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Eisele BS, Silva GCV, Bessow C, Donato R, Genro VK, Cunha-Filho JS. An in silico model using prognostic genetic factors for ovarian response in controlled ovarian stimulation: A systematic review. J Assist Reprod Genet 2021; 38:2007-2020. [PMID: 33788133 DOI: 10.1007/s10815-021-02141-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/02/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To study the use of in silica model to better understand and propose new markers of ovarian response to controlled ovarian stimulation before IVF. METHODS A systematic review and in silica model using bioinformatics. After the selection of 103 papers from a systematic review process, we performed a GRADE qualification of all included papers for evidence-based quality evaluation. We included 57 genes in the silica model using a functional protein network interaction. Moreover, the construction of protein-protein interaction network was done importing these results to Cytoscape. Therefore, a cluster analysis using MCODE was done, which was exported to a plugin BINGO to determine Gene Ontology. A p value of < 0.05 was considered significant, using a Bonferroni correction test. RESULTS In silica model was robust, presenting an ovulation-related gene network with 87 nodes (genes) and 348 edges (interactions between the genes). Related to the network centralities, the network has a betweenness mean value = 102.54; closeness mean = 0.007; and degree mean = 8.0. Moreover, the gene with a higher betweenness was PTPN1. Genes with the higher closeness were SRD5A1 and HSD17B3, and the gene with the lowest closeness was GDF9. Finally, the gene with a higher degree value was UBB; this gene participates in the regulation of TP53 activity pathway. CONCLUSIONS This systematic review demonstrated that we cannot use any genetic marker before controlled ovarian stimulation for IVF. Moreover, in silica model is a useful tool for understanding and finding new markers for an IVF individualization. PROSPERO CRD42020197185.
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Affiliation(s)
- B S Eisele
- Obstetrics/Gynecology Post-Graduate Program, Medical School, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2350-11 andar, Porto Alegre, Rio Grande do Sul, CEP 91003-001, Brazil
| | - G C Villalba Silva
- Graduate Program in Genetics and Molecular Biology, Gene Therapy Center and Bioinformatics Core, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - C Bessow
- Obstetrics/Gynecology Post-Graduate Program, Medical School, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2350-11 andar, Porto Alegre, Rio Grande do Sul, CEP 91003-001, Brazil
| | - R Donato
- Obstetrics/Gynecology Post-Graduate Program, Medical School, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2350-11 andar, Porto Alegre, Rio Grande do Sul, CEP 91003-001, Brazil
| | - V K Genro
- Hospital de Clínicas de Porto Alegre, Ob/Gyn Service, Porto Alegre, Rio Grande do Sul, Brazil
| | - J S Cunha-Filho
- Obstetrics/Gynecology Post-Graduate Program, Medical School, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2350-11 andar, Porto Alegre, Rio Grande do Sul, CEP 91003-001, Brazil.
- Hospital de Clínicas de Porto Alegre, Ob/Gyn Service, Porto Alegre, Rio Grande do Sul, Brazil.
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Mao Z, Fan L, Yu Q, Luo S, Wu X, Tang J, Kang G, Tang L. Abnormality of Klotho Signaling Is Involved in Polycystic Ovary Syndrome. Reprod Sci 2017; 25:372-383. [PMID: 28673204 DOI: 10.1177/1933719117715129] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study investigated the involvement of the klotho-associated signaling in the apoptosis of granulosa cells (GCs) from the ovaries of patients with polycystic ovary syndrome (PCOS) and PCOS animals. Primary GCs were obtained from 26 healthy women and 43 women with PCOS. The PCOS animal model was established by the injection of dehydroepiandrosterone (DHEA). Klotho protein and associated microRNA expression in human primary GCs and rats' ovarian tissues were measured by Western blot and real-time polymerase chain reaction, respectively. Results showed that significantly lower miR-126-5p and miR-29a-5p microRNA expressions, higher klotho protein expression, lower insulin growth factor 1 (IGF-1R) and Wnt family member 1 (Wnt1) protein expressions, and lower Akt phosphorylation at Ser473 and Thr308 residues were observed in the GCs from patients with PCOS and the ovarian tissues of PCOS rats compared to that in GCs from healthy women and ovarian tissues of normal control rats, respectively. Knockdown of klotho gene expression normalized IGF-1R and Wnt1 protein expressions and Akt phosphorylation in GCs from patients with PCOS and the ovarian tissues from PCOS rats; it also blocked the effects of insulin on apoptosis and proliferation in GCs from patients with PCOS and inhibited caspase-3 activity in ovarian tissues of PCOS rats. Knockdown of klotho gene expression increased the pregnancy rate in DHEA-treated female rats and increased the body weight of their newborns through normalizing the ovarian function and decreasing the formation of cystic follicles. In conclusion, the miR-126-5p, miR-29a-5p/klotho/insulin-IGF-1, Wnt, and Akt signal pathway may be involved in the apoptosis of GCs and subsequent development of PCOS.
