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1.
Anim Sci J ; 91(1): e13477, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33372383

RESUMO

For the timed re-insemination at the minimal interbreeding interval, cows were treated with a progesterone (P4 )-releasing intravaginal device from Days 13-15 to 21 post-insemination (Day 0 = estrus), followed by plasma P4 assay on Day 23 and then subjected to the Experiments 1 and 2. In Experiment 1, of 18 cows, 6 cows were determined as luteolysis with low (<1 ng/ml) plasma P4 concentrations on Day 23 and ovulated on Days 24 (3 cows), 25 (1 cow), and 26 (1 cow) except a cow affected by ovarian quiescence. In Experiment 2, all cows were treated with GnRH on Day 23. Cows with low (<1 ng/ml) plasma P4 concentrations on Day 23 were diagnosed as non-pregnant and subjected to the re-insemination in the morning of Day 24 irrespective of estrous signs. Of 36 cows, 15 cows were diagnosed as being non-pregnant on Day 23. Fourteen cows of the non-pregnant animals were re-inseminated in the morning of Day 24 irrespective of estrous signs and the pregnancy rate of re-insemination was 36%. The conception rates of initial and re-inseminations were 50% (18/36) and 36% (5/14), respectively. The overall pregnancy rate by adding the rates of initial and re-inseminations was 64% (23/36).


Assuntos
Cruzamento/métodos , Bovinos/metabolismo , Bovinos/fisiologia , Indústria de Laticínios/métodos , Hormônio Liberador de Gonadotropina/administração & dosagem , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Taxa de Gravidez , Testes de Gravidez/veterinária , Prenhez , Animais , Ciclo Estral/fisiologia , Feminino , Inseminação Artificial/instrumentação , Luteólise , Ovário/fisiologia , Ovulação , Gravidez , Progesterona/administração & dosagem , Progesterona/sangue , Fatores de Tempo
2.
Anim Sci J ; 91(1): e13476, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33078458

RESUMO

We investigated the feasibility of piglet production by non-surgical embryo transfer (Ns-ET) of vitrified porcine blastocysts and expanded blastocysts transported to commercial farms and warmed on site (V/T/W embryos). Ns-ET was performed by depositing 11-20 vitrified and warmed embryos at a proximal site within the uterus via a catheter. In Experiment 1, the effect of donor-recipient estrous cycle asynchrony on the efficiency of Ns-ET of vitrified and ordinary warmed embryos was investigated at the experimental facility. With a 1-day delay recipients relative to that of donor, the farrowing rate was 50.0% and the survival rate to term was 21.1%. In Experiment 2, Ns-ET using recipients with a 1-day delay and vitrified embryos after one-step warming and dilution was evaluated at the experimental facility. Although the resulting farrowing rate was 42.9%, the survival rate was 6.4%. In Experiment 3, Ns-ET was conducted using V/T/W embryos at four commercial farms, where piglets derived from them were produced. When artificial insemination was conducted prior to Ns-ET, the farrowing and survival rates obtained using V/T/W embryos were 75.0%, and 21.3%, respectively. These results show that Ns-ET of V/T/W embryos using this protocol would be feasible for piglet production at farms.


Assuntos
Blastocisto , Cruzamento/métodos , Criopreservação/métodos , Criopreservação/veterinária , Técnicas de Cultura Embrionária/métodos , Técnicas de Cultura Embrionária/veterinária , Transferência Embrionária/métodos , Transferência Embrionária/veterinária , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Animais , Ciclo Estral , Fazendas , Estudos de Viabilidade , Feminino , Suínos
3.
Anim Sci J ; 91(1): e13453, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32926526

RESUMO

This study was performed to evaluate reproductive performance after non-surgical embryo transfer (Ns-ET) of 10-15 porcine expanded blastocysts (ExBs) that had been vitrified and warmed (V/W) using the micro volume air cooling (MVAC) method. The effect of asynchrony between the donor and recipient estrous cycle was investigated. Ns-ET was conducted in recipients whose estrous cycle was asynchronous to that of donors by a delay of 2, 1, or 0 days. In the 2-day and 1-day groups, the similar farrowing rates (27.3% and 25.0%) and survival rates to term (13.9% and 15.7%) were obtained after Ns-ET of V/W ExBs. None of the recipients in 0-day group farrowed. Artificial insemination (AI) prior to Ns-ET was then evaluated. Ten-15 V/W ExBs were transferred non-surgically to 12 recipients whose estrous cycles were asynchronous to that of donors by a 2-day delay. All of the recipients produced piglets, and all (100.0%) delivered piglets were derived from the transferred V/W ExBs. The survival rate of V/W ExBs to term was 25.2%. These results demonstrate that Ns-ET of V/W ExBs using MVAC can facilitate piglet production, even if 10-15 embryos are transferred. Moreover, piglets were obtained stably when AI was performed prior to Ns-ET.


