Dr. Ernesto Bosch Instituto Valenciano de Infertilidad Valencia, Spain. Declared no potential conflict of interest
|
|
- Eunice Todd
- 6 years ago
- Views:
Transcription
1 Dr. Ernesto Bosch Instituto Valenciano de Infertilidad Valencia, Spain Declared no potential conflict of interest
2 Is there a role for LH in elderly patients? Dr. Ernesto Bosch Instituto Valenciano de Infertilidad. Valencia, Spain
3 Which is NOT the objetive? +
4 Which is NOT the objetive?
5 Objectives 1. To review the endocrinological features of the aging ovary 2. To understand the action of LH at the follicular level when given for COS and the potencial effect in older women 3. To analyse the current evidence-based knowledge on the use of LH in this population
6 Age of motherhood in EU
7 Age for IVF (IVI Valencia 2015)
8 Age for IVF (IVI Valencia 2015) 33% 24% 43% < >=40
9 Late Reproductive stage Hale et al,, et al. J Steroid Biochem Mol Biol 2014;142:
10 Ovarian aging Hale et al,, et al. J Steroid Biochem Mol Biol 2014;142:
11 LH (IU/L) FSH (IU/L) Ovarian aging Klein et al JCEM 1996;81:
12 24-Hour Mean Plasma Total Testosterone (ng/dl) Ovarian aging Total Testosterone Levels in Women Decrease with Age n = 33 r = 0.54; P< Age (Years) Zumoff, et al. JCEM 1995;80:
13 Quienes son las Ovarian pacientes aging con respuesta subóptima? n = 1423 Total testosterone 55% DHEAS 77% Free testosterone 49% Androstenedione 64% Davison et al (2005) JCEM 90:
14 Ovarian aging Estradiol Androstenodione Hours after r-fsh Hours after r-fsh Old Young Welt et al (2006) Hum Reprod;21:
15 Objectives 1. To review the endocrinological features of the aging ovary Subtle changes in menstrual cycle Decrease of primordial, non growing and antral follicle count Variable-increasing levels of FSH in the early follicular phase Normal LH levels Decreasing AMH and Inhibin-B levels. Decrease of basal androgen levels (Te, A, DHEAS) with normal SHBG Decreased A synthesis in response to rfsh stimulation Preserved E2 synthesis in response to rfsh stimulation
16 LH during folliculogenesis in the natural cycle SEarly follicular phase Induction of androgens production in the theca cells Increase in follicular recruitment Paracrine activity From intermediate follicular phase Expression of LH receptors in the granulosa Jeppesen et al., JCEM, 2012 Sustain of FSH-dependent granulosa activities, including aromatase induction and growth factors release (IGF-1, EGF etc ) Optimization of steroidogenesis
17 Impact of LH administration in COS for IVF 30 oocyte donors (< 35 yrs, normogonadotrophic) Long protocol: GnRH agonist + intranasal nafarelin rec FSH rec LH 75 0 FSH 300 FSH/LH 225/75 FSH/LH 150/150 Bosch, et al. Fertil Steril 2006;86:Suppl.2: S425
18 Impact of LH administration in COS for IVF Serum hormone determinations on day of hcg FSH 300 IU FSH/LH 225/75 IU FSH/LH 150/150 IU E2 (pg/ml) 2662 ± ± ±1339 NS P4 (ng/ml) 1.1 ± ± ±0.5 NS FSH (miu/ml) 13.4 ±4.5 a 8.6 ±4.1 b 7.5 ±1.3 b p (a > b) LH (miu/ml) 2.0 ± ± ±1.8 NS Te (ng/ml) 0.6 ± ± ±0.3 NS Δ4 (ng/ml) 2.7 ± ± ±1.1 NS DHEAS (µg/dl) 206 ± ± ±78 NS
19 Impact of LH administration in COS for IVF Follicular fluid hormone determinations LH E2 P4 Te Δ4 DHEAS
