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[PMID]:29215516
[Au] Autor:Jones T; Ho JR; Gualtieri M; Bruno-Gaston J; Chung K; Paulson RJ; Bendikson KA
[Ad] Endereço:Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
[Ti] Título:Clomiphene Stair-Step Protocol for Women With Polycystic Ovary Syndrome.
[So] Source:Obstet Gynecol;131(1):91-95, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare time to ovulation, ovulation rates, and side effect profile of traditional and the stair-step protocol for ovulation induction using clomiphene citrate in women with polycystic ovary syndrome (PCOS). METHODS: We performed a retrospective study of women seeking care for infertility with a diagnosis of PCOS at a university-based infertility clinic from July 2012 to July 2014. We included patients who were resistant to the initial starting dose of 50 mg clomiphene. The primary outcome was time to ovulation. Secondary outcomes included ovulation rates, clinical pregnancy rates, and mild and moderate-to-severe side effects based on dose. For the traditional protocol, higher doses of clomiphene were used each subsequent month if no ovulation occurred. For the stair-step protocol, higher doses of clomiphene were given 7 days after the last dose if no dominant follicles were seen on ultrasonography. Our study had 80% power to detect a 20% difference in ovulation. RESULTS: One hundred nine patients were included in the analysis with 66 (60.6%) in the traditional and 43 (39.4%) in the stair-step protocol. Age and body mass index were similar between groups. The time to ovulation was decreased in the stair-step protocol group compared with the traditional protocol group (23.1±0.9 days vs 47.5±6.3 days). Ovulation rates were increased in the stair-step group compared with the traditional group at 150 mg (16 [37%] vs 8 [12%], P=.004) and at 200 mg (9 [21%] vs 3 [5%], P=.01). Pregnancy rates were similar between groups once ovulation was achieved (12 [18.1%] vs 7 [16.3%], P=.08). The stair-step protocol had an increased incidence of mild side effects (vasomotor flushes, headaches, gastrointestinal disturbance, mastalgia, changes in mood; 18 [41%] vs 8 [12%]), but there was no difference in the incidence of severe side effects (headaches, visual disturbances). CONCLUSION: For women with PCOS, the stair-step clomiphene protocol is associated with decreased time to ovulation and increased ovulation rates at higher doses when compared with the traditional protocol.
[Mh] Termos MeSH primário: Clomifeno/administração & dosagem
Fármacos para a Fertilidade/administração & dosagem
Indução da Ovulação/métodos
Síndrome do Ovário Policístico/tratamento farmacológico
Taxa de Gravidez
[Mh] Termos MeSH secundário: Adulto
Análise de Variância
Clomifeno/efeitos adversos
Estudos de Coortes
Relação Dose-Resposta a Droga
Esquema de Medicação
Feminino
Fármacos para a Fertilidade/efeitos adversos
Seguimentos
Hospitais Universitários
Seres Humanos
Ovulação/efeitos dos fármacos
Síndrome do Ovário Policístico/diagnóstico por imagem
Gravidez
Estudos Retrospectivos
Medição de Risco
Estatísticas não Paramétricas
Fatores de Tempo
Resultado do Tratamento
Ultrassonografia Doppler/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents); 1HRS458QU2 (Clomiphene)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002418


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[PMID]:28603109
[Au] Autor:Qureshi M; Mehjabeen -; Noorjahan -; Muhammad S; Siddiqui FA; Baig I; Ahmad M
[Ad] Endereço:Research Institute of Pharmaceutical Sciences, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan.
[Ti] Título:Phytochemical and biological assessments on Lipidium meyenii (maca) and Epimidium sagittatum (horny goat weed).
[So] Source:Pak J Pharm Sci;30(1):29-36, 2017 Jan.
