Increased cytotoxic natural killer cells in the endometrium alone cannot be considered the immunological cause of recurrent miscarriage.

OBJECTIVE: To study the distribution and gene expression of endometrial immune cell populations, especially natural killer (NK) subsets, between assisted reproductive technology patients and healthy donors and explore a possible relationship of these results with patients' killer cell immunoglobulin-like receptor (KIR) genotypes and KIR-human antigen leukocyte-C (HLA-C) binding. DESIGN: Prospective observational cohort study. SETTING: Clinic and university laboratories. PATIENT(S): Participants included 39 women with recurrent miscarriages who had undergone in vitro fertilization cycles with donated oocytes and 21 healthy oocyte donors with proven fertility. INTERVENTION(S): Endometrial biopsy samples were collected from both patients and donors, and the KIR genotypes of the assisted reproductive technology patients were analyzed. MAIN OUTCOME MEASURE(S): Endometrial gene expression (cluster of differentiation [CD] antigens and anti-inflammatory and proinflammatory interleukins) and the number and percentage of regulatory T and NK cell populations in patients and donors were determined. Subsequently, the results obtained were categorized in the group of patients by KIR genotype. Killer cell immunoglobulin-like receptor-HLA-C binding was also examined in patients, considering their KIRs. RESULT(S): A higher percentage of CD56dimCD16+ NK cells were observed in patients than those in healthy donors. Nevertheless, when categorizing patients by KIR genotype and comparing the KIR AA (35.9%), AB (43.6%), and BB (20.5%) groups, no statistically significant difference was observed in either endometrial gene expression or any of the immune cell populations analyzed. Finally, no differences in binding between KIR and HLA-C molecules were registered among these 3 sets of patients. CONCLUSION(S): The reported increase in the number of NK cells with a cytotoxic profile in the endometrium of women with a history of recurrent miscarriages cannot alone explain these events because no relationship is observed between such cellular increase and the KIR genotypes, which individually, and in combination with the different HLA-C alleles, have also been associated, by previous studies, with negative reproductive outcomes. CLINICAL TRIAL REGISTRATION NUMBER: 1405-MAD-025-JG.

Distress response in granulosa cells of women affected by PCOS with or without insulin resistance.

PURPOSE: In this study, we investigated whether metabolic dysfunction in women with Polycystic ovarian syndrome (PCOS) induces granulosa cell (GC) stress and activates in the endoplamatic reticulum and the mitochondria (UPRer and UPRmt, respectively). METHODS: Women who were diagnosed with PCOS (based on the Rotterdam criteria), were divided into two groups, PCOS with insulin resistance (PCOS-IR; n = 20) and PCOS with no insulin resistance (PCOS-nIR; n = 20), and compared to healthy oocyte donors (CONT; n = 20). Insulin resistance (IR) was assessed on the results of homeostasis model assessment (HOMA) that determines IR using the concentration of fasting plasma glucose and fasting insuline. Expression of UPRer genes (i.e., IRE1, ATF4, ATF6, XBP1, BIP, and CHOP), and UPRmt genes (i.e., HSP60, HSP10, CLPP, and HSP40) was assessed in cumulus GCs by qRT-PCR. RESULTS: We found that several genes involved in UPRer and UPRmt were overexpressed in the GCs of PCOS-IR and PCOS-nIR compared to CONT. IRE1, ATF4 and XBP1, that are activated by ER stress, were significantly overexpressed in PCOS-IR compared to CONT. BIP and CHOP were overexpressed in PCOS groups compared to CONT. HSP10 and HSP40 were upregulated in PCOS-IR and PCOS-nIR groups compared to the CONT. HSP60 and CLPP showed no statistical different expression in PCOS-IR and PCOS-nIR compared to CONT group. CONCLUSION: Our findings suggest that the GCs of women with PCOS (with or without IR) are metabolically distressed and upregulate UPRer and UPRmt genes. Our study contributes to the understanding of the molecular mechanisms underlying the pathological changes that occur in the follicular microenvironment of women with PCOS.

