Sequential low-dose step-up and step-down protocols with recombinant follicle-stimulating hormone in polycystic ovary syndrome: prospective comparison with step-down protocol

Casadei, Luisa; Puca, Francesco; Emidi, Emanuela; Manicuti, Claudia; Madrigale, Alessandra; Piccione, Emilio

doi:10.1007/s00404-012-2430-3

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…In infertile women with a BMI ≥ 25 kg/m 2 , it is necessary to modify lifestyle and diet, as well as to implement exercise to lose weight [27][28][29][30]. However, in these women with and without PCOS, a pharmacological intervention with the administration of exogenous FSH is often required to restore ovulation and facilitate pregnancy [31].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Ovarian Reserve Markers and Body Mass Index in Infertile Women with and without Polycystic Ovary Syndrome: A Retrospective Case–Control Study

Casadei,

Nacci,

Vicomandi

et al. 2023

Reprod. Med.

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This study, carried out on 94 women with polycystic ovary syndrome (PCOS) and 176 controls without it, investigated the influence of body mass index (BMI) on serum levels of antimüllerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), and 17ß-estradiol (E2) in infertile patients. Patients were assigned to four subgroups according to age (<35 or ≥35 years) and BMI (<25 kg/m2 or ≥25 kg/m2). Significant differences between PCOS-affected and control women were observed with respect to most of the parameters of interest. In both PCOS-affected and control women, age was inversely correlated with AMH. In the control patients, age was directly correlated with FSH and LH. In women affected by PCOS, no correlation was found between BMI and serum levels of AMH, E2, and LH, except FSH. No correlation was found between BMI and markers of ovarian reserve in control women. BMI was not correlated with AMH in any of the four subgroups considered regardless of the presence of PCOS. An inverse correlation was found only in PCOS-affected women aged ≥35 years between a BMI < 25/FSH and a BMI ≥ 25/LH. The possible association between BMI and ovulation disorder (OD) was investigated in 96 control women aged ≤37 years. In women with OD, the BMI values were significantly higher and FSH and E2 levels were lower than those of patients without OD. Taken together, our data suggest that BMI is not related to hormonal parameters of ovarian reserve, irrespective of the presence of PCOS, and could influence ovulation disorder rather than cause a decrease in ovarian reserve.

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Section: Discussionmentioning

confidence: 99%

Relationship between Ovarian Reserve Markers and Body Mass Index in Infertile Women with and without Polycystic Ovary Syndrome: A Retrospective Case–Control Study

Casadei,

Nacci,

Vicomandi

et al. 2023

Reprod. Med.

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“…34 Low-dose step-up and low-dose step-down protocols are more effective than the step-down conventional protocol, and both have the same pregnancy rate per started cycle. 55 In anovulatory women hyperresponding to FSH during ovulation induction, the addition of recombinant LH (rLH) to FSH in the late follicular phase may lead to the dominance of a single follicle, inducing the atresia of secondary follicles. 56 In fact, LH activity in menotrophin preparations for ovulation induction seems to modify follicular development, leading to a significant reduced number of intermediate-sized follicles.…”

Section: Gonadotropinsmentioning

confidence: 99%

Management Options for Infertile Women with Polycystic Ovary Syndrome

Mariani¹,

Bellver²

2018

US Endocrinology

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olycystic ovary syndrome (PCOS) is a heterogenous condition affecting 5-10% of women at reproductive age. It is the most common cause of anovulatory infertility, characterized by hyperandrogenism and arrested follicle development, and is frequently associated with metabolic features such as insulin resistance and obesity. The diagnosis of PCOS, based on the Rotterdam criteria ( 2003), can be made when at least two of the following three main features are met: oligo-ovulation and/or anovulation, hyperandrogenism (clinical and/or biochemical), and polycystic ovarian morphology at ultrasound examination. Several approaches to ovulation induction have been proposed in women with PCOS. These approaches vary in efficacy, treatment duration, cost, and patient compliance. Management includes lifestyle changes, pharmacotherapy (metformin, clomiphene citrate, letrozole, gonadotropins, inositol), laparoscopic surgery (ovarian drilling), and assisted reproductive techniques, usually in vitro fertilization (see Figure 1). Clinical decisions in PCOS anovulatory patients are currently supported by a recently published international evidence-based guideline that provides 166 recommendations to help clinicians in the diagnosis and management of PCOS and to guide clinical practice.

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The Frequency of Ovarian Hyperstimulation Syndrome and Thromboembolism with Originator Recombinant Human Follitropin Alfa (GONAL-f) for Medically Assisted Reproduction: A Systematic Review

et al. 2020

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Background: Recombinant human follitropin alfa (r-hFSH) is used for ovarian stimulation as part of medically assisted reproduction. There is a risk for ovarian hyperstimulation syndrome (OHSS) with r-hFSH treatment, and an increased risk for thromboembolic events in the presence of pregnancy with OHSS. Objectives: To report the frequency of OHSS and thromboembolism with originator follitropin alfa (GONAL-f) based on the Global Safety Database of Merck KGaA, Darmstadt, Germany and a systematic review of published data. Data Sources: Reports of OHSS and thromboembolism were obtained from the Global Safety Database of Merck KGaA, Darmstadt, Germany from 20 October 1995 to 19 October 2018. The systematic review was based on MEDLINE and Embase searches from inception to 19 October 2018. Study Eligibility Criteria: Patients receiving GONAL-f for ovulation induction or ART, with a starting dose within the range included in the prescribing information and providing information on the occurrence of OHSS and/or thromboembolism. Study Appraisal and Synthesis Matches: In the Global Safety Database of Merck KGaA, Darmstadt, Germany there were an estimated 16,525,975 treatment cycles since 20 October 1995; 1110 reported cases of OHSS and 80 reported cases of thromboembolic events (reporting rates 6.7 and 0.48 per 100,000 treatment cycles, respectively). The systematic review identified 45 studies (5186 patients exposed to GONAL-f; 5240 treatment cycles).

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Sequential low-dose step-up and step-down protocols with recombinant follicle-stimulating hormone in polycystic ovary syndrome: prospective comparison with step-down protocol

Cited by 4 publications

References 22 publications

Relationship between Ovarian Reserve Markers and Body Mass Index in Infertile Women with and without Polycystic Ovary Syndrome: A Retrospective Case–Control Study

Relationship between Ovarian Reserve Markers and Body Mass Index in Infertile Women with and without Polycystic Ovary Syndrome: A Retrospective Case–Control Study

Management Options for Infertile Women with Polycystic Ovary Syndrome

The Frequency of Ovarian Hyperstimulation Syndrome and Thromboembolism with Originator Recombinant Human Follitropin Alfa (GONAL-f) for Medically Assisted Reproduction: A Systematic Review

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