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Affiliation(s)
- Zenghui Mao
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Liqing Fan
- 2 Institute of Reproduction and Stem Cell Engineering, Central South University, Changsha, Hunan, People's Republic of China
| | - Qiao Yu
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Shuwei Luo
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Xianling Wu
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Jun Tang
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Gehua Kang
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
| | - Le Tang
- 1 Reproductive Medicine Center, Reproductive Medicine Hospital of Hunan Province, Changsha, Hunan, People's Republic of China
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Psychological stress during in vitro fertilization and embryo transfer is influenced by the patients' background and gender. Reprod Med Biol 2012; 11:143-148. [PMID: 29662362 DOI: 10.1007/s12522-012-0124-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022] Open
Abstract
Purpose This study evaluated the changes in psychological stress during in vitro fertilization and embryo transfer (IVF-ET) and the relationship of such stress to the patients' background and gender. Methods Sixty couples undergoing IVF-ET were administered the State-Trait Anxiety Inventory-JYZ (STAI) test at six different points during IVF-ET procedures. Anxiety scores at each time point were recorded and analyzed according to gender, fertility status, and duration of treatment. Results The median state anxiety score for women increased following induction until oocyte collection, after which it temporarily declined and then increased again until the pregnancy test. No such changes were noted in men. Scores for women who had undergone a shorter period of IVF treatments were higher while state and trait anxiety in men increased with a prolonged treatment period. Unsuccessful treatment increased the state and trait anxiety of women. Conclusions Psychological stress changed periodically depending on the duration of the patients' treatment and fertility status also influenced anxiety levels. These findings will prove helpful in guiding psychological therapy and counseling for couples attempting to conceive by in vitro fertilization.
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Takikawa S, Iwase A, Goto M, Harata T, Umezu T, Nakahara T, Kobayashi H, Suzuki K, Manabe S, Kikkawa F. Assessment of the predictive value of follicular fluid insulin, leptin and adiponectin in assisted reproductive cycles. Gynecol Endocrinol 2010; 26:494-9. [PMID: 20170349 DOI: 10.3109/09513591003632050] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To assess the correlation of intrafollicular insulin, leptin and adiponectin levels with assisted reproductive technologies (ART) outcome. METHODS This was a retrospective study of 46 patients undergoing in vitro fertilisation/intracytoplasmic sperm injection. Follicular fluid (FF) samples collected at oocyte retrieval were assayed for insulin, leptin and adiponectin levels using enzyme-linked immunosorbent assay, and correlations with ART outcome were analysed. RESULTS There was no significant correlation between intrafollicular insulin, leptin and adiponectin levels. There was a significant difference in the concentration of insulin (P = 0.007), but not leptin or adiponectin, between pregnant (n = 20) and non-pregnant (n = 26) cycles. Only two pregnancies was observed in the 12 cycles in which the concentration of insulin was greater than 7 mU/l in FF, while 18 pregnancies was observed in the 34 cycles in which the concentration of insulin was less than 7 mU/l (P = 0.043). The significantly high concentration of insulin in FF was observed in non-pregnant cycles of patients with polycystic ovary syndrome (PCOS). CONCLUSIONS Our results suggest the possible involvement of intrafollicular insulin in folliculogenesis. Insulin resistance-related substances may affect the reproductive process in patients with PCOS.