20 Impact of LH administration in COS for IVF Relationship between follicular esteroids levels and oocyte maturation Metaphase II Metaphase I GV p E2 (pg/ml) 165± 60 a 91 ± 79 b 175 ± 19 a 0.04 (a>b) P4 (ng/ml) 17.5 ± ± ± 15.1 NS LH (miu/ml) 1.4 ± ± ± 0.7 NS Te (ng/ml) 7.8 ± 6.2 b 21.6 ± 30.7 a 12.4 ± (a>b) A (ng/ml) 94.1 ± 54.1 b 302 ± 281 a 161 ± 5.7 < (a>b) DHEAS (µg/dl) 219 ± ± ± 10.6 NS
21 Impact of LH activity administration in COS for IVF Serum hormonal profile during stimulation Smitz et al (2007) Hum Reprod 22:
22 Impact of LH activity administration in COS for IVF Follicular fluid hormonal levels Smitz et al (2007) Hum Reprod 22:
23 Impact of LH activity administration in COS for IVF Ongoing pregnancy rate per started cycle transfer according to androgen levels FSH FSH+LH RR (95% CI) p Te 0.45 ng/ml 33.1 ( ) 44.4 ( ) 1.34 ( ) 0.06 Te >0.45 ng/ml 50.0 ( ) 40.0 ( ) 0.80 ( ) 0.28 DHEAS 156 mcg/l 32.4 ( ) 38.2 ( ) 1.18 ( ) 0.37 DHEAS >156 mcg/l 47.3 ( ) 43.4% ( ) 0.92 ( ) 0.63 Δ ng/ml 39.1 ( ) 46.0 ( ) 1.18 ( ) 0.30 Δ 4 >1.90 ng/ml 40.3 ( ) 47.9 ( ) 1.19 ( ) 0.35 Bosch et al (2011), ESHRE.
24 Objectives 2. To understand the action of LH at the follicular level when given for COS and the potencial effect in older women LH administration is related to higher E2, Te and A serum levels at the end of stimulation, and lower P LH administration is positively related in a dose dependent manner to follicular E2, Te and A levels LH administration may be beneficial for patients with low basal androgen levels
25 LH administration in the elderly patient Hill et al (2012) Fertil Steril 97:
26 LH administration in the elderly patient Study Age Protocol LH administration Marrs 2004 >=35 GnRH agonist long 150 UI from day 6 Humaidan 2004 >=35 GnRH agonist long Ratio 2:1 from day 8 Fábregues 2006 >=35 GnRH agonist long 150 UI from day 6 NyboeAndersen 2008 >=35 GnRH agonist long 75 UI from day 6 Barrenechea 2008 >=40 or POR Flare up 150 UI from day 7 Matorras GnRH agonist long 150 UI from day 6 Bosch Antagonist 75 UI from day 1
27 Previous cycle: OC (0.030 mg of etinyl-estradiol mg of drospirenone) FSH alone GnRH antag x18mm rfsh: 300 IU rlh: Ø FSH + LH GnRH antag x18mm rfsh: 225 IU rlh: 75 IU rfsh; 75 UI rlh; 75 UI Cetrorelix; 0.25 mg rcg; 6500 UI
28 35 E2 on day of hcg (pg/ml) P on day of hcg (ng/ml) FSH (n=172) FSH + LH (n=161) 1542 ± ± ± ± Nº of oocytes 11.3 ± ± Nº of Metaphase II (ICSI) 7.8 ± ± Fertilization rate 67.4 ± ± Nº of transferred embryos 1.9 ± ± OHSS 5.3 ( ) 7.0 ( ) P E2 on day of hcg (pg/ml) P on day of hcg (ng/ml) FSH (n=142) FSH + LH (n=150) 1388 ± ± ± ±0.38 < 0.01 Nº of oocytes 10.1 ± ± Nº of Metaphase II (ICSI) Fertilization rate Nº transferred embryos OHSS 5.0 ( ) 7.0 ± ± ± ± ± ± ( ) P Bosch et al (2011) Fertil Steril 95; ; ASRM 2008 General Program Price Paper Award
29 Implantation rate Ongoing Pregnancy rate per Randomized patient (ITT analysis) p=0.84 OR: 1.03 ( ) p=0.03 OR: 1.56 ( ) OR: 1.0 ( ); p=1.0 OR: 1.49 ( ); p= <= <= FSH alone FSH + LH Bosch et al (2011) Fertil Steril 95; ; ASRM 2008 General Program Price Paper Award
30 Bosch et al (2011) Fertil Steril 95; ; ASRM 2008 General Program Price Paper Award
31 Different findings when LH is started on day 6 Konnig et al. Hum Reprod 2013;
