Use Of GnRH Research Articles

Effect of strategies to increase progesterone levels on fertility of bovine embryo transfer recipients - A meta-analysis

The pregnancy rate following embryo transfer (ET) is a very important factor in the success of embryo production programs. Different strategies were therefore developed to increase pregnancy rates. The aim of this meta-analysis was to investigate the effects of hormone treatments used to increase the success of embryo transfer programs on pregnancy rates. A meta-analysis was performed of 46 trials from 39 publications involving treated (n = 7856) and control (n = 6663) cattle. The meta-analysis explained the effect size with its 95 % confidence interval (CI) for pregnancy per embryo transfer (P/ET) after hormonal treatment under different moderators. Hormonal support was found to increase P/ET compared to the control group (P < 0.05). However, GnRH treatment was found to increase P/ET by approximately 4.3 % and hCG treatment by 8.0 %. Progesterone supplementation was not found to have a statistically significant effect on P/ET. In addition, GnRH treatment significantly increased P/ET when used to transfer in vitro or frozen-thawed embryos or in studies using cows as recipients. It was observed that hCG treatment had a positive effect on P/ET according to all moderators. Progesterone supplementation significantly increased P/ET when frozen embryos were transferred and reduced P/ET, especially in publications where fresh or in vitro produced embryos were transferred or cows were used as recipients. The results of this meta-analysis showed that the use of GnRH, and hCG, in bovine embryo transfer programs increased P/ET, whereas the use of progesterone had no effect on P/ET. However, it was found that P/ET could increase/decrease depending on the moderator.

An endometrium of type C along with an endometrial thickness of < 8 mm are risk factors for ectopic pregnancy after stimulated cycles with fresh embryo transfer

BackgroundThe study investigated whether specific ultrasonographically observed endometrial features (including endometrium type and thickness) were linked to ectopic pregnancy after stimulated cycles with fresh embryo transfer.MethodOf 6246 pregnancy cycles after fresh embryo transfer, 6076 resulted in intrauterine pregnancy and 170 in ectopic pregnancy. The primary outcome of the study was ectopic pregnancy, with the main variables being endometrium type and endometrial thickness. Univariate and subsequent multiple-stepwise logistic regression analyses were used to identify the risk factors of ectopic pregnancy.Results1. Compared with patients with an endometrial thickness ≥ 8 mm, the adjusted odds ratio for those with an endometrial thickness < 8 mm was 3.368 (P < 0.001). The adjusted odds ratio for women with a type-C endometrium was 1.897 (P = 0.019) compared with non-type C. 2. A larger dose of gonadotropin used during controlled ovarian hyperstimulation was a protective factor against ectopic pregnancy (P = 0.008). 3. The GnRH antagonist protocol (P = 0.007) was a risk factor for ectopic pregnancy, compared with the use of GnRH agonists.Conclusion(1) An endometrial thickness < 8 mm coupled with a type C endometrium significantly increased the risk of ectopic pregnancy after fresh embryo transfer. (2) A thin endometrial thickness and a type C endometrium could be further related to an abnormal endometrial receptivity/peristaltic wave. (3) Patients at a high risk of ectopic pregnancy should therefore be given special attention, with early diagnosis during the peri-transplantation period may assist in the prevention of ectopic pregnancy.

Application of the "echo-synch protocol" to advance pregnancy onset in ewe lambs at the first reproductive season.

This study assessed the efficacy and economic impact of a reproductive protocol based on repeated ultrasound scanning (US) associated with the use of GnRH to advance pregnancy onset in ewe lambs. Prepubertal ewe lambs (n = 133) were divided into three weight groups (High: HW n = 35; Medium: MW n = 65; Low: LW n = 33). Thereafter, animals were randomly allocated into two subgroups: GnRH, ewe lambs treated with GnRH analog and then exposed to rams; CTR, ewe lambs exposed to rams only. CTR groups were joined with rams as a single flock. GnRH groups were kept separate from rams receiving a single dose of gonadorelin (40 μg/head) and then were evaluated after a week of US. Animals showing corpora lutea received an injection of PGF2α analog (100 μg/head) and then were joined with rams. The remaining ewe lambs received a second dose of gonadorelin and were kept separate from the rams. After another week, animals were checked again and the ones showing corpora lutea were injected with the PGF2α analog, while the others received a third injection of gonadorelin. On the same day, all the animals were joined with rams. Pregnancies were confirmed within 30 days by US. The efficacy of the protocol was determined by assessing differences in the number of days required to achieve pregnancy rates of 25, 50, and 75% and in the total costs and incomes from birth to the end of first lactation within the groups. The GnRH-MW group showed the best performances in reaching the threshold pregnancy rates of 25, 50, and 75%, but the effect of treatment was significant only at the 25% threshold (p < 0.01). Both low groups displayed an overall poorer performance at 50 and 75% thresholds than medium and high-weight groups (p = 0.01 and p < 0.01, respectively). The GnRH administration did not advance pregnancy onset in GnRH-HW compared with CTR-HW. In the balance between costs and income, the HW-CTR and MW-GnRH groups showed higher gross margins than the other groups. Using the US/GnRH protocol in ewe lambs appears technically and economically effective in animals that have not reached the optimal weight at the first breeding season, advancing ewe lambs' pregnncies and increasing farm profitability.

