The effect of luteal GnRH antagonist on moderate and severe early ovarian hyperstimulation syndrome during in vitro fertilization treatment: a prospective cohort study

Zeng, Cheng; Shang, Jin; Jin, Aoming; Wu, Peili; Li, Xin; Xue, Qing

doi:10.1007/s00404-019-05163-3

Cited by 16 publications

(9 citation statements)

References 33 publications

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“…The follicular growth was constantly monitored via transvaginal ultrasonography every 2 to 3 days. When at least 1 follicle reached 13-14 mm, 0.25 mg of gonadotropin-releasing hormone (GnRH) antagonist (Cetrorelix acetate, Cetrotide, Merck Serono SA, Switzerland) (10) was started and continued until HCG administration. Estradiol was measured as soon as at least 3 follicles with over 18 millimeters of diameter were observed to specify the underlying type of the trigger.…”

Section: Clinical Evaluation Stimulation Protocolmentioning

confidence: 99%

“…Estradiol was measured as soon as at least 3 follicles with over 18 millimeters of diameter were observed to specify the underlying type of the trigger. In the case of the serum estradiol level more than 5000 pg/ mL (10) on the day, the GnRH agonist was injected so that to avoid the risk of ovarian hyperstimulation syndrome. The patient was then removed from the study.…”

Section: Clinical Evaluation Stimulation Protocolmentioning

confidence: 99%

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Comparison of Oocyte and Embryo Quality in Women With Polycystic Ovary Syndrome and the Control Group Candidate for In Vitro Fertilization and Intracytoplasmic Sperm Injection

Afiat

Khadem

Nayeri

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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Objectives: Polycystic ovary syndrome (PCOS) is the most common cause of female infertility. The aim of this study was to compare the oocyte and embryo quality between the PCOS women with the control group candidate for in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Materials and Methods: The present study was designed at the Infertility Research Center of Milad in the prospective cohort format and was carried out on 100 cases of infertile women with confirmed PCOS (case group) and the male factor (control group) as the first IVF cycle candidates. Both groups underwent the ovary stimulation cycle and ICSI under the standard antagonist protocol. The collected data were then processed and analyzed using the SPSS software, version 16. Results: The average age of study cases was 35±3, and oocyte necrosis was the underlying pathological factor in both groups (28% and 26% in the PCOS and control groups, respectively). In addition, most embryones belonged to either grade 1 or 2 or were 8-cell embryos. Furthermore, the highest number of transferred embryos among the patients was related to the 8-cell and grade 1. The occurrences of biochemical pregnancy in the PCOS and control groups were up to 31.91% and 22%, respectively, leading to 72.73% and 60% childbirth in cases of both groups. Finally, there were no significant differences observed with respect to the quality and the quantity of the embryones, the oocyte, the transferred embryo, the germinal vesicle oocytes, and the rate of pregnancy among the two groups (P>0.05). Conclusions: According to the results of the present study, no differences were found concerning the oocyte quality, embryo, and the pregnancy rate between PCOS cases and any other patients requiring ICSI. Therefore, such cases can similarly benefit from ICSI methods as well.

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Section: Clinical Evaluation Stimulation Protocolmentioning

confidence: 99%

Section: Clinical Evaluation Stimulation Protocolmentioning

confidence: 99%

Comparison of Oocyte and Embryo Quality in Women With Polycystic Ovary Syndrome and the Control Group Candidate for In Vitro Fertilization and Intracytoplasmic Sperm Injection

Afiat

Khadem

Nayeri

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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“…In granulosa cells, for example, the EGR1 level was upregulated by hCG, and these findings were linked to follicle maturation, ovulation, and luteinization 44 . Furthermore, there was a significant difference in the levels of EGR1 and VEGF in OHSS patients treated with cetrorelix, a GnRH antagonist, and untreated OHSS patients, with cetrorelix reducing the incidence of moderate and severe OHSS 45 . Other studies have reported an upregulation in EGR1 expression in several experimental models of vascular disease 35 , 36 .…”

Section: Discussionmentioning

confidence: 94%

Tie1 contributes to the development of ovarian hyperstimulation syndrome under the regulation of EGR1 in granulosa cells

et al. 2022

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The expression of tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 1 (Tie1), a transmembrane protein expressed almost exclusively by endothelial cells, has been reported in granulosa cells. However, its significance in ovarian hyperstimulation syndrome (OHSS), which can occur after the injection of gonadotropins in infertile women undergoing controlled ovarian stimulation, is unknown. Here, we report significantly increased Tie1 and vascular endothelial growth factor (VEGF) expression in cultured granulosa cells from OHSS patients, as well as ovaries from rats with experimentally established OHSS, compared to controls, with the levels of both proteins also increasing in granulosa and SVOG cells (a nontumorigenic human granulosa-lutein cell line) treated with an acute dose of human chorionic gonadotropin (hCG). Tie1 silencing abolished the hCG-induced VEGF level in SVOG cells and attenuated the progression of OHSS in rats, as determined by histological analysis. Further studies in SVOG cells revealed that the hCG-induced upregulation of Tie1 expression involved the phosphoinositide 3-kinase/protein kinase B signaling pathway. We also report that early growth response protein 1 (EGR1), whose expression was also upregulated by hCG, bound directly to the Tie1 promoter and activated its transcription. Taken together, our results indicate that Tie1 may be a therapeutic target in cases of moderate-to-severe OHSS. Further studies are needed to address its clinical relevance.

