Chorionic Gonadotropin Administration Research Articles

Estradiol (E 2) Reduction Adversely Affect the Embryo Quality and Clinical Outcomes of In Vitro Fertilization and Embryo transfer (IVF-ET).

Objective The purpose of this study was to explore the influence of decreased serum estradiol (E2) levels during controlled ovarian hyperstimulation (COH) on in vitro fertilization and embryo transfer (IVF). Methods The clinical data of 300 IVF-ET cycles with patients were analyzed retrospectively. According to the presence of falling E2 level during the COH, we divided all subjects into two groups: the E2 levels fall group (n = 120, group A) and the control group (n = 180, group B). In group A, there were 57 patients with falling E2 with drug dosage reduction. The other 63 patients experienced the decreased E2 level spontaneously. The clinical and laboratory variables in the groups were compared. Receiver operator characteristic (ROC) curve analyses were carried out in order to evaluate the predict value of E2 level on the day of human chorionic gonadotropin (hCG) administration on IVF outcomes. Results Duration and total dosage of gonadotropin (Gn) used were statistically more in group A than in group B (P < 0.001). The high-quality embryo rate was significantly lower in group A (P = 0.048). Women in group A had lower clinical pregnancy rate (P = 0.029), live birth rate (P < 0.001), ongoing pregnancy rate (P = 0.001), and higher early abortion rates (P = 0.008) than group B. Women with spontaneously falling E2 group had a higher BMI index than those in the drug dosage reduction group (P = 0.001). More dosage and longer duration of Gn in spontaneously falling E2 group than in the drug dosage reduction group (P < 0.01). There were no differences in clinical outcomes between the two types of E2 decreased groups. Results from ROC showed an E2 level <1987.5 pg/ml on the hCG day might predict early abortion in this study. The sensitivity was 58.4% and the specificity was 78.9%. In addition, an E2 level >2020 pg/ml on the hCG day might be an index to predict live birth. The sensitivity was 57.0% and the specificity was 61.7%. Conclusions Reduction of E2 during COH might adversely affect the clinical pregnancy, early abortion, and ongoing pregnancy of IVF-ET.

Chorionic gonadotropin stimulates maternal hepatocyte proliferation during pregnancy

The liver increases its size during pregnancy to adapt to metabolic demand associated with pregnancy. Our previous study showed that proliferation of maternal hepatocytes are increased during pregnancy in mice and that estradiol (E2) is one of the candidate hormones responsible for maternal hepatocyte proliferation. Here, we discovered that chorionic gonadotropin (CG) induces maternal hepatocyte proliferation during pregnancy. CG administration was sufficient to stimulate hepatocyte proliferation in non-pregnant mice as well as in cell culture system. We conclude that CG stimulates proliferation in the early pregnancy of maternal hepatocytes. In contrast, estrogen stimulates hepatocyte proliferation in the late pregnancy.

P–309 Effectiveness of intrauterine infusion of platelet-rich plasma (PRP) vs. granulocyte colony-stimulating factor (G-CSF) in women with thin endometrium undergoing assisted reproduction

