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Minerva Endocrinol (Torino) 2021 Jun 11. Epub 2021 Jun 11.

Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Obstet Gynecol Sci 2021 Jun 9. Epub 2021 Jun 9.

Division of Gynecologic Reproductive Endocrinology and Infertility, The Department of Obstetrics and Gynecology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada.

Objective: Does the timing of cabergoline administration impact the rate of mild/moderate ovarian hyperstimulation syndrome in women with a GnRH agonist trigger?

Methods: We conducted a retrospective cohort analysis of 285 IVF patients at risk of OHSS who received a GnRH agonist trigger from 2011 to 2019 at McGill University Health Centre. Group 1 (Trig, n=101) began taking cabergoline 0.5 mg orally for 7 days at the time of GnRH agonist trigger, while Group 2 (Retriev, n=184) started taking cabergoline on the day of oocyte retrieval. Read More

Cochrane Database Syst Rev 2021 Jun 4;6:CD007535. Epub 2021 Jun 4.

Faculty of Science, University of Technology Sydney, Earlwood, Australia.

Background: Polycystic ovarian syndrome (PCOS) is characterised by both metabolic and reproductive disorders, and affects 5% to 15% of women of reproductive age. Different western medicines have been proposed for PCOS-related subfertility, such as oral contraceptives, insulin sensitisers and laparoscopic ovarian drilling (LOD). Chinese herbal medicines (CHM) have also been used for subfertility caused by PCOS for decades, and are expected to become an alternative treatment for subfertile women with PCOS. Read More

J Hum Reprod Sci 2021 Jan-Mar;14(1):36-41. Epub 2021 Mar 30.

Department of Reproductive Medicine, CRAFT Hospital and Research Centre, Thrissur, Kerala, India.

Background: Empty follicle syndrome (EFS) is a condition of undetermined etiology where no oocytes are retrieved in an ART cycle despite adequate response to ovarian stimulation and diligent follicular aspiration. Because of the rarity of this condition, no much published strategies are available to tackle this.

Aim: The aim of this study was to evaluate whether sequential administration of gonadotropin-releasing hormone agonist (GnRHa) and human chorionic gonadotropin (hCG) as a trigger at 40 h and 36 h, respectively, before oocyte retrieval (OCR) could correct genuine empty follicle syndrome (GEFS). Read More

J Hum Reprod Sci 2021 Jan-Mar;14(1):21-27. Epub 2021 Mar 30.

Department of Obstetrics and Gynaecology, ART Center, All India Institute of Medical Sciences, New Delhi, India.

Context: Tonic hypersecretion of luteinizing hormone (LH) appears to impact both fertility and pregnancy outcomes in women with polycystic ovary syndrome (PCOS).

Aim: Whether high basal day 2/3 serum LH levels and day 2/3 LH/follicle-stimulating hormone (FSH) ratio affect fertilization (IVF) cycle outcomes in PCOS patients undergoing controlled ovarian hyperstimulation using gonadotropin-releasing hormone (GnRH) antagonists.

Settings And Design: A retrospective cohort study was conducted in Assisted Reproductive Technique Center, Department of Obstetrics and Gynaecology, at a tertiary care institute, on PCOS patients undergoing IVF/intracytoplasmic sperm injection (ICSI) using GnRH antagonist protocol with human chorionic gonadotropin trigger between January 2014 to December 2019. Read More

Reprod Sci 2021 Jun 3. Epub 2021 Jun 3.

Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, 40, Daxue Road, Zhengzhou, 450052, Henan, China.

The sex ratio at birth is defined as the secondary sex ratio (SSR). Ovarian hyperstimulation syndrome (OHSS) is a serious and iatrogenic complication associated with controlled ovarian stimulation (COS) during assisted reproductive technology (ART) treatments. It has been hypothesized that the human SSR is partially controlled by parental hormone levels around the time of conception. Read More

Reprod Sci 2021 Jun 2. Epub 2021 Jun 2.

Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.

Oocyte in vitro maturation (IVM) is a technology with a long history that was established before IVF. Although it has been studied extensively, the efficiency of IVM has been poor for almost 30 years. In terms of the benefits of IVM, the efficiency and adoption of IVM are being improved by some notable improvements that have occurred in recent years. Read More

Reprod Sci 2021 Jun 2. Epub 2021 Jun 2.

Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, 229899, Singapore.

