Prostaglandin therapy during the proliferative phase improves pregnancy rates following frozen embryo transfer in a hormone replacement cycle
|
|
- Betty Malone
- 5 years ago
- Views:
Transcription
1 bs_bs_banner doi: /jog J. Obstet. Gynaecol. Res. Vol. 40, No. 5: , May 2014 Prostaglandin therapy during the proliferative phase improves pregnancy rates following frozen embryo transfer in a hormone replacement cycle Koji Nakagawa 1, Yuko Ojiro 1, Hiroyasu Jyuen 1, Yayoi Nishi 1, Rie Sugiyama 2, Yasushi Kuribayashi 2 and Rikikazu Sugiyama 1 1 Division of Reproductive Medicine, Sugiyama Clinic, and 2 Center for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Tokyo, Japan Abstract Aim: To determine the efficacy of prostaglandin administration during the proliferative phase in order to improve pregnancy rates following frozen embryo transfer during a hormone replacement cycle (HRC). Methods: From September 2010 through March 2012, patients (n = 135) were recruited who had undergone oocyte retrieval during a stimulation cycle with clomiphene and had deferred fresh embryo transfer (ET) due to a thin uterine endometrium. All patients were less than 40 years of age and underwent thawed ET following all embryo cryopreservation, and were randomly divided into two groups for thawed ET using a conventional hormone replacement cycle with or without prostaglandin derivatives (prostaglandin or conventional group). Prostaglandin derivatives were administrated during the proliferative phase. Pregnancy and implantation rates following frozen ET were compared between the two groups. Results: Although the endometrial thickness on the day of ET was similar for the prostaglandin and conventional groups, the pregnancy and implantation rates for the prostaglandin group were 40.0% and 22.0%, respectively, which was significantly higher than the rates for the conventional group (P < 0.01). Conclusion: Among patients who avoided fresh ET due to a thin endometrium, the pregnancy rate following a thawed cycle was low. However, it was improved when prostaglandin derivatives were used during the proliferative phase. Key words: clomiphene, prostaglandin, thawed embryo transfer, thin uterine endometrium. Introduction Recently, mild ovarian stimulation protocol using clomiphene citrate (CC) has gained in popularity 1 for use in assisted reproductive technology (ART) treatment, because this protocol does not require daily gonadotropin administration, 2 and it is less burdensome for patients compared with a conventional mild stimulation protocol using gonadotropin-releasing hormone antagonist. Although this protocol may make patients happy by reducing the number and times of injection, as well as reducing the cost, concerns have been raised about this protocol and its use of CC. One of their concerns is that CC sometimes thins the endometrium which can cause implantation failure. Indeed, when patients show a thin uterine endometrium on the day of embryo transfer (ET), they are forced to defer fresh ET, but they can undergo thawed ET in the following Received: January Accepted: October Reprint request to: Dr Koji Nakagawa, Division of Reproductive Medicine, Sugiyama Clinic, Ohara, Setagaya, Tokyo , Japan. nakagawa-jiko@spice.ocn.ne.jp Conflict of interest: The authors have received no funding for this study, and they have no financial interest in any companies The Authors 1331
2 K. Nakagawa et al. cycle. The uterine endometrium is known to thicken with graduated administrations of estrogen, and most of the patients deferring fresh ET due to a thin endometrium have been treated by a graduated estrogen administration protocol to prepare the uterine endometrium for thawed ET. Recently, an interesting paper was published that showed the pregnancy rates following frozen ET. 3 The authors of that report found that women who were forced to defer fresh ET due to a thin uterine endometrium experienced a pregnancy rate that was significantly lower than that for women who deferred fresh ET due to the risk of ovarian hyperstimulation syndrome (OHSS), and they suggested that the women of the former example may be failing to attain adequate endometrial thickness despite a graduated estrogen regimen. Therefore, an improvement is need in both the thickness and implantation ability of the uterine endometrium. Evidence suggests that prostaglandins (PG) play an important role in reproductive processes that include ovulation, implantation and menstruation. 4,5 A recent publication regarding the role of PG 6 found that patients with repeated in vitro fertilization (IVF) failure had very low levels of cytosolic phospholipase A 2, which is the rate-limiting enzyme in PG synthesis, and cyclooxygenase (COX)-2, possibly reducing the function of PG synthesis. The authors concluded that PG synthesis appears to be disrupted in patients with repeated IVF failure and they suggested that reduced PG synthesis in the human endometrium may lead to poor endometrial receptivity. Therefore, for the endometrial condition where reduced PG synthesis is thought to be a serious disadvantage for embryo implantation, the addition of PG during the proliferative phase may improve the implantation ability of the uterine endometrium. The purpose of the present study was to determine whether adding PG during the proliferative phase could improve the chance of successful embryo implantation because of the known role of PG in enhancing implantation. Methods From September 2010 through March 2012, we recruited patients (n = 135) who had undergone oocyte retrieval during a stimulation cycle with clomiphene and who had been forced to defer fresh ET due to a thin uterine endometrium. All patients were less than 40 years of age and had undergone thawed ET following all embryo cryopreservation. The patients were randomly divided into two groups for thawed ET using a conventional hormone replacement cycle (HRC) with or without PG derivatives (PG or conventional group). PG derivatives were administrated during the proliferative phase. Pregnancy and implantation rates following frozen ET were compared between the two groups. Patients and ovarian stimulation for oocyte retrieval (OPU) and patients conditions From September 2010 through March 2012, a total of 135 treatment cycles among 135 women who had undergone ART treatment at the Sugiyama Clinic were recruited for the present study. All patients were less than 40 years of age, and had been forced to defer ET due to a thin uterine endometrium on the day that fresh ET was available. Informed consent was obtained from them, and the institutional review board of the Sugiyama Clinic approved the study. All treatment cycles used our mild stimulation protocol with CC and recombinant-follicle stimulating hormone (rec-fsh). 1 Briefly, patients took 50 mg of clomiphene citrate (Serophen; Merck Serono, Tokyo, Japan) per day for 5 days between days 3 and 7 of the menstrual cycle, and 225 IU of rec-fsh (Gonal-F; Merck Serono) were administrated on days 3, 5 and 7 of the menstrual cycle. On day 9, when the dominant follicles reached 16 mm or more in diameter, IU of hcg (Gonatropin, Mochida, Tokyo) or 600 μg of buserelin acetate (Buserequr; Fuji-Pharma, Tokyo, Japan) was nasally administrated, and OPU was performed 35 h later. Additional rec-fsh (150 IU/day) was administrated as needed, based on follicular growth. When the patients showed an endometrial thickness of less than 8 mm on the day of ET (day 3) and acquired a morphologically good embryo (MGE) on day 3 (72 h after OPU), they avoided fresh ET and all MGE were cryopreserved on day 3. Subsequently, they received a thawed ET during a different cycle. Vitrification and warming methods Embryos were cryopreserved via the vitrification method and were warmed using two previously published steps. 7 All solutions used in both vitrification and warming are commercially available (Vitrification kit; KITAZATO BioPhama, Sizuoka, Japan). Two hours after thawing, the appearance of the embryos was examined using an inverted microscope at 400 magnification. Embryos meeting the following criteria were defined as morphologically good: The Authors