Abstract Study question To compare the effect of intrauterine infusion of platelet-rich plasma (PRP) and granulocyte colony-stimulating factor (G-CSF) on endometrial thickness, clinical pregnancy rate and live-birth rate. Summary answer According to our research, PRP-therapy has more positive results in pregnancy rates. Nevertheless, there is still limited data to answer all questions completely. What is known already Thin endometrium is defined as endometrium thickness &amp;lt;7 mm or &amp;lt; 8 mm on the day of human chorionic gonadotropin (HCG) administration, which negatively affects the onset of pregnancy during natural fertilization and in assisted reproduction. Endometrial thickness may impact pregnancy and live-birth rates in fresh and frozen IVF cycles but, currently, there is minimal evidence to support any specific protocol to significantly improve pregnancy outcomes in patients with thin endometrium. Therefore, we decided to compare effects of two methods: transvaginal intrauterine perfusion of G-CSF for infertile women with thin endometrium in IVF cycles and intrauterine infusion of PRP. Study design, size, duration We conducted a systematic review and meta-analysis by PRISMA checklist. PubMed, The Cochrane Library, ClinicalTrials.gov and Google Scholar were searched electronically until 2021 using key words: “G-CSF”, “PRP”, “endometrium”. We included published and unpublished randomized clinical trials (RCT) and non-randomized clinical trials in English which include min.10 patients. Participants/materials, setting, methods Participants: female infertile patients of reproductive age with thin endometrium (≤ 7 mm) in embryo transfer cycles. Exclusion criteria: history of any chromosomal or genetic abnormalities and hematological disorders. Outcomes – endometrial thickness, pregnancy and live-birth rates.Risk of bias assessment was held using The Cochrane Handbook and The Cochrane collaboration tools. RoB 2 tool was used for randomized trials and ROBINS-I tool for non-randomized trials. For quantitative synthesis RevMan 5.4 was used to conduct meta-analysis. Main results and the role of chance Literature search resulted in 144 potentially relevant publications initially (Google Scholar: 126, PubMed: 1, Clinicaltrials: 14, Cochrane: 3). These publications were checked for titles and abstracts, duplicates were removed and 7 publications were selected. After evaluating the selection criteria, 2 articles were excluded. As a result, 5 articles remained for qualitative and quantitative synthesis, including 2 randomized controlled trials (RCT), 2 retrospective cohort studies, and 1 prospective cohort study. 403 patients participated in selected studies (the PRP group included 205 patients, and the G-CSF group - 198 patients). The primary quantitative analysis (meta-analysis) is aimed at comparison of endometrial thickness in patients receiving PRP therapy and patients receiving G-CSF. Two RCTs were included in this meta-analysis. (RR = 1.07, 95% CI: 0.81 to 1.43, P = 0.63). The heterogeneity for this comparison was 0%. Consequently, both options are equally altered by the thickness of endometrium. The secondary analysis compared clinical pregnancy rates in patients receiving PRP therapy and G-CSF. 4 studies were eligible for this synthesis. (RR = 1.36, 95% Cl: 1.06 to 1.76, P = 0.02). The heterogeneity for this comparison was 55%. PRP was significantly more effective. Limitations, reasons for caution Firstly, only 5 publications were found for the entire time. There are not enough well-conducted studies for more accurate analysis. Secondly, according to risk of bias assessment most of included studies had moderate concerns. Finally, there is no sufficient data to judge about live-birth rates after both types of treatment. Wider implications of the findings: Thin endometrium negatively affects the onset of pregnancy in assisted reproduction.Based on our meta-analysis, PRP therapy has a considerable effect on pregnancy rates in patients with thin endometrium in comparison with G-CSF.Currently, there is minimal evidence to support any specific protocol for improving IVF outcomes in women with thin endometrium. Trial registration number PROSPERO 2020 CRD42020222075

Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

Oestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

Effect of progesterone on hCG day-to-basal progesterone ratio on live birth rate in long agonist fresh IVF/ICSI cycles: a 5-year, single-center study of more than 10,000 cycles

Objective To investigate whether the ratio of the serum progesterone level on the day of human chorionic gonadotrophin (hCG) administration to the basal serum progesterone level (PhCG/Pbasal) is a predictor of pregnancy outcome during in vitro fertilization (IVF). Methods A total of 12,708 cycles were performed in 9747 patients between 19 and 36 years of age who were undergoing controlled ovarian stimulation from October 2011 to July 2016 for their first or second attempts at IVF followed by fresh embryo transfer (ET). hCG was administered 36 h before oocyte retrieval to trigger final oocyte maturation. The serum progesterone level was measured on menstrual cycle days 2-4 (basal progesterone, Pbasal) and on the day of hCG administration (PhCG). PhCG/Pbasal was calculated. Live birth rates were compared among various ordinal PhCG/Pbasal intervals (< 0.5, 0.5–1.0, 1.0–1.5, 1.5–2.0, 2.0–2.5, > 2.5). Results The average age of the patients recruited was 29.9 years. The average basal progesterone level was 0.8 ng/ml, while the average progesterone level on the day of hCG administration was 0.9 ng/ml. The live birth rates (according to the abovementioned ordinal PhCG/Pbasal intervals) were 47.3, 49.9, 47.8, 46.3, 45.5 and 44.0%, respectively. The live birth rates were significantly higher for patients with PhCG/Pbasal between 0.5–1.0 (OR = 1.14, 95% CI, 1.02–1.27, p = .02). Conclusions PhCG/Pbasal between 0.5-1.0 predicts a higher live birth rate in IVF. Both PhCG/Pbasal and P on hCG day is less predictive value for predicting live birth rate.