Assuntos
Blastocisto , Sobrevivência Celular , Criopreservação/métodos , Criopreservação/veterinária , Técnicas de Cultura Embrionária/veterinária , Transferência Embrionária/métodos , Transferência Embrionária/veterinária , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Suínos/fisiologia , Vitrificação , Animais , Ciclo Estral , Feminino , Reprodução
4.
Medicine (Baltimore) ; 99(31): e21006, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756085

RESUMO

BACKGROUND: With the medical advancement some studies put forward that letrozole (LE), a specific aromatase inhibitor with the function of reducing oestrogen synthesis, has recently been applied as a potentially better alternative compared with clomiphene citrate (CC), owing to that it has a superior efficacy as compared with CC in patients of unexplained infertility undergoing intrauterine insemination (IUI). However, there is no one study can clear and definite whether LE can replace the CC as first line drug. OBJECTIVE: Our objective is to compare the LE with CC in the induction of ovulation in patients with unexplained infertility IUI. METHOD: Searching databases consist of all kinds of searching tools, such as Medline, The Cochrane Library, Embase, PubMed, etc. All the include studies should meet our demand of this meta-analysis: RESULT:: Based on the current meta-analysis, we rigorously consider that LE has a likelihood to improve dominant follicles (MD= -0.56, I= 100%, P= .04; MD= -0.39, I= 73%, P = .0003, respectively) and reduces the miscarriage rate (RR= 0.61, I= 0%, P = .03). There is no significant differences between the 2 groups in The total rate of pregnancy, pregnancy rate per cycle, multiple pregnancy and endometrial thickness. (RR= 1.06, I= 11%, P = .38; RR= 1.09, I= 7%, P = .32; RR= 0.79, I= 0%, P = .46; respectively) CONCLUSION:: Combined with the results of current systematic review and meta-analysis through subgroup analysis and sensitivity analysis, we can be cautious: in general, compared with CC, LE is an effective treatment in the IUI cycle, has a likelihood to improve dominant follicles and reduces the miscarriage rate.


Assuntos
Clomifeno/uso terapêutico , Fármacos para a Fertilidade Feminina/uso terapêutico , Infertilidade Feminina/tratamento farmacológico , Inseminação Artificial/métodos , Letrozol/uso terapêutico , Superovulação/efeitos dos fármacos , Feminino , Humanos
5.
Sci Rep ; 10(1): 7719, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32382043

RESUMO

This multicentre, randomised, controlled cross-over trial was designed to investigate the effect of intra-uterine slow-release insemination (SRI) on pregnancy rates in women with confirmed infertility or the need for semen donation who were eligible for standard bolus intra-uterine insemination (IUI). Data for a total of 182 women were analysed after randomisation to receive IUI (n = 96) or SRI (n = 86) first. The primary outcome was serological pregnancy defined by a positive beta human chorionic gonadotropin test, two weeks after insemination. Patients who did not conceive after the first cycle switched to the alternative technique for the second cycle: 44 women switched to IUI and 58 switched to SRI. In total, there were 284 treatment cycles (IUI: n = 140; SRI: n = 144). Pregnancy rates following SRI and IUI were 13.2% and 10.0%, respectively, which was not statistically significant (p = 0.202). A statistically significant difference in pregnancy rates for SRI versus IUI was detected in women aged under 35 years. In this subgroup, the pregnancy rate with SRI was 17% compared to 7% with IUI (relative risk 2.33; p = 0.032) across both cycles. These results support the hypothesis that the pregnancy rate might be improved with SRI compared to standard bolus IUI, especially in women aged under 35 years.


Assuntos
Fertilização In Vitro/métodos , Infertilidade/terapia , Inseminação Artificial/métodos , Taxa de Gravidez , Adolescente , Adulto , Gonadotropina Coriônica/metabolismo , Feminino , Humanos , Infertilidade/patologia , Nascimento Vivo/epidemiologia , Masculino , Gravidez , Doadores de Tecidos , Adulto Jovem
6.
Obstet Gynecol ; 135(5): 1005-1014, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32282611

RESUMO

OBJECTIVE: To estimate the risk of a multiple gestation pregnancy in ovarian stimulation intrauterine insemination (IUI) cycles when stratified by patient age and mature follicle number. METHODS: We conducted a retrospective cohort study at a single private practice fertility center of IUI cycles performed from 2004 to 2017. Intervention(s) were ovarian stimulation and IUI if postwash total motile sperm count was more than 8 million. Mature follicles were defined as 14 mm or more as measured on the day of ovulation trigger. Main outcomes and measures were rates of clinical pregnancy and multiple gestation. RESULTS: We identified 24,649 women who underwent a total of 50,473 IUI cycles. Increasing the number of mature follicles from one to five at the time of IUI in women younger than age 38 years increased the clinical pregnancy rate from 14.6% to 21.9% (adjusted odds ratio [aOR] 1.6, 95% CI 1.4-1.9), almost entirely from a marked increase in multiple gestations per cycle from 0.6% to 6.5% (aOR 9.9, 95% CI 6.9-14.2). There was little increase in singleton pregnancies per IUI (14.1-16.4%) regardless of mature follicle number. The per-pregnancy twin and higher-order multiple gestation risk significantly increased (3.9-23.3%, P<.01 and 0.2-10.6%, P<.01, respectively) when comparing one with five mature follicles present at the time of IUI (P<.01). In women younger than age 38 years with more than three follicles present, more than one quarter of all pregnancies were multiples. Similar findings occurred in women aged 38-40 years. In women older than age 40 years, up to four follicles tripled the odds of pregnancy (aOR 3.1, 95% CI 2.1-4.5) while maintaining a less than 12% risk of multiple gestation per pregnancy and a 1.0% absolute risk of multiples. CONCLUSION: Caution should be used in proceeding with IUI after ovarian stimulation when there are more than two mature follicles in women younger than age 40 years owing to the substantially increased risk of multiple gestation without an improved chance of singleton clinical pregnancy.


