Mean Follicular Diameter Research Articles

Reducing 3D Hydrogel Stiffness, Addition of Oestradiol in a Physiological Concentration and Increasing FSH Concentration Improve In Vitro Growth of Murine Preantral Follicles.

This study aimed to optimise culture conditions for murine preantral follicles to improve their growth and survival. Preantral follicles (diameter 100-130 µm) were isolated from prepubertal NMRI mice and individually cultured within alginate beads for 12 days. Three conditions were evaluated: (1) follicle re-encapsulation on day 6 of culture-reducing alginate concentration (0.5% to 0.25% w/v), (2) the presence of oestradiol (E2), and (3) increased follicle-stimulating hormone (FSH) concentration in the culture medium (from 10 to 100 mIU/mL FSH). Follicle morphology and growth, as well as anti-Müllerian hormone (AMH) production, were evaluated. From day 8, re-embedded follicles had a larger average diameter compared to follicles without alginate re-encapsulation (0.5% and 0.25% groups, p < 0.05). Oestradiol (1 µM) had a significantly positive effect on the mean follicular diameter and antrum formation (p < 0.001). Moreover, follicles cultured with 100 mIU/mL FSH showed faster growth (p < 0.05) and significantly higher antrum formation (p < 0.05) compared to the low FSH group. Nevertheless, AMH production was not affected by any of the culture conditions. In conclusion, the growth and survival of mouse preantral follicles during a 12-day period were improved by altering the alginate concentration midways during culture and adding E2 and FSH to the culture medium.

Effects of estradiol, progesterone and kisspeptin-1 concentrations at the time of insemination on conception rates in cattle

The present study aimed to investigate the effects of kisspeptin (Kiss-1), estradiol (E2), and progesterone (P4) levels at the time of artificial insemination (AI) on conception rates and also whether or not there is a relationship between Kiss-1 and E2 levels in cattle. Cows (n=100) raised on a semi-closed farm system and having corpus luteum were administered 25mg of prostaglandin F2a (Dinolytic®, Zoetis, Spain) and were evaluated following injection for signs of estrus. Just prior to AI, pre-ovulatory follicle diameters were assessed by ultrasonography (USG) and recorded. Then blood samples were collected. Blood serum samples were separated and stored until analyzed. Pregnancies were determined with rectal USG on day 30±2 following AI. The mean follicular diameters at the time of AI were similar in pregnant (17.9±0.01 mm) and non-pregnant (17.9±0.01 mm) cows. E2, P4, and Kiss-1 levels at the time of AI were determined from serum samples using the ELISA method. The Kiss-1 level at the time of AI in pregnant cows (80.58±4.4 pg/mL) was statistically higher than that in non-pregnant cows (66.68±2.48 pg/mL) (P=0.003). There were no statistically significant differences in E2 and P4 levels between pregnant and non-pregnant cows. Moreover, while a significant correlation was found between serum kiss-1 level and follicle diameter, no significant correlation was found between serum estrogen and progesterone levels. In conclusion, Kiss-1 levels at the time of AI may be used to predict the possibility of successful pregnancy in cattle, allowing different approaches to be developed to increase pregnancy rates in animals with low Kiss-1 levels at the time of AI.

Effect of Stress on Ovarian Follicular Activity in Postpartum Sahiwal Cows during Hot-humid Season

Present investigation was carried out to study the effect of stress on ovarian follicular activity in postpartum acyclic Sahiwal cows during hot-humid months. Postpartum ovarian activity was monitored using trans-rectal ultrasound scanning on alternate days beginning between day 60 and 90 postpartum in Sahiwal cows (n=16) up to next 21 days.Daily maximum temperature and relative humidity was recorded andtemperature-humidity index (THI)was calculated during study period. Six animals (37.5 %) showed presence of dominant follicle (≥10 mm, cyclic) and 10 animals (62.5 %) were classified as acyclic (ovarian follicle &lt; 10 mm diameter). Present study demonstrated that as the value of THI reduced, the mean follicular diameter proportionately increased and vice versa. Based on the findings of present study, it may be concluded that development of ovarian follicle is highly affected by THI value during hot-humid season in Sahiwal cows and the reproductive performance of animal may be predicted using THI values.

Automated Follicular Assessment Using a Novel Two-dimensional Ultrasound-based Solution.