[Is] ISSN:1011-601X
[Cp] País de publicação:Pakistan
[La] Idioma:eng
[Ab] Resumo:The effects of Lipidium meyenii (maca, LM) and Epimidium sagittatum (horny goat weed, ES) have been investigated due to their involvement in fertilization. Both of the drugs showed good results before, during and after fertilization in male and female mice. The results revealed that the crude extract of Lipidium meyenii caused a significant decrease in the no. of writhes at 300 and 500mg/kg (p<0.05) as compare to control, Epimidium sagittatum and standard drug. The gross behavioral, open field, exploratory behaviour, forced swimming test for stress, diuretic activity, chronic toxicity with the effect on reproduction of both male and female and change in body weight were also studied. The phytochemical study showed the presence of tannin, alkaloid, carbohydrate, rich protein and absence of sterol in LM, whereas ES shows presence of sterol and less protein. LS improve in muscle activity and exploratory behaviours without any toxic effects on mice and their pups. It does not have diuretic effect for first two hour but act normally after initial phase of drug therapy. Epimidium sagittatum has dual action that is at low dose it has slight stimulation action and at high dose little depressive effect. ES also has some diuretic effect. Overall these results suggest that LM is highly effective remedy for treatment of impotency and reduces stress and depression, because of dual effect ES not only suggested as an anxiolytic medicine but also effective in female hormonal disorder.
[Mh] Termos MeSH primário: Ansiolíticos/farmacologia
Antidepressivos/farmacologia
Comportamento Animal/efeitos dos fármacos
Epimedium/química
Fármacos para a Fertilidade/farmacologia
Fertilidade/efeitos dos fármacos
Lepidium/química
Compostos Fitoquímicos/farmacologia
Extratos Vegetais/farmacologia
[Mh] Termos MeSH secundário: Ácido Acético
Analgésicos/isolamento & purificação
Analgésicos/farmacologia
Animais
Ansiolíticos/isolamento & purificação
Ansiolíticos/toxicidade
Antidepressivos/isolamento & purificação
Antidepressivos/toxicidade
Modelos Animais de Doenças
Diurese/efeitos dos fármacos
Diuréticos/isolamento & purificação
Diuréticos/farmacologia
Feminino
Fármacos para a Fertilidade/isolamento & purificação
Fármacos para a Fertilidade/toxicidade
Masculino
Atividade Motora/efeitos dos fármacos
Dor/induzido quimicamente
Dor/fisiopatologia
Dor/prevenção & controle
Limiar da Dor/efeitos dos fármacos
Compostos Fitoquímicos/isolamento & purificação
Compostos Fitoquímicos/toxicidade
Fitoterapia
Extratos Vegetais/isolamento & purificação
Extratos Vegetais/toxicidade
Plantas Medicinais
Comportamento Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (Anti-Anxiety Agents); 0 (Antidepressive Agents); 0 (Diuretics); 0 (Fertility Agents); 0 (Phytochemicals); 0 (Plant Extracts); Q40Q9N063P (Acetic Acid)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE


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[PMID]:28385819
[Au] Autor:Udell JA; Lu H; Redelmeier DA
[Ad] Endereço:Women's College Hospital and Toronto General Hospital (Udell), University of Toronto; Institute for Clinical Evaluative Sciences (Udell, Lu); Department of Medicine (Redelmeier), Sunnybrook Health Sciences Centre, University of Toronto; Evaluative Clinical Sciences (Redelmeier), Sunnybrook Research Institute, Toronto, Ont. jay.udell@utoronto.ca.
[Ti] Título:Failure of fertility therapy and subsequent adverse cardiovascular events.
