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Sample records for controlled ovarian hyperstimulation

  1. Decrease of free thyroxine levels after controlled ovarian hyperstimulation

    NARCIS (Netherlands)

    A.F. Muller (Alex); A. Verhoeff; M.J. Mantel; F.H. de Jong (Frank); A. Berghout (Arie)

    2000-01-01

    textabstractControlled ovarian hyperstimulation could lead to opposing effects on thyroid function. Therefore, in a prospective study of 65 women undergoing controlled ovarian hyperstimulation, thyroid hormones, T4-binding globulin, TPO antibodies, gonadotropins, estrad

  2. Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation?

    NARCIS (Netherlands)

    Tjon-Kon-Fat, R. I.; Bensdorp, A. J.; Bossuyt, P. M. M.; Koks, C.; Oosterhuis, G. J. E.; Hoek, A.; Hompes, P.; Broekmans, F. J.; Verhoeve, H. R.; de Bruin, J. P.; van Golde, R.; Repping, S.; Cohlen, B. J.; Lambers, M. D. A.; van Bommel, P. F.; Slappendel, E.; Perquin, D.; Smeenk, J.; Pelinck, M. J.; Gianotten, J.; Hoozemans, D. A.; Maas, J. W. M.; Groen, H.; Eijkemans, M. J. C.; van der Veen, F.; Mol, B. W. J.; van Wely, M.

    2015-01-01

    STUDY QUESTION: What is the cost-effectiveness of in vitro fertilization(IVF) with conventional ovarian stimulation, single embryotransfer (SET) and subsequent cryocycles or IVF in a modified natural cycle (MNC) compared with intrauterine insemination with controlled ovarian hyperstimulation

  3. Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation?

    NARCIS (Netherlands)

    Tjon-Kon-Fat, R. I.; Bensdorp, A. J.; Bossuyt, P. M M; Koks, C.; Oosterhuis, G. J E; Hoek, A.; Hompes, P.; Broekmans, F. J.; Verhoeve, H. R.; De Bruin, J. P.; Van Golde, R.; Repping, S.; Cohlen, B. J.; Lambers, M. D A; Van Bommel, P. F.; Slappendel, E.; Perquin, D.; Smeenk, J.; Pelinck, M. J.; Gianotten, J.; Hoozemans, D. A.; Maas, J. W M; Groen, H.; Eijkemans, M. J C; Van Der Veen, F.; Mol, B. W J; Van Wely, M.

    2015-01-01

    STUDY QUESTION What is the cost-effectiveness of in vitro fertilization (IVF) with conventional ovarian stimulation, single embryo transfer (SET) and subsequent cryocycles or IVF in a modified natural cycle (MNC) compared with intrauterine insemination with controlled ovarian hyperstimulation

  4. The effect of functional status of the ovaries on the embryological results of controlled ovarian hyperstimulation

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    Grzegorz Mrugacz

    2013-12-01

    Full Text Available Introduction: Controlled ovarian hyperstimulation is an integral part of infertility treatment. Despite many years of use, some aspects of controlled ovarian stimulation have not yet been clarified, especially the role of the functional status of the ovaries before hormonal stimulation. Aim of the research: To assess the effect of the functional status of the ovaries on the embryological results of controlled ovarian hyperstimulation. Material and methods: The retrospective study included female patients treated for infertility. The patients were divided into two groups depending on the ultrasonographic appearance of the ovaries before controlled ovarian hyperstimulation. Patients with small antral follicles 0.05. The numbers of A, C, D quality embryos were comparable between the groups (p > 0.05. There were more B quality embryos in group I than II (p > 0.05. The embryo growth rate was significantly faster in group I than II. Conclusions: The results of the present study indicate that the functional status of the ovaries before controlled ovarian hyperstimulation plays a pivotal role in treatment outcome.

  5. Changes in Coagulation and Fibrinolytic Indices in Women with Polycystic Ovarian Syndrome Undergoing Controlled Ovarian Hyperstimulation

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    Ying Huang

    2014-01-01

    Full Text Available Background. Polycystic ovarian syndrome (PCOS women undergoing in vitro fertilization and embryo transfer (IVF-ET treatment always attain a low cumulative pregnancy rate disaccording with the satisfactory number of oocytes. Objective. We aim to evaluate the status of coagulation and fibrinolytic system in PCOS patients undergoing controlled ovarian hyperstimulation (COH process. Method. Of the 97 women, 30 patients with PCOS composed the study group; 67 women of child-bearing age with normal endocrine function composed the control group. All participants underwent GnRH agonist standard long protocol, and plasma HCY, FVIII, FX, and D-dimer levels as well as hormone parameters were measured at day of full downregulation, hCG priming, and embryos transfer. Results. On day of full downregulation, FX levels were significantly higher in PCOS group (P<0.01. On hCG priming day, FX and estrogen levels in PCOS group were higher than in the control group and FVIII levels were significantly lower on day of embryos transfer whereas FX and E2 levels were significantly higher in PCOS group. Conclusion. Hypercoagulable state during peri-implantation phase would probably lead to poor microcirculation of endometrium and be one of the most important disadvantages of successful implantation and subsequent clinical pregnancy.

  6. Renal and Hepatic Functions after A Week of Controlled Ovarian Hyperstimulation during In Vitro Fertilization Cycles

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    Romito Ilaria

    2017-01-01

    Full Text Available Background: One the main aspects of in vitro fertilization (IVF cycle is to avoid any possible systemic damage on women undergoing a controlled ovarian hyperstimulation (COH. The aim of this work is to evaluate renal and hepatic function blood tests in patients undergoing controlled ovarian hyperstimulation during IVF cycles. Materials and Methods: We performed a prospective cohort analysis. All patients re- ceived a long stimulation protocol with gonadotropin-releasing hormone (GnRH analogues by daily administration, since the twenty-first day of the previous ovarian cycle followed by COH with recombinant follicle-stimulating hormone (FSH. The daily dose of exogenous gonadotropins for every single patient was modified according to her follicular growth. The oocytes were retrieved during the oocyte pick up and fertilized by standard procedures of intracytoplasmic sperm injection (ICSI. The blood samples to evaluate renal and hepatic functions were taken at the 7th day of ovarian stimulation. Results: We enrolled 426 women aged between 19 and 44 years, with a mean body mass index (BMI of 24.68 Kg/m2. The mean value of blood urea nitrogen was 14 ± 3.16 mg/ dl, creatinine: 1 ± 0.45 mg/dl, uric acid: 4 ± 1.95 mg/dl, total proteins: 7 ± 3.93 mg/dl, aspartate aminotransferase: 18 ± 6.29 mU/ml, alanine aminotransferase: 19 ± 10.41 mU/ ml, alkaline phosphatase: 81 ± 45.25 mU/ml, total bilirubin 1 ± 0.35 mg/dL. All of the results were considered as a normal range following the Medical Council of Canada. Conclusion: Our data suggest that, unlike ovarian hyperstimulation syndrome (OHSS, COH patients did not show any alteration to renal and hepatic functions.

  7. 卵巢低反应人群超促排卵的治疗策略%Treatment strategy of controlled ovarian hyperstimulation cycle in poor ovarian responders

    Institute of Scientific and Technical Information of China (English)

    何方方

    2012-01-01

    This article reviews the guideline of the European Society of Human Reproduction and Embryology (ESHRE) for poor ovarian responders and provides an introduction in the classification, predictive index, the effects of all kinds of controlled ovarian hyperstimulation (COH) protocols in poor ovarian responders and the coping strategies.

  8. Acute respiratory failure following ovarian hyperstimulation syndrome

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    Antonello Nicolini

    2013-03-01

    Full Text Available Ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiological complication that may be encountered in patients who undergo controlled ovarian hyperstimulation cycles. The syndrome is typically associated with regimes of exogenous gonadotropins, but it can be seen, albeit rarely, when clomiphene is administered during the induction phase. Although this syndrome is widely described in scientific literature and is well known by obstetricians, the knowledge of this pathological and potentially life-threatening condition is generally less than satisfactory among physicians. The dramatic increase in therapeutic strategies to treat infertility has pushed this condition into the realm of acute care therapy. The potential complications of this syndrome, including pulmonary involvement, should be considered and identified so as to allow a more appropriate diagnosis and management. We describe a case of a woman with an extremely severe (Stage 6 ovarian hyperstimulation syndrome who presented ascites, bilateral pleural effusion and severe respiratory failure treated with non-invasive ventilation. The patient was admitted to the intensive care unit because of severe respiratory failure, ascites, and bilateral pleural effusion due to ovarian hyperstimulation syndrome. Treatment included non-invasive ventilation and three thoracentesis procedures, plus the administration of albumin, colloid solutions and high-dose furosemid. Severe form of ovarian hyperstimulation syndrome is observed in 0.5-5% of the women treated, and intensive care may be required for management of thromboembolic complications, renal failure and severe respiratory failure. Pulmonary intensive care may involve thoracentesis, oxygen supplementation and, in more severe cases, assisted ventilation. To our knowledge, there have been only two studies in English language medical literature that describe severe respiratory failure treated with non

  9. Modified natural cycle versus controlled ovarian hyperstimulation IVF : a cost-effectiveness evaluation of three simulated treatment scenarios

    NARCIS (Netherlands)

    Groen, Henk; Tonch, Nino; Simons, Arnold H. M.; van der Veen, Fulco; Hoek, Annemieke; Land, Jolande A.

    2013-01-01

    STUDY QUESTION: Can modified natural cycle IVF or ICSI (MNC) be a cost-effective alternative for controlled ovarian hyperstimulation IVF or ICSI (COH)? SUMMARY ANSWER: The comparison of simulated scenarios indicates that a strategy of three to six cycles of MNC with minimized medication is a cost-ef

  10. Use of medroxyprogesterone acetate in women with ovarian endometriosis undergoing controlled ovarian hyperstimulation for in vitro fertilization.

    Science.gov (United States)

    Guo, Haiyan; Wang, Yun; Chen, Qiuju; Chai, Weiran; Sun, Lihua; Ai, Ai; Fu, Yonglun; Lyu, Qifeng; Kuang, Yanping

    2017-09-20

    This study investigated the use of medroxyprogesterone acetate (MPA) or a short protocol for controlled ovarian hyperstimulation (COH) in patients with advanced endometriosis who have normal ovarian function, and to compare cycle characteristics and pregnancy outcomes after frozen-thawed embryo transfer (FET). This was a retrospective case-control study of 244 patients with advanced endometriosis undering COH. The patients were allocated to three groups: the surgery group with MPA COH (62 patients, 71 IVF/ICSI cycles, 78 FET cycles); the aspiration group with MPA COH (85 patients had ovarian "chocolate" cysts (>3 cm) aspirated, 90 IVF/ICSI cycles, 76 FET cycles); and the short protocol group (97 patients, 101 IVF/ICSI cycles, 51 FET cycles). The results showed that higher rates of mature oocyte, D3 high quality embryo, hMG dose were observed in the two study groups using MPA compared with the short protocol. The number of >10-14 mm follicles on the trigger day, D3 top-quality embryos, viable embryos, rates of cancellation, fertilization, implantation, pregnancy outcomes were similar among the three groups. The oocytes, embryos, and pregnancy outcomes were not influenced by endometrioma surgery or presence of endometrioma. MPA COH could be effective for women with ovarian advanced endometriosis who had normal ovarian function.

  11. Follicular fluid lipid peroxidation levels in women with endometriosis during controlled ovarian hyperstimulation.

    Science.gov (United States)

    de Lima, Camila Bruna; Cordeiro, Fernanda Bertuccez; Camargo, Mariana; Zylbersztejn, Daniel Suslik; Cedenho, Agnaldo Pereira; Bertolla, Ricardo Pimenta; Lo Turco, Edson Guimarães

    2017-04-01

    This observational study aimed to establishing a relationship between lipid peroxidation and endometriosis in women undergoing controlled ovarian hyperstimulation. A total of 79 women were divided into two groups: (i) controls (tubal or male factor); and (ii) endometriosis (stages III/IV). The endometriosis diagnosis was confirmed by videolaparoscopy and the controlled ovarian stimulation protocol was similar to all patients. Follicular fluid (FF) lipid peroxidation levels were determined through the quantification of malondialdehyde. Statistical analysis was performed using parametric and non-parametric tests, logistic regression was performed to estimate the chance of achieving a pregnancy in each group and a moving average was calculated for the endometriosis group. Peroxidation levels in the endometriosis group were significantly higher when compared to controls. The moving average showed a decrease of MDA levels in the endometriosis group with increasing female age. Moreover, women with endometriosis who were under 33 years of age were 4.3 times more likely to achieve a pregnancy than women above that age. In conclusion, endometriosis is associated with increased FF oxidative stress (OS) in patients undergoing in vitro fertilization (IVF). Also, increasing age is associated with a decrease in severity of the oxidative status, but a decreased chance of pregnancy.

  12. Endometrial Mucin-1 and Pinopode in Peri-implantation Phase in Ovarian High Responders during Controlled Ovarian Hyperstimulation Cycles

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate effects of ovarian high response on endometrial mucin-1 (MUC1) and pinopode in peri-implantation phase in controlled ovarian hyperstimulation(COH)cycles.Methods Ovarian high response was deftned as serum E2>15 000 pmol/L on the day of hCG administration in COH cycle using GnRH agonist and recombinant FSH(n=8).Healthy and fertile women were used as the natural control (n=10).Endometrial biopsies were performed on the day of LH+7/hCG+7.Pinopode formation was observed by scanning electron microscope.Expression of MUC1 was detected with quantitative Real-time PCR and immunohistochemistry.Results In high response group,the lumen surface was covered with variant pinopodes and microvillous.The expression of MUC1 mRNA in high response group was lower than that in the natural control (P<0.05).Immunostaining for MUC1 protein in glandular and luminal epithelium in high response group was lower than that in the natural control (P<0.05).Conclusion Asynchronized pinopode appearance and lower expression of MUC1during peri-implantation period were the characteristics of endometrium in high response group,which may provide a clue of decreased endometrial receptivity in the supraphysiological hormone milieu.

  13. Pregnancy Rate after Controlled Ovarian Hyperstimulation and Intrauterine Insemination for the Treatment of Endometriosis following Surgery

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    Attila Keresztúri

    2015-01-01

    Full Text Available Objective. To compare pregnancy rate after controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI with no treatment in patients with endometriosis-associated infertility treated with laparoscopy. Design. A clinical cohort study. Setting. University-level tertiary care center. Patients. 238 women with various stages of endometriosis after laparoscopic treatment. Interventions. Either COH-IUI or follow-up for 12 months. Main Outcome Measures. The primary outcome measures were clinical pregnancy and live birth rate. Predictive factors evaluated were female age, maternal BMI, and duration of infertility. Results. The pregnancy rate attained after the integrated laparoscopy–COH-IUI approach was 53.4%, while it was significantly lower (38.5% in the control group. Similarly, a significant difference was observed in live births (48.3% versus 34.2%. Patients with severe endometriosis were less likely to achieve pregnancy (38% and live birth (35% than their counterparts with milder forms (57% and 53%. Conclusions. In patients with endometriosis-based infertility, surgery followed by COH-IUI is more effective than surgery alone.

  14. Investigating the association between polymorphism of follicle-stimulating hormone receptor gene and ovarian response in controlled ovarian hyperstimulation

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    Mohammad Hasan Sheikhha

    2011-01-01

    Full Text Available Aim : The aim of the study was to investigate the association between follicle-stimulating hormone receptor (FSHR gene polymorphism at Position 680 and the outcomes of controlled ovarian hyperstimulation for in vitro fertilization and embryo transfer (IVF-ET in infertile women. Materials and Methods : One hundred and eight patients under 35 years of age who underwent IVF-ET procedures were included in this study. The hormonal profile and treatment of all patients were analyzed and FSHR polymorphism was examined by polymerase chain reaction-restriction fragment length polymorphism. Women from all groups were classified based on polymorphisms at Position 680, occupied either by asparagines (Asn or serine (Ser as Asn/Asn, Asn/Ser, and Ser/Ser genotype. Result : Our study showed that all patients in the Asn/Asn group were normal responders and in the Asn/Ser group 64.8% were normal responders and 21.1% and 14.1% were poor and hyper responders respectively. In the Ser/Ser group we did not have normal responders and 46.7% of these patients were poor responders and 53.3% were hyper responders. Conclusion : FSH receptor polymorphism is correlated with response to ovarian stimulation.

  15. Thrombosis following ovarian hyperstimulation syndrome.

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    Kasum, Miro; Danolić, Damir; Orešković, Slavko; Ježek, Davor; Beketić-Orešković, Lidija; Pekez, Marijeta

    2014-11-01

    The aim of this review is to analyse the pathophysiology and complications of thrombosis in conjuction with ovarian hyperstimulation syndrome (OHSS) following ovulation induction and to suggest practical guidelines usefull for the prevention and treatment. Although the incidence of thrombosis varies from 0.2% among in vitro fertilization (IVF) cycles and up to 10% for severe cases of the syndrome, it represents the most dangerous complication of OHSS. Different changes in haemostatic markers have been found to create a state of hypercoagulability, but no single standard test is available to estimate the state of thrombosis. The role of markers for thrombophilia is controversial. Thromboses are mostly venous (67-75%) involving upper limbs and neck, then arterial (25-33%) which are mainly intracerebral. The predominant sites of venous thromboembolism in the upper part of the body may be explained by higher concentrations of estrogens drained through lymphatic ducts from ascites and by compression of rudimentary branchyal cysts. Once early diagnosis is established, it is crucial to use an anticoagulant treatment with heparin proceeded with thromboprophylaxis. However, identification of patients at risk and preventive measures of OHSS are the best means in reducing the risk of thrombosis after ovarian stimulation.

  16. Pleural effusion following ovarian hyperstimulation.

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    Junqueira, Jader Joel Machado; Bammann, Ricardo Helbert; Terra, Ricardo Mingarini; Castro, Ana Cristina P; Ishy, Augusto; Fernandez, Angelo

    2012-01-01

    Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that occurs in the luteal phase of an induced hormonal cycle. In most cases, the symptoms are self-limited and spontaneous regression occurs. However, severe cases are typically accompanied by acute respiratory distress. The objective of the present study was to describe the clinical presentation, treatment, and outcome of pleural effusion associated with OHSS in three patients undergoing in vitro fertilization. The patients ranged in age from 27 to 33 years. The onset of symptomatic pleural effusion (bilateral in all cases) occurred, on average, 43 days (range, 27-60 days) after initiation of hormone therapy for ovulation induction. All three patients required hospitalization for massive fluid resuscitation, and two required noninvasive mechanical ventilation. Although all three patients initially underwent thoracentesis, early recurrence of symptoms and pleural effusion prompted the use of drainage with a pigtail catheter. Despite the high output from the pleural drain (mean, 1,000 mL/day in the first week) and prolonged drainage (for 9-22 days), the outcomes were excellent: all three patients were discharged from hospital. Although pleural effusion secondary to OHSS is probably underdiagnosed, the associated morbidity should not be underestimated, especially because it affects potentially pregnant patients. In this study, early diagnosis and appropriate supportive measures yielded favorable results, limiting the surgical approach to adequate pleural drainage.

  17. Thoracic manifestations of ovarian hyperstimulation syndrome

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    Levin, M.F.; Hutton, L.C.; Kaplan, B.R. [University of Western Ontario, London, ON (Canada)

    1995-02-01

    In order to determine the thoracic manifestations of severe ovarian hyperstimulation syndrome, the medical records and available images of 771 patients who had received gonadotropins to induce superovulation, were reviewed. In 22 patients (3%) severe hyperstimulation syndrome was diagnosed clinically and confirmed with ultrasonography (US). Pleural effusion occurred in five of these (23%), one of whom required thoracentesis. Atelectasis and internal jugular vein thrombosis developed in one patient, and ventilation-perfusion mismatch occurred in another. The study concluded that respiratory distress in patients with ovarian hyperstimulation syndrome was most likely due to lung restriction. Pulmonary manifestations formed an important part of this syndrome, and radiologic input were considered necessary for assessment, monitoring and management. 10 refs., 2 figs., 1 tab.

  18. Effects of IL-6 on the development of zygote in mice after controlled ovarian hyperstimulation

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    Chun-hua WEI

    2016-04-01

    Full Text Available Objective  To study the effect of IL -6 on the development of zygotes of mice after controlled ovarian hyperstimulation. Methods  The present experiment included three parts: a Addition of IL-6: 80 female ICR mice were divided into 7 groups by random number table including 6 groups of superovulation (10 each and a group of natural ovulation cycle (n=20. According to addition of IL-6 in different concentration to culture media, the superovulated ICR mice were divided into superovulation control group (0pg/ml IL -6 group, 1pg/ml IL-6 group, 5pg/ml IL-6 group, 10pg/ml IL -6 group, 25pg/ml IL-6 group, and 50pg/ml IL-6 group, with ICR mice in natural ovulation cycle served as control. b Addition of IL-6 receptor antibody (RA: 90 female ICR mice were divided into 7 groups according to the random number table, including 5 groups of superovulation (10 each on the basis of addition of different concentrations IL-6 and IL-6 RA to culture media (0pg/ml IL-6+RA groups, 1pg/ml IL-6+RA group, 5pg/ml IL-6+RA group, 10pg/ml IL-6+RA group, 25pg/ml IL-6+RA group, and 2 groups of normal natural cycle (20 each, including control group and the control group+IL -6 RA (100pg/ml group. Mice in normal control group conceived naturally while those in superovulation group conceived after superovulation. The zygotes were collected and cultured in vitro for 1 day till the formation of 2-cell embryos, then the rate of 2-cell formation was observed under microscope. Experiments of each group were repeated three times. c Immunofluorescence identification: 10 female ICR mice were divided into control group and superovulation group (5 each by random number table method. The expressions of IL -6 in zygotes were determined with confocal immunofluorescence method. Results  IL-6 addition experiment: the rate of 2-cell formation was significantly lower (P<0.05 in superovulated control group, 1pg/ml IL -6, 25pg/ml IL -6 and 50pg/ml IL-6 groups than in control group (P=0.023, P=0

  19. Ovarian hyperstimulation syndrome in a spontaneous pregnancy ...

    African Journals Online (AJOL)

    Ovarian hyperstimulation syndrome in a spontaneous pregnancy with invasive mole: report of a case. ... Pan African Medical Journal ... in the case of multiple gestations, hypothyroidism or polycystic ovary syndrome. We report a case of severe OHSS in spontaneous pregnancy with invasive mole in a 34 years old woman.

  20. Ovarian Hyperstimulation Syndrome (OHSS) Presented as Massive Hydrothorax.

    Science.gov (United States)

    Saha, Pradip Kumar; Goel, Poonam; Tandon, Rimpy

    2013-12-01

    Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian stimulation. Although considered uncommon, the severe form is potentially fatal. Patient can present with varied clinical presentation like pain abdomen, abdominal distension or tachypnea. Diagnosis is made by careful history, examination and investigation. Treatment is conservative and supportive care. Here, we have presented a case of severe OHSS which was missed initially, as the doctor who had first seen probably was not aware of this disease.

  1. Differences in gene expression of granulosa cells from women undergoing controlled ovarian hyperstimulation with either recombinant follicle-stimulating hormone or highly purified human menopausal gonadotropin

    DEFF Research Database (Denmark)

    Grøndahl, Marie Louise; Borup, Rehannah; Lee, Young Bae

    2009-01-01

    OBJECTIVE: To investigate the differences in the gene expression profile of granulosa cells from preovulatory follicles after controlled ovarian hyperstimulation (COH) with recombinant follicle-stimulating hormone (FSH) or urinary human menopausal gonadotropin (hMG) FSH. DESIGN: Prospective rando...... be important for periovulatory events, which suggests that the preparation used for COH is important for granulosa cell function and may influence the developmental competence of the oocyte and the function of corpus luteum....

  2. [Effects of Kuntai Capsules on endometrial thickness and expressions of leukemia inhibitory factor and epidermal growth factor in mouse after controlled ovarian hyperstimulation].

    Science.gov (United States)

    Chu, Xiying; Song, Yuxia; Wan, Lijing; Tan, Li

    2014-08-05

    To explore the effects of Kuntai Capsules on endometrial thickness and the expressions of leukemia inhibitory factor (LIF) and epidermal growth factor (EGF) in mouse after controlled ovarian hyperstimulation. Healthy Sprague-Dawley mice were randomly allocated into 4 groups of control (group A), controlled ovarian hyperstimulation [COH (group B)], COH plus low-dose Kuntai Capsules (group C) and COH plus large-dose Kuntai Capsules [2x low-dose (group D)]. The controlled ovarian hyperstimulation model was established. The endometrial thickness was measured by computerized multi-functional image analyzer. And the expressions of LIF and EGF in proliferating endometrium were examined by immunohistochemistry. The endometrial thickness of groups C and D were higher than that of groups A and B. And there were significant differences (P Capsules can promote the growth of endometrium and enhance the expression levels of EGF and LIF in mice. And it may improve the ability of endometrial receptivity through optimized microenvironment. And a larger dose of Kuntai Capsules yields better outcomes.

  3. [Changes in preovulatory molecular relationship between estradiol and progesterone in patients undergoing controlled ovarian hyperstimulation. Can they be used for the evaluation of ovarian reserve?].

    Science.gov (United States)

    Kably Ambe, A; Barrón Vallejo, J; Fernández Castro, M; Karchmer Krivitzky, S

    2000-09-01

    The objective was to evaluate if the preovulatory molecular ratio between progesterone and estradiol has age-dependent changes in patients undergone controlled ovarian hyperstimulation. Were studied 180 cycles of conventional in vitro fertilization. Patients were divided in three groups: Group 1 (age less than 30 years; n = 40), group 2 (age between 30 and 35 years; n = 82), and group 3 (age between 36 and 40 years; n = 58). Leuprolide acetate was used in all cases. Molecular progesterone/estradiol ratio was calculate with the following formula: [Serum progesterone (ng/mL) x 3180 (SI x 10(3) divided by serum estradiol (pg/mL) x 3.671 (SI)]. In patients with age more than 38.5 years there was positive correlation between preovulatory progesterone and estradiol (R = 0.55, R2 = 0.30). There were significant difference in molecular progesterone/estradiol ratio between group 1 compared to group 2 (P less than 0.001), group 1 compared to group 3 (P less than 0.0001), as soon as group 1 compared to group 2 plus group 3 (P less than 0.0001). It is concluded that molecular progesterone/estradiol ratio decreases before any endocrino evidence of ovarian aging. The value of this putative test of ovarian reserve is discussed.

  4. Update on management of ovarian hyperstimulation syndrome

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    Chin-Der Chen

    2011-03-01

    Full Text Available Ovarian hyperstimulation syndrome (OHSS is a relatively common complication of ovarian stimulation and can be life threatening. The pathophysiology of OHSS is characterized by increased capillary permeability, leading to leakage of fluid from the vascular compartment, with third-space fluid accumulation and intravascular dehydration. The increased intra-abdominal pressure indicated that OHSS may be considered a compartment syndrome. Vascular endothelial growth factor, also known as vascular permeability factor, has emerged as one of the mediators intrinsic to the development of OHSS. Conventional management is focused on supportive care until the spontaneous resolution of the condition. The standard of care for treatment—monitoring of appropriate clinical parameters, fluid balance management, thrombosis prophylaxis, and ascites treatment—should prevent severe morbidity in most cases. This review will cover inpatient and outpatient management. The potential therapeutic approach targeting the vascular endothelial growth factor system will be discussed.

  5. Serum GDF-8 levels change dynamically during controlled ovarian hyperstimulation in patients undergoing IVF/ICSI-ET

    Science.gov (United States)

    Fang, Lanlan; Yu, Yiping; Zhang, Ruizhe; He, Jingyan; Sun, Ying-Pu

    2016-01-01

    Growth differentiation factor-8 (GDF-8) is found in the human serum, follicular fluid and granulosa cells. Our previous studies have shown that the human cumulus expansion and steroidogenesis can be regulated by GDF-8. However, thus far, the expression profile of GDF-8 in serum and whether the level of serum GDF-8 influences pregnancy results for patients treated with in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) is totally unknown. In this study, we showed that GDF-8 had a dynamic trend during controlled ovarian hyperstimulation (COH) procedure. On human chorionic gonadotropin (hCG) administration day, patients with a GDF-8 level higher than 4.7 ng/ml had lower progesterone levels and a higher pregnancy rate. From hCG day to oocyte pick-up day, patients with a GDF-8 decrease greater than 1.3 ng/ml had a higher progesterone increase and a higher pregnancy rate. Importantly, the levels of GDF-8 were negatively correlated with progesterone levels. Our findings provide evidences that GDF-8 plays an important role in ensuring successful pregnancy by regulating progesterone levels. PMID:27329327

  6. The prevention of ovarian hyperstimulation syndrome.

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    Corbett, Shannon; Shmorgun, Doron; Claman, Paul; Healey, Sarah; Gysler, Mathias

    2014-11-01

    Objectif : Passer en revue les aspects cliniques du syndrome d’hyperstimulation ovarienne et fournir des recommandations quant à sa prévention. Options : La mise en œuvre de mesures de prévention, la constatation précoce de la présence de ce syndrome et l’offre sans délai et systématique de soins de soutien nous aideront à éviter l’obtention de piètres issues. Issues : Établir des lignes directrices permettant d’orienter la prévention du syndrome d’hyperstimulation ovarienne, la constatation précoce de la présence du syndrome lorsque ce dernier se manifeste et l’offre de mesures de soutien appropriées dans le bon contexte. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans Medline, Embase et The Cochrane Library entre 2011 et 2013 au moyen d’un vocabulaire contrôlé (« ovarian hyperstimulation syndrome », « agonist IVF », « antagonist IVF », « metformin », « HCG », « gonadotropin », « coasting », « freeze all », « agonist trigger », « progesterone ») et de mots clés (« ovarian hyperstimulation syndrome », « ovarian stimulation », « gonadotropin », « human chorionic gonadotropin », « prevention ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais. Aucune restriction n’a été imposée en matière de date. Les recherches ont été mises à jour de façon régulière et ont été intégrées à la directive clinique jusqu’en février 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et

  7. Prevention of Ovarian Hyperstimulation Syndrome: A Review

    Directory of Open Access Journals (Sweden)

    Vinayak Smith

    2015-01-01

    Full Text Available The following review aims to examine the available evidence to guide best practice in preventing ovarian hyperstimulation syndrome (OHSS. As it stands, there is no single method to completely prevent OHSS. There seems to be a benefit, however, in categorizing women based on their risk of OHSS and individualizing treatments to curtail their chances of developing the syndrome. At present, both Anti-Müllerian Hormone and the antral follicle count seem to be promising in this regard. Both available and upcoming therapies are also reviewed to give a broad perspective to clinicians with regard to management options. At present, we recommend the use of a “step-up” regimen for ovulation induction, adjunct metformin utilization, utilizing a GnRH agonist as an ovulation trigger, and cabergoline usage. A summary of recommendations is also made available for ease of clinical application. In addition, areas for potential research are also identified where relevant.