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“…The details about the ovulation induction and IVF/ICSI stimulation protocols have been described in our previous studies [ 16 , 17 ]. The initial and ongoing dosages were adjusted according to the patient’s age, ovarian response and previous IVF/ICSI procedure.…”

Section: Methodsmentioning

confidence: 99%

Effect of frozen-thawed embryo transfer with a poor-quality embryo and a good-quality embryo on pregnancy and neonatal outcomes

Zeng,

Lu,

et al. 2024

Reprod Biol Endocrinol

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Background To evaluate the impact of embryo quality and quantity, specifically a poor quality embryo (PQE) in combination with a good quality embryo (GQE), by double embryo transfer (DET) on the live birth rate (LBR) and neonatal outcomes in patients undergoing frozen-thawed embryo transfer (FET) cycles. Methods A study on a cohort of women who underwent a total of 1462 frozen-thawed cleavage or blastocyst embryo transfer cycles with autologous oocytes was conducted between January 2018 and December 2021. To compare the outcomes between single embryo transfer (SET) with a GQE and DET with a GQE and a PQE, propensity score matching (PSM) was applied to control for potential confounders, and a generalized estimating equation (GEE) model was used to determine the association between the effect of an additional PQE and the outcomes. Subgroup analysis was also performed for patients stratified by female age. Results After PS matching, DET-GQE + PQE did not significantly alter the LBR (adjusted odds ratio [OR] 1.421, 95% CI 0.907–2.228) compared with SET-GQE in cleavage-stage embryo transfer but did increase the multiple birth rate (MBR, [OR] 3.917, 95% CI 1.189–12.911). However, in patients who underwent blastocyst-stage embryo transfer, adding a second PQE increased the live birth rate by 7.8% ([OR] 1.477, 95% CI 1.046–2.086) and the multiple birth rate by 19.6% ([OR] 28.355, 95% CI 3.926–204.790), and resulted in adverse neonatal outcomes. For patients who underwent cleavage-stage embryo transfer, transferring a PQE with a GQE led to a significant increase in the MBR ([OR] 4.724, 95% CI 1.121–19.913) in women under 35 years old but not in the LBR ([OR] 1.227, 95% CI 0.719–2.092). The increases in LBR and MBR for DET-GQE + PQE compared with SET-GQE in women older than 35 years were nonsignificant toward. For patients who underwent blastocyst-stage embryo transfer, DET-GQE + PQE had a greater LBR ([OR] 1.803, 95% CI 1.165–2.789), MBR ([OR] 24.185, 95% CI 3.285–178.062) and preterm birth rate (PBR, [OR] 4.092, 95% CI 1.153–14.518) than did SET-GQE in women under 35 years old, while no significant impact on the LBR ([OR] 1.053, 95% CI 0.589–1.884) or MBR (0% vs. 8.3%) was observed in women older than 35 years. Conclusions The addition of a PQE has no significant benefit on the LBR but significantly increases the MBR in patients who underwent frozen-thawed cleavage-stage embryo transfer. However, for patients who underwent blastocyst-stage embryo transfer, DET-GQE + PQE resulted in an increase in both the LBR and MBR, which may lead to adverse neonatal outcomes. Thus, the benefits and risks of double blastocyst-stage embryo transfer should be balanced. In patients younger than 35 years, SET-GQE achieved satisfactory LBR either in cleavage-stage embryo transfer or blastocyst-stage embryo transfer, while DET-GQE + PQE resulted in a dramatically increased MBR. Considering the low LBR in women older than 35 years who underwent single cleavage-stage embryo transfer, selective single blastocyst-stage embryo transfer appears to be a more promising approach for reducing the risk of multiple live births and adverse neonatal outcomes.

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The effect of luteal GnRH antagonist on moderate and severe early ovarian hyperstimulation syndrome during in vitro fertilization treatment: a prospective cohort study

Cited by 16 publications

References 33 publications

Comparison of Oocyte and Embryo Quality in Women With Polycystic Ovary Syndrome and the Control Group Candidate for In Vitro Fertilization and Intracytoplasmic Sperm Injection

Comparison of Oocyte and Embryo Quality in Women With Polycystic Ovary Syndrome and the Control Group Candidate for In Vitro Fertilization and Intracytoplasmic Sperm Injection

Tie1 contributes to the development of ovarian hyperstimulation syndrome under the regulation of EGR1 in granulosa cells

Effect of frozen-thawed embryo transfer with a poor-quality embryo and a good-quality embryo on pregnancy and neonatal outcomes

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