141 Effect of combined treatment of melatonin and equine chorionic gonadotrophin on fresh semen quality of Beetal bucks during the non-breeding season

In the subtropics, bucks show seasonal breeding patterns, and their semen quality decreases during the non-breeding season. Therefore, breeders tend to improve bucks’ semen quality before the breeding season for higher conception rates. In the current study, we hypothesised that simultaneous administration of equine chorionic gonadotrophin (ECG) and melatonin would improve fresh semen quality in bucks before the breeding season. Nine Beetal bucks were randomly assigned (n=3 per treatment) to three treatments: control, melatonin, and melatonin + ECG. Melatonin implants (18 mg; BTC Lab) were placed subcutaneously at the base of the ear. Bucks in the melatonin + ECG treatment were administered ECG (400 IU; Syncro-Part, Ceva Santé Animale) intramuscularly on every fourth day until the end of the experiment. Control bucks were administered normal saline (400 IU; Otuska Pakistan) intramuscularly on every fourth day. Semen was collected twice per week using an artificial vagina (42°C) and immediately evaluated for volume, color, pH, and contaminants. Sperm concentration, motility and kinematics (curvilinear velocity, straight-line velocity, average path velocity, and amplitude of lateral head displacement), viability, DNA, and acrosomal and mitochondrial integrity were monitored using a computer-assisted semen analyzer (AndroVision, Minitube). Weekly concentrations of plasma testosterone and melatonin of all bucks were analysed using radioimmunoassay (Immunotech, Beckman Coulter Ltd.) and enzyme-linked immunosorbent assay (450nm), respectively. Comparisons within and between treatments were made using generalised linear models (repeated-measures analysis of variance). Weekly single-point variance between the treatments was determined (analysis of variance) at P ≤ 0.05 (SPSS ver. 20.0; IBM Corp.). Semen quality (volume, pH, total motility (%), and concentration) improved after Week 4 in the melatonin + ECG treatment compared with the control and melatonin treatments (P&amp;lt;0.05). Similarly, progressive motility (%), viability, DNA, acrosomal and mitochondrial integrity, and sperm kinematics (curvilinear velocity, straight-line velocity, average path velocity, and amplitude of lateral head displacement) improved (P&amp;lt;0.05) after Week 4 in the melatonin + ECG treatment. Similarly, non-viability and ratio of abnormal spermatozoa decreased by Week 3 in the melatonin + ECG treatment (P&amp;lt;0.05) compared with the control and melatonin treatments. Likewise, plasma testosterone concentration (ngmL−1) of bucks was higher (P&amp;lt;0.05) at Week 3 in the melatonin + ECG treatment (4.2±0.2) than in the melatonin (0.8±0.1) and control (1.2±0.1) treatments. Within the melatonin + ECG treatment, plasma testosterone concentration was higher (P&amp;lt;0.05) at Week 5 (4.9±0.2) and Week 9 (4.5±0.1) than at Week 3 (4.2±0.2). Plasma melatonin concentration (pgmL−1) increased (P&amp;lt;0.05) from Week 5 onward in the melatonin + eCG (12.5±0.1) and melatonin (10.2±0.1) treatments compared with the control (2.65±0.1). In conclusion, the simultaneous administration of melatonin and ECG improved fresh semen quality in Beetal bucks.

93 Efficient introduction of green fluorescent protein-9R, a protein with cell-penetrating peptides, into oocytes using intracytoplasmic sperm injection