  8. The impact of premature progesterone rise on the outcome of intrauterine insemination cycles with controlled ovarian hyperstimulation in unexplained infertility.

    Science.gov (United States)

    Mutlu, Mehmet Firat; Erdem, Mehmet; Erdem, Ahmet; Mutlu, Ilknur; Guler, Ismail; Demirdağ, Erhan

    2016-08-01

    To ascertain the incidence of premature progesterone P rise and its impact on outcomes in controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI) cycles, and also to identify variables related with premature P rise. Four hundred sixty cycles of 460 couples with unexplained infertility having COH-IUI treatment with a starting dose of 75IU recombinant FSH enrolled in this prospective study. Serum P levels were determined on the day of hCG trigger. Premature P rise was defined as progesterone ≥1ng/mL. The primary outcome measure was live birth per cycle with regard to P levels of ≥1ng/mL and ≥1.5ng/mL. Secondary outcome measures were cycle characteristics associated with P rise. The incidence of premature P rise was 22.0%. P levels on hCG day were significantly lower in cycles with live birth as compared to cycles without live birth 0.49±0.51 vs. 0.73±0.82ng/mL. Live birth rates were significantly lower in cycles with hCG day P levels ≥1.0ng/mL (%7.9 vs. %22.6) and ≥1.5ng/mL (%6.4 vs. %20.8). Among age, number of dominant follicles, estradiol, LH and P levels on the day of hCG trigger, it was found that P levels was the only significant variable to predict live birth on multivariate analysis. The number of dominant follicles on hCG day and premature LH surge were the only significant variables related with premature P rise. Premature P is a frequent feature of COH-IUI cycles and associated with decreased live birth rates. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Plasma inflammatory cytokines correlate to the ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Abramov, Y; Schenker, J G; Lewin, A; Friedler, S; Nisman, B; Barak, V

    1996-07-01

    The objective of this study was to follow the kinetics of four inflammatory cytokines in the plasma and ascitic fluid of seven patients who developed severe ovarian hyperstimulation syndrome (OHSS) after induction of ovulation for in-vitro fertilization. Blood samples were obtained from these patients at three different times: upon hospitalization; when significant clinical improvement was evident; and after complete resolution. Samples were analysed for interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor alpha (TNF-alpha). Ascitic fluid was obtained by therapeutic paracentesis from all study patients during the active phase and analysed for these cytokines. Two control groups were available: the first included 15 women undergoing controlled ovarian stimulation for in-vitro fertilization without developing OHSS, while the second consisted of 25 healthy women not undergoing ovulation induction or any other medical treatment. High concentrations of IL-1, IL-6 and TNF-alpha were detected in all individuals upon admission for severe OHSS. Concentrations dropped significantly along with clinical improvement, reaching normal values after complete resolution. A statistically significant correlation was found between plasma cytokine concentrations and certain biological characteristics of the syndrome such as leukocytosis, increased haematocrit, and elevated plasma 17-beta-oestradiol concentrations. Ascitic fluid obtained from the study patients contained high IL-6 and IL-8 concentrations, while other cytokines were unaltered. These results suggest close association between inflammatory cytokines and the pathophysiology of the ovarian hyperstimulation syndrome.

  10. Spontaneous ovarian hyperstimulation syndrome following a thawed embryo transfer cycle.

    Science.gov (United States)

    Kim, Mi Kyoung; Won, Hyung Jae; Shim, Sung Han; Cha, Dong Hyun; Yoon, Tae Ki

    2014-09-01

    This article reports a case of spontaneous ovarian hyperstimulation syndrome (OHSS) following a thawed embryo transfer cycle. OHSS, a potentially life-threatening condition, is an iatrogenic complication of controlled ovarian stimulation; therefore, it is very important to prevent and treat OHSS during treatment with ovulation-inducing agents. Despite our efforts to prevent OHSS, in this case, severe spontaneous OHSS occurred, which resulted in uncontrolled preterm labor and a preterm delivery and also persisted for 6 weeks after delivery. Freezing all embryos cannot entirely prevent the development of OHSS because OHSS can occur spontaneously. Although spontaneous OHSS remains a rare event, females with a history of OHSS may have an elevated risk for spontaneous OHSS. We suggest closely monitoring cases of pregnancy following thawed embryo transfer for early diagnosis of spontaneous OHSS and the use of conservative management.

  11. Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy

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    Creticus P. Marak

    2013-01-01

    Full Text Available Ovarian hyperstimulation syndrome (OHSS is an iatrogenic complication of controlled ovarian hyperstimulation (COH protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.

  12. Ovarian hyperstimulation syndrome as an etiology of obstructive uropathy.

    Science.gov (United States)

    Marak, Creticus P; Chopra, Amit; Alappan, Narendrakumar; Ponea, Ana M; Guddati, Achuta K

    2013-01-01

    Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF) secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.

  13. Modified natural cycle versus controlled ovarian hyperstimulation IVF: a cost-effectiveness evaluation of three simulated treatment scenarios.

    Science.gov (United States)

    Groen, Henk; Tonch, Nino; Simons, Arnold H M; van der Veen, Fulco; Hoek, Annemieke; Land, Jolande A

    2013-12-01

    Can modified natural cycle IVF or ICSI (MNC) be a cost-effective alternative for controlled ovarian hyperstimulation IVF or ICSI (COH)? The comparison of simulated scenarios indicates that a strategy of three to six cycles of MNC with minimized medication is a cost-effective alternative for one cycle of COH with strict application of single embryo transfer (SET). MNC is cheaper per cycle than COH but also less effective in terms of live birth rate (LBR). However, strict application of SET in COH cycles reduces effectiveness and up to three MNC cycles can be performed at the same costs as one COH cycle. The cost-effectiveness of MNC versus COH was evaluated in three simulated treatment scenarios: three cycles of MNC versus one cycle of COH with SET or double embryo transfer (DET) and subsequent transfer of cryopreserved embryos (Scenario 1); six cycles of MNC versus one cycle of COH with strictly SET and subsequent transfer of cryopreserved embryos (Scenario 2); six cycles of MNC with minimized medication (hCG ovulation trigger only) versus one cycle of COH with SET or DET and subsequent transfer of cryopreserved embryos (Scenario 3). We used baseline data obtained from two retrospective cohorts of consecutive patients (2005-2008) undergoing MNC in the University Medical Center Groningen (n = 499, maximum six cycles per patient) or their first COH cycle with subsequent transfer of cryopreserved embryos in the Academic Medical Center Amsterdam (n = 392). Data from 1994 MNC cycles (958 MNC-IVF and 1036 MNC-ICSI) and 392 fresh COH cycles (one per patient, 196 COH-IVF and 196 COH-ICSI) with subsequent transfer of cryopreserved embryos (n = 72 and n = 94 in MNC and COH cycles, respectively) in ovulatory, subfertile women cost-effectiveness ratio (ICER) was calculated, defined as the ratio of the difference in IVF costs up to 6 weeks postpartum to the difference in LBR. Live birth was the primary outcome measure and was defined as the birth of at least one living child

  14. PIVET rFSH dosing algorithms for individualized controlled ovarian stimulation enables optimized pregnancy productivity rates and avoidance of ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Yovich, John L; Alsbjerg, Birgit; Conceicao, Jason L; Hinchliffe, Peter M; Keane, Kevin N

    2016-01-01

    The first PIVET algorithm for individualized recombinant follicle stimulating hormone (rFSH) dosing in in vitro fertilization, reported in 2012, was based on age and antral follicle count grading with adjustments for anti-Müllerian hormone level, body mass index, day-2 FSH, and smoking history. In 2007, it was enabled by the introduction of a metered rFSH pen allowing small dosage increments of ~8.3 IU per click. In 2011, a second rFSH pen was introduced allowing more precise dosages of 12.5 IU per click, and both pens with their individual algorithms have been applied continuously at our clinic. The objective of this observational study was to validate the PIVET algorithms pertaining to the two rFSH pens with the aim of collecting ≤15 oocytes and minimizing the risk of ovarian hyperstimulation syndrome. The data set included 2,822 in vitro fertilization stimulations over a 6-year period until April 2014 applying either of the two individualized dosing algorithms and corresponding pens. The main outcome measures were mean oocytes retrieved and resultant embryos designated for transfer or cryopreservation permitted calculation of oocyte and embryo utilization rates. Ensuing pregnancies were tracked until live births, and live birth productivity rates embracing fresh and frozen transfers were calculated. Overall, the results showed that mean oocyte numbers were 10.0 for all women productivity rates exceeded 50% for women 15 oocytes, significantly lower than recently published data applying conventional dosages (38.2%; Pproducts, with very similar results, and they can be considered validated on the basis of effectiveness and safety, clearly avoiding ovarian hyperstimulation syndrome.

  15. The Utrogestan and hMG protocol in patients with polycystic ovarian syndrome undergoing controlled ovarian hyperstimulation during IVF/ICSI treatments.

    Science.gov (United States)

    Zhu, Xiuxian; Ye, Hongjuan; Fu, Yonglun

    2016-07-01

    Poor oocyte quality is a main concern for decreased reproductive outcomes in women with polycystic ovarian syndrome (PCOS) during controlled ovarian hyperstimulation (COH). A primary way to improve oocyte quality is to optimize the COH protocol. It was demonstrated that the viable embryo rate per oocyte retrieved in the Utrogestan and hMG protocol, a novel regimen based on frozen-thawed embryo transfer (FET), is statistically higher than that in the short protocol. Thus, a retrospective study was conducted to evaluate the endocrine characteristics and clinical outcomes in PCOS patients subjected to the Utrogestan and hMG protocol compared with those subjected to the short protocol.One hundred twenty three PCOS patients enrolled in the study group and were simultaneously administered Utrogestan and human menopausal gonadotropin (hMG) from cycle day 3 until the trigger day. When the dominant follicles matured, gonadotropin-releasing hormone agonist (GnRH-a) 0.1 mg was used as the trigger. A short protocol was applied in the control group including 77 PCOS women. Viable embryos were cryopreserved for later transfer in both groups. The primary outcome was the viable embryo rate per oocyte retrieved. The secondary outcomes included the number of oocytes retrieved, fertilization rate, and clinical pregnancy outcomes from FET cycles.The pituitary luteinizing hormone (LH) level was suppressed in most patients; however, the LH level in 13 women, whose basic LH level was more than 10 IU/L, surpassed 10 IU/L on menstruation cycle day (MC)9-11 and decreased subsequently. No significant between-group differences were observed in the number of oocytes retrieved (13.27 ± 7.46 vs 13.1 ± 7.98), number of viable embryos (5.57 ± 3.27 vs 5 ± 2.79), mature oocyte rate (90.14 ± 11.81% vs 93.02 ± 8.95%), and cleavage rate (97.69 ± 6.22% vs 95.89 ± 9.57%). The fertilization rate (76.11 ± 19.04% vs 69.34 ± 21.81%; P < 0

  16. Does ovarian hyperstimulation in intrauterine insemination for cervical factor subfertility improve pregnancy rates?

    NARCIS (Netherlands)

    Steures, P; van der Steeg, JW; Verhoeve, HR; van Dop, PA; Hompes, PGA; Bossuyt, PMM; van der Veen, F; Habbema, JDF; Eijkemans, MJC; Mol, BWJ

    2004-01-01

    BACKGROUND: Intrauterine insemination (IUI) can be performed with or without controlled ovarian hyperstimulation (COH). Studies in which the additional benefit of COH on IUI for cervical factor subfertility is assessed are lacking. We assessed whether COH in IUI improved pregnancy rates in cervical

  17. Does ovarian hyperstimulation in intrauterine insemination for cervical factor subfertility improve pregnancy rates?

    NARCIS (Netherlands)

    Steures, P; van der Steeg, JW; Verhoeve, HR; van Dop, PA; Hompes, PGA; Bossuyt, PMM; van der Veen, F; Habbema, JDF; Eijkemans, MJC; Mol, BWJ

    2004-01-01

    BACKGROUND: Intrauterine insemination (IUI) can be performed with or without controlled ovarian hyperstimulation (COH). Studies in which the additional benefit of COH on IUI for cervical factor subfertility is assessed are lacking. We assessed whether COH in IUI improved pregnancy rates in cervical

  18. Does ovarian hyperstimulation in intrauterine insemination for cervical factor subfertility improve pregnancy rates?

    NARCIS (Netherlands)

    P. Steures (Pieternel); J.W. van der Steeg (Jan Willem); H.R. Verhoeve (Harold); P.A. van Dop; P.G. Hompes (Peter); P.M.M. Bossuyt (Patrick); F. Veen (Fulco); J.D.F. Habbema (Dik); M.J.C. Eijkemans (René); B.W.J. Mol (Ben)

    2004-01-01

    textabstractBackground: Intrauterine insemination (IUI) can be performed with or without controlled ovarian hyperstimulation (COH). Studies in which the additional benefit of COH on IUI for cervical factor subfertility is assessed are lacking. We assessed whether COH in IUI improved pregnancy rates

  19. PIVET rFSH dosing algorithms for individualized controlled ovarian stimulation enables optimized pregnancy productivity rates and avoidance of ovarian hyperstimulation syndrome

    Directory of Open Access Journals (Sweden)

    Yovich JL

    2016-08-01

    Full Text Available John L Yovich,1,2,* Birgit Alsbjerg,3,4,* Jason L Conceicao,1 Peter M Hinchliffe,1 Kevin N Keane1,2,* 1PIVET Medical Centre, Perth, 2School of Biomedical Science, Curtin Health Innovation Research Institute Bioscience, Curtin University, Perth, WA, Australia; 3The Fertility Clinic, Skive Regional Hospital, Skive, 4Faculty of Health, Aarhus University, Aarhus, Denmark *These authors contributed equally to this work Abstract: The first PIVET algorithm for individualized recombinant follicle stimulating hormone (rFSH dosing in in vitro fertilization, reported in 2012, was based on age and antral follicle count grading with adjustments for anti-Müllerian hormone level, body mass index, day-2 FSH, and smoking history. In 2007, it was enabled by the introduction of a metered rFSH pen allowing small dosage increments of ~8.3 IU per click. In 2011, a second rFSH pen was introduced allowing more precise dosages of 12.5 IU per click, and both pens with their individual algorithms have been applied continuously at our clinic. The objective of this observational study was to validate the PIVET algorithms pertaining to the two rFSH pens with the aim of collecting ≤15 oocytes and minimizing the risk of ovarian hyperstimulation syndrome. The data set included 2,822 in vitro fertilization stimulations over a 6-year period until April 2014 applying either of the two individualized dosing algorithms and corresponding pens. The main outcome measures were mean oocytes retrieved and resultant embryos designated for transfer or cryopreservation permitted calculation of oocyte and embryo utilization rates. Ensuing pregnancies were tracked until live births, and live birth productivity rates embracing fresh and frozen transfers were calculated. Overall, the results showed that mean oocyte numbers were 10.0 for all women <40 years with 24% requiring rFSH dosages <150 IU. Applying both specific algorithms in our clinic meant that the starting dose was not altered for

  20. Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization.

    Science.gov (United States)

    Kuang, Yanping; Chen, Qiuju; Fu, Yonglun; Wang, Yun; Hong, Qingqing; Lyu, Qifeng; Ai, Ai; Shoham, Zeev

    2015-07-01

    To investigate the use of medroxyprogesterone acetate (MPA) to prevent LH surge during controlled ovarian hyperstimulation (COH) and to compare cycle characteristics and pregnancy outcomes in subsequently frozen-thawed ET (FET) cycles. A prospective controlled study. Tertiary-care academic medical center. Three hundred patients undergoing IVF/intracytoplasmic sperm injection treatment. In the study group, hMG and MPA were administered simultaneously beginning on cycle day 3. Ovulation was induced with a GnRH agonist or cotriggered by a GnRH agonist and hCG when dominant follicles matured. A short protocol was used in the control group. Viable embryos were cryopreserved for later transfer in both protocols. The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the number of mature oocytes, the incidence of premature LH surge, and clinical pregnancy outcomes from FETs. The number of oocytes retrieved in the study group was similar to those in the controls (9.9 ± 6.7 vs. 9.0 ± 6.0), and higher doses of hMG were administered. In the study group, LH suppression persisted during ovarian stimulation, and the incidence of premature LH surge was 0.7% (1/150). No statistically significant differences were found in the clinical pregnancy rates (47.8% vs. 43.3%), implantation rates (31.9% vs. 27.7%), and live-birth rates (42.6% vs. 35.5%) in the study group and controls. The results show that MPA is an effective oral alternative for the prevention of premature LH surge in woman undergoing COH. This finding will help establish a new regimen for ovarian stimulation in combination with embryo cryopreservation. ChiCTR-ONRC-14004419. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Cumulus cells gene expression profiling in terms of oocyte maturity in controlled ovarian hyperstimulation using GnRH agonist or GnRH antagonist.

    Directory of Open Access Journals (Sweden)

    Rok Devjak

    Full Text Available In in vitro fertilization (IVF cycles controlled ovarian hyperstimulation (COH is established by gonadotropins in combination with gonadotropin-releasing hormone (GnRH agonists or antagonists, to prevent premature luteinizing hormone (LH surge. The aim of our study was to improve the understanding of gene expression profile of cumulus cells (CC in terms of ovarian stimulation protocol and oocyte maturity. We applied Affymetrix gene expression profiling in CC of oocytes at different maturation stages using either GnRH agonists or GnRH antagonists. Two analyses were performed: the first involved CC of immature metaphase I (MI and mature metaphase II (MII oocytes where 359 genes were differentially expressed, and the second involved the two GnRH analogues where no differentially expressed genes were observed at the entire transcriptome level. A further analysis of 359 differentially genes was performed, focusing on anti-Müllerian hormone receptor 2 (AMHR2, follicle stimulating hormone receptor (FSHR, vascular endothelial growth factor C (VEGFC and serine protease inhibitor E2 (SERPINE2. Among other differentially expressed genes we observed a marked number of new genes connected to cell adhesion and neurotransmitters such as dopamine, glycine and γ-Aminobutyric acid (GABA. No differential expression in CC between the two GnRH analogues supports the findings of clinical studies where no significant difference in live birth rates between both GnRH analogues has been proven.

  2. Comparison of GnRH Agonist, GnRH Antagonist, and GnRH Antagonist Mild Protocol of Controlled Ovarian Hyperstimulation in Good Prognosis Patients

    Directory of Open Access Journals (Sweden)

    Martin Stimpfel

    2015-01-01

    Full Text Available The reports on how to stimulate the ovaries for oocyte retrieval in good prognosis patients are contradictory and often favor one type of controlled ovarian hyperstimulation (COH. For this reason, we retrospectively analyzed data from IVF/ICSI cycles carried out at our IVF Unit in good prognosis patients (aged <38 years, first and second attempts of IVF/ICSI, more than 3 oocytes retrieved to elucidate which type of COH is optimal at our condition. The included patients were undergoing COH using GnRH agonist, GnRH antagonist or GnRH antagonist mild protocol in combination with gonadotrophins. We found significant differences in the average number of retrieved oocytes, immature oocytes, fertilized oocytes, embryos, transferred embryos, embryos frozen per cycle, and cycles with embryo freezing between studied COH protocols. Although there were no differences in live birth rate (LBR, miscarriages, and ectopic pregnancies between compared protocols, pregnancy rate was significantly higher in GnRH antagonist mild protocol in comparison with both GnRH antagonist and GnRH agonist protocols and cumulative LBR per cycle was significantly higher in GnRH antagonist mild protocol in comparison to GnRH agonist protocol. Our data show that GnRH antagonist mild protocol of COH could be the best method of choice in good prognosis patients.

  3. Correlation of IL-1, IL-6, IL-10 Concentrations to Ovarian Hyperstimulation Syndrome and Effect of Intravenous Immunoglobulin on Ovarian Hyperstimulated Rats

    Institute of Scientific and Technical Information of China (English)

    Lei ZHANG; Jing-yong ZHOU

    2008-01-01

    Objective To investigate the correlation of interleukin(IL)-1,IL-6 and IL-10 concen-trations to ovarian hyperstimulation syndrome(OHSS) and whether intravenousimmunoglobulin(IVIG) has the effects on ovarian hyperstimulated rats. Methods Immature female Wistar rats were divided into control group,OHSS group (n=13)and IVIG group(n=13).For the latter two groups,pregnancy mare serum gonadotropin(PMSG)and human chorionic gonadotropin(hCG)were given to induce OHSS,and rats in IVIG group were treated with immunoglobulin.Forty—eight hours after administration of hCG,capillary permeability was evaluated from the Evans blue dye(EB) concentration in the ovaries and the EB concentration in peritoneal irrigated fluid at 30 min after the intravenous injection of EB.Rats’blood samples and ovaries were obtained to be measured for IL-1,IL-6 and IL-10 by ELISA.Results In OHSS group,total weights of bilateral ovaries and the ovarian EB concen—tration were significantly higher than those in others(P<0.05).Both serum and ovarian concentrations of IL-1 were significantly higher in OHSS and IVIG groups than those in control group (P<0.05).The ovarian concentrations of IL-6 and IL-10 in IVIG group were significantly lower than those in control group(P<0.05).Furthermore,the ovarian IL-10 concentration in IVIG group was significantly lower than that in OHSS group(P<0.05). Conclusion Inflammation involved IL-1 in OHSS rats plays an important role.Vascular permeability was mostly increased in ovaries of hyperstimulated rats.It appears that ovaries of OHSS rats may be the primary places of inflammation.IVIG treatment resulted in statistically significant reductions in ovaries’weights and ovarian vascular permeability of OHSS rats,with a decreased level of ovarian IL-10.It implys that IVIG have a beneficial effect in reducing the severity of OHSS in the experimental model maybe by restrainning IL-10.

  4. Evaluating Thrombophilia in Severe Ovarian Hyperstimulation Syndrome

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    A Alleyassin

    2012-04-01

    Full Text Available Background: Ovarian hyper stimulation syndrome (OHSS and its consequences, especially thromboembolic events, are of the most dangerous complications of assisted reproductive technologies (ART. It is unclear whether a thrombophilic predisposition or changes in blood components during clinical presentation of OHSS increase thrombotic risks. Testing for certain thrombophilias in selected high risk patients may help risk assessment and decision-making about prophylactic measures.Methods: In this study carried out in April 2010 to March 2011, 108 in vitro fertilization candidates with ≥20 follicles following ovarian stimulation were recruited. Protein S, protein C, antithrombin, lupus anticoagulant and anticardiolipin antibodies were measured. Blood tests were compared between severe and non-severe OHSS groups and their changes were traced after onset of clinical OHSS in 43 patients presenting with severe symptoms by repeating the tests at hospital admission.Results: Mean protein S activity was lower in severe OHSS group (101.7±16.3 vs. 118.4±17.0; P<0.001. After clinical presentation of severe OHSS, this level decreased to 91.6±20.1 (P<0.001. Antithrombin levels decreased 2.09% after the onset of symptoms in the group with severe OHSS, but this difference was not statistically significant (P=0.051. Protein C, lupus anticoagulant and anticardiolipin antibodies were not correlated to severe OHSS development.Conclusion: Patients with relatively lower protein S activity were at higher risk for the development of severe OHSS, and its dangerous consequences. During clinical OHSS presentation, protein S decreased even more, and patients were more vulnerable to hypercoagulability states. These points should be kept in mind in risk assessment and adoption of prophylactic strategies.

  5. [Changes in blood pressure and heart rate by an increase in serum estradiol in women undergoing controlled ovarian hyperstimulation].

    Science.gov (United States)

    Tomczy, Rita; Paluch, Katarzyna; Gałuszka-Bednarczyk, Anna; Milewicz, Tomasz; Janeczko, Jarosław; Klocek, Marek

    2015-01-01

    The aim of the study was to evaluate changes in blood pressure and heart rate in women undergoing controlled ovarian stimulation (COH) in preparation for assisted reproduction techniques. Material and method: The comparison of blood pressure and heart rate measurements obtained from 5 women (age 35.3 +/- 9.4 years) was performed. The data were collected during the 24-hour ambulatory blood pressure monitoring (ABPM) using Holcard sphygmomanometer CR-07 Aspel S.A. at the beginning and in the last day of short protocol of COH with the use of triptorelin (Decapeptyl 0.1 mg/day--Ferring GmbH) and the total supply of Gonalu F 225 U/day--Merck Serono) and Menotropiny 75j FSH + LH 75 U/day (Merional Imed/lBSA). During COH the increase in the serum estradiol level was detected (54.03 +/- 9.4 pg/ml at baseline vs. 1128.7 +/- 208.6 pg/ml after COH, p heart rate (HR) was measured (in overall ABPM statistics: baseline HR 68.5 +/- 12.8/min vs. 73.6 +/- 13.7/ min after COH, pheart rate and reduction in mean arterial pressure measured by oscillometric method. However, short-term increase in serum estradiol during COH is not associated with significant changes in systolic and diastolic blood pressure in women preparing for the in vitro procedure.

  6. The non-ergot derived dopamine agonist quinagolide in prevention of early ovarian hyperstimulation syndrome in IVF patients: a randomized, double-blind, placebo-controlled trial†

    Science.gov (United States)

    Busso, Cristiano; Fernández-Sánchez, Manuel; García-Velasco, Juan Antonio; Landeras, José; Ballesteros, Augustín; Muñoz, Elkin; González, Sandra; Simón, Carlos; Arce, Joan-Carles; Pellicer, Antonio

    2010-01-01

    BACKGROUND Ovarian hyperstimulation syndrome (OHSS) seems to be induced by the ovarian release of vascular endothelial growth factor (VEGF), which increases vascular permeability. Dopamine agonists inhibit VEGF receptor phosphorylation and thereby decrease vascular permeability. METHODS A randomized, double-blind, placebo-controlled, multicentre study assessing three oral doses (50, 100, 200 µg/day) of the non-ergot derived dopamine agonist quinagolide started on the day of human chorionic gonadotrophin (hCG) and continued for 17–21 days without dose-titration in comparison to placebo in preventing moderate/severe early OHSS (onset ≤9 days after hCG administration) in 182 IVF patients with ≥20 but less than 30 follicles ≥10 mm. RESULTS The incidence of moderate/severe early OHSS was 23% (12/53) in the placebo group and 12% (6/51), 13% (7/52) and 4% (1/26) in the quinagolide 50, 100 and 200 µg/day groups, respectively. The moderate/severe early OHSS rate was significantly lower with all quinagolide groups combined compared with placebo [P = 0.019; OR = 0.28 (0.09–0.81)]. The incidence of ultrasound evidence of ascites among patients with no clinical pregnancy was significantly reduced from 31% (8/26) with placebo to 11% (8/70) with all quinagolide groups combined [P = 0.033; OR = 0.29 (0.10–0.88)], although there was no difference for those with clinical pregnancy. Quinagolide did not have a detrimental effect on pregnancy or live birth rates. The incidence of gastrointestinal and central nervous system adverse events increased with increasing doses of quinagolide. CONCLUSIONS Quinagolide appears to prevent moderate/severe early OHSS while not affecting treatment outcome. The effect is more marked in patients who did not achieve a clinical pregnancy. Quinagolide administered in high doses without dose-titration is associated with poor tolerability. ClinicalTrials.gov Identifier: NCT00329693. PMID:20139430

  7. Spontaneous ovarian hyperstimulation syndrome with primary hypothyroidism: Imaging a rare entity

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    Subramanian Ilanchezhian, MBBS, MD

    2015-01-01

    Full Text Available Ovarian hyperstimulation syndrome is a disorder associated with ovulation induction and is rarely seen in pregnant women. Very few cases of spontaneous ovarian hyperstimulation syndrome have been reported in a woman who is neither pregnant nor undergoing ovulation therapy. This case report describes how spontaneous ovarian hyperstimulation syndrome is associated with primary hypothyroidism in a 25-year-old, nonpregnant woman who is not on ovulation induction therapy. Imaging and laboratory findings confirmed the diagnosis of this rare entity, which aided the clinicians in providing prompt management and in preventing further complications.

  8. Severe ovarian hyperstimulation syndrome: Intensive care management of two cases

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    Praveen Talawar

    2011-01-01

    Full Text Available Severe ovarian hyperstimulation syndrome (OHSS is characterized by increased capillary permeability and fluid retention in the third space. It is generally a complication of assisted reproduction therapy (ART with exogenous gonadotropins, but cases with natural onset of OHSS have been reported. The massive extravascular exudation can cause tense ascites, pleural and pericardial effusion, hypovolemic shock, oliguria, electrolyte imbalance (hyponatremia and hyperkalemia, and hemoconcentration, with a tendency for hypercoagulability and risk of life-threatening thromboembolic complications. The patient can rarely develop multi-organ failure (adult respiratory distress syndrome, renal failure and death. With increasing use of ART, this syndrome may be seen more frequently in the intensive care unit (ICU, requiring multidisciplinary care. We report the management of two cases of severe OHSS, which required admission to the ICU in our hospital.