Assuntos
Fatores Etários , Inseminação Artificial/estatística & dados numéricos , Folículo Ovariano , Indução da Ovulação/estatística & dados numéricos , Gravidez Múltipla/estatística & dados numéricos , Adulto , Feminino , Humanos , Inseminação Artificial/métodos , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos
7.
Cochrane Database Syst Rev ; 3: CD001838, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32124980

RESUMO

BACKGROUND: Intra-uterine insemination (IUI) is a widely-used fertility treatment for couples with unexplained subfertility. Although IUI is less invasive and less expensive than in vitro fertilisation (IVF), the safety of IUI in combination with ovarian hyperstimulation (OH) is debated. The main concern about IUI treatment with OH is the increase in multiple pregnancy rates. OBJECTIVES: To determine whether, for couples with unexplained subfertility, the live birth rate is improved following IUI treatment with or without OH compared to timed intercourse (TI) or expectant management with or without OH, or following IUI treatment with OH compared to IUI in a natural cycle. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL and two trials registers up to 17 October 2019, together with reference checking and contact with study authors for missing or unpublished data. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing IUI with TI or expectant management, both in stimulated or natural cycles, or IUI in stimulated cycles with IUI in natural cycles in couples with unexplained subfertility. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, quality assessment and data extraction. Primary review outcomes were live birth rate and multiple pregnancy rate. MAIN RESULTS: We include 15 trials with 2068 women. The evidence was of very low to moderate quality. The main limitation was very serious imprecision. IUI in a natural cycle versus timed intercourse or expectant management in a natural cycle It is uncertain whether treatment with IUI in a natural cycle improves live birth rate compared to treatment with expectant management in a natural cycle (odds ratio (OR) 1.60, 95% confidence interval (CI) 0.92 to 2.78; 1 RCT, 334 women; low-quality evidence). If we assume the chance of a live birth with expectant management in a natural cycle to be 16%, that of IUI in a natural cycle would be between 15% and 34%. It is uncertain whether treatment with IUI in a natural cycle reduces multiple pregnancy rates compared to control (OR 0.50, 95% CI 0.04 to 5.53; 1 RCT, 334 women; low-quality evidence). IUI in a stimulated cycle versus timed intercourse or expectant management in a stimulated cycle It is uncertain whether treatment with IUI in a stimulated cycle improves live birth rates compared to treatment with TI in a stimulated cycle (OR 1.59, 95% CI 0.88 to 2.88; 2 RCTs, 208 women; I2 = 72%; low-quality evidence). If we assume the chance of achieving a live birth with TI in a stimulated cycle was 26%, the chance with IUI in a stimulated cycle would be between 23% and 50%. It is uncertain whether treatment with IUI in a stimulated cycle reduces multiple pregnancy rates compared to control (OR 1.46, 95% CI 0.55 to 3.87; 4 RCTs, 316 women; I2 = 0%; low-quality evidence). IUI in a stimulated cycle versus timed intercourse or expectant management in a natural cycle In couples with a low prediction score of natural conception, treatment with IUI combined with clomiphene citrate or letrozole probably results in a higher live birth rate compared to treatment with expectant management in a natural cycle (OR 4.48, 95% CI 2.00 to 10.01; 1 RCT; 201 women; moderate-quality evidence). If we assume the chance of a live birth with expectant management in a natural cycle was 9%, the chance of a live birth with IUI in a stimulated cycle would be between 17% and 50%. It is uncertain whether treatment with IUI in a stimulated cycle results in a lower multiple pregnancy rate compared to control (OR 3.01, 95% CI 0.47 to 19.28; 2 RCTs, 454 women; I2 = 0%; low-quality evidence). IUI in a natural cycle versus timed intercourse or expectant management in a stimulated cycle Treatment with IUI in a natural cycle probably results in a higher cumulative live birth rate compared to treatment with expectant management in a stimulated cycle (OR 1.95, 95% CI 1.10 to 3.44; 1 RCT, 342 women: moderate-quality evidence). If we assume the chance of a live birth with expectant management in a stimulated cycle was 13%, the chance of a live birth with IUI in a natural cycle would be between 14% and 34%. It is uncertain whether treatment with IUI in a natural cycle results in a lower multiple pregnancy rate compared to control (OR 1.05, 95% CI 0.07 to 16.90; 1 RCT, 342 women; low-quality evidence). IUI in a stimulated cycle versus IUI in a natural cycle Treatment with IUI in a stimulated cycle may result in a higher cumulative live birth rate compared to treatment with IUI in a natural cycle (OR 2.07, 95% CI 1.22 to 3.50; 4 RCTs, 396 women; I2 = 0%; low-quality evidence). If we assume the chance of a live birth with IUI in a natural cycle was 14%, the chance of a live birth with IUI in a stimulated cycle would be between 17% and 36%. It is uncertain whether treatment with IUI in a stimulated cycle results in a higher multiple pregnancy rate compared to control (OR 3.00, 95% CI 0.11 to 78.27; 2 RCTs, 65 women; low-quality evidence). AUTHORS' CONCLUSIONS: Due to insufficient data, it is uncertain whether treatment with IUI with or without OH compared to timed intercourse or expectant management with or without OH improves cumulative live birth rates with acceptable multiple pregnancy rates in couples with unexplained subfertility. However, treatment with IUI with OH probably results in a higher cumulative live birth rate compared to expectant management without OH in couples with a low prediction score of natural conception. Similarly, treatment with IUI in a natural cycle probably results in a higher cumulative live birth rate compared to treatment with timed intercourse with OH. Treatment with IUI in a stimulated cycle may result in a higher cumulative live birth rate compared to treatment with IUI in a natural cycle.