Comportamiento epidemiológico de SARS-CoV-2 en población trabajadora afiliada al Instituto Mexicano del Seguro Social / SARS-CoV-2 epidemic behavior in worker population affiliated to the Mexican Social Security Institute

Resumen: Objetivo: Describir el comportamiento de la epidemia de SARS-CoV-2 entre los trabajadores afiliados al Instituto Mexicano del Seguro Social (IMSS). Material y métodos: Se analizaron las incapacidades temporales para el trabajo por enfermedades respiratorias (ITT-ER), las hospitalizaciones y defunciones asociadas durante el periodo del 1 marzo al 31 diciembre 2020. Se estimó la tasa de ataque (TA) por SARS-CoV-2, así como los riesgos relativos (RR) de ITT-ER, hospitalización y defunción. Resultados: De los trabajadores afiliados al IMSS, 8.8% (n=1 730 334) recibió al menos una ITT-ER. La TA fue mayor en mujeres y en ambos sexos fue menor en el grupo de >60 años. Los RR de hospitalización y defunción fueron mayores en hombres y aumentaron con la edad. Comparado con las ITT-ER de 2015-2019, Durango, Tamaulipas y Nuevo León tuvieron un RR mayor de ITT-ER que el resto del país. Conclusiones: La epidemia de SARS-CoV-2 tuvo repercusiones importantes en los trabajadores afiliados al IMSS; se observó un exceso de ITT-ER de 4.6 veces respecto a la frecuencia esperada y cerca de un millón de casos de SARS-CoV-2. Los datos sugieren que el sistema de ITT-ER puede ser utilizado como elemento adicional para la vigilancia epidemiológica de enfermedades emergentes.

Abstract: Objective: To describe the behavior of SARS-CoV-2 epidemic among workers affiliated to the Mexican Social Security Institute. Materials and methods: We analyzed Short Term Disability Claims due to Respiratory Diseases (RD-STDC), associated hospitalizations and deaths (March 1 - December 31, 2020). We estimated the attack rate (AR) for SARS-CoV-2, and relative risks (RR) of TWD-RD, hospitalization and deaths. Results: 1 730 334 workers received at least one RD-STDC. AR was higher in women and in both sexes it was lower in >60 years old. RR of hospitalization and death were higher in men and increased with age. Compared with RD-STDC of 2015-2019, the states of Durango, Tamaulipas and Nuevo Leon had a higher RR of RD-STDC than the rest of the country. Conclusions: The SARS-CoV-2 epidemic impacted IMSS-affiliated workers significantly. We observed a 4.6 fold excess in RD-STDC compared to the expected frequency and nearly 1 million SARS-CoV-2 cases in this population. Our data suggest that the RD-STDC system can be used as an additional resource for epidemiological surveillance of emerging diseases.

Reproductive senescence and energetic metabolism of human luteinized granulosa cells: is it all about ATP? A prospective cohort and critical view.

Mitochondria are known to play a key role in the regulation of reproductive capacity. Senescence is known to impair mitochondrial function and, ultimately, cellular energetic metabolism. Therefore, as women age, a deficient energy supply is likely to affect oocyte quality. The analysis of granulosa cells is considered a valuable noninvasive strategy to assess factors implicated in oocyte competence. Thus, we conducted an observational prospective cohort to evaluate the impact of aging on energy production by luteinized granulosa cells (LGCs). The control group comprised 13 young oocyte donors, whereas the comparison group included 13 infertile women over 38 years of age undergoing in vitro fertilization. Women with diseases that could potentially impact mitochondrial function were excluded. No differences were detected in the ATP levels in LGCs from young donors and infertile patients of advanced reproductive age (1.9 ± 0.99 picomoles in the control group vs. 2.1 ± 0.59 picomoles; p-value = .139). Likewise, the ATP levels in our series did not correlate with either oocyte number or maturity. Despite the similar ATP levels in LGCs, an age effect on the bioenergetic status cannot be excluded. Energy metabolism is very complex, and ATP does not seem to be the most important and reliable parameter.