[So] Source:CMAJ;189(10):E391-E397, 2017 Mar 13.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Infertility may indicate an underlying predisposition toward premature cardiovascular disease, yet little is known about potential long-term cardiovascular events following fertility therapy. We investigated whether failure of fertility therapy is associated with subsequent adverse cardiovascular events. METHODS: We performed a population-based cohort analysis of women who received gonadotropin-based fertility therapy between Apr. 1, 1993, and Mar. 31, 2011, distinguishing those who subsequently gave birth and those who did not. Using multivariable Poisson regression models, we estimated the relative rate ratio of adverse cardiovascular events associated with fertility therapy failure, accounting for age, year, baseline risk factors, health care history and number of fertility cycles. The primary outcome was subsequent treatment for nonfatal coronary ischemia, stroke, transient ischemic attack, heart failure or thromboembolism. RESULTS: Of 28 442 women who received fertility therapy, 9349 (32.9%) subsequently gave birth and 19 093 (67.1%) did not. The median number of fertility treatments was 3 (interquartile range 1-5). We identified 2686 cardiovascular events over a median 8.4 years of follow-up. The annual rate of cardiovascular events was 19% higher among women who did not give birth after fertility therapy than among those who did (1.08 v. 0.91 per 100 patient-years, < 0.001), equivalent to a 21% relative increase in the annual rate (95% confidence interval 13%-30%). We observed no association between event rates and number of treatment cycles. INTERPRETATION: Fertility therapy failure was associated with an increased risk of long-term adverse cardiovascular events. These women merit surveillance for subsequent cardiovascular events.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/epidemiologia
Infertilidade/terapia
Falha de Tratamento
[Mh] Termos MeSH secundário: Adulto
Doenças Cardiovasculares/classificação
Feminino
Fármacos para a Fertilidade/efeitos adversos
Gonadotropinas/efeitos adversos
Seres Humanos
Estudos Longitudinais
Análise Multivariada
Ontário
Análise de Regressão
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents); 0 (Gonadotropins)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170419
[Lr] Data última revisão:
170419
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.160744


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[PMID]:28238492
[Au] Autor:Green KA; Zolton JR; Schermerhorn SM; Lewis TD; Healy MW; Terry N; DeCherney AH; Hill MJ
[Ad] Endereço:Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: katherine.green@nih.gov.
[Ti] Título:Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis.
[So] Source:Fertil Steril;107(4):924-933.e5, 2017 Apr.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effect of progesterone (P) for luteal phase support after ovulation induction (OI) and intrauterine insemination (IUI). DESIGN: An updated systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Patients undergoing OI-IUI for infertility. INTERVENTION(S): Exogenous P luteal support after OI-IUI. MAIN OUTCOME MEASURE(S): Live birth. RESULT(S): Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21-2.02) and live birth (RR 1.77, 95% CI 1.30-2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24-2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52-1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90-1.76). CONCLUSION(S): Progesterone luteal phase support is beneficial to patients undergoing ovulation induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing ovulation induction with clomiphene citrate or clomiphene plus gonadotropins.
[Mh] Termos MeSH primário: Fármacos para a Fertilidade/administração & dosagem
Gonadotropinas/administração & dosagem
Infertilidade/terapia
Inseminação Artificial
Fase Luteal/efeitos dos fármacos
Indução da Ovulação/métodos
Ovulação/efeitos dos fármacos
Progesterona/administração & dosagem
[Mh] Termos MeSH secundário: Feminino
Fertilidade/efeitos dos fármacos
Fármacos para a Fertilidade/efeitos adversos
Gonadotropinas/efeitos adversos
Seres Humanos
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Inseminação Artificial/efeitos adversos
Nascimento Vivo
Razão de Chances
Indução da Ovulação/efeitos adversos
Gravidez
Taxa de Gravidez
Progesterona/efeitos adversos
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Fertility Agents); 0 (Gonadotropins); 4G7DS2Q64Y (Progesterone)
[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:170228
[St] Status:MEDLINE


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[PMID]:28212592
[Au] Autor:Brown JL; Roberson M
[Ad] Endereço:Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York.
[Ti] Título:Novel Insights into Gonadotropin-Releasing Hormone Action in the Pituitary Gonadotrope.
[So] Source:Semin Reprod Med;35(2):130-138, 2017 Mar.