  9. Effect of oral contraceptive pills dose on controlled ovarian hyperstimulation%口服避孕药用量对超促排卵的影响

    Institute of Scientific and Technical Information of China (English)

    李豫峰; 王玲; 熊露; 赖巧红; 饶群; 章汉旺; 刘玉芹

    2011-01-01

    目的:探讨超促排卵长方案中,采用口服避孕药联合促性腺激素释放激素激动剂双降调在体外受精-胚胎移植中的应用价值.方法:共收集397例月经规律患者行体外受精-胚胎移植,均采用长方案超促排卵,降调节均为达菲林0.1 mg隔日皮下注射共7支;其中未服用妈寓隆组25例(Ⅰ组),于月经第19天直接降调;常规服用妈富隆组194例(Ⅱ组),于月经第3天起服用妈富隆,1次/日,共21片,于月经第19天降调;加用剂量组(Ⅲ组)178例于月经第3天起服用妈富隆,1次/日,服用22~63片,其中服用2个周期(42片)及3个周期(63片)有9例,于月经第19~21天降调.结果:降调后E、LH水平用药组较未用药组低,LH水平加大剂量组较常规用药纽激素水平更低;而优势卵泡数未用药组较加大剂量组高;降调天数、获卵数、GN用量、HCG日内膜厚度、可用胚胎数、妊娠率、受精率、OHSS发生率无统计学差异.结论:①在体外受精一胚胎移植长方案中,对于月经规律患者应用口服避孕药可以更有效抑制激素水平,达到充分降调节,不影响内膜厚度、获卵数、妊娠率等,建议应用口服避孕药;②口服避孕药用量越大,降调后激素水平越低,优势卵泡数减少,建议应用1个周期的口服避孕药,不推荐门服避孕药长时间应用.%Objective: To explore the application value of oral contraceptive pills (OCPs) combined with gonadotrophin releasing hormone agonist ( GnRH - a) in dual suppression of in vitro fertilization - embryo transplantation ( IVF - ET) in long protocol of controlled ovarian hyperstimulation.Methods: 397 cases with regular menstruation received IVF - ET ( long protocol of controlled ovarian hyperstimulation), 0.1 mg Diphereline was injected subcutaneously every two days for 7 times; 25 cases did not take Marvelon ( group Ⅰ ), down - regulation was performed on the nineteenth day of menstruation; 194 cases took Marvelon

  10. Spontaneous Ovarian Hyperstimulation Syndrome in a Term Pregnancy

    Directory of Open Access Journals (Sweden)

    Aytekin Tokmak

    2015-09-01

    Full Text Available Spontaneous OHSS in a term pregnancy is extremely rare. The aim of this study is to present a case of spontaneous ovarian hyperstimulation syndrome (OHSS in a term pregnancy. A 29-year-old primigravida woman conceived spontaneously and was observed up until 35 weeks of gestation. During this time the patient had a normal pregnancy with normal ovaries. She applied to the current clinic during the 37th week of gestation with complaints of rapid weight gain, abdominal disturbance, and pain. Ultrasound examination showed large bilateral ovaries with multiple follicles and mild ascites. At 39 weeks of gestation, the ovaries were the same as detected previously, and a caesarean section was performed due to fetal macrosomia. A healthy female foetus weighing 4060 gr was delivered. The enlarged bilateral ovaries containing multiple follicles were drilled with electrocautery. The ovaries returned to a near normal state for two weeks after the birth. There are no reported cases of spontaneous OHSS in late pregnancy in the literature. Ovarian drilling may be useful during caesarean section. [Cukurova Med J 2015; 40(3.000: 623-626

  11. Miscarriage risk for IVF pregnancies in poor responders to ovarian hyperstimulation.

    NARCIS (Netherlands)

    Haadsma, M.L.; Groen, H.; Mooij, T.M.; Burger, C.W.; Broekmans, F.J.; Lambalk, C.B.; Leeuwen, F.E. van; Hoek, A.

    2010-01-01

    The increasing miscarriage rate with advancing female age is attributed to a decline in oocyte quality. A poor response to ovarian hyperstimulation is often an expression of a decrease in oocyte quantity. Although oocyte quality and quantity both decrease as a result of ovarian ageing, it is unclear

  12. Miscarriage risk for IVF pregnancies in poor responders to ovarian hyperstimulation

    NARCIS (Netherlands)

    Haadsma, Maaike L.; Groen, Henk; Mooij, Thea M.; Burger, Curt W.; Broekmans, Frank J. M.; Lambalk, Cornelis B.; van Leeuwen, Flora E.; Hoek, Annemiek

    2010-01-01

    The increasing miscarriage rate with advancing female age is attributed to a decline in oocyte quality. A poor response to ovarian hyperstimulation is often an expression of a decrease in oocyte quantity. Although oocyte quality and quantity both decrease as a result of ovarian ageing, it is unclear

  13. The addition of GnRH antagonists in intrauterine insemination cycles with mild ovarian hyperstimulation does not increase live birth rates-a randomized, double-blinded, placebo-controlled trial

    NARCIS (Netherlands)

    Cantineau, A. E. P.; Cohlen, B. J.; Klip, H.; Heineman, M. J.; Hoek, Annemieke

    2011-01-01

    BACKGROUND: This multicenter, double-blinded RCT investigated the efficacy of GnRH antagonists in cycles with mild ovarian hyperstimulation (MOH) followed by IUI in subfertile women. METHODS: Couples diagnosed with unexplained, male factor subfertility or associated with the presence of minimal or m

  14. Clinical analyses for 93 cycles of moderate and severe ovarian hyperstimulation syndrome

    Institute of Scientific and Technical Information of China (English)

    Fan Yan-hong; Chen Gui-an; Chen Xin-na; Zhang Li-zhu; Ma Cai-hong; Liu Ping; Qiao Jie

    2004-01-01

    Objective:To investigate the high risk factors and methods of prevention and treatment of ovarian hyperstimulation syndrome (OHSS) in assisted reproductive techniques (ART).Methods: Clinical data of 93 cycles of OHSS patients after IVF-ET treatment from Apr. 1989to Oct. 2002 were analyzed retrospectively.Results: (1) A large number of follicles stimulated, luteal phase support with HCG and pregnancy were high risk factors to induce OHSS. (2) Longer disease process, more severe symptoms and more albumins used for treatment of OHSS were commonoy observed in pregnant patients with OHSS compared with non-pregnant ones. (3) Vena dropping human serum albumin is one of the most successful treatment as plasma expanders through restoration of colloid osmotic pressure; paracentesis is necessary for critical OHSS patients with severe ascites and hydrothorax;(4) Occasionally therapeutic abortion of an early gestation may be an only way for lifesaving when all other methods have failed.Conclusions: OHSS is a serious complication of controlled ovarian hyperstimulation. Proper prevention and treatment of OHSS are important for patient safety in ART.

  15. Urinary hMG versus recombinant FSH for controlled ovarian hyperstimulation following an agonist long down-regulation protocol in IVF or ICSI treatment: a systematic review and meta-analysis.

    Science.gov (United States)

    Coomarasamy, Arri; Afnan, Masoud; Cheema, Deepti; van der Veen, Fulco; Bossuyt, Patrick M M; van Wely, Madelon

    2008-02-01

    Since the most recent Cochrane review on hMG versus rFSH for controlled ovarian hyperstimulation following a long down-regulation protocol, several new trials have emerged. We conducted a systematic review and meta-analysis of randomized trials comparing the effectiveness of hMG versus rFSH following a long down-regulation protocol in IVF-ICSI cycles, on the primary outcome of live birth per woman randomized, as well as several other secondary outcomes. Searches were conducted in MEDLINE, EMBASE, Science Direct, Cochrane Library and databases of abstracts (last search January 2007). Seven randomized trials, consisting of a total of 2159 randomized women, were identified. A meta-analysis of these trials showed a significant increase in live birth rate with hMG when compared with rFSH (relative risk, RR = 1.18, 95% CI: 1.02-1.38, P = 0.03). The heterogeneity test was non-significant (P = 0.97), suggesting that there was no statistical inconsistency between the seven studies. The pooled risk difference (RD) for the outcome of live birth rate was 4% (95% CI: 1-7%) for these study populations. There was an increase in clinical pregnancy rates with hMG when compared with rFSH (RR = 1.17, 95% CI 1.03-1.34). No significant differences were noted for gonadotrophin use, spontaneous abortion, multiple pregnancy, cancellation and ovarian hyperstimulation syndrome rates. For the populations in the randomized trials, hMG was associated with a pooled 4% increase in live birth rate when compared with rFSH in IVF-ICSI treatment following a long down-regulation protocol.

  16. GnRH Analogues in the Prevention of Ovarian Hyperstimulation Syndrome

    Science.gov (United States)

    Alama, Pilar; Bellver, Jose; Vidal, Carmen; Giles, Juan

    2013-01-01

    The GnRH analogue (agonist and antagonist GnRH) changed ovarian stimulation. On the one hand, it improved chances of pregnancy to obtain more oocytes and better embryos. This leads to an ovarian hyper-response, which can be complicated by the ovarian hyperstimulation syndrome (OHSS). On the other hand, the GnRH analogue can prevent the incidence of OHSS: GnRH antagonist protocols, GnRH agonist for triggering final oocyte maturation, either together or separately, coasting, and the GnRH analogue may prove useful for avoiding OHSS in high-risk patients. We review these topics in this article. PMID:23825982

  17. The Effectiveness of Cabergoline for the Prevention of Ovarian Hyperstimulation Syndrome

    Directory of Open Access Journals (Sweden)

    Marzieh Agha Hosseini

    2011-09-01

    Full Text Available Type 2 receptors for vascular endothelial growth factor are believed to be involved in the pathophysiology of ovarian hyperstimulation syndrome (OHSS. The objective of this study was to examine the preventive effects of cabergoline on OHSS and its complications. The study is a non randomized clinical trial conducted in 2006-2008 on 75 patients, which were at risk of OHSS and underwent assisted reproductive techniques. The diagnosis and severity of OHSS were determined using standard criteria. The study included an intervention and a control group. The intervention group comprised of 50 women at risk of OHSS, who were treated with cabergoline (1 mg every other day for 8 days commencing from the day of ovum pick up. The control group comprised of 25 historical cases, which were similar to the case group. The latter group did not receive cabergoline, and their OHSS, if occurred, were managed conservatively after hospital admission. The rates of OHSS, baseline characteristics, ovarian stimulation parameters, and pregnancy occurrence were compared. There was no significant difference between baseline characteristics or ovarian stimulation parameters form the two groups. The incidence of OHSS in the cabergoline-treated group, was significantly (P=0.01 lower than that in the control group (12% vs 36%. Embryo freezing was significantly (P=0.001 lower in the control group, but cycle cancellation was significantly (0.03 lower in the cabergoline group. The findings of the study indicate that cabergoline reduces the incidence of OHSS, and is not associated with adverse effects on pregnancy

  18. Differential Diagnosis of a Severe Late Onset Ovarian Hyperstimulation Syndrome Associated with Prolonged Ascites Production – a Case Report

    Directory of Open Access Journals (Sweden)

    Ujvari E

    2005-01-01

    Full Text Available Capsule: A case of severe late onset ovarian hyperstimulation syndrome (OHSS with prolonged ascites production. Difficulties of differential diagnosis and management. Objective: This report describes a case of extremely prolonged, severe ovarian hyperstimulation syndrome. Results: 17 litres of ascites have been removed from the abdominal cavity by repeated paracenteses until the 25th week of pregnancy, which progressed after the complete resolution of symptoms to the 34th week, when cesarean section was done. Conclusion: Severe ovarian hyperstimulation syndrome can occasionally follow an unusually prolonged course. Chronic formation of abundant ascites, the presence of ovarian enlargement and elevated levels of certain tumour markers might raise the probability of ovarian cancer. Adequate differential diagnosis and management resulted in delivery of a healthy newborn.

  19. Does ovarian hyperstimulation in intrauterine insemination for cervical factor subfertility improve pregnancy rates?

    Science.gov (United States)

    Steures, Pieternel; van der Steeg, Jan Willem; Verhoeve, Harold R; van Dop, Peter A; Hompes, Peter G A; Bossuyt, Patrick M M; van der Veen, Fulco; Habbema, J Dik F; Eijkemans, Marinus J C; Mol, Ben W J

    2004-10-01

    Intrauterine insemination (IUI) can be performed with or without controlled ovarian hyperstimulation (COH). Studies in which the additional benefit of COH on IUI for cervical factor subfertility is assessed are lacking. We assessed whether COH in IUI improved pregnancy rates in cervical factor subfertility. We performed a historical cohort study among couples with cervical factor subfertility, treated with IUI. A cervical factor was diagnosed by a well-timed, non-progressive post-coital test with normal semen parameters. We compared ongoing pregnancy rate per cycle in groups treated with IUI with or without COH. We tabulated ongoing pregnancy rates per cycle number and compared the effectiveness of COH by stratified univariable analysis. We included 181 couples who underwent 330 cycles without COH and 417 cycles with COH. Ongoing pregnancy rates in IUI cycles without and with COH were 9.7% and 12.7%, respectively (odds ratio 1.4; 95% confidence interval 0.85-2.2). The pregnancy rates in IUI without COH in cycles 1, 2, 3 and 4 were 14%, 11%, 6% and 15%, respectively. For IUI with COH, these rates were 17%, 15%, 14% and 16%, respectively. Although our data indicate that COH improves the pregnancy rate over IUI without COH, IUI without COH generates acceptable pregnancy rates in couples with cervical factor subfertility. Since IUI without COH bears no increased risk for multiple pregnancy, this treatment should be seriously considered in couples with cervical factor subfertility.

  20. The pathophysiology of ovarian hyperstimulation syndrome: an unrecognized compartment syndrome

    Science.gov (United States)

    Grossman, Lisa C.; Michalakis, Konstantinos G.; Browne, Hyacinth; Payson, Mark D.; Segars, James H.

    2011-01-01

    Objective To compare and contrast the pathophysiology of ovarian hyperstimualtion syndrome (OHSS) with known syndromes of increased intraabdominal pressure (IAP), and to explore the relationship of increased IAP with symptom severity in OHSS. Design Literature review. Main Outcome Measure(s) Correlation of OHSS symptoms with IAP; effects of paracentesis on IAP in patients with OHSS. Setting Academic Research Institution. Intervention(s) None. Result(s) OHSS involves a rapid accumulation of volume (from 1.5–17 liters) in the peritoneal cavity that can lead to organ dysfunction, including respiratory impairment and oliguria. In published reports of 20 moderate-to-severe OHSS patients in whom IAP was measured, IAP was found to be elevated to a pathologic range. The increased IAP indicates that OHSS may be considered a compartment syndrome and meets criteria for abdominal compartment syndrome in advanced cases. For this reason, management of OHSS should include reduction of pressure by paracentesis to avoid morbidity and syndrome progression. In addition, measurement of IAP may help to classify the stage of OHSS. Conclusion(s) IAP was found to be elevated in the few cases of OHSS in which it was measured, substantiating the conclusion that OHSS may be considered a compartment syndrome. An understanding of the pathophysiology of increased intrabdominal pressure is useful in the management of OHSS. PMID:19836016

  1. 控制性超促排卵中人绒毛膜促性腺激素最佳扳机时间的探讨%Best Time of Human Chorionic Gonadotropin to Trigger Ovulation in Controlled Ovarian Hyperstimulation

    Institute of Scientific and Technical Information of China (English)

    蔡素芬; 张顺吉; 龚斐

    2012-01-01

    本文综合分析了hCG注射日LH、E2、P、E2/P水平,及hCG注射日卵泡大小、每卵泡血清E2水平等各因素与hCG注射时机的相互关系,并指出hCG扳机时机需在卵泡大小达到一定程度,大卵泡达到一定比例,每卵泡E2水平达到200~350 pg/ml之间时,兼顾各激素水平及内膜情况进行综合考虑.%There were two important elements in in vitro fertilization and embryo transplantation (IVF-ET). One is to obtain a synchronous mature egg of high quality which can develop into a plantation potencial embryo after fertilization; the other is a synchronous developped endometrium which allows the embryo implantation. And how to choose the appropriate hCG time to trigger ovulation is crucial to affect above two factors. hCG can stimulate the luteinizing hormone (LH) surge, which has the effect on evoke follicle maturation, ovulation, and corpus luteum funcion. Therefore, hCG injection has become a indispensable part in controlled ovarian hyperstimulation (COH). If the injection of hCG is too earlier, the cumulus cells are too small and attach follicle wall tightly, which will influence the oocyte recovery, and most of collected oocytes may be immatured which will result in low fertilization rate. If hCG injection is too late, endogenous LH surge will occur and make early recovery of oocytes mitosis, so that the oocytes will miss the best time of fertilization, cleavage and implantation after oocyte retrival. Now the studies focus on the best time of hCG injection, and there are no uniform standards in the whole world. Our study reviewed papers of hCG injection and summarize the related factors.

  2. The Groningen ART cohort study : ovarian hyperstimulation and the in vitro procedure do not affect neurological outcome in infancy

    NARCIS (Netherlands)

    Middelburg, K. J.; Heineman, M. J.; Bos, A. F.; Pereboom, M.; Fidler, V.; Hadders-Algra, M.

    2009-01-01

    Due to the growing number of children born following assisted reproduction technology, even subtle changes in the children's health and development are of importance to society at large. The aim of the present study was to evaluate the specific effects of ovarian hyperstimulation and the in vitro pr

  3. Is ovarian hyperstimulation associated with higher blood pressure in 4-year-old IVF offspring? Part I : multivariable regression analysis

    NARCIS (Netherlands)

    Seggers, Jorien; Haadsma, Maaike L.; La Bastide-Van Gemert, Sacha; Heineman, Maas Jan; Middelburg, Karin J.; Roseboom, Tessa J.; Schendelaar, Pamela; Van den Heuvel, Edwin R.; Hadders-Algra, Mijna

    2014-01-01

    STUDY QUESTION: Does ovarian hyperstimulation, the in vitro procedure, or a combination of these two negatively influence blood pressure (BP) and anthropometrics of 4-year-old children born following IVF? SUMMARY ANSWER: Higher systolic blood pressure (SBP) percentiles were found in 4-year-old child

  4. The Groningen ART cohort study : ovarian hyperstimulation and the in vitro procedure do not affect neurological outcome in infancy

    NARCIS (Netherlands)

    Middelburg, K. J.; Heineman, M. J.; Bos, A. F.; Pereboom, M.; Fidler, V.; Hadders-Algra, M.

    2009-01-01

    Due to the growing number of children born following assisted reproduction technology, even subtle changes in the children's health and development are of importance to society at large. The aim of the present study was to evaluate the specific effects of ovarian hyperstimulation and the in vitro

  5. Is ovarian hyperstimulation associated with higher blood pressure in 4-year-old IVF offspring? Part I : multivariable regression analysis

    NARCIS (Netherlands)

    Seggers, Jorien; Haadsma, Maaike L.; La Bastide-Van Gemert, Sacha; Heineman, Maas Jan; Middelburg, Karin J.; Roseboom, Tessa J.; Schendelaar, Pamela; Van den Heuvel, Edwin R.; Hadders-Algra, Mijna

    STUDY QUESTION: Does ovarian hyperstimulation, the in vitro procedure, or a combination of these two negatively influence blood pressure (BP) and anthropometrics of 4-year-old children born following IVF? SUMMARY ANSWER: Higher systolic blood pressure (SBP) percentiles were found in 4-year-old

  6. Herbal Medicines and Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study

    Science.gov (United States)

    Rasekhjahromi, Athar; Alipour, Farzaneh; Maalhagh, Mehrnoosh; Sobhanian, Saeed

    2016-01-01

    Background. The aim of this study was to assess the association between herbal medication and OHSS. Methods. This retrospective cohort study was conducted with 101 polycystic ovary syndrome patients. 66 patients took conventional pharmacological medications and 35 took herbal medications. Data were analyzed by statistical test including Fisher's Exact and binominal logistic regression. P < 0.05 was considered significant. Results. Of the 101 females, 53 were married and 48 were single. There was no significant association between the groups in marriage. No significant association was found in mean age between the two groups (23.9 ± 5.8 years in the control group versus 26.3 ± 6.7 years in the case group). There was a significant difference between the two groups .After adding the dependent (OHSS prevalence) and independent (marriage and group) variables into the model, the Hosmer-Lemeshow test showed suitability. Variances analyzed with this model ranged between 29.4% and 40.7%. Conclusion. The indiscriminate use of herbs is correlated with OHSS. Because patients increasingly consume herbs, they should be aware of potential side effects. However, appropriate dosages of herbs could be obtained for use instead of conventional treatments, which often have side effects. PMID:27688772

  7. Ovarian hyperstimulation syndrome prevention strategies: use of gonadotropin-releasing hormone antagonists.

    Science.gov (United States)

    Griesinger, Georg

    2010-11-01

    The most serious complication of ovarian stimulation for in vitro fertilization is severe ovarian hyperstimulation syndrome (OHSS), a rare but potentially life-threatening condition. The present review discusses the place of gonadotropin-releasing hormone antagonists (GnRH-ant) in primary, secondary, and tertiary prevention of OHSS. Sound evidence indicates that the routine use of GnRH-ant instead of GnRH agonists (GnRHa) during ovarian stimulation drastically reduces the relative risk of OHSS. GnRH-ant are therefore useful for primary OHSS prevention, and an increased use of antagonists should help reduce the overall incidence of severe OHSS with its associated risks and complications. In patients on antagonist protocols identified to be at risk of developing severe OHSS, replacing human chorionic gonadotropin with GnRHa as a trigger of final oocyte maturation has been proposed as an effective measure of secondary prevention. A concept of combining GnRHa triggering with cryopreservation of all oocytes or embryos has yielded promising results as far as total avoidance of OHSS is concerned while providing a good chance of pregnancy for the patient in later frozen-thawed embryo transfers. In patients with early onset of OHSS, reinitiation of GnRH-ant in the luteal phase as a measure of tertiary prevention might lead to rapid regression of the syndrome; however only limited data on this new concept are available in the literature.

  8. High dose gonadotrophin-releasing hormone antagonist (ganirelix) may prevent ovarian hyperstimulation syndrome caused by ovarian stimulation for in-vitro fertilization

    NARCIS (Netherlands)

    D. de Jong (Danielle); N.S. Macklon (Nick); B.M. Mannaerts; H.J. Coelingh Bennink; B.C.J.M. Fauser (Bart)

    1998-01-01

    textabstractThis case report describes the first attempt to treat imminent ovarian hyperstimulation syndrome (OHSS) by using a gonadotrophin-releasing hormone (GnRH) antagonist. A 33 year old, normo-ovulatory woman undergoing in-vitro fertilization received daily subcut

  9. Effect of varying doses of tamoxifen on ovarian histopathology, serum VEGF, and endothelin 1 levels in ovarian hyperstimulation syndrome: an experimental study.

    Science.gov (United States)

    Pala, Şehmus; Atilgan, Remzi; Ozkan, Zehra Sema; Kavak, Salih Burçin; Ilhan, Nevin; Akpolat, Nusret; Sapmaz, Ekrem

    2015-01-01

    To examine the effects of low-to-high doses of tamoxifen on ovarian histopathology, serum VEGF, and endothelin 1 levels in ovarian hyperstimulation syndrome (OHSS) in an experimental setting. A total of 20 female Wistar albino rats, 22 days of age, were randomly divided into four groups. Follicle-stimulating hormone 10 IU was administered subcutaneously in 15 rats on 4 consecutive days, with OHSS induction on day 5 by 30 IU of human chorionic gonadotropin. Group 1 (n=5) comprised 35-day-old control rats, group 2 (n=5) 35-day-old OHSS rats, group 3 (n=5) 27-day-old OHSS rats receiving 1 mg/kg of oral tamoxifen for 7 days, group 4 (n=5) 27-day-old OHSS rats receiving 3 mg/kg of oral tamoxifen for 7 days. All rats were decapitated on day 35. Serum VEGF, endothelin 1, and ovarian follicular reserve were assessed in all rats. Kruskal-Wallis variance analysis and the Mann-Whitney U-test were used for statistical comparisons. A Bonferroni correction was performed to control the inflation of significance, with a significance level set at a P-value of less than 0.025. Despite higher serum VEGF, endothelin 1, follicular reserve, and angiogenesis and fibrosis of the corpus luteum in the OHSS group compared to controls, these differences were not significant (P>0.025, Mann-Whitney U-test). There was a significant reduction in the ovarian follicular reserve in tamoxifen groups compared to controls (Ptamoxifen (Ptamoxifen group in comparison with rats in the high-dose tamoxifen group (P0.025, Mann-Whitney U-test). Tamoxifen 1 g and 3 g resulted in a dose-dependent increase in VEGF and endothelin 1 levels, and ovarian follicle reserves were significantly reduced in our experimental model.

  10. Ovarian hyperstimulation syndrome: review and new classification criteria for reporting in clinical trials.

    Science.gov (United States)

    Humaidan, P; Nelson, S M; Devroey, P; Coddington, C C; Schwartz, L B; Gordon, K; Frattarelli, J L; Tarlatzis, B C; Fatemi, H M; Lutjen, P; Stegmann, B J

    2016-09-01

    What is an objective approach that employs measurable and reproducible physiologic changes as the basis for the classification of ovarian hyperstimulation syndrome (OHSS) in order to facilitate more accurate reporting of incidence rates within and across clinical trials? The OHSS flow diagram is an objective approach that will facilitate consistent capture, classification and reporting of OHSS within and across clinical trials. OHSS is a potentially life-threatening iatrogenic complication of the early luteal phase and/or early pregnancy after ovulation induction (OI) or ovarian stimulation (OS). The clinical picture of OHSS (the constellation of symptoms associated with each stage of the disease) is highly variable, hampering its appropriate classification in clinical trials. Although some degree of ovarian hyperstimulation is normal after stimulation, the point at which symptoms transition from those anticipated to those of a disease state is nebulous. An OHSS working group, comprised of subject matter experts and clinical researchers who have significantly contributed to the field of fertility, was convened in April and November 2014. The OHSS working group was tasked with reaching a consensus on the definition and the classification of OHSS for reporting in clinical trials. The group engaged in targeted discussion regarding the scientific background of OHSS, the criteria proposed for the definition and the rationale for universal adoption. An agreement was reached after discussion with all members. One of the following conditions must be met prior to making the diagnosis of OHSS in the context of a clinical trial: (i) the subject has undergone OS (either controlled OS or OI) AND has received a trigger shot for final oocyte maturation (e.g. hCG, GnRH agonist [GnRHa] or kisspeptin) followed by either fresh transfer or segmentation (cryopreservation of embryos) or (ii) the subject has undergone OS or OI AND has a positive pregnancy test. All study patients who

  11. Review of the evidence base of strategies to prevent ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Mathur, Raj; Kailasam, Chandra; Jenkins, Julian

    2007-06-01

    The English-language literature was reviewed to examine the evidence base for strategies that have been used to prevent ovarian hyperstimulation syndrome (OHSS). Prediction of OHSS by pretreatment patient characteristics and ovarian response parameters is unreliable, with a significant number of OHSS cases occurring in patients not thought to be high risk, while the majority of 'high-risk' cycles do not result in OHSS. Alternatives to ovarian stimulation should always be considered, depending on the clinical situation. Monofollicular ovulation induction with a cautious step-up regime carries a lower risk of overstimulation than step-down regimes. In in vitro fertilization (IVF) cycles, a low starting dose of follicle-stimulating hormone (FSH) and the use of 5000 iu human chorionic gonadotrophin (hCG) for final follicular maturation may benefit patients at high risk of OHSS. The role of GnRH antagonists is unclear. In women with polycystic ovaries, who are undergoing ovarian stimulation for IVF, metformin co-treatment may reduce the risk of OHSS. Coasting of cycles with over-response is associated with a reduced risk of OHSS, although precise criteria for initiating and ending coasting are not definable at present. Elective cryopreservation of all embryos prevents late OHSS, but its value has been poorly researched. The literature does not support a role for intravenous albumin, administered around the time of oocyte retrieval, in preventing OHSS. Evidence is insufficient regarding a possible role for hexa-ethyl starch. hCG should not be used for luteal support, as it is associated with a higher risk of OHSS, and equivalent pregnancy rates are obtained with the use of progesterone.

  12. Ovarian hyperstimulation syndrome prevention strategies: reducing the human chorionic gonadotropin trigger dose.

    Science.gov (United States)

    Kashyap, Sonya; Parker, Kasey; Cedars, Marcelle I; Rosenwaks, Zev

    2010-11-01

    This article reviews the biological plausibility and evidence for the use of a low triggering dose of human chorionic gonadotropin (hCG) in the prevention of ovarian hyperstimulation syndrome (OHSS). A systematic search of the literature revealed very little published data for or against the use of low-dose hCG in the prevention of OHSS after assisted reproductive technology. We have had success at avoiding OHSS as a result of gentle stimulation and low-dose sliding scale hCG trigger based on estradiol (E₂) levels. We therefore present the biological plausibility for such an approach by reviewing the relationship between OHSS, vascular endothelial growth factor, and hCG; the physiology of hCG; the relationship between risk of OHSS and E₂ at trigger; and the physiology of alternative methods of triggering such as recombinant luteinizing hormone and gonadotropin-releasing hormone agonist. We also present the results of a quasi-experimental before and after study of the sliding scale protocol for hCG trigger dose in in vitro fertilization with or without intracytoplasmic sperm injection cycles.