3 Prostaglandin therapy for thawed ET Figure 1 For the protocol of hormone replacement cycle (HRC), the uterine endometrium was prepared for embryo transfer (ET) using conjugated estrogens (Premarin mg) and transdermal estradiol (Estrana TAPE 0.72 mg). These treatments were administrated from the third day of the menstrual cycle (first day without bleeding) until the day of the pregnancy test. Administration of progesterone (100 mg in oil; Progestone Depot-S) was initiated on the 12th day of the menstrual cycle. Three days after the initiation of progesterone treatment, the embryos were warmed and those that had survived and met the criteria mentioned below were used in embryo transfer. developed to at least the seven-cell stage with less than 10% fragmentation after warming. 8 This system of embryo assessment was based on the classification system described by Veeck. 9 Embryos that failed to meet the criteria mentioned above were not transferred to the uterine cavity. Preparation of uterine endometrium and ET All patients who could acquire MGE on day 3 underwent ET in the HRC. The conventional protocol for HRC involved a uterine endometrium that was prepared for ET using conjugated estrogens (Premarin mg; Wyeth, Tokyo, Japan) and transdermal estradiol (Estrana TAPE 0.72 mg; Hisamitsu Pharmaceutical, Tokyo, Japan). These treatments were administrated from the third day of the menstrual cycle (first day without bleeding) until the day of the pregnancy test. The administration of progesterone (100 mg in oil; Progestone Depot-S; Fuji Pharmaceutical, Tokyo, Japan) was initiated on the 12th day of the menstrual cycle. Three days after the initiation of progesterone treatment, embryos were warmed and those that had survived and met the criteria mentioned below were used for ET. 8 All patients underwent thawed ET within the HRC with or without misoprostol, and they were randomized on the starting day of the HRC to one of the following two groups by a simple randomization method using the patient s identification number as follows: patients were assigned to the treatment groups when their identification number was odd, and to the control groups when it was even. The conventional protocol of the HRC (conventional group) is mentioned above, but the HRC with misoprostol, which is a PGE1 derivative, was defined as the PG-HRC protocol (PG group).the PG-HRC protocol was the same as the conventional HRC protocol except for the use of misoprostol, which is summarized in Figure 1. Briefly, on the day that the use of conjugated estrogens was begun, patients started to receive 200 μg of misoprostol (Cytotec; Kaken Phamaceutical, Tokyo, Japan) divided into two equal doses 12 h apart until the administration of progesterone (for 11 days). The conjugated estrogens and transdermal estradiol were administrated in the same manner as the conventional HRC protocol. Administration of progesterone (100 mg in oil; Progestone Depot-S, Fuji Pharmaceutical) was initiated on the 12th day of the menstrual cycle. Three days after the initiation of progesterone treatment, embryos were warmed and those that had survived and met the criteria mentioned above were used in ET. 8 Embryos were replaced into a patient s uterus transcervically using a soft catheter (Kitazato ET catheter; Kitazato Supply, Shizuoka, Japan). In all patients, either one or two embryos were transferred. 10 Assessment and data analysis A pregnancy was recognized when the development of a gestational sac was detected by transvaginal ultrasound imaging on the 21st day after the day of ET. The endometrial thickness on the day of ET, difference of endometrial thickness between on the ET cancellation day and the day of ET, pregnancy rate and implantation rate were compared between the conventional and PG groups. Statistical analysis was performed using an unpaired Student s t-test and a χ 2 -test. Statistical significance was set at P < The Authors 1333
4 K. Nakagawa et al. Table 1 Backgrounds of patients in prostaglandin and conventional groups Prostaglandin group Conventional group No. of patients No. of ET cycles Age* 38.4 ± ± 2.6 Endometrial thickness on the ET 7.1 ± ± 1.1 cancellation day* No. of transferred embryos (mean) Period between the last CC treatment and the day of embryo transfer* 54.4 ± ± 18.6 *Values were mean ± standard deviation. CC, clomiphene citrate; ET, embryo transfer. Figure 2 (a) The endometrial thicknesses on the day of embryo transfer (ET) in the prostaglandin and conventional groups were 10.0 and 9.8 mm, respectively. (b) The change of endometrial thicknesses between the ET cancellation day and the day of ET in the prostaglandin and conventional groups were +3.0 and +2.8 mm, respectively, and there was no significant difference between the groups. Results Sixty-seven patients underwent thawed ET using PG-HRC (PG group) and 68 used conventional HRC (conventional group). The backgrounds of patients in both groups are summarized in Table 1. The average age (years) of the patients in the PG group was 38.4 ± 4.1, and it was similar to that in the conventional group (39.0 ± 2.6). Endometrial thicknesses on the ET cancellation day in the PG and conventional groups were 7.1 ± 1.1 and 6.5 ± 1.1 mm, respectively, and there were no significant differences. The endometrial thicknesses on the day of ET for the PG and conventional groups were 10.0 and 9.8 mm, respectively (Fig. 2a), and the changes in endometrial thicknesses between the ET cancellation day and the day of ET in the PG and conventional groups were +3.0 and +2.8 mm, respectively, and there were no significant differences between the groups (Fig. 2b). The pregnancy rate in the PG group was 40.0% which was significantly higher than that in the conventional group (25.0%, P < 0.01) (Fig. 3a). The implantation rate in the PG group (22.0%) was also significantly higher Figure 3 (a) The pregnancy rate in the prostaglandin group was 40.0%, which was significantly higher than that in the conventional group (25.0%, P < 0.01). (b) The implantation rate in the prostaglandin group (22.0%) was also significantly higher than that in the conventional group (13.0%, P < 0.01). than that in the conventional group (13.0%, P < 0.01) (Fig. 3b). The miscarriage rates for the PG and conventional groups were 25.1% and 28.6%, respectively, and there were no significant differences. Twelve patients (17.9%) of the PG group experienced side-effects from misoprostol that included either lower abdominal pain (including abdominal distension), nausea or discomfort in the stomach, but these were not severe and none of the patients stopped taking misoprostol due to these symptoms. Discussion Endometrial thickness on the day of ET is a good predictor of success for ART treatment, and the pregnancy and implantation rates for the patients who showed an endometrial thickness of between 7.1 and 14 mm were significantly higher than those of patients who showed a thin endometrium (<7 mm). 11 Therefore, the patients The Authors
