Human Chorionic Gonadotropin Administration Research Articles

Intrauterine Insemination After Human Chorionic Gonadotropin Trigger or Luteinizing Hormone Surge: A Meta-analysis.

To assess the odds of pregnancy after intrauterine insemination (IUI) timed by ultrasound monitoring and human chorionic gonadotropin (hCG) administration compared with monitoring luteinizing hormone (LH) levels. We searched PubMed (MEDLINE), EMBASE (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), ClinicalTrials.gov (National Institutes of Health), and the Cochrane Library (Wiley) from the inception until October 1, 2022. No language limitations were applied. After deduplication, 3,607 unique citations were subjected to blinded independent review by three investigators. Thirteen studies (five retrospective cohort, four cross-sectional, two randomized controlled trials, and two randomized crossover studies) that enrolled women undergoing natural cycle, oral medication (clomid or letrozole), or both for IUI were included in the final random-effects model meta-analysis. Methodologic quality of included studies was assessed with the Downs and Black checklist. Data extraction was compiled by two authors, including publication information, hCG and LH monitoring guidelines, and pregnancy outcomes. No significant difference in odds of pregnancy between hCG administration and endogenous LH monitoring was observed (odds ratio [OR] 0.92, 95% CI 0.69-1.22, P=.53). Subgroup analysis of the five studies that included natural cycle IUI outcomes also showed no significant difference in odds of pregnancy between the two methods (OR 0.88, 95% CI 0.46-1.69, P=.61). Finally, a subgroup analysis of 10 studies that included women who underwent ovarian stimulation with oral medications (clomid or letrozole) did not demonstrate a difference in odds of pregnancy between ultrasonography with hCG trigger and LH-timed IUI (OR 0.88, 95% CI 0.66-1.16, P=.32). Statistically significant heterogeneity was noted between studies. This meta-analysis showed no difference between pregnancy outcomes between at-home LH monitoring and timed IUI. PROSPERO, CRD42021230520.

Impact of Accessory Corpus Luteum Induced by Gonadotropin-Releasing Hormone or Human Chorionic Gonadotropin on Pregnancy Rates of Dairy Cattle following Embryo Transfer: A META-Analysis.

The circulation of progesterone (P4) concentrations of recipients has positive correlations with embryo survival and pregnancy success of embryo transfer (ET) in dairy cows. One strategy to improve P4 concentration is the administration of gonadotropin-releasing hormone (GnRH) or human chorionic gonadotropin (hCG), thereby inducing the formation of accessory corpus luteum (CL). This study aimed at determining the efficacy of GnRH or hCG treatment regarding embryo transfer (ET) and providing a better clinical veterinary practice guidance. A meta-analysis was conducted on the data from 2048 treated recipient cows and 1546 untreated cows. By inducing the formation of accessory CL with GnRH (100 µg), GnRH analogue Buserelin (8-10 µg), or hCG (≥1500 IU) 5-11 days after synchronized ovulation, hCG alone achieved an improvement (RR = 1.39, p < 0.05), while GnRH and GnRH analogue did not result in significant changes (RR = 1.04, p = 0.26). Treatment with GnRH or hCG 5-7 days after synchronized ovulation was associated with increased chances of pregnancy compared with later treatment (11-14 days). Owing to the treatment, the pregnancy rate of cows with very poor fertility (<40%) was improved, while that of cows with good fertility (≥40%) was not affected. Treatment with GnRH or hCG greatly improved pregnancy rates of parous lactating cows (RR = 1.32, p < 0.05) compared with heifers (RR = 1.02, p > 0.05). Additionally, as indicated by pregnancy loss analysis, the treatment had no benefit on late embryo/early fetus survival at days 28-81. In conclusion, the induction of accessory CL with GnRH or hCG may benefit fertility and have important implications for the management of reproductive performance in the dairy industry.

Effectiveness of letrozole in pituitary downregulated normogonadotrophic young women with an initial poor response.

