Increased Serum Progesterone Research Articles

Metabolic syndrome impairs endometrial functioning and early pregnancy: an in vivo study.

Metabolic syndrome (MS) is increasingly associated with impaired reproductive health. This study aimed to assess the endometrial characteristics and reproductive outcomes of a female MS mouse model and evaluate metformin's therapeutic effects. Twenty-one-day-old female C57BL/6 mice were randomly divided into a high-fat diet group (N = 50) and a control group (N = 30) that received standard chow. After 11 weeks, a subset of HF mice (N = 25) was given oral metformin at 300 mg/kg/day, while the other ones continued on HF diet. After 15 weeks, mice were either sacrificed during estrus or mated and euthanized on day 7.5 of pregnancy (N = 15 per group). The estrous cycle, progesterone and estradiol levels, uterine morphology, endometrial cell proliferation, reproductive performance, and metformin's treatment effects were assessed. Mice on a high-fat diet developed MS, which was characterized by moderate glycemic dysregulation, increased cholesterol, insulin resistance, and central obesity. Experimental MS caused estrous cycle disruptions and increased serum progesterone levels, which were normalized by metformin. MS also affected endometrial histology, producing hyperplasia and altering cell proliferation, while metformin restored normal endometrial architecture by inhibiting cell proliferation. Additionally, MS impaired reproductive success by delaying coitus and reducing the ratio of implantation sites to corpora lutea, both of which were rectified by metformin. In conclusion, MS adversely affects reproductive function, but metformin offers improvement. Our findings highlight the need for further research on the impact of MS on reproduction and the exploration of treatments to enhance reproductive health in women with MS.

Effectiveness of dual combination therapy of acarbose plus metformin and acarbose plus myo-inositol in ameliorating the metabolic and endocrinologic complications of polycystic ovary syndrome – A randomized controlled trial

IntroductionPCOS, beyond being characterized by reproductive disturbances, is a complicated rapid expanding metabolic and endocrinologic disorder of the recent times. Nearly 70% PCOS women show resistance to insulin. AIM: The aim of the study is to determine and compare the effectiveness of acarbose plus metformin and acarbose plus myo-inositol combination therapy in alleviating the metabolic and endocrinologic complications of PCOS. Materials and methodsAn open labelled RCT was conducted on 168 PCOS women attending the gynaecology clinic at SRM MCH & RC, Chengalpattu and the trial was registered in CTRI (No. CTRI/2022/04/041877). Group A (n = 56) received metformin 500 mg/TID alone; group B (n = 54) received (acarbose 25 mg/TID for 4 weeks then 50 mg/TID for other 20 weeks) along with metformin 500 mg/TID and group C (n = 54) received (acarbose 25 mg/TID for 4 weeks then 50 mg/TID for other 20 weeks) along with myoinositol 1000 mg/BD. All parameters were measured at baseline and at the end of 6 months. ResultsSignificant reduction of LH, LH: FSH, TT, HOMA-IR was observed in all the groups. FSH increased only in metformin group. Increase in serum progesterone and reduction in FI, TGL, LDL were significant only in acarbose plus myo-inositol group. SHBG and HDL increased significantly only in acarbose plus metformin group. No changes in BMI, TC and VLDL were observed in any group. ConclusionTherefore, decrease in FI, HOMA-IR, TGL, LDL seen in acarbose plus myo-inositol group indirectly contributes to cardio-metabolic safety in PCOS. Similarly, a significant increase in SHBG levels with acarbose plus metformin group shows correction of the excess androgen and restoration of ovulation.