5 Prostaglandin therapy for thawed ET who showed a thin endometrium (<7 mm) on the day of ET deferred fresh ET. Cryopreservation was used for all embryos, and these patients had to undergo thawed ET in the following HRC with a graduated rising dose of estradiol. Recently, an interesting paper was published regarding pregnancy rates following frozen ET. 3 The authors of that paper compared the pregnancy rates following frozen ET based on the reasons for deferring fresh ET. In these cases, all embryos were cryopreserved due to the risk of OHSS or if there was inadequate endometrial thickness. In that report, the clinical and live delivered pregnancy rates were 42.8% and 31.9%, respectively, for women who deferred based on the risk of OHSS, and the rates for women who deferred due to inadequate endometrial thickness were significantly lower (28.7% and 21.8%, P < 0.05). The authors discussed why the women who deferred fresh ET due to thin uterine endometrium might have failed to attain adequate endometrial thickness despite a graduated estrogen regimen. According to their report, a particular group of patients following frozen ET from their OPU cycles had a lessened chance of pregnancy; therefore, that study provided the basis for choosing a comparison study group for the present study. In the present study, the endometrial thickness on the day of ET in the conventional group was improved only by the administration of estrogen and the change in endometrial thickness between the ET cancellation day and the day of ET in the conventional group was +2.8 mm. These data show that the condition of the uterine endometrium may be easily reversed by the graduated administration of estrogen. However, the pregnancy rate in the conventional group was significantly lower, which raised the question of why this low pregnancy rate occurred despite an improvement in endometrial thickness by graduated estrogen administration. We speculated that something had decreased the uterine receptivity because all patients had been stimulated with CC and rec-fsh in the previous cycle, and the CC might have caused the poor endometrial receptivity. Therefore, a solution to this problem is needed. The relationship between PG and the uterine endometrium has been studied for more than 20 years. PG dehydrogenase, which inactivates PG, plays a key role in controlling the effective local concentration of PG and is found in the human endometrium at high levels in the secretory phase of the menstrual cycle, but it is absent during the proliferative phase. 12 PG dehydrogenase is a critical enzyme in maintaining low PG levels within tissues. In the uterus, the enzyme is present in the myometrium, 12 and it is present in the endometrium during the higher activity of the secretory phase of the menstrual cycle compared with the activity during the proliferative phase. 13 A demonstration that raised PG dehydrogenase levels during the secretory phase indicated that inactivation of PG prevented myometrium contraction via PGE2. By contrast, a decrease in PG dehydrogenase levels in the endometrium during the proliferative phase maintained a high concentration of PG in the uterine endometrium, and contributed to a thickening of the uterine endometrium. However, Kelly and coworkers examined the PG dehydrogenase activity in the human endometrium from women who had been treated with CC at an early stage of the menstrual cycle, and they found high levels of PG dehydrogenase activity in the proliferative phase rather than in the secretory phase. 14 These results indicated that PG were lower in the proliferative phase than in the secretory phase. The PG, and particularly PGE2, may have an important role in developing the uterine endometrium, and subsequently in the development endometrial thickness. Recently, Achache and co-workers published interesting data. 6 According to their report, PG synthesis in the secretory endometrium appeared to be disrupted in patients with repeated IVF failure compared with fertile women, and they suggested that reduced PG synthesis, in particular PGE2, in the human endometrium may lead to poor endometrial receptivity. Therefore, PGE2 also plays an important role in the secretory phase, and a decrease in the PGE2 level must be avoided wherever possible. CC has induced low PG levels via a decrease in PG hydrogenase, and this adverse effect could remain in effect for the following cycles, so that addition of PGE1 during the proliferative phase may correct the PG levels, and, consequently, improve the pregnancy rate. Moreover, a report by Check et al. indicated that patients who took 81 mg of aspirin daily beginning on day 2 of the frozen ET cycle for 3 weeks showed significant lower pregnancy and implantation rates compared with patients who received no aspirin. 15 According to these reports, a decrease in PG levels in the uterine endometrium resulted in lower rates of pregnancy, even though in frozen ET cycles, the administration of PG may be a solution. There was a very interesting report concerning the characteristics of clomiphene citrate. This report 2014 The Authors 1335
6 K. Nakagawa et al. mentioned that clomiphene, possessing aspects as a weak estrogen and as an anti-estrogen, was a very potent PG synthesis inhibitor, being equal in this parameter to indomethacin. 16 From this report, CC acted as a PG synthesis inhibitor and raised PG dehydrogenase concentration in the human endometrium. Moreover, it is well known that the use of non-steroidal anti-inflammatory drugs (NSAIDs) inhibit both COX-1 and COX-2. COX-1 is responsible for the constitutive levels of PG, whereas COX-2 produces PG with proper stimulation. 17 Therefore, NSAIDs inhibit the downstream signaling pathways of PG, which impairs angiogenesis and cell adhesions, and consequently impairs embryo attachment to the uterine endometrium. The use of CC is also bad for implantation, and this effect may be retained. In the present study, we attempted to use PG derivatives for the groups who had limited use of frozen ET following a clomiphene controlled ovarian hyperstimulation (COH) protocol, but these products may only improve pregnancy rates following IVF-ET fresh cycles, with no improvement to the pregnancy rates following frozen ET cycles for embryos derived from COH without using CC, because some of the patients experienced recurrent implantation failure in ART treatment due to impaired PG levels in their uterine endometrium. 