It has been reported that 10 to 15% of young normogonadotrophic women show suboptimal response to standard long protocols. Letrozole (LE), an aromatase inhibitor, was shown to improve ovarian sensitivity to follicle stimulating hormone (FSH) and follicular response to gonadotrophin treatment in poor ovarian response patients. We reasoned that it might be possible to utilize LE in young normogonadotrophic patients with unexpected hypo-response in standard gonadotropin-releasing hormone agonist long protocol. A total of 652 patients defined as normogonadotrophic patients with unexpected hypo-response were divided into 2 groups, the +LE group and the +Gn group. +LE group: A fixed daily dose of 2.5 mg of LE was added on day 8 of stimulation. +Gn group: A fixed daily dose of 75 U of human menopausal gonadotrophin was added on day 8 of stimulation. The primary outcome measures were the number of oocytes obtained, fertilization rate, days of stimulation, and total FSH dosage. The secondary outcome measures were the implantation rate and ongoing pregnancy rate. There were no significant differences in the clinical and hormonal characteristics between the 2 groups. A shorter duration of stimulation and a lower dosage of recombinant FSH consumption on the day of human chorionic gonadotropin administration were all observed in the +LE group. Patients who received LE therapy showed a higher number of oocytes obtained and significantly higher fertilization rates. The implantation rate and ongoing pregnancy rate were comparable in both groups. LE significantly improves the number of oocytes obtained in patients with suboptimal response to standard gonadotropin-releasing hormone agonist long protocol.

Correction: Clinical outcome of intrauterine administration of peripheral mononuclear cells or human chorionic gonadotropin in unexplained implantation failure

Correction: Clinical outcome of intrauterine administration of peripheral mononuclear cells or human chorionic gonadotropin in unexplained implantation failure

Prediction of patients with ovarian hyperstimulation syndrome in gonadotropin-releasing hormone agonist prolonged protocol: a retrospective study

Background: Ovarian Hyperstimulation Syndrome (OHSS), a life-threatening complication and the most common adverse effect of fertility treatment, currently lacks an effective prevention method. Objectives: We investigated associated risk factors of OHSS in stimulated ovarian cycles with assisted reproductive technology (ART), with the aim of providing guidance for clinicians on how to prevent OHSS. Methods: A logistic regression analysis was conducted on 336 patients who had completed in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI)/embryo transfer (ET) cycles between April 2019 and April 2021 in the first affiliated hospital of Kunming Medical University. Receiver-operating characteristic (ROC) curves for OHSS were calculated for each predictor using cut-off values. Area under the curve (AUC) analysis and logistic regression models were performed to compare the performance of laboratory biomarkers. Results: According to clinical diagnosis, 61 out of 336 cycles experienced OHSS, resulting in an incidence rate of 18.15%. Patients were graded based on their clinical symptoms and severity, with 27 instances of moderate OHSS (8.04%) and 8 cases of severe OHSS (2.38%). The cut-off values for anti-Müllerian hormone (AMH), Estradiol (E2) on Human Chorionic Gonadotropin (HCG) day, and eggs retrieved to predict moderate and severe OHSS were determined as 7.495 ng/ml, 4828 pg/ml, and 19.5, respectively, in the Gonadotropin-Releasing Hormone agonist (GnRH-a) Prolonged Protocol. The sensitivities for these parameters were 77.0%, 67.2%, and 80.3%, with specificities of 68.0%, 70.9%, and 81.5%, respectively. AUC values for AMH, E2 on HCG day, and the number of retrieved oocytes, predicting moderate and severe OHSS, were 0.754, 0.738, and 0.876, respectively. Additionally, the combined index yielded an AUC value of 0.898, attaining the highest AUC with 85.2% sensitivity and 83.6% specificity. Conclusions: AMH, E2 on the day of HCG administration, and the total number of retrieved eggs collectively exhibit a robust predictive influence on the occurrence of OHSS. The predictive efficacy is enhanced significantly when these three indicators are combined.