Local effect of allopregnanolone in rat ovarian steroidogenesis, follicular and corpora lutea development

Allopregnanolone (ALLO) is a known neurosteroid and a progesterone metabolite synthesized in the ovary, CNS, PNS, adrenals and placenta. Its role in the neuroendocrine control of ovarian physiology has been studied, but its in situ ovarian effects are still largely unknown. The aims of this work were to characterize the effects of intrabursal ALLO administration on different ovarian parameters, and the probable mechanism of action. ALLO administration increased serum progesterone concentration and ovarian 3β-HSD2 while decreasing 20α-HSD mRNA expression. ALLO increased the number of atretic follicles and the number of positive TUNEL granulosa and theca cells, while decreasing positive PCNA immunostaining. On the other hand, there was an increase in corpora lutea diameter and PCNA immunostaining, whereas the count of TUNEL-positive luteal cells decreased. Ovarian angiogenesis and the immunohistochemical expression of GABAA receptor increased after ALLO treatment. To evaluate if the ovarian GABAA receptor was involved in these effects, we conducted a functional experiment with a specific antagonist, bicuculline. The administration of bicuculline restored the number of atretic follicles and the diameter of corpora lutea to normal values. These results show the actions of ALLO on the ovarian physiology of the female rat during the follicular phase, some of them through the GABAA receptor. Intrabursal ALLO administration alters several processes of the ovarian morpho-physiology of the female rat, related to fertility and oocyte quality.

Evaluation of Serum Estrogen, Progesterone, Prolactin and Testosterone in Patients of Melasma

Objective: To evaluate the estrogen, progesterone, Prolactin and testosterone serum levels in melasma patients.
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Dermatology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Jul to Dec2020.
 Methodology: A total of 40 patients with melasma and 40 without melasma were included in this study. The study comprisedfemale melasma patients aged 20 to 50 years old. All participants were tested for serum estrogen, progesterone, Prolactin andtestosterone levels using immunoassay in the follicular phase (9th day) of the menstrual cycle.
 Results: The statistically significant increase in serum progesterone (p=0.001) was found in patients with melasma. Asignificant decrease in prolactin levels (p=0.0001) was found in patients with melasma. No association was found betweenGroup-1 and Group-2 regarding serum estradiol and testosterone (p=0.070 and p=0.461 respectively)
 Conclusion: Patients with melasma have increased progesterone levels and decreased serum prolactin levels.

Effect of increased serum progesterone on luteal morphology and function, pregnancy, and gestational loss in Nelore cows.

The aim of the present study was to determine the impact of different strategies for increasing the level of serum progesterone (P4) on luteal morphology and function in bovine females. The effects of increasing P4 on pregnancy rate and gestational loss (GL) in Nelore cows subjected to timed artificial insemination (TAI) were also evaluated. A total of 939 cows were divided into three groups: P4LA (n=305), 150 mg of long-acting injectable P4 7 days after TAI; GnRH (n=306), 10μg of buserelin acetate 7 days after TAI; and control (n=328), no hormone treatment after TAI. Doppler ultrasound assessments and P4 measurements were performed on days 7 and 16 after TAI. The pregnancy rate and GL as a function of treatment were compared using the SAS GLIMMIX procedure. Corpus luteum (CL) vascular perfusion, volume, and plasma P4 concentration were analysed using the SAS PROC MIXED procedure. No significant difference was found among the treatments in terms of volume, number of pixels, and CL intensity or in the serum P4 concentration at 7 days after ovulation. The CL blood flow at 16 days after ovulation was lower in the P4LA and GnRH groups than that in the control group (p < .01). Serum concentrations of P4 at 16 days after ovulation were higher in the P4LA and GnRH groups than those in the control group (p=.04). A difference in the pregnancy rate (p=.003) and a trend in GL (p=.07) as a function of treatment were found. Overall, long-acting injectable P4 supplementation on day 7 after TAI or GnRH administration affected CL vascularization and increased the serum concentrations of P4 16 days after ovulation, promoting better pregnancy rates than the control.

Evolution of serum progesterone levels in the very early luteal phase of stimulated IVF/ICSI cycles post hCG trigger: a proof of concept study.

