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1.
Zygote ; 31(4): 373-379, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37198964

RESUMO

The live birth rate following embryo transfer is comparable between spontaneous, stimulated and artificial cycles. However, the pregnancy loss rate appears elevated with hormonal therapy, possibly due to luteal insufficiency. This study aimed to determine whether the serum progesterone level on transfer day differed according to the endometrial preparation method for frozen embryo transfer (FET). Twenty spontaneous cycles (SC), 27 ovarian stimulation cycles (OS) and 65 artificial cycles (AC) were retrospectively studied from May to December 2019 in a single French hospital. The primary endpoint was the level of serum progesterone on the day of FET between the three endometrial preparation methods. The mean serum progesterone level on transfer day was 29.47 ng/ml in the OS group versus 20.03 ng/ml in the SC group and 14.32 ng/ml AC group (P < 0.0001). Progesterone levels remained significantly different after logistic regression on age and anti-Müllerian hormone (AMH) level. There was no significant difference in demographic and hormone characteristics (age, body mass index, embryo stage of embryo, type of infertility, basal follicle stimulating hormone, luteinizing hormone, estradiol and AMH levels), endometrial thickness, number and type of embryos transferred, duration of infertility, pregnancy rate, live birth rate and pregnancy loss rate. No difference was found in serum progesterone levels between clinical pregnancy with fetal heartbeat and no clinical pregnancy (no pregnancy or pregnancy loss, 17.49 ng/ml vs 20.83 ng/ml, respectively, P = 0.07). The lower serum progesterone level found on FET day in the AC group should be further investigated to see whether this difference has a clinical effect on the live birth rate.


Assuntos
Infertilidade , Progesterona , Feminino , Gravidez , Humanos , Estudos Retrospectivos , Nascido Vivo , Transferência Embrionária/métodos , Taxa de Gravidez
3.
Reprod Biomed Online ; 36(5): 543-551, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29506861

RESUMO

A lower number of metaphase II oocytes eligible for vitrification after controlled stimulation in cancer patients has recently been reported, suggesting that cancer may impair the dynamics and quality of follicular growth. In this prospective, non-interventional study, the pattern of follicular growth and oocyte cohort after ovarian stimulation in cancer patients was analysed. Ninety cancer patients, recruited before starting chemotherapy, were compared with 180 time- and age-matched healthy controls undergoing intracytoplasmic sperm injection. Primary outcome was total number of metaphase II oocytes and metaphase II /total oocytes rate. Basal anti-Müllerian hormone levels (P < 0.05) and antral follicle count (P < 0.0001) were significantly lower in cancer patients. Recombinant FSH total dose was significantly higher in the cancer group (P < 0.0001). No differences were found in duration of stimulation, mean number of mature follicles on day of ovulation induction and total oocyte number after retrieval; the number of metaphase II oocytes retrieved (6.2 ± 4.7 versus 8.8 ± 4.2; P < 0.0001) and number of metaphase II oocytes-total oocytes ratio were significantly lower in cancer patients (56% versus 78%, P < 0.0001). Fewer metaphase II oocytes were eligible for vitrification and lower maturation rate in the cancer group.


Assuntos
Preservação da Fertilidade , Neoplasias/complicações , Oócitos/crescimento & desenvolvimento , Indução da Ovulação , Adolescente , Adulto , Hormônio Antimülleriano/sangue , Criopreservação , Feminino , Humanos , Recuperação de Oócitos , Oócitos/citologia , Folículo Ovariano/efeitos dos fármacos , Estudos Prospectivos
4.
Eur J Endocrinol ; 172(6): 669-76, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25740852

RESUMO

OBJECTIVE: Although an inhibin B assay may be useful in the assessment of testicular function in a number of genital conditions, reliable reference ranges are still lacking. The present study sought to establish the reference range for serum inhibin B by applying the updated Gen II assay. DESIGN: This prospective study included 818 men referred for semen analysis: 377 were normozoospermic (reference group) and 441 presented at least one abnormal semen parameter (case group). METHODS: Semen parameters were interpreted according to the 2010 World Health Organization manual and David's modified classification for normal morphology. The inhibin B concentration was determined with the current ELISA. RESULTS: In the reference group, the 2.5th percentile for inhibin B was 92 pg/ml and the 97.5th percentile for FSH was 7.8 IU/l. In the overall population, an inhibin B level <92 pg/ml was associated with increased odds ratio (OR; 95% CI) for oligozoospermia (16.93 (9.82-29.18), P<0.0001), asthenozoospermia (4.87 (2.88-8.10), P<0.0001), and teratozoospermia (2.20 (1.31-3.68), P=0.0026). The combination of a FSH >7.8 IU/l and an inhibin B <92 pg/ml was associated with greater OR for oligozoospermia (98.74 (23.99-406.35), P<0.0001) than for each hormone considered separately. CONCLUSIONS: A new reference range for serum inhibin B was established by the use of updated immunoassay. The correlations between hormone levels and semen parameters highlighted the importance of establishing these values with respect to the spermogram. When combined with FSH assay, the inhibin B range may be of value in the evaluation of spermatogenesis in a number of male genital conditions.


Assuntos
Astenozoospermia/sangue , Hormônio Foliculoestimulante/sangue , Inibinas/sangue , Oligospermia/sangue , Análise do Sêmen , Espermatozoides/patologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Adulto Jovem
5.
Fertil Steril ; 103(1): 112-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25450303

RESUMO

OBJECTIVE: To evaluate the relationship between polycystic ovarian morphology (PCOM) and oocyte quality after controlled ovarian stimulation for intracytoplasmic sperm injection (ICSI). DESIGN: Prospective, comparative study with concurrently treated and age-matched controls. SETTING: Academic IVF unit of the Lille University Hospital. PATIENT(S): A total of 194 women were prospectively included before their first IVF-ICSI attempt for exclusive male infertility. They were classified into PCOM (n = 97) or control groups (n = 97) according to their follicle number per ovary. The nuclear maturation and morphologic aspects of 1,013 oocytes from PCOM patients were assessed and compared with those of 774 oocytes from controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Rate of metaphase II (MII) and morphologically abnormal oocytes. RESULT(S): The mean number of total and MII oocytes retrieved was significantly higher in the PCOM group. The rate of MII and morphologically abnormal oocytes was equivalent between the two groups. The mean number of embryos was significantly higher in the PCOM group. However, the percentage of top-quality embryos on day 3 was similar between the two groups. The implantation and clinical pregnancy rates were significantly higher in the PCOM group. CONCLUSION(S): Polycystic ovarian morphology does not have a negative impact on the quality of oocytes and embryos or the outcome of IVF-ICSI.


Assuntos
Infertilidade Feminina/patologia , Infertilidade Feminina/terapia , Oócitos/patologia , Indução da Ovulação/estatística & dados numéricos , Síndrome do Ovário Policístico/epidemiologia , Síndrome do Ovário Policístico/patologia , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Adulto , Terapia Combinada/estatística & dados numéricos , Comorbidade , Feminino , França/epidemiologia , Humanos , Infertilidade Feminina/epidemiologia , Prevalência , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
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