The importance of infertility duration and follicle size according to pregnancy success in women undergoing ovulation induction with gonadotropins and intrauterine insemination

In this study, we aimed to evaluate the effect of infertility duration and dominant follicle size measured on the day of human chorionic gonadotropin (HCG) administration on pregnancy rates in infertile women undergoing ovulation induction (OI) with gonadotropin (GND). A total of 352 patients aged 20 to 41 years who were diagnosed with unexplained infertility or polycystic ovary syndrome (PCOS) were included in this study. Patients with a history of multifollicular development or follicle stimulating hormone (FSH) value more than 12 IU/ml were excluded from the study. The demographic and clinical features of the patients were obtained from the patients’ files and hospital automation system and recorded for each woman. The demographic and clinical features of the patients were recorded. Patients were divided into two groups as live birth (group 1, n = 47) and non-live birth groups (group 2, n = 305). There were no statistically significant differences in regard to age, infertility type, follicle stimulating hormone (FSH) level, oestradiol (E2) level, antral follicle count (AFC), cycle characteristics, GND type, number of follicles, E2 level and endometrial thickness on HCG day, total GND dose, dominant follicle size (p > 0.05). Infertility duration in group 1 was 3.5 ± 2.1; in group 2, 4.7 ± 3.9 years. This difference was statistically significant (p = .014). According to this study, live birth rates after GND + IUIs(intrauterine insemination) were significantly affected by the duration of infertility. But the dominant follicle size and endometrial thickness measured on HCG day in GND and IUI cycles did not have a significant effect on pregnancy rates. IMPACT STATEMENT What is already known on the subject? It is thought that the timing of the ovarian triggering is vital for the success of intrauterine insemmination (IUI) treatment. What do the results of this study add? According to our results live birth rates after GND + IUIs were significantly affected by the duration of infertility. What are the implications of these findings for clinical practice and/or further research? It is determined that the duration of infertility is significant and patients should be encouraged to the treatment as soon as possible.

Effects of trigger-day progesterone in the preimplantation genetic testing cycle on the embryo quality and pregnancy outcomes of the subsequent first frozen-thawed blastocyst transfer.

To assess whether progesterone (P) levels on the trigger day during preimplantation genetic testing (PGT) cycles are associated with embryo quality and pregnancy outcomes in the subsequent first frozen-thawed blastocyst transfer (FET) cycle. In this retrospective analysis, 504 eligible patients who underwent ICSI followed by frozen-thawed embryo transfer (FET) with preimplantation genetic test (PGT) between December 2014 and December 2019 were recruited. All patients adopted the same protocol, namely, the midluteal, short-acting, gonadotropin-releasing hormone agonist long protocol. The cutoff P values were 0.5 and 1.5 ng/ml when serum P was measured on the day of human chorionic gonadotropin (HCG) administration, and cycles were grouped according to P level on the day of HCG administration. Furthermore, the effect of trigger-day progesterone on embryo quality and the subsequent clinical outcome of FET in this PGT population was evaluated. In total, 504 PGT cycles were analyzed. There was no significant difference in the number of euploid blastocysts, top-quality blastocysts, euploidy rate, or miscarriage rate among the three groups (P>0.05). The 2PN fertilization rate (80.32% vs. 80.17% vs. 79.07%) and the top-quality blastocyst rate (8.71% vs. 8.24% vs. 7.94%) showed a downward trend with increasing P, and the between-group comparisons showed no significant differences (P>0.05). The clinical pregnancy rate (41.25% vs. 64.79%; P<0.05) and live birth rate (35.00% vs. 54.93%; P<0.05) in subsequent FET cycles were substantially lower in the high-P group than in the P ≤ 0.5 ng/ml group. After adjustments were made for confounding variables, multivariate logistic regression analysis revealed that the high-P group had a lower clinical pregnancy rate (adjusted OR, 0.317; 95% CI, 0.145-0.692; P=0.004) and live birth rate (adjusted OR, 0.352; 95% CI, 0.160-0.773; P=0.009) than the low-P group in subsequent FET cycles, and the differences were significant. This study demonstrates that in the PGT population, elevated P on the trigger day may diminish the top-quality blastocyst rate (although there is no difference in the euploidy rate). Trigger-day P is an important factor influencing clinical outcomes in subsequent FET cycles.