Comparison of fertility parameters in Romanov sheep synchronized with progesterone-based protocol plus PMSG or GnRH

Objective: The aim of this study was to compare the fertility parameters in response to pregnant mare serum gonadotropin (conventional treatment) or gonadotrophin-releasing hormone (alternative treatment) in Romanov sheep subjected to a 7-d short-term protocol out of breeding season. Materials and Methods: Sheep (n=57) received an intravaginal sponge impregnated with 20 mg fluorogestone acetate for 7 days and 125 µg cloprostenol at sponge removal. Sheep were randomly assigned to receive no treatment (CON, n=16), 240 IU pregnant mare serum gonadotropin (PMSG, n=24) at sponge removal or 10 µg busereline acetate (GnRH, n=17) at 30 h after sponge removal. Results: Estrous response and pregnancy rate were 86% and 75.4% in all sheep, respectively. Estrous response was numerically higher about 7% (p&amp;gt;0.05) in treatment groups (PMSG, 87.5%; GnRH, 88.2%) than CON (81.2%). However, pregnancy rate was numerically higher in PMSG (83.3%) than GnRH (70.6%) and CON (68.7%). As in pregnancy rate, lambing rate was approximately 15% numerically greater (p&amp;gt;0.05) in the PMSG (79.1%) than in GnRH (64.7%) and CON (62.5%) groups. Similarly, litter size numerically higher (p&amp;gt;0.05) in PMSG (2.1) than GnRH (1.9) and CON (1.9) groups. Conclusion: The use of GnRH offered similar estrous response compared to PMSG in Romanov sheep synchronized with short-term protocol. However, PMSG had numerically higher pregnancy rate, lambing rate, and litter size than GnRH. Considering the serious ethical concerns and animal welfare for the production of PMSG, it is necessary to use alternatively gonadotropins. Comprehensive studies are needed to compare the fertility parameters between PMSG and GnRH in Romanov sheep.

Mitigation of low pregnancy rate in excitable Nellore cows by administration of GnRH or P4

This research aimed to determine the effect of temperament on reproductive parameters including cortisol and progesterone (P4) in Nellore cows. Additionally, two methods for increasing plasma progesterone (P4) levels in excitable animals to enhance pregnancy rate (P/AI) and reduce pregnancy loss were investigated. In total, 939 cows were subjected to timed artificial insemination (TAI) and divided into three groups: (P4LA; n = 305) 150 mg of injectable long-acting progestogen 7 days after TAI; (GnRH; n = 306), 10 μg of buserelin acetate on day 7 after TAI; control group (CG; n = 328) without hormonal treatment. In 213 cows, randomly chosen from each group, ultrasound evaluations of the preovulatory follicle (Mode B) were performed on the day of insemination and of the corpus luteum (Color Doppler) 7 and 16 days after TAI. Blood samples were obtained from 20% of the 939 animals, randomly chosen from each group, on the day of insemination and after 7 and 16 days to measure cortisol and progesterone, respectively. At the time of insemination, subjective temperament evaluations were performed with the animals being classified as excitable (EXC) or adequate (ADQ). The SAS GLIMMIX procedure was used to compare the pregnancy rate (P/AI) and gestational loss within each temperament for the three experimental groups. Continuous variables were analyzed utilizing SAS PROC MIXED procedure. Cortisol concentration was higher and POF (preovulatory follicle) and CL (corpus luteum) volumes at the time of insemination and 7 days after AI, respectively, were lower in EXC animals than in ADQ. No significant difference was observed between the number of pixels, CL intensity, and plasma concentration of P4, 7 days after TAI. However, 16 days post-insemination, among the animals classified as EXC, higher concentrations of P4 were observed in the GnRH and P4LA groups than in the control. Regarding P4 concentrations, there was a tendency to be lower in animals classified as EXC than in ADQ within the control group (P = 0.06), while rate of blood flow from the CL was lower in EXC animals than in ADQ animals (P = 0.04). Among the ADQ animals, the GnRH and P4LA groups showed a lower CL flow rate than that observed in the control (P = 0.04), 16 days after the TAI. Among EXC animals, a higher pregnancy rate was observed in the GnRH and P4LA groups than in the control group (P = 0.01). In the control group, the pregnancy rate (P/AI) of the ADQ animals was higher than that of the EXC animals (P = 0.05). No statistically significant differences were observed between gestational losses when the treatments or temperaments were compared. In conclusion, the use of GnRH or P4LA, 7 days after insemination, improves pregnancy rates in excitable animals and is a viable alternative to minimize the negative impact of stress and improve reproductive efficiency in beef cattle.

Type of endocrine therapy and DFS in patients with early HER2+/HR+ BC: Analysis from the phase III randomized ShortHER trial.