  13. The use of gonadotropin-releasing hormone antagonist post-ovulation trigger in ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Chappell, Neil; Gibbons, William E

    2017-06-01

    The purpose of this paper is to assimilate all data pertaining to the use of gonadotropin-releasing hormone (GnRH) antagonists in in vitro fertilization cycles after ovulation trigger to reduce the symptoms of ovarian hyperstimulation syndrome (OHSS). A systematic review of the literature was performed to identify all studies performed on the use of a GnRH antagonist in IVF cycle post-ovulation trigger with patients at high risk for OHSS. Ten studies were identified and reviewed. Descriptions of the studies and their individual results are presented in the following manuscript. Due to significant heterogeneity among the studies, it was not possible to perform a group analysis. The use of GnRH antagonists post-ovulation trigger for treatment of OHSS has been considered for almost 20 years, though research into its use is sparse. Definitive conclusions and recommendations cannot be made at this time, though preliminary data from these trials demonstrate the potential for GnRH antagonists to play a role in the treatment of OHSS in certain patient populations.

  14. Hemorrhagic ovarian cyst without peritoneal bleeding in a patient with ovarian hyperstimulation syndrome: case report

    Institute of Scientific and Technical Information of China (English)

    Hiroko Kurioka; Kentaro Takahashi; Nobuyuki Kita; Yoichi Noda

    2005-01-01

    @@ Gynecologic and obstetric disorders presenting with abdominal pain are ectopic pregnancy, rupture of endometrial cysts, mature cystic teratoma and torsion of the adnexae. Hemorrhagic ovarian cysts, which included among the functional cysts, are often involved in acute abdomen leading to laparotomy intervention.

  15. The Groningen ART cohort study: Does ovarian hyperstimulation, the in vitro procedure or a combination of both influence cognitive and behavioural development of 4-year-old IVF-offspring?

    NARCIS (Netherlands)

    Schendelaar, P.; La Bastide-Van Gemert, S.; Heineman, M.J.; Middelburg, K.J.; Seggers, J.; Van Den Heuvel, E.R.; Hadders-Algra, M.

    2014-01-01

    Study question: Evaluating the effects and underlying causal relationships of ovarian hyperstimulation, the in vitro procedure and the combination of both on cognitive and behavioural development in 4-year-olds. Summary answer: Our preliminary results suggest that ovarian hyperstimulation, the in

  16. 体外受精-胚胎移植中预处理对多囊卵巢综合征患者超排卵和结局影响的研究%The Study of Effects of Pretreatment on Controlled Ovarian Hyperstimulation and Outcomes of IVF-ET in Patients with PCOS

    Institute of Scientific and Technical Information of China (English)

    雷萍; 吴重聪; 阮永铭; 蔡桂丰; 王磊; 杨桂艳

    2012-01-01

      目的:探讨体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)中多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者在超促排卵周期前应用口服避孕药(oral contraceptive pill,OCP)预处理的效果.方法:回顾性分析112例行 IVF-ET 的 PCOS 患者,按周期前是否使用过 OCP 分为 A 组(OCP 预处理组,n=66)和 B 组(对照组,n=46).对入选患者的病历资料进行统计分析,评估 OCP 预处理对 PCOS 患者促排卵的效果、中重度卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)的发生及助孕结果的影响.结果:OCP 预处理能明显减少卵巢功能性囊肿形成(P0.05),两组获卵数、受精率、种植率、临床妊娠率等差异均无统计学意义.结论:口服避孕药预处理能较好地控制多囊卵巢综合征患者促排卵的时间,卵泡发育的同步性更高,但并不改变中重度 OHSS 的发生率.%  Objective :To explore the effects of oral contraceptive pill (OCP) pretreatment in patients with polycystic ovarian syndrome (PCOS) undergoing controlled ovarian hyperstimulation (COS) for IVF-ET. Methods :112 patients with PCOS undergoing IVF-ET were randomized divided into group A (n=66), who received OCP pretreatment before cycle and group B (n=46),who did not received OCP.A retrospective analysis of the data of the patients was carried out for the assessment of the ovulation promoting effect of OCP pretreatment and the influence on the incidence of OHSS and IVF-ET results. Results :The formation of ovarian cyst was significantly decreased in group A (P<0.01).Compared with group B,the duration of gonadotropin stimulation and the gonadotropin consumption were both increased in group A (P<0.05).The ratio of ovum was increased in group A(91.87% versus 85.69%,P<0.05).But no significant differences were observed regarding on the proportion of patents who developed OHSS,the number of retrieved acolytes,fertilization rate

  17. Síndrome de hiperestimulación ovárica Ovarian hyperstimulation syndrome

    Directory of Open Access Journals (Sweden)

    B. Azcona

    2009-01-01

    Full Text Available La experiencia con el tratamiento inductor de la ovulación y el conocimiento de la fisiopatología del síndrome de hiperestimulación ovárica (SHO, los factores de riesgo y las características clínicas son claves para la prevención y el manejo del SHO. Las manifestaciones leves del SHO son bastante comunes, ocurriendo en hasta un tercio de los ciclos con superovulación inducidos por gonadotropinas exógenas. El empeoramiento de los síntomas del SHO normalmente todavía se puede manejar de forma ambulatoria, pero es esencial la monitorización y evaluación frecuente. La enfermedad grave resultante del SHO es mucho menos común, pero puede conllevar riesgo vital. La hospitalización puede ser necesaria, en algunos casos.Experience with ovulation induction treatment and understanding of the physiopathology of ovarian hyperstimulation syndrome (OHS, the risk factors and the clinical characteristics are of key importance for preventing and managing OHS. Light manifestations of OHS are fairly common, occurring in up to a third of the cycles with superovulation induced by exogenous gonadotropins. A worsening of the symptoms of OHS can still normally be managed in out-patient form, but frequent monitoring and evaluation are essential. Serious disease resulting from OHS is much less common, but can involve risk to life. Hospitalisation might be necessary in some cases.

  18. Hematocrit as a simple method to predict and manage ovarian hyperstimulation syndrome in assisted reproduction

    Directory of Open Access Journals (Sweden)

    Taswin Kaur

    2015-01-01

    Full Text Available Aim: The aim was to analyze the hematocrit levels in cases of ovarian hyperstimulation syndrome (OHSS, syndrome occurring during in-vitro fertilization (IVF, and study its role as a prognostic indicator. Subjects and Methods: Two years data of 66 women at high risk for developing OHSS was analyzed. Twenty-seven women who developed OHSS were further analyzed based on their hematocrit levels on the day of oocyte pick-up (OPU and the day of embryo transfer (ET to see if there was a prognostic trend. Results: Of the total 225 IVF cases, 66 were deemed high risk for developing OHSS. Twenty-seven of these developed OHSS (40.9%. Of these 27, 21 (77.8% had a hematocrit >35% on the day of OPU. The mean hematocrit in women developing OHSS on the day of OPU was 37.39% (standard deviation [SD] 2.66 as against 35.97% (2.80 in those not developing OHSS. This difference was statistically significant (P = 0.043. On the day of ET, 23/27 (85.8% who developed OHSS had a hematocrit of >35%. The mean hematocrit was 39.29% (SD 3.85 in those who developed OHSS as against 34.7% (2.88 in those who did not. This difference (4.85 was statistically significant (P 35%. Those who required cancellation of ET had a hematocrit of >35% on the day of ET or showed a significant increase of 3% from OPU to ET.

  19. Febrile morbidity in severe and critical ovarian hyperstimulation syndrome: a multicentre study.

    Science.gov (United States)

    Abramov, Y; Elchalal, U; Schenker, J G

    1998-11-01

    The objective of this study was to define the incidence of febrile morbidity and its causes in severe and critical ovarian hyperstimulation syndrome (OHSS). For this purpose, we reviewed the medical records of all OHSS patients hospitalized in 16 out of 19 tertiary medical centres in Israel between January 1987 and December 1996. Febrile morbidity was defined as at least one episode of temperature rise above 38 degrees C lasting > or =24 h. A total of 2902 patients (3305 hospitalizations) with OHSS was identified, of whom 196 had severe, and 13 critical, OHSS. Among the 209 patients investigated the incidence of febrile morbidity was 82.3%, of which 20.5% was attributed to urinary tract infection, 3.8% to pneumonia, 3.3% to upper respiratory tract infection, 2.0% to intravenous line phlebitis, 1.0% to cellulitis at an abdominal puncture site, 1.0% to postoperative wound infections and 0.5 % to gluteal abscess at the site of progesterone injection. Non-typical organisms were frequently isolated, such as Pseudomonas, Proteus, Klebsiella and Enterobacter species. No infectious aetiology was found in 105 patients (50.2%). Hypoglobulinaemia was recorded in most patients, while ascitic and pleural fluids aspirated from these patients contained high globulin concentrations. We conclude that infection-related febrile morbidity in severe and critical OHSS is high, and may be attributed to some degree of immunodeficiency associated with loss of plasma globulins to the third space. However, non-infection-related febrile morbidity is even higher and may be attributed to endogenous pyrogenic mechanisms.

  20. Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome

    DEFF Research Database (Denmark)

    Iliodromiti, Stamatina; Lan, Vuong Thi Ngoc; Tuong, Ho Manh;

    2013-01-01

    Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implanta......Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory...

  1. Effect of varying doses of tamoxifen on ovarian histopathology, serum VEGF, and endothelin 1 levels in ovarian hyperstimulation syndrome: an experimental study

    Directory of Open Access Journals (Sweden)

    Pala S

    2015-03-01

    Full Text Available Sehmus Pala,1 Remzi Atilgan,1 Zehra Sema Ozkan,1 Salih Burçin Kavak,1 Nevin Ilhan,2 Nusret Akpolat,3 Ekrem Sapmaz1 1Department of Obstetrics and Gynecology, 2Department of Biochemistry, 3Department of Pathology, Firat University School of Medicine, Elazig, Turkey Objective: To examine the effects of low-to-high doses of tamoxifen on ovarian histopathology, serum VEGF, and endothelin 1 levels in ovarian hyperstimulation syndrome (OHSS in an experimental setting.Materials and methods: A total of 20 female Wistar albino rats, 22 days of age, were randomly divided into four groups. Follicle-stimulating hormone 10 IU was administered subcutaneously in 15 rats on 4 consecutive days, with OHSS induction on day 5 by 30 IU of human chorionic gonadotropin. Group 1 (n=5 comprised 35-day-old control rats, group 2 (n=5 35-day-old OHSS rats, group 3 (n=5 27-day-old OHSS rats receiving 1 mg/kg of oral tamoxifen for 7 days, group 4 (n=5 27-day-old OHSS rats receiving 3 mg/kg of oral tamoxifen for 7 days. All rats were decapitated on day 35. Serum VEGF, endothelin 1, and ovarian follicular reserve were assessed in all rats. Kruskal–Wallis variance analysis and the Mann–Whitney U-test were used for statistical comparisons. A Bonferroni correction was performed to control the inflation of significance, with a significance level set at a P-value of less than 0.025.Results: Despite higher serum VEGF, endothelin 1, follicular reserve, and angiogenesis and fibrosis of the corpus luteum in the OHSS group compared to controls, these differences were not significant (P>0.025, Mann–Whitney U-test. There was a significant reduction in the ovarian follicular reserve in tamoxifen groups compared to controls (P<0.025, Mann–Whitney U-test, while angiogenesis of the corpus luteum, number of atretic follicles, fibrosis, and serum VEGF were significantly higher in rats receiving tamoxifen (P<0.025, Mann–Whitney U-test. Also, significantly lower follicular reserve and

  2. 超促排卵对小鼠胚胎发育及输卵管中IL-6表达的影响%Effect of controlled ovarian hyperstimulation on the development of embryos and salpingian IL-6 expression in mice

    Institute of Scientific and Technical Information of China (English)

    尉春华; 胡彩妮; 姚元庆

    2017-01-01

    [目的]探讨超排卵对小鼠受精卵发育到囊胚及受精卵期输卵管中白细胞介素-6(Interleukin-6,IL-6)表达的影响.[方法]90只雌性ICR小鼠采用随机数字表法分为对照组(60只)和超排组(30只),收集受精卵体外培养3d,显微镜下观察两细胞、四细胞及囊胚形成率.收集对照组和超排组小鼠受精后0.5 d(days post coitum,dpc)的输卵管,应用免疫荧光共聚焦法检测其IL-6的表达.[结果]与对照组相比,超排组两细胞形成率及囊胚形成率降低,二者差异具有统计学意义(P<0.05);免疫荧光共聚焦结果显示0.5 dpc超排组输卵管中IL-6表达多于对照组.[结论]控制性超排卵能够增加受精卵期输卵管中IL-6的表达,可能与其保障受精卵发育有关.%[Objective] To explore the effect of controlled ovarian hyperstimulation on the development of zygote to blastocyst and the salpingian IL-6 expression during the zygote stage in mice.[Methods] A total of 90 female ICR mice were randomly divided into control group (n=60) and superovulated group (n=30) by random number table.Mouse zygotes were collected and cultured in vitro for 3 d.The formation rates of 2 cells,4 cells and blastocyst were observed under microscope.The 0.5dpc salpinges in pregnant mice were collected from the control group and superovulated group,and the expression of IL-6 in fallopian tubes was detected by confocal immunofluorescence method.[Results] The rates of 2-cell formation and blastocyst formation in the superovulated group were significantly lower than those in the control group (P<0.05).The results of confocal immunofluorescence method,showed that the salpingian IL-6 expression in 0.5dpc superovlated group was obviously higher than that in the control group.[Conclusion] Controlled ovarian hyperstimulation can increase the salpingian IL-6 expression at zygote stage,which may relate to supporting the development of zygotes.

  3. Risk of severe ovarian hyperstimulation syndrome in GnRH antagonist versus GnRH agonist protocol

    DEFF Research Database (Denmark)

    Toftager, M.; Bogstad, J; Bryndorf, T

    2016-01-01

    and thus predict risk of OHSS, were not performed. Finally, the physicians were not blinded to GnRH treatment group after randomization. WIDER IMPLICATIONS OF THE FINDINGS: The short GnRH antagonist protocol should be the protocol of choice for patients undergoing their first ART cycle in females years...... between the two arms. None of the women had undergone previous ART treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS: All infertile women referred for their first IVF/ICSI at two public fertility clinics, less than 40 years of age and with no uterine malformations were asked to participate. A total......STUDY QUESTION: Is the risk of severe ovarian hyperstimulation syndrome (OHSS) similar in a short GnRH antagonist and long GnRH agonist protocol in first cycle IVF/ICSI patients less than 40 years of age?. SUMMARY ANSWER: There is an increased risk of severe OHSS in the long GnRH agonist group...

  4. Pregnancy Outcomes of In Vitro Fertilization with or without Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study in Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    Xuan Jiang; Cheng-Yan Deng; Zheng-Yi Sun; Wei-Lin Chen; Han-Bi Wang; Yuan-Zheng Zhou; Li Jin

    2015-01-01

    Background: The effect of ovarian hyperstimulation syndrome (OHSS) on pregnancy outcomes of in vitro fertilization (IVF) patients is still ambiguous.This study aimed to analyze pregnancy outcomes of IVF with or without OHSS in Chinese patients.Methods: A retrospective cohort study was undertaken to compare pregnancy outcomes between 190 women with OHSS and 197 women without OHSS.We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, preterm delivery, preterm birth before 34 weeks' gestation, cesarean delivery, low birth weight (LBW), and small-for-gestational age (SGA) between the two groups.Odds ratios (ORs) and 95% confidence intervals (CIs) of measure of clinical pregnancy were also analyzed.Results: The clinical pregnancy rate of OHSS patients was significantly higher than that of non-OHSS patients (91.8% vs.43.5%, P < 0.001).After controlling for drug protocol and causes of infertility, the adjusted ORs of moderate OHSS and severe/critical OHSS for clinical pregnancy were 4.65 (95% CI, 1.86-11.61) and 5.83 (95% CI, 3.45-9.86), respectively.There were no significant differences in rates of multiple pregnancy (4.0% vs.3.7%) and miscarriage (16.1% vs.17.5%) between the two groups.With regard to ongoing clinical pregnancy, we also found no significant differences in the rates of live birth (82.1% vs.78.8%), preterm delivery (20.9% vs.17.5%), preterm birth before 34 weeks' gestation (8.6% vs.7.9%), cesarean delivery (84.9% vs.66.3%), LBW (30.2% vs.23.5%), and SGA (21.9% vs.17.6%) between the two groups.Conclusion: OHSS, which occurs in the luteal phase or early pregnancy in IVF patients and represents abnormal transient hemodynamics, does not exert any obviously adverse effect on the subsequent pregnancy.

  5. How to control the synchronization of oocyte nuclear and cytoplasmic maturation in the controlled ovarian hyperstimulation cycles%超排卵周期如何控制卵母细胞胞核与胞质的同步成熟

    Institute of Scientific and Technical Information of China (English)

    王玢; 孙海翔

    2012-01-01

    Complete maturation of oocyte includes both nuclear and cytoplasmic maturation. At present, expulsion of the first polar body is known as the marker of oocyte nuclear maturation. Expansions of granulose cells and oocyte-corona-cumulus complex synchronize with the maturation of oocyte nuclei following the maturation of oocyte in the natural cycle. However, the expansion of oocyte-corona-cumulus complex and nuclear maturation are not synchronized due to disturbance of exogenous gonadotropins in controlled ovarian hyperstimulation (COH) cycles. The status of expansion of oocyte-corona-cumulus complex can not be used to estimate the maturation of oocyte maturation in COH cycles. The morphology characteristics of oocyte, migration of cortical granules and relative factors such as GDF9 , BMP15 etc. can not monitor cytoplasmic maturation fast and directly. In COH cycles, fertilization rate, cleavage rate, pregnancy rate and implantation rate display a rising trend along with the increased proportion of matured oocytes. The rate of available embryos from the oocytes with large follicular diameter is higher than that from the oocytes with small follicular diameter. Oocyte maturation rate and fertilization rate decrease but the fragments in embryos increase along with the reduction of follicular diameter. However, the diameter of dominant follicle does not reflect overall situation of follicular development in ovary. A group of follicles on behalf of the development synchronization of total follicles are named as "object follicles" in progress of COH. The "object follicles" determine the trigger time of hCG. In vitro investigations of mouse embryos also confirm that cultured oocyte in vitro for some time after hCG injection plays an important role in the maturation of oocyte nuclei and cytoplasm, where higher proportion and quicker speed of pronuclei development can be acquired after fertilization or artificial activation. High-quality embryo rate and pregnancy rate increase

  6. Utilização da contagem de folículos antrais para predição do padrão de resposta em ciclos de hiperestimulação controlada com antagonista de GnRH Use of antral follicle count to predict the response pattern in controlled ovarian hyperstimulation cycles with GnRH antagonist

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Borges de Souza

    2008-01-01

    Full Text Available OBJETIVO: verificar se existe relação preditiva entre a contagem de folículos antrais (CFA no segundo dia do ciclo com o padrão de resposta em ciclos de hiperestimulação ovariana controlada para injeção intracitoplasmática de espermatozóide (ICSI. MÉTODOS: estudo prospectivo, desenvolvido de maio de 2004 a maio de 2005, no qual 51 pacientes com idade 15 mm no dia do desencadeamento da ovulação, número total e em metáfase II de oócitos captados, número de embriões de boa qualidade transferidos e taxa de gestação. A análise estatística foi realizada pelos testes t de Student e de Mann-Whitney, com significância estatística de 5% (pPURPOSE: to establish whether there is a predictive relationship between the antral follicle count (AFC on the second day of the cycle and the response pattern in controlled ovarian hyperstimulation cycles for intracytoplasmic sperm injection (ICSI. METHODS: a prospective study developed from May 2004 to May 2005, in which 51 patients aged 15 mm on the day of ovulation triggering, the total number of oocytes retrieved and in metaphases II, the number of good quality embryos transferred and pregnancy rate. The statistical analysis was performed by the t-Student test and the Mann-Whitney test, with statistical significance of 5% (p15 mm on the day of ovulation triggering (p=0.0001, the total number of oocytes retrieved (p=0.0001 and those in metaphases II (p=0.0001. Such correlation between AFC and pregnancy was not observed (p=0.43. There was no significant correlation between AFC and the number of good quality embryos transferred (p=0.081. CONCLUSIONS: AFC on the second day of the stimulated cycle can be used to predict the quality of ovarian stimulation, the number of oocytes retrieved and the number of mature oocytes in in vitro fertilization cycles using GnRH antagonist.

  7. 半量GnRH拮抗剂方案对IVF-ET控制性超促排卵(COH)的临床效果%Clinical Efficacy of Half-dose GnRH Antagonist on Protocol during Controlled Ovarian Hyperstimulation (COH) for IVF-ET

    Institute of Scientific and Technical Information of China (English)

    欧俊; 张慧琴; 朱旻; 佘立平; 松迪; 惠宁

    2011-01-01

    Objective: To explore the efficacy of half-dose GnRH-antagonist (GnRNA) on the outcome in patients undergoing controlled ovarian hyperstimulation (COH) for IVF-ET. Methods: A total of 272 patients who underwent IVF-ET were enrolled in this study. They were divieded into group A and group B acording to half-dose GnRHA protocol and GnRH agonist (GnRHa) long protocol, 136 cycles per group. The duration of gonadotrophins (Gn) administration, the number of oocytes retrieved, fertilization rates, cleavage rates, the number of high quality embryo, pregnancy rates were recoreded. Results: There was no significant difference in the fertilization rates as well as the cleavage rates, the number of high quality embryo, pregnancy rates between the two groups. Group A has a significantly lower probility in the duration and dose of gonadtrophine as well as the number of oocytes retrieved, embryo quality, multiple birth rate and implantation rate than those in group B. Conclusion: The half-dose GnRHA protocol works as well as GnRHa long protocol for patients with normal ovarian function undergoing COH in IVF-ET treatmen. Moreover, it can also reduce the duration and dose of Gn and the burden of the patients.%目的:探讨半量促性腺激素释放激素拮杭剂(GnRHA)方案对体外授精-胚胎移植(IVF-ET)超促排卵的临床结局.方法:回顾性分析272例行IVF-ET治疗的患者,半量GnRHA方案组((A组)共136个周期和GnRH激动剂(GnRHa)长方案组((B组)136个周期.比较2种控制性超促排卵(COH)方案的临床结局.结果:A组的Gn使用剂量、使用天数、获卵数、胚胎种植率和多胎率均小于B组(P0.05).结论:对正常卵巢储备的患者COH后行IVF-ET结局而言,半量GnRHA方案可以取得与标准GnRHa长方案一样的效果,并可减少Gn的使用天数及剂量,减轻患者的负担.

  8. Spontaneous Bacterial Peritonitis and Anasarca in a Female Patient with Ovarian Hyperstimulation Syndrome Complicated by Respiratory and Kidney Failure

    Directory of Open Access Journals (Sweden)

    Muhammad Abdul Mabood  Khalil

    2016-08-01

    Full Text Available Ovarian hyperstimulation syndrome (OHSS was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output. She was found to have edema, ascites, effusion and acute kidney injury (AKI. Considering the symptoms preceding the drug history and anasarca, a diagnosis of severe OHSS was made. Ascites was further complicated by spontaneous bacterial peritonitis (SBP, which had already been reported before. We speculate that low immunity due to decreased immunoglobulin in patients with OHSS makes them prone to SBP. In our case, septicemia secondary to SBP and fluid loss due to capillary leakage from OHSS resulted in AKI and respiratory failure. This critically ill patient was treated in a special care unit, and she fully recovered with supportive measures. Severe OHSS may present as anasarca including ascites which can develop SBP leading to sepsis and multiorgan failure.

  9. Spontaneous Bacterial Peritonitis and Anasarca in a Female Patient with Ovarian Hyperstimulation Syndrome Complicated by Respiratory and Kidney Failure

    Science.gov (United States)

    Khalil, Muhammad Abdul Mabood; Ghazni, Muhammad Salman; Tan, Jackson; Naseer, Nazish; Khalil, Muhammad Ashhad Ullah

    2016-01-01

    Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output. She was found to have edema, ascites, effusion and acute kidney injury (AKI). Considering the symptoms preceding the drug history and anasarca, a diagnosis of severe OHSS was made. Ascites was further complicated by spontaneous bacterial peritonitis (SBP), which had already been reported before. We speculate that low immunity due to decreased immunoglobulin in patients with OHSS makes them prone to SBP. In our case, septicemia secondary to SBP and fluid loss due to capillary leakage from OHSS resulted in AKI and respiratory failure. This critically ill patient was treated in a special care unit, and she fully recovered with supportive measures. Severe OHSS may present as anasarca including ascites which can develop SBP leading to sepsis and multiorgan failure. PMID:27721728

  10. 3种不同超促排卵方案在高龄患者体外受精-胚胎移植中的临床效果分析%Clinical efficacy of three controlled ovarian hyperstimulation protocols in advanced age undergoing in vitro fertilization and embryo transfer

    Institute of Scientific and Technical Information of China (English)

    杨菁; 冯亭亭; 孙伟; 冯雪花; 冯晓军; 贾婷

    2016-01-01

    Objective:To assess the efficacy of different controlled ovarian hyperstimu-lation protocols in advanced age (36~45 years) on pregnancy outcome undergoing in vitro fer-tilization and embryo transfer. Methods:A retrospective analysis was performed in a total of 484 cycles,which were divided into three groups with different stimulation protocols:GnRH-a long protocol group( Group A,148 cycles);GnRH-ant protocol group ( Group B,165cycles);ultra-short GnRH-a protocol ( Group C,171 cycles). The general conditions and the clinical out-comes of the three groups were compared. Results:The level LH on hCG injection day in group A was significantly lower than that in group B and group C. Group A had the longest duration of gonadotrophin administration,obtained the most number of eggs,2PN fertilization,2PN cleav-age,high-quality embryos and frozen embryos (P0. 05). Embryo implantation rate and clinical pregnancy rate in group A was the highest, the second in group B, the lowest ingroup C,while there was significant difference between group A and group C. Conclusion:Gn-RH-a long protocol has a better clinical outcome for advanced age with relatively better ovarian reserve function;for advanced age with poor ovarian reserve,GnRH-ant protocol has an accepta-ble clinical outcome and may be a valid alternative and comparative economic strategy,while re-quiring relatively less Gn dosage.%目的::探讨高龄(36~45岁)患者采用不同超促排卵方案对体外受精-胚胎移植周期妊娠结局的影响。方法:回顾分析484个周期的高龄患者的资料,根据促排卵方案不同将患者分组:GnRH-a长方案组(148个周期)、拮抗剂方案组(165个周期)、GnRH-a超短方案组(171个周期),比较3组患者的基本资料及临床结局。结果:GnRH-a长方案组的hCG日LH水平低于拮抗剂方案组和GnRH-a超短方案组, GnRH-a长方案组的Gn时间最长,获卵数、2 PN受精数、2 PN卵裂数、优质胚胎数及冷冻数最多( P0.05);

  11. Analysis on related indexes of follicular developmental retardation during controlled ovarian hyperstimulation among the patients .with polycystic ovary syndrome%多囊卵巢综合征患者超排卵中卵泡发育迟缓相关指标分析

    Institute of Scientific and Technical Information of China (English)

    周晓燕; 刘雨生; 吴丽敏

    2012-01-01

    Objective: To explore the causes of follicular developmental retardation during long protocol controlled ovarian hypers-timulation ( COH) of in vitro fertilization and embryo transfer (IVF - ET) or intracytoplasmic sperm injection (ICSI) among the infertile patients with polycystic ovary syndrome (PCOS) . Methods; Forty COH cycles of the infertile patients with PCOS from December 2009 to December 2010 were analyzed retrospectively, then they were divided into follicular normal development group (group A, 19 cycles) and follicular developmental retardation group ( group B, 21 cycles) . Results: There was no significant difference in age, the duration of infertility, basic reproductive hormones levels between the two groups ( P < 0.05 ) . The start dose of gonadotropin in group A was lower than that in group B ( P < 0.05 ) . The duration of ovulation stimulation and the total dose of gonadotropin in group A were significantly higher than those in group B (P<0.05) . The fertilization rate, cleavage rate, the incidence of ovarian hyperstimuktion syndrome (OHSS), the number of high quality embryo, and clinical pregnancy rate in group A were significantly lower than those in group B (P <0.05) . Conclusion: The low start dose of gonadotropin may be one of the important factors inducing follicular developmental retardation during COH among the patients with PCOS.%目的:探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)不孕症患者体外受精-胚胎移植(IVF - ET)或单精子卵胞浆内注射(ICSI)超排卵(COH)长方案中卵泡发育迟缓的原因.方法:回顾性分析2009年12月~2010年12月多囊卵巢综合征不孕症患者超排卵40个周期,卵泡正常发育组(A组)19个周期,卵泡发育迟缓组(B组)21个周期作为对照.结果:年龄、不孕年限,基础生殖激素水平在两组间无统计学差异(P>0.05).与B组比较,A组促性腺素(Gn)起始剂量低于B组(P<0.05).A组促排天数、Gn总量明显高于B组(P<0.05).A

  12. IVF-ET中促性腺激素释放激素激动剂的超促排卵应用与剂量研究%Gonadotropin-releasing Hormone Agonist for Controlled Ovarian Hyperstimulation and Dose-finding Study in In Vitro Fertilization-Embryo Transfer

    Institute of Scientific and Technical Information of China (English)

    郜虹媛; 匡延平

    2012-01-01

    Gonadotropin-releasing hormone agonist(GnRH-a) is one of the most effective drugs used for controlled ovarian hyperstimulation (COH) in in vitro fertilization-embryo transfer (IVF-ET). The early "flare up" of GnRH-a can stimulate the sharp release of endogenous gonadotropins. Continuous administration of GnRH-a caused reversibly block of pituitary function and low level of endogenous gonadotropin, which is the so-called down-regulation. Therefore, GnRH agonist protocol with exogenous gonadotropins can prevent a luteinizing nor-mone surge, premature oocyte maturation and luteinization. In addition, GnRH-a triggering which can take the place of hCG triggering leads to a significant reduction of OHSS rate. To explore the effective low dose of GnRH-a which can prevent a LH surge without excessive pituitary desensitization has a critical role for COH.%促性腺激素释放激素激动剂(GnRH-a)是体外受精-胚胎移植(IVF-ET)技术中重要用药.GnRH-a与GnRH受体结合后,早期"突发"作用可刺激垂体促性腺激素急剧释放,持续应用后使垂体受抑制,内源性促性腺激素(Gn)水平下降,即所谓的降调节作用.利用这种生物学特性,GnRH-a联合Gn超促排卵可预防早发黄体生成素(LH)峰,避免卵泡过早黄素化.另外,GnRH-a代替人绒毛膜促性腺激素诱发排卵可降低卵巢过度刺激综合征(OHSS)发生率.探索既能有效抑制LH峰,又不使垂体过度抑制的GnRH-a有效低剂量对于超促排卵有重要意义.

