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1.
Reprod Biomed Online ; 46(2): 363-370, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36604213

RESUMO

RESEARCH QUESTION: Are oxytocin preprotein and the oxytocin receptor expressed in human spermatozoa and is their mRNA expression different between normal semen samples and samples with at least one abnormal parameter? DESIGN: An in-vitro prospective study of 175 semen samples from Greek men, according to World Health Organization criteria, 2010. mRNA expression levels were compared between different categories of semen samples, classified according to their concentration, total number, motility and morphology. Immunohistochemistry was used to detect oxytocin preprotein and its receptor on spermatozoa smears. RESULTS: Compared with normal samples (normal motility and normal concentration), samples with at least one abnormal sperm parameter had statistically significantly lower oxytocin preprotein mRNA expression (P = 0.019) and higher oxytocin receptor mRNA expression levels (P < 0.001). Oligozoospermic samples had statistically significantly higher oxytocin preprotein mRNA expression levels (P = 0.002) and lower oxytocin receptor mRNA expression levels (P = 0.047). Asthenozoospermic samples had statistically significantly lower oxytocin preprotein mRNA expression levels (P < 0.001). Teratozoospermic samples had statistically significantly lower oxytocin preprotein mRNA expression levels (P = 0.049) and higher oxytocin receptor mRNA expression levels (P < 0.001). Oxytocin preprotein mRNA expression was positively associated with total progressive motility (P < 0.001) and negatively associated with the percentage of immotile spermatozoa (P = 0.001). Oxytocin receptor mRNA expression was negatively associated with the percentage of normal forms (P < 0.001). CONCLUSION: Oxytocin preprotein and oxytocin receptor mRNA expression in spermatozoa could be used as a novel and unbiased diagnostic tool for male infertility.


Assuntos
Infertilidade Masculina , Sêmen , Humanos , Masculino , Sêmen/metabolismo , Ocitocina/metabolismo , Receptores de Ocitocina/genética , Estudos Prospectivos , Motilidade dos Espermatozoides , Espermatozoides/metabolismo , Infertilidade Masculina/diagnóstico , RNA Mensageiro/metabolismo
2.
Gynecol Endocrinol ; 37(7): 618-623, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33016794

RESUMO

AIM: To assess the birthweight of neonates conceived after fresh and frozen embryo transfers (FET) and, if different, to investigate whether estradiol levels during the late follicular phase were associated with the observed difference. METHODS: Singleton pregnancies from fresh and FET transfers between January 1990 and December 2013 were compared retrospectively. A total of 2885 singleton pregnancies after fresh embryo transfer and 746 after FET were analyzed. Obstetric and neonatal outcomes were compared between fresh and FET cycles. RESULTS: The singletons born after FET were found to have a significantly higher birth weight (3313 g), compared to those born after fresh embryo transfer (3143 g); p < .001. The main predictor of this difference was found to be estradiol levels at the end of the follicular phase. The difference in birthweight was inversely correlated to estradiol levels considering all cycles together but also considering fresh and frozen cycles separately. CONCLUSIONS: Our study demonstrates a link between high estradiol levels and low birth weight of singletons after IVF both in fresh and frozen-thawed embryo transfer cycles. It provides additional support to the involvement of hyperestrogenemia in the process of implantation and on the subsequent fetal development.


Assuntos
Peso ao Nascer , Criopreservação/estatística & dados numéricos , Transferência Embrionária/métodos , Estradiol/sangue , Macrossomia Fetal/epidemiologia , Pré-Eclâmpsia/epidemiologia , Nascimento Prematuro/epidemiologia , Adulto , Diabetes Gestacional/epidemiologia , Feminino , Fertilização in vitro , Fase Folicular/sangue , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Mortalidade Perinatal , Gravidez , Estudos Retrospectivos
3.
Reprod Biomed Online ; 34(1): 11-18, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27793549