547 Background: Optimal adjuvant endocrine therapy for HER2+/HR+ patients treated with chemotherapy and trastuzumab is still unclear. We evaluated the impact of the type of endocrine therapy on DFS in patients with HER2+/HR+ breast cancer enrolled in the phase III ShortHER trial. Methods: The Short-HER study randomized 1254 patients with HER2+ early breast cancer to receive 9 weeks vs 1 year of adjuvant trastuzumab combined with anthracycline-taxane chemotherapy. The type of adjuvant endocrine was collected every 6 months during the first 5 years of follow-up and was classified as: aromatase inhibitor (AI), tamoxifen and aromatase inhibitor (TAM-AI, in case of both drugs were administered for at least 1 year each), or tamoxifen (TAM). For premenopausal patients, the use of GnRH analogue was also collected. DFS was calculated from randomization to disease recurrence (locoregional or metastatic), second primary invasive cancer, or death. Results: 853 patients with HR+ BC (ER and/or PgR &gt;10%) were included: 60% postmenopausal, 40% premenopausal. The pattern of endocrine therapy was: 55% AI, 22% TAM, 15% TAM-AI (8% missing data). Among premenopausal patients, 51% received GnRH. At a median follow up of 8.7 years (IQR 7.6-9.0), patients who received AI had a significantly better DFS as compared to patients who received TAM or TAM-AI: 7-yr DFS 87.3% vs 81.7%, log-rank P=0.017 (HR 1.46, 95%CI 1.05-2.03). In multivariate analysis including menopausal status, stage, and treatment arm, the type of endocrine therapy maintained a significant association with DFS (Table). In the subgroup of premenopausal patients, the use of GnRH was associated with numerically improved DFS: 86.6% vs 81.6%, log-rank P=0.168 (HR=0.70, 95%CI 0.43-1.16). Conclusions: In this post-hoc analysis of the ShortHER trial, adjuvant treatment with aromatase inhibitor was independently associated with improved DFS. Subgroup analysis in premenopausal patients suggests potential benefit with ovarian suppression. Clinical trial information: NCT00629278. [Table: see text]

Efficiency of using bioregulators depending on the system and method of keeping of cows

Relevance. For the reproduction of the breeding stock of cattle, the conditions of detention should maximally meet the optimal conditions for the life of animals. In this regard, the study of the characteristics of physiological changes after injections of bioregulators to induce estrus in cows under various systems and methods of keeping is of great importance and is an important area of research. The purpose of the work is to study the reproductive function of cows depending on age and various conditions of keeping.Methods. The results of the work are based on analytical, biometric, statistical methods and the authors’ own research.Results. In studies was found that a general decrease in the effectiveness of the use of GnRH analogs and hCG to increase fertility can occur due to treatments carried out in the summer months. The greatest effect of the use of GnRH and hCG preparations should be expected when they are introduced in parallel with insemination in induced estrus in the winter-spring and autumn-winter months. At the same time, the fertility rates in cows tethered were slightly higher in the stall-pasture system of keeping, and slightly lower in the camp-pasture system than in loose ones. When studying the reproductive function, depending on the number of lactations, as a result of the use of a complex of bioregulators, high indicators of cows that came into the hunt were obtained, from 74 to 91% of the total number of animals showed signs of estrus according to the different number of lactations. Cows with 1st and 2nd lactation have the highest rate for those who came into heat (91% and 87%) with the lowest insemination efficiency (47% and 49%, respectively). In cows of the 3rd and 4th lactations, the highest adjustment to the restoration of the ovarian cycle is observed, with the average indicators of those who came to the hunt, the highest insemination efficiency was subsequently obtained (70 and 75%, respectively). For three or more months after calving, more than half of the herd of calving cows (71.6%) were fruitfully inseminated.

Exploring the association between use of gonadotropin releasing hormones agonists and prostate cancer diagnosis per se and diabetes control in men with type 2 diabetes mellitus: a nationwide, population-based cohort study

BackgroundGonadotropin Releasing Hormones agonists (GnRH), which are first line treatment for metastatic prostate cancer (PCa), increase risk of type 2 diabetes mellitus (T2DM). This study aims to quantify the association of use of GnRH with diabetes control in PCa men with T2DM.MethodsNationwide population-based cohort study in the Swedish National Diabetes Register and Prostate Cancer data Base Sweden 4.1, on the association between GnRH and diabetes control in T2DM men with PCa by comparing T2DM men with PCa vs. without PCa, as well as comparing T2DM men with PCa on or not on GnRH. The primary exposure was use of GnRH. Worsening diabetes control was the primary outcome, defined as: 1) HbA1c rose to 58 mmol/mol or higher; 2) HbA1c increase by 10 mmol/mol or more; 3) Start of antidiabetic drugs or switch to insulin. We also combined all above definitions. Cox proportional hazards regression was used to analyze the association.ResultsThere were 5714 T2DM men with PCa of whom 692 were on GnRH and 28,445 PCa-free men with T2DM with similar baseline characteristics. Diabetes control was worse in men with GnRH vs. PCa-free men (HR: 1.24, 95% CI: 1.13–1.34) as well as compared with PCa men without GnRH (HR:1.58, 95% CI: 1.39–1.80), when we defined the worsening control of diabetes by combining all definitions above.ConclusionUse of GnRH in T2DM men with PCa was associated with worse glycemic control. The findings highlight the need to closely monitor diabetes control in men with T2DM and PCa starting GnRH.