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Affiliation(s)
- Sachiko Takikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
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Evaluation of the safety of time-lapse observations for human embryos. J Assist Reprod Genet 2010; 27:93-6. [PMID: 20127164 DOI: 10.1007/s10815-010-9385-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 01/04/2010] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To assess the effects of light from an integrated optical microscope and evaluate the safety of time-lapse observations using a built-in microscope incubator. METHODS We prospectively compared the fertilization rate and embryonic morphology after intracytoplasmic sperm injection between embryos cultured with time-lapse observations every 15 min in an incubator with an integrated optical microscope and embryos with intermittent observations (once a day) in conventional incubators. RESULTS No significant differences were observed in the fertilization rate (57.5% vs. 57.5%) or the rate of excellent-good cleavage embryos (36.0% vs. 36.0%). CONCLUSIONS These results suggest that time-lapse observations using an incubator with an integrated optical microscope may therefore be safely utilized in clinical practice.
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Drug delivery for in vitro fertilization: rationale, current strategies and challenges. Adv Drug Deliv Rev 2009; 61:871-82. [PMID: 19426774 DOI: 10.1016/j.addr.2009.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 04/28/2009] [Indexed: 11/23/2022]
Abstract
In vitro fertilization has experienced phenomenal progress in the last thirty years and awaits the additional refinement and enhancement of medication delivery systems. Opportunity exists for the novel delivery of gonadotropins, progesterone and other adjuvants. This review highlights the rationale for various medications, present delivery methods and introduces the status of novel ideas and possibilities.
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Iwase A, Goto M, Harata T, Takigawa S, Nakahara T, Suzuki K, Manabe S, Kikkawa F. Insulin attenuates the insulin-like growth factor-I (IGF-I)-Akt pathway, not IGF-I-extracellularly regulated kinase pathway, in luteinized granulosa cells with an increase in PTEN. J Clin Endocrinol Metab 2009; 94:2184-91. [PMID: 19318457 DOI: 10.1210/jc.2008-1948] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Insulin resistance is considered as part of the pathogenesis of polycystic ovary syndrome (PCOS), and PCOS patients often show hyperinsulinemia. The influence of insulin on folliculogenesis in women with PCOS has not been fully investigated. OBJECTIVE Our objective was to assess the induction of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expression with insulin treatment and effects of PTEN on IGF-I-induced granulosa cell proliferation as well as the correlation of PTEN levels with the concentration of insulin in follicular fluid in PCOS and non-PCOS patients. DESIGN, SETTING, PATIENTS, AND MAIN OUTCOME MEASURES: A cell proliferation assay, real-time RT-PCR, and Western blotting for PTEN, Akt, and ERK1/2 were conducted in primary cultured granulosa cells under IGF-I stimulation with or without insulin pretreatment. Phosphorylation of Akt and ERK1/2 was also determined by Western blotting. We also measured the insulin concentration in follicular fluid and the levels of PTEN expression in granulosa cells collected at the time of oocyte retrieval of in vitro fertilization in PCOS (n = 13) and non-PCOS patients (n = 37). RESULTS PTEN expression was induced by insulin. Pretreatment with insulin attenuated the IGF-I-induced Akt phosphorylation and cell proliferation but not ERK1/2 phosphorylation. A phosphatidylinositol 3-kinase inhibitor, LY294002, inhibited the IGF-I-induced cell proliferation. Suppression of insulin-induced PTEN expression using small interfering RNA recovered IGF-I-induced Akt phosphorylation. PTEN levels in granulosa cells, which tended to be higher in PCOS patients, were correlated with the insulin concentration in follicular fluid. CONCLUSIONS PTEN may influence the proliferation of human granulosa cells as well as disturbance of follicular growth in PCOS patients.