Background:High intra- and interobserver variability in the follicular assessment using two-dimensional (2D) ultrasound (US) is still a concern. To solve this issue, we have developed a novel software solution, which automatically provides follicles' count and their diameters using 2D US images obtained by a manual sweep of an ovary. The primary objective of this study was to compare the result of the automated solution with a manual 2D US-based assessment.Methods:In the first phase, multiple follicular US sweeps were collected from 54 subjects; these sweeps were used to develop the software. In the second phase, data from 10 subjects were collected for validation of the developed solution. During each phase, for follicles ≥5 mm, their count and diameters were recorded by the sonologist using 2D US.Results:For the total follicle count, a high correlation (0.787) was observed between the solution and manual assessment. The 95% limits of agreement between the two methods were in the range of 4.232 to −4.258. The two methods had an excellent correlation (0.817) for the measurement of mean follicular diameter. However, the solution had a tendency to underestimate the mean diameter by an average of 1.725 mm (±2.16 mm). The limits of agreement between the two methods for mean diameter measurement were from 2.508 to −5.960 mm.Conclusion:This study validates the feasibility of our solution for automatic assessment of follicle count and diameter with accuracy comparable to the 2D US-based manual assessment. We further observed that the solution's performance is better than known intra- and interobserver variability of the manual assessment. We recommend further validation of the solution to confirm these initial results and potential time gain with an automated assessment.

Randomized controlled open-label study of the effect of vitamin E supplementation on fertility in clomiphene citrate-resistant polycystic ovary syndrome.

To evaluate the effect of vitamin E on ovulation and pregnancy in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). A prospective, randomized, controlled, open label study was conducted on women with CC-resistant PCOS. Patients were randomized, to either control group (n = 30), who received metformin 500 mg thrice daily, in addition to 150 mg/day CC for 5 days starting from day 3 of menstruation for three menstruation cycles, or vitamin E group (n = 30) who received vitamin E 1500 IU/day for the whole study period in addition to metformin and CC with the same previous regimen. The primary outcome was cumulative ovulation rate, while secondary outcomes were pregnancy rate, serum midluteal progesterone, mean follicular diameter, number of dominant follicles and endometrial thickness. Ovulation was reported in 57 (64.8%) of 88 cycles in the control group and 63 (73.3%) of 86 cycles in the vitamin E group (P = 0.227), while pregnancy was reported in 4 (4.5%) of 88 cycles in the control group and 6 (7%) of 86 cycles in the vitamin E group (P = 0.491).There were nonsignificant differences between groups regarding serum midluteal progesterone, number of dominant follicles and mean follicular diameter. Endometrial thickness was significantly higher in the vitamin E group compared to the control group. The findings of this trial do not support the hypothesis that vitamin E may increase the ovulation and pregnancy rates in women with clomiphene citrate-resistant PCOS.

Factors affecting oocyte recovery and pregnancy rates of fresh and frozen/thawed ICSI embryos

The aim of the present study was to verify how repeated ovum pick-up (OPU), performed in anestrous and cyclic mares, affect ovarian activity, measured by progesterone (P4) and 17ß-estradiol (E2) plasma levels. Ovum pick-up of all visible follicles was performed every 9 to 12 days, and four sessions were carried out during anestrous (A) and breeding season (BS). The number of aspirated follicles per mare at each session was not significantly different between the two periods (BS: 6.1 ± 2.4; A: 7.5 ± 4.4; P > 0.05), but the mean follicular diameter was significantly higher during BS (16.0 ± 7.1 vs. 10.2 ± 5.1 mm; P < 0.05); during A the number of aspirated follicles less than 15 mm in diameter resulted significantly higher than that registered in BS (5.1 ± 2.7 vs. 3.0 ± 1.8; P < 0.05). The total mean value of P4 was higher in BS than in A (6.3 ± 4.4 vs. 0.3 ± 1.8 ng/mL; P < 0.05), whereas the total mean level of E2 was not different between the two periods (3.8 ± 3.4 vs. 2.5 ± 2.7 pg/mL; P > 0.05). Estradiol plasma values resulted positively correlated, in A and BS, with diameter of follicles detected on the ovaries (R = 0.345 and R = 0.331, respectively), whereas a negative correlation was observed between P4 and follicular diameter in BS (R = −0.162). Both E2 and P4 presented a high individual variability during BS; in particular, in three of seven mares, P4 trend was compatible with a normal estrous cycle, and the interval between two consecutive peaks was 21 days. In two of seven mares, with CL at first OPU, P4 concentrations remained more than 3 ng/mL throughout the entire treatment period. Finally, in two of seven animals, P4 levels initially showed a similar pattern to that of a normal estrous cycle, then, after the second aspiration, they remained consistently higher than 3 ng/mL. When the procedure was carried out in cyclic animals, the influence of this technique on ovarian activity seemed to be related to individual variability although, according to progesterone values, structures observed on the ovaries after aspirations presented luteal function. Furthermore, the resumption of normal ovarian activity, after repeated OPU sessions, occurred in a period not much longer than the duration of a normal estrous cycle (25.4 ± 5.2 days). Data recorded during nonbreeding period showed that repeated OPU in anestrous mares do not affect ovarian activity and do not anticipate the resumption of ovarian cyclicity. However, based on the number of aspirated follicles in anestrous and cyclic mares, both types of subjects could be considered as oocyte donors.