RESUMO

The aim of this study was to evaluate whether pregnancies resulting from oocyte donation have a higher risk of preeclampsia compared with pregnancies after IVF using autologous oocytes. Propensity score matching on maternal age and parity was carried out on a one to one basis, and a total of 144 singleton pregnancies resulting in delivery beyond 22 gestational weeks, achieved by oocyte donation, were compared with 144 pregnancies achieved through IVF and intracytoplasmic sperm injection with the use of autologous oocytes. All pregnancies were achieved after fresh embryo transfer. Obstetric and neonatal outcomes were compared for each pregnancy. Singleton pregnancies after oocyte donation were associated with a significantly higher risk for preeclampsia (OR 2.4, CI 1.02 to 5.8; P = 0.046), as well as for pregnancy-induced hypertension (OR 5.3, CI 1.1 to 25.2; P = 0.036), and caesarean delivery (OR 2.3, CI 1.4 to 3.7; P = 0.001) compared with pregnancies using autologous oocytes.


Assuntos
Fertilização in vitro , Infertilidade/complicações , Doação de Oócitos , Oócitos/citologia , Pré-Eclâmpsia/epidemiologia , Adulto , Transferência Embrionária , Feminino , Humanos , Hipertensão Induzida pela Gravidez , Ovário/fisiologia , Pré-Eclâmpsia/diagnóstico , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Risco , Injeções de Esperma Intracitoplásmicas
4.
J Assist Reprod Genet ; 34(10): 1341-1351, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28710674

RESUMO

PURPOSE: The purpose of the present study is to study what is the best predictor of severe ovarian hyperstimulation syndrome (OHSS) in IVF. METHODS: This is a retrospective analysis of all consecutive IVF/intracytoplasmic injection cycles performed during a 5-year period (2009-2014) in a single university fertility centre. All fresh IVF cycles where ovarian stimulation was performed with gonadotrophins and GnRH agonists or antagonists and triggering of final oocyte maturation was induced with the administration of urinary or recombinant hCG were analyzed (2982 patients undergoing 5493 cycles). Because some patients contributed more than one cycle, the analysis of the data was performed with the use of generalized estimating equation (GEE). RESULTS: Severe OHSS was diagnosed in 20 cycles (0.36%, 95% CI 0.20-0.52). The number of follicles ≥10 mm on the day of triggering final oocyte maturation represents the best predictor of severe OHSS in IVF cycles. The cutoff in the number of follicles ≥10 mm with the best capacity to discriminate between women that will and will not develop severe OHSS was ≥15. CONCLUSION: The presence of more than 15 follicles ≥10 mm on the day of triggering final oocyte maturation represents the best predictor of severe OHSS in IVF cycles.


Assuntos
Biomarcadores/análise , Síndrome de Hiperestimulação Ovariana/etiologia , Indução da Ovulação/efeitos adversos , Indução da Ovulação/métodos , Adulto , Gonadotropina Coriônica/urina , Estudos de Coortes , Estradiol/sangue , Feminino , Fertilização in vitro/efeitos adversos , Hormônio Foliculoestimulante/farmacologia , Hormônio Liberador de Gonadotropina/análogos & derivados , Humanos , Técnicas de Maturação in Vitro de Oócitos/métodos , Modelos Logísticos , Hormônio Luteinizante/sangue , Folículo Ovariano/efeitos dos fármacos
5.
Reprod Biol Endocrinol ; 10: 69, 2012 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-22938051