The proteome map of the escamolera ant (Liometopum apiculatum Mayr) larvae reveals immunogenic proteins and several hexamerin proteoforms.

The larvae of escamolera ant (Liometopum apiculatum Mayr) have been considered a delicacy since Pre-Hispanic times. The increased demand for this stew has led to massive collection of ant nests. Yet biological aspects of L. apiculatum larvae remain unknown, and mapping the proteome of this species is important for understanding its biological characteristics. Two-dimensional gel electrophoresis (2-DE) followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis was used to characterize the larvae proteome profile. From 380 protein spots analyzed, 174 were identified by LC-MS/MS and homology search against the Hymenoptera subset of the NCBInr protein database using the Mascot search engine. Peptide de novo sequencing and homology-based alignment allowed the identification of 36 additional protein spots. Identified proteins were classified by cellular location, molecular function, and biological process according to the Gene Ontology annotation. Immunity- and defense-related proteins were identified including PPIases, FK506, PEBP, and chitinases. Several hexamerin proteoforms were identified and the cDNA of the most abundant protein detected in the 2-DE map was isolated and characterized. L. apiculatum hexamerin (LaHEX, GeneBank accession no. MH256667) contains an open reading frame of 2199 bp encoding a polypeptide of 733 amino acid residues with a calculated molecular mass of 82.41 kDa. LaHEX protein is more similar to HEX110 than HEX70 from Apis mellifera. Down-regulation of LaHEX was observed throughout ant development. This work represents the first proteome map as well as the first hexamerin characterized from L. apiculatum larvae.

Impact of vitamin D levels on ovarian reserve and ovarian response to ovarian stimulation in oocyte donors.

Recently, growing interest in vitamin D has emerged from findings that demonstrate a low vitamin D status in populations. Similarly, much interest has been shown in the role that anti-Müllerian hormone (AMH) plays in reproductive physiology. Considerable confusion as to whether vitamin D status is related to ovarian function can be found in the literature. Our retrospective study was performed from June 2014 to April 2015. Oocyte donors were recruited and stimulated under the antagonist protocol with gonadotrophin-releasing hormone (GnRH) agonist to trigger ovulation. In 851 stimulation cycles, we determined the association among serum total and bioavailable vitamin D levels, ovarian reserve and response to ovarian stimulation and the reproductive outcome in their recipients. We showed that vitamin D levels were unrelated to ovarian reserve or ovarian response after ovarian stimulation; in oocyte recipients, gestational outcome did not differ according to a donor's vitamin D serum status. No correlation was observed between serum AMH and vitamin D. Bioavailable vitamin D was not related to recipients' ongoing pregnancy rate. Highly prevalent vitamin D insufficiency neither impaired ovarian reserve nor response or oocyte quality in egg donors. No evidence was found for recommending the analysis of vitamin D status in oocyte donors.

Mapa conceptual en la comprensión lectora de estudiantes de odontología según estilos de aprendizaje / The use of conceptual map in reading comprehension of dental students according to learning style

Objetivos: Se determinó que haciendo uso del mapa conceptual utilizando Cmap Tools se favoreció la comprensión lectora de un texto expositivo en estudiantes de odontología, según estilos de aprendizaje. Materiales y Método: Se realizó un estudio cuasi experimental con pre test y pos test en 50 estudiantes de odontología de la Universidad Andina Néstor Caceres Velasquez de Juliaca. Los estilos de aprendizaje fueron clasificados con el cuestionario de Honey-Alonso de Estilos de Aprendizaje (CHAEA), el nivel de comprensión de lectura se determinó con el test de comprensión lectora prediseñado, y la rúbrica semántica de Miller-Cañas 2008 se utilizó para la evaluación del contenido del mapa conceptual. Resultados: Las comparaciones del pre test y pos test de comprensión lectora alcanzaron una puntuación promedio para el total de la muestra de 7,5 incrementándose a 9,3 siendo favorecidos los estilos de aprendizaje teórico y reflexivo. La evaluación semántica del mapa conceptual pasó de 4,5 a 9,1 puntos, aquí todos los estilos fueron favorecidos. Conclusiones: La utilización de los mapas conceptuales a nivel de la educación superior es muy importante mejorando de esta manera la comprensión lectora del estudiante en su aprendizaje. (AU)