Different factors affecting the success of intrauterine insemination

Objective: The purpose of this study was to investigate the influence of various factors on the outcome of intrauterine insemination (IUI) as a trial for improving the quality of health care provided for women with infertility problems as well as infertility center outcomes. Methods: Cohort study conducted over two years between December 2016 and December 2018 in IVFICSI center. Two hundred forty-nine couples diagnosed with different infertility etiologies underwent 487 cycles of IUI were enrolled. Ultrasound follicular measurements were recorded around time of ovulation as well as different factors were col- lected and compared between pregnant and non-pregnant groups. Main outcome measures were clinical pregnancy rate and risk of OHSS ac- cording to the woman’s age, BMI, infertility type, different etiology of female infertility, the ovulation drug used and the quantity and size of ovarian follicles before hCG injection. Setting: Department of Obstetrics and Gynecology, Suez Canal Uni- versity Hospitals, Ismailia. Results:Pregnancy was achieved in 21.4% of cycles enrolled in the anal- ysis being significantly higher in women with mean follicular diameter of leading follicle of (19.8 +/- 1.97mm) in women with shorter infertility duration. The highest pregnancy rate was achieved in third IUI cycle. Conclusion: Leading follicle mean diameter of 19.8 mm was the op- timum diameter to trigger the ovulation and to have pregnancy. Early treatment of infertility is recommended as the success rate of IUI seems to get less with longer duration of infertility.

Effect of Social Isolation on Rat Ovary and the Possible Protective Role of Melatonin: Light, Electron Microscopic, Biochemical and Molecular Study

Abstract Background: Social Isolation (SI) is an influential stressor in animals and humans, which has a negative impact on mental and physical health. It is associated with increased oxidative stress and decreased antioxidant capacity. Melatonin (MT) is well known by its antioxidant properties that help in prevention of tissue damage. Aim of Study: The present study aimed to investigate the harmful effect of SI on rat ovary and the possible protective role of MT. Material and Methods: Twenty adult female albino rats were divided into four groups; five rats in each (control, MT, SI and SI + MT). Histological examination was done using hematoxylin and eosin, semithin sections were stained with toluidine blue and ultrathin sections were performed. Meas-urements of Malondialdehyde (MDA) and Superoxide Dis-mutase (SOD) activity in ovarian tissue were carried out. Quantitative analysis of SIRT1 gene expression was done by real-time Polymerase Chain Reaction (PCR). Morphometric measurements were also performed. Results: Light microscopic examination of ovarian follicles from SI group showed shrunken granulosa cells with pyknotic nuclei and irregular oocytes with rarified cytoplasm. Cyto-plasmic vacuolation was observed in granulosa cells, theca cells and granulosa lutein cells. Ultrastructural examination of granulocsa cells showed swollen mitochondria and abundant lipid droplets. The oocytes exhibited disrupted microvilli. There was significant decrease in the mean follicular diameter, granulosa and theca layer thickness in SI group compared to control group. These morphological changes were associated with significant increase in MDA and decrease in SOD activity, in addition to increased SIRT1 gene expression. Concomitant administration of MT improved the previously mentioned alterations. Conclusion: Social isolation induced histological, ul-trastructural and morphometric changes in the ovary of rats. These changes were associated with oxidative stress, decreased antioxidant capacity and increased SIRT1 gene expression. Melatonin administration ameliorated these harmful effects, possibly due to its antioxidant property.