6 Several PG products are available in Japan such as alprostadil (PGE1) for the treatment of peripheral arterial occlusive diseases, or misoprostol (PGE1) for gastric ulcers or dinoprost (PGF2α) and dinoprostone betadex (PGE2) for the inducement of labor. Alprostadil is taken by i.v. injection and is expensive, which makes it difficult for patients to use, and dinoprost and dinoprostone betadex induce uterine contraction, and subsequently induce lower abdominal pain, which also makes this difficult for infertile patients to use. Misoprostol has a low price, and minimal side-effects. Of course, PGE2 products may be better theoretically, but we decided to use misoprostol as a PG product because it was regarded as safe (less burdensome than the use of PGE2 products), which is important. In conclusion, the patients who were forced to defer fresh ET cycles due to thin endometrium were treated with CC in ovarian stimulation, which improved the thickness of the uterine endometrium following a HRC that used the graduated administration of estrogen. However, the pregnancy rates following a thawed cycle were low. These lower pregnancy rates were improved when thawed ET was undergone in the HRC after the administration of PG derivatives during the proliferative phase. Acknowledgments The authors would like to thank Dr Toshifumi Takahashi (Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine) for his comments and advice, and the authors received no financial support. References 1. Nakagawa K, Nishi Y, Sugiyama R et al. A programmed schedule of oocyte retrieval using mild ovarian stimulation (clomiphene citrate and recombinant follicular stimulating hormone). Reprod Med Biol 2012; 11: Sugiyama R, Nakagawa K, Nishi Y, Sugiyama R, Ezaki K, Inoue M. The dilemma faced by patients who undergo single embryo transfer. Reprod Med Biol 2009; 8: Check LH, Choe JK, Brasile D, Cohen R, HOrwath D. Comparison of pregnancy rates following frozen embryo transfer according to the reason for freezing: Risk of ovarian hyperstimulationvs inadequate undometrial thickness. Clin Exp Obstet Gynecol 2012; 39: Jabbour HN, Sales KJ. Prostaglandin receptor signaling and function in human endometrial pathology. Trends Endocrinol Metab 2004; 15: Kang J, Chapdelaine P, Parent J, Madore E, Laberge PY, Fortier MA. Expression of human prostaglandin transporter in the human endometrium across the menstrual cycle. J Clin Endocrinol Metab 2005; 90: Achache H, Tsafrir A, Prus D, Reich R, Revel A. Defective endometrial prostaglandin synthesisidentified in patients with repeated implantationfailure undergoing in vitro fertilization. Fertil Steril 2010; 94: Sugiyama R, Nakagawa K, Shirai A et al. Clinical outcomes of resulting from transfer of vitrified human embryos using a new device for cryopreservation (plastic blade). J Assist Reprod Genet 2010; 27: Nakagawa K, Takahashi C, Nishi Y et al. Hyaluronanenriched transfer medium improves outcome in patients with multiple embryo transfer failures. J Assist Reprod Genet 2012; 29: Veeck LL. Atlas of the Human Oocyte and Early Conceptus. 2, Baltimore, MD: Williams & Wilkins Co, Nakagawa K, Nishi Y, Sugiyama R, Kuribayashi Y, Sugiyama R, Inoue M. Elective single cleavage-stage embryo transfer need not result in lower pregnancy ratescompared to double cleavage-stage embryo transfer. J Obstet Gynocol Res 2010; 36: Amir W, Micha B, Ariel H, Liat L-G, Jehoshua D, Adrian S. Predicting factors for endometrial thickness during treatment with assisted reproductive technology. Fertil Steril 2007; 87: Casey ML, Hemsell DL, Johnston JM, Madonald PC. NAD dependent 15-hydroxyprostadlandin dehydrogenase activity in human endometrium. Prostaglandins 1980; 19: The Authors
7 Prostaglandin therapy for thawed ET 13. Abel MH, Kelly RW. Metabolism of prostaglandins by the non-pregnant human uterus. J Clin Endocrinol Metab 1983; 56: Kelly RW, Linan C, Thong J, Young EL, Baird DT. Prostaglandin inactivation is increased in endometrium after exposure to clomiphene. Prostaglandins Leukot Essent Fatty Acids 1994; 50: Check JH, Dietterich C, Lurie D, Nazari A, Chuong J. A matched study to determine whether low-dose aspirin without heparin improves pregnancy rates following frozen embryo transfer and/or affects endometrial sonographic parameters. J Assit Reprod Genet 1998; 15: Lerner LJ, Carminati P, Schiatti P. Correlation if antiinflammatory activity with inhibition of prostagrlandin synthesis activity of nonsteroidal anti-estrogens and esrofgens (38532). Proc Soc Exp Biol Med 1975; 148: Morita I. Distinct functions ofcox-1 andcox-2. Prostaglandins Other Lipid Mediat 2002; 68 69: The Authors 1337
LOW RESPONDERS. Poor Ovarian Response, Por
LOW RESPONDERS Poor Ovarian Response, Por Patients with a low number of retrieved oocytes despite adequate ovarian stimulation during fertility treatment. Diagnosis Female About Low responders In patients
More informationA study of the effect of an extremely low oxygen concentration on the development of human embryos in assisted reproductive technology
Reprod Med Biol (2010) 9:163 168 DOI 10.1007/s12522-010-0052-7 ORIGINAL ARTICLE A study of the effect of an extremely low oxygen concentration on the development of human embryos in assisted reproductive
More informationA Tale of Three Hormones: hcg, Progesterone and AMH
A Tale of Three Hormones: hcg, Progesterone and AMH Download the Ferring AR ipad/iphone app from the Apple Store: http://bit.ly/1okk74m Interpreting Follicular Phase Progesterone Ernesto Bosch IVI Valencia,
More informationIVM in PCOS patients. Introduction (1) Introduction (2) Michael Grynberg René Frydman
IVM in PCOS patients Michael Grynberg René Frydman Department of Obstetrics and Gynecology A. Beclere Hospital, Clamart, France Maribor, Slovenia, 27-28 February 2009 Introduction (1) IVM could be a major
More informationINDICATIONS OF IVF/ICSI
PROCESS OF IVF/ICSI INDICATIONS OF IVF/ICSI IVF is most clearly indicated when infertility results from one or more causes having no other effective treatment; Tubal disease. In women with blocked fallopian
More informationEndometrial Preparation for Frozen Embryo Transfer (FET) Zitao Liu, MD, PhD New Hope Fertility Center, NY
Endometrial Preparation for Frozen Embryo Transfer (FET) Zitao Liu, MD, PhD New Hope Fertility Center, NY Natural Cycle FET Protocol for endometrial preparation N FET, including modified N FET HRT FET:
More informationPatient Information: Patient Name: Date of Birth:
Weill Cornell Medicine Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine Informed Consent for Oocyte (Egg) Cryopreservation Patient Information: Part 1: I have requested to be treated
More informationUW MEDICINE PATIENT EDUCATION. In Vitro Fertilization How to prepare and what to expect DRAFT
UW MEDICINE PATIENT EDUCATION In Vitro Fertilization How to prepare and what to expect This handout tells how to prepare for and what to expect when you go through a cycle of in vitro fertilization. It
More informationRecent Developments in Infertility Treatment
Recent Developments in Infertility Treatment John T. Queenan Jr., MD Professor, Dept. Of Ob/Gyn University of Rochester Medical Center Rochester, NY Disclosures I don t have financial interest or other
More informationIn Vitro Fertilization What to expect
Patient Education In Vitro Fertilization What to expect This handout describes how to prepare for and what to expect when you have in vitro fertilization. It provides written information about this process,
More informationEmbryo Selection after IVF
Embryo Selection after IVF Embryo Selection after IVF Many of human embryos produced after in vitro fertilization carry abnormal chromosomes. Placing a chromosomally normal embryo (s) into a normal uterus
More informationIs it the seed or the soil? Arthur Leader, MD, FRCSC
The Physiological Limits of Ovarian Stimulation Is it the seed or the soil? Arthur Leader, MD, FRCSC Objectives 1. To consider how ovarian stimulation protocols work in IVF 2. To review the key events
More informationLUTEAL PHASE SUPPORT. Doç. Dr. Nafiye Yılmaz. Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi
LUTEAL PHASE SUPPORT Doç. Dr. Nafiye Yılmaz Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi TAJEV, 2014 1 ART & success *Live birth rate 2 Optimal luteal phase Etiology of luteal phase deficiency
More informationEstradiol Level on Day 2 and Day of Trigger: A Potential Predictor of the IVF-ET Success
DOI 10.1007/s13224-014-0515-6 ORIGINAL ARTICLE Estradiol Level on Day 2 and Day of Trigger: A Potential Predictor of the IVF-ET Success Prasad Sudha Kumar Yogesh Singhal Megha Sharma Shashi Received: 27
More informationHow to make the best use of the natural cycle for frozen-thawed embryo transfer?
