In Vitro Fertilization Versus Mild Stimulation Intrauterine Insemination in Women Aged 40 and Older

Nemer, Laurice Bou; Weitzman, Vanessa N.; Arheart, Kristopher L.; Barrionuevo, Marcelo J.; Christie, Daniel R.; Mouhayar, Youssef; Hoffman, Donna L.; Maxson, Wayne S.; Ory, Steven J.

doi:10.1177/1933719116667215

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…This type of "low-intensity" stimulation lacks many of the unwanted characteristics of high-dose gonadotropin stimulation protocols typically used in IVF cycles of similar patient populations, such as a possible increase in aneuploidy rate. [9][10][11] During oocyte retrieval, FF was collected using a 17G Cook single lumen oocyte retrieval needle (Brisbane, Australia) under suction. The first follicle to be collected was the largest, and after the oocyte was isolated from the FF under microscopic guidance, FF from this follicle was processed for analysis.…”

Section: Methodsmentioning

confidence: 99%

Effect of Body Weight on Metabolic Hormones and Fatty Acid Metabolism in Follicular Fluid of Women Undergoing In Vitro Fertilization: A Pilot Study

Nemer

Shi

Carr³

et al. 2019

Reprod. Sci.

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Section: Methodsmentioning

confidence: 99%

Effect of Body Weight on Metabolic Hormones and Fatty Acid Metabolism in Follicular Fluid of Women Undergoing In Vitro Fertilization: A Pilot Study

Nemer

Shi

Carr³

et al. 2019

Reprod. Sci.

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“…Ovulatory women with infertility can be treated with COS and ART, and an overview of their treatment is shown in Figure 4 [9]. Conventional COS results in a greater number of oocytes retrieved compared with mild stimulation or natural cycles [10,11]. As the number of oocytes retrieved has been observed to be positively correlated with pregnancy and live birth outcomes, COS should be the preferred treatment option in this population [12][13][14][15].…”

Section: Ovulatory Women (Including Women With Unexplained Infertilitmentioning

confidence: 99%

Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility

Lunenfeld

Bilger

Longobardi

et al. 2019

Gynecological Endocrinology

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It is essential that fertility treatment is individualized based on a thorough diagnostic work-up, with treatment tailored to the patients' requirements. This individualization should be kept in mind during the main decision points that occur before and during treatment. Treatment customization must include consideration of both the woman and her partner involved in the process together, including their collective treatment goals. Once treatment goals have been agreed and diagnostic evaluations performed, personalization based on patient characteristics, together with an understanding of treatment goals and patient preferences, enables the selection of appropriate treatments, protocols, products and their dosing. Following treatment initiation, monitoring and adaptation of product and dose can then ensure optimal outcomes. Currently, it is not possible to base treatment decisions on every characteristic of the patient and personalization is based on biomarkers that have been identified as the most relevant. However, in the future, the use of artificial intelligence coupled with continuous monitoring should enable greater individualization and improve outcomes. This review considers the current state-of-the-art related to decision points during individualized treatment of female infertility, before looking at future developments that might further assist in making individualized treatment decisions, including the use of computer-assisted decision making. ARTICLE HISTORY

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“…While high-dose stimulation protocols remain popular among fertility centers, there has been an increased interest in the use of 'milder' forms of stimulation, such as modified natural cycle, minimal or mild stimulation IVF. These types of stimulation decrease cost and are thought to be more patient-friendly than the traditional high-dose stimulations (Devroey et al 2009;Fauser et al 2010;Bou Nemer et al 2017). One of the main drawbacks of such stimulation protocols is the higher rate of cancellation, partly due to premature ovulation (Pelinck et al 2002).…”

Section: Introductionmentioning

confidence: 99%

Effect of single-dose ibuprofen on follicular fluid levels of interleukins in poor responders undergoingin vitrofertilization

Nemer

Shi

Carr

et al. 2018

Systems Biology in Reproductive Medicine

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Premature follicular rupture during in vitro fertilization (IVF) is a well-known culprit for cycle cancellation. We sought to evaluate whether a single oral dose of ibuprofen will have an effect on the follicular fluid (FF) levels of inflammatory markers involved in ovulation. This is a prospective within-subjects study following nine patients undergoing IVF. Every patient underwent a first cycle of minimal stimulation IVF followed by a second cycle using the same stimulation protocol, except one oral dose of ibuprofen 800 mg was administered 15-18 h post-trigger injection. FF was obtained during oocyte retrievals of both cycles and analyzed for levels of selected inflammatory markers. A total of 27 cytokines and 9 matrix metalloproteinases (MMPs) were tested. Results demonstrate significantly decreased levels of interleukin (IL)-6, IL-8, granulocyte-colony stimulating factor (G-CSF), eotaxin, MMP3, MMP7, MMP12, and MMP13 in FF of cycles where ibuprofen was administered. However, other cytokines levels, such IL-1 and vascular endothelial growth factor (VEGF), were similar with or without ibuprofen. Levels of MMPs described to be involved in ovulation, namely MMP-2 and MMP-9, were either undetectable or unchanged by ibuprofen, respectively. In conclusion, our data show that one dose of ibuprofen administered orally the day after trigger injection revealed a significant impact on the FF inflammatory milieu.

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In Vitro Fertilization Versus Mild Stimulation Intrauterine Insemination in Women Aged 40 and Older

Abstract: While IVF and mini-stim IUI were found to have similar PRs in women aged 41 and above, POs are significantly better in IVF. A larger study is required to clarify the above results.

Cited by 9 publications

References 19 publications

Effect of Body Weight on Metabolic Hormones and Fatty Acid Metabolism in Follicular Fluid of Women Undergoing In Vitro Fertilization: A Pilot Study

Effect of Body Weight on Metabolic Hormones and Fatty Acid Metabolism in Follicular Fluid of Women Undergoing In Vitro Fertilization: A Pilot Study

Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility

Effect of single-dose ibuprofen on follicular fluid levels of interleukins in poor responders undergoingin vitrofertilization

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