32 Different findings when LH is started on day 6 (n=120) (n=120) Vuong et al. Hum Reprod 2015;
33 Different findings when LH is started on day 6
34 Objectives 3. To analyse the current evidence-based knowledge on the use of LH in this population Conflicting results across the RCT published so far Different design among the studies In antagonist cycles: Beneficial effect when LH given from day 1 of stimulation while no impact when given from day 6. Possible role of OCP pretreatment
35 Take-home messages Women in their late reproductive stage are the most frequent group of patients undergoing IVF The aging ovary shows a different endocrine basal situation, but also a different response to rfsh, suggesting a thecal insufficiency LH administration enhances follicular steroid-genesis, increasing the synthesis of androgens for their later aromatization to estrogens This function seems to be beneficial for women > 35 undergoing COS for IVF. To achieve this improvement, LH should be administered form the first day of stimulation
36
Advanced age, poor responders and the role of LH supplementation. C. Alviggi University Federico II, Naples, Italy
Advanced age, poor responders and the role of LH supplementation C. Alviggi University Federico II, Naples, Italy LH serum level (IU/L) 20.0 15.0 10.0 5.0 0.0 LH levels during spontaneous and stimulated
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 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 Human Ovarian Steroidogenesis and Gonadotrophin Stimulation Johan
More informationRaoul Orvieto. The Chaim Sheba Medical Center Tel Hashomer, Israel. Declared no potential conflict of interest
Raoul Orvieto The Chaim Sheba Medical Center Tel Hashomer, Israel Declared no potential conflict of interest LH in antagonist cycles; is the story really written? Raoul Orvieto M.D. Israel Overview Role
More informationThe emergence of Personalized Medicine protocols for IVF.
Individualising IVF: Introduction to the POSEIDON Concept Introduction The emergence of Personalized Medicine protocols for IVF. Differences between patients: age, ovarian reserve, BMI or presence of ovarian
More informationPoor & Hyper responders: what is the best approach?
Poor & Hyper responders: what is the best approach? A. La Marca ObGyn Dept University of Modena and Reggio Emilia Italy Center for Reproductive Medicine University Hospital of Modena Italy Criteria used
More informationTreatment of Poor Responders
Treatment of Poor Responders Pathophysiology of Poor Responders Deficiency in systemic IGF 1 levels (Bahceci, 2007) Lower intra ovarian T levels Reduced FSH receptor expression (Cai, 2007) Bahceci, 2007,
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 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 informationLH activity administration during the
LH activity administration during the luteal-follicular transition Richard Fleming On behalf of the Luveris Pre-treatment group University of Glasgow Scotland Androgens have a Paracrine action in the Early
More informationSTIMULATION AND OVULATION TRIGGERING
STIMULATION AND OVULATION TRIGGERING Professor IOANNIS E. MESSINIS MD, PhD (Aberdeen, UK), FRCOG (UK) Department of Obs/Gynae University of Thessaly Larissa, GREECE DISCLOSURE Nothing to disclose Learning