How to make the best use of the natural cycle for frozen-thawed embryo transfer? Ariel Weissman, MD IVF Unit, Dep. Ob/Gyn Wolfson Medical Center, Holon Sackler Faculty of Medicine, Tel Aviv University
More informationInfertility treatment
In the name of God Infertility treatment Treatment options The optimal treatment is one that provide an acceptable success rate, has minimal risk and is costeffective. The treatment options are: 1- Ovulation
More informationIn Vitro Fertilization and Embryo Transfer
Acta Medica et Biologica Vol. 41, No.4, 171-176, 1993 The Influence of Low Ovarian Response on the Results of In Vitro Fertilization and Embryo Transfer Hirofumi HIRASAWA Department of Obstetrics and Gynecology,
More informationSonographic determination of a possible adverse effect of domiphene citrate on endometrial growth
Human Reproduction vol.5 no.6 pp.670-674, 1990 Sonographic determination of a possible adverse effect of domiphene citrate on endometrial growth Yael Gonen 1 and Robert F.Casper Division of Reproductive
More information(BMI)=18.0~24.9 kg/m 2 ;
33 10 Vol.33 No.10 2013 10 Oct. 2013 Reproduction & Contraception doi: 10.7669/j.issn.0253-357X.2013.10.0672 E-mail: randc_journal@163.com - ( 400013) : () GnRH-a - () : IVF- ET 233 A (I~II 102 ) B (III~IV
More informationIn Vitro Fertilization
Patient Education In Vitro Fertilization About the treatment This handout describes how to prepare for and what to expect when you have in vitro fertilization. It provides written information about this
More informationFRESH OR FROZEN EMBYOS WHAT IS THE LATEST EVIDENCE? DR. ASMA MOMANI CLEVELAND CLINIC, ANDROLOGY LAB TRAINEE 2018
FRESH OR FROZEN EMBYOS WHAT IS THE LATEST EVIDENCE? DR. ASMA MOMANI CLEVELAND CLINIC, ANDROLOGY LAB TRAINEE 2018 OBJECTIVES Hisory Indication of freezing embryos Slow freezing versus vitrification Advantages
More informationEffect of ovarian stimulation on oocyte quality and embryonic aneuploidy: a prospective, randomised controlled trial
FULL PROJECT TITLE: Effect of ovarian stimulation on oocyte quality and embryonic aneuploidy: a prospective, randomised controlled trial (STimulation Resulting in Embryonic Aneuploidy using Menopur (STREAM)
More informationFixed Schedule for in vitro Fertilization and Embryo Transfer: Comparison of Outcome between the Short and the Long Protocol
Yamanashi Med. J. 14(3), 77 ~ 82, 1999 Original Article Fixed Schedule for in vitro Fertilization and Embryo Transfer: Comparison of Outcome between the Short and the Long Protocol Tsuyoshi KASAI and Kazuhiko
More informationMedicine. Wei Yang, MMed, Tao Zhang, MMed, Zhou Li, PhD, Xinling Ren, PhD, Bo Huang, PhD, Guijin Zhu, MMed, Lei Jin, PhD. Observational Study
Observational Study Medicine Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst A retrospective
More informationHow to make the best use of the natural cycle for frozen-thawed embryo transfer?
How to make the best use of the natural cycle for frozen-thawed embryo transfer? Ariel Weissman, MD IVF Unit, Dep. Ob/Gyn Wolfson Medical Center, Holon Sackler Faculty of Medicine, Tel Aviv University
More informationEmbryo transfer and Luteal phase support
Embryo transfer and Luteal phase support PATCHARADA AMATYAKUL, M.D. DEPARTMENT OF OBSTETRICS AND GYNECOLOGY FACULTY OF MEDICINE NARESUAN UNIVERSITY Embryo Transfer http://www.regionalfertilityprogram.ca/program-embryotransfer.php
More informationAgonist versus antagonist in ICSI cycles: a randomized trial and cost effectiveness analysis Badrawi A, Zaki S, Al-Inany H, Ramzy A M, Hussein M
Agonist versus antagonist in ICSI cycles: a randomized trial and cost effectiveness analysis Badrawi A, Zaki S, Al-Inany H, Ramzy A M, Hussein M Record Status This is a critical abstract of an economic
More informationIn Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome
Original Article Effect of Laparoscopic Ovarian Drilling on Outcomes of In Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Maryam Eftekhar, M.D. 1, Razieh Deghani Firoozabadi,
More informationInternational Journal of Women s Health and Reproduction Sciences Vol. 6, No. 2, April 2018, ISSN
http://www.ijwhr.net Open Access doi 10.15296/ijwhr.2018.31 Original Article International Journal of Women s Health and Reproduction Sciences Vol. 6, No. 2, April 2018, 187 191 ISSN 2330-4456 Comparison
More informationMenstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists
Human Reproduction Vol.21, No.4 pp. 1012 1017, 2006 Advance Access publication December 8, 2005. doi:10.1093/humrep/dei415 Menstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists
More informationThe serum estradiol/oocyte ratio in patients with breast cancer undergoing ovarian stimulation with letrozole and gonadotropins
Original Article Obstet Gynecol Sci 2018;61(2):242-246 https://doi.org/10.5468/ogs.2018.61.2.242 pissn 2287-8572 eissn 2287-8580 The serum estradiol/oocyte ratio in patients with breast cancer undergoing
More informationWOMEN & INFANTS HOSPITAL Providence, RI CONSENT FOR THAWING AND TRANSFER OF CRYOPRESERVED EMBRYOS. I and
*40668* 40668 WOMEN & INFANTS HOSPITAL Providence, RI 02905 CONSENT FOR THAWING AND TRANSFER OF CRYOPRESERVED EMBRYOS FOR inpatients: affix patient label OR I and (Print Patient s name) (Print Partner
More informationArticle Minimal ovarian stimulation with clomiphene citrate: a large-scale retrospective study
RBMOnline - Vol 15. No 2. 2007 134-148 Reproductive BioMedicine Online; www.rbmonline.com/article/2711 on web 13 June 2007 Article Minimal ovarian stimulation with clomiphene citrate: a large-scale retrospective
More informationHana Park, Chung-Hoon Kim, Eun-Young Kim, Jei-Won Moon, Sung-Hoon Kim, Hee-Dong Chae, Byung-Moon Kang
Original Article Obstet Gynecol Sci 2015;58(6):481-486 http://dx.doi.org/10.5468/ogs.2015.58.6.481 pissn 2287-8572 eissn 2287-8580 Effect of second-line surgery on in vitro fertilization outcome in infertile