Use of GnRH antagonists in IVF stimulation protocols shortens controlled ovarian hyperstimulation (COH) and reduces the risk of ovarian hyperstimulation syndrome (OHSS). However, profound reduction in LH levels has been associated with use of GnRH antagonists. This study aims to determine if LH suppression during GnRH antagonist cycles results in poorer IVF outcomes. Read More

J Assist Reprod Genet 2021 Jun 1. Epub 2021 Jun 1.

Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Purpose: To investigate the factors associated with live births and the interaction between age and the number of embryos transferred after in vitro fertilisation (IVF) treatment.

Methods: This study analyses data from a population-based-assisted reproductive database of all registered artificial reproduction institutions (n = 80) from 2010 to 2016 in Taiwan. The probability of a live birth in correlation with the treatment parameters was measured with multivariate logistic regression analyses using the generalised additive model (GAM) and Pearson's chi-square exact test. Read More

Acta Obstet Gynecol Scand 2021 Jun 1. Epub 2021 Jun 1.

Porphyria Centre Sweden, Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.

Introduction: The acute porphyrias are rare disorders of the heme biosynthetic pathway and present with acute neurovisceral symptoms that can be induced by hormonal changes and medications. Women are far more likely to present with clinical symptoms than men, particularly during parts of their lifetime with changes in the level of female sex hormones such as ovulation, menstruation and pregnancy. Treatment of ovulatory dysfunction and controlled ovarian hyperstimulation require the administration of hormones, which are considered porphyrinogenic. Read More

Fertil Res Pract 2021 May 28;7(1):12. Epub 2021 May 28.

Obstetrics & Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Background: A number of studies have looked at dual triggers with hCG and GnRH agonist (GnRHa) in varying doses, but the question remains: what is the optimal dose of hCG to minimize ovarian hyperstimulation syndrome (OHSS) and still offer adequate pregnancy rates? The purpose of this study was to compare pregnancy and OHSS rates following dual trigger for oocyte maturation with GnRHa and a low-dose hCG versus hCG alone. A secondary objective was the assess pregnancy outcomes in subsequent frozen cycles for the same population.

Methods: A total of 963 women < 41 years old, with a BMI 18-40 kg/m and an AMH > 2 ng/mL who underwent fresh autologous in vitro fertilization (IVF) with GnRH antagonist protocol at a University-based fertility center were included in this retrospective cohort study. Read More

J Reprod Infertil 2021 Apr-Jun;22(2):116-124

Universitaeres interdisziplinäres Kinderwunschzentrum Duesseldorf (UniKiD), Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Duesseldorf, Duesseldorf, Germany.

Background: This phase IV routine care study evaluated ovarian responses when using a biosimilar follitropin alfa r-hFSH (Bemfola) for controlled ovarian stimulation (COS) in women undergoing assisted reproductive technology (ART) treatment who were pituitary-suppressed with a gonadotrophin-releasing hormone (GnRH) antagonist.

Methods: This multicenter, prospective, non-comparative, non-interventional study (Germany/Austria) was conducted with 885 women (Mean age of 34.0±4. Read More

Front Endocrinol (Lausanne) 2021 10;12:675670. Epub 2021 May 10.

Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy.

Background: A Delphi consensus was conducted to evaluate global expert opinions on key aspects of assisted reproductive technology (ART) treatment.

Methods: Ten experts plus the Scientific Coordinator discussed and amended statements plus supporting references proposed by the Scientific Coordinator. The statements were distributed an online survey to 35 experts, who voted on their level of agreement or disagreement with each statement. Read More

Reprod Sci 2021 May 25. Epub 2021 May 25.

Homerton Fertility Centre, Homerton University Hospital, London, UK.

Recent years have seen a dramatic rise in the number of frozen-thawed embryo replacement (FER) cycles. Along with the advances in embryo cryopreservation techniques, the optimization of endometrial receptivity has resulted in outcomes for FER that are similar to fresh embryo transfer. However, the question of whether the Freeze all strategy is for all is nowadays a hot topic. Read More

Ceska Gynekol 2021 ;86(2):124-127

Objective: To present current possibilities of the prevention and therapy of ovarian hyperstimulation syndrome (OHSS).

Methods: Literature and guidelines were researched.

Results: From the view of safety and prevention of OHSS, antagonistic protocol is suitable. Read More

Ceska Gynekol 2021 ;86(2):86-92

: Objective: The aim of the study CERES (CzEch REkovelle real life Study) was to gather experience with the use of a novel gonadotrophine, to evaluate the efficacy of follitropin delta in Czech clinical settings and to compare our results with the clinical trial ESTHER-1.