Effect modification by developmental stage of embryos on the association between late follicular phase progesterone elevation and live birth in fresh transfers

BackgroundLate follicular phase progesterone elevation (LFPE) during ovarian stimulation is associated with reduced live birth rates (LBRs) after cleavage-stage embryo transfer. However, due to better synchronization with a stimulated endometrium, prior studies shown that LFPE had no effect on transferring embryos at blastocyst stage. The study aim to exam whether the developmental stage of embryos and serum progesterone levels on the day of human chorionic gonadotropin (hCG) administration jointly affect the odds of live birth in fresh fresh IVF/intracytoplasmic sperm injection (ICSI) cycles. MethodsThe single-center retrospective cohort study included a total of 4,471 fresh embryo transfer cycles with 2,342 at cleavage stage versus 2,129 at blastocyst stage. Patients underwent IVF/ICSI with ovarian stimulation in gonadotropin-releasing hormone antagonist protocol. The serum progesterone level was examined both as a continuous variable and as a categorical variable by quartiles. Analysis was performed using the generalized estimating equations framework and multivariate regression models.ResultsLBRs were inversely associated with progesterone as a continuous variable on the day of hCG in both the cleavage-stage (crude OR 0.87, 95%CI 0.73–1.03; adjusted OR 0.80, 95% CI 0.65–0.98) and the blastocyst-stage (crude OR 0.66, 95%CI 0.56–0,78; adjusted OR 0.61, 95%CI 0.50–0.73) groups. The interaction testing was highly significant (P = 0.018) indicating an effect modifying role of stage of embryos transferred on the association of pregesterone values with the LBRs in fresh cycles. A similar pattern for a greater reduction in ORs for live birth in cycles with blastocysts transfer was also observed when progesterone was analyzed by interquartile ranges. The findings remained unchanged in subgroup analysis stratified by types of ovarian response.ConclusionsIn fresh cycles, detrimental effect of late follicular phase progesterone elevation on live birth was more prominent in blastocyst-stage group compared with that in clevaged-stage group.

The Outcome of Intramuscular Administration of Human Chorionic Gonadotropin to Restore Spermatogenesis in Patients with Non-Obstructive Azoospermia

The Outcome of Intramuscular Administration of Human Chorionic Gonadotropin to Restore Spermatogenesis in Patients with Non-Obstructive Azoospermia

A paradigm of higher success rate of intracytoplasmic sperm injection - preovulatory human chorionic gonadotropin-day serum oestradiol.

The aim of the study is to evaluate the correlation between the level of serum oestradiol (E2) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome. This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E2 level on the day of hCG administration: Group A - serum E2 < 1000 pg/ml; Group B - serum E2 1000 to < 2000 pg/ml; Group C - serum E2 2000 to < 3000 pg/ml;Group D - serum E2 3000 to < 4000 pg/ml; Group E - serum E2 ≥ 4000 pg/ml. The highest fertilization rate (58.1%) was among women with E2 ≥ 4000 pg/ml, while the lowest (37%) was in women with E2 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E2 > 4000 pg/ml, while the lowest (5.3%) was in women with E2 < 1000 pg/ml. In the current study the median serum E2 level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E2 at hCG administration was ≥ 3682.3 pg/ml. this study suggests that the optimal range of E2 level for achieving a successful pregnancy is > 4000 pg/ml.

Serum Progesterone Levels on the Day of Human Chorionic Gonadotrophin Trigger, and its effects on the Outcome of In Vitro Fertilization, and Embryo Transfer: A Two-Center Study

Abstract Introduction: Gonadotrophin-releasing hormone analogs were expected to make preovulatory progesterone (P4) elevation rare during in vitro fertilization (IVF) cycles, but despite its widespread use, subtle rise in P4 levels on the day of ovulation trigger has a documented prevalence of 5%–38%. The effect of preovulatory progesterone levels on IVF outcomes is still controversial and published data from West Africa is sparse. Materials and Methods: This was a prospective observational study of 107 women who underwent IVF in both Garki and Nisa hospitals in Abuja, Nigeria. A serum sample was obtained from participants on the day of human chorionic gonadotrophin administration for a single determination of progesterone level. Oocytes retrieved, biochemical pregnancy, and clinical pregnancy were the primary outcomes. Results: The mean P4 on human chorionic gonadotrophin (hCG) trigger day was 2.07 ± 0.24 ng/mL and 48 (44.9%) had P4 &gt; 1.5 ng/mL. There was no relationship between P4, and the number of oocytes retrieved but implantation, biochemical pregnancy, and clinical pregnancy were significantly diminished when P4 &gt;1.5 and &lt;1 ng/mL: biochemical pregnancy (27.3% vs. 61.5% vs. 14.6%, χ2 = 17.896; P &lt; 0.0001), clinical pregnancy (24.2% vs. 50.0% vs. 14.6%, χ2 = 11.041; P = 0.004). Conclusion: Pregnancy rates are diminished when P4 on hCG trigger day is elevated.