Assuntos
Coito , Infertilidade/terapia , Inseminação Artificial/métodos , Indução da Ovulação/métodos , Taxa de Gravidez , Aborto Espontâneo/epidemiologia , Feminino , Período Fértil/fisiologia , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Inseminação Artificial/efeitos adversos , Nascimento Vivo/epidemiologia , Masculino , Síndrome de Hiperestimulação Ovariana , Indução da Ovulação/efeitos adversos , Gravidez , Gravidez Múltipla/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Conduta Expectante
8.
Fertil Steril ; 113(4): 788-796.e4, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32147173

RESUMO

OBJECTIVE: To evaluate pregnancy outcomes following intrauterine insemination (IUI) in young women with low ovarian reserve compared to age-matched controls. DESIGN: Retrospective cohort SETTING: Single infertility center (July 2001-August 2018) PATIENT(S): Patients <35 years of age undergoing at least one IUI cycle with a documented serum anti-Müllerian hormone (AMH) level, patent fallopian tubes, and total motile sperm count of ≥10 million at the time of IUI. INTERVENTION(S): None MAIN OUTCOME MEASURE(S): The primary outcome was the presence of a positive serum hCG pregnancy test (>2 mIU/mL) obtained 2 weeks after the IUI procedure. Secondary outcomes included the incidence of live birth, biochemical loss, clinical miscarriage, and ectopic pregnancy. Additionally, cumulative reproductive outcomes including up to seven IUI cycles were calculated and compared between groups. RESULTS: A post-hoc power calculation demonstrated that the study sample size yielded >80% power to detect a 7% difference between groups in the primary outcome. There were 3019 patients included: 370 with AMH <1.0 ng/mL and 2649 with AMH ≥1.0 ng/mL. When adjusting for IUI treatment strategy, number of dominant follicles at time of IUI and body mass index, no difference in per-cycle or cumulative reproductive outcomes was identified between patients with low AMH (<1.0 ng/mL) and normal AMH (≥1.0 ng/mL). Analyses by treatment strategy also showed no difference in reproductive outcomes. CONCLUSION: Young patients (<35 years of age) with diminished ovarian reserve conceived as often and had per-cycle and cumulative pregnancy outcomes similar to those of age-matched controls after IUI, regardless of treatment strategy.


Assuntos
Fertilização In Vitro/tendências , Infertilidade Feminina/terapia , Inseminação Artificial/tendências , Reserva Ovariana/fisiologia , Resultado da Gravidez/epidemiologia , Adulto , Hormônio Antimülleriano/sangue , Estudos de Coortes , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/diagnóstico , Inseminação Artificial/métodos , Gravidez , Estudos Retrospectivos , Adulto Jovem
9.
Hum Cell ; 33(3): 521-527, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32172344

RESUMO

This study aimed to determine whether fertilization can be obtained by assisted fusion of oocyte and sperm without breaking the oocyte membrane. A total of 79 infertile couples, each with at least one unfertilized oocyte after in vitro fertilization (IVF), were recruited. Sperm collected from the zona pellucida (ZP) were pressed onto the membrane of unfertilized oocytes at either 6 h or 24 h after IVF, a procedure that we designated as assisted sperm fusion insemination (ASFI). The results of ASFI were compared with those obtained in a previous trial on oocytes in which rescue intracytoplasmic sperm injection (ICSI) was performed at 6 h after IVF. Acrosome reaction (AR) rate of sperm bound to ZP, fertilization rate, degeneration rate, and blastocyst formation rate were evaluated. The AR rate of sperm collected from the ZP was significantly higher than that of the motile sperm recovered from around the oocytes but not bound to the ZP after IVF (98.0% vs. 28.6%). ASFI which was performed at 6 h after IVF yielded a mean fertilization rate of 73.4% (58/79), a degeneration rate of 0% (0/79) and a blastocyst formation rate of 60.8% (31/51). Rescue ICSI which was performed at 6 h after IVF yielded a mean fertilization rate of 70.0% (70/100), a degeneration rate of 4% (4/100) and a blastocyst formation rate of 42.4% (25/59). Binding of sperm to the ZP typically results in AR. ASFI with acrosome-reacted sperm collected from the ZP yielded the fertilization rates similar to those obtained with rescue ICSI.