The introduction of functional molecules such as oligonucleotides, nucleic acids, peptides, and antibodies into gametes has been beneficial not only for research purposes but is also expected to provide a treatment modality for failure of assisted reproductive technology (ART). The use of cell-penetrating peptides (CPPs) has been established as a method to introduce proteins and nucleic acids, which cannot normally pass through the cell membrane, into cells. Cell-penetrating peptides are short sequences of amino acids that facilitate the penetration of conjugated cargoes across mammalian cell membranes. To date, reports on the introduction of proteins via CPP into germ cells have been limited, and the method has not achieved success in preimplantation embryos. Simple polyarginine peptides have been known to induce higher cell penetration rates among CPPs. In this study, we examined whether green fluorescent protein-conjugated nine arginines (GFP-9R) can be effectively introduced into mouse oocytes and spermatozoa. Oocytes were collected from oviducts of 8- to 10-week-old female ICR mice after administration of equine chorionic gonadotropin and human chorionic gonadotropin. Spermatozoa were collected from epididymides of 8- to 10-week-old male mice. Some oocytes were used to perform IVF and subsequently cultured. These oocytes, spermatozoa, and embryos were cultured with GFP-9R or GFP for 30min to 1h and were then fixed with 4% paraformaldehyde and observed with a confocal laser microscope to check the introduction of GFP-9R into intact germ cells. In addition, we also attempted to introduce GFP-9R into oocytes by performing IVF or intracytoplasmic sperm injection (ICSI) using GFP-9R-introduced spermatozoa. In the case of ICSI, the tails of sperm were removed by sonication. After performing IVF or ICSI, embryos were cultured and observed with a fluorescence microscope. As a result, the GFP fluorescence signal was not detected in the ooplasm incubated with GFP-9R but was detected in the perivitelline space, the zona pellucida, and the collapsed first polar body. No GFP fluorescence signal was detected in the oocytes incubated with GFP. On the other hand, GFP fluorescence was detected in some spermatozoa that were incubated with GFP-9R (GFP-9R 43.3% (26 out of 60) but not with GFP alone 0% (0 out of 67)). However, when IVF was performed using these spermatozoa, the fluorescence signal was not detected in spermatozoa attached to the zona pellucida, but a strong signal was detected in dead spermatozoa, which are not involved in fertilization. Furthermore, we found that efficiency of introduction of GFP-9R into sperm heads increased after sonication (GFP-9R 93.1% (27 of 29) vs. GFP 0% (0 of 23)). Finally, we performed ICSI with GFP-9R-introduced sperm heads which were sonicated. These ICSI embryos developed to blastocysts normally (GFP-9R 46.7% (7 of 15) vs. non-GFP-9R 50.0% (8 of 16)). In this study, we demonstrated efficient CPP protein delivery of sonicated sperm heads into oocytes via ICSI in mice, even though the CPPs did not enter effectively into intact germ cells directly.

A moderately extended time interval between hCG administration and oocyte retrieval is good for most patients with oocyte retrieval scheduled on the same day: a retrospective cohort study

Evidence is limited regarding the time intervals between human chorionic gonadotropin (hCG) administration and oocyte retrieval in controlled ovarian hyperstimulation cycles, and it is difficult to determine proper schedules to optimise outcomes for patients undergoing oocyte retrieval on the same day. We aimed to identify correlations between factors pertaining to treatment outcomes and time intervals to facilitate working schedules of ART centres. Our study included 2509 patients who underwent ICSI cycles. Based on different time intervals between hCG administration and oocyte retrieval, all cycles were divided into four groups: group 1 (34.00–35.99 hours), group 2 (36.00–36.99 hours), group 3 (37.00–37.99 hours) and group 4 (38.00–39.32 hours). Female age, basal FSH level, Gn starting stimulation dosage and total Gn dosage of group 1 were significantly higher than those of other groups. E2 level on hCG day and number of follicles aspirated were significantly higher in group 4 than in the other groups. Number of oocytes retrieved, oocyte retrieval rate, cleavage rate and number of usable embryos were positively correlated with the time interval, even after adjusting for female age, basal FSH level, E2 on hCG day and number of follicles aspirated. A fixed hCG administration time matching arranged oocyte retrieval is good enough for most patients to achieve maximal treatment outcomes. For patients with lower treatment expectations (expected no. of oocyte retrieval ≤3), moderately delayed oocyte retrieval would be more appropriate. Impact Statement What is already known on this subject? The time interval between hCG administration and OPU during COH is essential for ART treatment outcomes, but different intervals were reported in previous studies. What the results of this study add? Fixed hCG administration time matching arranged OPU is good enough for most patients to achieve maximal outcomes. For patients with lower treatment expectations (expected no. of oocyte retrieval ≤3), moderately delayed oocyte retrieval would be required. What the implications are of these findings for clinical practice and/or further research? We studied whether the oocytes and pregnancy outcomes changed along with extended time intervals, and there is no need to adhere to an exact interval for every patient. Therefore, it would help clinicians develop more reasonable time schedules for fertility centres and patients undergoing oocyte recovery on the same day.