Studies have suggested that controlled ovarian hyperstimulation adversely affects endometrial receptivity due to advanced endometrial maturation. This adverse effect is mainly attributed to supraphysiological levels of both estrogen and progesterone identified in stimulated cycles. There is a paucity of published data investigating the very early luteal steroid profile following hCG trigger. This prospective, observational study was undertaken to determine the increase in serum progesterone levels after human chorionic gonadotrophin (hCG) trigger in stimulated IVF/ICSI cycles. This proof-of-concept study included 11 patients requiring ovarian stimulation for IVF/ICSI and who planned to avail of pre-implantation genetic screening with embryo vitrification of their biopsied embryos at blastocyst stage. For each study participant, five additional blood samples were drawn at the following specific times in the stimulation cycle, on the morning (10.00-12.00) of the assigned day to induce final oocyte maturation with hCG trigger, immediately prior to administration of hCG for final oocyte maturation, 1h, 2h, and 36h post hCG trigger. A prediction model, the Gompertz curve, was used to determine serum progesterone levels at intervals between the 2h post hCG trigger sample and the day of oocyte retrieval. Statistically significant increases in serum progesterone levels were identified following hCG administration as early as 1h following trigger (P4 0.57ng/ml, p < 0.05), 2h following trigger (P4 0.88ng/ml, p < 0.001) and on the day of oocyte retrieval (P4 9.68ng/ml, p < 0.001). According to our prediction model, the Gompertz curve, the projected serum progesterone level at 4h post trigger would have achieved a level of 1.45ng/ml, 8h post trigger of 3.04ng/ml, and 12h post trigger of 4.8ng/ml. The very early and significant increases in serum progesterone following hCG trigger are clearly demonstrated in this study. The endometrium is undoubtedly exposed to rapidly increasing serum progesterone levels post hCG trigger that would not be identified until much later in natural menstrual cycles. This study is registered with clinicaltrials.gov under the identifier NCT04417569.

Exposure to disinfection by-products and reproductive hormones among women: Results from the Tongji Reproductive and Environmental (TREE) study

BackgroundDisinfection by-products (DBPs) have been shown to impair female reproductive function. However, epidemiological evidence on reproductive hormones is scarce. ObjectiveTo investigate the associations between DBP exposures and reproductive hormones among women undergoing assisted reproductive technology. MethodsWe included 725 women from the Tongji Reproductive and Environmental (TREE) Study, an ongoing cohort conducted in Wuhan, China during December 2018 and January 2020. Urine samples collected at recruitment were quantified for dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) as biomarkers of DBP exposures. At day 2–5 of menstruation, serum reproductive hormones including luteinizing hormone (LH), estradiol (E2), total testosterone (T), progesterone (PRGE), and prolactin (PRL) were determined. Multivariate linear regression models were performed to assess the associations of urinary DCAA and TCAA concentrations with reproductive hormone levels. Dose-response relationships were investigated using natural cubic spline (NCS) and restricted cubic spline (RCS) models. ResultsAfter adjusting for relevant confounders, we observed that higher urinary DCAA levels were associated with increased serum PRGE (9.2%; 95% CI: −0.55%, 19.8% for the highest vs. lowest tertile; P for trend = 0.06). Based on NCS models, we observed U-shaped associations of urinary DCAA with serum PRGE and PRL; each ln-unit increment in urinary DCAA concentrations above 3.61 μg/L and 6.30 μg/L was associated with 18.9% (95% CI: 4.8%, 34.7%) and 23.3% (95% CI: −0.92%, 53.5%) increase in serum PRGE and PRL, respectively. The U-shaped associations were further confirmed in RCS models (P for overall association ≤0.01 and P for non-linear associations ≤0.04). We did not observe evidence of associations between urinary TCAA and reproductive hormones. ConclusionUrinary DCAA but not TCAA was associated with altered serum PRGE and PRL levels among women undergoing assisted reproductive technology.

Dose-Dependent Effects of Royal Jelly on Estrogen- and Progesterone-Induced Mammary Gland Hyperplasia in Rats.