Assuntos
Membrana Celular , Fertilização/fisiologia , Oócitos/citologia , Interações Espermatozoide-Óvulo , Espermatozoides/fisiologia , Zona Pelúcida/metabolismo , Reação Acrossômica , Blastocisto , Feminino , Humanos , Inseminação Artificial/métodos , Masculino , Espermatozoides/metabolismo
10.
Rev. iberoam. fertil. reprod. hum ; 37(1): 0-0, ene.-mar. 2020.
Artigo em Espanhol | IBECS | ID: ibc-187703

RESUMO

La inseminación intrauterina es una de las técnicas más utilizadas en el manejo de la infertilidad. Sus indicaciones van desde ciclos anovulatorios o factor masculino leve, hasta parejas del mismo sexo o mujer soltera. Desde sus inicios, se han descrito diversos protocolos de estimulación ovárica. Probablemente el más utilizado sea el uso de clomifeno vía oral, debido a lo sencillo, económico y disponibilidad del mismo. No obstante, las nuevas tecnologías y el uso de gonadotropinas urinarias o recombinantes, han permitido mejorar los resultados en aquellos casos donde se observa una resistencia al clomifeno. La decisión sobre cuál es el mejor protocolo para una estimulación ovárica en inseminación intrauterina, no se basa simplemente en buscar el mejor fármaco, se deben considerar factores como el diagnóstico, la presencia o no de ciclos ovulatorios, el coste y disponibilidad de los medicamentos, entre otros. Es el propósito de este trabajo, realizar una revisión de las indicaciones y resultados para poder establecer y/o sugerir pautas de manejo


Intrauterine insemination is one of the most popular techniques for the management of infertility. Among its indications are anovulation, mild male factor, same sex couple and single woman. There are several controlled ovarian stimulation protocols that are being described. Probably, the most common drug is clomiphene citrate because of its simplicity, cost and availability. Nonetheless, the introduction of gonadotropins, either urinary or recombinant, has shown to be an efficient alternative especially in those cases of clomiphene resistance. The decision about which protocol has the best results is not based only on the drug used. We need to consider other factors like infertility factor, presence of ovulatory or anovulatory cycles, cost and availability of drugs. It is the purpose of the present paper, to review the indications and most recent evidence in order to establish or suggest guidelines for treatment


Assuntos
Humanos , Masculino , Feminino , Gravidez , Indução da Ovulação/métodos , Inseminação Artificial/métodos , Doação de Oócitos , Protocolos Clínicos , Medicina Baseada em Evidências
11.
J Dairy Sci ; 103(4): 3719-3729, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32089314

RESUMO

The objective of this experiment was to compare time to pregnancy and proportion of cows not pregnant 210 d after first service for cows managed for second and subsequent artificial insemination (AI) services with a reproductive management program that promoted reinsemination at detected estrus (AIE) or a program that promoted timed AI (TAI). After first service, lactating Holstein cows were blocked by parity and randomly assigned to d 32 Resynch (D32R; n = 464) or AIE Resynch (AIER; n = 512). To determine the effect of management strategies on time to pregnancy and cows not pregnant by the end of a 210 d at-risk period after first AI service, cows remained in AIER and D32R until pregnancy or herd exit. Cows in D32R received a GnRH treatment 32 ± 3 d after AI (first treatment intervention; FTI). Nonpregnancy diagnosis was conducted 7 d later by transrectal ultrasonography when nonpregnant cows with a corpus luteum (CL) ≥15 mm completed the Resynch protocol (PGF2α, 56 h later GnRH, and 16 to 18 h later TAI) and cows without a CL (NoCL cows) were enrolled in a PreG-Ovsynch protocol (GnRH, 7 d later GnRH, 7 d later PGF2α, 56 h later GnRH, and 16 to 18 h TAI) to receive TAI. For the AIER treatment, nonpregnant cows with a CL ≥15 mm observed by transrectal ultrasonography 32 ± 3 d after AI (i.e., FTI) received PGF2α to induce estrus. Cows not AIE within 7 d were enrolled in Resynch (GnRH, 7 d later PGF2α, 56 h later GnRH, and 16 to 18 h TAI). Cows in the NoCL group in AIER were enrolled in PreG-Ovsynch. Detection of estrus was performed based on visual observation of behavioral signs of estrus and tail-paint removal. Binomial data were analyzed with logistic regression and time to event data with Cox's proportional regression. After the FTI, a greater proportion of cows were AIE in AIER than D32R (36.0 vs. 11.9%) and more cows were AIE within 7 d of the FTI for AIER (25.0%) than D32R (4.8%). Overall pregnancy per AI at 68 ± 3 d after AI did not differ (AIER = 35.5% vs. D32R = 34.7%). The hazard of pregnancy up to 210 d after first AI for all cows enrolled (hazard ratio = 1.04, 95% CI 0.90 to 1.19) and for cows that received treatments only (D32R = 308, AIER = 349; hazard ratio = 1.00, 95% CI 0.85 to 1.19) did not differ. We conclude that a program aimed at increasing the proportion of cows reinseminated at detected estrus by treatment with PGF2α at 32 ± 3 d after AI may be an alternative strategy for dairy farms that prefer or need to inseminate more cows at detected estrus rather than by TAI.