Effect of progesterone/estradiol ratio on pregnancy outcome of patients with high trigger-day progesterone levels undergoing gonadotropin-releasing hormone antagonist intracytoplasmic sperm injection cycles: a retrospective cohort study

This study investigates the predictive power of serum progesterone/estradiol (P/E2) level for estimating the live birth rate in patients who had a serum progesterone (P) rate ≥ 1.5 ng/mL on the human chorionic gonadotropin (hCG) administration day and who received the gonadotropin-releasing hormone (GnRH) antagonist protocol and intracytoplasmic sperm injection (ICSI). This retrospective cohort study included 176 cycles. The P/E2 ratio was lower in patients with a live birth (0.73 ± 0.54) than those without a live birth (1.05 ± 1.38), but the difference was not statistically significant (p = .158). According to the receiver operating characteristic curve analysis of the hCG day P/E2 ratio, the area under the curve was 0.579 (95% confidence interval: 0.478 – 0.680, p = .158) for predicting live birth. In conclusion, this study suggests that a P/E2 ratio is not a significant predictor of a live birth rate in the patients with an hCG-day serum progesterone level of ≥1.5 ng/mL undergoing GnRH antagonist ICSI cycles with a fresh embryo transfer.Impact statementWhat is already known on this subject? As the progesterone (P) levels in the late follicular phase correlate with the estradiol (E2) levels and the increase in mature follicles, earlier studies have proposed the trigger-day progesterone/estradiol (P/E2) ratio as a potential new marker for a premature luteinisation and live birth success. Most of these studies were conducted on long agonist cycles, and found that arbitrarily defined P/E2 ratio of >1 to be associated with poor pregnancy outcomes.What do the results of this study add? This study retrospectively examines the gonadotropin-releasing hormone (GnRH) antagonist cycles with a trigger-day serum P value of ≥1.5 ng/mL undergoing the intracytoplasmic sperm injection (ICSI) treatment. The receiver operating characteristic (ROC) curve analysis did not identify a statistically significant threshold value for the trigger-day P/E2 ratio that was beneficial in predicting a live birth. The P/E2 ratio was also lower in the cycles with a live birth than those without a live birth, although the difference was not statistically significant.What are the implications of these findings for clinical practice and/or further research? The trigger-day P/E2 ratio does not seem to be an efficient prognostic factor for a live birth in the GnRH antagonist ICSI cycles with a trigger-day serum progesterone level of ≥1.5 ng/mL. Further studies are needed to clarify the association of the trigger-day P/E2 ratio and the pregnancy outcomes in GnRH antagonist ICSI cycles.

Clomiphene citrate in LH surge suppression for women undergoing ICSI

Abstract Objective To evaluate the effect of adding clomiphene citrate (CC) in the mid-to-late follicular phase as an adjuvant to gonadotropins to suppress luteinizing hormone (LH) surge in women undergoing intracytoplasmic sperm injection (ICSI). Methods Prospective non-randomized study of 108 women undergoing ICSI and subjected to ovarian stimulation with gonadotropins with addition of CC (50 mg 3 times per day) when a leading follicle reached 14 mm in diameter and continued till the day of human chorionic gonadotropin (HCG) administration. Women subjected to controlled ovarian stimulation (COS) with the gonadotropin-CC protocol (n = 50) were compared with a group of women were to COS with the flexible gonadotropin releasing hormone antagonist (GnRH-ant) protocol (n = 58). Results Serum LH level on day HCG administration was significantly higher in CC group than in GnRH-ant group and the incidence of LH surge was higher in CC group than in GnRH-ant group (10% vs 3.4%, respectively) but without statistically significant difference (P = .246). The oocyte maturation and fertilization rates, the biochemical and clinical pregnancy rates, the implantation rate and the ongoing pregnancy rate were comparable in both groups. Conclusion Adding CC in the mid-to-late follicular phase as an adjuvant to gonadotropins represents a less costly COS which is effective in eliminating the occurrence of premature LH surge without compromising the cycle outcomes in women undergoing ICSI.

Value of Endometrial Echopattern at HCG Administration Day in Predicting IVF Outcome.