RESUMO

BACKGROUND: Management of established severe OHSS requires prolonged hospitalization, occasionally in intensive care units, accompanied by multiple ascites punctures, correction of intravascular fluid volume and electrolyte imbalance. The aim of the present study was to evaluate whether it is feasible to manage women with severe OHSS as outpatients by treating them with GnRH antagonists in the luteal phase. METHODS: This is a single-centre, prospective, observational, cohort study. Forty patients diagnosed with severe OHSS, five days post oocyte retrieval, were managed as outpatients after administration of GnRH antagonist (0.25 mg) daily from days 5 to 8 post oocyte retrieval, combined with cryopreservation of all embryos. The primary outcome measure was the proportion of patients with severe OHSS, in whom outpatient management was not feasible. RESULTS: 11.3% (95% CI 8.3%-15.0%) of patients (40/353) developed severe early OHSS. None of the 40 patients required hospitalization following luteal antagonist administration and embryo cryopreservation. Ovarian volume, ascites, hematocrit, WBC, serum oestradiol and progesterone decreased significantly (P < 0.001) by the end of the monitoring period, indicating rapid resolution of severe OHSS. CONCLUSIONS: The current study suggests, for the first time, that successful outpatient management of severe OHSS with antagonist treatment in the luteal phase is feasible and is associated with rapid regression of the syndrome, challenging the dogma of inpatient management. The proposed management is a flexible approach that minimizes unnecessary embryo transfer cancellations in the majority (88.7%) of high risk for OHSS patients.


Assuntos
Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Antagonistas de Hormônios/uso terapêutico , Pacientes Ambulatoriais , Síndrome de Hiperestimulação Ovariana/tratamento farmacológico , Indução da Ovulação/efeitos adversos , Adulto , Estudos de Coortes , Criopreservação , Transferência Embrionária , Feminino , Hormônio Liberador de Gonadotropina/uso terapêutico , Humanos , Recuperação de Oócitos/efeitos adversos , Gravidez , Taxa de Gravidez
6.
Ann N Y Acad Sci ; 1205: 199-206, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20840273

RESUMO

Poor ovarian response is not infrequent and represents one of the major therapeutic challenges in in vitro fertilization. Although several tests have been proposed, which aim at predicting poor response to ovarian stimulation, available data are conflicting regarding their accuracy and clinical usefulness. Even though several therapeutic approaches have been explored, a single effective strategy has not yet been established. One of the major limitations of interpreting the relevant literature is the wide variability in the definitions used for poor ovarian response. Regarding the interventions that have been proposed to improve the probability of pregnancy in poor responders, limited evidence from relevant randomized controlled trials suggests that addition of growth hormone during ovarian stimulation, as well as performing embryo transfer on day 2 instead of day 3, might be beneficial. Further randomized control trials are warranted to reliably determine which would be the best approach for treating poor ovarian response.


Assuntos
Medicina Baseada em Evidências , Infertilidade Feminina/terapia , Ovário/fisiopatologia , Indução da Ovulação , Feminino , Fertilização in vitro , Humanos , Infertilidade Feminina/fisiopatologia , Ovário/efeitos dos fármacos , Gravidez , Falha de Tratamento
7.
Curr Opin Obstet Gynecol ; 20(3): 305-7, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18460946

RESUMO

PURPOSE OF REVIEW: Taking into consideration the increasing interest on hyaluronan and its biological as well as physiological properties, this review will focus on the role of this molecule in human embryo implantation. RECENT FINDINGS: Several studies have been performed up to date in order to assess whether the addition of hyaluronan in the human embryo culture system can improve pregnancy and implantation rates, including one retrospective and six randomized controlled trials. On the one hand, four of those studies showed significant increase in clinical pregnancy and/or implantation rates after using embryo transfer medium containing high concentration of hyaluronan. On the other hand, three studies did not demonstrate any significant improvement in clinical pregnancy and implantation rates. However, regardless of statistical significance, almost all studies demonstrate higher pregnancy and implantation rates after using embryo transfer medium containing high concentration of hyaluronan. SUMMARY: Up to date, the results regarding the role of hyaluronan in human embryo implantation are still conflicting and, thus, further prospective randomized clinical trials are necessary to draw solid conclusions.


Assuntos
Técnicas de Cultura Embrionária , Implantação do Embrião/efeitos dos fármacos , Ácido Hialurônico/farmacologia , Feminino , Fertilização in vitro , Humanos , Ácido Hialurônico/fisiologia , Gravidez , Taxa de Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
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