Assuntos
Bovinos/fisiologia , Indústria de Laticínios/métodos , Inseminação Artificial/veterinária , Reprodução/fisiologia , Animais , Estro , Detecção do Estro , Sincronização do Estro , Feminino , Inseminação Artificial/métodos , Lactação , Gravidez , Distribuição Aleatória , Fatores de Tempo , Ultrassonografia
13.
Fertil Steril ; 113(2): 305-322, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32106976

RESUMO

OBJECTIVE: To provide evidence-based recommendations to practicing physicians and others regarding the effectiveness and safety of therapies for unexplained infertility. METHODS: ASRM conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1968 through 2019. The ASRM Practice Committee and a task force of experts used available evidence and informal consensus to develop evidence-based guideline recommendations. MAIN OUTCOME MEASURE(S): Outcomes of interest included: live-birth rate, clinical pregnancy rate, implantation rate, fertilization rate, multiple pregnancy rate, dose of treatment, rate of ovarian hyperstimulation, abortion rate, and ectopic pregnancy rate. RESULT(S): The literature search identified 88 relevant studies to inform the evidence base for this guideline. RECOMMENDATION(S): Evidence-based recommendations were developed for the following treatments for couples with unexplained infertility: natural cycle with intrauterine insemination (IUI); clomiphene citrate with intercourse; aromatase inhibitors with intercourse; gonadotropins with intercourse; clomiphene citrate with IUI; aromatase inhibitors with IUI; combination of clomiphene citrate or letrozole and gonadotropins (low dose and conventional dose) with IUI; low-dose gonadotropins with IUI; conventional-dose gonadotropins with IUI; timing of IUI; and in vitro fertilization and treatment paradigms. CONCLUSION(S): The treatment of unexplained infertility is by necessity empiric. For most couples, the best initial therapy is a course (typically 3 or 4 cycles) of ovarian stimulation with oral medications and intrauterine insemination (OS-IUI) followed by in vitro fertilization for those unsuccessful with OS-IUI treatments.


Assuntos
Infertilidade Feminina/terapia , Inseminação Artificial/métodos , Inibidores da Aromatase/uso terapêutico , Clomifeno/uso terapêutico , Prática Clínica Baseada em Evidências , Feminino , Fertilização In Vitro , Gonadotropinas/uso terapêutico , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Int J Mol Sci ; 21(2)2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31963602

RESUMO

We have identified a Holstein sire named Tarantino who had been approved for artificial insemination that is based on normal semen characteristics (i.e., morphology, thermoresistance, motility, sperm concentration), but had no progeny after 412 first inseminations, resulting in a non-return rate (NRdev) of -29. Using whole genome association analysis and next generation sequencing, an associated nonsense variant in the α/ß-hydrolase domain-containing 16B gene (ABHD16B) on bovine chromosome 13 was identified. The frequency of the mutant allele in the German Holstein population was determined to be 0.0018 in 222,645 investigated cattle specimens. The mutant allele was traced back to Whirlhill Kingpin (bornFeb. 13th, 1959) as potential founder. The expression of ABHD16B was detected by Western blotting and immunohistochemistry in testis and epididymis of control bulls. A lipidome comparison of the plasma membrane of fresh semen from carriers and controls showed significant differences in the concentration of phosphatidylcholine (PC), diacylglycerol (DAG), ceramide (Cer), sphingomyelin (SM), and phosphatidylcholine (-ether) (PC O-), indicating that ABHD16B plays a role in lipid biosynthesis. The altered lipid contents may explain the reduced fertilization ability of mutated sperms.


Assuntos
Membrana Celular/metabolismo , Fertilização , Hidrolases/metabolismo , Inseminação Artificial/veterinária , Lipídeos/análise , Mutação , Espermatozoides/metabolismo , Animais , Bovinos , Feminino , Estudo de Associação Genômica Ampla , Hidrolases/genética , Inseminação Artificial/métodos , Lipídeos/química , Masculino , Análise do Sêmen/veterinária , Motilidade Espermática
15.
Anim Reprod Sci ; 213: 106249, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31987315

RESUMO

The current study was conducted to determine the optimal timing of artificial insemination and vaginal mucous characteristics relative to the onset of estrus in goats. Does (n = 257) were estrous synchronized using hormonal treatments. Intracervical inseminations with fresh semen were performed at 0, 12, 24 and 36 h after the onset of estrus. Characteristics of vaginal mucus (i.e., color, consistency, and volume) were observed and graded at the time of AI to calculate cumulative mucous score. The vaginal electrical resistance (VER) was recorded (Draminski® detector) at the time of AI. Pregnancy rate was less (P < 0.05) when inseminations occurred at 0 h (28.6%) compared with 12 (58.3%) and 24 h (56.4%) after the onset of estrus; however, pregnancy rate at 36 h (54.5%) did not differ (P> 0.05) compared with inseminations at 0, 12 or 24 h after estrous onset. Relative odds for pregnancy rate at 12, 24 and 36 h were 5.24, 5.20 and 3.29 times greater compared with 0 h. Cumulative mucous score varied (P < 0.05) relative to the onset of estrus and correlated well (P < 0.05) with the color and consistency than volume of the mucus. The VER was less (P < 0.05) at 12 than 0 and 36 h after estrous onset. In conclusion, goats can be inseminated between 12-36 h after the onset of estrus; however, the chances of pregnancy are greater with inseminations at the 12 or 24 h time periods.


Assuntos
Ciclo Estral/fisiologia , Cabras/fisiologia , Inseminação Artificial/veterinária , Muco/fisiologia , Vagina/fisiologia , Animais , Sincronização do Estro/métodos , Feminino , Inseminação Artificial/métodos , Gravidez , Fatores de Tempo
16.
Reprod Domest Anim ; 55(3): 401-404, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31916296

RESUMO

An extended lifespan of spermatozoa following artificial insemination (AI) can make the timing of insemination less critical, as previously demonstrated with immobilized spermatozoa that are gradually released from an alginate gel. The purpose was to examine the in vivo dissolution of SpermVital (SV) alginate gel over time by endoscopy and secondly to assess spermatozoa quality after incubation of the gel. In vivo endoscopy showed SV gel in the uterus 3, 6, 20 and 24 hr after AI, demonstrating the potential release of spermatozoa to the uterus during this period. In utero ex vivo incubation of the semen demonstrated that high motility and viability of sperm cells was sustained following overnight incubation.


