4,019 results match your criteria Ovarian Hyperstimulation Syndrome

Follicular-Phase GnRH Agonist Protocol Is Another Choice for Polycystic Ovary Syndrome Patients With Lower LH/FSH and Lower AMH Levels Without Increasing Severe OHSS Risk.

Front Endocrinol (Lausanne) 2022 10;13:905263. Epub 2022 Jun 10.

Department of Forensic Genetics, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China.

Purpose: To explore another choice for a controlled ovarian stimulation (COS) protocol that does not increase severe ovarian hyperstimulation syndrome (OHSS) risk among polycystic ovarian syndrome (PCOS) patients with specific clinical features.

Methods: A retrospective study was performed. Two hundred and fifty-nine participants were divided into two groups, group 1 (fixed GnRH antagonist protocol, n = 295) and group 2 (follicular-phase GnRH agonist protocol, n = 69) according to COS protocols. Read More

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Impact of abnormal karyotype on reproductive outcome in premature ovarian insufficiency.

Reprod Med Biol 2022 Jan-Dec;21(1):e12471. Epub 2022 Jun 15.

Advanced Reproductive Medicine Research Center International University of Health and Welfare School of Medicine Chiba Japan.

Purpose: This study evaluated the reproductive potential of premature ovarian insufficiency (POI) patients with abnormal karyotypes undergoing infertility treatments.

Methods: A retrospective analysis of infertility treatments in POI patients with an abnormal karyotype treatment. Clinical and laboratory data were analyzed. Read More

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Follicular Fluid: A Powerful Tool for the Understanding and Diagnosis of Polycystic Ovary Syndrome.

Biomedicines 2022 May 27;10(6). Epub 2022 May 27.

Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal.

Polycystic ovary syndrome (PCOS) represents one of the leading causes of anovulatory infertility and affects 5% to 20% of women worldwide. Until today, both the subsequent etiology and pathophysiology of PCOS remain unclear, and patients with PCOS that undergo assisted reproductive techniques (ART) might present a poor to exaggerated response, low oocyte quality, ovarian hyperstimulation syndrome, as well as changes in the follicular fluid metabolites pattern. These abnormalities originate a decrease of Metaphase II (MII) oocytes and decreased rates for fertilization, cleavage, implantation, blastocyst conversion, poor egg to follicle ratio, and increased miscarriages. Read More

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The cumulative live birth rate of recombinant follicle-stimulating hormone alfa verse urinary human follicle-stimulating hormone for ovarian stimulation in assisted reproductive technology cycles.

J Ovarian Res 2022 Jun 21;15(1):74. Epub 2022 Jun 21.

Reproductive Medicine Center, Northern Jiangsu People's Hospital, Address: 98 Nantong West Road, Yangzhou, Jiangsu, China.

Background: Infertility remains a significant public health concern. An issue with controlled ovarian stimulation (COS) is the selection of an exogenous gonadotropin (Gn) regimen, which is mainly based on urinary follicle-stimulating hormone (uFSH), recombinant follicle-stimulating hormone alfa (rFSH-alfa), and human menopausal gonadotropin (HMG). In addition, most previous studies focused on the clinical pregnancy rates or live birth rates (LBR) per transfer cycle, but not on the cumulative live birth rate (CLBR) per started cycle. Read More

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Triggering with 1,500 IU of human chorionic gonadotropin plus follicle-stimulating hormone compared to a standard human chorionic gonadotropin trigger dose for oocyte competence in in vitro fertilization cycles: a randomized, double-blinded, controlled noninferiority trial.

Fertil Steril 2022 Jun 12. Epub 2022 Jun 12.

Division of Reproductive Endocrinology and Infertility, Center for Reproductive Health, University of California San Francisco, San Francisco, California.

Objective: To assess if triggering with 1,500 IU of human chorionic gonadotropin (hCG) with 450 IU of follicle-stimulating hormone (FSH) induces noninferior oocyte competence to a standard dose of hCG trigger used in in vitro fertilization (IVF). The alternative trigger will be considered noninferior if it is at least 80% effective in promoting oocyte competence.

Design: Randomized, double-blinded, controlled noninferiority trial. Read More

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Regulatory Role and Potential Importance of GDF-8 in Ovarian Reproductive Activity.

Front Endocrinol (Lausanne) 2022 26;13:878069. Epub 2022 May 26.