More informationInterpreting follicular Progesterone: Late follicular Progesterone to Estradiol ratio is not influenced by protocols or gonadotropins used
Interpreting follicular Progesterone: Late follicular Progesterone to Estradiol ratio is not influenced by protocols or gonadotropins used Ellenbogen A., M.D., Shalom-Paz E., M.D, Asalih N., M.D, Samara
More informationUse of clomiphene to prevent premature luteinizing hormone surge during controlled ovarian hyper stimulation
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Bhandari S et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jun;5(6):1944-1948 www.ijrcog.org pissn 2320-1770 eissn 2320-1789
More informationWOMEN & INFANTS HOSPITAL Providence, RI CONSENT FOR IVF WITH EMBRYO TRANSFER
*40639* 40639 WOMEN & INFANTS HOSPITAL Providence, RI 02905 CONSENT FOR IVF WITH EMBRYO TRANSFER I have requested treatment by the physicians and (Print Patient s name) staff of the Women & Infants Fertility
More informationPredictive factors of successful pregnancy after assisted reproductive technology in women aged 40 years and older
Reprod Med Biol (2009) 8:145 149 DOI 10.1007/s12522-009-0023-z ORIGINAL ARTICLE Predictive factors of successful pregnancy after assisted reproductive technology in women aged 40 years and older Akihisa
More informationIVF Protocols: Hyper & Hypo-Responders, Implantation
IVF Protocols: Hyper & Hypo-Responders, Implantation Midwest Reproductive Symposium June 4-5, 4 2010 Subset : Hyper-Responders Mark R. Bush, MD, FACOG, FACS OBJECTIVE: Important goals for the PCOS patient
More informationHonorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive FIGO s Distinguished Merit Award for Services towards women s health.
Prof.Duru Shah Founder President The PCOS Society (India) President Elect of the Indian Society for Assisted Reproduction (ISAR) Honorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive
More informationComparison of tamoxifen and clomiphene citrate for induction of ovulation in cases with thin endometrium
Original Article Comparison of tamoxifen and clomiphene citrate for induction of ovulation in cases with thin endometrium Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University
More informationPresident : Indian Society for Assisted Reproduction (ISAR) Past President FOGSI. Past Chairman ICOG. Founder Trustee Women s Empowerment Foundation
Founder President: The PCOS Society, India Honorary Fellow of the Royal College of Obst.& Gyn. Prof.Duru Shah President : Indian Society for Assisted Reproduction (ISAR) Past President FOGSI. Past Chairman
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal myomectomy in leiomyoma management, 77 Abnormal uterine bleeding (AUB) described, 103 105 normal menstrual bleeding vs., 104
More informationIncreased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization embryo transfer
Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization embryo transfer Xingqi Zhang, Ph.D., a Chi-Huang Chen, M.D., b Edmond
More informationPrinciples of Ovarian Stimulation
Principles of Ovarian Stimulation Dr Genia Rozen Gynaecologist and Fertility Specialist Royal Women s Hospital and Melbourne IVF Learning objectives Why ovarian stimulation Recap physiology Ovarian cycle
More informationLuteal phase rescue after GnRHa triggering Progesterone and Estradiol
Luteal phase rescue after GnRHa triggering Progesterone and Estradiol L. Engmann University of Connecticut Disclaimer Fertility Speaker Bureau Merck Pharmaceuticals Introduction GnRH agonist is effective
More informationI. ART PROCEDURES. A. In Vitro Fertilization (IVF)
DFW Fertility Associates ASSISTED REPRODUCTIVE TECHNOLOGY (ART) Welcome to DFW Fertility Associates/ Presbyterian-Harris Methodist Hospital ARTS program. This document provides an overview of treatment
More informationFertility care for women diagnosed with cancer
Saint Mary s Hospital Department of Reproductive Medicine Information for Patients Fertility care for women diagnosed with cancer Contents Page Overview... 2 Our service... 2 Effects of cancer treatment
More informationProgesterone and clinical outcomes
Synchronization of Slowly Developing Embryos Restores Implantation Success Richard T. Scott, Jr, MD, HCLD Clinical and Scientific Director, Reproductive Medicine Associates of New Jersey Professor and
More informationUtility of color Doppler indices of dominant follicular
Ultrasound Obstet Gynecol 2002; 20: 592 596 Utility of color Doppler indices of dominant follicular Blackwell Science, Ltd blood flow for prediction of clinical factors in in vitro fertilization-embryo
More informationFemale Reproductive Physiology. Dr Raelia Lew CREI, FRANZCOG, PhD, MMed, MBBS Fertility Specialist, Melbourne IVF
Female Reproductive Physiology Dr Raelia Lew CREI, FRANZCOG, PhD, MMed, MBBS Fertility Specialist, Melbourne IVF REFERENCE Lew, R, Natural History of ovarian function including assessment of ovarian reserve
More informationOriginal Article Impact of estrogen-to-oocyte ratio on live birth rate in women undergoing in vitro fertilization and embryo transfer
Int J Clin Exp Med 2015;8(7):11327-11331 www.ijcem.com /ISSN:1940-5901/IJCEM0008838 Original Article Impact of estrogen-to-oocyte ratio on live birth rate in women undergoing in vitro fertilization and
More information10.7 The Reproductive Hormones
10.7 The Reproductive Hormones December 10, 2013. Website survey?? QUESTION: Who is more complicated: men or women? The Female Reproductive System ovaries: produce gametes (eggs) produce estrogen (steroid
More informationDoes previous response to clomifene citrate influence the selection of gonadotropin dosage given in subsequent superovulation treatment cycles?
J Assist Reprod Genet (26) 23:427 431 DOI 1.17/s1815-6-965-x ASSISTED REPRODUCTION Does previous response to clomifene citrate influence the selection of gonadotropin dosage given in subsequent superovulation
More informationAre all-freeze cycles & frozen-thawed embryo transfers improving IVF outcomes?