Ovarian hyperstimulation closely associated with resumption of follicular growth after chemotherapy during tamoxifen treatment in premenopausal women with breast cancer: a multicenter retrospective cohort study

BackgroundWe previously reported that tamoxifen (TAM)-induced ovarian hyperstimulation (OHS) is associated with high serum concentrations of estradiol in premenopausal women with breast cancer. To investigate risk factors for TAM-induced OHS, we performed a retrospective multicenter study.MethodsPremenopausal patients who received surgical therapy for endocrine-dependent breast cancer (n = 235) were recruited in this study and classified into 4 groups: group A, treated with TAM alone; group B, TAM treatment after 2-year-combined therapy with a gonadotropin-releasing hormone (Gn-RH) agonist; group C, TAM treatment after chemotherapy; group D, 5-year-combined therapy with TAM and a Gn-RH agonist. A serum estradiol value of more than 300 pg/mL or mean follicular diameter of more than 30 mm was defined as OHS.ResultsThe incidence of OHS in group A (n = 13/26, 50.0%) was significantly higher than those in group B (n = 17/63, 27.0%), group C (n = 20/110, 18.2%), and group D (n = 0/36, 0%). The incidence of OHS was significantly correlated with aging, and the median serum concentration of estradiol in the presence of OHS was 823.0 pg/mL. The incidence of OHS (less than 47 years old) was 62.5% in group A, 48.6% in group B, and 28.2% in group C, respectively. Notably, the incidence rate of OHS following amenorrhea in group C (n = 13/20, 65.0%) was significantly higher than that in group B (n = 1/17, 5.9%).ConclusionsThese findings indicate that the onset of OHS following amenorrhea was common in the post-chemotherapeutic group, while its ratio was low in the group after Gn-RH analog treatment, suggesting that combined treatment-based management involving TAM therapy is necessary for premenopausal patients with breast cancer.

Relationship of maximum follicular size, age of woman, and reproductive implications in women attending fertility clinic in St. Margaret's Hospital, Lokoja, using Creighton Model FertilityCare™ System and NaProTECHNOLOGY

Background: Some authorities have found that, when the mean follicular diameter is >25 mm, the follicle is considered large, and these authorities are convinced that large follicles are biomarkers to ovarian pathology. Several studies have been carried out to determine the optimal maximum follicular size (MFS) that will be adequate before the use of human chorionic gonadotropin trigger to induce ovulation. None of these studies have considered the woman's age as a factor. An in vitro fertilization-based study has also shown that large leading follicles did not result in higher percentage of matured oocytes, and they even result in a lower live birth rate; however, we note that the ages of the women were not specifically mentioned in connection with the problems of large follicle. Subjects and Methods: We set out in this study to evaluate the relationship between the MFS and the woman's age both in our control group (fertile women) Group (A) and in the women attending fertility clinic Group (B). Using the Creighton Model Fertility Care System and NaProTECHNOLOGY, it was possible to determine when to start follicular tracking and also determine ultrasound diagnosis of ovulation by recording the MFS and the reduced size. Results: In both Group A and Group B, we discovered that the MFS reduces as woman's age increases. We also discovered that the average MFS in the Group B was higher for age compared with the Group A (P = 0.0043). There was also an association between these bigger follicles for age and low mid-luteal progesterone. This is probably the first study that describes the association of follicular size and woman's age and its possible link with ovulation defects. Recommendation: We have proposed that this phenomenon of large matured maximum follicle for age could be a contributory factor to infertility and miscarriages. We propose further studies to verify this hypothesis. Conclusion: Despite the high percentage of complete rupturing of follicles in the AB cycles in the Group (B) there are very high proportion having low mid luteal (P+7) Progesterone. This may be due to pathologies associated with big follicles for woman's age. The E2/Pg ratio study in luteal phase strongly suggested that the women in Group (B) that may have fertility challenge are those in subgroup of AB in Group (B). Therefore matured follicular size should be considered with the woman's age. If the follicles grows bigger away from the range for a woman's age it may be the marker for infertility or reproductive health challenges.

Simultaneous Letrozole and Clomiphene Citrate versus Letrozole Alone in Clomiphene Citrate Resistant Polycystic Ovary Syndrome: A Randomised Controlled Trial