Effect of gonadotropin-releasing hormone administered at the time of artificial insemination for cows detected in estrus by conventional estrus detection or an automated activity-monitoring system

The objectives of this study were to determine the effects of GnRH at the time of artificial insemination (AI) on ovulation, progesterone 7 d post-AI, and pregnancy in cows detected in estrus using traditional methods (tail chalk removal and mount acceptance visualization) or an automated activity-monitoring (AAM) system. We hypothesized that administration of GnRH at the time of AI would increase ovulation rate, plasma progesterone post-AI, and pregnancy per AI (P/AI) in cows detected in estrus. In experiment 1, Holstein cows (n = 398) were blocked by parity and randomly assigned to receive an injection of GnRH at the time of estrus detection/AI (GnRH, n = 197) or to remain untreated (control, n = 201) on 4 farms. The GnRH was administered as 100 µg of gonadorelin acetate. Ovarian structures and plasma progesterone were assessed in a subset of cows (GnRH, n = 52; control, n = 55) in experiment 1 at the time of AI and 7 d later. In experiment 2, a group of 409 cows in an AAM farm were enrolled as described for experiment 1 (GnRH, n = 207; control, n = 202). Data were categorized for parity (primiparous vs. multiparous), season (cool vs. warm), number of services (first vs. > first), DIM (>150 DIM vs. ≤150 DIM), and for AAM cows in experiment 2 for activity level (high: 90-100 index vs. low: 35-89 index). Pregnancy diagnosis was performed between 32 and 45 d post-AI (P1) and 60 to 115 d post-AI (P2). In experiment 1, there was no difference in plasma progesterone at day of estrus detection (control = 0.09 ng/mL vs. GnRH = 0.16 ng/mL), 7 d later (control = 2.03 ng/mL vs. GnRH = 2.18 ng/mL), and ovulation rate (GnRH = 83.2% vs. control = 77.9%) between treatments. There were no effects of GnRH in experiment 1 for P/AI at P1 (control = 43.3% vs. GnRH = 38.6%), P2 (control = 38.4% vs. GnRH = 34.5%), and for pregnancy loss (control = 9.8% vs. GnRH = 8.2%). In experiment 2, there were no effects of GnRH for P/AI at P1 (control = 39.6% vs. GnRH = 40.1%), P2 (control = 35.0% vs. GnRH = 37.4%), and for pregnancy loss (control = 9.5% vs. GnRH = 6.2%). There was a tendency for a parity effect on P/AI for P1, but not P2 or for pregnancy loss. High-activity cows had greater P/AI in P1 (low activity = 27.9% vs. high activity = 44.1%), P2 (low activity = 21.8% vs. high activity = 41.2%), and lower pregnancy loss (low activity = 20.7% vs. high activity = 5.1%), but there were no interactions between treatment and activity level. The current study did not support the use of GnRH at estrus detection to improve ovulatory response, progesterone 1 wk post-AI, and P/AI. More research is needed to investigate the relationship between GnRH at the time of AI and activity level in herds using AAM systems.

Resynchronizing the first eligible estrus in dairy cattle after a prior insemination and fertility of the prior insemination after gonadotropin-releasing hormone and progesterone treatments

The hypothesis of this study tested whether application of designed treatments to synchronize estrus in nonpregnant previously inseminated lactating dairy cows increased the proportion of nonpregnant cows in estrus before early pregnancy diagnosis on Day 32 after the previous insemination (Day 0) and increase fertility of the pretreatment insemination. A progesterone insert (CIDR) and GnRH were applied to cows after insemination to resynchronize the returning estrus of cows that failed to conceive on Day 0. The combination of GnRH (Day 14) and a CIDR insert (d 17 through 24) in experiment 1 (n = 347 cows) did not increase (P = 0.13) the proportion of nonpregnant cows returning to estrus before pregnancy diagnosis, but increased (P < 0.01) the synchrony of their return by 24.4% points, and delayed (P < 0.01) that return by 2.3 ± 0.3 d compared with controls. Ovulation risk after GnRH treatment on Day 14 was only 10%. For cows that failed to return to estrus before Day 32, progesterone concentration on Days 14 and 17 were less than that in cows that returned to estrus by Day 32 and in pregnant cows. Cows that returned to estrus had larger follicles and fewer numbers of CL on Day 21 than pregnant cows and cows that failed to return to estrus, but concentrations of pregnancy-associated glycoproteins on Day 28 indicated that cows failing to return to estrus were likely pregnant but suffered embryo death. In experiment 2 (n = 881), use of GnRH alone (Day 7), a CIDR insert alone (Days 14 through 21), or in combination, failed to increase the proportion of nonpregnant cows in estrus before pregnancy diagnosis on Day 32 compared with controls. Cows receiving the CIDR insert had increased (P < 0.01) synchrony of estrus by 24–34% points compared with cows that did not receive a CIDR insert. More cows receiving GnRH had 2 or more CL on Days 14 and 21 compared with controls. Ovulation risk after GnRH on Day 7 was greater than 66%. In both experiments combined, treatments with GnRH or GnRH + CIDR insert increased (P = 0.015) pretreatment pregnancy per AI by 7.1% points, but did not affect pregnancy loss. Although administering GnRH with or without a CIDR insert synchronized returns to estrus, treatments failed to increase the proportion of nonpregnant cows reinseminated before pregnancy diagnosis, but increased pretreatment pregnancy risk.