Royal jelly (RJ) has a wide range of biological functions, its effect on hyperplasia of the mammary gland (HMG) in mammals is unclear. This study aims to investigate the effect of RJ on HMG and the dose-response relationship of RJ in the treatment of HMG. HMG rats are induced by intramuscular injection of estrogen (E2) and progesterone, and are treated with different doses of RJ (100, 200, 400, and 800 mg kg-1 d-1 ). As a result, RJ improves the expansion of acinar and breast tissue ducts, particularly at 100 and 800 mg kg-1 d-1 . These two doses also inhibit serum E2 and prolactin (PRL) secretion and increase serum progesterone secretion and the expression of estrogen receptor (ER)-β in the breast tissue. In addition, 800 mg kg-1 d-1 decrease and increase the mRNA expression of, respectively, hypothalamic gonadotropin-releasing hormone (GnRH) and pituitary GnRH receptors (GnRH-R). The lowest dosage (100 mg kg-1 d-1 ) increases GnRH-R mRNA expression as well. However, the effects of 200 and 400 mg kg-1 d-1 RJ on the reproductive parameters of HMG are not significant, implying a dose-dependent effect. RJ regulates endocrine dyscrasia in HMG rats and improves the breast tissue structure, indicating its potential in the prevention and treatment on HMG.

Fluctuations in serum steroid hormone concentrations and body mass during growth and sexual maturation in captive northern fur seals (Callorhinus ursinus).

Northern fur seals (Callorhinus ursinus) have a distinct life history pattern comprising annual terrestrial breeding and oceanic migration, and the physiological changes associated with these patterns are of particular interest for understanding their environmental adaptations. However, owing to their oceanic distribution, limited information is available on the reproductive physiology of wild individuals during the immature stage and the winter migration period. This study aimed to determine the relationships among the seasonal hormone profiles, body growth, age, and pregnancy using monthly serum samples collected over 3–5 years from two male and two female captive individuals during pubescence and sexual maturation. Small increases in the serum testosterone signaled puberty in males aged 3 and 4 years. Thereafter, males showed considerable increases in testosterone during breeding seasons, indicating sexual maturity. Immature female serum progesterone was maintained at low levels, but after pubescence, females showed an increase in serum progesterone in August, the month next to the peak of delivery, followed by a decrease. In non-pregnant females, progesterone did not increase significantly until the next breeding season, but in pregnant females, they increased again from February to March and then gradually decreased. Immature males increased body mass constantly and reached puberty when their body mass exceeded 20 kg, and they showed seasonal weight fluctuations after puberty. These results provide fundamental information for determining sexual maturity and pregnancy in this species based on sex steroid hormones and body mass measurements.

Antifibrotic Potential of Tetracarpidium conophorum (African Walnut) Leaves Extract on Diethylstilbestrol-Induced Rat Model of Uterine Fibroid

Background: The increased prevalence of uterine fibroid (UF) and its life-threatening impact among women of reproductive age led to the development of this study. The study investigated the antifibrotic potential of Tetracarpidium conophorum aqueous extract on UF-induced rats. Materials and Methods: Sixty-four female Wistar rats, with an average weight of 200 g, were used for the study. The rats were randomly divided into eight groups of eight animals each. UF was induced by oral administration of diethylstilbestrol (DES) and intramuscular injection of progesterone at dosages 1.35 and 1.0 mg/kg body weight, respectively. Group 1 was administered normal saline orally for 8 weeks. Groups 2 and 3 were treated with progesterone and a combination of DES and progesterone, respectively. Groups 4 and 5 were pretreated with 200 and 400 mg/kg T. conophorum extract, respectively, for 3 weeks before the administration of DES and progesterone for 5 weeks. Groups 6 and 7 were administered DES and progesterone for 5 weeks before being treated with 200 and 400 mg/kg T. conophorum extract, respectively, for 3 weeks. Group 8 was the self-recovery group-administered DES and progesterone for 5 weeks after which they were given normal saline orally for 3 weeks. Results: After the treatment period, the rats were euthanized, and blood was collected, while the uteruses were harvested. Co-administration of DES and progesterone produces UF conditions. However, pre- and post-treatment with 200 mg/kg of extract mitigated the effects that were induced by DES and progesterone, but no remarkable preventive and curative effects were observed with the higher dosage (400 mg/kg). There were a reduction of the serum prolactin level in the treatment groups and an increased serum progesterone level in the posttreatment group. Conclusion: The study has shown that T. conophorum has both preventive and curative effects on UF at low dosage (200 mg/kg).