More informationIntérêt de l hcg et induction de l ovulation. Christophe Blockeel, MD, PhD Centre for Reproductive Medicine, Brussels, Belgium
Intérêt de l hcg et induction de l ovulation Christophe Blockeel, MD, PhD Centre for Reproductive Medicine, Brussels, Belgium Conflict of interest The opinions expressed in this document are the opinions
More informationlbt lab tests t Conrolled Ovarian Hyperstimulation Dr Soheila Ansaripour
lbt lab tests t and Conrolled Ovarian Hyperstimulation Dr Soheila Ansaripour Research Instituteof Avicenna 4/23/2012 Why good prediction of poor response good prediction i of OHSS application appropriate
More informationIndividualized treatment based on ovarian reserve markers
Individualized treatment based on ovarian reserve markers Prof Dr. Nikolaos P. Polyzos M.D. PhD Professor and Medical Co- Director, Vrije Universiteit Brussel, UZ Brussel, Belgium Professor of Reproduc?ve
More informationIVF (,, ) : (HP-hMG) - (IVF- ET) : GnRH, HP-hMG (HP-hMG )57, (rfsh )140, (Gn)
34 11 Vol.34 No.11 2014 11 Nov. 2014 Reproduction & Contraception doi: 10.7669/j.issn.0253-3X.2014.11.0892 E-mail: randc_journal@163.com IVF ( 710003) : (H-hMG) - (IVF- ET) : GnRH H-hMG (H-hMG ) (rfsh
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 informationAMH CUT-OFF VALUES FOR PREDICTING OVARIAN RESPONSE IN IVF. Nguyễn Xuân Hợi, MD, PhD Hoàng Văn Hùng MsC, MD
AMH CUT-OFF VALUES FOR PREDICTING OVARIAN RESPONSE IN IVF Nguyễn Xuân Hợi, MD, PhD Hoàng Văn Hùng MsC, MD INTRODUCTION Ovarian stimulation is an important process in IVF treatment, aiming at obtain a number
More informationEffects of HCG and LH on ovarian stimulation. Are they bioequivalent?
Effects of HCG and LH on ovarian stimulation Are they bioequivalent? Know the type of gonadotrophin required to have enough oocytes of good quality to achieve a healthy child FSH MAXIMIZE EFFICIENCY MINIMIZE
More informationEvidence-based treatment of POR and POF. Ovarian Club X and CoGEN in Asia December 16-17, 2017 Hong Kong
Evidence-based treatment of POR and POF Norbert Gleicher, MD Medical Director and Chief Scientist, Center For Human Reproduction, New York, NY Presi d ent, Foundation For Reproductive Medicine, New York,
More information% Oocyte Donation Pregnancyes (days 3)
Ovulation induction in oocyte donors Roma- September 2007 Dr. José Remohí Dr. Carmen Rubio Dr. Amparo Mercader Dr. Pilar Alama Dr. Marco Melo Evolution of oocyte donation cycles 1500 1500 1000 58% 661
More informationRelevance of LH activity supplementation
Relevance of LH activity supplementation in ovulation induction Franco Lisi Servizio di Fisiopatologia della Riproduzione Clinica Villa Europa Roma, Italia Comprehension of the role of LH in follicular
More informationL8: Which POSEIDON groups may benefit of LH supplementation? C. Alviggi (Italy)
L8: Which POSEIDON groups may benefit of LH supplementation? C. Alviggi (Italy) LH in Poseidon Groups Agenda LH in natural and stimulated cycles LH in Group 1 Poseidon: The concept of hypo-response LH
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 informationDo aromatase inhibitors have a place in IVF?