Are all-freeze cycles & frozen-thawed embryo transfers improving IVF outcomes? Andrea Weghofer Foundation for Reproductive Medicine 2017 New York, November 16-19 Conflict of interest No relevant financial
More informationERA Endometrial Receptivity Analysis Operations Manual
ERA Endometrial Receptivity Analysis Operations Manual L_I_001_ERA_GHQ_EN_v1.0 Date of issue: 21 August 2017 Author: Alejandro Rincón Bertolín Authorized by: María Ruiz Alonso // Igenomix Quality Department
More informationInfluence ovarian stimulation on oocyte and embryo quality. Prof.Dr. Bart CJM Fauser
Influence ovarian stimulation on oocyte and embryo quality Prof.Dr. Bart CJM Fauser How to balance too much vs too little? Lecture Outline Context ovarian stimulation Impact ovarian stimulation on oocyte
More informationJMSCR Vol 06 Issue 09 Page September 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i9.53 Role of Anti-Mullerian Hormone
More informationUnderstanding Infertility, Evaluations, and Treatment Options
Understanding Infertility, Evaluations, and Treatment Options Arlene J. Morales, M.D., F.A.C.O.G. Fertility Specialists Medical Group, Inc. What We Will Cover Introduction What is infertility? Briefly
More informationWOMEN & INFANTS HOSPITAL Providence, RI CONSENT FOR IN VITRO FERTILIZATION USING A GESTATIONAL CARRIER (PATIENT/INTENDED PARENTS) 1.
*40675* 40675 MR-838 (9-2017) WOMEN & INFANTS HOSPITAL Providence, RI 02905 CONSENT FOR IN VITRO FERTILIZATION USING A GESTATIONAL CARRIER (PATIENT/INTENDED PARENTS) 1. I, and (Print Patient s name) (Print
More informationFrozen-thawed embryo transfer is associated with a significantly reduced incidence of ectopic pregnancy
ORIGINAL ARTICLES: EARLY PREGNANCY Frozen-thawed embryo transfer is associated with a significantly reduced incidence of ectopic pregnancy Bruce S. Shapiro, M.D., Ph.D., a,b Said T. Daneshmand, M.D., a,b
More information2013 Sep.; 24(3):
Journal of Reproduction & Contraception doi: 10.7669/j.issn.1001-7844.2013.03.0151 2013 Sep.; 24(3):151-158 E-mail: randc_journal@163.com Reducing the Trigger Dose of Human Chorionic Gonadotrophin Does
More informationAssisted Reproduction. By Dr. Afraa Mahjoob Al-Naddawi
Assisted Reproduction By Dr. Afraa Mahjoob Al-Naddawi Learning Objectives: By the end of this lecture, you will be able to: 1) Define assisted reproductive techniques (ART). 2) List indications for various
More informationUniversal Embryo Cryopreservation: Frozen versus Fresh Transfer. Zaher Merhi, M.D.
Universal Embryo Cryopreservation: Frozen versus Fresh Transfer Zaher Merhi, M.D. Disclosure: None Fewer complications with IVF 1.5% children in US are born through ART 1.1 million children since 2006
More informationFemale Reproductive System. Lesson 10
Female Reproductive System Lesson 10 Learning Goals 1. What are the five hormones involved in the female reproductive system? 2. Understand the four phases of the menstrual cycle. Human Reproductive System
More information1. During the follicular phase of the ovarian cycle, the hypothalamus releases GnRH.
1. During the follicular phase of the ovarian cycle, the hypothalamus releases GnRH. 2. This causes the anterior pituitary to secrete small quantities of FSH and LH. 3. At this time, the follicles in the
More informationEGG BANKS program at clinique ovo
EGG BANKS program at clinique ovo HISTORY The first pregnancy resulting from egg donation in an IVF cycle was in 1983 Egg donation plays an important role in assisted reproductive technologies since it
More informationLiyan Duan 1, Shihua Bao 1, Kunming Li 1, Xiaoming Teng 1, Ling Hong 1 and Xiaoyu Zhao 2. Abstract. Introduction
doi:10.1111/jog.13305 J. Obstet. Gynaecol. Res. Vol. 43, No. 6: 1037 1042, June 2017 Comparing the long-acting and short-acting forms of gonadotropin-releasing hormone agonists in the long protocol of
More informationFreeze-All Policy: Is It Right for Everyone?
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/online-education/non-certified-non-accredited/freeze-all-policy-it-righteveryone/9879/
More informationEgg donation in an in vitro fertilization program: an alternative approach to cycle synchronization and timing of embryo transfer
FERTILITY AND STERILITY Copyright tl 1989 The American Fertility Society Printed on acid-free paper in U. S.A. Egg donation in an in vitro fertilization program: an alternative approach to cycle synchronization
More informationBumiputera Sarawak Bumiputera Sabah. Others Foreigner. Had previous natural pregnancy Previous IVF pregnancies. IVF live births.
a. Date of notification: b. Name of reporting site: c.name of doctor in charge: AI : FEMALE PATIENT DETAILS & DEMOGRAPHICS (Instruction: if Mykad is not available, please complete Old IC or other ID document
More informationChapter 14 Reproduction Review Assignment
Date: Mark: _/45 Chapter 14 Reproduction Review Assignment Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Use the diagram above to answer the next question.
More informationPremature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles
Arch Gynecol Obstet (2010) 281:747 752 DOI 10.1007/s00404-009-1248-0 REPRODUCTIVE MEDICINE Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles Esra
More informationFertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr.
Dr. Shahin Ghadir A Primary Care Approach to Diagnosing and Treating Infertility St. Charles Bend Grand Rounds November 30, 2018 I have no conflicts of interest to disclose. + About SCRC State-of-the-art
More informationSchedule of Fees for Private Treatment
Schedule of Fees for Private Treatment Fertility Treatment is personalized to each individual and couple, based on diagnosis and best treatment options. At Fertility Plus, we are mindful of the costs involved
More informationBest practices of ASRM and ESHRE
Best practices of ASRM and ESHRE Late submission Cortina d Ampezzo, Italy 1-3 March 2012 A joint meeting between the American Society for Reproductive Medicine and the European Society of Human Reproduction
More informationPatricia T Jimenez 1*, Samantha B Schon 2, Randall R Odem 2, Valerie S Ratts 2 and Emily S Jungheim 2
Jimenez et al. Reproductive Biology and Endocrinology 2013, 11:35 RESEARCH Open Access A retrospective cross-sectional study: fresh cycle endometrial thickness is a sensitive predictor of inadequate endometrial
More informationWhich is the Best Protocol of Ovarian Stimulation Prior to Artificial Insemination by Donor
Journal of Reproduction & Contraception doi: 10.7669j.issn.1001-7844.2014.01.0041 2014 Mar.; 25(1):41-48 E-mail: randc_journal@163.com Which is the Best Protocol of Ovarian Stimulation Prior to Artificial
More informationMilder is better? Advantages and disadvantages of "mild" ovarian stimulation for human in vitro fertilization
Milder is better? Advantages and disadvantages of "mild" ovarian stimulation for human in vitro fertilization Revelli et al. Reproductive Biology and Endocrinology 2011, 9:25 Presenter: R2 孫怡虹 Background
More informationCauses of Infertility and Treatment Options
Causes of Infertility and Treatment Options Dr Mrs.Kiran D. Sekhar Former vice President-FOGSI Former Chairperson- Genetics and Foetal medicine-fogsi Founder and Medical Director-Kiran Infertility centre
More informationLink between effectiveness and cost data The costing was undertaken prospectively on the same patient sample that provided the effectiveness data.
Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-fsh vs. HPuFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis Revelli A, Poso F, Gennarelli
More information2015 Mar.; 26(1):
Journal of Reproduction & Contraception doi: 10.7669/j.issn.1001-7844.2015.01.0022 2015 Mar.; 26(1):22-30 E-mail: randc_journal@163.com Clinical outcomes of using three gonadatropins and medroxyprogestrone
More informationLaboratoires Genevirer Menotrophin IU 1.8.2
Important missing information VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Infertility is when a woman cannot get pregnant (conceive) despite having regular unprotected sexual
More informationObjective: To study the role of sildenafil on the echogenic pattern of endometrium in infertile patients with bad endometrium.
The effect of Sildenafil on endometrial characters in patients with infertility Ali F. Al-Assadi, F.I.C.O.G.,C.A.B.O.G.1. Sajeda A. Al-Rubaye, F.I.C.O.G.1 Zainab Laaiby, M.B.Ch.B.2 (1- Assist. Prof./Basra
More informationENDOCRINE CHARACTERISTICS OF ART CYCLES
ENDOCRINE CHARACTERISTICS OF ART CYCLES DOÇ. DR. SEBİHA ÖZDEMİR ÖZKAN KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, IVF UNIT 30.04.2014, ANTALYA INTRODUCTION The endocrine
More informationStudy on Several Factors Involved in IVF-ET of Human Beings
Study on Several Factors Involved in IVF-ET of Human Beings Lei X 1, Zhuoran W 1, Bin L 1, Huiming L 1, Hongxiu Z 1, Yajuan Z 1, Yingbo Q 1, Guixue Z 2 1 The First Clinical College of Harbin Medical University,
More informationDysfunctional Uterine Bleeding
Long term effects of PCOS Dysfunctional Uterine Bleeding Dr. Arulmozhi Ramarajan Church of South India Hospital, Bangalore Abnormal uterine bleeding Affects health-related QOL Causes social embarrasment
More information(1.,, ) (2.,,, )
33 11 Vol.33 No.11 2013 11 Nov. 2013 Reproduction & Contraception doi: 10.7669/j.issn.0253-357X.2013.11.0749 E-mail: randc_journal@163.com IVF-ET 1 2 1 1 1 1 1 (1. 510150) (2. 510150) : (COH) (premature
More informationNeil Goodman, MD, FACE
Initial Workup of Infertile Couple: Female Neil Goodman, MD, FACE Professor of Medicine Voluntary Faculty University of Miami Miller School of Medicine Scope of Infertility in the United States Affects
More informationRelation between the Number and Size of Follicles in Ovulation Induction and the Rate of Pregnancy
Relation between the Number and Size of Follicles in Ovulation Induction and the Rate of Pregnancy Aseel Mosa Jabber M.SC.G.O. The department of Obstetrics and Gynecology, Faculty of Medicine Thi-qar university
More informationIntroduction. Acta Medica Mediterranea, 2018, 34: 1765
Acta Medica Mediterranea, 2018, 34: 1765 THE STUDY OF NATURAL VERSUS HORMONE REPLACEMENT THERAPY CYCLES IN FROZEN EMBRYO TRANSFER IN INFERTILE COUPLES ON PREGNANCY OUTCOME: A DOUBLE BLIND RANDOMIZED CONTROL
More information5/5/2010. Infertility FINANCIAL DISCLOSURE. Infertility Definition. Objectives. Normal Human Fertility. Normal Menstrual Cycle
Infertility FINANCIAL DISCLOSURE I HAVE NO FINANCIAL INTEREST IN ANY OF THE PRODUCTS MENTIONED IN MY PRESENTATION Bryan K. Rone, M.D. University of Kentucky Obstetrics and Gynecology I AM RECEIVING COMPENSATION
More informationCURRICULUM VITAE. Guttenberg, NJ th Ave New York, NY B.S. Degree, Trinity College, Hartford, Ct.
Page 1 CURRICULUM VITAE ALTHEA M. O'SHAUGHNESSY, M.D., FACOG PLACE OF BIRTH: CITIZENSHIP: New York, N.Y. U.S.A. PERSONAL: Married: John Children: Sean Alison HOME ADDRESS: BUSINESS ADDRESS: 32 Lydia Drive
More informationPhases of the Ovarian Cycle
OVARIAN CYCLE An ovary contains many follicles, and each one contains an immature egg called an oocyte. A female is born with as many as 2 million follicles, but the number is reduced to 300,000 to 400,000
More informationInvestigation: The Human Menstrual Cycle Research Question: How do hormones control the menstrual cycle?
Investigation: The Human Menstrual Cycle Research Question: How do hormones control the menstrual cycle? Introduction: The menstrual cycle (changes within the uterus) is an approximately 28-day cycle that
More informationModule 3. Infertility: Protocols and Patient Management
Module 3 Infertility: Protocols and Patient Management Ann Scalia, BSN, RN, CNOR Manager Clinical Education Specialists Mary Vietzke, BSN, RN Senior Clinical Educational Specialist Walgreens Faculty Ann
More informationThe effect of adding oral oestradiol to progesterone as luteal phase support in ART cycles a randomized controlled study
Clinical research The effect of adding oral oestradiol to progesterone as luteal phase support in ART cycles a randomized controlled study Ashraf Moini 1,2, Shahrzad Zadeh Modarress 3, Elham Amirchaghmaghi
More informationUse of cetrorelix in combination with clomiphene citrate and gonadotrophins: a suitable approach to friendly IVF?
Human Reproduction Vol.17, No.8 pp. 2022 2026, 2002 Use of cetrorelix in combination with clomiphene citrate and gonadotrophins: a suitable approach to friendly IVF? J.B.Engel, M.Ludwig 1, R.Felberbaum,
More informationThrombosis during assisted reproduction. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology
Thrombosis during assisted reproduction Scott Nelson Muirhead Chair in Obstetrics & Gynaecology ART can be as safe as natural pregnancy!! What used to be the risk of thrombosis in ART!! We can use AMH
More information