Objectives: It was determined that making use of the conceptual map using Cmap Tools favored the reading comprehension of an expository text in dentistry students, according to learning styles. Material and Methods: A quasi-experimental study with pretest and posttest was carried out on 50 dentistry students from the Universidad Andina Nestor Caceres Velasquez de Juliaca. The learning styles were classified with the Honey-Alonso Learning Styles questionnaire (CHAEA), the level of reading comprehension was determined with the pre-designed reading comprehension test and the Miller-Cañas 2008 semantic rubric was used to the evaluation of the contents of the conceptual map. Results: comparisons of pretest and posttest of reading comprehension reached an average score for the total of the sample of 7.5 increasing to 9.3 being favored the styles of theoretical and reflexive learning. The semantic evaluation of the conceptual map went from 4.5 to 9.1 points, here all styles were favored. Conclusions: The use of conceptual maps at the level of higher education is important, as part of the improving the student's reading comprehension. (AU)

Consumption of Amaranth Induces the Accumulation of the Antioxidant Protein Paraoxonase/Arylesterase 1 and Modulates Dipeptidyl Peptidase IV Activity in Plasma of Streptozotocin-Induced Hyperglycemic Rats.

BACKGROUND/AIM: Amaranth is a source of several bioactive compounds, among which peptides with inhibitory activity upon dipeptidyl peptidase IV (DPP-IV) have been reported. However, there is no information about the action of amaranth DPP-IV-inhibitory peptides using in vivo models. The aim of this work was to evaluate the effect of amaranth consumption on plasma and kidney DPP-IV activity as well the changes in plasma proteome profile of streptozotocin (STZ)-induced hyperglycemic rats. METHODS: Rats were fed for 12 weeks with a diet containing 20% popped amaranth grain. Kidneys and blood samples were collected for lipid profile, DPP-IV activity and expression, and proteomic analysis. RESULTS: Total cholesterol and DPP-IV activity in plasma was increased in hyperglycemic rats, but this effect was reverted by amaranth consumption. Triacylglycerols were increased in the hyperglycemic group fed amaranth, and the highest levels of high-density lipoproteins were also observed in this group. These data correlated with the accumulation of apolipoprotein A-II in plasma. Accumulation of the antioxidant protein paraoxonase/arylesterase 1 in STZ-induced hyperglycemic rats was observed when amaranth was supplied in the diet. CONCLUSION: This study provides new insights into the molecular mechanisms by which amaranth exerts its beneficial health action in a hyperglycemic state.

Type of gonadotropin during controlled ovarian stimulation affects the endocrine profile in follicular fluid and apoptosis rate in cumulus cells.

OBJECTIVE: To determine whether the type of gonadotropin affects the secretion of oocyte-specific factors, the endocrine pattern in follicular fluid, and the apoptosis rate in cumulus cells. STUDY DESIGN: Prospective and observational study into an university-affiliated private in vitro fertilization setting. Ninety women included in our oocyte donation program were stimulated with human menopausal gonadotropin (hMG), recombinant follicle-stimulating hormone (FSH) or urinary FSH. Main outcome measures were growth-differentiation factor 9 (GDF-9) and bone morphogenetic protein 15 (BMP-15) expression, hormonal profile and apoptosis rate. RESULTS: No statistically significant differences were observed for GDF-9 and BMP-15 among the three treatment groups. Estradiol concentrations in follicular fluid were significantly higher in women treated with hMG compared with recombinant FSH or urinary FSH. Testosterone levels were also higher in the group treated with hMG. A statistically significant association was found between the degree of apoptosis in cumulus cells and the type of gonadotropin. CONCLUSIONS: The type of gonadotropin used during controlled ovarian stimulation significantly affects endocrine profiles in follicular fluid and the apoptosis rate in cumulus cells. However, there were no significant differences in the levels of oocyte-secreted factors between treatments.