Assuntos
Alginatos , Inseminação Artificial/veterinária , Espermatozoides/fisiologia , Animais , Bovinos , Criopreservação/veterinária , Endoscopia/veterinária , Feminino , Inseminação Artificial/métodos , Masculino , Análise do Sêmen , Preservação do Sêmen/métodos , Preservação do Sêmen/veterinária , Motilidade Espermática , Espermatozoides/efeitos dos fármacos , Útero
17.
Hum Reprod Update ; 26(1): 1-15, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31803930

RESUMO

BACKGROUND: IUI for unexplained infertility can be performed in a natural cycle or in combination with ovarian stimulation. A disadvantage of ovarian stimulation is an increased risk of multiple pregnancies with its inherent maternal and neonatal complication risks. Stimulation agents for ovarian stimulation are clomiphene citrate (CC), Letrozole or gonadotrophins. Although studies have compared two or three of these drugs to each other in IUI, they have never been compared to one another in one analysis. OBJECTIVE AND RATIONALE: The objective of this network meta-analysis was to compare the effectiveness and safety of IUI with CC, Letrozole or gonadotrophins with each other and with natural cycle IUI. SEARCH METHODS: We searched PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL and the Clinical Trial Registration Database indexed up to 16 August 2018. We included randomized controlled trials that compared a stimulation regimen with CC, Letrozole or gonadotrophins to each other or to natural cycle IUI among couples with unexplained infertility. We performed the network meta-analysis within a multivariate random effects model. OUTCOMES: We identified 26 studies reporting on 5316 women. The relative risk (RR) for live birth/ongoing pregnancy rates comparing IUI with CC to natural cycle IUI was 1.05 (95% CI 0.63-1.77, low quality of evidence), while comparing IUI with Letrozole to natural cycle IUI was 1.15 (95% CI 0.63-2.08, low quality of evidence) and comparing IUI with gonadotrophins to natural cycle IUI was 1.46 (95% CI 0.92-2.30, low quality of evidence). The RR for live birth/ongoing pregnancy rates comparing gonadotrophins to CC was 1.39 (95% CI 1.09-1.76, moderate quality of evidence), comparing Letrozole to CC was 1.09 (95% CI 0.76-1.57, moderate quality of evidence) and comparing Letrozole to gonadotrophins was 0.79 (95% CI 0.54-1.15, moderate quality of evidence). We did not perform network meta-analysis on multiple pregnancy due to high inconsistency. Pairwise meta-analyses showed an RR for multiple pregnancy rates of 9.11(95% CI 1.18-70.32) comparing IUI with gonadotrophins to natural cycle IUI. There was no data available on multiple pregnancy rates following IUI with CC or Letrozole compared to natural cycle IUI. The RR for multiple pregnancy rates comparing gonadotrophins to CC was 1.42 (95% CI 0.68-2.97), comparing Letrozole to CC was 0.97 (95% CI 0.47-2.01) and comparing Letrozole to gonadotrophins was 0.29 (95% CI 0.14-0.58).In a meta-analysis among studies with adherence to strict cancellation criteria, the RR for live births/ongoing pregnancy rates comparing gonadotrophins to CC was 1.20 (95% CI 0.95-1.51) and the RR for multiple pregnancy rates comparing gonadotropins to CC was 0.80 (95% CI 0.38-1.68). WIDER IMPLICATIONS: Based on low to moderate quality of evidence in this network meta-analysis, IUI with gonadotrophins ranked highest on live birth/ongoing pregnancy rates, but women undergoing this treatment protocol were also at risk for multiple pregnancies with high complication rates. IUI regimens with adherence to strict cancellation criteria led to an acceptable multiple pregnancy rate without compromising the effectiveness. Within a protocol with adherence to strict cancellation criteria, gonadotrophins seem to improve live birth/ongoing pregnancy rates compared to CC. We, therefore, suggest performing IUI with ovarian stimulation using gonadotrophins within a protocol that includes strict cancellation criteria. Obviously, this ignores the impact of costs and patients preference.


Assuntos
Clomifeno/uso terapêutico , Fármacos para a Fertilidade Feminina/uso terapêutico , Gonadotropinas/uso terapêutico , Inseminação Artificial/métodos , Letrozol/uso terapêutico , Indução da Ovulação/métodos , Feminino , Humanos , Infertilidade/terapia , Nascimento Vivo , Metanálise em Rede , Gravidez , Taxa de Gravidez , Gravidez Múltipla/estatística & dados numéricos
18.
Anim Reprod Sci ; 212: 106236, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31864489