Department of Pharmacy, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Growth differentiation factor-8 (GDF-8) is a member of the transforming growth factor-beta superfamily. Studies and have shown GDF-8 to be involved in the physiology and pathology of ovarian reproductive functions. experiments using a granulosa-cell model have demonstrated steroidogenesis, gonadotrophin responsiveness, glucose metabolism, cell proliferation as well as expression of lysyl oxidase and pentraxin 3 to be regulated by GDF-8 the mothers against decapentaplegic homolog signaling pathway. Read More

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The newly non-uniform endometrial echogenicity on transvaginal ultrasound do not impact in vitro fertilization and embryo transfer success: A retrospective cohort study.

Eur J Obstet Gynecol Reprod Biol 2022 Jul 2;274:204-209. Epub 2022 Jun 2.

Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China. Electronic address:

Objective: To evaluate the effect of newly non-uniform endometrial echogenicity diagnosed by transvaginal ultrasound on the outcome of pregnancy in vitro fertilization-embryo transfer (IVF-ET) during controlled ovarian hyperstimulation (COH) by retrospective cohort analysis.

Methods: A retrospective cohort study of a total of 604 patients with newly non-uniform endometrial echogenicity from January 2013 to June 2017, each woman was matched with three control subjects of similar age (±1 year), type of infertility (primary or secondary), the protocol used for COH, and the number of ET cycles in our unit. The patients in the study group and control group were matched according to the strict 1:3 matching principle. Read More

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Con: freeze-all for all? One size does not fit all.

Lan N Vuong

Hum Reprod 2022 May 28. Epub 2022 May 28.

Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

IVF has traditionally involved transfer of fresh embryos. However, a 'freeze-all' strategy where all embryos are cryopreserved for transfer in subsequent, unstimulated cycles has emerged as an alternative approach. This is thought to eliminate the negative effects of controlled ovarian stimulation on the endometrium and reduce the risk of ovarian hyperstimulation syndrome (OHSS). Read More

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Pro: Fresh versus frozen embryo transfer. Is frozen embryo transfer the future?

Hum Reprod 2022 May 28. Epub 2022 May 28.

Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.

Embryo cryopreservation has been an integral part of ART for close to 40 years and vitrification has boosted overall ART efficacy and safety. Recently, there has been a vivid scientific discussion on whether elective cryopreservation of all embryos (freeze-all) should be pursued for most patients, with a fresh embryo transfer taking place only in selected cases. In terms of efficacy, the available evidence suggests that the freeze-all strategy leads to higher live birth rates after the first embryo transfer compared to the conventional strategy in high responders, while there is no difference in normal responders. Read More

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Update on fertility preservation: new opportunities and challenges in the fight against infertility.

Clin Ter 2022 May;173(3):226-227

UOC Ostetricia e Ginecologia, AOOR Villa Sofia Cervello, University of Paler-mo, Italy.

Abstract: Infertility has been characterized as a disease by the World Health Organization (WHO) and reportedly affects about 10-12% of couples worldwide, while the incidence is even higher in Italy, at about 15%. The issue of iatrogenic infertility arising from treatments that can compromise an individual's reproductive capacity, it is necessary to inform patients of the possible damage on their future fertility and on the possibilities to preserve it. The complexities inherent in the various techniques and approaches aimed at preserving fertility should be expounded upon thoroughly to the patients, who should also receive proper psychological assistance and counseling, which ought to take into account the ethical distinctive challenges and the possible misgivings that may be caused in patients. Read More

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IVF Lite: a smart IVF programme based on mild ovarian stimulation for good prognosis patients.

Reprod Biomed Online 2022 Apr 14. Epub 2022 Apr 14.

SISMeR, Reproductive Medicine Unit Bologna, Italy.

Research Question: The IVF Lite programme is based on mild ovarian stimulation including up to three fresh/frozen embryo transfers within 12 months. Is it effective and safe in good prognosis patients?

Design: Single-centre prospective study on infertile patients at their first IVF attempt (female age ≤38 years, anti-Müllerian hormone concentrations >1.5 ng/ml and/or FSH ≤10 mIU/ml). Read More

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Predictive performance of peritoneal fluid in the pouch of Douglas measured five days after oocyte pick-up in predicting severe late-onset OHSS: A secondary analysis of a randomized trial.

Eur J Obstet Gynecol Reprod Biol 2022 Jul 11;274:83-87. Epub 2022 May 11.

Fertility Clinic, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark; Fertility Clinic, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.

Objectives: To investigate if the amount of peritoneal fluid (PF) in the Pouch of Douglas at oocyte pick-up (OPU) or OPU + 5 days predict severe late-onset ovarian hyperstimulation syndrome (OHSS) in women undergoing ovarian stimulation for assisted reproductive technology (ART).