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Affiliation(s)
- Akira Iwase
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
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Iwase A, Ando H, Toda S, Ishimatsu S, Harata T, Kurotsuchi S, Shimomura Y, Goto M, Kikkawa F. Oral progestogen versus intramuscular progesterone for luteal support after assisted reproductive technology treatment: a prospective randomized study. Arch Gynecol Obstet 2007; 277:319-24. [PMID: 17938943 DOI: 10.1007/s00404-007-0484-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate the efficacy of oral progestogen, chlormadinone acetate, and intramuscular (IM) progesterone for luteal support in patients, undergoing assisted reproductive technology (ART) treatment, who were treated with a gonadotropin-releasing hormone agonist (GnRHa). METHODS This was a prospective randomized study of 40 patients with normal and high response (serum estradiol > 2,000 pg/ml) in GnRHa down-regulation. Patients were randomized to receive either oral chlormadinone acetate or IM progesterone. The outcomes of ART treatment, including pregnancy and embryo implantation rates, were analyzed. RESULTS There were no significant differences in the clinical pregnancy rates (25 vs. 20%) and in the implantation rates (12.7 vs. 9.1%) of patients who received IM progesterone and oral chlormadinone acetate. Endometrial thickness was also comparable between oral chlormadinone acetate and IM progesterone. CONCLUSION Oral progestogen, chlormadinone acetate showed a comparable pregnancy rate and live birth rate with IM progesterone as luteal support for the high responders. The optimal methods for luteal support may be dependent on responses to stimulation with gonadotropin, although it is not concluded that oral chlormadinone acetate is recommended as an option for luteal support in high responders.
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Affiliation(s)
- Akira Iwase
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
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Kurotsuchi S, Ando H, Iwase A, Ishida Y, Hamajima N, Kikkawa F. The plausibility of Helicobacter pylori-related infertility in Japan. Fertil Steril 2007; 90:866-8. [PMID: 17905240 DOI: 10.1016/j.fertnstert.2007.06.097] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 06/28/2007] [Accepted: 06/28/2007] [Indexed: 01/03/2023]
Abstract
The aim of the present study was to confirm the seropositive rate of Helicobacter pylori to which antibodies cross-react with spermatozoon flagella in patients with infertility. Of the 204 patients in whom the anti-H. pylori IgG antibody in serum and follicular fluids were measured, 45 (22.1%) were seropositive for H. pylori and the seropositive percentage of infertile patients without any possible cause was higher than that of patients with one or more known infertility factors [8 of 21 patients (38.3%) vs. 37 of 183 patients (20.2%), respectively], which suggests a new concept: H. pylori-related infertility.
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Affiliation(s)
- Shozo Kurotsuchi
- Department of Obstetrics and Gynecology and Department of Maternal and Perinatal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Rosen MP, Shen S, McCulloch CE, Rinaudo PF, Cedars MI, Dobson AT. Methylenetetrahydrofolate reductase (MTHFR) is associated with ovarian follicular activity. Fertil Steril 2007; 88:632-8. [PMID: 17572411 DOI: 10.1016/j.fertnstert.2006.11.165] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Revised: 11/29/2006] [Accepted: 11/30/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Polymorphisms in the MTHFR gene have been associated with decreased cell division and apoptosis. This finding led us to evaluate whether MTHFR polymorphisms were associated with follicular growth within the ovary. More specifically, we investigated the effect of the two common polymorphisms C677T and A1298C in our population of women undergoing ovarian stimulation. DESIGN Prospective cohort study. SETTING Academic medical center. PATIENT(S) Two hundred twenty-three women undergoing ovarian stimulation. INTERVENTION(S) The DNA from patients was genotyped at the MTHFR C677T and A1298C polymorphisms. MAIN OUTCOME MEASURE(S) Day 3 FSH, E(2), antral follicle count, amount of gonadotropin used, the number of follicles >13 mm, E(2) on the day of hCG administration, and oocyte number. RESULT(S) Women with the variant MTHFR 1298 C allele had significantly higher basal FSH levels, and after ovarian stimulation, produced fewer follicles >13 mm, had lower E(2) levels on the day of hCG administration, and required more ampules of gonadotropin hormone during treatment. Women with the variant MTHFR 677 T allele demonstrated no significant differences. CONCLUSION(S) The MTHFR A1298C polymorphism, but not the C677T polymorphism, is associated with higher basal FSH levels and may be a determinant of response to ovarian stimulation. These findings make a compelling case for the MTHFR A1298C polymorphism to modulate folliculogenesis.
