A randomized controlled trial of gonadotropin-releasing hormone agonist versus gonadotropin-releasing hormone antagonist in Iranian infertile couples: oocyte gene expression

Hoseini, Fatemeh; Mugahi, Seyed Mohammad Hossein Noori; Akbari-Asbagh, Firoozeh; Eftekhari‐Yazdi, Poopak; Aflatoonian, Behrouz; Aghaee‐Bakhtiari, Seyed Hamid; Aflatoonian, Reza; Salsabili, Nasser

doi:10.1186/s40199-014-0067-4

Cited by 6 publications

(6 citation statements)

References 36 publications

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“…Although the mean number of oocytes retrieved was higher in the agonist group compared to the antagonist group, there was a trend for higher pregnancy rates and number of embryos in the antagonist group compared to the agonist group in low AMH group. In a recent study, Hoseini et al (2014) showed that the expression levels of some genes involved in the cytoplasmic maturity, antiapoptotic process and adenosine triphosphate production were higher in human oocytes of the women in the GnRH-ant protocol versus those of the women in the GnRH-a protocol (43). For these reasons, antagonist protocol may have a positive influence on both oocyte and embryo quality; consequently, increase the pregnancy rate.…”

Section: Discussionmentioning

confidence: 99%

Controlled Ovarian Stimulation in Endometriosis Patients Can Be Individualized by Anti-Mullerian Hormone Levels

et al. 2017

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Context. Anti-Mullerian hormone (AMH) assay is becoming the best indicator of successful IVF treatment response to fertility drugs and could be a useful marker of embryo implantation potential. Various protocols are being used for controlled ovarian stimulation (COS), but there is an uncertainty regarding the implementation of the best protocol for endometriosis patients and also little evidence is available concerning the clinical value of AMH levels in endometriosis.Objective. This study aimed to evaluate the prognostic value of serum AMH levels for pregnancy in COS using GnRH-agonist(GnRH-a) and GnRHantagonist(GnRH-ant) protocols in endometriosis patients.Design. This is a cross-sectional study between March 2012 and November 2015.Subjects and Methods. Data were collected from 249 COS cycles of endometriosis patients, including 129 cycles with GnRH-a and 120 cycles with GnRH-ant. Patients in each group were classified into three subgroups based on their serum AMH levels. The outcomes of ICSI program were evaluated.Results. The ROC curve analysis showed that embryo and oocyte counts and AMH were equally predictive for pregnancy, as demonstrated by a similar area under the curve (AUC) of 0.69, 0.66 and 0.64, respectively. The sensitivity and specificity for prediction of positive pregnancy were 70.91% and 67.01% for embryo counts, 70.91% and 67.53% for oocyte counts at the cutoff values of 5 and 7, respectively, and 83.64% and 52.58% for AMH levels at the cutoff values of 1.3ng/mL.Conclusions. This study demonstrates that AMH as a single test has substantial accuracy in the prediction of pregnancy using the GnRH antagonist protocol for patients with endometriosis. In other words, AMH assay prior to ovarian stimulation initiation guides the clinicians to choose the antagonist stimulation protocol for the patients with two extreme AMH levels. AMH levels can be used to individualize control ovarian stimulation in endometriosis patients.

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Section: Discussionmentioning

confidence: 99%

Controlled Ovarian Stimulation in Endometriosis Patients Can Be Individualized by Anti-Mullerian Hormone Levels

et al. 2017

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“…An important part of reproductive medicine in infertility treatment is ovarian stimulation by drugs to gain a higher number of mature oocyte retrieved for the purpose of increasing pregnancy rates in comparison with the normal cycles (1). Recently, drug usage has been founded to make final oocyte maturation in patients.…”

Section: Introductionmentioning

confidence: 99%

The effect of the human cumulus cells-conditioned medium on in vitro maturation of mouse oocyte: An experimental study