[Is] ISSN:1526-4564
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The hypothalamic-pituitary-gonadal axis controls reproduction via a series of hormones regulating gonadal function through interconnected feedback loops. Secretion of hypothalamic-derived gonadotropin-releasing hormone (GnRH) integrates inputs from higher brain centers to coordinate the activity of the pituitary gonadotrope and the biosynthesis and secretion of the gonadotropins which ultimately regulate gonadal function. Failure of GnRH to serve as the central integrator of this system has been associated with hypogonadotropic-hypogonadism and clinical infertility, while pharmacological application of GnRH analogs and gonadotropins have important implications of the treatment of such infertility. Furthermore, the GnRH-GnRH receptor system has been characterized in several types of cancer and may offer therapeutic possibilities in their treatment. Given the central role of GnRH action in the control of fertility, it is of paramount importance to understand the molecular basis of control of GnRH action in the pituitary gonadotrope, including new and novel alternate ways to modulate GnRH action and gonadotropin secretion. The goal of this review is to discuss several new findings in this field focusing on novel regulators of GnRH action.
[Mh] Termos MeSH primário: Sinalização do Cálcio
Fertilidade
Hormônio Liberador de Gonadotropina/metabolismo
Hipófise/metabolismo
Reprodução
[Mh] Termos MeSH secundário: Animais
Sinalização do Cálcio/efeitos dos fármacos
Fertilidade/efeitos dos fármacos
Fármacos para a Fertilidade/uso terapêutico
Seres Humanos
Hipogonadismo/tratamento farmacológico
Hipogonadismo/metabolismo
Hipogonadismo/fisiopatologia
Infertilidade/tratamento farmacológico
Infertilidade/metabolismo
Infertilidade/fisiopatologia
Hipófise/efeitos dos fármacos
Hipófise/fisiopatologia
Reprodução/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fertility Agents); 33515-09-2 (Gonadotropin-Releasing Hormone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE
[do] DOI:10.1055/s-0037-1599084


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[PMID]:28089575
[Au] Autor:Styer AK; Jin S; Liu D; Wang B; Polotsky AJ; Christianson MS; Vitek W; Engmann L; Hansen K; Wild R; Legro RS; Coutifaris C; Alvero R; Robinson RD; Casson P; Christman GM; Christy A; Diamond MP; Eisenberg E; Zhang H; Santoro N; National Institute of Child Health and Human Development Reproductive Medicine Network
[Ad] Endereço:Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts. Electronic address: astyer@mgh.harvard.edu.
[Ti] Título:Association of uterine fibroids and pregnancy outcomes after ovarian stimulation-intrauterine insemination for unexplained infertility.
[So] Source:Fertil Steril;107(3):756-762.e3, 2017 Mar.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the association of non-cavity-distorting uterine fibroids and pregnancy outcomes after ovarian stimulation-intrauterine insemination (OS-IUI) in couples with unexplained infertility. DESIGN: Secondary analysis from a prospective, randomized, multicenter clinical trial investigating fertility outcomes after OS-IUI. SETTING: Reproductive Medicine Network clinical sites. PATIENT(S): Nine hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. INTERVENTION(S): Participants were randomized to one of three arms (clomiphene citrate, letrozole, or gonadotropins), and treatment was continued for up to four cycles or until pregnancy was achieved. MAIN OUTCOMES MEASURE(S): Conception (serum hCG increase), clinical pregnancy (fetal cardiac activity), and live birth rates. RESULT(S): A total of 102/900 participants (11.3%) had at least one documented fibroid and a normal uterine cavity. Women with fibroids were older, more likely to be African American, had a greater uterine volume, lower serum antimüllerian hormone levels, and fewer antral follicles than women without fibroids. In conception cycles, clinical pregnancy rates were significantly lower in participants with fibroids than in those without uterine fibroids. Pregnancy loss before 12 weeks was more likely in African American women with fibroids compared with non-African American women with fibroids. There was no difference in conception and live birth rates in subjects with and without fibroids. CONCLUSION(S): No differences were observed in conception and live birth rates in women with non-cavity-distorting fibroids and those without fibroids. These findings provide reassurance that pregnancy success is not impacted in couples with non-cavity-distorting fibroids undergoing OS-IUI for unexplained infertility. CLINICAL TRIAL REGISTRATION NUMBER: NCT01044862.
