Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI)

Kwan, Irene; Bhattacharya, Siladitya; Kang, A.; Woolner, Andrea

doi:10.1002/14651858.cd005289.pub3

Cited by 54 publications

(23 citation statements)

References 31 publications

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“…This regimen helps to minimize multiple pregnancies and the risk of ovarian hyperstimulation syndrome. 230 After ovulation, progesterone production can be stimulated by repeated hCG injections or direct administration of progesterone during the postovulatory phase, until embryonic endogenous hCG secretion takes over.…”

Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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“…Endometrial thickness (EnT) directly reflects histological thickness, while endometrial pattern (EnP) changes in lockstep with the menstrual cycle, correlating closely with morphologic assessment of endometrial biopsies (24,25). While endometrial histology has long been recognized to inform the optimal window of implantation (26), the influence of EnT and EnP on endometrial receptivity and pregnancy rates (PR) has been intensively explored but not conclusively answered (27,28). …”

Section: Introductionmentioning

confidence: 99%

Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers

Gingold

Lee

Rodriguez-Purata

et al. 2015

Fertility and Sterility

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Objective To evaluate the relation of endometrial thickness (EnT) and endometrial pattern (EnP) to euploid embryo transfer (ET) outcomes. Design Retrospective cohort Setting Private academic clinic Patients Patients (n=277, 36.1±4.0 years) whose embryos (n=476) underwent aneuploidy screening with fresh (n=176) or frozen (n=180) ET from July 2010–March 2014. Interventions EnT and EnP were measured on trigger day and at ET. Patients were stratified by age and cycle type (fresh or frozen). Cycle data were combined at trigger day but separated at ET day. Main Outcome Measures Outcome measures were implantation (IR), pregnancy (PR) and clinical pregnancy (CPR) rates. Analysis was conducted by chi-square and Fisher exact test with significance at p<0.05. Results 234 gestational sacs, 251 pregnancies and 202 clinical pregnancies resulted from 356 cycles. EnT (9.6±1.8mm; range 5–15mm) at trigger day (n=241 cycles) as a continuous or categorical (≤8 vs >8mm) variable was not associated with IR, PR or CPR. EnT at day of fresh (9.7±2.2mm; range 4.4–17.9mm) (n=176 cycles) or frozen ET (9.1±2.1mm; range 4.2–17.7mm) (n=180 cycles) was not associated with IR, PR or CPR. Type 3 EnP at trigger day was associated with increased serum progesterone at trigger and decreased IR compared with type 2 EnP. EnP at fresh or frozen ET was not associated with IR, PR or CPR. Conclusions Within the study population, EnT was not significantly associated with clinical outcomes of euploid ETs. A type 3 EnP at trigger day suggests a prematurely closed window of implantation.

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“…Also, the incident rate for a mild form of OHSS in patients receiving albumin was significantly higher than HES and Cb. Although some studies have shown the effect of albumin in reducing the incidence of severe OHSS,[ 8 9 10 11 ] many recent studies have demonstrated that HA is not a proper intervention in preventing OHSS[ 14 19 ] due to side effects and the possibility of worsening OHSS. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 7 ] First introduced by Asch et al .,[ 8 ] many randomized clinical trials demonstrated the potential protective role of IV albumin in the prevention of OHSS. [ 9 10 11 ] However, some studies suggest that human albumin (HA) does not decrease the incidence of OHSS[ 12 ] and that due to possible side effects, HA in not recommended[ 13 14 ] in OHSS prevention. Hydroxylethyl starch (HES), another colloid solution was also suggested as an alternative to HA in the prevention of OHSS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction

Ghahiri¹,

Mogharehabed²,

Movahedi³

et al. 2015

J Res Med Sci

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Background:The purpose of this study was to compare the three different strategies, intravenous (IV) hydroxylethyl starch (HES), IV human albumin (HA), and oral Cabergoline (Cb) in the prevention of ovarian hyperstimulation syndrome (OHSS).Materials and Methods:In this prospective randomized clinical trial, 91 women at high risk of developing OHSS were allocated into the three groups, group one received 2 vial (2 × 50 ml) IV HAs, in group two, 1000 ml of 6% HES was administered IV, both groups 30 min after oocyte retrieval within 4 h. Group three, 31 infertile patients received oral Cb 0.5 mg daily for 7 days after oocyte retrieval. Patients were visited 14 ± 1 days after in-vitro fertilization and if β-human chorionic gonadotropin level >10, transvaginal ultrasonography was performed 2 weeks later to confirm intrauterine pregnancy. Patients were followed up weekly for 3 months for signs of OHSS and were also informed about the signs of OHSS and asked to contact immediately if any symptoms of were detected.Results:None of the participants in group HES developed severe OHSS and only 3 patients (10%) developed mild to moderate OHSS. The incident of severe OHSS was significantly higher in albumin group compared to Cb and HES group (P = 0.033 and P < 0.001, respectively). Also, the probability of developing severe OHSS was higher in Cb group than group HES (P = 0.031).Conclusion:The findings from this study suggest that administration of 1000 ml of HES 6% has a higher prophylactic effect compared to administration of IV HA and oral Cb.

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Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI)

Cited by 54 publications

References 31 publications

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers

Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction

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