Background: Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility. The therapeutic strategies for clomiphene citrate (CC)- resistant patients include the addition of corticosteroids, extended duration of clomiphene, gonadotrophin therapy, laparoscopic ovarian drilling, in vitro fertilization or the use of aromatase inhibitors recently. Letrozole decreases estrogen levels in the body, so it releases the hypothalamus and/or pituitary gland from the negative feedback of estrogen. This increases levels of gonadotrophins, which stimulates follicular growth. Objectives: To evaluate the role of letrozole alone and simultaneous use of letrozole and clomiphene citrate (CC) for ovulation induction in patients with clomiphene citrate-resistant PCOS (CCR-PCOS). Patients and Methods: This open-label randomised controlled study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt during the period from February 2018 to June 2019. The study included 60 CCR-PCOS patients who were randomly allocated by independent personnel into two arms: group A (letrozole alone) or B (letrozole + CC). In either group, monitoring the mean follicular diameter and endometrial thickness in the days 10, 12, and 14 of the cycle by transvaginal ultrasound and Measurement of serum Progesterone (ng/ml) 7 days after the expected time of ovulation. Results: We investigated various clinical and sonographic factors that may predict the outcome of the method of induction of ovulation in CCR-PCOS with no significant affection for the results. There was a non-significant difference between the studied groups regarding ovulation and pregnancy per cycle or per patient. Conclusion: Letrozole alone or simultaneous use of letrozole and CC offers a good second-line option for induction of ovulation in CCR-PCOS patients. However, the combination of CC and letrozole did not add any benefit over the use of letrozole alone regards ovulation rate, follicular volume, endometrial thickness, pregnancy rate and live birth rate.

Day 8 Embryos and Endometrium From Aluteal Cycles in Mares Exhibit Differential Gene Expression

The aim of the present study was to verify how repeated ovum pick-up (OPU), performed in anestrous and cyclic mares, affect ovarian activity, measured by progesterone (P4) and 17ß-estradiol (E2) plasma levels. Ovum pick-up of all visible follicles was performed every 9 to 12 days, and four sessions were carried out during anestrous (A) and breeding season (BS). The number of aspirated follicles per mare at each session was not significantly different between the two periods (BS: 6.1 ± 2.4; A: 7.5 ± 4.4; P > 0.05), but the mean follicular diameter was significantly higher during BS (16.0 ± 7.1 vs. 10.2 ± 5.1 mm; P < 0.05); during A the number of aspirated follicles less than 15 mm in diameter resulted significantly higher than that registered in BS (5.1 ± 2.7 vs. 3.0 ± 1.8; P < 0.05). The total mean value of P4 was higher in BS than in A (6.3 ± 4.4 vs. 0.3 ± 1.8 ng/mL; P < 0.05), whereas the total mean level of E2 was not different between the two periods (3.8 ± 3.4 vs. 2.5 ± 2.7 pg/mL; P > 0.05). Estradiol plasma values resulted positively correlated, in A and BS, with diameter of follicles detected on the ovaries (R = 0.345 and R = 0.331, respectively), whereas a negative correlation was observed between P4 and follicular diameter in BS (R = −0.162). Both E2 and P4 presented a high individual variability during BS; in particular, in three of seven mares, P4 trend was compatible with a normal estrous cycle, and the interval between two consecutive peaks was 21 days. In two of seven mares, with CL at first OPU, P4 concentrations remained more than 3 ng/mL throughout the entire treatment period. Finally, in two of seven animals, P4 levels initially showed a similar pattern to that of a normal estrous cycle, then, after the second aspiration, they remained consistently higher than 3 ng/mL. When the procedure was carried out in cyclic animals, the influence of this technique on ovarian activity seemed to be related to individual variability although, according to progesterone values, structures observed on the ovaries after aspirations presented luteal function. Furthermore, the resumption of normal ovarian activity, after repeated OPU sessions, occurred in a period not much longer than the duration of a normal estrous cycle (25.4 ± 5.2 days). Data recorded during nonbreeding period showed that repeated OPU in anestrous mares do not affect ovarian activity and do not anticipate the resumption of ovarian cyclicity. However, based on the number of aspirated follicles in anestrous and cyclic mares, both types of subjects could be considered as oocyte donors.

Dominant follicles development and estradiol-17β concentrations in non-ovulating and ovulating post-partum Bulgarian Murrah buffaloes.