[Mh] Termos MeSH primário: Fármacos para a Fertilidade/administração & dosagem
Infertilidade/terapia
Inseminação Artificial
Leiomioma/complicações
Indução da Ovulação/métodos
Ovulação/efeitos dos fármacos
Neoplasias Uterinas/complicações
[Mh] Termos MeSH secundário: Aborto Espontâneo/etnologia
Adulto
Afroamericanos
Quimioterapia Combinada
Feminino
Fertilidade/efeitos dos fármacos
Fármacos para a Fertilidade/efeitos adversos
Seres Humanos
Infertilidade/complicações
Infertilidade/etnologia
Infertilidade/fisiopatologia
Inseminação Artificial/efeitos adversos
Leiomioma/etnologia
Leiomioma/fisiopatologia
Nascimento Vivo
Indução da Ovulação/efeitos adversos
Gravidez
Taxa de Gravidez
Testes de Gravidez
Estudos Prospectivos
Fatores de Risco
Resultado do Tratamento
Estados Unidos/epidemiologia
Neoplasias Uterinas/etnologia
Neoplasias Uterinas/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Fertility Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE


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[PMID]:27908872
[Au] Autor:Godlee F
[Ad] Endereço:The BMJ.
[Ti] Título:Leaps in the dark.
[So] Source:BMJ;355:i6447, 2016 Dec 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Acesso à Informação
Fármacos para a Fertilidade/uso terapêutico
Educação de Pacientes como Assunto
Medicina Estatal
[Mh] Termos MeSH secundário: Acesso à Informação/ética
Fármacos para a Fertilidade/efeitos adversos
Fármacos para a Fertilidade/economia
Seres Humanos
Internet
Neoplasias/complicações
Educação de Pacientes como Assunto/economia
Educação de Pacientes como Assunto/ética
Educação de Pacientes como Assunto/métodos
Medicina Estatal/economia
Medicina Estatal/ética
Reino Unido
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Fertility Agents)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161203
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i6447


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[PMID]:27341989
[Au] Autor:Haas J; Ophir L; Barzilay E; Machtinger R; Yung Y; Orvieto R; Hourvitz A
[Ad] Endereço:Reproduction Research Laboratory and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: jigalh@hotmail.com.
[Ti] Título:Standard human chorionic gonadotropin versus double trigger for final oocyte maturation results in different granulosa cells gene expressions: a pilot study.
[So] Source:Fertil Steril;106(3):653-659.e1, 2016 Sep 01.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the messenger RNA (mRNA) expression of reproduction-related genes in granulosa cells (GCs) of patients triggered with hCG compared with patients triggered with GnRH agonist and hCG (double trigger) for final oocyte maturation. DESIGN: Granulosa cells were obtained at the time of oocyte retrieval, and gene expression was analyzed using quantitative real-time polymerase chain reaction. SETTING: Referral center. PATIENT(S): Fifteen women undergoing controlled ovarian hyperstimulation for IVF who received hCG for final follicular maturation and in a subsequent IVF cycle received double trigger. INTERVENTION(S): Granulosa cells collection. MAIN OUTCOME MEASURE(S): The expression of genes related to ovarian hyperstimulation syndrome, gap junction, and epidermal-like growth factor in GCs. RESULT(S): The mRNA expressions of amphiregulin (2.1 vs. 1, arbitrary unit) and epiregulin (2.5 vs. 1, arbitrary unit) were significantly higher in the double trigger group compared with the hCG group. We found no difference in luteinizing hormone receptor and follicle stimulating hormone receptor mRNA expressions between the two groups. Moreover, although the mRNA expression of pigment epithelium-derived factor (1.5 vs. 1, arbitrary unit) was significantly higher in the double trigger group, no between-group differences were observed in the expression of vascular endothelial growth factor and GnRH receptor. The mRNA expression of conexin43 in cumulus cells (0.7 vs. 1, arbitrary unit) was significantly lower in the double trigger group compared with the hCG group. CONCLUSION(S): Our findings suggest that the decreased expression of conexin43 and the increased expression of epiregulin and amphiregulin in the GCs from patients receiving the double trigger may explain the suggested improved oocyte and embryo quality related to the double triggering group.