Assisted reproductive treatment (ART) cycle is an expensive procedure with low implantation and pregnancy rate; therefore, it is necessary to evaluate the predictors of success in these patients. The relationship between endometrial echopattern and pregnancy rate was evaluated. The endometrial echopattern was analyzed prospectively on the day of human chorionic gonadotropin (HCG) administration in 280 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles with 8-14 mm endometrial thickness at Royan institute in 2013-2014. Based on echopattern, three groups were developed: pattern A (Triple line), pattern B (Heterogeneous-echogen) and pattern C (Homogeneous-echogen). Pregnancy rate (PR) was compared between all groups. Data was analyzed using SPSS (v.18, Chicago, IL, USA), and descriptive tests such as Chi-square and analytical tests like logistic regression, for controlling confounder variables like age. Among 280 patients finally evaluable, the distribution of endometrial echopattern on the day of HCG administration was 127 patients (45.4%) in group A, 98 patients (35%) in group B and 55 patients (19.6%) in group C. The highest PR per transfer pertained to group A (49.6%), and the lowest to group B (32.7%). The presence of pattern A (Triple line) appears more likely to favor pregnancy. Therefore, ultrasonographic evaluation of endometrial echopattern on the day of HCG administration has prognostic value in clinical settings for predicting implantation in ART cycle.

Ovarian Hyperstimulation Syndrome Due to Exogenous Human Chorionic Gonadotropin (hCG) Presenting More Than 7 Days After hCG Administration

We present a case of ovarian hyperstimulation syndrome (OHSS) occurring 8 days after human chorionic gonadotropin (hCG) administration. OHSS is classified as late type if it occurs 12 to 17 days after hCG administration and early type if it occurs within 7 days. Thus, the condition in this patient did not fit the definition of early or late OHSS. The OHSS was mild, and she recovered in approximately 10 days without requiring admission. The patient was not pregnant, and the OHSS was shown to be induced by exogenous hCG administration not endogenous hCG. In conclusion, OHSS can occur 8 to 11 days after hCG administration and it is important to distinguish whether OHSS is induced by endogenous or exogenous hCG.

Does thalassemia influence ovarian response? An analysis of 127 cycles involving pre-implantation genetic diagnosis of thalassemia in southern China

To evaluate the impact of thalassemia carrier status on the response to controlled ovarian stimulation (COS) and outcome of intracytoplasmic sperm injection (ICSI). Seventy couples that both carried a mutation attributed to thalassemia (PGD group) and 57 couples in which only the father was a thalassemia carrier (CON group) were enrolled. All female subjects received long protocol GnRH agonist stimulation and received equivalent doses of recombinant follicle-stimulating hormone and the number of retrieved oocytes and utilisable embryos did not differ significantly. The endometrial thickness at human chorionic gonadotropin (hCG) administration day and the number of transferable embryos was lower in the PGD groups. However, pregnancy outcomes, including the clinical pregnancy rate and ongoing pregnancy rate, did not differ significantly between the two groups per cycle. Ovarian response to COS is not impaired by maternal thalassemia carrier status and embryo biopsy did not impair preimplantation embryo development or pregnancy outcomes.

MicroRNA-376a regulates 78-kilodalton glucose-regulated protein expression in rat granulosa cells.

The 78-kilodalton glucose-regulated protein (GRP78) is a molecular chaperone that assists in protein assembly, folding, and translocation. Recently, our laboratory reported that GRP78 regulates the expression of luteinizing hormone-human chorionic gonadotropin receptor (LHR) in the early stage of corpus luteum formation. In this study, we investigated whether microRNAs (miRNAs), which post-transcriptionally regulate mRNA, are involved in the regulation mechanism of GRP78 in the ovary. A miRNA microarray was performed to analyze the overall miRNA expression profile, and the results indicated that 44 miRNAs were expressed highly after ovulation was induced. The results from a bio-informative database analysis and in vitro granulosa cell culture studies led us to focus on rno-miR-376a for further analysis. In both in vivo and in vitro studies, rno-miR-376a levels increased 12 h after human chorionic gonadotropin (hCG) administration. To elucidate whether rno-miR-376a induced mRNA destabilization or translational repression of GRP78, rno-miR-376a was transfected into cultured granulosa cells, resulting in decreased GPR78 protein levels without an alteration in GRP78 mRNA levels. To confirm that rno-miR-376a binds to GRP78 mRNA, we cloned the 3′-end of GRP78 mRNA (nucleotides 2439–2459) into a reporter vector that contained a Renilla luciferase coding region upstream of the cloning site. The luciferase assays revealed that rno-miR-376a bound to the 3′-end of GRP78 mRNA. From these data, we conclude that rno-miR-376a potentially negatively regulates GRP78 protein expression through translational repression at an early stage transition from the follicular phase to luteinization.