  13. Endocrine profiles after triggering of final oocyte maturation with GnRH agonist after cotreatment with the GnRH antagonist ganirelix during ovarian hyperstimulation for in vitro fertilization

    NARCIS (Netherlands)

    B.C.J.M. Fauser (Bart); D. de Jong (Danielle); F. Olivennes; H. Wramsby; C. Tay; J. Itskovitz-Eldor; H.G. van Hooren

    2002-01-01

    textabstractIn a randomized multicenter study, the efficacies of two different GnRH agonists were compared with that of hCG for triggering final stages of oocyte maturation after ovarian hyperstimulation for in vitro fertilization. Ovarian stimulation was conducted by recombinant F

  14. 多囊卵巢综合征患者控制性超促排卵过程 AMH 和 INHB 浓度变化的临床研究%Changes of anti-Mullerian hormone (AMH) and inhib in B (INHB) during controlled o varian hyperstimulation in polycystic ovarian syndrome

    Institute of Scientific and Technical Information of China (English)

    李莹; 聂明月; 方颖; 杨晓葵

    2014-01-01

    目的:探讨多囊卵巢综合征( polycystic ovarian syndrome , PCOS )患者控制性超促排卵( controlled ovarian hyperstimulation,COH)过程中血清抗苗勒管激素(anti-Müllerian hormone,AMH)和抑制素B(inhibin B,INHB)浓度的变化及其对COH结局的预测价值。方法 PCOS 组患者37例,对照组患者41例。检测患者月经周期第2/3天( D2/3)、促性腺激素(gonadotrophin,Gn)刺激第5天(D5)、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)日(D-hCG)血清AMH及INHB浓度及取卵日卵泡液中AMH及INHB浓度,观察其动态变化及其对COH结局的影响。结果在COH过程中,血清AMH浓度逐渐降低,而血清INHB浓度逐渐升高。 PCOS组患者hCG日血清雌二醇( estrodiol,E2)浓度、获卵数、冷冻胚胎数较对照组明显升高(P<0.05,P<0.001),而Gn用量、受精率均低于对照组,差异有统计学意义(P<0.05),2组患者的临床妊娠率比较,差异无统计学意义(P>0.05)。血清AMH和INHB浓度与Gn剂量、hCG日E 2浓度具有相关性(P<0.05,P<0.001),但是与获卵数、临床妊娠率无相关性(P>0.05)。结论 PCOS患者 AMH和INHB浓度在COH过程中呈现动态变化,可以预测COH中卵巢的反应性,但是对超促排卵结局的预测价值还有待进一步研究。%Objective To explore dynamics of anti-Müllerian hormone ( AMH ) and inhibin B ( INHB ) during controlled ovarian hyperstimulation ( COH) in polycystic ovarian syndrome ( PCOS ) , and assess the value of these dynamic changes on the prediction of outcome in PCOS patients undergoing in vitro fertilization ( IVF) .Methods Thirty-seven women with PCOS and 41 women with normal ovarian reserve as the control were recruited in the study .AMH and INHB levels were measured in serum on menstrual cycle day 2 or 3 (D2/3), day 5 of gonadotropin stimulation(D5), human chorionic

  15. Efficacy of guided ovarian hyperstimulation in patients with mild type endometriosis

    Directory of Open Access Journals (Sweden)

    Jašović-Siveska Emilija

    2008-01-01

    Full Text Available Background/Aim. Endometriosis befalls in one of the most frequent gynecologic diseases. It manifests itself by the presence and growth of focus of endometrium out of the uterus cavum that reacts to hormonal stimulations as the normal uterus endometrium does. Hyperstimulation and induction of ovulation together with intrauterine insemination (IUI are the most frequently used treatments of unexplained infertility in patients with mild type endometriosis. The aim of this study was to compare the effects of stimulation using human menopausal gonadotrophine (hMG in the patients with mild type endometriosis to the patients with infertility of unknown ethiology. Methods. The study included 50 patients with unexplained infertility (group N, as well as 50 patients with mild type endometriosis (group E confirmed by laparoscopy. Within the same therapeutic protocole hMG stimulation and horionic gonadotrophine induction (hCG were used. Results. In the group E ovulation occurred in 74% of the patients during the first stimulation, in 77.78% during the second cycle, and in 75% of the patients during the third one. Regarding the group N, ovulation appeared in 82% of the patients during the first stimulation. Stimulation was performed two times more in 38 patients with unknown couse of infertility, and ovulation appeared in 84.21% of them. In the group N stimulation was performed three times in 28 women resulting in ovulation in 85.71% of them. Conclusion. Considering the obtained results it can be concluded that hMG stimulation and hCG induction are efficient in the treatment of infertility, particularly in mild type endometriosis.

  16. Ovarian hyperstimulation syndrome prevention strategies: oral contraceptive pills-dual gonadotropin-releasing hormone agonist suppression with step-down gonadotropin protocols.

    Science.gov (United States)

    Damario, Mark A

    2010-11-01

    The identification of patients at high risk for excessive responses to ovarian stimulation for in vitro fertilization and embryo transfer is essential in the tailoring of safe and effective treatment strategies. Known factors associated with increased sensitivity to gonadotropins include polycystic ovary syndrome, young age, prior ovarian hyperstimulation syndrome (OHSS), high baseline antral follicle count, and high baseline ovarian volume. Although several treatment strategies have been proposed for these patients, this report describes the experience using the dual suppression with gonadotropin step-down protocol. This protocol uses oral contraceptive pretreatment in combination with a long gonadotropin-releasing hormone agonist followed by a programmed step-down in gonadotropin dosing. Hormonal characteristics of dual suppression include an improved luteinizing hormone-to-follicle-stimulating hormone ratio and lower serum androgens, particularly dehydroepiandrosterone sulfate. Clinical characteristics of the protocol include a lower cancellation rate and favorable clinical and ongoing pregnancy rates per initiated cycle while mitigating the risk of OHSS.

  17. GnRH-a控制性超促排卵(COH)对小鼠着床期Hoxa-10基因表达的影响%Effect of GnRH-a Controlled Ovarian Hyperstimulation (COH) on Homeobox a10 (Hoxa-10) Gene Expression in Mouse Peri-implantation

    Institute of Scientific and Technical Information of China (English)

    付正英; 卢建荣; 苏晓华

    2012-01-01

    Objective: To research the impact of long GnRH-a protocol controlled ovarian hyperstimulation (COH) on mouse pregnancy rate, embryo nidation rate, mRNA and protein expression of Hoxa-10 in peri-implantation, and to discuss the possible mechanisms of COH influencing on embryo nidation. Methods: Mice were randomly divided into treatment group (GnRH-a +hMG+hCG) and control group (9 g/L, NaCl), female and male mice were copulated, the situation of vaginal plug, pregnancy and embryo nidation were observed. RT-PCR, Real-time PCR were used to detect the concentration of Hoxa-l0mRNA and immunohistochemical method was used to detect the concentration of HOXA-10 protein expression in the uterine tissue in peri-implantation. Results: The vaginal plug rate and pregnancy rate in treatment group were significantiy lower than those in the control (p<0.01), the number of the embryo nidation was larger in treatment group than that in the control (P<0.01), but the implantation rate of embyro was significantly lower in in treatment group than that in the control (p<0.05). Both PCR and immunohistochemical method showed that the expressions of HOXA10 mRNA and protein in treatment group were significantly lower than those in the control. Conclusion: The GnRH-a COH can decrease the expression of Hoxa-10, it disturbs the endometrial receptivity and window phase of normal uterus, thus lower the rate of pregnancy and embryo nidation.%目的:研究GnRH-a长方案控制性超促排卵(COH)对小鼠妊娠率、胚胎着床率及着床期HOXA-10基因表达的影响,探讨COH影响胚胎着床的机制.方法:实验动物随机分为实验组(GnRH-a +hMG+hCG)和对照组(生理盐水),雌、雄合笼后观察小鼠阴栓率,于着床期取小鼠子宫,观察妊娠率及胚胎着床数,计算着床率;应用RT-PCR、Real-time PCR方法及免疫组织化学法分别检测小鼠着床期子宫内膜Hoxa-10 mRNA及蛋白的表达.结果:实验组小鼠阴栓率及妊娠

  18. Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles.

    Science.gov (United States)

    Gunnala, Vinay; Melnick, Alexis; Irani, Mohamad; Reichman, David; Schattman, Glenn; Davis, Owen; Rosenwaks, Zev

    2017-01-01

    To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity. Retrospective cohort. Academic medical center. Fresh IVF cycles from 9/2004-12/2011. 10,427 fresh IVF-ICSI cycles met inclusion criteria. hCG was administered according to E2 level at trigger: 10,000IU vs. 5,000IU vs. 4,000IU vs. 3,300IU vs. dual trigger (2mg leuprolide acetate + 1,500IU hCG). Serum absorption of hCG was assessed according to dose and BMI. Oocyte maturity was analyzed according to post-trigger serum b-hCG. Fertilization, clinical pregnancy, live birth and OHSS rates were examined by hCG trigger dose. Post-trigger serum b-hCG 20-30, 30-40, and 40-50 mIU/mL was associated with reduced oocyte maturity as compared b-hCG >50 (67.8% vs. 71.4% vs. 73.3% vs. 78.9%, respectively, PhCG 20-50 mIU/mL was associated with a 40.1% reduction in live birth (OR 0.59, 95% CI 0.41-0.87). No differences in IVF outcomes per retrieval were seen for varying doses of hCG or dual trigger when controlling for patient age. The incidence of moderate to severe OHSS was 0.13% (n = 14) and severe OHSS was 0.03% (n = 4) of cycles. Moderate stimulation with sliding scale hCG at trigger and fresh transfer is associated with low rates of OHSS and favorable pregnancy rates. Doses as low as 3,300IU alone or dual trigger with 1,500IU are sufficient to facilitate oocyte maturity.

  19. The pathogenesis of ovarian hyperstimulation syndrome: in vivo studies investigating the role of interleukin-1beta, interleukin-6, and vascular endothelial growth factor.

    Science.gov (United States)

    Pellicer, A; Albert, C; Mercader, A; Bonilla-Musoles, F; Remohí, J; Simón, C

    1999-03-01

    To evaluate systemic and ovarian changes in levels of interleukin (IL)-1beta, IL-6, and vascular endothelial growth factor (VEGF) in response to hCG administration to determine which may be the potential initiator of vascular effects and to identify the main source of the substance; to evaluate serum and follicular fluid levels of these cytokines as markers of ovarian hyperstimulation syndrome (OHSS), and to compare levels of these cytokines under basal conditions in women with normal ovulation and those with polycystic ovary syndrome (PCOS). Prospective controlled study. In vitro fertilization program at the Instituto Valenciano de Infertilidad, Valencia, Spain. Women undergoing IVF, in whom the first two study objectives were analyzed, and women with normal ovulation and patients with PCOS undergoing retrieval of immature oocytes in natural cycles or cycles stimulated for IUI but cancelled during induction of ovulation, in whom the third study objective was analyzed. Serum was collected before and after hCG administration, and follicular fluid was collected at ovum pick-up. Serum and follicular fluid levels of IL-1beta, IL-6, and VEGF. There was a significant increase in serum VEGF levels after hCG administration in patients who were at risk for OHSS compared with those who were not at risk for OHSS. Significantly lower VEGF levels were found in the follicular fluid of patients who were at risk; this decrease was the only useful marker to discriminate between the two groups. Moreover, both groups had similar cytokine production under basal conditions. An increase in serum E2 occurred coincident with a decrease in IL-1beta, IL-6, and VEGF in patients with PCOS. Vascular endothelial growth factor seems to be the mediator of hCG on the vascular tree. There was an early systemic increase in VEGF that may have significance in the development of OHSS. A decrease in the follicular fluid VEGF concentration is a valid marker to identify women in whom OHSS will develop

  20. Clinical analyses for 93 patients of ovarian hyperstimulation%促排卵后异位妊娠临床分析

    Institute of Scientific and Technical Information of China (English)

    于燕; 田洪帅; 李珍

    2012-01-01

    Objective To investigate the incidence rate and influential factor of ectopic pregnancy received in ovarian hyperstimulation. Method A retrospective study of 93 ectopic pregnancy patients received in ovarian hyperstimulation in our hospital. Result A total of 93 cases of ectopic pregnancy happened among 1 292 cases of clinical pregnancy patients, the occurrence rate was 7. 20%;there is no significant difference in ectopic pregnancy patients' age. Of these EP, there were 88 cases belonging to tubalpregnancies, which accounted for 94. 62% fall EP(P0. 05). Conclusion The occurrence rate of ectopic pregnancy in ovarian hyperstimulation is higher than that of spontaneous pregnancy, to make use of it you must avoidance high risk factor occurrence, to cut down the incidence rate and case fatality rate.%目的 探讨促排卵后异位妊娠的发生率与影响因素.方法 回顾性分析莱芜市妇幼保健院接受促排卵治疗93例异位妊娠患者的临床资料.结果 共有1292个周期获得妊娠,93例为异位妊娠(7.20%);年龄不影响异位妊娠的发生;93例异位妊娠病例中示输卵管及其相关因素共88例,占94.62% (P<0.05);异位妊娠发生率随成熟卵泡数目增多而增加,但三组比较差异无统计学意义(P>0.05).结论 促排卵后异位妊娠的发生率增高,应用中要尽量避免高危因素的发生,以降低发生率和病死率.

  1. Ovarian hyperstimulation syndrome

    Science.gov (United States)

    ... Elsevier Saunders; 2016:chap 236. Read More Endometriosis Infertility Pelvic inflammatory disease (PID) Review Date 9/26/2015 Updated by: Daniel N. Sacks MD, FACOG, obstetrics & gynecology in private practice, West Palm Beach, FL. Review ...

  2. Preventive and treatment value of dopamine receptor agonists in ovarian hyperstimulation syndrome%多巴胺受体激动剂在卵巢过度刺激综合征的防治价值

    Institute of Scientific and Technical Information of China (English)

    杨蕊; 马彩虹

    2012-01-01

    The vascular endothelial growth factor (VEGF) is a crucial element for increased vascular permeability which determines ovarian hyperstimulation syndrome (OHSS). Dopamine receptor agonists can selectively inhibit VEGF-induced vascular permeability without interfering with angiogenesis. Vascular endothelial growth factor receptor-2 (VEGFR-2) phosphorylation reduction seems to he associated with this effect. The preventive use of dopamine receptor agonists reduces the risk of OHSS in women after ovarian stimulation for in vitro fertilization (IVF). Statistically, evidence of their preventive effect on the severe OHSS is not as clear as on the moderate OHSS. The use of dopamine receptor agonists does not influence the outcome of IVF cycles. The occurrence of obstetric or neonatal complications is similar with that in control groups. The oral administration of cahergoline is the best studied dopamine receptor agonists regimen in the prevention of OHSS. High-dose quinagolide is rarely applied due to its intolerable side effects. Oral bromocriptine can also be occasionally associated with severe gastric discomfort, although less frequently than with quinagoline. Rectal bromocriptine is used with more and more frequency because of its safety, but it still requires further study. Although published data suggest that dopamine agonists also improve the clinical evolution of established OHSS, no randomized controlled trials have been reported to confirm their effectiveness. The use of dopamine receptor agonists may be combined with with other strategies to prevent or control OHSS, such as GnRH antagonists, in order to improve its efficacy.

  3. How to evaluate efficacy of coasting in prevention of ovarian hyperstimulation syndrome%如何评价Coasting预防卵巢过度刺激综合征的作用

    Institute of Scientific and Technical Information of China (English)

    孙晓溪

    2011-01-01

    Ovarian hyperstimulation syndrome (OHSS) is a serious complication following controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET). Several methods have been tried to prevent the syndrome, since little can be done to change the course of events once the syndrome develops. These methods included administration of lower dose of gonadotropin, unilateral ovarian follicular aspiration, usage of human albumin solution during oocyte retrieval, cryopreservation of all embryos and coasting. Withholding gonadotrophin administration and postponing hCG injection, termed coasting, has been applied in ovulation induction cycles to prevent excessive response. It appears the most popular method used to prevent OHSS. A long coasting period (>3 days) has a negative effect on the number of oocytes and tends to reduce the quality of oocytes.%控制性促排卵(COH)最严重和潜在致命的并发症是重度卵巢过度刺激综合征(OHSS).在体外受精-胚胎移植(IVF-ET)中有8.4%~23.3%患者并发OHSS,其中重度OHSS发生率为0.1%~0.2%[1].目前OHSS发生病因尚不十分清楚,可能的原因是颗粒细胞分泌大量导致OHSS发生的类固醇激素及血管活性物质.临床上常采用取消周期、冻胚移植、取卵日给予白蛋白、单侧卵巢卵泡抽吸术等方法,但疗效不佳,且患者经济上和精神上均难以接受.随着对OHSS发病机制研究的深入,OHSS的预防亦有所进展,尤其是Coasting疗法对预防OHSS起着重要的作用.

  4. Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome: a retrospective cohort study.

    Science.gov (United States)

    Iliodromiti, Stamatina; Lan, Vuong Thi Ngoc; Tuong, Ho Manh; Tuan, Phung Huy; Humaidan, Peter; Nelson, Scott M

    2013-12-26

    Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implantation rates can be sustained. The objective of this study was to assess the live-birth rate and incidence of OHSS after GnRHa trigger and intensive luteal steroid support compared to traditional hCG trigger and conventional luteal support in OHSS high risk Asian patients. We conducted a retrospective cohort study of 363 women exposed to GnRHa triggering with intensive luteal support compared with 257 women exposed to conventional hCG triggering. Women at risk of OHSS were defined by ovarian response ≥15 follicles ≥12 mm on the day of the trigger. Live-birth rates were similar in both groups GnRHa vs hCG; 29.8% vs 29.2% (p = 0.69). One late onset severe OHSS case was observed in the GnRHa trigger group (0.3%) compared to 18 cases (7%) after hCG trigger. GnRHa trigger combined with intensive luteal steroid support in this group of OHSS high risk Asian patients can facilitate fresh embryo transfer, however, in contrast to previous reports the occurrence of late onset OHSS was not completely eliminated.

  5. Impact of number of retrieved oocytes in women under 35 years old with a long protocol for controlled ovarian hyperstimulation on the clinical outcome of in vitro fertilization and embryo transfer%35岁以下患者长方案促排卵获卵数对体外受精-胚胎移植结局的影响

    Institute of Scientific and Technical Information of China (English)

    王雅琴; 杨菁; 徐望明; 谢青贞; 肖卓妮; 尹太郎

    2011-01-01

    目的 探讨体外受精-胚胎移植(IVF-ET)周期最佳获卵数及其对妊娠结局的影响.方法 回顾性分析我院2009年9月至2010年8月35岁以下行长方案IVF-ET治疗的544个获卵周期的资料.比较不同获卵数的受精率、卵裂率、优胚率、临床妊娠率及并发症等指标的差异.结果 不同获卵数各组间促性腺激素(Gn)刺激天数、Gn用量、卵裂率、优胚率无明显差别(P>0.05),获卵数>25个组受精率低于其他各组(P15个,临床妊娠率较前下降,累积妊娠率随获卵数增加而增加,当获卵数>25个,临床妊娠率和累积妊娠率明显下降.结论 获得适量的卵有利于获得较满意的妊娠结局.%Objective: To explore the effect of retrieved oocyte number on pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET).Methods: A retrospective analysis was carried out on 544-oocyte pick up(OPU) cycles in women under 35 years old with long protocol IVF-ET in the hospital from Sep 2009 to Aug 2010. The women were divided into 6 groups according to retrieved oocyte number: Group A (≤5 oocytes), Group B (6-10 oocytes), Group C (11-15 oocytes), Group D (16-20 oocytes), Group E (21-25 oocytes), Group F(>25 oocytes). The fertilization rate, cleavage rate, advanced embryo rate, clinical pregnancy rate, accumulated clinic pregnancy rate, complications etc. in 6 groups were analyzed.Results: The gonadotropin doses, gonadotropin days, cleavage rate or advanced embryo rate showed no statistical difference in women withdifferent number of retrieved oocytes (P>0. 05). The fertilization rate in the Group F was less than that in other groups (P<0.05). The frozen embryo number, the serum E2 level and ovarian hyperstimulation syndrome rate were raised with number retrieved oocytes increased.The clinical pregnancy rate enhanced with the retrieved oocyte number increased in ≤15 oocytes of groups,while decreased in >15 oocytes of groups. The accumulated pregnancy rate

  6. In-vitro maturation versus IVF with GnRH antagonist for women with polycystic ovary syndrome: treatment outcome and rates of ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Das, Mausumi; Son, Weon-Young; Buckett, William; Tulandi, Togas; Holzer, Hananel

    2014-11-01

    In-vitro maturation (IVM) treatment has gained popularity for decreasing the incidence of ovarian hyperstimulation syndrome (OHSS) by eliminating or minimizing the use of gonadotrophins in women with polycystic ovary syndrome (PCOS). Studies have shown that IVF with GnRH-antagonist protocol is associated with a lower incidence of OHSS. Data comparing the relative success of these two treatments is, however, lacking. Treatment outcome and rates of OHSS were compared in patients with PCOS who underwent assisted conception with either IVM or IVF with GnRH-antagonist protocol between 2006 and 2011. The number of oocytes retrieved was higher in the IVM group, whereas the number of mature oocytes, fertilization rate and number of embryos cleaved were comparable. The implantation rate was higher in the IVF group. The clinical pregnancy rates per embryo transfer were not statistically different (IVF: 45.8% versus IVM: 32.4%). The live-birth rate was higher in the IVF group (IVF: 40.7% versus IVM: 23.5%; P = 0.04). Five women developed moderate or severe OHSS in the IVF group, whereas none did in the IVM group. Both IVM and IVF with GnRH-antagonist protocol seem to be effective treatment regimens in women with PCOS, although IVM is associated with a lower risk of OHSS.

  7. Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction

    Directory of Open Access Journals (Sweden)

    Ataollah Ghahiri

    2015-01-01

    Full Text Available Background: The purpose of this study was to compare the three different strategies, intravenous (IV hydroxylethyl starch (HES, IV human albumin (HA, and oral Cabergoline (Cb in the prevention of ovarian hyperstimulation syndrome (OHSS. Materials and Methods: In this prospective randomized clinical trial, 91 women at high risk of developing OHSS were allocated into the three groups, group one received 2 vial (2 × 50 ml IV HAs, in group two, 1000 ml of 6% HES was administered IV, both groups 30 min after oocyte retrieval within 4 h. Group three, 31 infertile patients received oral Cb 0.5 mg daily for 7 days after oocyte retrieval. Patients were visited 14 ± 1 days after in-vitro fertilization and if β-human chorionic gonadotropin level >10, transvaginal ultrasonography was performed 2 weeks later to confirm intrauterine pregnancy. Patients were followed up weekly for 3 months for signs of OHSS and were also informed about the signs of OHSS and asked to contact immediately if any symptoms of were detected. Results: None of the participants in group HES developed severe OHSS and only 3 patients (10% developed mild to moderate OHSS. The incident of severe OHSS was significantly higher in albumin group compared to Cb and HES group (P = 0.033 and P < 0.001, respectively. Also, the probability of developing severe OHSS was higher in Cb group than group HES (P = 0.031. Conclusion: The findings from this study suggest that administration of 1000 ml of HES 6% has a higher prophylactic effect compared to administration of IV HA and oral Cb.

  8. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles.

    Science.gov (United States)

    Steward, Ryan G; Lan, Lan; Shah, Anish A; Yeh, Jason S; Price, Thomas M; Goldfarb, James M; Muasher, Suheil J

    2014-04-01

    To investigate the association between oocyte number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth (LB) in fresh autologous in vitro fertilization (IVF) cycles. Retrospective cohort study. An academic reproductive medicine practice. We analyzed data from 256,381 IVF cycles using the 2008-2010 Society for Assisted Reproductive Technology national registry. Patients were divided into five groups based on retrieved oocyte number. Rates of OHSS and LB were calculated for each group. A generalized estimating equation (GEE) was used to assess differences in OHSS and LB between groups. Receiver operating characteristic (ROC) curves were used to evaluate oocyte number as a predictor of OHSS and LB. None. The LB rate increased up to 15 oocytes, then plateaued (0-5: 17%, 6-10: 31.7%; 11-15: 39.3%; 16-20: 42.7%; 21-25: 43.8%; and >25 oocytes: 41.8%). However, the rate of OHSS became much more clinically significant after 15 oocytes (0-5: 0.09%; 6-10: 0.37%; 11-15: 0.93%; 16-20: 1.67%; 21-25: 3.03%; and >25 oocytes: 6.34%). These trends remained after adjustment with the use of GEE. ROC curves revealed that although oocyte number is not useful in the prediction of LB, 15 retrieved oocytes is the number that best predicts OHSS risk. Retrieval of >15 oocytes significantly increases OHSS risk without improving LB rate in fresh autologous IVF cycles. In general, less aggressive stimulation protocols should be considered, especially in high-responders, to optimize outcomes. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Efficacy of Kisspeptin-54 to Trigger Oocyte Maturation in Women at High Risk of Ovarian Hyperstimulation Syndrome (OHSS) During In Vitro Fertilization (IVF) Therapy.

    Science.gov (United States)

    Abbara, Ali; Jayasena, Channa N; Christopoulos, Georgios; Narayanaswamy, Shakunthala; Izzi-Engbeaya, Chioma; Nijher, Gurjinder M K; Comninos, Alexander N; Peters, Deborah; Buckley, Adam; Ratnasabapathy, Risheka; Prague, Julia K; Salim, Rehan; Lavery, Stuart A; Bloom, Stephen R; Szigeti, Matyas; Ashby, Deborah A; Trew, Geoffrey H; Dhillo, Waljit S

    2015-09-01

    In vitro fertilization (IVF) treatment is an effective therapy for infertility, but can result in the potentially life-threatening complication, ovarian hyperstimulation syndrome (OHSS). This study aimed to investigate whether kisspeptin-54 can be used to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS. This was a phase 2, multi-dose, open-label, randomized clinical trial of 60 women at high risk of developing OHSS carried out during 2013-2014 at Hammersmith Hospital IVF unit, London, United Kingdom. Following a standard recombinant FSH/GnRH antagonist protocol, patients were randomly assigned to receive a single injection of kisspeptin-54 to trigger oocyte maturation using an adaptive design for dose allocation (3.2 nmol/kg, n = 5; 6.4 nmol/kg, n = 20; 9.6 nmol/kg, n = 15; 12.8 nmol/kg, n = 20). Oocytes were retrieved 36 h after kisspeptin-54 administration, assessed for maturation, and fertilized by intracytoplasmic sperm injection with subsequent transfer of one or two embryos. Women were routinely screened for the development of OHSS. Oocyte maturation was measured by oocyte yield (percentage of mature oocytes retrieved from follicles ≥ 14 mm on ultrasound). Secondary outcomes include rates of OHSS and pregnancy. Oocyte maturation occurred in 95% of women. Highest oocyte yield (121%) was observed following 12.8 nmol/kg kisspeptin-54, which was +69% (confidence interval, -16-153%) greater than following 3.2 nmol/kg. At all doses of kisspeptin-54, biochemical pregnancy, clinical pregnancy, and live birth rates per transfer (n = 51) were 63, 53, and 45%, respectively. Highest pregnancy rates were observed following 9.6 nmol/kg kisspeptin-54 (85, 77, and 62%, respectively). No woman developed moderate, severe, or critical OHSS. Kisspeptin-54 is a promising approach to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS.

  10. Prediction of Ovarian Hyperstimulation Syndrome in Patients Treated with Corifollitropin alfa or rFSH in a GnRH Antagonist Protocol.

