scholarly journals Relationship between follicular size and developmental capacity of oocytes under controlled ovarian hyperstimulation in assisted reproductive technologies

Author(s):  
Isao Tamura ◽  
Mai Kawamoto‐Jozaki ◽  
Taishi Fujimura ◽  
Yumiko Doi‐Tanaka ◽  
Haruka Takagi ◽  
...  
2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Creticus P. Marak ◽  
Amit Chopra ◽  
Narendrakumar Alappan ◽  
Ana M. Ponea ◽  
Achuta K. Guddati

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF) secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.


Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 379
Author(s):  
Bogdan Doroftei ◽  
Ovidiu-Dumitru Ilie ◽  
Ana-Maria Dabuleanu ◽  
Roxana Diaconu ◽  
Radu Maftei ◽  
...  

Background and objectives: The latest reports suggest that follitropin delta is a highly efficient recombinant human follicle-stimulating hormone (r-hFSH) that became a part of the current assisted reproductive technologies (ARTs). Therefore, the present study aims to assess a series of parameters (follicles, oocytes, and embryos) and further by the outcomes in women following the administration of follitropin delta. Materials and methods: This observational study included 205 women. They were aged between 21 and 43 years (mean 33.45) and an anti-Müllerian hormone (AMH) level ranging from 0.11 to 16.00 ng/dL (mean 2.89). Results: In accordance with the established methodology and following the centralization of data, a total of fifty-eight pregnancies (28.29%) were achieved; forty-five (36.88%) were achieved in women under 35 years and thirteen (15.66%) in women above 35 years. These figures are positively correlated with women’s age considering that the number of follicles >18 mm, oocytes fertilized and embryo(s) varies among groups. Regarding the interest parameters, we noted n = 1719 follicles > 18 mm, n = 1279 retrieved oocytes, and n = 677 embryos at day 3. On the other hand, the following figures have been registered in women above 35 years: 814–follicles > 18 mm, 612 oocytes retrieved and 301 embryos at day 3. During this study, we registered only three cases of abortions (n = 1–0.81% in women under 35 years and n = 2–2.40% in women above 35 years). Nine pregnancies (7.37%) were stopped from evolution in females under 35 years, and twelve pregnancies (n = 8–6.55% in women under 35 years, while n = 4 in women above 35 years) were unsuccessful. A twin pregnancy has been confirmed (1.20%) in women above 35 years, six ongoing pregnancies (4.91%) in those under 35 years, and two in both groups (one per group–n = 1–0.81%, and 1.20%–n = 1) in which we did not know the exact result were registered at the end of the established studied interval. However, there were also situations in which the treatment cause an over-reactivity or had no effect; n = 2 were non-responders, and n = 1 exhibited moderate ovarian hyperstimulation syndrome (OHSS). Conclusions: Based on our results, we strongly encourage the use of this recombinant gonadotropin on a much larger scale.


2020 ◽  
Vol 16 ◽  
Author(s):  
Masoumeh Ghafarzadeh

: Assisted Reproductive Technologies (ART) has significantly improved the chances of pregnancy. In Vitro Fertilization (IVF) remains the most widely used ART procedure, which involves a series of steps like ovarian hyperstimulation followed by vaginal oocyte retrieval and in vitro fertilization of the oocytes with sperm, culture of the embryos, and the final transfer of the embryo to the recipient or surrogate recipient. Intracytoplasmic sperm injection (ICSI), another form of ART, is developed to circumvent the problems encountered in IVF. However, the studies have indicated that only about one-third of ART cycles result in live births. This review is designed to provide a comprehensive idea about advances in reproductive medicine in terms of preparation of gametes and implantation.


2017 ◽  
Vol 8 (2) ◽  
pp. 54-60
Author(s):  
Swati Singh ◽  
Sankalp Singh ◽  
Ambujakshy K Raman ◽  
Sujatha Ramakrishnan ◽  
C Mohamed Ashraf