ASSOCIATION BETWEEN PROGESTERONE LEVEL ON HUMAN CHRONIC GONADOTROPIN (HCG) TRIGGER DAY AND CLINCAL OUTCOMES OF CLEAVAGE-STAGE EMBRYOS OR BLASTOCYSTS TRANSFER IN ASSISTED REPRODUCTION TECHNOLOGY (ART) CYCLES

Several studies have reported that increased progesterone levels, usually defined as greater than 1.5 ng/mL, occur on the human chronic gonadotropin (hCG) day in approximately 6-30% of COH cycles. The increased serum progesterone level on the day of hCG administration is associated with significantly lower ongoing pregnancy rates in in vitro fertilization and embryo transfer (IVF-ET) cycles. However, the effect of increased serum progesterone levels on the day of hCG administration in COH cycles on clinical outcomes for different embryos transfer remains controversial.

Expression of steroidogenic enzymes and TGFβ superfamily members in follicular cells of prepubertal gilts with distinct endocrine profiles.

Regulation of the transforming growth factor beta (TGFβ) superfamily by gonadotrophins in swine follicular cells is not fully understood. This study evaluated the expression of steroidogenic enzymes and members of the TGFβ superfamily in prepubertal gilts allocated to three treatments: 1200 IU eCG at D -3 (eCG); 1200 IU eCG at D -6 plus 500 IU hCG at D -3 (eCG + hCG); and the control, composed of untreated gilts. Blood samples and ovaries were collected at slaughter (D0) and follicular cells were recovered thereafter. Relative gene expression was determined by real-time PCR. Serum progesterone levels were greater in the eCG + hCG group compared with the other groups (P < 0.01). No differences were observed in the expression of BMP15, BMPR1A, BMPR2, FSHR, GDF9, LHCGR and TGFBR1 (P > 0.05). Gilts from the eCG group presented numerically greater mean expression of CYP11A1 mRNA than in the control group that approached statistical significance (P = 0.08) and greater expression of CYP19A1 than in both the eCG and the control groups (P < 0.05). Expression of BMPR1B was lower in the eCG + hCG treatment group compared with the control (P < 0.05). In conclusion, eCG treatment increased the relative expression of steroidogenic enzymes, whereas treatment with eCG + hCG increased serum progesterone levels. Although most of the evaluated TGFβ members were not regulated after gonadotrophin treatment, the downregulation of BMPR1B observed after treatment with eCG + hCG and suggests a role in luteinization regulation.

Effects of Resveratrol on Receptor Expression and Serum Levels of Estrogen and Progesterone in the Rat Endometritis Model.

Endometritis is characterized by inflammation of the endometrial lining that leads to reduced reproductive potential. Restoring the impaired hormonal balance is an important component of endometritis treatment. The purpose of the current study was to evaluate the effects of resveratrol on estrogen and progesterone hormone status in endometritis. Mature female Sprague Dawley rats were used, and endometritis was induced by intrauterine infusion of Escherichia coli. Animals were treated with resveratrol alone or combined with marbofloxacin. Compared to the non-treated endometritis group, resveratrol treatment reduced serum oestradiol levels, increased serum progesterone levels, enhanced estrogen receptor (ER) expression in the uterine stroma, decreased ESR1 gene expression, and raised ESR2 gene expression. Resveratrol administration combined with marbofloxacin also increased ER expression in the uterine gland and progesterone receptor expression in the uterine epithelium. The findings of this study suggest that the actions of resveratrol on progesterone levels and estrogen receptor expression might be responsible for its beneficial effect in rats with endometritis.