[Mh] Termos MeSH primário: Gonadotropina Coriônica/administração & dosagem
Fármacos para a Fertilidade/administração & dosagem
Células da Granulosa/efeitos dos fármacos
Infertilidade/terapia
Oócitos/efeitos dos fármacos
Indução da Ovulação/métodos
Pamoato de Triptorrelina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Anfirregulina/genética
Anfirregulina/metabolismo
Conexina 43/genética
Conexina 43/metabolismo
Quimioterapia Combinada
Epirregulina/genética
Epirregulina/metabolismo
Feminino
Fertilidade
Fertilização In Vitro
Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos
Hormônio Liberador de Gonadotropina/agonistas
Células da Granulosa/metabolismo
Seres Humanos
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Recuperação de Oócitos
Síndrome de Hiperestimulação Ovariana/induzido quimicamente
Síndrome de Hiperestimulação Ovariana/genética
Projetos Piloto
Estudos Prospectivos
RNA Mensageiro/genética
RNA Mensageiro/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (AREG protein, human); 0 (Amphiregulin); 0 (Chorionic Gonadotropin); 0 (Connexin 43); 0 (EREG protein, human); 0 (Epiregulin); 0 (Fertility Agents); 0 (GJA1 protein, human); 0 (RNA, Messenger); 33515-09-2 (Gonadotropin-Releasing Hormone); 57773-63-4 (Triptorelin Pamoate)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160626
[St] Status:MEDLINE


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[PMID]:27320035
[Au] Autor:Londra L; Moreau C; Strobino D; Bhasin A; Zhao Y
[Ad] Endereço:Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University, Lutherville, Maryland. Electronic address: laura.londra@osumc.edu.
[Ti] Título:Is the type of gonadotropin-releasing hormone suppression protocol for ovarian hyperstimulation associated with ectopic pregnancy in fresh autologous cycles for in vitro fertilization?
[So] Source:Fertil Steril;106(3):666-72, 2016 Sep 01.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the association between different ovarian hyperstimulation protocols and ectopic pregnancy (EP) in in vitro fertilization (IVF) cycles in fresh autologous embryo transfer cycles in the United States between 2008 and 2011 as reported to the Society of Assisted Reproductive Technology (SART). DESIGN: Historical cohort study. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): All autologous cycles that resulted in a clinical pregnancy after a fresh, intrauterine embryo transfer and described characteristics of cycles according to protocol were included: luteal GnRH agonist, GnRH agonist flare, or GnRH antagonist. Multivariate logistic regression was conducted to investigate the association between type of protocol and EP. RESULT(S): Among 136,605 clinical pregnancies, 2,645 (1.94%) were EP. Ectopic pregnancy was more frequent with GnRH antagonist (2.4%) cycles than with GnRH agonist flare (2.1%) or luteal GnRH agonist (1.6%) cycles. After adjusting for maternal and treatment characteristics, the GnRH antagonist and the GnRH agonist flare protocols were associated with increased odds of EP (adjusted odds ratio [aOR] 1.52; 95% confidence interval [CI], 1.39-1.65; and aOR 1.25; 95% CI, 1.09-1.44, respectively) compared with luteal GnRH agonist. Analysis of differences in the factors related to EP in luteal GnRH agonist versus GnRH antagonist protocols indicated that diminished ovarian reserve was associated with an increased risk of EP in luteal GnRH agonist but not in GnRH antagonist cycles. CONCLUSION(S): The type of protocol used during ovarian hyperstimulation in fresh autologous cycles was associated with EP. This finding suggests a role for extrapituitary GnRH on the tubal and uterine environment during ovarian hyperstimulation treatment for IVF.