    Directory of Open Access Journals (Sweden)

    Georg Griesinger

    Full Text Available What is the threshold for the prediction of moderate to severe or severe ovarian hyperstimulation syndrome (OHSS based on the number of growing follicles ≥ 11 mm and/or estradiol (E2 levels?The optimal threshold of follicles ≥11 mm on the day of hCG to identify those at risk was 19 for both moderate to severe OHSS and for severe OHSS. Estradiol (E2 levels were less prognostic of OHSS than the number of follicles ≥ 11 mm.In comparison to long gonadotropin-releasing hormone (GnRH agonist protocols, the risk of severe OHSS is reduced by approximately 50% in a GnRH antagonist protocol for ovarian stimulation prior to in vitro fertilisation (IVF, while the two protocols provide equal chances of pregnancy per initiated cycle. Nevertheless, moderate to severe OHSS may still occur in GnRH antagonist protocols if human chorionic gonadotropin (hCG is administered to trigger final oocyte maturation, especially in high responder patients. Severe OHSS following hCG trigger may occur with an incidence of 1-2% in a relatively young (aged 18 to 36 years IVF population treated in a GnRH-antagonist protocol.From the Engage, Ensure and Trust trials, in total, 2,433 women who received hCG for oocyte maturation and for whom the number of follicles ≥ 11 mm and the level of E2 on the day of hCG administration were known were included in the analyses.The threshold for OHSS prediction of moderate and severe OHSS was assessed in women treated with corifollitropin alfa or daily recombinant follicle stimulation hormone (rFSH in a gonadotropin-releasing hormone (GnRH-antagonist protocol. Receiver operating characteristics curve analyses for moderate to severe OHSS and severe OHSS were performed on the combined dataset and the sensitivity and specificity for the optimal threshold of number of follicles ≥ 11 mm, E2 levels on the day of (hCG, and a combination of both, were determined.The optimal threshold of follicles ≥ 11 mm on the day of hCG to identify those at

  11. Efficacy of Kisspeptin-54 to Trigger Oocyte Maturation in Women at High Risk of Ovarian Hyperstimulation Syndrome (OHSS) During In Vitro Fertilization (IVF) Therapy

    Science.gov (United States)

    Abbara, Ali; Jayasena, Channa N.; Christopoulos, Georgios; Narayanaswamy, Shakunthala; Izzi-Engbeaya, Chioma; Nijher, Gurjinder M. K.; Comninos, Alexander N.; Peters, Deborah; Buckley, Adam; Ratnasabapathy, Risheka; Prague, Julia K.; Salim, Rehan; Lavery, Stuart A.; Bloom, Stephen R.; Szigeti, Matyas; Ashby, Deborah A.; Trew, Geoffrey H.

    2015-01-01

    Context: In vitro fertilization (IVF) treatment is an effective therapy for infertility, but can result in the potentially life-threatening complication, ovarian hyperstimulation syndrome (OHSS). Objective: This study aimed to investigate whether kisspeptin-54 can be used to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS. Setting and Design: This was a phase 2, multi-dose, open-label, randomized clinical trial of 60 women at high risk of developing OHSS carried out during 2013–2014 at Hammersmith Hospital IVF unit, London, United Kingdom. Intervention: Following a standard recombinant FSH/GnRH antagonist protocol, patients were randomly assigned to receive a single injection of kisspeptin-54 to trigger oocyte maturation using an adaptive design for dose allocation (3.2 nmol/kg, n = 5; 6.4 nmol/kg, n = 20; 9.6 nmol/kg, n = 15; 12.8 nmol/kg, n = 20). Oocytes were retrieved 36 h after kisspeptin-54 administration, assessed for maturation, and fertilized by intracytoplasmic sperm injection with subsequent transfer of one or two embryos. Women were routinely screened for the development of OHSS. Main Outcome Measure: Oocyte maturation was measured by oocyte yield (percentage of mature oocytes retrieved from follicles ≥ 14 mm on ultrasound). Secondary outcomes include rates of OHSS and pregnancy. Results: Oocyte maturation occurred in 95% of women. Highest oocyte yield (121%) was observed following 12.8 nmol/kg kisspeptin-54, which was +69% (confidence interval, −16–153%) greater than following 3.2 nmol/kg. At all doses of kisspeptin-54, biochemical pregnancy, clinical pregnancy, and live birth rates per transfer (n = 51) were 63, 53, and 45%, respectively. Highest pregnancy rates were observed following 9.6 nmol/kg kisspeptin-54 (85, 77, and 62%, respectively). No woman developed moderate, severe, or critical OHSS. Conclusion: Kisspeptin-54 is a promising approach to effectively and safely

  12. 超促排卵并发中、重度卵巢过度刺激综合征的护理%Nursing of Patients with Moderate or Severe Ovarian Hyperstimulation Syndrome Caused by Superovulation

    Institute of Scientific and Technical Information of China (English)

    蔡微微

    2013-01-01

    Objective To discuss the nursing methods of patients with moderate or severe Ovarian Hyperstimulation Syndrome(OHSS) caused by superovulation. Methods Nursing experiences and clinical data of 80 patients with moderate or severe OHSS from June 2010 to June 2011 in our hospital were summarized retrospectively. Results All of the 80 patients recovered and released after active treatment and nursing, with 32 cases pregnant and 48 cases terminating pregnancy. Conclusion Preventive monitoring and psychological nursing,diet and medication education, abdominal distension and pain nursing, ascites drainage and discharge guidance all play important roles in nursing for patients with moderate or severe OHSS.%目的 探讨超促排卵治疗过程中并发中、重度卵巢过度刺激综合征(ovarian hyper-stimulation syndrome,OHSS)的护理对策.方法 回顾性总结2010年6月至2011年6月在接受体外受精-胚胎移植治疗的患者中,80例因超促排卵并发中、重度卵巢过度刺激综合征患者的临床资料及护理体会.结果 80例患者经积极治疗及护理后,均全部康复,其中32例获得妊娠、48例终止妊娠.结论 中、重度卵巢过度刺激综合征患者的护理重点应包括预防性监测及护理、心理护理、饮食及用药护理、腹胀及腹痛的护理、腹水引流的护理及出院后指导等.

  13. Peroxidação lipídica e vitamina E no soro e no fluido folicular de mulheres inférteis com endometriose submetidas à estimulação ovariana controlada Lipid peroxidation and vitamin E in serum and follicular fluid of infertile women with endometriosis submitted to controlled ovarian hyperstimulation

    Directory of Open Access Journals (Sweden)

    Carla Campos Petean

    2007-06-01

    Full Text Available OBJETIVO: avaliar o nível de peroxidação lipídica e vitamina E no fluido folicular e soro de pacientes inférteis, com ou sem endometriose, submetidas à indução da ovulação para procedimentos de reprodução assistida. MÉTODOS: estudo prospectivo envolvendo, consecutivamente, 36 pacientes inférteis com idade entre 20 e 38 anos, divididas em dois grupos: Endometriose (n=17 e Controle (n=19, laqueadura tubária prévia ou fator masculino. Amostras sanguíneas foram coletadas em: D1 (imediatamente antes do início do uso de gonadotrofinas, D2 (dia da aplicação da gonadotrofina coriônica humana e D3 (dia da aspiração folicular. Em D3, amostras de fluido folicular livres de contaminação sanguínea foram coletadas e armazenadas. O nível de eroxidação lipídica foi mensurado pela quantificação de malondialdeído (MDA por espectrofotometria, e o status antioxidante por meio da medida da vitamina E por cromatografia líquida de alta pressão. RESULTADOS: em D1, nenhuma diferença significante foi observada entre os Grupos Endometriose (2,4 nmol/mL e Controle (1,9 nmol/mL no nível de MDA. Contudo, os níveis de vitamina E foram significativamente mais elevados no Grupo Controle (24 mimol/L. Em D2, os níveis de MDA foram significantemente maiores no Grupo Endometriose (2,3 nmol/mL quando comparados com o Controle (1,4 nmol/mL, enquanto os níveis de vitamina E permaneceram significativamente mais elevados no Controle (23,4 mimol/L. Em D3 não houve diferença significante nos níveis de MDA e de vitamina E do soro e fluido folicular entre os grupos. Contudo, em D3, os níveis de vitamina E foram significativamente mais elevados no soro do que no fluido folicular em ambos os grupos, e os níveis de MDA foram significativamente menores no fluido folicular do que no soro apenas no Grupo Controle. CONCLUSÃO: antes do início da indução da ovulação, uma diminuição significativa nos níveis séricos de vitamina E foi observada em

  14. Clinical application of single-blastocyst transfer in high-risk patients for ovarian hyperstimulation syndrome%卵巢过度刺激综合征高风险患者单囊胚移植的应用

    Institute of Scientific and Technical Information of China (English)

    窦倩; 孙莹璞; 金海霞; 王芳; 苏迎春

    2012-01-01

    目的:探讨在卵巢过度刺激综合征(OHSS)高风险患者中移植单囊胚的妊娠结局.方法:回顾分析2009年8月至2011年8月在我中心助孕的患者,OHSS高风险患者中移植单囊胚者为囊胚组(136例)、移植D3天新鲜胚胎者为胚胎组(142例)、全部胚胎冷冻后择期行冻融胚胎移植者为冷冻组(155例),分析组间临床特征、超促排卵情况、胚胎质量、妊娠率、着床率、多胎率、中重度OHSS发生率.结果:3组间的临床特征、超排卵情况、胚胎形成情况均无统计学差异(P>0.05).3组间着床率、临床妊娠率、多胎妊娠率、中重度OHSS发生率均有统计学差异(P<0.05).单囊胚移植组的着床率(51.47%)高于其他两组,临床妊娠率(51.47%)高于冻融胚胎组,多胎率(1.43%)明显低于其他两组,中重度OHSS发生率(0.74%)低于胚胎移植组,与冻融胚胎组无明显差异.结论:单囊胚移植在保证较高妊娠率的同时显著降低了多胎妊娠率,但并未增高OHSS发生率.%Objective; To investigate the pregnancy outcomes of single-blastoeyst transfer (SBT)in the patients who have high-risk for OHSS. Methods; The clinical data of the patients who received assisted reproductive technology in our center during August 2009 to August 2011 were analyzed retrospectively. The high-risk patients for OHSS who received SBT were for trial group, who received cleavage-stage embryo transfer and freezing embryo transfer for two control groups. The clinical features, controlled ovarian hyperstimulation ( COH ) , pregnancy rate, implantation rate, multiple pregnancy rate, incidence of moderate to severe OIISS were included. Results: The clinical characteristics, COH, embryo formation among the three groups had no statistical difference ( P>0. 05) . Implantation rate , clinical pregnancy rate, multiple pregnancy rate, the rate of occurrence of severe OHSS among the three groups were significantly different (P<0.05). Implantation rale

  15. Ovarian response during IVF cycle following laparascopic cystectomy of ovarian endometrioma

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    Nasrin Moghadami Tabrizi

    2013-07-01

    Full Text Available Background: Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF (In vitro fertilization cycle following laparoscopic unilateral cystectomy of endometrioma. Methods: In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of  unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary. Results: The mean age (±SD of patients was 32.3 (±3.4. The mean (±SD diameter of excised ovarian endometrioma was 42.4 (±10.4 mm. Interval since ovarian surgery to induction ovulation was 2.7 (±2.6 years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was 2.5 (±1.2 with the range of 1 to 5 and in the control ovary 3.9 (±1.4 with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one (P<0.001.Conclusion: Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.

  16. 单胎与多胎妊娠卵巢过度刺激综合征的临床分析%Clinical Analysis of Single and Multiple Fetus Pregnancy Complicated with Ovarian Hyperstimulation Syndrome

    Institute of Scientific and Technical Information of China (English)

    江兴; 杨菁

    2012-01-01

    Objective: To investigate the clinical manifestations and pregnancy outcomes of single and multiple fetus pregnancy complicated with ovarian hyperstimulation syndrome(OHSS) after IVF-ET or ICSI. Methods : 52 cases of single fetus and 96 cases of multiple pregnancy complicated with OHSS after IVF-ET or ICSI from January 2005 to January 2011 in the Reproductive Center of our hospital were retrospectively analyzed. Results : (1) Multiple fetus pregnancy had longer disease process, more severe symptoms, more usage of albumin for treatment of OHSS, higher incidence rates of ascites and hydrothorax, more chest puncture than single fetus pregnancy(P < 0.05, P < 0.01). (2) The rates of miscarriage and premature delivery were higher in multiple pregnancy than those in single pregnancy(P<0.05,P<0.01). Conclusions:Multiple pregnancywill worsen and prolong the clinical process of OHSS, even cause adverse pregnancy outcomes, so controlling the number of embryo transfer is crucial for the prevention of OHSS.%目的:探讨辅助生殖技术中的卵巢过度刺激综合征(OHSS)患者中单胎与多胎妊娠的临床特征及妊娠结局.方法:对2005年1月至2011年1月在我院生殖中心行常规体外受精-胚胎移植(IVF-ET)/单精子胞浆内注射(ICSI)治疗周期中发生OHSS住院治疗的52例单胎及96例多胎患者进行回顾性分析,比较两组患者的临床特征.结果:①多胎妊娠患者较单胎OHSS病程长、肝肾功能损害大、白蛋白使用率高(P<0.01,P<0.05),多胎的胸腹水发生率及胸腔穿刺率较单胎高(P<0.05).②多胎妊娠与单胎妊娠OHSS患者的结局比较:多胎妊娠的流产率及早产率均较单胎妊娠高(P <0.05,P<0.01).结论:多胎妊娠会加重并延长OHSS的临床病情,并对妊娠结局产生不利影响,控制好胚胎移植数量是预防OHSS发生的关键环节.

  17. Is ovarian hyperstimulation associated with higher blood pressure in 4-year-old IVF offspring? Part II : an explorative causal inference approach

    NARCIS (Netherlands)

    La Bastide-Van Gemert, Sacha; Seggers, Jorien; Haadsma, Maaike L.; Heineman, Maas Jan; Middelburg, Karin J.; Roseboom, Tessa J.; Schendelaar, Pamela; Hadders-Algra, Mijna; Van den Heuvel, Edwin R.

    STUDY QUESTION: What causal relationships underlie the associations between ovarian stimulation, the IVF procedure, parental-, fertility- and child characteristics, and blood pressure (BP) and anthropometrics of 4-year-old IVF children? SUMMARY ANSWER: Causal models compatible with the data suggest

  18. Preterm ovarian hyperstimulation syndrome: a case report and literature review%早产卵巢过度刺激综合征一例并文献复习

    Institute of Scientific and Technical Information of China (English)

    陈翠娥; 狄天伟; 朱融和; 张玲玲; 王楸; 钱燕; 孙媛媛

    2016-01-01

    Objective To discuss the clinical characteristics,pathogenesis,diagnosis and treatment of preterm ovarian hyperstimulation syndrome (POHS).Method The process of diagnosis and treatment of a test-tube female baby were summarized.She was deliveried at 32+2 weeks of gestation,diagnosed with POHS,and born in the First Affiliated Hospital of Wenzhou Medical University(in 2015).Retrieval of related literature in PubMed database and Wanfang database was performed using the key words "ovarian hyperstimulation syndrome" and " preterm infants or newborns" from 1980 to 2015.Result The patient developed labial hyperemia and edema,ectropion of vaginal mucosa and plica,swelling of the hypogastrium and upper legs at 41 days (38+1 weeks post-conception).The child was continuously observed because diagnosis was not clear.The pelvic and abdominal ultrasonography examinations revealed a cyst in the right ovary and laboratory evaluation of the baby showed high concentrations of gonadotropin and estradiol at 49 days (39+2 weeks post-conception),and thus the baby was diagnosed with POHS.With no special intervention measures,the baby became normal at 169 days (4 months post-conception).Six papers from foreign literature were retrieved and none from Chinese literature,which reported 12 cases of POHS.They all characterized prematurity,ovarian cyst/cysts,labial hyperemia and edema,swelling of the hypogastrium and upper leg,high serum gonadotropin and estradiol levels at 35 to 39 weeks post-conception,including 3 cases with breast enlargement,1 case with vaginal bleeding and 1 case with ectropion of vaginal mucosa and plica.The treatments included in 1 case combined surgery with pharmacological intervention,in another case only pharmacological intervention,and in the others no interventional measures were taken but were only followed up.As for the results,the baby with the surgical treatment had recurrence,but the symptoms,ovarian cyst and hormone concentration of the other babies gradually

  19. Outcomes and Recommendations of an Indian Expert Panel for Improved Practice in Controlled Ovarian Stimulation for Assisted Reproductive Technology

    Science.gov (United States)

    Ahemmed, Baiju; Sundarapandian, Vani; Gutgutia, Rohit; Balasubramanyam, Sathya; Jagtap, Richa; Biliangady, Reeta; Gupta, Priti; Jadhav, Sachin; Satwik, Ruma; Thakor, Priti

    2017-01-01

    Purpose. To improve success of in vitro fertilization (IVF), assisted reproductive technology (ART) experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR)? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should “freeze-all” policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG) administration? Methods. Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART. Results. Strong association existed between retrieved oocytes number (RON) and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS). Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration. Conclusions. Ovarian stimulation should be designed to retrieve 10–15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH) antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt “freeze-all” policy. Further research is needed due to lack of data availability on progesterone threshold or index. PMID:28246628

  20. The Application of GnRH-antagonist to Mediate Ovarian Hyperstimulation%GnRH拮抗剂在超促排卵中的应用

    Institute of Scientific and Technical Information of China (English)

    付敏; 钱卫平; 房尚华; 杨伟洪; 张秋菊

    2013-01-01

    Objective:To compare the clinical outcomes of protocols with GnRH antagonist and agonist for ovarian stimulation.Methods:To observe endometrial width and E2 concentrations on the day of HCG trigger,fertilization,usable embryo percentage,clinical pregnancy rate,implantation,miscarriage rates between GnRH antagonist and agonist groups,between the prengnancy and non-pregnancy group.Results:The total clinic characters are similar beteen GnRH antagonist and agonist group.E2 concentrations on the day of HCG trigger and usable embryo percent were significantly higher in GnRH antagonist pregnancy group compared with the non-pregnancy group.Conclusion:The slow or pausal increase of E2 concentrations on the late luteal and the low E2 concentrations on the day of HCG.trigger,who indicate inferior pregnancy outcomes.Further studies will be needed for confirmation weather GnRH antagonist was harmful to the endometrium and embryos.%目的:比较GnRH拮抗剂与GnRH激动剂促排卵方案的临床应用效果.方法:比较GnRH拮抗剂与GnRH激动剂方案及GnRH拮抗剂方案妊娠组与非妊娠组的HCG日子宫内膜厚度及E2水平、受精率、可用胚胎率、着床率、临床妊娠率、流产率等.结果:GnRH拮抗剂与GnRH激动剂方案的临床资料无统计学差异,GnRH拮抗剂方案妊娠组血E2水平及可用胚胎率明显高于非妊娠组,差异具有统计学意义.结论:GnRH拮抗剂方案中卵泡后期血E2上升缓慢或停滞,血HCG日E2明显偏低,提示妊娠结局不良.但是,GnRH拮抗剂是否对子宫内膜及胚胎有影响仍需进一步研究.

  1. 卵巢过度刺激综合征高风险患者单胚胎移植妊娠结局分析%Analysis of the pregnancy outcomes of single embryo transfer in patients with high risks for ovarian hyperstimulation syndrome

    Institute of Scientific and Technical Information of China (English)

    单丹; 葛红山; 陈华; 黄永刚; 侯晓红; 肖宇; 吕杰强

    2013-01-01

    目的:探讨卵巢过度刺激综合征高风险患者单胚胎移植的妊娠结局.方法:回顾性分析2010年3月至2012年3月在我院生殖中心进行体外受精-胚胎移植(IVF-ET)治疗的不孕患者资料,卵巢过度刺激综合征(OHSS)高风险患者行单胚胎移植113个周期(A组),行双胚胎移植173个周期(B组),行全胚冷冻首次冻融胚胎移植122个周期(C组),比较三组之间一般情况、促排情况、胚胎发育情况及临床妊娠率、种植率、多胎率、中重OHSS发生率.结果:三组不孕患者体重指数、基础FSH、Gn使用量、Gn使用时间、HCG注射日E2水平、获卵率、正常受精率、卵裂率、优质胚胎率比较差异均无统计学意义(P>0.05).C组种植率低于A组和B组(P<0.05),但三组之间的临床妊娠率比较差异均无统计学意义(P>0.05).中重度OHSS发生率A组(0.88%)和C组(0.82%)明显小于B组(5.78%),多胎率A组(0%)明显<B组(30.38%)和C组(23.81%)差异均有统计学意义(P<0.05).结论:卵巢过度刺激综合征高风险患者行单胚胎移植可以减小OHSS及多胎妊娠的发生,且不影响临床妊娠率.%Objective To investigate the pregnancy outcomes of single-embryo transfer (SET) in patients with high risks for ovarian hyperstimulation syndrome (OHSS). Methods Data of patients who received assisted reproductive technology in our center from March 2010 to March 2012 were retrospectively analyzed. Patients with high risks for OHSS were divided into 3 groups; Group A received 113 cycles of SET, Group B received 173 cycles of double embryo transfer (DET), Group C received 122 cycles of freezing embryo transfer (FET). The clinical general condition, controlled ovarian hyperstimulation (COH), embryo development information, pregnancy rate, implantation rate, multiple pregnancy rate, incidence of moderate to severe OHSS were recorded and analyzed. Results The general condition, COH, embryo information among the three groups

  2. "hCG priming" effect in controlled ovarian stimulation through a long protocol

    Directory of Open Access Journals (Sweden)

    Antsaklis Aris

    2009-08-01

    Full Text Available Abstract Background Recently, it has been demonstrated that, in patients down-regulated by GnRH analogues (GnRHa, a short-term pre-treatment with recombinant LH (rLH, prior to recombinant FSH (rFSH administration, increases the number of small antral follicle prior to FSH stimulation and the yield of normally fertilized embryos. However, no data exist in the literature regarding the potential beneficial effect of "hCG priming" in controlled ovarian hyperstimulation (COH through a long GnRH-a protocol, which binds the same receptor (LH/hCGR, though it is a much more potent compared to LH. The primary aims of this study were to assess the effect of short-term pre-rFSH administration of hCG in women entering an ICSI treatment cycle on follicular development, quality of oocytes and early embryo development. The secondary endpoints were to record the effects on endometrial quality and pregnancy rate. Methods Patients with a history of at least one previous unsuccessful ICSI cycle were randomly assigned into two groups to receive treatment with either a long protocol with rFSH (control group or a long protocol with rFSH and pre-treatment with hCG (hCG group. In particular, in the latter group, a fixed 7 days course of 200 IU/day hCG was administered as soon as pituitary desensitization was confirmed. Results The mean number of oocytes retrieved was not significantly different between the two treatment groups, although the percentage of mature oocytes tended to be higher but not significantly different in hCG-treated patients. The percentage of patients with more than one grade 3 embryos was higher in the pre-treatment group, which also showed a higher pregnancy rate. Conclusion All the above clinical observations, in conjunction with previous data, suggest a point towards a beneficial "hCG priming" effect in controlled ovarian hyperstimulation through a long GnRH-a down-regulation protocol, particularly in patients with previous ART failures.

  3. Control of ovarian primordial follicle activation

    Science.gov (United States)

    2012-01-01

    The ovarian follicles develop initially from primordial follicles. The majority of ovarian primordial follicles are maintained quiescently as a reserve for the reproductive life span. Only a few of them are activated and develop to an advanced follicular stage. The maintenance of dormancy and activation of primordial follicles are controlled by coordinated actions of a suppressor/activator with close communications with somatic cells and intra-oocyte signaling pathways. Many growth factors and signaling pathways have been identified and the transforming growth factor-beta superfamily plays important roles in early folliculogenesis. However, the mechanism of maintaining the dormancy and survival of primordial follicles has remained unknown for decades. Recently, since the first finding that all primordial follicles are activated prematurely in mice deficient forkhead box O3a, phosphatidylinositol 3 kinase/phosphatase and tensin homolog (PTEN) signaling pathway was reported to be important in the regulation of dormancy and initial follicular activation. With these informations on early folliculogenesis, clinical application can be expected such as in vitro maturation of immature oocytes or in vitro activation of follicles by PTEN inhibitor in cryopreserved ovarian cortical tissues for fertility preservation. PMID:22563545

  4. Relationship of Single Nucleotide Polymorphisms of AMH/AMHR Ⅱ and Ovarian Hyperstimulation Syndrome%抗苗勒氏管激素及其受体Ⅱ的基因多态性与卵巢过度刺激综合征关系初探

    Institute of Scientific and Technical Information of China (English)

    赵义清; 章汉旺

    2013-01-01

    Objective: To investigate the relationship between single nucleotide polymorphism (SNP) of anti-Miillerian hormone/anti-Müllerian hormone receptor Ⅱ (AMH/AMHR Ⅱ) and ovarian hyperstimulation syndrome (OHSS). Methods: A total of 27 patients with OHSS and 22 non-OHSS healthy controls were recruited in this study. Polymorphisms and genotype of AMH and AMHRII exons were detected by polymerase chain reaction (PCR) and DNA sequencing. Results: Statistically significant difference in the distribution of AMH first exon 146 G>T and AMH second exon 134 G>A genotypes was found between OHSS group and the control(PA was found between OHSS group and the control (P>0.05). No mutation was found in AMHR Ⅱ exons. Conclusion: The single nucleotide polymorphisms of AMH may associate with OHSS.%目的:初步探讨抗苗勒氏管激素(AMH)及其受体Ⅱ (AMHR Ⅱ)的基因多态性与卵巢过度刺激综合征(OHSS)的关系.方法:采用聚合酶链反应(PCR)和DNA测序法,分别检测27例OHSS患者和22例促排卵后非OHSS患者(对照组)的AMH及其受体AMHR Ⅱ的基因外显子DNA序列,行单核苷酸多态性(SNP)分析.结果:OHSS组AMH的第1外显子146位G>T、第2外显子134位G>A基因型分布与对照组比较,有统计学差异(P<0.05).OHSS组AMH基因的第1外显子303位G>A基因型与对照组比较,无统计学差异(P>0.05). OHSS组和对照组AMHR Ⅱ基因的1~11号外显子均未检测出SNP突变.结论:AMH基因多态性可能是导致卵巢对外源性激素敏感性增强、OHSS发病的因素之一.

  5. Effects of ketoconazole on ovarian response in patients with polycystic ovarian syndrome: A double blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Niloofar Memarpour

    2007-03-01

    Full Text Available Objective: The study assessed the efficacy of low dose ketoconazole in addition to clomiphene citrate (CC and hMG on ovulation induction.Materials and methods:A double blind, randomized, clinical trial was performed on fifty infertile patients with PCOS who had failed to respond to a daily dose of hMG and 100 mg CC for controlled ovarian hyperstimulation in Vali-e-Asr Reproductive Health Research Center.These patients were randomly divided into two equal groups receiving ketoconazole or placebo.All patients received CC and hMG for controlled ovarian hyperstimulation.Number of mature follicles, estradiol and progesterone levels at the time of hCG adminstration, endometrial thickness, ovarian hyperstimulation syndrome(OHSS, pregnancy rate, abortion, multiple pregnancies were measured. SPSS 11 software was used for statistical analysis. Statistical significance was defined as P < 0.05.Results: No significant statistical differences existed in the number of mature follicles,   estradiol and progesterone levels prior to hCG administration ,endometrial thickness, OHSS and pregnancy rate between two groups. Estradiol level was lower among those receiving ketoconazole. No abortion and multiple pregnancy were found.Conclusion: Ketoconazole may suppress steroid production in resistant PCOS patients undergoing CC and hMG induction. But it has no effects on follicular maturation and OHSS prevention.

  6. Controlled Ovarian Stimulation Using Medroxyprogesterone Acetate and hMG in Patients With Polycystic Ovary Syndrome Treated for IVF

    Science.gov (United States)

    Wang, Yun; Chen, Qiuju; Wang, NingLing; Chen, Hong; Lyu, Qifeng; Kuang, Yanping

    2016-01-01

    Abstract Ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation is a current challenge for patients with polycystic ovarian syndrome (PCOS). Our previous studies indicated that progestin can prevent premature luteinizing hormone (LH) surge or moderate/severe OHSS in the general subfertile population, both in the follicular-phase and luteal-phase ovarian stimulation but it is unclear if this is true for patients with PCOS. The aim of the article was to analyze cycle characteristics and endocrinological profiles using human menopausal gonadotropin (hMG) in combination with medroxyprogesterone acetate (MPA) for PCOS patients who are undergoing IVF/intracytoplasmic sperm injection (ICSI) treatments and investigate the subsequently pregnancy outcomes of frozen embryo transfer (FET). In the randomized prospective controlled study, 120 PCOS patients undergoing IVF/ICSI were recruited and randomly classified into 2 groups according to the ovarian stimulation protocols: hMG and MPA (group A, n = 60) or short protocol (group B, n = 60). In the study group, hMG (150–225IU) and MPA (10 mg/d) were administered simultaneously beginning on cycle day 3. Ovulation was cotriggered by a gonadotropinreleasing hormone (GnRH) agonist (0.1 mg) and hCG (1000IU) when dominant follicles matured. A short protocol was used as a control. The primary end-point was the ongoing pregnancy rate per transfer and incidence of OHSS. Doses of hMG administrated in group A are significantly higher than those in the controls. LH suppression persisted during ovarian stimulation and no incidence of premature LH surge was seen in both groups. The fertilization rate and the ongoing pregnant rate in the study group were higher than that in the control. The number of oocytes retrieved, mature oocytes, clinical pregnancy rates per transfer, implantation rates, and cumulative pregnancy rates per patient were comparable between the 2 groups. The incidence of OHSS was low between the 2

  7. Laparoscopic ovarian diathermy after clomiphene failure in polycystic ovary syndrome: is it worthwhile? A randomized controlled trial.

    Science.gov (United States)

    Abu Hashim, Hatem; Foda, Osama; Ghayaty, Essam; Elawa, Ahmed

    2011-11-01

    Laparoscopic ovarian diathermy (LOD) represents a successful treatment option for women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). However, in case of CC failure PCOS, LOD offers several theoretical advantages. This study was conducted to compare the efficacy of LOD versus continuation of CC up to six further cycles in PCOS patients who failed to achieve pregnancy despite the previous successful CC induced ovulation. One hundred and seventy six infertile women with CC failure PCOS were selected in this randomized controlled trial. Patients (n = 87) underwent LOD with 6 months follow-up or received CC (n = 89) up to six cycles. Outcome measures were; clinical pregnancy rate, midcycle endometrial thickness, cycle length, miscarriage and live birth rates. The clinical pregnancy rate per patient and the cumulative pregnancy rate after six cycles were comparable in both groups (39 vs. 33.7% and 47 vs. 39.2%, respectively). Four twin pregnancies occurred in CC group and none in LOD group and the difference was statistically significant (p < 0.05). No significant difference in midcycle endometrial thickness was observed (8.8 ± 1.2 mm vs. 7.7 ± 1.1 mm). Improvement in cycle length, miscarriage and live birth rates were comparable in both groups. No cases of ovarian hyperstimulation syndrome occurred in either group. LOD during the 6 months follow-up period and CC for up to six further cycles are equally effective for achieving pregnancy in CC failure PCOS patients.