ABSTRACT Introduction Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that arises due to assisted reproductive technologies (ARTs) during infertility treatment. Recently, the use of selective dopamine receptor agonists on D2 receptors (e.g., cabergoline) has been suggested in the prevention of OHSS. The aim of this study was to evaluate the effect of cabergoline in the prevention of OHSS in high-risk patients undergoing ART. Materials and methods This was a randomized, double-blind, parallel group (cabergoline group and placebo) study. A total of 110 women undergoing in vitro fertilization (IVF)–intracytoplasmic sperm injection procedure using a long agonist protocol with high risk for OHSS were recruited for the study on the day of final trigger. All the patients were followed up every 48 hours for 10 days from the day of the final trigger and clinically assessed with ultrasound and blood tests. The size of ovaries and fluid collection in the pouch of Douglas (POD) was measured with ultrasound. A sample size of 92 subjects was calculated for the study to be powered at 80%. Assuming a drop-out rate of 10%, 110 subjects were enrolled for the study. Results There was no significant difference observed in the size of right and left ovary, POD fluid volume, total leukocyte count (TLC), and serum estradiol level (E2 level) between both the groups from day 0 to day 8, except packed cell volume. No significant difference was observed in the incidence rate of moderate OHSS between both groups (p = 0.728). The differences in clinical pregnancy rate, implantation rate, and live birth rate were also insignificant. Conclusion Cabergoline does not reduce the incidence of moderate OHSS when compared with placebo. Large, well-designed studies are needed to evaluate the effectiveness of cabergoline when used for the prevention of OHSS. How to cite this article Singh S, Singh S, Raman AK, Ramakrishnan S, Ashraf CM. Efficacy of Cabergoline in the Prevention of Ovarian Hyperstimulation Syndrome: A Randomized, Double-blind and Placebo-controlled Trial. Int J Infertil Fetal Med 2017;8(2):54-60


2004 ◽  
Vol 16 (2) ◽  
pp. 289
Author(s):  
M. Takenoshita ◽  
S. Ohta ◽  
N. Fujinami ◽  
T. Yamochi ◽  
T. Kunieda ◽  
...  

Variability in the superovulatory response continues to be one of the most frustrating problems with the application of assisted reproductive technologies in non-human primates. Superstimulation of donor animals with equine chorionic gonadotrophin (eCG) and human chorionic gonadotrophin (hCG) is widely used, but individual responses to these hormones vary widely. In human in vitro fertilization, follicle size is commonly used as a marker to determine the timing of hCG treatment in order to acquire oocytes matured in vivo. Incorporation of techniques designed to control follicular size in humans may improve superstimulatory response in non-human primates. In this study, we measured follicle size and examined oocyte quality in Cynomologus Monkeys superstimulated as described below. On the first day of spontaneous menses, monkeys were treated with long-acting GnRH (Luprin: Takeda Pharm, Co. Ltd., Osaka, Japan;; Day 0). A dose of 25IU/kg/day eCG (Serotoropin;; Teikokuzoki Pharm, Co. Ltd., Tokyo, Japan) was administered i.m. from Day 1 to Day 9, followed by 200IUkg−1 hCG (Puberogen;; Sankyo Pharm, Co. Ltd., Tokyo, Japan) i.m. on Day 10. Dominant follicle sizes were measured on Days 7 and 9 by ultrasonography. Oocytes were collected by laparoscopy in anesthetized monkeys 40h after the hCG injection. Oocytes were classified by nuclear status. Immature oocytes at the stages of germinal vesicles (GV) and metaphase (MI) were cultured until reaching the stage of Metaphase II (MII). Matured oocytes (MII) were fertilized by ICSI and cultured for 7 days. At the end of culture, the developmental stage of oocytes was examined. The ovaries with different-sized follicles on Day 7 were divided into two groups;; ovaries with large follicles (>4.5mm) were in the first group and ovaries with small follicles (<4.0mm) were in the second group. On Day 9, follicles in first group grew to more than 5.0mm and follicles in second group remained less than 5.0mm. Sixty-two percent of oocytes from follicles in first group were at MI or MII stage, while only 15% of oocytes in second group reached the MI or MII stage. After ICSI, 42% of MII oocytes from first group developed to the blastocyst stage, while no blastocyts were observed in second group. These results suggest that the size of dominant follicle was a limiting factor for the developmental ability of oocytes in vitro. For production of Cynomolgus monkey blastocysts derived from ICSI, the diameter of dominant follicle was required to be at least 5mm before hCG in order to collect MI and MII oocytes. Incorporation of hormonal treatments designed to optimize follicular size probably reduced the variability in quality of oocytes. Therefore, we expect that an adjustment of dose and duration of eCG and hCG treatment may improve developmental ability of oocytes from follicles that had not reached 5mm.


Sign in / Sign up

Export Citation Format

Share Document