Timing of human chorionic gonadotropin (hCG) hormone administration in IVF/ICSI protocols using GnRH agonist or antagonists: a systematic review and meta-analysis

Objective: To evaluate the effect of altering the timing of human chorionic gonadotropin (hCG) administration on the clinical outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) using gonadotropic hormone releasing hormone (GnRH) agonist or antagonist.Methods: We systematically searched six databases. Randomized controlled trials (RCTs) of the effects of altering the timing of hCG administration on the clinical outcome of IVF and ICSI using GnRH agonist or antagonist were included. A meta-analysis was conducted following a quality evaluation performed with Cochrane Collaboration’s Review Manager (RevMan) 5.0.2.Results: Seven RCTs and a total of 1295 participants were included. Significant difference was observed regarding estradiol and progesterone levels on the day of hCG administration and oocyte retrieval between early hCG and late hCG administration group and in favor of the latter. The fertilization rate was not statistically different between early and 24-h late hCG groups, but it is significantly higher in the 48-h late hCG group. The pooled results showed no significant differences in the ongoing pregnancy rate per oocyte pick-up, the miscarriage rate and the live birth rate.Conclusion: The prolongation of follicular phase by delaying hCG administration could increase estradiol, progesterone levels and oocyte retrieval, which will not influence ongoing pregnancy rate per oocyte pick-up, miscarriage rate and live birth rate. Postponing hCG may enable increased flexibility of cycle scheduling to avoid weekend procedures.

Effectof human chorionic gonadotropin on post-ovulatory mid-luteal profile and subsequent pregnancy rate in anestrus buffalo using two synchronization regimes

The present study was aimed to assess the impact of post-insemination human chorionic gonadotropin (hCG) administration on mid-luteal functions and conception rate in Murrah buffalo. The study was conducted on 2 buffalo treatment groups viz., estradiol + controlled internal drug releaser (CIDR) + gonadotropin releasing hormone (GnRH, n = 27) and ovsynch + CIDR (n = 22). Half of the animals in each group received intramuscular (i.m.) hCG (3000 IU, i.m.) on day 12 post-ovulation while groups served as control. The CG administration on day 12 post-ovulation improved corpus luteum size and progesterone level as well as first service conception rate after timed insemination in buffaloes.

Temporary Calf Removal and Equine Chorionic Gonadotropin (Ecg) Administration after Progesterone-Based Protocol Improves the Reproductive Performance of Beef Cattle

This study aimed to evaluate the effects of equine chorionic gonadotropin (eCG) administration and the temporary 48-h calf removal (CR) in a long-term progesterone (P4)based protocol in suckled Nelore cows. In all, 150 cows were randomly submitted to P4 protocol as follows. At day 0 (d 0), an intravaginal device containing 1.9 g P4 was inserted, and 1 mg estradiol benzoate (EB) was injected intramuscularly (im). On d 8, the P4 device was removed, and cows were im injected 500 µg of prostaglandin F group 2 alpha (PGF 2α ). On the same day, 75 cows (eCGCR group) received 400 IU im of eCG and were separated from their calves for 48 h. The other 75 cows (NoeCGCR group) stayed with the calves and did not receive eCG. On d 10, the calves were returned to the eCGCR group. After 8 days, all the cows were observed for estrus. The ovulatory follicle size was measured using ultrasonography at the day estrus was detected, and artificial insemination (AI) was performed 12 h later. Pregnancy was diagnosed 35 days after AI. The respective parameters for the eCGCR and NoeCGCR groups were as follows: pregnancy rate, 74.6% and 50.6% ( p 0.05). Thus, eCGCR after a long-term P4 protocol markedly improved pregnancy rates and estrus induction.