Association of pregnancy per artificial insemination with gonadotropin-releasing hormone and human chorionic gonadotropin administered during the luteal phase after artificial insemination in dairy cows: A meta-analysis

One strategy for improving fertility in cattle is administration of GnRH or human chorionic gonadotropin (hCG) during the luteal phase, which increases progesterone (P4) secretion and delays luteolysis. To provide an overview of how GnRH or hCG treatment between 4 and 15 d after artificial insemination (AI) improves pregnancy per AI (P/AI) in cows, a meta-analysis was performed on 107 different trials from 52 publications. Data from 18,082 treated cows and 18,385 untreated controls were meta-analyzed. The meta-analysis explained the relative risk for P/AI with GnRH or hCG treatment under various circumstances. The results did not show any difference in P/AI between cows treated with hCG and cows treated with GnRH. Compared with no treatment, treatment with GnRH or hCG improved the chances of P/AI in cows with very poor (<30%) and poor (30.1 to 45%) fertility, whereas treatment did not benefit cows with very good fertility (>60.1%). Moreover, treatment with GnRH and hCG improved the chances of P/AI in primiparous cows. The improvement was much better in primiparous cows with very low fertility. Treatment with buserelin at a dose above 10 µg and with hCG at a dose above 2,500 IU was associated with increased chances of P/AI compared with lower doses. Treatment with GnRH 10 d after AI was also associated with increased chances of P/AI compared with earlier treatment. The present meta-analysis showed that the use of GnRH and hCG after AI should be focused on cows expected to have low or moderate fertility. Day and dose of treatment have to be considered as well.

Regulation of follicle waves to maximize fertility in cattle

Cattle have recurrent follicular waves every 7-10 days in most physiological situations; an FSH increase is associated with emergence of the wave and LH pulse frequency determines the fate of the dominant follicle. To control oestrus with hormones it is necessary to ensure that either induced corpus luteum regression or the termination of a progestogen treatment coincides with the selection of the dominant follicle during the wave, to give a precise onset of oestrus and high fertility. The exogenous administration of progesterone or progestagen blocks the normal turnover of the dominant follicle once the corpus luteum regresses. Thus, the effects of duration of dominance of the preovulatory follicle on onset of oestrus and fertility were examined. The variation in onset of oestrus was reduced but occurred 5-9 h later after 4 versus 8 days of dominance; pregnancy rate was also affected with dominance periods of 2-4, 4-8 and > 10 days resulting in 0, 10-15% or 20-50% reduction in pregnancy rates, respectively. The necessity for short duration of dominance of the preovulatory follicle means that to ensure high fertility the follicular wave needs to be regulated when using hormones to control oestrus. Two approaches were examined, namely the use of GnRH or oestradiol at time of progesterone intravaginal releasing device insertion. The effect of 250 micrograms of synthetic GnRH on the fate of an existing follicle wave was to ovulate the dominant follicle (20/20 cows) and a new wave emerged 1.6 +/- 0.3 days later; however, there was no effect of GnRH on the wave if administered before dominant follicle selection. The effect of oestradiol concentrations on suppression of FSH in ovariectomized heifers showed that increasing oestradiol to 10-15 pg ml-1 caused a 37 +/- 6.9% decrease in FSH for 24 h, with a subsequent increase to pretreatment values by 57 +/- 13 h. In cyclic heifers, increasing oestradiol to > 10 pg ml-1 in conjunction with progesterone treatment at emergence of the first wave of the cycle affected the current follicle wave by either preventing dominant follicle selection or decreasing diameter of the dominant follicle, without consistently affecting the interval to new wave emergence. Increase of oestradiol after dominance, however, delayed new wave emergence by 2-5 days. A better understanding of the hormonal control of follicle waves will lead to development of improved hormonal regimens to control oestrus sufficiently to give high pregnancy rates to a single AI without recourse to detection of oestrus.

The Effects of Separate and Combined Use of PGF2α and GnRH Hormones and the Addition of Βeta-Carotene on Fertility Parameters in Dairy Cows with Ovarian Cysts