[Mh] Termos MeSH primário: Fármacos para a Fertilidade/efeitos adversos
Fertilização In Vitro/efeitos adversos
Hormônio Liberador de Gonadotropina/antagonistas & inibidores
Antagonistas de Hormônios/efeitos adversos
Infertilidade/terapia
Indução da Ovulação/efeitos adversos
Gravidez Ectópica/etiologia
[Mh] Termos MeSH secundário: Adulto
Transferência Embrionária/efeitos adversos
Feminino
Fertilidade
Fármacos para a Fertilidade/administração & dosagem
Hormônio Liberador de Gonadotropina/agonistas
Antagonistas de Hormônios/administração & dosagem
Seres Humanos
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Modelos Logísticos
Análise Multivariada
Razão de Chances
Indução da Ovulação/métodos
Gravidez
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents); 0 (Hormone Antagonists); 33515-09-2 (Gonadotropin-Releasing Hormone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160621
[St] Status:MEDLINE


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[PMID]:27230877
[Au] Autor:Bolnick A; Abdulhasan M; Kilburn B; Xie Y; Howard M; Andresen P; Shamir AM; Dai J; Puscheck EE; Rappolee DA
[Ad] Endereço:CS Mott Center for Human Growth and Development, Department of Ob/Gyn, Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, 275 East Hancock, Detroit, MI, 48201, USA. abolnick@med.wayne.edu.
[Ti] Título:Commonly used fertility drugs, a diet supplement, and stress force AMPK-dependent block of stemness and development in cultured mammalian embryos.
[So] Source:J Assist Reprod Genet;33(8):1027-39, 2016 Aug.
[Is] ISSN:1573-7330
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the present study is to test whether metformin, aspirin, or diet supplement (DS) BioResponse-3,3'-Diindolylmethane (BR-DIM) can induce AMP-activated protein kinase (AMPK)-dependent potency loss in cultured embryos and whether metformin (Met) + Aspirin (Asa) or BR-DIM causes an AMPK-dependent decrease in embryonic development. METHODS: The methods used were as follows: culture post-thaw mouse zygotes to the two-cell embryo stage and test effects after 1-h AMPK agonists' (e.g., Met, Asa, BR-DIM, control hyperosmotic stress) exposure on AMPK-dependent loss of Oct4 and/or Rex1 nuclear potency factors, confirm AMPK dependence by reversing potency loss in two-cell-stage embryos with AMPK inhibitor compound C (CC), test whether Met + Asa (i.e., co-added) or DS BR-DIM decreases development of two-cell to blastocyst stage in an AMPK-dependent (CC-sensitive) manner, and evaluate the level of Rex1 and Oct4 nuclear fluorescence in two-cell-stage embryos and rate of two-cell-stage embryo development to blastocysts. RESULT(S): Met, Asa, BR-DIM, or hyperosmotic sorbitol stress induces rapid ~50-85 % Rex1 and/or Oct4 protein loss in two-cell embryos. This loss is ~60-90 % reversible by co-culture with AMPK inhibitor CC. Embryo development from two-cell to blastocyst stage is decreased in culture with either Met + Asa or BR-DIM, and this is either >90 or ~60 % reversible with CC, respectively. CONCLUSION: These experimental designs here showed that Met-, Asa-, BR-DIM-, or sorbitol stress-induced rapid potency loss in two-cell embryos is AMPK dependent as suggested by inhibition of Rex1 and/or Oct4 protein loss with an AMPK inhibitor. The DS BR-DIM or fertility drugs (e.g., Met + Asa) that are used to enhance maternal metabolism to support fertility can also chronically slow embryo growth and block development in an AMPK-dependent manner.
[Mh] Termos MeSH primário: Proteínas Quinases Ativadas por AMP/metabolismo
Aspirina/farmacologia
Embrião de Mamíferos/citologia
Desenvolvimento Embrionário/efeitos dos fármacos
Fármacos para a Fertilidade/farmacologia
Indóis/farmacologia
Metformina/farmacologia
Sorbitol/farmacologia
[Mh] Termos MeSH secundário: Animais
Suplementos Nutricionais
Técnicas de Cultura Embrionária
Camundongos
Células-Tronco/citologia
Estresse Fisiológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fertility Agents); 0 (Indoles); 506T60A25R (Sorbitol); 9100L32L2N (Metformin); EC 2.7.11.31 (AMP-Activated Protein Kinases); R16CO5Y76E (Aspirin); SSZ9HQT61Z (3,3'-diindolylmethane)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160528
[St] Status:MEDLINE
[do] DOI:10.1007/s10815-016-0735-z



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