Trial of Recombinant Follicle-Stimulating Hormone Pretreatment for GnRH-Induced Fertility in Patients with Congenital Hypogonadotropic Hypogonadism

The optimal strategy for inducing fertility in men with congenital hypogonadotropic hypogonadism (CHH) is equivocal. Albeit a biologically plausible approach, pretreatment with recombinant FSH (rFSH) before GnRH/human chorionic gonadotropin administration has not been sufficiently assessed. The objective of the study was to test this method. This was a randomized, open-label treatment protocol at an academic medical center. GnRH-deficient men (CHH) with prepubertal testes (<4 mL), no cryptorchidism, and no prior gonadotropin therapy were randomly assigned to either 24 months of pulsatile GnRH therapy alone (inducing endogenous LH and FSH release) or 4 months of rFSH pretreatment followed by 24 months of GnRH therapy. Patients underwent serial testicular biopsies, ultrasound assessments of testicular volume, serum hormone measurements, and seminal fluid analyses. rFSH treatment increased inhibin B levels into the normal range (from 29 ± 9 to 107 ± 41 pg/mL, P < .05) and doubled testicular volume (from 1.1 ± 0.2 to 2.2 ± 0.3 mL, P < .005). Histological analysis showed proliferation of both Sertoli cells (SCs) and spermatogonia, a decreased SC to germ cell ratio (from 0.74 to 0.35), and SC cytoskeletal rearrangements. With pulsatile GnRH, the groups had similar hormonal responses and exhibited significant testicular growth. All men receiving rFSH pretreatment developed sperm in their ejaculate (7 of 7 vs 4 of 6 in the GnRH-only group) and showed trends toward higher maximal sperm counts. rFSH pretreatment followed by GnRH is successful in inducing testicular growth and fertility in men with CHH with prepubertal testes. rFSH not only appears to maximize the SC population but also induces morphologic changes, suggesting broader developmental roles.

Correlation between Endometrial Thickness and IVF Outcome in an African Population

Background: The endometrium undergoes cyclic changes during the menstrual cycle in preparation for implantation. Successful implantation depends on a close interaction between the embryo and the receptive endometrium. The association between endometrial thickness and IVF outcome was investigated in this study. Objective: To study the prognostic effect of endometrial thickness on outcome of In Vitro Fertilization (IVF) cycles Method: A retrospective analysis of 267 IVF/ICSI cycles between 2009 and 2011 at Human reproductive research program of University of Benin Teaching Hospital was conducted. Cycle parameters were compared between pregnant and non-pregnant patients, main outcome measure being clinical pregnancy following IVF cycles. The endometrial thickness was measured on the day of human Chorionic Gonadotrophin (hCG) administration. The clinical pregnancy rates at each millimeter of endometrial thickness was evaluated to determine its predictive role Results: Fifty-four among 267 cycles (20.2%) resulted in clinical pregnancy. The endometrial thickness on day of hCG administration was significantly higher in pregnant group compared to non-pregnant group [10.1 ± 1.7 mm versus 8.9 ± 2.0; p<0.0001). The endometrial thickness cut-off value of at least 7 mm strongly correlated with clinical pregnancy. Conclusion: Amongst other factors a thicker endometrial lining is associated with higher pregnancy rates. Effort should be made to institute protocols that will improve endometrial growth as a means of improving cycle outcome.

Influence of Sexual Stimulation and the Administration of Human Chorionic Gonadotrophin on Plasma Testosterone Levels in Dogs

The influence of sexual stimulation and human chorionic gonadotrophin (hCG) administration on plasma testosterone concentrations was assessed in five male Beagles. Each dog was exposed to three experimental treatments: C treatment (Control, no stimulation), hCG treatment (dogs were SC injected with 1000 IU of hCG) and sexually stimulated (SS) treatment where semen was collected from the males. All dogs were exposed to all treatments, one per week for three consecutive weeks, with a 1 week of rest between treatments. Blood samples were taken with the same time intervals (0, 10, 30, 60 and 120 min) relative to treatments. Plasma testosterone concentrations were determined with a solid-phase I(125) radioimmunoassay. In the control treatment, the testosterone plasma levels did not show significant changes throughout the tested period (mean values ranging between 2.8 and 4.7 ng/ml); the hCG group presented a significant increase (p < 0.05) in plasma testosterone levels 30 min after hCG administration and had the highest value (8.7 ng/ml) at 120 min post-hCG. Finally, the SS group revealed a slight reduction in testosterone concentration immediately after ejaculation, but the values remained nearly unaltered until 120 min after semen collection. When the groups were compared, the hCG group showed higher plasma testosterone values (p < 0.05) than did the C and SS groups, starting at 30 min and continuing until the end of sampling. This study demonstrates that sexual stimulation associated with semen collection does not produce transitory modifications in plasma testosterone concentrations.