Background: Ovarian cysts are commonly observed pathologies, which interfere with normal cyclic activity and adversely affect fertility in cows. Beta-carotene is effective in the reduction of reproductive problems by inducing the natural defence mechanisms of the body. There are several methods that can be used for the treatment of ovarian cysts. The separate and combined use of GnRH and PGF2α commonly uses in the treatment of ovarian cysts. Therefore, in the presented study the effects of Beta-carotene (βC) addition for the treatment of ovarian cysts either with GnRH solely or GnRH and PGF2α in combination on the fertility parameters of dairy cows were investigated.Materials, Methods &amp; Results: Seventy-six Holstein Friesian cows having ovarian cysts diagnosed by ultrasonography (USG) were divided into three groups. Cows in Group I (GI, n = 27), were injected with GnRH (Buserelin acetate, 5 mL, im), PGF2α (Tiaprost-trometamol, 5 mL, im) and βC (20 mL/cow, into 4 regions by im route). In Group II (GII, n = 25) GnRH (Buserelin acetate, 5 mL, im) and PGF2α (Tiaprost-trometamol, 5mL, im) were administrated while GnRH (Buserelin acetate, 5 mL, im) solely in Group III (GIII, n = 24). Cysts were monitored via USG, and blood samples were collected on the on day of treatment (day 0) and on the 7th and 14th days following the administrations. Cows shoving oestrous were inseminated and pregnancy diagnoses were performed on the 40th day following insemination. Treatment results showed that there were statistically no significant differences between GI and GII (P &gt; 0.05). Only numerical difference obtained in time from therapy to pregnancy and overall pregnancy index (P &gt; 0.05). Overall pregnancy rate (85 %), first service pregnancy rates (40 %) and overall pregnancy index (2.11) in GI were found significantly higher than GIII (53.3 %; 20 %; 4.12) [P &lt; 0.05]. No significant difference was observed in progesterone (P4) levels between the groups (P &gt; 0.05). It was found that βC administrations significantly increased βC levels in GI than GII and GIII on the 7th and 14th days (P &lt; 0.05).Discussion: One of the most common problems encountered in modern dairy production is the development of ovarian cysts. Treatments for ovarian cyst are numerous and variable, and have changed considerably over the years. In the present study, GnRH and PGF2α were administered together as a combination, and as a result of this combined use, higher percentages were obtained for both pregnancy rate and fertility parameters in GI and GII, in comparison to the group administered with GnRH alone (GIII). Better outcome from combination therapy (GnRH and PGF2α) may be due to the fact that luteal thickening in the walls of cysts was determined by ultrasonography, but P4 values were not identified immediately and the treatments were not categorized in accord with these values. No statistically significant differences were determined between GI and GII concerning the fertility parameters investigated, however numerical and proportional differences were observed. βC levels were significantly higher on day 7 and 14 after treatment in GI which were administered βC additionally to the treatment protocol for ovarian cysts. This statistical difference suggests that administration of βC in combination therapy is also effective in the treatment of ovarian cysts. In conclusion, it was determined that high pregnancy rates were obtained by the combined treatment of ovarian cysts (GnRH + PGF2α) and number of inseminations per conception were at desired limits. Better percentile and numerical fertility parameters were achieved in the group, which additionally received βC, high numbers of infertility cases, βC supplementation could be a viable option for treatment.

Ovarian response to controlled ovarian stimulation in women with different polycystic ovary syndrome phenotypes

Controlled ovarian stimulation (COH) in PCOS is a challenge for fertility expert both ovarian hyperstimulation syndrome (OHSS) and oocytes immaturity are the two major complication. Ovarian response to COH vary widely among POCS patients and while some patients are more likely to show resistance to COH, other experienced an exaggerated response. The aim of our study is to investigate a possible correlation between PCOS phenotypes and the variety of ovarian response to COH and ART outcomes in patients with different PCOS phenotypes. We retrospectively analyzed a total of 71 cycles performed in 44 PCOS infertile patients attending ART at Centre of Infertility and Assisted Reproduction of Pisa University between January 2013 and January 2016. Patientsundergoing IVF with GnRH-antagonist protocol and 150–225 UI/days of recombinant FSH; triggering was carried out using 250 mg of recombinant hCG or a GnRH analogous on the basis of the risk to OHSS. We observed that Phenotype B had a tendency to have a greater doses of gonadotropins used respect to all phenotypes. Phenotype A group showed a greater serum estrogen levels compared to all phenotypes groups, a greater number of follicles of diameter between 8–12 mm found by ultrasound on the day of triggering and a greater mean number of freeze embryo. Additionally serum AMH and antral follicles count (AFC) follow the same trend in the different phenotypes ad they were significantly higher in phenotype A and in phenotype D. In conclusion this study shows that the features of PCOS phenotypes reflect the variety of ovarian response to COH as well as the risks to develop OHSS. Serum AMH and AFC are related to the degree of ovulatory dysfunction making these ‘added values’ in identifying the different PCOS phenotypes. Phenotype A seems to be the phenotype with the higher risk to develop OHSS and the use of GnRH as a trigger seems to improve oocyte quality. To classify PCOS phenotype at diagnosis might help clinicians to identify patients at greater risk of OHSS, customize therapy and subsequently plan the trigger agent.

Effect of reproductive methods and GnRH administration on long-term protocol in Santa Ines ewes.

This study aimed to determine whether reproductive performance of ewes submitted to laparoscopic timed artificial insemination (TAI) would be similar to ante meridiem (AM)/post meridiem (PM) rule and assisted natural mating (NM), and whether GnRH may enhance the pregnancy rate in TAI. In experiment I, 191 non-lactating ewes were synchronized, then TAI was performed either 48h after progesterone (P4) removal (TAI-48h) or 12h after estrus detection (AM/PM); moreover, some ewes were submitted to NM (NM) as control treatment. In experiment II, 247 non-lactating ewes were allocated in five treatments, a control (no-GnRH on protocol) and four treatments arranged in a factorial design 2×2. The factors were time and dose of GnRH: ewes that received either 10μg (TAI-10μg-36h) or 25μg of GnRH (TAI-25μg-36h) 36h after P4 removal and ewes that received either 10μg (TAI-10μg-48h) or 25μg of GnRH (TAI-25μg-48h) at time of insemination, 48h after P4 removal. In experiment I, pregnancy rate in TAI-48h was lower (P=0.03) than AM/PM and NM. Moreover, the probability of pregnancy in TAI-48h was higher (P=0.06) in ewes detected in estrus early. In experiment II, the use of GnRH in TAI protocols increased (P<0.01) pregnancy rate at synchronization, and TAI-25μ-48h and TAI-10μg-36h treatments increased (P=0.02) pregnancy rate compered to TAI-10μg-48h. We conclude that TAI decreased pregnancy rate compered to NM and AM/PM, which may be improved by GnRH use in TAI to synchronize ovulation.