This study was designed to evaluate the dominant follicles development and the estradiol-17β concentrations in non-ovulating and ovulating post-partum buffaloes. Sixteen Bulgarian Murrah buffaloes were submitted to transrectal ultrasonographic examination from the 1st post-partum day until day 50, 3days apart. The follicular diameter of the different categories of follicles and the ovulations was recorded. The animals were allocated into two groups: I (n=6) non-ovulating and II (n=10) ovulating buffaloes. Serum estradiol-17β concentrations on the days for dominant follicle registration were measured by enzyme-linked immunosorbent assay. The results were statistically processed by analysis of variance, non-parametric and correlation analysis. The mean intervals between calving and first dominant follicle detection differed significantly (p<.05) among the groups (19.5±6.2 vs. 13.8±5.1days), while the mean intervals between registered dominant follicles from two successive waves were comparable. The mean follicular diameters for the same category follicles in both groups were similar. Different estradiol-17β concentrations (p<.05) for the first dominant follicle between non-ovulating (23.5±7.0pg/ml) and ovulating (33.3±8.4pg/ml) buffaloes were determined. The cumulative percentages of buffaloes with firstly detected dominant follicle and ovulating animals correlated positively (r≥.84; p<.05) to post-partum days. In conclusion, non-ovulating and ovulating post-partum Bulgarian Murrah buffaloes showed differences in the development of the first dominant follicle and estradiol-17β concentrations during the time of dominant follicles detection.

Operative transvaginal hydrolaparoscopy improve ovulation rate after clomiphene failure in polycystic ovary syndrome

Aim of our study was to assess the ovulation rate, with mid-luteal progesterone level and ultrasound follicles monitoring, in PCOS CC-resistant patients undergone transvaginal hydrolaparoscopy ovarian drilling. A prospective observational study was carried out in 123 PCOS, infertile, CC-resistant patients who undergone THL ovarian drilling. Each woman was evaluated by hormonal measurement, and ultrasound evaluation during 6 months follow-up. Progesterone serum levels were assessed on days 20–24 of the cycle after surgical treatment. Pg levels >3 ng/mL were considered as ovulation. Ovulation frequency and the highest mean follicular diameters during the monitoring were recorded. 117 patients complete the study, since six patients were lost to follow-up. Mean follicular diameter during ovulation monitoring was 16.37 mm. Ovulation rate at the follow up was 64.1% one month after treatment, 79.5% after three months and 82.9% after six months. 28 patients conceived during follow-up period. Pregnancy rate was 70.1%. Our study has shown that THL ovarian drilling improves ovulation and pregnancy rate in women with CC-resistant PCOS. We believe that this approach should be offered as second-line therapy at all PCOS CC-resistant women who fail the medical methods of ovulation induction.

Age-related Microscopic Changes in the Thyroid Gland of West African Dwarf Goat During Foetal and Post-natal Periods of Development

The histometric and histologic standard techniques were used to provide comprehensive information on the morphological changes in the thyroid gland of West African Dwarf goat during the foetal and postnatal development stages. The foetal age was determined using crown rump length and the pre-pubertal and pubertal age of animals was determined by dentition. The early foetal thyroid, surrounded by a thin capsule of dense irregular connective tissue, was continuous with well vascularised loose connective tissue septa. The parenchyma was composed of solid cell clusters of follicular epithelial cells surrounding small lumina. Follicular arrangement was indistinct in foetal thyroid by 50-70 days of gestational age and many follicles of different sizes were present by 95-125 days onwards. Significant variations in the mean follicular diameter, mean capsule thickness and mean epithelial cell height of the thyroids were observed in all stages of development. The mean large follicular diameter in the foetal, pre-pubertal and pubertal ages were 17.70 ± 0.09 µm, 54.41 ± 0.28 µm,142.77 ± 0.51 µm respectively. The follicular cells were of low cuboidal shape in foetuses, assumed high cuboidal or columnar form in pre-pubertal group and squamous in older pubertal age. Ultimobranchial follicles were encountered in early foetal goat thyroids, while focal areas of follicular cell hyperplasia were frequently seen in the older pubertal thyroids. The strong PAS-positive reaction increased strikingly from the 95-125 days foetal age, and by pubertal age all follicles were fully distended with colloid. Colloid vacuolation (colloid droplets) were encountered frequently by the age of 95-125 days, indicating the ability to synthesize hormones towards the last trimester of gestation. Parafollicular cells were distinguished by its pale cytoplasm and large nucleus at 75-90 days onwards. They were located basally and as clusters in the interfollicular tissue. This finding suggested possible high prenatal function for the thyroids of goats in the synthesis of thyroid hormones.