Methods: Individualized follitropin delta daily dose in µg based on the patient’s anti-Müllerian hormone (AMH) level and body weight (AMH < 15 pmol/ L: 12 µg/ d; AMH > 15 pmol/ L: 0.10–0. Read More

Semin Reprod Med 2021 May 17. Epub 2021 May 17.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, Canada.

Alongside an interplay of a multitude of factors, attainment of a favorable pregnancy outcome is predicated on successful implantation, which in itself is a complex process anchored by balanced interchange with the hemostatic system. Among other etiologies, failure of implantation can result in infertility, and lead affected couples to consider assisted reproductive technology (ART) in an effort to fulfill their desire for procreation. Given the critical role of the hemostatic system in the process of implantation, documentation of a hypercoagulable state during controlled ovarian stimulation in the context of in vitro fertilization, as well as the potential association of its derangement in the setting of thrombophilia, with infertility, ART, ovarian hyperstimulation syndrome, and failure of implantation are explored. Read More

Clin Biochem 2021 May 14. Epub 2021 May 14.

Department of Pathology, Texas Children's Hospital, Houston, TX, United States. Electronic address:

Objective: Our study aims to evaluate the diagnostic performance of a high-sensitivity picoAnti-Müllerian Hormone (picoAMH) for predicting ovarian response in women undergoing controlled ovarian hyperstimulation and occurrence of ovarian hyperstimulation syndrome.

Methods: Retrospective cohort study at a single academic fertility center including all patients with picoAMH ELISA who underwent controlled ovarian hyperstimulation. The primary outcome was the number of oocytes retrieved, and secondary outcomes included cycle cancellation and ovarian hyperstimulation syndrome. Read More

BMC Pregnancy Childbirth 2021 May 11;21(1):372. Epub 2021 May 11.

Reproductive Center, Women and Children's Hospital of Hubei Province, No. 745, Wuluo Road, Hongshan District, 430070, Wuhan, China.

Background: The gonadotrophin-releasing hormone (GnRH) antagonist protocol has some advantages, such as a simple method, short medication duration, and low incidence of ovarian hyperstimulation syndrome, but whether the GnRH antagonist protocol is suitable for normal ovarian responders has been controversial. We compared the clinical outcomes of fresh and frozen-thawed transfer cycles between the depot GnRH agonist protocol and GnRH antagonist protocol in normal ovarian responders.

Methods: Data of normal ovarian responders who underwent in vitro fertilization-embryo transfer (IVF-ET) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) between January 2017 and December 2018 in our hospital were retrospectively analysed. Read More

Int J Gynaecol Obstet 2021 May 10. Epub 2021 May 10.

Molecular Assisted Reproduction and Genetics, MAR&Gen Clinic, Granada, Spain.

Objective: To examine whether adding a second HCG trigger, 12.5 h after the first (36.5 h before ovarian puncture), can facilitate recovery of oocytes in women with a paucifollicular response to ovarian stimulation. Read More

Minerva Obstet Gynecol 2021 May 5. Epub 2021 May 5.

Fetal Medicine Unit, Department of Medical and Surgical Sciences, Department of Obstetrics and Gynecology, University of Foggia, Foggia, Italy -

Purpose Of The Article: To investigate the association between ovarian hyperstimulation syndrome (OHSS) and adverse pregnancy outcome.

Material And Methods: Medline, Embase and Cochrane databases were searched. The primary outcome was a composite score of adverse maternal outcome including either preterm birth (PTB), gestational diabetes mellitus (GDM), pre-eclampsia (PE) or pregnancy induced hypertension, intra-hepatic cholestasis of pregnancy, thromboembolic events or need for caesarean section (CS). Read More

Mol Hum Reprod 2021 May 1. Epub 2021 May 1.

Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.

Oocyte IVM technology is an option for fertility preservation in some groups of patients, such as those with polycystic ovary syndrome, patients with ovarian hyperstimulation syndrome, and for patients with cancer. However, the developmental potential of oocytes from IVM still needs to improve. Several previous studies have reported that lysophosphatidic acid (LPA) promotes glucose metabolism, cumulus cell (CC) expansion, and oocyte nuclear maturation. Read More

Reprod Biomed Online 2021 Jun 18;42(6):1108-1118. Epub 2021 Mar 18.

The Fertility Clinic, Skive Regional Hospital, Resenvej 25, Skive 7800, Denmark; Faculty of Health, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, Aarhus 8200, Denmark.

Research Question: Is the reproductive outcome similar after gonadotrophin-releasing hormone agonist (GnRHa) trigger followed by luteal human chorionic gonadotrophin (HCG) boluses compared with HCG trigger and a standard luteal phase support (LPS)?