Study Design: A secondary analysis of a dual-centre RCT on 1050 women referred for their first ART treatment in two public fertility clinics in Denmark and randomized 1:1 to GnRH-antagonist or GnRH-agonist protocol. All women from the two arms who were examined on day of OPU and OPU + 5 days were included in this study (n = 940). Read More

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Advances in clinical applications of kisspeptin-GnRH pathway in female reproduction.

Reprod Biol Endocrinol 2022 May 23;20(1):81. Epub 2022 May 23.

Zhejiang MedicalTech Therapeutics Company, No.665 Yumeng Road, Wenzhou, People's Republic of China, 325200.

Background: Kisspeptin is the leading upstream regulator of pulsatile and surge Gonadotrophin-Releasing Hormone secretion (GnRH) in the hypothalamus, which acts as the key governor of the hypothalamic-pituitary-ovary axis.

Main Text: Exogenous kisspeptin or its receptor agonist can stimulate GnRH release and subsequent physiological gonadotropin secretion in humans. Based on the role of kisspeptin in the hypothalamus, a broad application of kisspeptin and its receptor agonist has been recently uncovered in humans, including central control of ovulation, oocyte maturation (particularly in women at a high risk of ovarian hyperstimulation syndrome), test for GnRH neuronal function, and gatekeepers of puberty onset. Read More

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Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF: the E-Freeze RCT.

Health Technol Assess 2022 05;26(25):1-142

Gyanecology and Assisted Conception, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.

Background: Freezing all embryos, followed by thawing and transferring them into the uterine cavity at a later stage (freeze-all), instead of fresh-embryo transfer may lead to improved pregnancy rates and fewer complications during in vitro fertilisation and pregnancies resulting from it.

Objective: We aimed to evaluate if a policy of freeze-all results in a higher healthy baby rate than the current policy of transferring fresh embryos.

Design: This was a pragmatic, multicentre, two-arm, parallel-group, non-blinded, randomised controlled trial. Read More

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Ovulation triggering with hCG alone, GnRH agonist alone or in combination? A randomized controlled trial in advanced-age women undergoing IVF/ICSI cycles.

Hum Reprod 2022 May 20. Epub 2022 May 20.

Reproductive Medical Center, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Study Question: Is a dual ovulation trigger with a combination of GnRH agonist (GnRHa) and hCG superior to single hCG and/or single GnRHa trigger in improving treatment outcomes in advanced-age women (aged ≥ 35 years) undergoing IVF/ICSI treatment?

Summary Answer: Co-administration of GnRHa and hCG as a dual trigger increases the number of good-quality embryos but it is not associated with a higher number of oocytes retrieved, compared with single hCG or GnRHa trigger.

What Is Known Already: Many studies have demonstrated that a dual trigger has positive impact on oocyte maturation, retrieval rate and pregnancy rate without increasing the risk of ovarian hyperstimulation syndrome (OHSS) in some groups of IVF patients, when compared with single hCG trigger. Few studies have however been conducted to compare a dual trigger with a single GnRHa trigger, and insufficient evidence exists to support which trigger can achieve the best outcomes in IVF patients aged ≥35 years. Read More

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Analysis and prediction of risk factors of ovarian hyperstimulation caused by Long-acting GnRH agonist protocol in follicular phase.

Eur Rev Med Pharmacol Sci 2022 May;26(9):3261-3268

Department of Gynecology, Department of Reproductive Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.

Objective: The aim of the study was to explore the risk factors of ovarian hyperstimulation in patients undergoing long-acting gonadotropin-releasing hormone (GnRH) agonist protocol in follicular phase of ovulation induction therapy and to establish a predictive model.

Patients And Methods: A total of 1289 patients who received Long-acting GnRH agonist protocol in follicular phase for ovulation induction in the Fujian Provincial Maternity and Child Health Hospital from July 1, 2018, to July 31, 2019, were selected. Among them, 33 patients developed moderate/severe ovarian hyperstimulation syndrome. Read More

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One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients.

Rev Bras Ginecol Obstet 2022 May 16. Epub 2022 May 16.

Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil.

Objective:  It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. Read More

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Comparison of bromocriptine and hydroxyethyl starch in the prevention of ovarian hyperstimulation syndrome.

Int J Gynaecol Obstet 2022 May 16. Epub 2022 May 16.

Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China.

Objective: To evaluate the effectiveness of bromocriptine for prevention of ovarian hyperstimulation syndrome (OHSS).