Long-term exposure to particulate matter and residential greenness in relation to androgen and progesterone levels among rural Chinese adults

BackgroundPopulation-based studies on the associations of long-term exposure to particulate matter (PM) with androgen and progesterone are still scant. Residential greenness is benefits health by promoting physical activity, reducing air pollution, and improving mental health, but it remains unclear whether it is related to androgen and progesterone levels among humans. AimsThis study aimed to explore the individual and interactive effects of PM and residential greenness on serum testosterone and progesterone levels among rural Chinese adults. MethodsA total of 6017 subjects were recruited from the baseline of the Henan Rural Cohort Study in 2016. Serum testosterone and progesterone were measured with liquid chromatography-tandem mass spectrometry. Particulate matters (PM) (PM1, PM2.5, and PM10) were assessed by machine learning algorithms. Residential greenness was assessed using the normalized difference vegetation index (NDVI) within 500-m, 1000-m, and 3000-m buffers around participants’ residences. The effects of air pollutants and residential greenness and their interaction on serum testosterone and progesterone levels were assessed using linear mixed-effects models with township as a random intercept. ResultsAfter adjusting for potential confounding factors, a 1 μg/m3 increase in PM2.5 or PM10 was associated with a 0.037 or 0.030 ng/ml increase in serum testosterone, respectively, in females and with a 0.111 or 0.182 ng/ml decrease in serum progesterone, respectively, in males. A 1 μg/m3 increase in PM1, PM2.5 or PM10 was associated with a 0.222, 0.306, or 0.295 ng/ml decrease in serum progesterone, respectively, among females. Moreover, a 0.1-unit increase in NDVI was associated with a 0.310 ng/ml increase in serum testosterone and a 0.170 ng/ml increased in serum progesterone in males, as well as with a 0.143 ng/ml increase in serum progesterone in females. Interaction effects of PM and residential greenness on serum testosterone and progesterone levels were observed, indicating that the effects of residential greenness on serum testosterone and progesterone were modified by high levels of PM. In addition, physical activity significantly mediated 2.92% of the estimated association between greenness and testosterone levels. ConclusionsOur study suggested that long-term exposure to PM was positively associated with serum testosterone in males but negatively associated with progesterone levels in both genderssin. In addition, positive associations of residential greenness with serum testosterone and progesterone levels were observed, but they were modified by high levels of PM. Furthermore, the estimated effects of residential greenness on testosterone levels were partly mediated by physical activity.

Subcutaneous luteal phase progesterone rescue rectifies ongoing pregnancy rates in hormone replacement therapy vitrified–warmed blastocyst transfer cycles

Research questionWill luteal phase rescue with additional progesterone increase serum progesterone concentrations and improve reproductive outcomes in patients with low serum progesterone concentrations undergoing hormone replacement therapy (HRT) cycles? DesignCase–control study including 40 consecutive patients with serum progesterone concentrations <8.75 ng/ml on the 5th day of progesterone supplementation who underwent rescue with a daily bolus of 25 mg s.c. progesterone, starting on the afternoon of the 5th day of progesterone administration. For every patient who underwent progesterone rescue, three patients matched by age, body mass index, number of previous attempts and number of blastocysts transferred, with serum progesterone concentration >8.75 ng/ml on the 5th day of progesterone administration served as controls (n = 120). The main outcome measure was ongoing pregnancy rate (OPR). ResultsBaseline demographic features and embryological data of the rescue and control groups were comparable. As expected, the mean serum progesterone concentration was lower in the rescue group on the 5th day of progesterone administration (7.84 ± 0.92 versus 15.32 ± 5.02 ng/ml; P < 0.001). Following rescue, the mean serum progesterone concentration on the day of vitrified–warmed embryo transfer (6th day of progesterone administration) was 33.43 ± 10.83 ng/ml (range 14.61–82.64 ng/ml), and the OPR of the rescue and control groups were comparable. ConclusionsIn patients undergoing HRT vitrified–warmed blastocyst transfer with serum progesterone concentrations lower than 8.75 ng/ml 1 day prior to the scheduled embryo transfer (6th day of progesterone administration), additional supplementation with a 25 mg s.c. daily progesterone dose seems to rescue the cycle, resulting in OPR comparable to those of patients with serum progesterone >8.75 ng/ml.

