Area under the curve of temporal estrogen and progesterone measurements during assisted reproductive technology: Which hormone is the main determinant of cycle outcome?

Özkaya, Enis; Kutlu, Tayfun; Yayla, Cigdem Abide; Eser, S; Sanverdi, Ilhan; Devranoğlu, Belgin

doi:10.1111/jog.13492

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…Since the role of P4 in cycling ewes is to make the endometria receptive for implantation of the conceptus, it is reasonable to assume that breeding the Swakara ewes in autumn, summer and winter can be fairly successful since the endometrium is exposed to fairly high levels of P4, unlike in spring. The Damara endometria, however, due to the uniformly high exposure to P4, may explain the year round breeding success [17, 28].…”

Section: Discussionmentioning

confidence: 99%

Characterization of Oestrus Cycles in Namibian Swakara and Damara Sheep through Determination of Circannual Plasma Progesterone Levels

Kandiwa

Mushonga

Madzingira

et al. 2019

Journal of Veterinary Medicine

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A year-long prospective study characterized the seasonality of oestrus cycles in primiparous, nonpregnant Swakara (n=8) and Damara (n=5) ewes through surveillance of plasma progesterone (P4) levels. During this period, Swakara and Damara groups evidently averaged 23 oestrus cycles with an average length of 17 days. Damara ewes showed greater mean peak plasma P4 levels (11.4±0.16ng/ml) than Swakara ewes (5.4±0.11ng/ml) (P<0.05). Oestrus cycles in Damara ewes showed relatively uniform plasma P4 peaks throughout the year ranging from 10.6±0.16 to 12.6±0.24ng/ml. In Swakara ewes, P4 peaks were highest in the autumn oestrus cycles (from 7.1±0.16 to 7.5±0.11ng/ml), rapidly declining through winter to 2.2±0.08ng/ml by midspring and then rapidly increasing to 4.9±0.37ng/ml at the commencement of summer, followed by a gradual increase from 5.7± to 7.1±ng/ml by the start of autumn. The annual mean area under the curve temporal progesterone measurements (AUCPM) in Damara ewes (115.9±18.6ng⁎day/ml) was greater than that in Swakara ewes (58.6±25.3ng⁎day/ml) (p<0.05). For Swakara ewes, the mean AUCPM in summer and autumn cycles (68.2±14.7 and 79.5±10.0ng⁎day/ml, respectively) were greater than those in spring and winter cycles (28.7±12.3 and 55.0±27.3ng⁎day/ml), respectively (P<0.05). There was no seasonal variation in the exposure of the Damara ewes to P4 in between seasons (P>0.05), though, however, the Damara ewes had greater P4 levels than the Swakara ewes (P<0.05). Progesterone profiles showed that Swakara ewes possessed ‘residual’ seasonality, whereas the Damara ewes were no longer seasonal. The implications of this disparity in the seasonal exposure of Swakara and Damara ewes to luteal P4 on fertility warrant further investigation.

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Section: Discussionmentioning

confidence: 99%

Characterization of Oestrus Cycles in Namibian Swakara and Damara Sheep through Determination of Circannual Plasma Progesterone Levels

Kandiwa

Mushonga

Madzingira

et al. 2019

Journal of Veterinary Medicine

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“…The primary outcome in the TIC-TOC trial will be the area under the curve (AUC) of these surveys which results in a continuous outcome measure ranging between 0 and 100 [ 19 ]. AUC is commonly used for the analysis of longitudinal quality of life surveys and our approach to the derivation of AUC is similar to published literature [ 20 , 21 ]. All four PedsQL measures (at the various time points) will be used in the calculation of the AUC for the Brain and the Both injury groups.…”

Section: Methods/study Designmentioning

confidence: 99%

The design of a Bayesian adaptive clinical trial of tranexamic acid in severely injured children

VanBuren

Casper

Nishijima

et al. 2021

Trials

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Background Trauma is the leading cause of death and disability in children in the USA. Tranexamic acid (TXA) reduces the blood transfusion requirements in adults and children during surgery. Several studies have evaluated TXA in adults with hemorrhagic trauma, but no randomized controlled trials have occurred in children with trauma. We propose a Bayesian adaptive clinical trial to investigate TXA in children with brain and/or torso hemorrhagic trauma. Methods/design We designed a double-blind, Bayesian adaptive clinical trial that will enroll up to 2000 patients. We extend the traditional Emax dose-response model to incorporate a hierarchical structure so multiple doses of TXA can be evaluated in different injury populations (isolated head injury, isolated torso injury, or both head and torso injury). Up to 3 doses of TXA (15 mg/kg, 30 mg/kg, and 45 mg/kg bolus doses) will be compared to placebo. Equal allocation between placebo, 15 mg/kg, and 30 mg/kg will be used for an initial period within each injury group. Depending on the dose-response curve, the 45 mg/kg arm may open in an injury group if there is a trend towards increasing efficacy based on the observed relationship using the data from the lower doses. Response-adaptive randomization allows each injury group to differ in allocation proportions of TXA so an optimal dose can be identified for each injury group. Frequent interim stopping periods are included to evaluate efficacy and futility. The statistical design is evaluated through extensive simulations to determine the operating characteristics in several plausible scenarios. This trial achieves adequate power in each injury group. Discussion This trial design evaluating TXA in pediatric hemorrhagic trauma allows for three separate injury populations to be analyzed and compared within a single study framework. Individual conclusions regarding optimal dosing of TXA can be made within each injury group. Identifying the optimal dose of TXA, if any, for various injury types in childhood may reduce death and disability.

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“…A recent interesting study tried to associate impaired implantation with the total exposure to estrogen or progesterone during ovarian stimulation [162]. Although it appears that estrogen exposure was the main hormonal determinant of endometrial receptivity, there was a significant correlation between the AUC for estrogen and progesterone and emphasis was given to the duration of exposure throughout the cycle.…”

Section: When To Measure It?mentioning

confidence: 99%

The curious case of premature luteinization

Kaponis

Chronopoulou

Decavalas

2018

J Assist Reprod Genet

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Authors need to speak the same language when studying PL in order to facilitate comparisons. The terminology, progesterone cut-off, measurement methods and days of measurement should be standardized and globally accepted; otherwise, there can be no scientific dialog. Future research should focus on specific patient profiles that may require a tailored approach. Progesterone measurements throughout the follicular phase possibly depict the progesterone exposure better than an isolated measurement on the day of hCG. Adequately powered randomized controlled trials should confirm which the best prevention and management plan of PL is, before introducing any strategy into clinical practice.

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Area under the curve of temporal estrogen and progesterone measurements during assisted reproductive technology: Which hormone is the main determinant of cycle outcome?

Abstract: Our data showed that the degree of endometrial estrogen exposure is the main factor functioning as a detrimental effect of ovarian stimulation on endometrial receptivity.

Cited by 10 publications

References 23 publications

Characterization of Oestrus Cycles in Namibian Swakara and Damara Sheep through Determination of Circannual Plasma Progesterone Levels

Characterization of Oestrus Cycles in Namibian Swakara and Damara Sheep through Determination of Circannual Plasma Progesterone Levels

The design of a Bayesian adaptive clinical trial of tranexamic acid in severely injured children

The curious case of premature luteinization

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