METHODOLOGICAL RECOMMENDATIONS FOR THE USE OF REPRODUCTIVE TECHNOLOGIES TO CREATE GENETICALLY MODIFIED RABBITS

In this article, we present some practical recommendations that we developed in the course of two years of work on obtaining several lines of rabbits with an artificially modified genome. The technology of obtaining genetically modified rabbits, based on obtaining dated fertilized eggs with further microinjection of genetic constructs, assessment of survival and embryo transfer by laparoscopic and laparotomic methods. The following regimen demonstrated the greatest efficiency: administration of serum gonadotropin (Follimag, MOSAGROGEN, Russia) at a dose of 4ME/kg subcutaneously and intravenous administration of human chorionic gonadotropin (Chorulon, Merck Animal Health, USA) at a dose of 60ME/kg. Thus, the resulting operating procedure allows the operator to perform microinjections with high transfer efficiency and maximum cell survival. Microinjection is carried out through an Eppendorf FemtoJet 4i pneumatic microinjector using hydraulic micromanipulators under visual control through a NIKON ECLIPSE TS2R inverted research microscope. The described results may be useful in the compilation of standard operating procedures used in laboratories that are engaged in the production of genetically modified rabbit animals.

Serum LH Level on the Day of hCG Administration as a Predictor of the Reproductive Outcomes in Ovulation Induction Cycle Frozen-Thawed Embryo Transfer.

Purpose: To evaluate the clinical utility of serum luteinizing hormone (LH) level in predicting frozen embryo transfer (FET) outcomes among the patients with an ovulation induction (OI) cycle. Methods: A total of 250 patients who underwent OI cycle frozen-thawed embryo transfer from January 2018 to June 2020 in Drum Tower Hospital affiliated with Nanjing University Medical School were retrospectively analyzed. The primary outcomes were clinical pregnancy rate and the live birth rate. Results: The results showed that a significant difference in Serum LH level on the day of human chorionic gonadotropin (hCG) administration was observed between the clinical pregnancy group and no clinical pregnancy group (p = 0.002), while there was no significant difference between the live birth group and no live birth group (p = 0.06). Multiple logistic regression analysis of factors related to clinical pregnancy showed serum LH level on the day of hCG administration was related to improved clinical pregnancy rate (OR was 1.02, 95% CI: 1.0-1.03, p = 0.02), while serum LH level had no significant effect on live birth rate. The ROC curves revealed the serum LH level was significantly correlated with clinical pregnancy rate and live birth rate; the cut-off point of serum LH level on the day of hCG administration was 8.46 miu/mL for clinical pregnancy rate (AUC 0.609, p = 0.003). Conclusion: In patients with OI FET, serum LH level on the day of hCG administration might be a biomarker for the prediction of clinical pregnancy. The prediction that patients who underwent OI cycle frozen-thawed embryo transfer with serum LH levels below 8.46 mIU /mL might be pregnant appeared to be meaningful.

Neurotensin expression, regulation, and function during the ovulatory period in the mouse ovary†.

The luteinizing hormone (LH) surge induces paracrine mediators within the ovarian follicle that promote ovulation. The present study explores neurotensin (NTS), a neuropeptide, as a potential ovulatory mediator in the mouse ovary. Ovaries and granulosa cells (GCs) were collected from immature 23-day-old pregnant mare serum gonadotropin primed mice before (0h) and after administration of human chorionic gonadotropin (hCG; an LH analog) across the periovulatory period (4, 8, 12, and 24h). In response to hCG, Nts expression rapidly increased 250-fold at 4h, remained elevated until 8h, and decreased until 24h. Expression of Nts receptors for Ntsr1 remained unchanged across the periovulatory period, Ntsr2 was undetectable, whereas Sort1 expression (also called Ntsr3) gradually decreased in both the ovary and GCs after hCG administration. To better understand Nts regulation, inhibitors of the LH/CG signaling pathways were utilized. Our data revealed that hCG regulated Nts expression through the protein kinase A (PKA) and p38 mitogen-activated protein kinase (p38MAPK) signaling pathways. Additionally, epidermal-like-growth factor (EGF) receptor signaling also mediated Nts induction in GCs. To elucidate the role of NTS in the ovulatory process, we used a Nts silencing approach (si-Nts) followed by RNA-sequencing (RNA-seq). RNA-seq analysis of GCs collected after hCG with or without si-Nts identified and qPCR confirmed Ell2, Rsad2, Vps37a, and Smtnl2 as genes downstream of Nts. In summary, these findings demonstrate that hCG induces Nts and that Nts expression is mediated by PKA, p38MAPK, and EGF receptor signaling pathways. Additionally, NTS regulates several novel genes that could potentially impact the ovulatory process.