56 THE EFFECTS OF SERUM LEVEL OF ANDROGENS, LUTEINIZING HORMONE, AND INSULIN-LIKE GROWTH FACTOR 1 IN EARLY FOLLICULAR PHASE ON OVARIAN FOLLICULAR GROWTH PARAMETERS AND PREGNANCY RATE

Many studies have showed the role of androgens on ovarian follicular maturation. The present study investigated the effect of serum concentration of androgens, LH, and insulin-like growth factor 1 (IGF1) in the early follicular phase on the results of the ovulation induction (I/O) and intrauterine insemination (IUI) cycles. This cross-sectional study was done in the infertility clinic of Akbar Abadi hospital. Fifty-nine infertile patients who were not affected by polycystic ovary syndrome (PCO) and were candidates for induction ovulation or intrauterine insemination were chosen at random. The serum concentrations of androgens (free testosterone, dihydroepiandrosterone, and androstenedione), LH, and IGF1 were measured on the third day of menstruation. Sonographic monitoring was started from the ninth day of the cycle. The ampule of hCG was injected when there was at least one follicle with the diameter of 18 mm. The relationships of concentration of androgens, LH, and IGF1 with follicular growth parameters and pregnancy rate were analysed. There was no statistically significant link between the number and diameter of follicles with concentration of free testosterone, dihydroepiandrosterone, androstenedione, IGF1, and LH. There was no statistically significant link between the number of follicles in the ovaries and concentrations of testosterone (P = 0.090 and r = 0.223), dihydroepiandrosterone (P = 0.642 and r = 0.062), androstenedione (P = 0.526 and r = 0.084), IGF1 (P = 0.470 and r = 0.096), and LH (P = 0.446 and r = 0.102). There was no statistically significant link between the mean follicular diameter and concentration of testosterone (P = 0.822 and r = 0.03), dihydroepiandrosterone (P = 0.733 and r = 0.045), androstenedione (P = 0.526 and r = 0.084), IGF1 (P = 0.799 and r = 0.034), and LH (P = 0.626 and r = 0.065). Beta human chorionic gonadotropin (β-hCG) was positive in 11 patients (18.6%) and negative in 48 patients (81.4%). Serum concentrations of androgen profile, LH, and IGF1 in the positive (β-hCG) group were not significantly different in comparison with the negative β-hCG group. It seems that in women who were not affected by PCO, concentrations of free testosterone, dihydroepiandrosterone, androstenedione, IGF1, and LH in the early follicular phase were not related to follicular growth parameters and pregnancy rate.

Advantages of Recombinant Follicle-Stimulating Hormone over Human Menopausal Gonadotropin in Intrauterine Insemination: A Randomized Clinical Trial in Polycystic Ovary Syndrome-Associated Infertility

Background: Various gonadotropin preparations have been used for ovarian stimulation in intrauterine insemination (IUI). The purpose of the current study was to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (rFSH) combined with clomiphene citrate (CC) in IUI cycles for polycystic ovary syndrome-associated infertility. Methods: In this prospective trial, couples prepared for IUI cycles were randomly allocated either to receive CC and rFSH (group A, n = 132) or CC and hMG (group B, n = 144) for ovarian stimulation. Outcomes including rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome, multiple pregnancy, cancellation and live birth were compared. Results: The duration of gonadotropin therapy was shorter and total doses of gonadotropins was lower in the rFSH group. The number of stimulated follicles reaching >17 mm diameter was comparable between groups, but the mean follicular diameter was significantly higher in the rFSH group. The endometrium was also significantly thicker at the time of human chorionic gonadotropin administration in the rFSH group. However, pregnancy outcomes, including the rates of clinical pregnancy, ongoing pregnancy, live birth, miscarriage, ovarian hyperstimulation syndrome and cancellation, were similar between groups. Conclusion: IUI cycles in which rFSH is administered may result in shorter duration of treatment, a lower total gonadotropin dose and better follicular and endometrial characteristics on the day of human chorionic gonadotropin injection.

Protective effect of gonadotropin-releasing hormone analog on the ovarian reserve in rats receiving cyclophosphamide treatment.

ObjectiveThe aim of the study reported here was to investigate the protective effect of gonadotropin-releasing hormone analog (GnRHa) against cyclophosphamide (CTX)-induced gonadotoxicity.MethodsEighty Fischer 344 rats were divided randomly into four groups (20 per group). One group received normal saline, one GnRHa, one CTX, and one GnRHa+CTX. Several parameters were used to observe the ovarian reserve, including ovary weight, follicle number and diameter, concentrations of estradiol (E2) and follicle-stimulating hormone (FSH), and expressions of sex hormone receptors.ResultsWhen treatment was finished, the number of small follicles in the GnRHa+CTX group was significantly higher than in the CTX-alone group. Thirty days after treatment, the ovary weight, percentage of small follicles, mean follicular diameter, and serum concentrations of E2 and FSH in the GnRHa+CTX group all recovered, approaching normal levels. Sex hormone receptors did not show significant differences between the four groups.ConclusionCombination treatment with GnRHa could prevent CTX-induced damage to ovarian reserve.