Ongoing pregnancy rates in intrauterine insemination are affected by late follicular-phase progesterone levels.

OBJECTIVE: To determine the relationship between serum P levels on the day of hCG administration and ongoing pregnancy rates. DESIGN: Retrospective study. SETTING: University-affiliated private IVF. PATIENT(S): A total of 2,458 couples undergoing IUI. INTERVENTION(S): Ovarian stimulation with human recombinant FSH. MAIN OUTCOME MEASURE(S): Ongoing pregnancy and miscarriage rates. RESULT(S): Progesterone concentrations were significantly higher given that the E2 concentration increased. Ongoing pregnancy rates were significantly decreased in women with P levels higher than 1.1 ng/mL; similar results were obtained in relation to miscarriage rates. CONCLUSION(S): Significant differences in ongoing pregnancy rates when P levels were elevated on the day of hCG administration may help clinicians to counsel patients about the reduced success rates with IUI and manage the timing of insemination to optimize implantation.

Atrofia muscular espinal tipo 1: enfermedad de Werdnig-Hoffmann / Type I spinal muscular atrophy: Werdnig-Hoffmann disease

Introducción. Las atrofias musculares espinales de la infancia son enfermedades neuromusculares hereditarias, autosómicas, recesivas, caracterizadas por la degeneración de las neuronas motoras del asta anterior de la médula espinal. La atrofia muscular espinal tipo I (enfermedad de Werdnig-Hoffmann) es la forma más severa. Se inicia in útero o durante los primeros meses de vida. La muerte suele ocurrir antes de los dos años de edad. Caso clínico. Lactante de 6 meses de edad que ingresa al Servicio de Urgencias por dificultad respiratoria severa. Presenta marcada hipotonía muscular, debilidad de musculatura intercostal y fasciculaciones de la lengua. La electromiografía es compatible con polineuropatía motora con daño mielínico y axonal. El análisis molecular reportó un estado homocigoto para la deleción de los exones 7 y 8 del gen SMN-1 . Con estos dos estudios se integra el diagnóstico de atrofia muscular espinal tipo 1 (enfermedad de Werdnig-Hoffmann). Conclusiones. Es importante conocer y diagnosticar esta entidad para brindar consejo genético a la familia, así como asesoramiento y apoyo en el manejo del paciente.

Background. Childhood spinal muscular atrophy is an autosomal recessive neuromuscular disease characterized by degeneration of the anterior horn cells of the spinal cord. SMA type I, the most severe form (Werdnig-Hoffmann disease) can be detected in utero or during the first months of life. Death typically occurs within the first 2 years of life. Case report. A 6-month-old female was admitted to the emergency room for severe respiratory distress. She had muscular hypotonia, intercostal muscle weakness and tongue fasciculations. Electromyography was compatible with motor polyneuropathy with axonal and myelin damage. Molecular analysis of SMN-1 gene reported homozygous for deletion of exons 7 and 8 of SMN-1 gene. Conclusions. It is imperative to recognize and diagnose this entity in order to provide genetic counseling to the family as well as to offer support and advice in the care of the patient.

In vitro inhibition of dipeptidyl peptidase IV by peptides derived from the hydrolysis of amaranth (Amaranthus hypochondriacus L.) proteins.

Bioactive compounds present in foods could potentially have beneficial effects on human health. In this study we report the in vitro inhibitory capacity of peptides released from amaranth seed proteins after enzymatic digestion, against dipeptidyl peptidase IV (DPPIV); an enzyme known to deactivate incretins, hormones involved in insulin secretion. Other seeds, such as soybean, black bean, and wheat were also tested. The highest inhibition of DPPIV was observed with amaranth peptides released after simulated gastrointestinal digestion, showing an IC(50) of 1.1mg/mL in a dose-dependent manner. In silico tryptic digestion of amaranth globulins was carried out releasing peptides larger than 13 residues. Some of these peptides were used for the in silico prediction of their binding modes with DPPIV. Docking models showed that the possible mechanism of globulin peptides to inhibit DPPIV was through blocking the active dimer formation. Peptides were also found inside the major cavity where the natural substrates reach the catalytic site of the enzyme. This is the first report of the identification of inhibitory DPPIV peptides from amaranth hydrolysates and the prediction of their binding modes at the molecular level, leading to their possible use as functional food ingredients in the prevention of diabetes.