The value of serum progesterone level on day of human chorionic gonadotrophin administration / metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

BackgroundThe clinical implication of the increased serum progesterone level on the day of HCG administration in assisted reproduction treatment (ART) is still controversial. The current study aimed to compare the predictive value of serum progesterone on day of HCG administration / metaphase II oocyte (P/MII) ratio on IVF/ ICSI outcome to serum progesterone (P) level alone and the ratio of serum progesterone/estradiol level (P/E2) ratio in prediction of pregnancy rates after ART.Material & methodsTwo hundred patients admitted to the IVF/ICSI program at Minia IVF center in Egypt in the period from October 2016 to May 2018 were included in this study. Serum Progesterone (P) and Estradiol (E2) levels were estimated on the day of HCG administration. The ratio between serum P and the number of MII oocytes (P/MII ratio) was calculated and the predictive values of the three parameters (P, P/E2 ratio and P/MII ratio) in prediction of cycle outcomes were measured.ResultsP/ MII oocyte ratio was significantly lower in patients who attained clinical pregnancy (n = 97) as compared with those who couldn’t whilst there was no significant difference in P and P/E2 ratio between the two groups. Using a cut off value of 0.125, the sensitivity and specificity of progesterone/ MII ratio in prediction of no pregnancy in IVF/ICSI were 75.7 and 77.1% respectively with the area under The Receiver operating curve (ROC-AUC) = 0.808. The respective values of the ROC-AUC for the P and P/E2 ratio were 0.651 and 0.712 with sensitivity and specificity of 71.2 and 73.5%for P level and of 72.5 and 75.3% for P/E2 ratio. Implantation or clinical pregnancy rates were significantly different between patients with high and low P/MII ratio irrespective of day of embryo transfer (day 3 or 5).ConclusionsIn patients with normal ovarian response, serum progesterone on day of HCG / MII oocyte ratio can be a useful predictor of pregnancy outcomes and in deciding on freezing of all embryos for later transfer instead of high progesterone level alone.

Endometrial thickness is not predictive for live birth after embryo transfer, even without a cutoff

To investigate the predictive value of endometrial thickness (EMT) for live birth when a lower threshold of EMT is not employed for embryo transfer (ET). Retrospective study SETTING: Academic assisted reproduction center PATIENT(S): All women who underwent fresh or frozen-thawed ET at the Koç University Hospital Assisted Reproduction Unit between October 2016 and August 2019 INTERVENTION(S): After ruling out endometrial pathology, blastocyst transfer was planned regardless of the EMT in the absence of increased serum progesterone level on the trigger day in fresh embryo transfer cycles or before commencing progesterone treatment in artificially prepared frozen-thawed ET cycles. The primary outcome was live birth. Live birth and miscarriage rates per ET were stratified according to fresh and frozen-thawed ET cycles for each millimeter of endometrial thickness. Receiver operator characteristic curve analyses were performed to evaluate the predictive value of EMT for live birth. A total of 560 ET cycles, 273 fresh and 287 frozen-thawed, were included in the study. Relevant patient characteristics as well as EMTs were similar between women who achieved a live birth and those who did not after fresh or frozen-thawed ET. There was no linear association between EMT and live birth or miscarriage rates. Area under the curve values for EMT to predict live birth after fresh, frozen-thawed, and all ETs were 0.56, 0.47, and 0.52, respectively. Our results showed that the EMT was not predictive for live birth in either fresh or frozen-thawed ET cycles. Once intracavitary pathology and inadvertent progesterone exposure were excluded, women with thinner EMTs should not be denied their potential for live birth because it is comparable to that of those with thicker EMT.

Impact of Premature Progesterone Rise on Intracytoplasmic Sperm Injection Outcomes Using Gonadotropin-Releasing Hormone Antagonist Protocol