Do aromatase inhibitors have a place in IVF? Roy Homburg Maccabi Medical Services and Barzilai Medical Centre, Ashkelon, Israel Antalya, September, 2009 Human Follicle Growth Primordial follicle 1 layer
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 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 informationClinical Study Clinical Effects of a Natural Extract of Urinary Human Menopausal Gonadotrophin in Normogonadotropic Infertile Patients
International Reproductive Medicine Volume 2013, Article ID 135258, 4 pages http://dx.doi.org/10.1155/2013/135258 Clinical Study Clinical Effects of a Natural Extract of Urinary Human Menopausal Gonadotrophin
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 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 informationAbstract. Introduction
RBMOnline - Vol 19. No 6. 2009 888 898 Reproductive BioMedicine Online; www.rbmonline.com/article/ 3981 on web 30 September 2009 Review Role of androgens in the treatment of patients with low ovarian response
More informationAndrogen supplementation in women with low functional ovarian reserve
Androgen supplementation in women with low functional ovarian reserve Norbert Gleicher, MD Medical Director and Chief Scientist, Center For Human Reproduction, New York, NY President, Foundation For Reproductive
More informationPersonalizing ovarian stimulation for IVF
Personalizing ovarian stimulation for IVF Biljana Popovic-Todorovic MD,PhD Centre for Reproductive Medicine UZ Brussel QuickTime and are needed to see this picture. Controlled ovarian stimulation for IVF/ICSI
More informationManish Banker. Declared receipt of grants; member of a company advisory board, board of director or similar group
Manish Banker Nova IVI Fertility Pulse Women's Hospital Gujarat, India Declared receipt of grants; member of a company advisory board, board of director or similar group The Indian point of view Manish
More informationInfertility Clinical Guideline
Infertility Clinical Guideline Ovarian Stimulation Guideline Purpose: To provide sufficient background regarding various ovarian stimulation protocols for In Vitro Fertilization cycles. Goal: To assist
More informationOptimizing the Management of the Poor Responder. Kaylen Silverberg, M.D. Texas Fertility Center Austin, Texas
Optimizing the Management of the Poor Responder Kaylen Silverberg, M.D. Texas Fertility Center Austin, Texas 2 Choices Donor Oocytes Break, eat, visit, enjoy weather Listen to lecture Argue, get grumpy,
More information1 (gonadotropin, Gn) -,, : - (IVF-ET); (COH); ; : R711.6 : A : X(2014)
34 10 Vol.34 No.10 2014 10 Oct. 2014 Reproduction & Contraception doi: 10.7669/j.issn.0253-357X.2014.10.0858 E-mail: randc_journal@163.com ( 200001) - : - (IVF-ET); (COH); ; : R711.6 : A : 0253-357X(2014)10-0858-07
More informationOvarian hyperstimulation syndrome (OHSS)
Ovarian hyperstimulation syndrome (OHSS) OHSS OHSS: exaggerated response to gonadotropins and hcg Characterized by: ovarian enlargement increased vascular permeability fluid accumulation in abdomen Associated
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 informationEndocrinology of the Female Reproductive Axis
Endocrinology of the Female Reproductive Axis girlontheriver.com Geralyn Lambert-Messerlian, PhD, FACB Professor Women and Infants Hospital Alpert Medical School at Brown University Women & Infants BROWN
More informationMinimal monitoring / Minimal stimulation as a means of increasing access to ART in developing countries
Minimal monitoring / Minimal stimulation as a means of increasing access to ART in developing countries Willem Ombelet Genk Institute for Fertility Technology Maribor, 27-02-09 Third World = overpopulation
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 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 informationHighly purified hmg versus recombinant FSH in ovarian hyperstimulation with GnRH antagonists a randomized study
Human Reproduction Vol.23, No.10 pp. 2346 2351, 2008 Advance Access publication on June 25, 2008 doi:10.1093/humrep/den220 Highly purified hmg versus recombinant FSH in ovarian hyperstimulation with GnRH
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 informationROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU)
ROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU) In 1935, Stein and Leventhal described 7 women with bilateral enlarged PCO, amenorrhea or irregular menses, infertility and masculinizing
More informationFactors influencing serum progesterone level on triggering day in stimulated in vitro fertilization cycles
ORIGINAL ARTICLE pissn 2233-8233 eissn 2233-8241 Clin Exp Reprod Med 2015;42(2):67-71 Factors influencing serum progesterone level on triggering day in stimulated in vitro fertilization cycles Ju Hee Park
More informationThe old IVF patient: An evidence based approach. Stratis Kolibianakis MD MSc PhD
The old IVF patient: An evidence based approach Stratis Kolibianakis MD MSc PhD Unit for Human Reproduction 1 st Dept Ob/Gyn Aristotle University of Thessaloniki No conflict of interest How old is old?