Color of meconium and interleukin-6.

OBJECTIVE: To test the hypothesis that the color of meconial fluid is associated with inflammatory biomarkers, by determining C-reactive protein (CRP) and Interleukin-6 (IL-6) in serum from the umbilical cord. METHODS: In this prospective study, the authors selected 30 newborns with meconium-stained amniotic fluid (MSAF): 14 with green/brown 656 R color and 16 with brown/cinnamon 654 R color, and 20 newborns which showed clear amniotic fluid without MSAF (non-MSAF); all newborns were from mothers without risk factors for neonatal sepsis. RESULTS: IL-6 concentration from umbilical cord blood, [median of 12.9 pg/mL (interquartile range {IQR} 8.7-31.0)] of MSAF-green/brown 656 R increased significantly (p < 0.05) when compared with IL-6 concentration, [median of 9.2 pg/mL (IQR 7.2-12.2)] of newborns with clear amniotic fluid and without meconium. CRP from MSAF-green/brown 656 R was median of 0.5 mg/mL (IQR 0.0-2.7), and median of 1.0 mg/mL (IQR 0.0-5.5) from clear amniotic fluid, without meconium. CONCLUSIONS: Significant association was found between MSAF-green/brown 656 R and increase in IL-6, with normal CRP values.

Effect of GnRH agonist and hCG treatment on VEGF, angiopoietin-2, and VE-cadherin: trying to explain the link to ovarian hyperstimulation syndrome.

This study evaluated the differentially modulated expression of vascular mediators in oocyte donors after hCG vs. GnRHa triggering, trying to understand ovarian hyperstimulation syndrome pathophysiology. Donors who received GnRH agonist triggering showed a statistically significant decrease in vascular endothelial growth factor in follicular fluid and in mRNA expression in granulosa cells, with no differences in angiopoietin 2 and vascular endothelial cadherin levels in serum or follicular fluid. This differential regulation of vascular endothelial growth factor by hCG might explain the higher likelihood of ovarian hyperstimulation syndrome following hCG administration compared with GnRH agonists.

Low-dose human chorionic gonadotropin versus estradiol/progesterone luteal phase support in gonadotropin-releasing hormone agonist-triggered assisted reproductive technique cycles: understanding a new approach.

It remains unclear how GnRH agonist (GnRHa) triggering affects the luteal phase, so we investigated the luteal phase after GnRHa triggering, supported with conventional E(2)/P with or without low-dose hCG. E(2)/P support, compared with low-dose hCG, induced a shorter luteal phase (11.2 ± 1.1 vs. 15.0 ± 1.6 days) and fewer subjective complaints (0 vs. 42%), whereas hCG caused more free fluid accumulation and enlarged ovaries than E(2)/P alone. Steroids and low-dose hCG differentially affected corpus luteum function, ovarian size, free fluid accumulation, and patient comfort.

Amaranth lunasin-like peptide internalizes into the cell nucleus and inhibits chemical carcinogen-induced transformation of NIH-3T3 cells.

Because an unbalanced diet is an important risk factor for several illnesses, interest has increased in finding novel health-promoting foods. Amaranth produces seeds that not only have substantial nutritional properties but that also contain phytochemical compounds as rutin and nicotiflorin and peptides with antihypertensive and anticarcinogenic activities. We report that a cancer-preventive peptide in amaranth has activities similar to those of soybean lunasin. The amaranth lunasin-like peptide, however, requires less time than the soybean lunasin to internalize into the nucleus of NIH-3T3 cells, and inhibits histone acetylation (H(3) and H(4) in a 70 and 77%, respectively). The amaranth lunasin-like peptide inhibited the transformation of NIH-3T3 cells to cancerous foci. The open reading frame (ORF) of amaranth lunasin corresponds to a bifunctional inhibitor/lipid-transfer protein (LTP). LTPs are a family of proteins that in plants are implicated in different functions, albeit all linked to developmental processes and biotic and abiotic stress resistance. Our results open new intriguing questions about the function of lunasin in plants and support that amaranth is a food alternative containing natural peptides with health-promoting benefits.