Background: Premature progesterone rise (PPR) refers to an increase in serum progesterone (P4) levels on or before the human chorionic gonadotropin (hCG) trigger day. This work aimed to evaluate the impact of serum P4 levels on the day of hCG trigger on the outcomes of intracytoplasmic sperm injection (ICSI) cycles using the gonadotropin-releasing hormone (GnRH) antagonist protocol. Methods: The prospective cohort study was conducted at the Cytogenetics and Endoscopy unit, Obstetrics & Gynaecology Department, Zagazig University, including 150 women having ICSI/fresh-embryo transfer (ET). Each patient had one trial of ICSI/fresh ET cycle. In the study, patients were subjected to controlled ovarian stimulation (COS) using a GnRH antagonist protocol. P4 levels were measured on the hCG trigger day (hCG-P4), and the results were correlated to the outcomes of the ICSI cycle. Results: There was a statistically significant negative correlation between hCG-P4 and the top-quality embryo (TQE) rate. No significant association was found between hCG-P4 level and clinical pregnancy, ongoing pregnancy, or miscarriage. The cutoff for hCG-P4 predicting unsuccessful achievement of clinical pregnancy was ≥ 0.925 (p>0.05). Patients with hCG-P4 level ≥0.925 ng/ml had a significantly lower TQE rate than patients with hCG-P4

Homeostatic Regulation of Estrus Cycle of Young Female Mice on Western Diet.

The etiology of reproductive disorders correlates with weight gain in patients, but the link between reproduction, diet, and weight has been difficult to translate in rodents. As rates of childhood obesity and reproductive disorders increase, the need to study the effects of weight and diet on adolescent females is key. Previous studies show that female mice are resistant to high-fat diet–induced weight gain, but the mechanisms are unclear. Literature also suggests that ovarian function is essential to resistance in weight gain, as an ovariectomy leads to a weight-gaining phenotype similar to male mice on a high-fat diet. However, reproductive changes that occur in adolescent mice on high-fat diet have not been assessed. Here, we show that regulation of the estrus cycle via progesterone is critical to metabolic homeostasis in female mice on a high-fat diet. Female mice were put on high-fat diet or control diet for 12 weeks starting at 4 weeks of age. Every 4 weeks, their estrus cycle was tracked and fasting glucose was measured. We found that after 4 weeks on high-fat diet, there was no difference in weight between groups, but an increase in time spent in proestrus and estrus in mice on high-fat diet and an increase in serum progesterone during proestrus. These results show that intact females modulate their estrus cycle in response to a high-fat diet as a mechanism of homeostatic regulation of body weight, protecting them from metabolic abnormalities. Understanding the mechanisms behind this protection may yield therapeutic opportunities for treatment of reproductive disorders in adolescent female patients.

Measurement of Metabolic and Inflammatory Serum Markers and Immune Marker Gene Expression during Superovulation in Beef Cattle

Health status of donor cows during superovulation is important to ensure optimal embryo quality at time of collection. Because nutritional and metabolic status impact embryo quality some form of nutritional supplementation is often provided before and during superovulation. OmniGen-AF&reg (OG) feeding has been shown to assist in the maintenance of animal health through regulation of metabolic status and balance and supporting aspects of immune function. We observed feeding donor cows OG decreased percent degenerate embryos recovered following superovulation increased serum progesterone concentration and improved in vitro embryo development. Evaluation of OG feeding on markers of metabolic function and inflammatory and immune function in beef cattle embryo donors are reported here. Similarly, cow metabolic and inflammatory response with repeated superovulation protocols is not known. Biomarkers to monitor and evaluate cow health during superovulation may provide management options to improve embryo recovery and quality. Twenty-four Angus cross-bred cattle were randomly assigned to four treatment groups, fed 0 or 56 g/hd/day for 49 days and superovulated with 200 or 400 mg Folltropin V (FSH). Blood was collected weekly for analyses. The protocol was repeated on all cows 90 - 120 d later with cows reassigned to their original groups. No differences (P > 0.10) were observed due to OG feeding or FSH dose on metabolic and inflammatory markers. Replicate exerted a significant effect where serum concentration of albumin, IL1β, IL6, PGE2 and leptin were lower (P < 0.05) in Replicate 1 compared to 2. There was also a similar pattern of change in several of the metabolic and inflammatory markers during the superovulation protocol where concentrations were higher at the time of estrus and ovulation. Taken together, physiologic changes during the estrous cycle and the number of superovulation protocols can modulate metabolic markers and inflammatory response.