  8. Ovarian endometriomas and IVF: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Guidetti Daniela

    2011-06-01

    Full Text Available Abstract We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112 were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142. Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins.

  9. 高反应人群超排卵%Controlled ovarian stimulation for high responder women undergoing in vitro fertilization

    Institute of Scientific and Technical Information of China (English)

    叶虹

    2012-01-01

    High responder women are characterized by high response to exogenous gonadotrophin therapy manifested hy recruitment of a large number of follicles, rapid estradiol response and significant cancellation rate due to the potential risk of ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization-embryo transfer. Even for those patients who progress to oocyte retrieval and embryo transfer, appreciably lower fertilization rate and chromosomally normal blastocyst development rate are found. The super ovulation strategies for high responder women are included to reduce excessive ovarian stimulation and avoid OHSS by several approaches, such as dual suppression with oral contraceptives and GnRH agonist, reduced doses of GnRH agonist, GnRH antagonist protocol and GnRH agonist instead of hCG to trigger the final oocyte maturation, gonadotrophins step up and step down, different gonadotrophins for ovarian stimulation, application of metf ormin, and mild ovarian stimulation.

  10. The gonadotropin-releasing hormone antagonist protocol--the protocol of choice for the polycystic ovary syndrome patient undergoing controlled ovarian stimulation

    DEFF Research Database (Denmark)

    Kol, Shahar; Homburg, Roy; Alsbjerg, Birgit

    2012-01-01

    Polycystic ovary syndrome (PCOS) patients are prone to develop ovarian hyperstimulation syndrome (OHSS), a condition which can be minimized or completely eliminated by the use of a gonadotropin-releasing hormone agonist (GnRHa) trigger. In this commentary paper, we maintain that the gonadotropin-releasing...... hormone antagonist protocol should be the protocol of choice for the PCOS patient undergoing ovarian stimulation with gonadotropins for in vitro fertilization. If an excessive ovarian response is encountered, the clinician will always have two options: either to trigger final oocyte maturation...

  11. [Three cases of ovarian cancer after ovulation induction for infertility].

    Science.gov (United States)

    Abboud, J; Attieh, E; Atallah, D; Kessrouani, A; Chaoul, G

    1997-01-01

    We report three cases of ovarian carcinoma associated with fertility drugs. Two patients were hyperstimulated by clomiphen citrate (CC). The third had hMG + CC. Two of these patients had a Borderline ovarian carcinoma and the third had an invasive ovarian carcinoma associated with endometrial carcinoma.

  12. Ovarian cancer and talc: a case-control study.

    Science.gov (United States)

    Cramer, D W; Welch, W R; Scully, R E; Wojciechowski, C A

    1982-07-15

    Opportunities for genital exposure to talc were assessed in 215 white females with epithelial ovarian cancers and in 215 control women from the general population matched by age, race, and residence. Ninety-two (42.8%) cases regularly used talc either as a dusting powder on the perineum or on sanitary napkins compared with 61 (28.4%) controls. Adjusted for parity and menopausal status, this difference yielded a relative risk of 1.92 (P less than 0.003) for ovarian cancer associated with these practices. Women who had regularly engaged in both practices had an adjusted relative risk of 3.28 (P less than 0.001) compared to women with neither exposure. This provides some support for an association between talc and ovarian cancer hypothesized because of the similarity of ovarian cancer to mesotheliomas and the chemical relation of talc to asbestos, a known cause of mesotheliomas. The authors also investigated opportunities for potential talc exposure from rubber products such as condoms or diaphragms or from pelvic surgery. No significant differences were noted between cases and controls in these exposures, although the intensity of talc exposure from these sources was likely affected by variables not assessed in this study.

  13. Controlled Ovarian Stimulation Using Medroxyprogesterone Acetate and hMG in Patients With Polycystic Ovary Syndrome Treated for IVF: A Double-Blind Randomized Crossover Clinical Trial.

    Science.gov (United States)

    Wang, Yun; Chen, Qiuju; Wang, NingLing; Chen, Hong; Lyu, Qifeng; Kuang, Yanping

    2016-03-01

    Ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation is a current challenge for patients with polycystic ovarian syndrome (PCOS). Our previous studies indicated that progestin can prevent premature luteinizing hormone (LH) surge or moderate/severe OHSS in the general subfertile population, both in the follicular-phase and luteal-phase ovarian stimulation but it is unclear if this is true for patients with PCOS. The aim of the article was to analyze cycle characteristics and endocrinological profiles using human menopausal gonadotropin (hMG) in combination with medroxyprogesterone acetate (MPA) for PCOS patients who are undergoing IVF/intracytoplasmic sperm injection (ICSI) treatments and investigate the subsequently pregnancy outcomes of frozen embryo transfer (FET). In the randomized prospective controlled study, 120 PCOS patients undergoing IVF/ICSI were recruited and randomly classified into 2 groups according to the ovarian stimulation protocols: hMG and MPA (group A, n = 60) or short protocol (group B, n = 60). In the study group, hMG (150-225IU) and MPA (10 mg/d) were administered simultaneously beginning on cycle day 3. Ovulation was cotriggered by a gonadotropinreleasing hormone (GnRH) agonist (0.1 mg) and hCG (1000IU) when dominant follicles matured. A short protocol was used as a control. The primary end-point was the ongoing pregnancy rate per transfer and incidence of OHSS. Doses of hMG administrated in group A are significantly higher than those in the controls. LH suppression persisted during ovarian stimulation and no incidence of premature LH surge was seen in both groups. The fertilization rate and the ongoing pregnant rate in the study group were higher than that in the control. The number of oocytes retrieved, mature oocytes, clinical pregnancy rates per transfer, implantation rates, and cumulative pregnancy rates per patient were comparable between the 2 groups. The incidence of OHSS was low between the 2 groups, with

  14. Efficacy of Dehydroepiandrosterone (DHEA) to overcome the effect of ovarian ageing (DITTO): A proof of principle double blinded randomized placebo controlled trial.

    Science.gov (United States)

    Narkwichean, Amarin; Maalouf, Walid; Baumgarten, Miriam; Polanski, Lukasz; Raine-Fenning, Nick; Campbell, Bruce; Jayaprakasan, Kannamannadiar

    2017-09-08

    To evaluate the effect of DHEA supplementation on In-Vitro Fertilisation (IVF) outcome as assessed by ovarian response, oocyte developmental competence and live birth rates in women predicted to have poor ovarian reserve (OR). The feasibility of conducting a large trial is also assessed by evaluating the recruitment rates and compliance of the recruited participants with DHEA/placebo intake and follow-up rates. A single centre, double blinded, placebo controlled, randomized trial was performed over two years with 60 women undergoing in-vitro fertilisation (IVF). Subjects were randomized, based on a computer-generated pseudo-random code to receive either DHEA or placebo with both capsules having similar colour, size and appearance. 60 women with poor OR based on antral follicle count or anti-Mullerian hormone thresholds undergoing IVF were recruited. They were randomised to receive DHEA 75mg/day or placebo for at-least 12 weeks before starting ovarian stimulation. They had long protocol using hMG 300 IU/day. Data analysed by "intention to treat". Ovarian response, live birth rates and molecular markers of oocyte quality were compared between the study and control groups. The recruitment rate was 39% (60/154). A total of 52 participants (27 versus 25 in the study and placebo groups) were included in the final analysis after excluding eight. While the mean (standard deviation) DHEA levels were similar at recruitment (9.4 (5) versus 7.5 (2.4) ng/ml; P=0.1), the DHEA levels at pre-stimulation were higher in the study group than in the controls (16.3 (5.8) versus 11.1 (4.5) ng/ml; PDHEA supplementation, albeit statistical power in this study is low, did not improve the response to controlled ovarian hyperstimulation or oocyte quality or live birth rates during IVF treatment with long protocol in women predicted to have poor OR. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  15. Clinical observation on preventing ovarian hyperstimulation syndrome by frozen-thawed embryo transfer after all embryo freezing%全胚冷冻后行冻融胚胎移植预防卵巢过度刺激综合征的临床观察

    Institute of Scientific and Technical Information of China (English)

    黄永刚; 黄朝霞; 侯晓红; 肖宇; 吕杰强

    2012-01-01

    Objective: To compare the clinical pregnancy outcomes of frozen - thawed embryo transfer (FET) after all embryo freezing and routine in -vitro fertilization and embryo transfer (IVF - ET) , and explore the clinical application for prevention of ovarian hyperstimulation syndrome ( OHSS) . Methods: The clinical data of 124 patients receiving FET to prevent moderate and severe OHSS and 987 patients receiving routine long protocol of IVF — ET were analyzed retrospectively, ihe embryo implantation rates and clinical pregnancy rates in the two groups were compared. Results: There was no statistically significant difference in age, duration of infertility, body mass index, the number of transferred embryos, embryo implantation rate, and clinical pregnancy rate between the two groups ( P > 0. 05 ) , After IVF -ET, 25 patients in patients receiving IVF, went to hospital for treatment because of severe OHSS, and no one in patients receiving FET went to hospital. Conclusion: FET after all embryo freezing can achieve a good pregnancy outcome, which is a safe clinical application scheme for preventing moderate and severe OHSS.%目的:比较全胚冷冻后行冻融胚胎移植(FET)和常规体外受精-胚胎移植(IVF-ET)的临床妊娠结局,探讨预防卵巢过度刺激综合征(OHSS)的临床应用.方法:回顾性分析1VF-ET过程中为防止中、重度OHSS而行FET的124例患者和常规长方案IVF-ET987例患者的临床资料,比较其胚胎种植率、临床妊娠率.结果:2组的年龄、不孕年限、体重指数差异无统计学意义(P>0.05),移植胚胎个数、胚胎种植率、临床妊娠率差异亦无统计学意义(P>0.05).IVF组移植后有25例患者因重度OHSS发生而住院治疗,冷冻组无一例住院治疗.结论:全胚冷冻后行冻融胚胎移植可以获得良好的妊娠结局,是一项安全的预防中、重度卵巢过度刺激综合征的临床应用方案.

  16. AMH: An ovarian reserve biomarker in assisted reproduction.

    Science.gov (United States)

    Peluso, C; Fonseca, F L A; Rodart, I F; Cavalcanti, V; Gastaldo, G; Christofolini, D M; Barbosa, C P; Bianco, B

    2014-11-01

    Ovarian reserve tests provide knowledge of a possible response to controlled ovarian hyperstimulation in patients undergoing assisted reproduction treatment, allowing management and alteration of treatment protocol with the appropriate dose of gonadotrophin. Several parameters have been used as predictors of ovarian response. The basal FSH serum level on the third day of the menstrual cycle seemed to be the best predictor, but with significant intraindividual variability from one cycle to another. Thus, the anti-Müllerian hormone (AMH) emerges as a new ovarian test marker. AMH is produced exclusively in the gonads, by the granulosa cells, and plays an important role in folliculogenesis, acting on the modulation of follicular recruitment in the granulosa cells in order to limit the number of recruited oocytes and to regulate the number of growing follicles and their selection for ovulation. It has been suggested that AMH is strongly associated with oocyte yield after ovarian stimulation and could therefore be capable of predicting the ovarian response and the quality of oocytes and embryos. In this review, we discuss the role of AMH in assisted reproduction outcomes.

  17. Ovarian Hyper-Response to Administration of an GnRH-Agonist Without Gonadotropins

    OpenAIRE

    Park, Hyun Tae; Bae, Hyo Sook; Kim, Tak; Kim, Sun Haeng

    2011-01-01

    Several case reports have indicated that a small subgroup of patients may develop ovarian hyperstimulation following the administration of gonadotropin-releasing hormone agonists (GnRHa) without gonadotropins. However, since only few such cases have been published, it is unclear what course to follow in subsequent cycles after ovarian hyperstimulation in the first cycle using only GnRHa. A 33-yr-old woman was referred to in vitro fertilization for oocyte donation. A depot preparation (3.75 mg...

  18. Reference values in ovarian response to controlled ovarian stimulation throughout the reproductive period.

    Science.gov (United States)

    La Marca, Antonio; Grisendi, Valentina; Spada, Elena; Argento, Cindy; Milani, Silvano; Plebani, Maddalena; Seracchioli, Renato; Volpe, Annibale

    2014-01-01

    Abstract The age-related decline in ovarian response to gonadotropins has been well known since the beginning of ovarian stimulation in IVF cycles and has been considered secondary to the age-related decline in ovarian reserve. The objective of this study was to establish reference values and to construct nomograms of ovarian response for any specific age to gonadotropins in IVF/ICSI cycles. We analyzed our database containing information on IVF cycles. According to inclusion and exclusion criteria, a total of 703 patients were selected. Among inclusion criteria, there were regular menstrual cycle, treatment with a long GnRH agonist protocol and starting follicle-stimulating hormone (FSH) dose of at least 200 IU per day. To estimate the reference values of ovarian response, the CG-LMS method was used. A linear decline in the parameters of ovarian response with age was observed: the median number of oocytes decreases approximately by one every three years, and the median number of follicles >16 mm by one every eight years. The number of oocytes and growing follicles corresponding to the 5th, 25th, 50th, 75th and 95th centiles has been calculated. This study confirmed the well known negative relationship between ovarian response to FSH and female ageing and permitted the construction of nomograms of ovarian response.

  19. Can anti-Müllerian hormone concentrations be used to determine gonadotrophin dose and treatment protocol for ovarian stimulation?

    Science.gov (United States)

    Fleming, R; Broekmans, F; Calhaz-Jorge, C; Dracea, L; Alexander, H; Nyboe Andersen, A; Blockeel, C; Jenkins, J; Lunenfeld, B; Platteau, P; Smitz, J; de Ziegler, D

    2013-05-01

    The ability to predict the response potential of women to ovarian stimulation may allow the development of individualized ovarian stimulation protocols. This tailored approach to ovarian stimulation could reduce the incidence of ovarian hyperstimulation syndrome in women predicted to have an excessive response to stimulation or could improve pregnancy outcomes in women classed as poor responders. Namely, variation of the type of gonadotrophin-releasing hormone (GnRH) analogue or the form and dosage of gonadotrophin used for stimulation could be adjusted according to an individual's response potential. The serum concentration of anti-Müllerian hormone (AMH) is established as a reliable marker of ovarian reserve, with decreasing concentrations correlated with reduced response potential. This review examines the current evidence evaluating individualized ovarian stimulation protocols using AMH concentration as a predictive marker of ovarian response. The rationale behind why specific treatment protocols based on individual response potential may be more suitable is also discussed. Based on current evidence, it appears that the use of AMH serum concentrations to predict ovarian response and optimize treatment strategies is a promising approach for improving pregnancy outcomes in women undergoing ovarian stimulation. However, prospective randomized controlled trials evaluating this approach are needed before any firm conclusions can be drawn.

  20. The application of in vitro maturation of oocytes in the infertile patients with polycystic ovarian syndrome

    Institute of Scientific and Technical Information of China (English)

    Ye Bi-lu; Chen Ya; Zhao Jun-zhao; Ge Hong-shan; Lin Jin-ju

    2005-01-01

    Objective: To evaluate the effects of in vitro maturation (IVM) of oocytes in the infertile patients with polycystic ovarian syndrome(PCOS).Methods:The infertile patients with PCOS who underwent IVM or IVF/ICSI from January 2004 to August 2005 were studied retrospectively. 68 unstimulated cycles (48 cases) underwent IVM as IVM group, 42 cycles (39 cases) underwent IVF/ICSI as control group. Main outcomes including the number of oocytes retrival, the rates of fertilization, embryo cleavage, implantation, pregnancy, miscarriage, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy were assessed. Results: No FSH was administered in IVM group and the mean number of FSH used was (25±6.2) ampoules in control group. When compared with control group, women in IVM group had significant increase in fertilization rate (70.7% versus 63.9%) and decrease in cleavage rate (87.9% versus 99.4%) and ovarian hyperstimulation syndrome (0 versus 7.1%). No significant differences between IVM group and control group were found in the number of oocytes obtained, implantation rate, clinical pregnancy rate, miscarriage rate and multiple pregnancy rate.Conclusion:Our results suggested that for infertile PCOS women who required assisted conception treatment, IVM is a more economical method with less OHSS complication than that of conventional IVF treatment.

  1. CNS structures presumably involved in vagal control of ovarian function.

    Science.gov (United States)

    Gerendai, I; Tóth, I E; Boldogköi, Z; Medveczky, I; Halász, B

    2000-04-12

    The contribution of the vagus nerve to viral transneuronal labeling of brain structures from the ovaries demonstrated recently by us was investigated. Unilateral vagotomy was performed prior to ipsilateral intraovarian virus injection. Virus-infected neurons were visualized by immunostaining. In vagotomized rats such neurons were detected only in certain cell groups of the brain (parapyramidal nucleus, A(1), A(5) cell group, caudal raphe nuclei, hypothalamic paraventricular nucleus, lateral hypothalamus). Vagotomy interfered with labeling of several structures that were labeled in controls, including area postrema, nucleus of the solitary tract, dorsal vagal complex, nucleus ambiguus, A(7) cell group, Barrington's nucleus, locus coeruleus, periaqueductal gray, dorsal hypothalamus. Findings provide a morphological basis to study the functional significance of brain structures presumably involved in the control of ovarian function and acting via the vagus or the sympathetic nerves.

  2. Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles.

    Science.gov (United States)

    Pereira, Nigel; Reichman, David E; Goldschlag, Dan E; Lekovich, Jovana P; Rosenwaks, Zev

    2015-04-01

    To investigate the impact of elevated serum estradiol (E2) levels on the day of hCG trigger on the birth weight of term singletons after fresh In Vitro Fertilization (IVF)-Embryo Transfer (ET) cycles. Retrospective cohort study of all patients initiating fresh IVF-ET cycles resulting in live births between January 2004 and February 2013. The incidence of low birthweight (LBW) term singletons in patients with E2 levels on day of hCG trigger above or below the 95 % cutoff for E2 values in our clinic (3,069.2 pg/mL) was estimated. Multiple gestations and vanishing twin pregnancies were excluded. Two thousand nine hundred thirty-nine singleton live births were identified for inclusion. One hundred forty seven (5 %) and 2792 (95 %) live singleton births occurred in patients with peak E2 levels above and below 3,069.2 pg/mL, respectively. The overall incidence of term LBW was 5.4 % in the >3,069.2 pg/mL group compared to 2.4 % in the ≤3,069.2 pg/mL group (P = .038). An E2 level >3,069.2 pg/mL on the day of hCG administration was associated with increased odds of LBW term singletons (OR = 2.29; 95 % CI = 1.03-5.11). The increased odds remained unchanged when adjusting for maternal age (aOR = 2.29; 95 % CI = 1.02-5.14; P = .037), gestational age at delivery (aOR = 2.04; 95 % CI = 1.22-3.98; P = .025), and day 3 versus blastocyst transfer (aOR = 2.5; 95 % CI = 1.11-5.64; P = .023). Peak E2 level >3,069.2 pg/mL is associated with increased odds of LBW term singletons after fresh IVF-ET cycles. Conservative stimulation protocols aiming not to exceed an E2 level of 3,000 pg/mL may be advantageous for placentation and fetal growth if a fresh transfer is planned.

  3. Effect of body mass index on the outcomes of controlled ovarian hyperstimulation in Chinese women with polycystic ovary syndrome: a multicenter, prospective, observational study.

    Science.gov (United States)

    Sheng, Yan; Lu, Guangxiu; Liu, Jiayin; Liang, Xiaoyan; Ma, Yanping; Zhang, Xuehong; Zhang, Songying; Sun, Yingpu; Sun, Yun; Chen, Wenfeng; Fang, Wenhui; Chen, Zijiang

    2017-01-01

    The purpose of the present study is to explore the influence of body mass index (BMI) on outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) techniques in Chinese women with polycystic ovary syndrome (PCOS). This was a multicenter, prospective, observational study that enrolled 800 subjects with PCOS from nine hospitals in China. Patients were categorized according to BMI categories: underweight, BMI categories. Hormone levels (estradiol, follicle-stimulating hormone (FSH), LH, testosterone, and progesterone) were measured using electrochemiluminescence assays. Among the 774 subjects, 27.3 % were overweight and 8.1 % were obese. The rFSH dose used differed significantly among BMI categories (P BMI categories (P = 0.033), but there was no difference for biochemical (P = 0.327) and ongoing (P = 0.084) pregnancy rates. The miscarriage rate was similar among BMI categories. More than one third of Chinese women with PCOS undergoing IVF/ICSI are overweight or obese. Elevated BMI is associated with reduced clinical pregnancy rate but similar ongoing pregnancy rates, suggesting that BMI has little impact on IVF outcomes.

  4. A new ovarian response prediction index (ORPI: implications for individualised controlled ovarian stimulation

    Directory of Open Access Journals (Sweden)

    Oliveira Joao Batista A

    2012-11-01

    Full Text Available Abstract Background The objective was to present a new ovarian response prediction index (ORPI, which was based on anti-Müllerian hormone (AMH levels, antral follicle count (AFC and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response. Methods A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml by the number of antral follicles (2–9 mm, and the result was divided by the age (years of the patient (ORPI=(AMH x AFC/Patient age. Results The regression analysis demonstrated significant (PP=0.006 and collecting greater than or equal to 4 oocytes (OR: 49.25; PPP Conclusions The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients.

  5. Effectiveness of ovarian suspension in preventing post-operative ovarian adhesions in women with pelvic endometriosis: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pandis George

    2011-05-01

    Full Text Available Abstract Background Endometriosis is a common benign condition, which is characterized by the growth of endometrial-like tissue in ectopic sites outside the uterus. Laparoscopic excision of the disease is frequently carried out for the treatment of severe endometriosis. Pelvic adhesions often develop following surgery and they can compromise the success of treatment. Ovarian suspension (elevating both ovaries to the anterior abdominal wall using a Prolene suture is a simple procedure which has been used to facilitate ovarian retraction during surgery for severe pelvic endometriosis. The study aims to assess the effect of temporary ovarian suspension following laparoscopic surgery for severe pelvic endometriosis on the prevalence of post-operative ovarian adhesions. Methods A prospective double blind randomised controlled trial for patients with severe pelvic endometriosis requiring extensive laparoscopic dissection with preservation of the uterus and ovaries. Severity of the disease and eligibility for inclusion will be confirmed at surgery. Patients unable to provide written consent, inability to tolerate a transvaginal ultrasound scan, unsuccessful surgeries or suffer complications leading to oophorectomies, bowel injuries or open surgery will be excluded. Both ovaries are routinely suspended to the anterior abdominal wall during surgery. At the end of the operation, each participant will be randomised to having only one ovary suspended post-operatively. A new transabdominal suture will be reinserted to act as a placebo. Both sutures will be cut 36 to 48 hours after surgery before the woman is discharged home. Three months after surgery, all randomised patients will have a transvaginal ultrasound scan to assess for ovarian mobility. Both the patients and the person performing the scan will be blinded to the randomisation process. The primary outcome is the prevalence of ovarian adhesions on ultrasound examination. Secondary outcomes are the

  6. Coffee, tea, and caffeine consumption and risk of epithelial ovarian cancer and borderline ovarian tumors: Results from a Danish case-control study.

    Science.gov (United States)

    Gosvig, Camilla F; Kjaer, Susanne K; Blaakær, Jan; Høgdall, Estrid; Høgdall, Claus; Jensen, Allan

    2015-01-01

    Epidemiological studies that have investigated the association between coffee, tea and caffeine consumption and ovarian cancer risk have produced conflicting results. Furthermore, only few studies have examined the role of coffee and tea consumption separately for borderline ovarian tumors. By use of data from a large Danish population-based case-control study, we examined the risk of ovarian tumors associated with coffee, tea, and caffeine consumption with a particular focus on characterizing risks by tumor behavior and histology. From 1995 through 1999, we included 267 women with ovarian cancer, 115 women with borderline ovarian tumors and 911 randomly selected control women. All women completed a beverage frequency questionnaire with detailed information on coffee and tea consumption. Analyses were performed using multiple logistic regression models. Both coffee (OR = 0.90; 95% CI 0.84-0.97 per cup/day) and total caffeine consumption from coffee and tea combined (OR = 0.93; 95% CI 0.88-0.98 per 100 mg/day) decreased the risk of ovarian cancer. These associations were significant only for the serous and "other" subtypes of ovarian cancer. No relation between tea consumption and ovarian cancer risk was observed. The risk estimates for borderline ovarian tumors resembled those observed for ovarian cancer, but did not reach statistical significance. Our results indicate that coffee consumption and total caffeine consumption from coffee and tea combined is associated with a modest decreased risk of ovarian cancer. However, more biological studies are needed to identify bioactive chemical compounds in coffee that potentially could affect ovarian cancer development.

  7. Anti-Mullerian hormone and antral follicle count as predictors of ovarian reserve and successful IVF

    Institute of Scientific and Technical Information of China (English)

    Ibrahim A Abdelazim; Maha M Belal; Hanan H Makhlouf

    2012-01-01

    Objective:To investigate the role ofAnti-Mullerian hormone and antral follicle count in predicting the ovarian reserve, and success ofIVF.Methods:Ninety two infertile couples complaining of infertility due to male or tubal or unexplained factors were included in this comparative prospective study forIVF/ICSI.Day-3 basal hormonal level ofFSH,LH,E2, and AMH were measured, followed byTransvaginal ultrasound(TVS) to evaluate theAFC.Controlled ovarian hyperstimulation was done using the long protocol for ovarian hyperstimulation.Results:According to the number of retrieved oocytes women included in this study were classified into two groups; good responders(≥4 retrieved oocytes) and poor responders(<4 retrieved oocytes). Ovarian reserve in this study was assessed by day-3 basal hormonal levels andAFC.The mean Day-3AMH and meanAFC were significantly high(4.93±1.22) ng/mL, and(12.72±5.70) ng/mL; respectively) in good responders compared with poor responders, also, the number of retrieved oocytes were significantly high in the good responders group compared with poor responders (13.52±9.70) versus(3.91±1.20)(P<0.05).The numbers of chemical and clinical pregnancies were significantly high(6 cases(75%) and13 cases(72.2%); respectively) in the good responders compared with poor responders(2 cases(25%) and5 cases(27.8%); respectively).Conclusions:Day-3AMH andAFC are good predictors for ovarian reserve, there were positively correlated with the number of retrieved oocytes and numbers of chemical and clinical pregnancies.

  8. A case-control study of risk factors for epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Ghaem Maghami Noori F

    2001-09-01

    Full Text Available Ovarian cancer is second prevalent cancer among gynecologic malignancies and the most common type of ovarian cancer is epithelial form (85-90 percent. To detect the risk factors for the epithelial ovarian cancer, a case-control study was conducted in Valieasr hospital in 1988. In this study, 118 cases with epithelial ovarian cancer (according histological records and 240 controls without any gynecological cancer in gynecologic clinic had been interviewed. For data analysis, T-test, Chi2 test and logistic regression have been used at a =0.05 as level of significance. The mean age in cases was 50±13 and in controls was 49.9±12 years, without significant different. The mean number of pregnancies and parity in cases was less than controls, significantly (P<0.03. The mean months of breast feeding in cases was less than controls (54.9±71.2 versus 82.4±62.7 (P<0.001. The cases had a lower mean age of menarch than controls (P=0.03. 58 percent of cases and 21.3 percent of controls hadn't used any contraception methods (P=0.00001. The mean years of contraception was significantly less in cases versus controls (P<0.001. The odds ratio for epithelial ovarian cancer was 0.24 (95 percent CI: 0.13-0.48 in OCP users, 0.47 (95 percent CI: 0.005-0.43 in TL method, and was 0.41 (95 percent CI: 0.22-0.76 in other contraception methods, relative to women who hadn't used any contraception methods. This study reveals that epithelial ovarian cancer risk increases significantly with earlier menarch, decreasing number of pregnancy, deliveries duration of breast feeding and use of contraception methods. Use of contraception pill and tubal ligation method decreases risk of epithelial ovarian cancer.