Methods: The retrospective study included women at risk of OHSS who were receiving gonadotropin-releasing hormone antagonist protocols, including 52 women given 2.5 mg bromocriptine by rectal insertion, 52 women given 500 ml intravenous hydroxyethyl starch (HES), and 40 women who received no intervention. Read More

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Algorithm-based individualization methodology of the starting gonadotropin dose in IVF/ICSI and the freeze-all strategy prevent OHSS equally in normal responders: a systematic review and network meta-analysis of the evidence.

J Assist Reprod Genet 2022 May 13. Epub 2022 May 13.

Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Via Ausonia 43/45, 90144, Palermo, Italy.

Purpose: Ovarian hyperstimulation syndrome (OHSS) represents a rare but dangerous condition associated with controlled ovarian stimulation (COS) in IVF/ICSI. Over the last decades, many strategies have been introduced into clinical practice with the objective of preventing this potentially life-threatening condition. Among these, the freeze-all policy has gained great popularity, thanks to improvements in vitrification. Read More

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Are anthropometric data a tool for determining the severity of OHSS? Yes, it could be!

BMC Womens Health 2022 05 10;22(1):155. Epub 2022 May 10.

City Clinical Hospital №1 named after Yu.Ya. Gordeev, Saratov, Russian Federation.

Background: All management guidelines of ovarian hyperstimulation syndrome (OHSS) recommend daily monitoring of women's body weight, waist circumference and note that as indicators increase, the severity OHSS also increases. However, the dynamics of abdominal size and its relationship with markers of OHSS severity have not been highlighted. The purpose of this study is to assess the usefulness of various anthropometric indicators for determining the degree of OHSS severity as well as paracentesis indications. Read More

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The effect of mildly stimulated cycle versus artificial cycle on pregnancy outcomes in overweight/obese women with PCOS prior to frozen embryo transfer: a retrospective cohort study.

BMC Pregnancy Childbirth 2022 May 7;22(1):394. Epub 2022 May 7.

Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.

Background: Previous studies have shown that frozen embryo transfer (FET) resulted in increased live birth rates (LBR) and reduced the risk of ovarian hyperstimulation syndrome (OHSS) than did fresh embryo transfer in women with polycystic ovary syndrome (PCOS). In addition, overweight/obese women with PCOS are at increased risk of subfertility and complications of pregnancy, compared with normal-weight women. The ovarian stimulation and artificial hormone regimes are the two more commonly used endometrial preparation protocols in PCOS patients. Read More

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-Acetylcysteine improves oocyte quality through modulating the Nrf2 signaling pathway to ameliorate oxidative stress caused by repeated controlled ovarian hyperstimulation.

Reprod Fertil Dev 2022 Jun;34(10):736-750

Hebei Key Laboratory of Integrative Medicine on Liver-Kidney Patterns, Institute of Integrative Medicine, College of Integrative Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050091, China.

Context: N -acetyl-cysteine (NAC) is a potent antioxidant that can be used for many gynecological diseases such as polycystic ovary syndrome and endometriosis. Controlled ovarian hyperstimulation (COH) is a critical step in infertility treatment. Our previous clinical studies have shown that repeated COH led to oxidative stress in follicle fluid and ovarian granulosa cells. Read More

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Effectiveness and safety of gonadotropins used in female infertility: a population-based study in the Lazio region, Italy.

Eur J Clin Pharmacol 2022 Jul 4;78(7):1185-1196. Epub 2022 May 4.

Department of Epidemiology, Regional Health Service, ASL Roma 1, Rome, Lazio, Italy.

Purpose: Infertility is a topic of growing interest, and female infertility is often treated with gonadotropins. Evidence regarding comparative safety and efficacy of different gonadotropin formulations is available from clinical studies, while real-world data are missing. The present study aims to investigate effectiveness and safety of treatment with different gonadotropin formulations in women undergoing medically assisted procreation treatments in Latium, a region in central Italy, through a real-world data approach. Read More

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Reproductive Outcome After GnRH Agonist Triggering With Co-Administration of 1500 IU hCG on the Day of Oocyte Retrieval in High Responders: A Long-Term Retrospective Cohort Study.

Front Endocrinol (Lausanne) 2022 6;13:826411. Epub 2022 Apr 6.

Division of Obstetrics and Gynaecology, Department of Human Reproduction, University Medical Centre Ljubljana, Ljubljana, Slovenia.

While triggering oocyte maturation with GnRH agonist (GnRHa) seems to be safe and effective in terms of the risk of developing OHSS and the number of metaphase II oocytes, it nevertheless results in luteal phase deficiency. To date, strategies have been developed in order to rescue defective luteal phase of GnRHa triggered cycles. Our study aimed to assess the reproductive outcome of GnRHa triggered cycles combined with modified luteal support (1500 IU hCG at the day of oocyte retrieval) in women with high ovarian response and to compare the outcome with hCG triggered cycles in GnRH antagonist IVF-ICSI procedures. Read More

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A systematic review and standardized clinical validity assessment of genes involved in female reproductive failure.