More informationMODULE 1: OVULATION INDUCTION IN NORMAL RESPONDERS, POOR RESPONDERS, AND HYPERRESPONDERS
MODULE 1: OVULATION INDUCTION IN NORMAL RESPONDERS, POOR RESPONDERS, AND HYPERRESPONDERS Contents OVULATION INDUCTION IN NORMAL RESPONDERS, POOR RESPONDERS, AND HYPERRESPONDERS Ovulation Induction.....................................................................
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 informationModified natural cycles: the Italian experience
CLINICA VALLE GIULIA, Rome Modified natural cycles: the Italian experience Filippo Maria Ubaldi M.D. M.Sc. Poor ovarian Response ESHRE Campus symposium Bologna 19-20 March 2010 Introduction Ovarian superovulation
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 informationCOMPARING AMH, AFC AND FSH FOR PREDICTING HIGH OVARIAN RESPONSE IN WOMEN UNDERGOING ANTAGONIST PROTOCOL
COMPARING AMH, AFC AND FSH FOR PREDICTING HIGH OVARIAN RESPONSE IN WOMEN UNDERGOING ANTAGONIST PROTOCOL Nguyen Xuan Hoi1, Nguyen Manh Ha2 1 National Obstetrics and Gynecology Hospital, 2Hanoi Medical Unviversity
More informationPrognosticating ovarian reserve by the new ovarian response prediction index
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Tak A et al. Int J Reprod Contracept Obstet Gynecol. 2018 Mar;7(3):1196-1200 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180917
More informationUse of in vitro maturation for fertility preservation
Use of in vitro maturation for fertility preservation G. Arroyo Servei de Medicina de la Reproducció Departament d Obstetrícia, Ginecologia i Reproducció INSTITUT UNIVERSITARI DEXEUS MEDICAL STRATEGY TO
More information(Predictive. value) Soheila Ansaripour Fellowship of infertility Ai Avicena Research In
Ovarian Rese erve Lab Tests In (Predictive IVF value) Soheila Ansaripour Fellowship of infertility Ai Avicena Research In nstitute t Case Presentation 29 y/o,primary inf 1.5yr, Hx of irregular menses (
More informationR-Recent Advance in Patient Friendly Protocol
R-Recent Advance in Patient Friendly Protocol Somjate Manipalviratn, M.D. Reproductive Endocrinologist and Infertility Specialist Clinical Director Superior A.R.T., Bangkok, Thailand Objective of ovarian
More informationHuanhuan Zhang 1,2, Yaping Chu 1, Ping Zhou 1, Xiaojin He 1, Qianhua Xu 1, Zhiguo Zhang 1, Yunxia Cao 1 and Zhaolian Wei 1*
Zhang et al. Reproductive Biology and Endocrinology (2016) 14:9 DOI 10.1186/s12958-016-0139-z RESEARCH Open Access Dehydroepiandrosterone plus climen supplementation shows better effects than dehydroepiandrosterone
More informationDipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche. Tecniche di sincronizzazione ovocitaria. La sincronizzazione follicolare
Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche Tecniche di sincronizzazione ovocitaria. La sincronizzazione follicolare Carlo Alviggi The rational of Follicular synchronization
More informationCase Questions. Polycystic Ovarian Syndrome: Treatment Goals and Options. Differential Diagnosis of Hyperandrogenic Anovulation
Polycystic Ovarian Syndrome: Treatment Goals and Options Marc Cornier, MD Division of Endocrinology, Metabolism and Diabetes Colorado Center for Health and Wellness University of Colorado School of Medicine
More informationClinical Study Comparison of IVF Outcomes between Minimal Stimulation and High-Dose Stimulation for Patients with Poor Ovarian Reserve
Hindawi Publishing Corporation International Journal of Reproductive Medicine Volume 2014, Article ID 581451, 5 pages http://dx.doi.org/10.1155/2014/581451 Clinical Study Comparison of IVF Outcomes between
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 informationMinimising IVF related mortality and morbidity. Scott Nelson Muirhead Professor in Obstetrics & Gynaecology
Minimising IVF related mortality and morbidity Scott Nelson Muirhead Professor in Obstetrics & Gynaecology We rarely say no - so what I will cover today VTE as an example of a modifiable IVF complication
More informationHormone Balance - Female Report SAMPLE. result graph based on Luteal Phase. result graph based on Luteal Phase
Patient Name: Patient DOB: Gender: Physician: Test Hormone Balance - Female Report SAMPLE Grote, Mary Jane Batch Number: B6437 2/16/1954 Accession Number: N52281 F Date Received: 2/3/2015 Any Lab Test
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 informationNGUYEN QUOC ANH. M.D., M.Sc. Tu Du Hospital Vietnam