Effects of intrauterine human chorionic gonadotropin administration on endometrial receptivity and embryo implantation

AimsEven though major advances have occurred in in vitro fertilization-embryo transfer (IVF-ET) techniques in recent years, low efficacy of embryo implantation rates after fresh cycle of IVF-ET around 25–30 % is still a biggest challenge to physicians. To address this, clinicians have used intrauterine administration of human chorionic gonadotropin (hCG), one of the initial arrays of molecular crosstalk occurred at maternal-fetal interface. However, many reports have demonstrated the conflicting outcomes with various efficacy. This study aims to provide evidence of the optimal timing of hCG administration to enhance the rates of embryo implantation via improving the uterine environment. Main methodshCG was administered into one side of mouse uterine horns and saline was infused into the other side of horns as a control. Alterations in the endometrial thickness, endometrial receptivity and angiogenesis-related gene expression, responses of progesterone receptor, and subsequent in vitro fertility assessment were evaluated in hCG-treated endometrium in mice. Key findingshCG administration induced a serial induction of endometrial receptivity and angiogenesis-related genes and maximally enhanced their expression levels around 72 h after treatment with no significant morphological alterations in the numbers of endometrial glands and thickness. Moreover, using an in vitro model of embryo attachment, hCG treatment significantly promoted the stability of attached embryos, supporting the positive effect of hCG on the initial stage of embryo implantation. SignificanceOur findings suggest a new consensus criteria providing a potential strategy of clinical use of hCG for the cleavage-stage ET rather than blastocyst-stage ET to achieve maximal effects of IVF-ET.

Endometrial compaction after human chorionic gonadotrophin administration reduces ectopic pregnancy rate following fresh embryo transfer in vitro fertilization/intracytoplasmic sperm injection cycles in patients with non-thin endometrium: a retrospective cohort study

BackgroundThis study aims to study whether the change of endometrial thickness between the day of human chorionic gonadotrophin (HCG) administration and the day of embryo transfer (ET) has any effect on ectopic pregnancy (EP) rate following fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.MethodsThis study retrospectively analyzed 3134 patients who underwent fresh IVF/ICSI ET, including 3022 intrauterine, 112 ectopic cycles. Multiple logistic regression analysis and stratified analysis were used to study the effect of endometrial compaction after HCG administration on EP in patients with non-thin endometrium after adjusting for confounding factors.ResultsAfter adjusting for confounders, multiple logistic regression analysis found that the risk of EP in the compaction group was significantly lower than that in the non-compaction group (OR = 0.49; 95% CI: 0.31–0.78; P = 0.0023). The results of the stratified analysis demonstrated the EP rate in patients with an endometrial thickness ≥ 8 mm on the day of ET; the compaction group significantly reduced the incidence of EP (OR = 0.49; 95% CI: 0.31–0.79; P = 0.0036). In patients with an endometrial thickness ≥ 8 mm on the day of ET, the incidence of EP had no statistical significance in two group (OR = 1.02; 95% CI: 0.18–5.88; P = 9790).Conclusion(s)In patients with non-thin endometrium, endometrial thickness compaction from the day of HCG to the ET day reduced the risk of EP significantly.

WHAT IS THE OPTIMAL ENDOMETRIAL PREPARATION PROTOCOLS IN EUPLOID FROZEN EMBRYO TRANSFER (FET)?