Could the addition of hp-hMG and GnRH antagonists modulate the response in IVF-ICSI cycles?

OBJECTIVE: To assess if the luteinizing hormone/human chorionic gonadotropin present in some gonadotropin formulations may be of benefit in protocols with GnRH antagonists. METHODS: Open, quasi-experimental, multicenter, prospective, parallel-controlled study compared 136 women undergoing in vitro fertilization--intracytoplasmic sperm injection after stimulation with highly purified human menopausal gonadotropin (hp-hMG) (n = 44), recombinant-follicle stimulating hormone (r-FSH) (n = 46), or a combination of both (r FSH + hp-hMG) (n = 46) following an antagonist protocol. Blood determinations were made on day 6 of stimulation and on the day of ovulation induction, with centralized analysis. RESULTS: No differences were found in the ongoing pregnancy rates between groups [37.0% versus 29.5% (hp-hMG) and 23.9% (r-FSH); p = 0.688]. However, the ratio top-quality embryos/retrieved oocytes (TQE/RO) was higher in the combined therapy group (19.6%)--reaching significance versus the r-FSH group (6.5%) (p = 0.008), but not versus hp-hMG (12.3%) (p = 0.137). CONCLUSIONS: An improved TQE/RO ratio was obtained together with a greater percentage of frozen embryos in the patients that incorporated hp-hMG to their stimulation protocol. Despite good results of adding hp-hMG, non statistical differences were found in terms of ongoing pregnancy rate.

GnRH analogue for the prevention of ovarian hyperstimulation syndrome: a pilot study.

Continuation of GnRH analogue after ovum retrieval produces a faster decline in vascular endothelial growth factor levels and ascitis in women at risk of ovarian hyperstimulation syndrome.

Differential regulation of VEGF after final oocyte maturation with GnRH agonist versus hCG: a rationale for OHSS reduction.

In a prospective cohort study, we compared the effect of hCG and GnRH agonist triggering of final oocyte maturation on vascular endothelial growth factor production. Vascular endothelial growth factor follicular fluid concentration was significantly lower in response to GnRH agonist versus hCG, which may partially explain the absence of OHSS in these of women.

Endocrine modifications associated with final oocyte maturation with gonadotropin-releasing hormone agonists vs. human chorionic gonadotropin in women undergoing intrauterine insemination.

OBJECTIVE: To compare the hormonal profile when using triptorelin vs. human chorionic gonadotropin (hCG) to trigger ovulation in intrauterine insemination (IUI) cycles. STUDY DESIGN: Twenty-five patients who underwent 48 cycles were enrolled in a prospective, randomized, crossover study. After ovulation induction with recombinant follicle-stimulating hormone (FSH), couples were randomly allocated to a first cycle with a single dose of 0.2 mg of triptorelin or 5,000 IU of urinary hCG to trigger ovulation; if pregnancy did not occur, a second cycle was carried out, and the patient was crossed over to the other treatment group. Blood was collected the day of hCG/triptorelin administration and both days after IUI. RESULTS: Patients treated with triptorelin showed a significantly higher FSH and luteinizing hormone (LH) rise 24 hours after the injection when compared to hCG. Serum progesterone was significantly increased 48 hours after hCG administration, although estradiol levels were comparable between the groups. CONCLUSION: A higher LH and FSH peak than that induced by hCG was observed. Considering that serum progesterone levels were suboptimal in both protocols and taking into account the lower progesterone production in gonadotropin releasing hormone analogue cycles, corpus luteum supplementation in the luteal phase should be recommended for these patients.