RESUMO

Seminal doses used for cervical and post-cervical artificial insemination (CAI and PCAI, respectively) vary in volume, the number of spermatozoa and packaging. The aim was to evaluate the outcomes when there was use of routine processing procedures for CAI- and PCAI-doses. Two different types of seminal doses were processed: 1) CAI: 2.7 × 109 sperm/80 ml; 2) PCAI: 1.5 × 109 sperm/45 ml. In Experiment 1, the cooling curve of seminal doses during processing occurred in two phases: 1st) At room temperature (23.4 ±â€¯0.5 °C) from 0 (just after packaging) to 120 min; 2nd) At refrigeration (15.7 ±â€¯0.8 °C) from 121-240 min. For the PCAI-doses, the time required to reach room temperature was 47 min compared to 107 min for CAI-doses (decreasing velocity of 0.093 °C/min and 0.048 °C/min, respectively). During refrigeration, for the PCAI-doses the time required to reach the desired preservation temperature was 20 min less than for CAI-doses (PCAI: 90 min, 0.074 °C/min; CAI: 110 min, 0.066 °C/min). In Experiment 2, sperm motility, kinetic parameters and acrosome damage for both types of doses were evaluated at 0, 24, 48 and 72 h of refrigeration. Also, morphology, pH, and osmolality were assessed at 0 and 72 h. Values for all these did not differ between CAI- and PCAI-doses. In conclusion, PCAI-doses took less time than CAI-doses to reach the desired temperature, but sperm quality was similar for CAI- and PCAI-doses during storage. Nevertheless, the different cooling curves should be taken into consideration for further investigation.


Assuntos
Análise do Sêmen/veterinária , Preservação do Sêmen/veterinária , Sêmen/fisiologia , Espermatozoides/fisiologia , Suínos/fisiologia , Animais , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Masculino , Temperatura , Fatores de Tempo
19.
Fertil Steril ; 113(1): 114-120, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31718827

RESUMO

OBJECTIVE: To evaluate whether superovulation improves fecundity in women undergoing therapeutic donor insemination (TDI). DESIGN: Retrospective cohort study. SETTING: University-affiliated fertility clinic. PATIENT(S): Healthy women aged 23-45 years with no history of or risk factors for infertility who underwent 152 medicated and 104 unmedicated TDI cycles from 2013 to 2018. INTERVENTION: Unmedicated TDI versus use of medication in a TDI cycle (clomiphene citrate or letrozole). MAIN OUTCOME MEASURE(S): Cumulative probability of pregnancy in six TDI cycles. RESULT(S): In adjusted all-cycle analysis, medicated TDI cycles were less likely to result in pregnancy compared with unmedicated cycles. The incidence of twins was 23% in the medicated group and 0% in the unmedicated group. Medicated cycles were less likely to result in pregnancy in women younger than 40 years or with an antimüllerian hormone (AMH) level >1.2. After three cycles not resulting in pregnancy, the only women who conceived were those who crossed over from an unmedicated to a medicated cycle (12% vs. 0%). CONCLUSION(S): Patients undergoing unmedicated TDI cycles had higher fecundity and no incidence of twin gestations. Older women, those with low AMH, and those who fail to conceive after three unmedicated cycles may benefit from medication.


Assuntos
Pesquisa Empírica , Fertilidade/fisiologia , Inseminação Artificial/métodos , Superovulação/fisiologia , Doadores de Tecidos , Adulto , Estudos de Coortes , Feminino , Voluntários Saudáveis , Humanos , Inseminação Artificial/tendências , Masculino , Estudos Retrospectivos , Adulto Jovem
20.
Theriogenology ; 142: 315-319, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31711693

RESUMO

The aim of this study was to evaluate the effect of body weight, oxytocin deposition in the uterus at artificial insemination (AI), vaginal cytology, serum progesterone (P4) concentration at AI, semen volume and total sperm cells per AI on whelping rate and litter size of English Bulldogs bitches following intrauterine surgical semen deposition. Seventy-eight English Bulldog bitches were artificially inseminated via semen infusion (number of sperm cells inseminated 300-2500 × 106) at the uterine body with fresh semen without extender and under general anesthesia. Whelping rate was greater (P < 0.05) in bitches with >23 kg than bitches with <23 kg (83.9 vs 63.8%). Whelping rate was greater (P < 0.01) in bitches with >75% vaginal cornified epithelium at AI (85.1%) than animals with <75% cornified epithelium (51.6%). Whelping rates were influenced (P < 0.01) by the semen volume at AI (54.3% vs 86.1% for bitches receiving <4 mL or >4 mL of semen). Litter size was larger (P < 0.05) in bitches >23 kg than lighter animals (3.72 ±â€¯1.79 and 2.30 ±â€¯1.46 pups per litter, respectively). Litter size was not influenced by sperm concentration, semen volume, vaginal cytology, serum P4 concentration and infusion of oxytocin in the uterus at AI (P > 0.1). The results of this study indicate that increasing body weight of English Bulldog bitches is related to higher whelping rates and larger litter size. Also, >75% of superficial cornified vaginal cells (squamous) at AI and >4 mL semen volume maximize whelping rates in this breed of dogs.


Assuntos
Cruzamento , Cães , Infertilidade/etiologia , Inseminação Artificial , Animais , Líquidos Corporais , Peso Corporal/fisiologia , Cruzamento/métodos , Feminino , Fertilidade/fisiologia , Infertilidade/veterinária , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Tamanho da Ninhada de Vivíparos , Masculino , Ocitocina/análise , Gravidez , Fatores de Risco , Sêmen/citologia , Sêmen/fisiologia , Resultado do Tratamento , Vagina/química , Vagina/citologia , Vagina/cirurgia
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