Various factors, including treatment protocols, can influence the outcomes of frozen embryo transfers (FETs). In order to prepare the endometrium, several protocols have been suggested: natural cycles, where detecting the luteinising hormone (LH) surge, and, therefore, the ovulation, defines the timing of the transfer; modified natural cycles, where ovulation is triggered by the administration of human chorionic gonadotrophin (hCG); hormone replacement therapy (HRT) or artificial cycle with estradiol (E2) and progesterone (P4), with or without using gonadotropin-releasing hormone (GnRH) analogs; and, finally, stimulated cycles with low doses of gonadotropins.

ASSOCIATION BETWEEN CYTOKINE LEVELS IN BLOOD PLASMA AND PBMC CULTURE MEDIA

Intrauterine administration of human chorionic gonadotropin (hCG) activated peripheral blood mononuclear cells (PBMC) has positive effect on embryo implantation in repeated implantation failure patients. This effect is mainly caused by the PBMC cytokine production. The aim of this study was to find association between the tumor necrosis factor alpha (TNFα), interleukin 6 (IL6), interleukin 4 (IL4) and interleukin 10 (IL10) plasma levels and their respective concentrations in the media of cultivated PBMC alone or treated with hCG.

The effect of the ratio of serum progesterone level to oocyte count on the day of IVF-ICSI injection on pregnancy outcomes in HCG cycles.

There has been several discussion and debates regarding the possible setremental influence of elevated serum progesterone (SP) on the day of human chorionic gonadotropin (hCG) administration. Our study aims to assess progestron to oocyte rates for assessing CPRand live birth rate (LBR) in IVF cycles and review previous articles. In this prospective cohort study, women under ovulation induction through IVF-ICSI using the GnRH-antagonist protocol were studied. Five specific indicators were considered to assess pregnancy outcome. The statistical analysis was done using SPSS software. In the present research, 78 patients underwent IVF. The cut-off points for each of the three parameters were 1.2 (with a sensitivity of 65.4% and a specificity of54%), 6.5 (with a sensitivity of 73.1% and a specificity of 56%), and 0.16 (with a sensitivity of 65.4% and a specificity of 60%, respectively). Only the number of oocytes (area below the curve of 0.64) was able to predict clinical pregnancy. The cut-off point for this parameter was 6.5 (witha sensitivity of 74.1% and a specificity of 66%). On the other hand, none of the parameters were able to predict livebirth. The findings of this study should assist in the clinical management of patients with high SP on theday of HCG administration. We recommend, that the ratioof SP to oocyte is a useful parameter for refining the criteria of patients who have had embryo freezing of all embryos (by selective freezing) and subsequent transfer offrozen embryos.

The Effect of Age on IVF-ET Outcome in Infertile Patients with PCOS Based on Tiangui Theory in Chinese Medicine.

Objective Our aim was to investigate the effect of age on the outcome of IVF-ET and ICSI in infertile PCOS patients under the guidance of Tiangui theory in traditional Chinese medicine. Method This was a retrospective analysis of 532 infertile women with PCOS and 1,392 women with infertility due to tubal factors as the controls. All of the participants were divided into different age groups-aged 20–28 years, 29–35 years, and ≥36 years-according to the stages of female reproductive development in Tiangui theory as described in the Canon of Internal Medicine-Treatise of Ancient Natural Truth. We explored the effect of age on controlled ovarian hyperstimulation (including the initial dosage and duration of Gn and the estradiol level on the day of human chorionic gonadotropin administration); the numbers of retrieved oocytes, 2PN zygotes, and embryos; and the rates of fertilization, clinical pregnancy, abortion, live birth, and OHSS incidence. Results Compared to controls, the maximum follicular diameter and the numbers of follicles with d ≥ 20 mm, retrieved oocytes, and 2PN zygotes were greater in the PCOS group with age >28 years (p < 0.05). The abortion rate of PCOS patients with age ≤28 years was higher than that of the controls. All PCOS groups and the control group showed reduced numbers of retrieved oocytes and live births with age. The difference in age was not significant in the PCOS groups but was significant in the control group (p < 0.05), and the trend in the PCOS groups was more gradual. Conclusion The fertility of all subjects decreased with age, but PCOS patients decreased more slowly than in controls at the same age, which verified the applicability of the guiding principles of Tiangui theory in the clinic.