-Releasing Hormone); 4G7DS2Q64Y (Progesterone); 61489-71-2 (Menotropins); 9002-67-9 (Luteinizing Hormone); C2QI4IOI2G (Medroxyprogesterone Acetate)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160805
[St] Status:MEDLINE


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[PMID]:27428219
[Au] Autor:Zhu X; Ye H; Fu Y
[Ad] Endereço:Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
[Ti] Título:The Utrogestan and hMG protocol in patients with polycystic ovarian syndrome undergoing controlled ovarian hyperstimulation during IVF/ICSI treatments.
[So] Source:Medicine (Baltimore);95(28):e4193, 2016 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Poor oocyte quality is a main concern for decreased reproductive outcomes in women with polycystic ovarian syndrome (PCOS) during controlled ovarian hyperstimulation (COH). A primary way to improve oocyte quality is to optimize the COH protocol. It was demonstrated that the viable embryo rate per oocyte retrieved in the Utrogestan and hMG protocol, a novel regimen based on frozen-thawed embryo transfer (FET), is statistically higher than that in the short protocol. Thus, a retrospective study was conducted to evaluate the endocrine characteristics and clinical outcomes in PCOS patients subjected to the Utrogestan and hMG protocol compared with those subjected to the short protocol.One hundred twenty three PCOS patients enrolled in the study group and were simultaneously administered Utrogestan and human menopausal gonadotropin (hMG) from cycle day 3 until the trigger day. When the dominant follicles matured, gonadotropin-releasing hormone agonist (GnRH-a) 0.1 mg was used as the trigger. A short protocol was applied in the control group including 77 PCOS women. Viable embryos were cryopreserved for later transfer in both groups. The primary outcome was the viable embryo rate per oocyte retrieved. The secondary outcomes included the number of oocytes retrieved, fertilization rate, and clinical pregnancy outcomes from FET cycles.The pituitary luteinizing hormone (LH) level was suppressed in most patients; however, the LH level in 13 women, whose basic LH level was more than 10 IU/L, surpassed 10 IU/L on menstruation cycle day (MC)9-11 and decreased subsequently. No significant between-group differences were observed in the number of oocytes retrieved (13.27 ±â€Š7.46 vs 13.1 ±â€Š7.98), number of viable embryos (5.57 ±â€Š3.27 vs 5 ±â€Š2.79), mature oocyte rate (90.14 ±â€Š11.81% vs 93.02 ±â€Š8.95%), and cleavage rate (97.69 ±â€Š6.22% vs 95.89 ±â€Š9.57%). The fertilization rate (76.11 ±â€Š19.04% vs 69.34 ±â€Š21.81%; P < 0.05), viable embryo rate per oocyte retrieved (39.85% vs 34.68%; P < 0.05), biochemical pregnancy rate (71.72% vs 56.67%; P < 0.05), clinical pregnancy rate (64.65% vs 51.65%; P < 0.05), and implantation rate (46.46% vs 31.35%; P < 0.05) in the study group were significant higher than those in the control group.This study shows that the Utrogestan and hMG protocol was feasible to improve the oocyte quality, possibly providing a new choice for PCOS patients undergoing IVF/ICSI treatments in combination with embryo cryopreservation.
[Mh] Termos MeSH primário: Fertilização In Vitro/métodos
Infertilidade Feminina/terapia
Hormônio Luteinizante/efeitos dos fármacos
Menotropinas/administração & dosagem
Síndrome de Hiperestimulação Ovariana/prevenção & controle
Síndrome do Ovário Policístico/complicações
Progesterona/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Terapia de Reposição de Estrogênios
Feminino
Fármacos para a Fertilidade Feminina/administração & dosagem
Seres Humanos
Indução da Ovulação/métodos
Gravidez
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents, Female); 4G7DS2Q64Y (Progesterone); 61489-71-2 (Menotropins); 9002-67-9 (Luteinizing Hormone)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160719
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000004193