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Affiliation(s)
- Mitchell P Rosen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California 94115, USA
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Nomura M, Iwase A, Furui K, Kitagawa T, Matsui Y, Yoshikawa M, Kikkawa F. Preferable correlation to blastocyst development and pregnancy rates with a new embryo grading system specific for day 3 embryos. J Assist Reprod Genet 2006; 24:23-8. [PMID: 17165150 PMCID: PMC3455081 DOI: 10.1007/s10815-006-9086-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 11/07/2006] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the cleavage stage embryo quality by the correlation between the morphological features and blastocyst development rate to develop a new embryo grading system. METHODS A retrospective analysis, including 216 cycles of cleavage stage embryo transfer and 251 cycles of blastocyst transfer. The correlation with blastocyst development of the embryo cleavage stage, fragmentation and uniformity of blastomeres was evaluated. RESULTS There were significant differences in the blastocyst development rate between > or =7 cells and < or=6 cells (68.8% vs. 30.7%), <50% fragmentation and > or =50% fragmentation (51.9% vs. 25.7%), and evenly sized blastomeres and unevenly sized blastomeres (48.7% vs. 30.1%) on day 3. The new grading system defined by these 3 parameters showed a preferable correlation to the pregnancy rate. CONCLUSIONS The new grading system specific for day 3 embryos is useful for the selection of good quality embryos and may improve the pregnancy rate.
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Affiliation(s)
- Masao Nomura
- Cinic Mama 3-34-1 Imajyuku, Ogaki, 503-0807 Japan
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
| | - Akira Iwase
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
- Department of Maternal and Perinatal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Furui
- Cinic Mama 3-34-1 Imajyuku, Ogaki, 503-0807 Japan
| | | | - Yuka Matsui
- Cinic Mama 3-34-1 Imajyuku, Ogaki, 503-0807 Japan
| | | | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
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Lossl K, Andersen AN, Loft A, Freiesleben NLC, Bangsbøll S, Andersen CY. Androgen priming using aromatase inhibitor and hCG during early-follicular-phase GnRH antagonist down-regulation in modified antagonist protocols. Hum Reprod 2006; 21:2593-600. [PMID: 16785262 DOI: 10.1093/humrep/del221] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Temporary exposure of follicles to increased levels of androgens may enhance their sensitivity to FSH. The aim of this study was to increase the intraovarian androgen level using aromatase inhibitors and hCG before controlled ovarian stimulation (COH) and to test this concept clinically. METHODS In a prospective, non-randomized study, 45 patients were treated in modified antagonist protocols including early-follicular-phase down-regulation and androgen priming before COH. All patients received cetrorelix, 3 mg s.c., on cycle days 2 and 5. Group I (n=15) received no other pretreatment. Group II (n=15) received 1 daily tablet of aromatase inhibitor, letrozole 2.5 mg, from cycle days 2 to 8. Group III (n=15) received letrozole as Group II and 1250 IU of hCG s.c. on cycle day 2. From cycle day 8, all patients were stimulated with highly purified menotrophin in a flexible antagonist protocol. RESULTS Aromatase inhibitor increased the level of testosterone in follicular fluid (P<0.002), but not in plasma. Androgen priming with aromatase inhibitor and hCG increased the number of good-quality embryos (P=0.015) but did not increase the implantation rate. CONCLUSIONS The use of aromatase inhibitor before COH significantly influences the local endocrine environment before and during stimulation. Androgen priming with both aromatase inhibitor and hCG may result in more good-quality embryos.
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Affiliation(s)
- K Lossl
- The Fertility Clinic 4071, Laboratory of Reproductive Biology 5712, Copenhagen University Hospital, Rigshospitalet, Denmark.
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Barad DH. Use of follicle-stimulating hormone test to predict poor response in in vitro fertilization. Obstet Gynecol 2005; 106:196-7; author reply 197. [PMID: 15994648 DOI: 10.1097/01.aog.0000169592.30628.770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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