Ovarian Features after 2 Weeks, 3 Weeks and 4 Weeks Transdermal Testosterone Gel Treatment and Their Associated Effect on IVF Outcomes in Poor Responders.

This study was performed to investigate the effect of of transdermal testosterone gel (TTG) on controlled ovarian stimulation (COS) and IVF outcomes and ovarian morphology according to pretreatment duration in poor responders. A total of 120 women were recruited for this pilot study. They were randomized into control, 2 weeks, 3 weeks or 4 weeks TTG treatment groups. For three TTG treatment groups, 12.5 mg TTG was applied daily for 2 weeks, 3 weeks or 4 weeks in preceding period of study stimulation cycle. After 3 weeks of TTG pretreatment, significant increase of antral follicle count (AFC) and significant decreases of mean follicular diameter (MFD) and resistance index (RI) value of ovarian stromal artery were observed (p=0.026, p<0.001, p<0.01, respectively). The total dose of rhFSH administered for COS significantly decreased after 3 and 4 weeks TTG treatment both compared with control group (p<0.001, p<0.001). The numbers of oocytes retrieved and mature oocytes were significanty higher in 3 and 4 weeks TTG treatment groups than control group (p<0.001, p<0.001 in the number of oocytes retrieved; p<0.001, p<0.001 in the number of mature oocytes). The clinical pregnancy rate and live birth rate were increased only in 4 weeks TTG treatment group compared with control group (p=0.030 and p=0.042, respectively). These data demonstrated that TTG pretreatment for 3 to 4 weeks increases AFC and ovarian stromal blood flow, thereby potentially improving the ovarian response to COS and IVF outcome in poor responders undergoing IVF/ICSI.

Effects of repeated transvaginal ultrasound–guided aspirations performed in anestrous and cyclic mares on P4 and E2 plasma levels and luteal function

The aim of the present study was to verify how repeated ovum pick-up (OPU), performed in anestrous and cyclic mares, affect ovarian activity, measured by progesterone (P4) and 17ß-estradiol (E2) plasma levels. Ovum pick-up of all visible follicles was performed every 9 to 12 days, and four sessions were carried out during anestrous (A) and breeding season (BS). The number of aspirated follicles per mare at each session was not significantly different between the two periods (BS: 6.1 ± 2.4; A: 7.5 ± 4.4; P > 0.05), but the mean follicular diameter was significantly higher during BS (16.0 ± 7.1 vs. 10.2 ± 5.1 mm; P < 0.05); during A the number of aspirated follicles less than 15 mm in diameter resulted significantly higher than that registered in BS (5.1 ± 2.7 vs. 3.0 ± 1.8; P < 0.05). The total mean value of P4 was higher in BS than in A (6.3 ± 4.4 vs. 0.3 ± 1.8 ng/mL; P < 0.05), whereas the total mean level of E2 was not different between the two periods (3.8 ± 3.4 vs. 2.5 ± 2.7 pg/mL; P > 0.05). Estradiol plasma values resulted positively correlated, in A and BS, with diameter of follicles detected on the ovaries (R = 0.345 and R = 0.331, respectively), whereas a negative correlation was observed between P4 and follicular diameter in BS (R = −0.162). Both E2 and P4 presented a high individual variability during BS; in particular, in three of seven mares, P4 trend was compatible with a normal estrous cycle, and the interval between two consecutive peaks was 21 days. In two of seven mares, with CL at first OPU, P4 concentrations remained more than 3 ng/mL throughout the entire treatment period. Finally, in two of seven animals, P4 levels initially showed a similar pattern to that of a normal estrous cycle, then, after the second aspiration, they remained consistently higher than 3 ng/mL. When the procedure was carried out in cyclic animals, the influence of this technique on ovarian activity seemed to be related to individual variability although, according to progesterone values, structures observed on the ovaries after aspirations presented luteal function. Furthermore, the resumption of normal ovarian activity, after repeated OPU sessions, occurred in a period not much longer than the duration of a normal estrous cycle (25.4 ± 5.2 days). Data recorded during nonbreeding period showed that repeated OPU in anestrous mares do not affect ovarian activity and do not anticipate the resumption of ovarian cyclicity. However, based on the number of aspirated follicles in anestrous and cyclic mares, both types of subjects could be considered as oocyte donors.