Reproduction 2022 04 22;163(6):351-363. Epub 2022 Apr 22.

Scientific Laboratory of Molecular Genetics, Riga Stradins University, Riga, Latvia.

Genetic testing is becoming increasingly required at almost every stage of failed female reproduction/infertility. Nonetheless, clinical evidence for the majority of identified gene-disease relationships is ill-defined, thus leading to difficult gene variant interpretation and poor translation of existing knowledge into clinics. We aimed to identify the genes that have ever been implicated in monogenic female reproductive failure in humans and to classify the identified gene-disease relationship pairs using a standardized clinical validity assessment. Read More

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A randomized, controlled, first-in-patient trial of choriogonadotropin beta added to follitropin delta in women undergoing ovarian stimulation in a long GnRH agonist protocol.

Hum Reprod 2022 05;37(6):1161-1174

Reproductive Medicine & Maternal Health, Ferring Pharmaceuticals, Copenhagen, Denmark.

Study Question: Does addition of choriogonadotropin beta (recombinant CG beta) to follitropin delta increase the number of good-quality blastocysts following ovarian stimulation in a long GnRH agonist protocol?

Summary Answer: At the doses investigated, the addition of CG beta reduced the number of intermediate follicles and related down-stream parameters including the number of oocytes and blastocysts.

What Is Known Already: CG beta is a novel recombinant hCG (rhCG) molecule expressed by a human cell line (PER.C6®) and has a different glycosylation profile compared to urinary hCG or rhCG derived from a Chinese Hamster Ovary (CHO) cell line. Read More

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Transcriptomic landscape of granulosa cells and peripheral blood mononuclear cells in women with PCOS compared to young poor responders and women with normal response.

Hum Reprod 2022 05;37(6):1274-1286

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.

Study Question: Are transcriptomic profiles altered in ovarian granulosa cells (GCs) and peripheral blood mononuclear cells (PBMNCs) of women with polycystic ovary syndrome (PCOS) compared to young poor responders (YPR) and women with normal response to ovarian stimulation?

Summary Answer: RNA expression profiles in ovarian GCs and PBMNCs were significantly altered in patients with PCOS compared with normoresponder controls (CONT) and YPR.

What Is Known Already: PCOS is characterised by a higher number of follicles at all developmental stages. During controlled ovarian hyperstimulation, PCOS women develop a larger number of follicles as a result of an exacerbated response, with an increased risk of ovarian hyperstimulation syndrome. Read More

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A case report of spontaneous ovarian hyperstimulation syndrome and the long-term management of the endocrine disorder.

Ann Transl Med 2022 Mar;10(6):384

Department of Reproduction and Infertility, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Background: Spontaneous ovarian hyperstimulation syndrome (sOHSS) is a rarely reported clinical symptom of uncertain origin with the incidence of 0.2-1.2%. Read More

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Single-Dose Versus Multiple-Dose GnRH Agonist for Luteal-Phase Support in Women Undergoing IVF/ICSI Cycles: A Network Meta-Analysis of Randomized Controlled Trials.

Front Endocrinol (Lausanne) 2022 31;13:802688. Epub 2022 Mar 31.

Department of Reproduction, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Background: Although gonadotropin-releasing hormone (GnRH) agonist has been introduced as a beneficial luteal phase support (LPS), the optimal strategy of GnRH agonist remains unclear. This network meta-analysis was therefore performed to determine the comparative efficacy and safety of multiple-dose versus single-dose GnRH agonist protocol for LPS in patients undergoing IVF/ICSI cycles.

Methods: We searched relevant studies in PubMed, Embase and the Cochrane Registry of Controlled Trials (CENTRAL) from their inception util to September 2021. Read More

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GnRH Agonist and hCG (Dual Trigger) Versus hCG Trigger for Final Oocyte Maturation in Expected Normal Responders With a High Immature Oocyte Rate: Study Protocol for a Randomized, Superiority, Parallel Group, Controlled Trial.

Front Endocrinol (Lausanne) 2022 28;13:831859. Epub 2022 Mar 28.

The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China.

Introduction: The choice of trigger drug for the controlled ovarian hyperstimulation (COH) protocol correlates with the outcome of fertilization/intracytoplasmic sperm injection embryo transfer (IVF/ICSI-ET). The co-administration of gonadotropin releasing hormone agonist (GnRH-a) and human chorionic gonadotropin (hCG), i.e. Read More

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