RESUMO
OBJECTIVE: To evaluate the effect of growth hormone-releasing factor (GRF), given in addition to follicle-stimulating hormone (FSH), after pituitary down-regulation, on follicular development in poor responders. GRF was added in a prospective, randomized manner to an existing stimulation protocol. STUDY DESIGN: Forty-two women, demonstrated to be poor responders in previous attempts at induction of ovulation, were included in the study. Follicular stimulation with FSH was started after pituitary downregulation obtained using gonadotropin-releasing hormone agonist (GnRH-a). GRF, 1,000 mg/day, was given in addition to FSH to 22 patients randomly chosen until human chorionic gonadotropin administration. RESULTS: The number of ampules of FSH needed to obtain follicular growth was significantly reduced in the group of women who received GRF. Also, the number of follicles obtained was higher and the days of treatment generally reduced. However, a greatly beneficial effect for some women was observed, while a second subgroup did not have any. No differences were observed in follicular steroid and insulin growth factor 1 (IGF-1) between GRF patients and controls or in serum IGF-1 between the two subgroups of patients who received GRF. CONCLUSION: In vivo administration of GRF with FSH after pituitary down-regulation may be beneficial for some poor responders, although prognostic criteria could not be established. However, the use of GRF does not seem to influence the chance of obtaining pregnancy; it remains low in these patients.
Assuntos
Hormônio Foliculoestimulante/uso terapêutico , Hormônio Liberador de Hormônio do Crescimento/uso terapêutico , Infertilidade Feminina/tratamento farmacológico , Indução da Ovulação/métodos , Adulto , Feminino , Humanos , Infertilidade Feminina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Falha de TratamentoRESUMO
The functional integrity of sperm plasma membrane of 87 semen samples collected from fertile and infertile men was assessed by the hypoosmotic swelling test (HOS). The results were correlated with sperm motility and supravital stains using trypan blue and eosin Y. These data indicate that sperm swelling and staining methods evaluate different properties of spermatozoa. Moreover the present report shows that staining percentages with trypan blue are significantly lower than with eosin Y.