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[PMID]:27343309
[Au] Autor:Nada AM; ElSetohy KA; Banat MM; Shaheen AF
[Ad] Endereço:Faculty of Medicine, Department of Gynecology and Obstetrics, Cairo University, Cairo, Egypt.
[Ti] Título:Antagonist protocol versus clomiphene in unexplained infertility: A randomized controlled study.
[So] Source:Taiwan J Obstet Gynecol;55(3):326-30, 2016 Jun.
[Is] ISSN:1875-6263
[Cp] País de publicação:China (Republic : 1949- )
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The primary purpose of this randomized controlled trial study was to compare clinical pregnancy rates and ovulation parameters in female patients of unexplained infertility undergoing intrauterine insemination (IUI) using an antagonist protocol versus a conventional clomiphene citrate protocol. MATERIALS AND METHODS: This was a multicenter parallel randomized controlled, open-label trial. A central randomization center used computer generated tables to allocate treatments. We conducted the study in two centers: Saudi Center and Samir Abbas and Assisted Reproductive Techniques Center of Cairo University, Cairo, Egypt between January 2011 and January 2014. Six hundred and twenty-two couples with unexplained infertility were randomized into two equal groups with 27 excluded after randomization: the antagonist protocol group and the clomiphene group. Antagonist protocol: human menopausal gonadotropins were given to 298 patients from Day 2 to reach a dominant follicle of 18-22 mm, intramuscularly. Then, orgalutrone (0.25 mg) was subcutaneously started from Day 6 or Day 7 until the day of human chorionic gonadotropins (hCG; that was given in the dose of 10,000 IU, intramuscularly) when follicles reached 18-22 mm. Afterward, the IUI of 0.5 mL was done from 34 hours to 36 hours using IUI catheter without guidance of ultrasonography and with an empty urinary bladder. The clomiphene citrate protocol was clomiphene citrate given 100 mg/d to 297 patients from Day 2 to Day 6 and follow up until day of hCG. The clinical pregnancy rate detected with ultrasound confirmed fetal heart pulsations at 6-weeks' gestation (4 weeks after IUI). The number of dominant follicles, level of serum estradiol, and luteinizing hormone at the day of hCG injection and the incidence of twin or triplet pregnancies in both groups were secondary outcome measures. RESULTS: The clinical pregnancy rate in the antagonist protocol group was significantly (p < 0.001) higher than in the clomiphene group. It was 80 patients (27%) in the antagonist protocol group versus 41 patients (14%) in the clomiphene group. The mean number of dominant follicles was significantly (p < 0.001) greater in the antagonist protocol group (4.36 ± 1.36 dominant follicles) compared with the clomiphene group (2.71 ± 0.96 dominant follicles). In addition, the rate of twin pregnancies was 15 cases in the antagonist protocol group versus six cases only in the clomiphene group (p = 0.047). The luteinizing hormone also was significantly lower in the antagonist group (2.1 ± 1.3) compared with that in the clomiphene group (9.5 ± 3.6). CONCLUSION: IUI clinical pregnancy rates were significantly higher by antagonist protocol.
[Mh] Termos MeSH primário: Clomifeno/administração & dosagem
Fármacos para a Fertilidade Feminina/administração & dosagem
Hormônio Liberador de Gonadotropina/análogos & derivados
Antagonistas de Hormônios/administração & dosagem
Infertilidade Feminina/tratamento farmacológico
Menotropinas/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Feminino
Hormônio Liberador de Gonadotropina/administração & dosagem
Seres Humanos
Inseminação Artificial
Hormônio Luteinizante/sangue
Folículo Ovariano/efeitos dos fármacos
Gravidez
Taxa de Gravidez
Gravidez de Gêmeos/efeitos dos fármacos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Fertility Agents, Female); 0 (Hormone Antagonists); 1HRS458QU2 (Clomiphene); 33515-09-2 (Gonadotropin-Releasing Hormone); 61489-71-2 (Menotropins); 9002-67-9 (Luteinizing Hormone); IX503L9WN0 (ganirelix)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160626
[St] Status:MEDLINE


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[PMID]:27292256
[Au] Autor:Patel DP; Chandrapal JC; Hotaling JM
[Ad] Endereço:Division of Urology, Department of Surgery, University of Utah Health Care, 30 N 1900 E, Rm 3B420, Salt Lake City, UT, 84132, USA.
[Ti] Título:Hormone-Based Treatments in Subfertile Males.
[So] Source:Curr Urol Rep;17(8):56, 2016 Aug.
[Is] ISSN:1534-6285
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Subfertility is defined as the condition of being less than normally fertile though still capable of effecting fertilization. When these subfertile couples seek assistance for conception, a thorough evaluation of male endocrine function is often overlooked. Spermatogenesis is a complex process where even subtle alterations in this process can lead to subfertility or infertility. Male endocrine abnormalities may suggest a specific diagnosis contributing to subfertility; however, in many patients, the underlying etiology is still unknown. Optimizing underlying endocrine abnormalities may improve spermatogenesis and fertility. This manuscript reviews reproductive endocrine abnormalities and hormone-based treatments.
[Mh] Termos MeSH primário: Inibidores da Aromatase/uso terapêutico
Infertilidade Masculina/tratamento farmacológico
Substâncias para o Controle da Reprodução/uso terapêutico
Moduladores Seletivos de Receptor Estrogênico/uso terapêutico
[Mh] Termos MeSH secundário: Hiperplasia Suprarrenal Congênita/complicações
Hiperplasia Suprarrenal Congênita/diagnóstico
Síndrome de Resistência a Andrógenos/complicações
Síndrome de Resistência a Andrógenos/diagnóstico
Gonadotropina Coriônica/uso terapêutico
Clomifeno/uso terapêutico
Hormônio Foliculoestimulante Humano/uso terapêutico
Seres Humanos
Hiperprolactinemia/complicações
Hiperprolactinemia/diagnóstico
Hipogonadismo/complicações
Hipogonadismo/diagnóstico
Infertilidade Masculina/etiologia
Masculino
Menotropinas/uso terapêutico
Obesidade/complicações
Tamoxifeno/uso terapêutico
Doenças da Glândula Tireoide/complicações
Doenças da Glândula Tireoide/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Aromatase Inhibitors); 0 (Chorionic Gonadotropin); 0 (Follicle Stimulating Hormone, Human); 0 (Reproductive Control Agents); 0 (Selective Estrogen Receptor Modulators); 094ZI81Y45 (Tamoxifen); 1HRS458QU2 (Clomiphene); 61489-71-2 (Menotropins)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160614
[St] Status:MEDLINE
[do] DOI:10.1007/s11934-016-0612-4



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