NGUYEN QUOC ANH M.D., M.Sc. Tu Du Hospital Vietnam FULLY AUTOMATED AMH TESTING OF OVARIAN RESPONSE IN IVF NGUYỄN QUỐC ANH MD. Infertility dep. Tudu hospital Index What is AMH? Standard AMH testing Fully
More informationResults and Discussion
The AMH and Inhibin B in serum and follicular fluid was a very good predictive marker for assessment of oocyte quantity but did not correlate with the maturity of the oocyte or fertilization or reproductive
More informationBiomarkers for Prediction of Pregnancy Outcome in Fertility Patients. Scott Nelson Muirhead Chair in Obstetrics & Gynaecology
Biomarkers for Prediction of Pregnancy Outcome in Fertility Patients Scott Nelson Muirhead Chair in Obstetrics & Gynaecology Why do we need to know ovarian response? Anna Sarah Just do IVF and see response
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 informationDoes triggering ovulation by 5000 IU of uhcg affect ICSI outcome? *
Middle East Fertility Society Journal Vol. 11, No. 2, 2006 Copyright Middle East Fertility Society Does triggering ovulation by 5000 IU of uhcg affect ICSI outcome? * Amany A.M. Shaltout, M.D. Mohamed
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 informationResearch Article. Jayakrishnan Krishnakumar 1, Akansha Agarwal 1, Divya Nambiar 1, Shankar Radhakrishnan 2 *
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Krishnakumar J et al. Int J Reprod Contracept Obstet Gynecol. 2016 Aug;5(8):2762-2767 www.ijrcog.org pissn 2320-1770 eissn
More informationL6: DuoStim: the alternative of oocytes/embryos accumulation programs Carlo Alviggi
L6: DuoStim: the alternative of oocytes/embryos accumulation programs Carlo Alviggi Italy What is the aim of IVF? What is the measure of success in IVF? Cumulative live birth rate per started cycle Live
More informationComparison of serum and follicular fluid hormone levels with recombinant and urinary human chorionic gonadotropin during in vitro fertilization
Comparison of serum and follicular fluid hormone levels with recombinant and urinary human chorionic gonadotropin during in vitro fertilization Peter Kovacs, M.D., a Timea Kovats, M.D., a Artur Bernard,
More informationOverview of Reproductive Endocrinology
Overview of Reproductive Endocrinology I have no conflicts of interest to report. Maria Yialamas, MD Female Hypothalamic--Gonadal Axis 15 4 Hormone Secretion in the Normal Menstrual Cycle LH FSH E2, Progesterone,
More informationSample size a Main finding b Main limitations
1 Table 1. Available studies on the relation between endometriosis and miscarriage (1995-2015). Study (citation) Country Study period Study design Sample size a Main finding b Main limitations Matoras
More informationProf. Antonio Pellicer
Improving outcomes in ART : Time-lapse technology for monitoring COS and blastocyst culture Prof. Antonio Pellicer Instituto Valenciano de Infertilidad (IVI) University of Valencia apellicer@ivi.es www.ivi.es
More informationwww.iffs-reproduction.org @IntFertilitySoc Int@FedFertilitySoc Aims of male and female work-up To decide whether IVF is the right treatment To prepare the couple for IVF To predict response to stimulation
More informationThe impact of HMG on follicular fluid hormone levels, embryo quality and IVF outcome
Eastern Journal of Medicine 19 (2014) 22-27 Original Article The impact of HMG on follicular fluid hormone levels, embryo quality and IVF outcome Gokce Anik Ilhan a,*, Gozde Erkanli Senturk a, Ozgur Oktem
More informationReproductive Health and Pituitary Disease
Reproductive Health and Pituitary Disease Janet F. McLaren, MD Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology jmclaren@uabmc.edu Objectives
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 informationThe intra-follicular molecular biology mandating advancement of egg retrieval in some women
The intra-follicular molecular biology mandating advancement of egg retrieval in some women David H. Barad, USA Director of Assisted Reproductive Technology, The Center for Human Reproduction New York
More informationHow to supplement hypo-androgenic women correctly
How to supplement hypo-androgenic women correctly Norbert Gleicher, MD Medical Director and Chief Scientist, Center For Human Reproduction, New York, NY President, Foundation For Reproductive Medicine,
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 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 informationDoes PCOS Compromise the oocyte and embryo quality or the endometrium?