Abstract P5-13-04: Voice of cancer patients: Analysis of patient concerns regarding pregnancy and fertility preservation in patients with breast cancer

Abstract Breast cancer accounts for one third of all cancers seen in reproductive-age women. Adjuvant chemotherapy regimens used for treatment commonly affect fertility and cause premature ovarian failure. Fertility preservation in young cancer survivors is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Many patients share their experiences in online forums, which contain millions of freely shared messages that can be used to analyze concerns regarding pregnancy and fertility preservation. However, this data is unstructured and difficult to analyze. We organize it using methods from Big Data Science (BDS) and analyze it by creating a Decision Support System (DSS) and an interface that can be used by patients and by providers to understand concerns of these patients. Method: We collected 5.8 million unique messages (by 170,000 users) from 20 unrestricted breast cancer forums that provide clinically relevant information. We next built custom ontologies for breast cancer, treatment, pregnancy and fertility and supportive therapies. We then created a DSS using methods from BDS, including topic modeling, information retrieval, and natural language processing to extract relevant information from these messages. To use this system, a user provides disease-related parameters, key questions and the treatment. The DSS then gives messages discussing a similar cohort of patients that have similar parameters and are going through similar treatments. Results: Of 170,000 patients, only 5,109 patients reported their age and 1,604 patients reported their age below 45 years. 2,378 patients posted 6,377 messages discussing pregnancy and fertility related issues during Breast-Cancer treatment, and of these, 907 reported their age below 45. Their specific concerns included: · Does pregnancy increase the risk of recurrence (31 messages from 24 patients) · Chances of successful pregnancy in patients who are 30 to 39 years old · Risk of birth and genetic defects (23 messages from 21 patients) Fertility options being discussed: · Freezing embryos, eggs, or ovarian tissues. (169 messages from 138 patients) · Artificial Insemination, hormone assisted pregnancy, or ovarian stimulation- in vitro fertilization (55 messages from 43 patients) · Use of GNRH to preserve fertility during chemo with Lupron (291 messages) and Zolodex ( 391 messages) Other findings include: · 893 messages talked about stopping tamoxifen early, mostly within first 1.5 to 3 years so as to try the pregnancy option and 116 patients said that they stopped tamoxifen early. · 83 patients talked about a successful pregnancy. Only 40 patients discussed getting fertility experts involved early. Conclusion: · This interactive system reliably provides meaningful insights from patient's point of view to their treatment, their concerns, and suggestions for supportive therapy. It also gives insight into unmet needs where more resources and research should be focused. · Fertility preservation is a major concern in pre-menopausal patients. It should be addressed early on to prevent patients taking harmful decisions such as cutting short their hormonal therapy. · Fertility counseling seems to be underutilized. Citation Format: Aggarwal S, Sharma R, Sharma R, Gupta A, singh D, Aggarwal A. Voice of cancer patients: Analysis of patient concerns regarding pregnancy and fertility preservation in patients with breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-04.

The effect of GnRHa with or without dopamine inhibitor on reproductive hormone levels and sperm quality in tench Tinca tinca

The impact of treatment with mGnRHa, mGnRHa with metoclopramide, and metoclopramide on secretion of luteinizing hormone (LH), testosterone (T) and 11-ketotestosterone (11-KT) and on milt and spermatozoon characteristics was studied in male tench Tinca tinca. Male tench were divided into four groups and treated with following preparations: 0.9% NaCl; mGnRHa (25μgkg−1); mGnRHa (25μgkg−1) combined with metoclopramide (20mgkg−1); and metoclopramide (20mgkg−1). Administration of the combined treatment induced an LH surge at 12h post injection (PI) reaching significantly higher values (P<0.05) than was observed with stimulation by mGnRHa alone or with metoclopramide alone. Monitoring of LH levels demonstrated a rapid surge in LH release with the combined treatment versus gradual increase with mGnRHa alone (P<0.05). Experimental treatments with GnRHa alone, metoclopramide alone and metoclopramide combined with mGnRHa significantly increased milt production and relative number of spermatozoa kg−1 BW at 24h PI compared to controls, with no differences among experimental groups (P<0.05). No significant differences among groups (P<0.05) were found in motility or velocity (VLC, VAP, VSL). The only significant decrease of VLC and VAP was detected after treatment with metoclopramide alone compared to all other groups. Nonsignificant differences (P<0.05) were observed in T and 11-KT secretion, with the exception of a significant difference in T secretion (P<0.05) at 24h PI between the combined group and the metoclopramide treatment and the controls. We conclude that the use of GnRH, combined or not with metoclopramide, are suitable hormonal treatments to control the spermiation in mature tench.