Design: Two open-label pilot randomized controlled trials (RCT) with 250 patients from 2014 to 2019, with a primary outcome of ongoing pregnancy per embryo transfer. Patients with ≤13 follicles on the trigger day were randomized (RCT 1) to: Group A (n = 65): GnRHa trigger followed by a bolus of 1500 IU HCG s.c. Read More

Medicina (Kaunas) 2021 Apr 14;57(4). Epub 2021 Apr 14.

Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", University Street, no 16, 700115 Iasi, Romania.

: The latest reports suggest that follitropin delta is a highly efficient recombinant human follicle-stimulating hormone (r-hFSH) that became a part of the current assisted reproductive technologies (ARTs). Therefore, the present study aims to assess a series of parameters (follicles, oocytes, and embryos) and further by the outcomes in women following the administration of follitropin delta. : This observational study included 205 women. Read More

J Gynecol Obstet Hum Reprod 2021 Apr 20;50(8):102143. Epub 2021 Apr 20.

OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada. Electronic address:

Research Question: Presence of endometrial fluid (EF) is a poorly understood pathology and remains a challenge for clinicians, as very little data exists to explain its consequences and treatment. Our objective was to investigate risk factors for EF during IVF.

Design: This retrospective cohort study included all women with a freeze all embryos cycle (FAE) for EF between 2010 and 2016 at a university-affiliated private IVF center. Read More

Cochrane Database Syst Rev 2021 04 14;4:CD008605. Epub 2021 Apr 14.

School of Women's and Infants' Health, The University of Western Australia, King Edward Memorial Hospital and Fertility Specialists of Western Australia, Subiaco, Perth, Australia.

Background: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). It is characterised by enlarged ovaries and an acute fluid shift from the intravascular space to the third space, resulting in bloating, increased risk of venous thromboembolism, and decreased organ perfusion. Most cases are mild, but forms of moderate or severe OHSS appear in 3% to 8% of in vitro fertilisation (IVF) cycles. Read More

Reprod Sci 2021 Apr 13. Epub 2021 Apr 13.

The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.

Gonadotropin-releasing hormone agonist (GnRHa) for final oocyte maturation, along with vitrification of all usable embryos followed by transfer in a subsequent frozen-thawed cycle, is the most effective strategy to avoid ovarian hyperstimulation syndrome (OHSS). However, less is known about the ovulation induction triggers effect on early embryo development and blastocyst formation. This study is a secondary analysis of a multicenter, randomized controlled trial, with the aim to compare embryo development in normo-ovulatory women, randomized to GnRHa or human chorionic gonadotropin (hCG) trigger. Read More

Cochrane Database Syst Rev 2021 04 12;4:CD005289. Epub 2021 Apr 12.

Division of Applied Health Sciences, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, UK.

Background: Monitoring of in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) is necessary to detect as well as reduce the incidence and severity of ovarian hyperstimulation syndrome (OHSS) whilst achieving the optimal ovarian response needed for assisted reproduction treatment. Traditional monitoring of ovarian hyperstimulation during in vitro fertilisation IVF and ICSI treatment has included transvaginal ultrasonography (TVUS) plus serum estradiol levels. The need for combined monitoring (using TVUS and serum estradiol) during ovarian stimulation in assisted reproduction is controversial. Read More

Ann Transl Med 2021 Mar;9(5):387

Department of Assisted Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

Background: Exogenous progestational agents have recently been introduced as an alternative pituitary modulator for the prevention of premature luteinizing hormone (LH) surges during in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments. There is increasing evidence that frozen-embryo transfer (FET) is associated with a lower risk of ovarian hyperstimulation syndrome (OHSS) in women with polycystic ovary syndrome (PCOS). Herein, we compared the clinical outcomes of the progesterone protocol with the gonadotropin releasing hormone antagonist (GnRH-ant) protocol in PCOS patients with a ''freeze-all'' strategy. Read More

J Clin Endocrinol Metab 2021 Apr 11. Epub 2021 Apr 11.

Reproductive medicine unit, University College London Hospitals, London, UK.

Context: Clinical practice guidelines (CPGs) are key instruments to implement the practice of evidence-based medicine. We aimed to evaluate the methodological quality and variations in CPGs recommendations on the diagnosis and management of polycystic ovary syndrome (PCOS).

Evidence Acquisition: We searched MEDLINE, EMBASE, and CENTRAL until December 2020 for all evidence-based CPGs and consensus statements on PCOS. Read More