Adib

Seifati

Ashkezari

et al. 2020

IJRM

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Background: To increase the results of infertility treatment, many efforts have been made to improve the treatment methods. As assisted reproductive technology is mainly using cell culture methods, one of the approaches to improve this technology is conditioned medium from different sources. It is desirable to apply in vitro maturation (IVM) and use oocytes from normal cycles instead of stimulating ovulation. Objective: To investigate the effect of human cumulus cell condition medium (hCCCM) on the IVM of immature mouse oocytes and morphology. Materials and Methods: In this experimental study, 240 germinal vesile oocytes were collected from four-six wk-old mice after 48 hr of 5IU pregnant mare serum gonadotropin (PMSG) injection and cultured in hCCCM (test group, n = 120) and DMEM + 20% FBS (control group, n = 120). The IVM rates and changes in perivitelline space (PVS) and shape were investigated at 8, 16, and 24 hr following the culture. The mature (MII) oocytes were subjected to in vitro fertilization (IVF) and the fertilization rate was assessed in three days. Results: A significant difference was observed between the maturation rates in the hCCCM and control groups (24.16% vs 0%; p = 0.001), as well as morphologic changes between the two groups (p = 0.04, p = 0.05). The development rate for MII oocytes attained from IVM in the hCCCM group was 27.58% (2-cell) and 6.89% (4-cell). Data displayed that hCCCM is an effective medium for oocytes maturation compared to the control medium. Conclusion: hCCCM supports oocyte in vitro growth and maturation. Moreover, hCCCM changes the oocyte shape and size of perivitelline space. Key words: Germinal vesicle, Cumulus cell, Conditioned medium, In vitro fertilization, In vitro maturation, Oocyte.

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“…Moreover, it was accompanied by an increase in the incidence of ovarian hyperstimulation syndrome (OHSS) and canceled cycles ( 17 , 32 ). In contrast to these results, the molecular studies on the oocytes, obtained through the antagonist protocol in patients with high AMH levels, indicated that the gene expressions of ATPase and BMP15 , as two indicators of oocyte quality, enhanced through the antagonist protocol ( 4 ). Therefore, the antagonist protocol can be the more desirable option in high AMH cases.…”

Section: Discussionmentioning

confidence: 71%

“…Although the two common ovarian stimulation protocols (GnRH agonist and GnRH antagonist) exhibit similar implantation and pregnancy rates, each protocol entails specific characteristics. In fact, the agonist protocol leads to higher number of oocytes per cycle, whereas the antagonist protocol curtails the gonadotropin dose, shortening the stimulation period and saving the treatment costs, which in turn leads to patient comfort ( 1 - 4 ).…”

Section: Introductionmentioning

confidence: 99%

A comparative study on the results of agonist and antagonist protocols based on serum AMH levels in patients undergoing intracytoplasmic sperm injection

Nikmard

Aflatoonian²,

Hosseini

et al. 2016

IJRM

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Background:Serum concentrations of antimullerian hormone (AMH) correlate with ovarian response during assisted reproduction treatment (ART) cycles.Objective:This retrospective study attempted to evaluate the selection of ovarian stimulation protocols based on serum AMH levels in patients and its impact on the results of ART.Materials and Methods:Based on AMH levels, the patients with tubal factor infertility were divided in three groups of normal, low and high AMH levels. Oocyte, good embryo number and pregnancy rate in each group were analyzed. Results:Using agonist and antagonist protocols, an increase in serum AMH led to higher number of oocytes and better quality embryos. At all low, normal and high AMH levels, the agonist protocol led to a more significant increase in the number of oocytes than the antagonist protocol (p<0.05). The number of high quality embryos significantly increased by the agonist protocol than antagonist protocol in women with normal AMH levels of 1.3-2.6 ng/ml (p=0.00). Moreover, the results for the number of high quality embryos at AMH ˃2.6 ng/ml was in favor of the antagonist protocol (p=0.00). The results showed the lowest pregnancy rate at AMH ˂1.3 ng/ml. At AMH ˃2.6 ng/ml, there was a significant increase in pregnancy rate through the antagonist protocol (p=0.04). Conclusion:Findings of this study suggested that the ART results are predictable, taking into account the AMH levels. The protocol specific to each patient can be used given the AMH level in each individual. This is because the results of each protocol depend on individual conditions.

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A randomized controlled trial of gonadotropin-releasing hormone agonist versus gonadotropin-releasing hormone antagonist in Iranian infertile couples: oocyte gene expression

Cited by 6 publications

References 36 publications

Controlled Ovarian Stimulation in Endometriosis Patients Can Be Individualized by Anti-Mullerian Hormone Levels

Controlled Ovarian Stimulation in Endometriosis Patients Can Be Individualized by Anti-Mullerian Hormone Levels

The effect of the human cumulus cells-conditioned medium on in vitro maturation of mouse oocyte: An experimental study

A comparative study on the results of agonist and antagonist protocols based on serum AMH levels in patients undergoing intracytoplasmic sperm injection

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