Dose‐dependent effect of androgen deprivation therapy for localized prostate cancer on adverse cardiac events

To investigate the dose-dependent effect of androgen deprivation therapy (ADT) on adverse cardiac events in elderly men with non-metastatic prostate cancer (PCa) stratified according to life expectancy. A total of 50384 men diagnosed with localized PCa between 1992 and 2007 were identified within the Surveillance, Epidemiology, and End Results registry areas. We compared those who received ADT within 2years of PCa diagnosis with those who did not, calculated as monthly equivalent doses of GnRH agonists (<8, ≥8 doses), or orchiectomy. Men were further stratified according to life expectancy (<5years, 5-10years and >10years). Adjusted Cox hazard models assessed the risk of new-onset coronary heart disease (CHD), acute myocardial infarction (AMI), sudden cardiac death (SCD) and cardiac-related interventions, as well as any of these events. Overall, patients receiving GnRH agonists were more likely to experience a cardiac event, with the most pronounced effect among those receiving ≥8 doses (hazard ratio [HR] <8 doses: 1.13, 95% confidence interval [CI] 1.09-1.16, and HR ≥8 doses: 1.18, 95% CI 1.14-1.22; both P < 0.001). The effect of prolonged (≥8 doses) GnRH agonist use on cardiac events was sustained across all strata of life expectancy; however, there was no effect among men with a life expectancy of <5years and when use of GnRH agonists was limited to <8 doses (HR 0.99, 95% CI 0.67-1.46; P = 0.964). The use of GnRH agonists was associated with a higher risk of CHD (HR <8 doses: 1.13, 95% CI 1.09-1.17 and HR ≥8 doses: 1.17, 95% CI 1.13-1.21; both P< 0.001). Conversely, the use of GnRH was generally not associated with an increased risk of AMI or SCD, except for men who received ≥8 doses of GnRH agonists and had a life expectancy of ≥5years, who were at a significantly higher risk of SCD (HR for life expectancy 5-10years: 1.19, 95% CI 1.06-1.33; P = 0.003 and HR for life expectancy >10years: 1.16, 95% CI 1.04-1.29; P = 0.006). Finally, orchiectomy was not associated with overall cardiac events, AMI or SCD, and was protective with regard to cardiac-related interventions (HR 0.78, 95% CI 0.68-0.90, P = 0.001). Exposure to ADT with GnRH agonists is associated with an increased risk of cardiac events in elderly men with localized PCa and a decent life expectancy. Clinicians should carefully weigh the risks and benefits of ADT in patients with a prolonged life expectancy. Routine screening and lifestyle interventions are warranted in at-risk subpopulations treated with ADT.

Treatment of Ovarian Cysts in Dairy Cows with Simultaneous Administration of GnRH and PGF2α has no Clear Advantage Over the Use of GnRH Alone

Abstract The aim of the study was to determine the therapeutic efficacy o f simultaneous administration of GnRH and PGF2α in dairy cows with ovarian cysts. Ovarian cyst-affected dairy cows were divided into two experimental groups: 54 cows treated with GnRH and PGF2α, and 42 cows treated with GnRH alone, whereas 22 untreated cows served as the control group. Clinical response and reproductive performance were evaluated. The cumulative disappearance was better in treated cows than in the control group; however, there were no differences between the treatment groups (92.6; 95.2% vs. 72.3%). The mean interval from calving to conception was not significantly shorter (being so by 29 d) in the GnRH/PGF2α group than in the cows treated with GnRH alone (P &gt; 0.05). The intervals from treatment to conception were also similar in these groups. The pregnancy rate in both treated groups was similar (62%) and higher than in the control cows (53%). In the cows with luteal cysts, the total pregnancy rate was higher in all experimental groups; however, only in GnRH-treated cows was this difference statistically significant (77.8% vs. 50.0%, P &lt; 0.05). With time after parturition, the pregnancy rate decreased in all groups. In general, the cows treated with GnRH and PGF2α simultaneously displayed a good clinical response and slight improvement in reproductive performance compared to the single-therapy GnRH group; however, this was not fully convincing.

Outcome of Gonadotropin Releasing Hormone Treatment 12 Days Post AI and Double Insemination on Conception Rate of Repeat Breeding Cows in Mekelle, Tigray, Ethiopia

The aim of the present study was to determine outcome of gonadotropin releasing hormone analogue given 12 days post AI and double inseminations during estrous period of dairy cattle and improvement of conception rate. Field trial was carried out on repeat breeding cross breed dairy cows which are lactating, apparently healthy and exhibits estrus regularly. A total of Sixty three repeat-breeding cows from twenty eight herds were selected and assigned randomly in to three equal groups G (1, 2 and 3); two treated and one control group. Group1 (n=21) cattle were treated intramuscularly with 10 µg buserelin acetate 12 days post AI. Group2 (n=21) cattle were inseminated twice during estrus exhibition with 6-8 hours interval. Group3 (n=21) cattle were receive no treatment, inseminated once as heat was detected and considered as a control group. Dairy cows were examined for pregnancy after three months through rectal palpation. Pregnancy rates recorded were 52%, 38% and 28% in G1, G2 and G3 respectively. Conception rates of treated groups (G1 and G2) exceed control group by 24% and 10% respectively and showed a significant statistical variation (P<0.05) as compared to control groups. Comparison between treated groups also indicated that G1 has statistical significant difference from G2. From this experiment, it is recommended that use of GnRH 12 days can improve pregnancy rate as compared to double insemination and single service.