Does PCOS Compromise the oocyte and embryo quality or the endometrium? Richard S. Legro, M.D., Penn State College of Medicine, Dept of Ob/Gyn, Hershey, PA, USA Disclosures Consultant: Bayer, Ogeda (Euroscreen),
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/25877
More informationReproductive FSH. Analyte Information
Reproductive FSH Analyte Information 1 Follicle-stimulating hormone Introduction Follicle-stimulating hormone (FSH, also known as follitropin) is a glycoprotein hormone secreted by the anterior pituitary
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 informationReproductive System. Testes. Accessory reproductive organs. gametogenesis hormones. Reproductive tract & Glands
Reproductive System Testes gametogenesis hormones Accessory reproductive organs Reproductive tract & Glands transport gametes provide nourishment for gametes Hormonal regulation in men Hypothalamus - puberty
More informationA multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of
A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of Endometrioma and deep infiltrating endometriosis Professor C. Chapron and the Group
More informationFERTILITY PRESERVATION IN BREAST CANCER PATIENTS: FOLLICULAR BIOMARKERS IN LETROZOLE ASSOCIATED OVARIAN HYPERSTIMULATION
FERTILITY PRESERVATION IN BREAST CANCER PATIENTS: FOLLICULAR BIOMARKERS IN LETROZOLE ASSOCIATED OVARIAN HYPERSTIMULATION Ornit GOLDRAT Research Laboratory in Human Reproduction, Fertility Clinic, Department
More informationS.Fisher 1,3, A.Grin 2, A.Paltoo 2 and H.M.Shapiro 2
Human Reproduction Vol.20, No.1 pp. 84 88, 2005 Advance Access publication October 15, 2004 doi:10.1093/humrep/deh543 Falling estradiol levels as a result of intentional reduction in gonadotrophin dose
More informationLOW 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 informationArticle Luteal hormonal profile of oocyte donors stimulated with a GnRH antagonist compared with natural cycles
RBMOnline - Vol 13. No 3. 2006 326 330 Reproductive BioMedicine Online; www.rbmonline.com/article/1911 on web 13 June 2006 Article Luteal hormonal profile of oocyte donors stimulated with a GnRH antagonist
More informationAndrogen priming using aromatase inhibitor and hcg during early-follicular-phase GnRH antagonist down-regulation in modified antagonist protocols
Human Reproduction Vol.21, No.10 pp. 2593 2600, 2006 Advance Access publication June 19, 2006. doi:10.1093/humrep/del221 Androgen priming using aromatase inhibitor and hcg during early-follicular-phase
More informationSummary
Summary 118 This thesis is focused on the background of elevated levels of FSH in the early follicular phase of women with regular menstrual cycles. In the introduction (chapter 1) we describe the characteristics
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 informationRBMOnline - Vol 15. No Reproductive BioMedicine Online; on web 15 August 2007
RBMOnline - Vol 15. No 4. 2007 468-477 Reproductive BioMedicine Online; www.rbmonline.com/article/3039 on web 15 August 2007 This review summarizes a series of lectures given at a recent Continuing Medical
More informationAchieving Pregnancy: Obesity and Infertility. Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center
Achieving Pregnancy: Obesity and Infertility Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center Disclosures Speakers Bureau EMD Serono Board of Directors Nurse
More information