  9. A Controlled Trial of Chemoprevention Using COX-2 Inhibitors in an Avian Model of Spontaneous Ovarian Carcinogesis

    Science.gov (United States)

    2007-09-01

    ovarian cancer risk: collaborative analysis of seven US case control studies . Epithelial ovarian cancer in black women. JNCI 1993;85:142-147. 26...594- 598. 20 27. Franceschi S, Parazzini F, Negri, et al. Pooled analysis of 3 European case control studies of epithelial ovarian cancer. Oral...development of cancer or cause reversion of the malignant phenotype. To more directly address the potential preventive role of NSAIDs, case - control studies of

  10. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

    Science.gov (United States)

    Jacobs, Ian J; Menon, Usha; Ryan, Andy; Gentry-Maharaj, Aleksandra; Burnell, Matthew; Kalsi, Jatinderpal K; Amso, Nazar N; Apostolidou, Sophia; Benjamin, Elizabeth; Cruickshank, Derek; Crump, Danielle N; Davies, Susan K; Dawnay, Anne; Dobbs, Stephen; Fletcher, Gwendolen; Ford, Jeremy; Godfrey, Keith; Gunu, Richard; Habib, Mariam; Hallett, Rachel; Herod, Jonathan; Jenkins, Howard; Karpinskyj, Chloe; Leeson, Simon; Lewis, Sara J; Liston, William R; Lopes, Alberto; Mould, Tim; Murdoch, John; Oram, David; Rabideau, Dustin J; Reynolds, Karina; Scott, Ian; Seif, Mourad W; Sharma, Aarti; Singh, Naveena; Taylor, Julie; Warburton, Fiona; Widschwendter, Martin; Williamson, Karin; Woolas, Robert; Fallowfield, Lesley; McGuire, Alistair J; Campbell, Stuart; Parmar, Mahesh; Skates, Steven J

    2016-01-01

    Summary Background Ovarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality. Methods In this randomised controlled trial, we recruited postmenopausal women aged 50–74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032. Findings Between June 1, 2001, and Oct 21, 2005, we randomly allocated 202 638 women: 50 640 (25·0%) to MMS, 50 639 (25·0%) to USS, and 101 359 (50·0%) to no screening. 202 546 (>99·9%) women were eligible for analysis: 50 624 (>99·9%) women in the MMS group, 50 623 (>99·9%) in the USS group, and 101 299 (>99·9%) in the no screening group. Screening ended on Dec 31, 2011, and included 345 570 MMS and 327 775 USS annual screening episodes. At a median follow-up of 11·1 years (IQR 10·0–12·0), we diagnosed ovarian cancer in

  11. Ovarian serous adenocarcinoma identified during IVF: diagnostic approach, surgical management, and reproductive outcome

    Directory of Open Access Journals (Sweden)

    Gleeson Noreen C

    2009-05-01

    Full Text Available Abstract Background To present a diagnostic evaluation and treatment strategy for serous adenocarcinoma of the ovary discovered during an in vitro fertilisation (IVF sequence, and report on reproductive outcome after tumour resection and embryo transfer. Case presentation Cycle monitoring in IVF identified an abnormal ovarian lesion which was subjected to ultrasound-guided needle aspiration. Cytology suggested malignancy, and unilateral oophorectomy was performed after formal staging. After surgery, the patient underwent an anonymous donor oocyte IVF cycle which established a viable twin intrauterine pregnancy. No recurrence of cancer has been detected in the >72 month follow-up interval; mother and twin daughters continue to do well. Conclusion Suspicious adnexal structures noted during controlled ovarian hyperstimulation for IVF warrant assessment, and this report confirms the role of aspiration cytology in such cases. If uterine conservation is possible, successful livebirth can be achieved from IVF if donor oocyes are utilised, as described here.

  12. Prevalence and contribution of BRCA1 mutations in breast cancer and ovarian cancer: Results from three US population-based case-control studies of ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Whittemore, A.S.; Gong, G.; Itnyre, J. [Stanford Univ. School of Medicine, CA (United States)

    1997-03-01

    We investigate the familial risks of cancers of the breast and ovary, using data pooled from three population-based case-control studies of ovarian cancer that were conducted in the United States. We base estimates of the frequency of mutations of BRCA1 (and possibly other genes) on the reported occurrence of breast cancer and ovarian cancer in the mothers and sisters of 922 women with incident ovarian cancer (cases) and in 922 women with no history of ovarian cancer (controls). Segregation analysis and goodness-of-fit testing of genetic models suggest that rare mutations (frequency .0014; 95% confidence interval .0002-.011) account for all the observed aggregation of breast cancer and ovarian cancer in these families. The estimated risk of breast cancer by age 80 years is 73.5% in mutation carriers and 6.8% in noncarriers. The corresponding estimates for ovarian cancer are 27.8% in carriers and 1.8% in noncarriers. For cancer risk in carriers, these estimates are lower than those obtained from families selected for high cancer prevalence. The estimated proportion of all U.S. cancer diagnoses, by age 80 years, that are due to germ-line BRCA1 mutations is 3.0% for breast cancer and 4.4% for ovarian cancer. Aggregation of breast cancer and ovarian cancer was less evident in the families of 169 cases with borderline ovarian cancers than in the families of cases with invasive cancers. Familial aggregation did not differ by the ethnicity of the probands, although the number of non-White and Hispanic cases (N = 99) was sparse. 14 refs., 3 figs., 6 tabs.

  13. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls

    DEFF Research Database (Denmark)

    Cancer, Collaborative Group on Epidemiological Studies of Ovarian; Beral, V.; Doll, R.

    2008-01-01

    BACKGROUND: Oral contraceptives were introduced almost 50 years ago, and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer, but the eventual public-health effects of this reduction will depend on how long the protection lasts after use ceases. We...... aimed to assess these effects. METHODS: Individual data for 23,257 women with ovarian cancer (cases) and 87,303 without ovarian cancer (controls) from 45 epidemiological studies in 21 countries were checked and analysed centrally. The relative risk of ovarian cancer in relation to oral contraceptive use...... was estimated, stratifying by study, age, parity, and hysterectomy. FINDINGS: Overall 7308 (31%) cases and 32,717 (37%) controls had ever used oral contraceptives, for average durations among users of 4.4 and 5.0 years, respectively. The median year of cancer diagnosis was 1993, when cases were aged an average...

  14. Acrylamide Hemoglobin Adduct Levels and Ovarian Cancer Risk: a nested case-control study

    Science.gov (United States)

    Xie, Jing; Terry, Kathryn L.; Poole, Elizabeth M.; Wilson, Kathryn M.; Rosner, Bernard A.; Willett, Walter C.; Vesper, Hubert W.; Tworoger, Shelley S.

    2013-01-01

    Background Acrylamide is a probable human carcinogen formed during cooking of starchy foods. Two large prospective cohort studies of dietary acrylamide intake and ovarian cancer risk observed a positive association, although two other studies reported no association. Methods We measured acrylamide exposure using red blood cell acrylamide and glycidamide hemoglobin adducts among women in two large prospective cohorts: the Nurses’ Health Study and Nurses’ Health Study II. Between blood collection and 2010, we identified 263 incident cases of epithelial ovarian cancer, matching two controls per case. We used logistic regression models to examine the association between acrylamide exposure and ovarian cancer risk, adjusting for matching factors, family history of ovarian cancer, tubal ligation, oral contraceptive use, body mass index (BMI), parity, alcohol intake, smoking, physical activity, and caffeine intake. Results The multivariate-adjusted relative risk (RR) of ovarian cancer comparing the highest versus lowest tertile of total acrylamide adducts was 0.79 (95% CI: 0.50–1.24, P trend = 0.08). The comparable RR of ovarian cancer among non-smokers at blood draw was 0.85 (95% CI: 0.57–1.27, P trend =0.14). The association did not differ by tumor histology (serous invasive versus not), P for heterogeneity=0.41. Individual adduct types (acrylamide or glycidamide) were not associated with risk. Conclusions We observed no evidence that acrylamide exposure as measured by adducts to hemoglobin is associated with an increased risk of ovarian cancer. Impact Our finding indicates that acrylamide intake may not increase risk of ovarian cancer. PMID:23417989

  15. Mulltiple birth resulting from ovarian stimulation for subfertility treatment

    NARCIS (Netherlands)

    Fauser, BCJM; Devroey, P; Macklon, NS

    2005-01-01

    Assisted reproductive technologies (ARTs) aim to increase a woman's chances of becoming pregnant by bringing many female and male gametes into close proximity. Techniques to achieve this objective include ovarian hyperstimulation by maturation of several oocytes, intrauterine insemination (lUl) of c

  16. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies.

    Science.gov (United States)

    Rasmussen, Christina B; Kjaer, Susanne K; Albieri, Vanna; Bandera, Elisa V; Doherty, Jennifer A; Høgdall, Estrid; Webb, Penelope M; Jordan, Susan J; Rossing, Mary Anne; Wicklund, Kristine G; Goodman, Marc T; Modugno, Francesmary; Moysich, Kirsten B; Ness, Roberta B; Edwards, Robert P; Schildkraut, Joellen M; Berchuck, Andrew; Olson, Sara H; Kiemeney, Lambertus A; Massuger, Leon F A G; Narod, Steven A; Phelan, Catherine M; Anton-Culver, Hoda; Ziogas, Argyrios; Wu, Anna H; Pearce, Celeste L; Risch, Harvey A; Jensen, Allan

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to tumor behavior and histotype. We pooled data from 13 case-control studies, conducted between 1989 and 2009, from the Ovarian Cancer Association Consortium (OCAC), including 9,162 women with ovarian cancers, 2,354 women with borderline tumors, and 14,736 control participants. Study-specific odds ratios were estimated and subsequently combined into a pooled odds ratio using a random-effects model. A history of PID was associated with an increased risk of borderline tumors (pooled odds ratio (pOR) = 1.32, 95% confidence interval (CI): 1.10, 1.58). Women with at least 2 episodes of PID had a 2-fold increased risk of borderline tumors (pOR = 2.14, 95% CI: 1.08, 4.24). No association was observed between PID and ovarian cancer risk overall (pOR = 0.99, 95% CI: 0.83, 1.19); however, a statistically nonsignificantly increased risk of low-grade serous tumors (pOR = 1.48, 95% CI: 0.92, 2.38) was noted. In conclusion, PID was associated with an increased risk of borderline ovarian tumors, particularly among women who had had multiple episodes of PID. Although our results indicated a histotype-specific association with PID, the association of PID with ovarian cancer risk is still somewhat uncertain and requires further investigation. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. A case-control study of borderline ovarian tumors: the influence of perineal exposure to talc.

    Science.gov (United States)

    Harlow, B L; Weiss, N S

    1989-08-01

    The authors interviewed 116 female residents of western Washington State with serous and mucinous borderline ovarian tumors diagnosed between 1980 and 1985 and questioned them on their use of hygienic powders. A sample of 158 control women from the same counties were identified through random digit dialing and were interviewed as well. Neither the perineal application of baby powder nor the perineal application of cornstarch was associated with an appreciably altered risk of borderline ovarian tumors. However, women who used deodorizing powders alone or in combination with other talc-containing powders had 2.8 times the risk (95% confidence interval 1.1-11.7) of women who had not had perineal exposure to powder. These results suggest that future studies of ovarian tumors in relation to the application of talc-containing powders should consider ascertaining the specific type(s) of powder used.

  18. The pregnancy outcome of progestin-primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial.

    Science.gov (United States)

    Dong, J; Wang, Y; Chai, W R; Hong, Q Q; Wang, N L; Sun, L H; Long, H; Wang, L; Tian, H; Lyu, Q F; Lu, X F; Chen, Q J; Kuang, Y P

    2017-06-01

    To investigate the clinical outcome and endocrinological characteristics of progestin-primed ovarian stimulation (PPOS) using 4 versus 10 mg of medroxyprogesterone acetate (MPA) per day in infertile women with normal ovary reserve. A randomised parallel controlled trial. Tertiary-care academic medical centre. A cohort of 300 infertile women undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment. Human menopausal gonadotropin (hMG; 225 iu per day) and MPA (group A, 10 mg per day; group B, 4 mg per day) were started simultaneously from cycle day 3 onwards. Ovulation was co-triggered by human chorionic gonadotropin (hCG; 1000 iu) and gonadotropin-releasing hormone agonist (GnRH agonist; 0.1 mg) when dominant follicles matured. Viable embryos were cryopreserved for later frozen embryo transfer (FET) in both groups. The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the incidence of a premature surge in luteinising hormone (LH), the number of viable embryos, and clinical pregnancy outcomes. The number of oocytes retrieved and viable embryos were similar between two groups (9.8 ± 6.3 versus 9.6 ± 5.9; 4.2 ± 2.6 versus 3.7 ± 3.0; P > 0.05). No significant difference was found in clinical pregnancy rate (58.0 versus 48.7%) and live birth rate per participant (48.7 versus 42.0%; P > 0.05). No premature LH surge and ovarian hyperstimulation syndrome (OHSS) occurred in either group. Progestin-primed ovarian stimulation (PPOS) using 4 or 10 mg of MPA per day was comparable in terms of the number of oocytes retrieved and pregnancy outcome after FET. The administration of 4 mg of MPA per day was sufficient to prevent an untimely LH rise in women undergoing IVF/ICSI treatment. An RCT confirmed similar pregnancy outcome in P-primed ovarian stimulation with a daily dose of 4 or 10 mg MPA. © 2017 Royal College of Obstetricians and Gynaecologists.

  19. Long-term effects of repeated superovulation on ovarian structure and function in rhesus monkeys.

    Science.gov (United States)

    Dong, Guoying; Guo, Yueshuai; Cao, Huarong; Zhou, Tao; Zhou, Zuomin; Sha, Jiahao; Guo, Xuejiang; Zhu, Hui

    2014-11-01

    To assess the long-term effects of repeated controlled ovarian hyperstimulation (COH) on ovarian structure and function. Experimental study. Laboratory. Adult female rhesus macaques. A repeated COH rhesus macaque model (superovulation group) with spontaneously ovulating macaques used as controls (normal group) and samples of serum and ovarian tissue collected over a 5-year period. Steroid hormone levels, and structural, functional, and protein changes in ovaries. The follicular histology, proportion of follicles at each developmental stage, and expression levels of oocyte-specific genes showed no statistically significant differences between the two groups. However, the superovulation group exhibited mitochondrial abnormalities in the granulosa cells and a low expression of genes involved in steroid hormone synthesis compared with the normal group. A comparison of protein expression in the ovaries of both groups using tandem mass tag labeling with mass spectrometry revealed that most of the differentially-expressed proteins were down-regulated in the superovulation group. These proteins were mainly localized in the mitochondria and cytosol, and changes in protein levels in the superovulation group mainly inhibited cell proliferation and differentiation but promoted apoptosis. Our study indicates that repeated COH could change the expression of many proteins in the ovaries even after several years, potentially affecting the development and function of ovarian cells. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Endocrine effects of hCG supplementation to recombinant FSH throughout controlled ovarian stimulation for IVF: a dose–response study

    DEFF Research Database (Denmark)

    Thuesen, Leif; Smitz, J; Loft, A;

    2013-01-01

    To analyse the endocrine response in relation to the Δ-4 and Δ-5 pathways of ovarian steroidogenesis after different doses of human chorionic gonadotrophin (hCG) supplementation to recombinant FSH from Day 1 of controlled ovarian stimulation for IVF.......To analyse the endocrine response in relation to the Δ-4 and Δ-5 pathways of ovarian steroidogenesis after different doses of human chorionic gonadotrophin (hCG) supplementation to recombinant FSH from Day 1 of controlled ovarian stimulation for IVF....

  1. Bacterial colonization of the ovarian bursa in dogs with clinically suspected pyometra and in controls.

    Science.gov (United States)

    Rubio, Alejandro; Boyen, Filip; Tas, Olaf; Kitshoff, Adriaan; Polis, Ingeborgh; Van Goethem, Bart; de Rooster, Hilde

    2014-10-15

    Septic peritonitis occurs relatively commonly in dogs. Secondary septic peritonitis is usually associated with perforation of intestines or infected viscera, such as the uterus in pyometra cases. The aim of this study was to evaluate the bacterial flora in the ovarian bursae of intact bitches as a potential source of contamination. One hundred forty dogs, clinically suspected of pyometra, were prospectively enrolled. The control group consisted of 26 dogs that underwent elective ovariohysterectomies and 18 dogs with mammary gland tumors that were neutered at the time of mastectomy. Bacteriology samples were taken aseptically at the time of surgery from the bursae and the uterus in all dogs. Twenty-two dogs that were clinically suspected of pyometra had sterile uterine content ("mucometra" cases); the remaining 118 had positive uterine cultures ("pyometra" cases) and septic peritoneal fluid was present in 10% of these cases. Of the 118 pyometra cases, 9 had unilateral and 15 had bilateral bacterial colonization of their ovarian bursae. However, the bacteria from the ovarian bursa were similar to those recovered from the uterine pus in only half of the cases. Furthermore, positive bursae were also seen in one mucometra dog (unilateral) and in four control dogs (two unilateral and two bilateral). The data illustrate that the canine ovarian bursa can harbor bacteria. The biological importance of these isolations remains unclear. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Ovarian torsion and spontaneous ovarian hyperstimulation syndrome in a twin pregnancy: A case report

    Directory of Open Access Journals (Sweden)

    Núria Gil Navarro

    2017-01-01

    Conclusion: Spontaneous OHSS should be included in the differential diagnosis of acute abdomen in pregnant women; if spontaneous OHSS is diagnosed, the etiology should be determined in order to focus the treatment and avoid future complications.

  3. Differential flatness properties and multivariable adaptive control of ovarian system dynamics

    Science.gov (United States)

    Rigatos, Gerasimos

    2016-12-01

    The ovarian system exhibits nonlinear dynamics which is modeled by a set of coupled nonlinear differential equations. The paper proposes adaptive fuzzy control based on differential flatness theory for the complex dynamics of the ovarian system. It is proven that the dynamic model of the ovarian system, having as state variables the LH and the FSH hormones and their derivatives, is a differentially flat one. This means that all its state variables and its control inputs can be described as differential functions of the flat output. By exploiting differential flatness properties the system's dynamic model is written in the multivariable linear canonical (Brunovsky) form, for which the design of a state feedback controller becomes possible. After this transformation, the new control inputs of the system contain unknown nonlinear parts, which are identified with the use of neurofuzzy approximators. The learning procedure for these estimators is determined by the requirement the first derivative of the closed-loop's Lyapunov function to be a negative one. Moreover, Lyapunov stability analysis shows that H-infinity tracking performance is succeeded for the feedback control loop and this assures improved robustness to the aforementioned model uncertainty as well as to external perturbations. The efficiency of the proposed adaptive fuzzy control scheme is confirmed through simulation experiments.

  4. Cryptic choice of conspecific sperm controlled by the impact of ovarian fluid on sperm swimming behavior.

    Science.gov (United States)

    Yeates, Sarah E; Diamond, Sian E; Einum, Sigurd; Emerson, Brent C; Holt, William V; Gage, Matthew J G

    2013-12-01

    Despite evidence that variation in male-female reproductive compatibility exists in many fertilization systems, identifying mechanisms of cryptic female choice at the gamete level has been a challenge. Here, under risks of genetic incompatibility through hybridization, we show how salmon and trout eggs promote fertilization by conspecific sperm. Using in vitro fertilization experiments that replicate the gametic microenvironment, we find complete interfertility between both species. However, if either species' ova were presented with equivalent numbers of both sperm types, conspecific sperm gained fertilization precedence. Surprisingly, the species' identity of the eggs did not explain this cryptic female choice, which instead was primarily controlled by conspecific ovarian fluid, a semiviscous, protein-rich solution that bathes the eggs and is released at spawning. Video analyses revealed that ovarian fluid doubled sperm motile life span and straightened swimming trajectory, behaviors allowing chemoattraction up a concentration gradient. To confirm chemoattraction, cell migration tests through membranes containing pores that approximated to the egg micropyle showed that conspecific ovarian fluid attracted many more spermatozoa through the membrane, compared with heterospecific fluid or water. These combined findings together identify how cryptic female choice can evolve at the gamete level and promote reproductive isolation, mediated by a specific chemoattractive influence of ovarian fluid on sperm swimming behavior.

  5. Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: A randomized controlled trial

    NARCIS (Netherlands)

    E.B. Baart (Esther); E. Martini (Elena); M.J.C. Eijkemans (René); D. van Opstal (Diane); N.G.M. Beckers (Nicole); A. Verhoeff (Arie); N.S. Macklon (Nick); B.C.J.M. Fauser (Bart)

    2007-01-01

    textabstractBACKGROUND: To test whether ovarian stimulation for in-vitro fertilization (IVF) affects oocyte quality and thus chromosome segregation behaviour during meiosis and early embryo development, preimplantation genetic screening of embryos was employed in a prospective, randomized controlled

  6. Leptin controls rabbit ovarian function in vivo and in vitro: possible interrelationships with ghrelin.

    Science.gov (United States)

    Sirotkin, A V; Rafay, J; Kotwica, J

    2009-10-01

    The aim of these in vivo and in vitro studies was to examine the role of leptin in the control of plasma hormone concentrations, reproduction, and secretory activity of ovarian granulosa cells. In in vivo experiments, 15 female European domestic rabbit (Oryctolagus cuniculus) were treated with leptin (5 microg animal(-1)d(-1) for 1 wk before induction of ovulation with 25 IU equine chorionic gonadotropin and 0.25 IU human chorionic gonadotropin), and 15 females constituted the control group (treated with phosphate-buffered saline). Plasma concentrations of progesterone (P(4)), testosterone (T), estradiol (E(2)), estrone sulfate (ES), and insulin-like growth factor I (IGF-I) were determined at the estimated day of ovulation by radioimmunoassay (RIA), and number, viability, and body weight of newborns were recorded at parturition. In in vitro experiments, granulosa cells were isolated from periovulatory ovarian follicles of five control and five females treated with ghrelin (10 microg animal(-1)d(-1) for 1 wk before induced ovulation). Isolated cells were cultured for 2 d with and without leptin (0, 1, 10, or 100 ng/mL medium). Secretion of P(4), T, E(2), IGF-I, and prostaglandin F (PGF) was assessed in culture medium by RIA. In in vivo experiments, leptin administrations reduced plasma P(4), T, E(2), ES, and IGF-I levels. Leptin treatments did not affect ovarian weight or total number and body mass of newborns, but the proportion of pregnant females and number of live newborns were significantly higher in leptin-treated females than that in control females. In in vitro experiments, leptin significantly decreased (at 1 and 10 ng/mL) or increased (at 100 ng/mL) P(4) secretion, promoted E(2) and IGF-I (both at 100 ng/mL) secretion, and reduced T (at 1 and 10 ng/mL) and PGF (at 10 ng/mL) secretion. Granulosa cells from ghrelin-treated animals secreted less P(4), T, E(2), and PGF, but not IGF-I, than that secreted by granulosa cells from control animals. Furthermore

  7. Recreational physical activity and epithelial ovarian cancer: a case-control study, systematic review, and meta-analysis.

    Science.gov (United States)

    Olsen, Catherine M; Bain, Christopher J; Jordan, Susan J; Nagle, Christina M; Green, Adèle C; Whiteman, David C; Webb, Penelope M

    2007-11-01

    It remains unclear whether physical activity is associated with epithelial ovarian cancer risk. We therefore examined the association between recreational physical activity and risk of ovarian cancer in a national population-based case-control study in Australia. We also systematically reviewed all the available evidence linking physical activity with ovarian cancer to provide the best summary estimate of the association. The case-control study included women ages 18 to 79 years with a new diagnosis of invasive (n=1,269) or borderline (n=311) epithelial ovarian cancer identified through a network of clinics, physicians, and state cancer registries throughout Australia. Controls (n=1,509) were randomly selected from the national electoral roll and were frequency matched to cases by age and state. For the systematic review, we identified eligible studies using Medline, the ISI Science Citation Index, and manual review of retrieved references, and included all case-control or cohort studies that permitted assessment of an association between physical activity (recreational/occupational/sedentary behavior) and histologically confirmed ovarian cancer. Meta-analysis was restricted to the subset of these studies that reported on recreational physical activity. In our case-control study, we observed weakly inverse or null associations between recreational physical activity and risk of epithelial ovarian cancer overall. There was no evidence that the effects varied by tumor behavior or histologic subtype. Twelve studies were included in the meta-analysis, which gave summary estimates of 0.79 (95% confidence interval, 0.70-0.85) for case-control studies and 0.81 (95% confidence interval, 0.57-1.17) for cohort studies for the risk of ovarian cancer associated with highest versus lowest levels of recreational physical activity. Thus, pooled results from observational studies suggest that a modest inverse association exists between level of recreational physical activity and

  8. The impact of unilateral oophorectomy on ovarian reserve in assisted reproduction: a systematic review and meta-analysis.

    Science.gov (United States)

    Younis, J S; Naoum, I; Salem, N; Perlitz, Y; Izhaki, I

    2017-09-05

    Women following unilateral oophorectomy (UO) are occasionally encountered during assisted reproduction treatment. To explore the impact of UO on ovarian reserve in assisted reproduction. An electronic database search was performed using PubMed, EBSCO, ISI, Trip, ClinicalTrial.gov and the Cochrane library followed by a manual search to identify published research between January 1978 and December 2015. Controlled studies that compared infertile women following UO undergoing IVF-ET treatment with women with two intact ovaries. Two reviewers independently extracted the data concerning the impact of UO on ovarian reserve tests, ovarian response to controlled ovarian hyperstimulation and clinical pregnancy rate. Meta-analysis was performed using these measures. Twenty-one studies were eligible for quantitative analysis. They included 1045 and 18 172 IVF cycles in women with one and two intact ovaries, respectively. Basal FSH weighted mean difference (WMD) was significant (2.01 IU/l; 95% CI: 0.24-3.79, P = 0.026). Similarly, the WMD of serum E2 level on the day of hCG administration was significant (WMD: -431 pg/ml; 95% CI: -616 to -246, P < 0.001). However, the weighted overall odds ratio (OR) of clinical pregnancy between women with a single ovary and women with two ovaries was comparable (overall OR: 0.76; 95% CI: 0.57-1.00, P = 0.054). All eligible studies were retrospectively conducted and the heterogeneity among ovarian response measures was high. Available pooled data supports an adverse effect of UO on ovarian reserve involving the quantity but not the quality of the ovarian pool. Review finds women with one ovary removed have less IVF capacity but the same pregnancy rate as women with two ovaries. © 2017 Royal College of Obstetricians and Gynaecologists.

  9. Use of dairy products, lactose, and calcium and risk of ovarian cancer - results from a Danish case-control study.

    Science.gov (United States)

    Faber, Mette T; Jensen, Allan; Søgaard, Marie; Høgdall, Estrid; Høgdall, Claus; Blaakaer, Jan; Kjaer, Susanne K

    2012-04-01

    A number of epidemiological studies have examined the association between use of dairy products and risk of ovarian cancer, but results are conflicting. Using data from a large Danish population-based case-control study we here further examined the association between dairy consumption, lactose, and calcium and risk of overall ovarian cancer and histological types of ovarian cancer. In the period 1995-1999 we included 554 women with epithelial ovarian cancer and 1554 randomly selected age-matched controls (35-79 years). All women participated in a detailed personal interview that included questions about dairy consumption. Data were analysed using multiple logistic regression models. Total dairy intake was associated with ovarian cancer risk (OR = 1.11; 95% CI: 1.07-1.15 per 100 ml/day). The association was strongest for milk [OR = 1.14; 95% CI: 1.03-1.27 per glass (200 ml)/day], soured milk products [OR = 1.49; 95% CI: 1.22-1.81 per portion (250 ml)/day] and yoghurt [OR = 1.65; 95% CI: 1.22-2.23 per portion (250 ml)/day]. In contrast, intake of cheese was associated with a decreased risk [OR = 0.70; 95% CI: 0.55-0.89 for > 1 portion (100 ml)/day compared with no intake]. Intake of lactose, but not calcium, was also associated with an increased ovarian cancer risk (OR = 1.24; 95% CI: 1.10-1.40 per 10 g of lactose/day). Similar risk patterns were observed for the different histological types of ovarian cancer, indicating virtually identical aetiologies with regard to dairy intake, lactose, and calcium. Our results indicate that intake of dairy products is associated with a modest increased risk of ovarian cancer. In addition, ovarian cancer development was associated with lactose intake.

  10. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies

    NARCIS (Netherlands)

    Rasmussen, C.B.; Kjaer, S.K.; Albieri, V.; Bandera, E.V.; Doherty, J.A.; Hogdall, E.; Webb, P.M.; Jordan, S.J.; Rossing, M.A.; Wicklund, K.G.; Goodman, M.T.; Modugno, F.; Moysich, K.B.; Ness, R.B.; Edwards, R.P.; Schildkraut, J.M.; Berchuck, A.; Olson, S.H.; Kiemeney, L.A.L.M.; Massuger, L.F.A.G.; Narod, S.A.; Phelan, C.M.; Anton-Culver, H.; Ziogas, A.; Wu, A.H.; Pearce, C.L.; Risch, H.A.; Jensen, A.

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to

  11. Predictive value of ovarian stroma measurement for cardiovascular risk in polycyctic ovary syndrome: a case control study

    Directory of Open Access Journals (Sweden)

    Loverro Giuseppe

    2010-11-01

    Full Text Available Abstract Background To verify the feasibility of ovarian stromal evaluation and correlate ovarian parameteres (echogenicity and volume with hyperandrogenism, and both cardiovascular and metabolic risk factors in PCOS. Methods Twenty four young PCOS patients and twelve age-matched control women were enrolled. Diagnosis of PCOS was based on the Rotterdam criteria. Ultrasound ovarian study included ovarian volume, stromal volume, stromal area and stromal area/total ovarian area ratio (S/A. Concerning hormones, insulin, LH, FSH, estradiol, androstenedione, testosterone, DHEAS, 17-hydroxy-progesterone, and SHBG were measured during the early follicular phase (days 2-5. Cardiovascular risk factors were represented by fasting plasma levels of glucose, lipids (total and HDL-cholesterol, plasminogen activator inhibitor 1 (PAI-1, von-Willebrand factor (vWF, and adiponectin. Carotid intima-media thickness (C-IMT was measured as a parameter of cardiovascular risk. Results A positive correlation between the S/A ratio and plasma levels of testosterone (p Conclusions This study shows that the ultrasound measurement of ovarian stroma is a predicting factor of hyperandrogenism degree, prothrombotic factors and cardiovascular risk in patients with PCOS.

  12. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies.

    Science.gov (United States)

    Pearce, Celeste Leigh; Templeman, Claire; Rossing, Mary Anne; Lee, Alice; Near, Aimee M; Webb, Penelope M; Nagle, Christina M; Doherty, Jennifer A; Cushing-Haugen, Kara L; Wicklund, Kristine G; Chang-Claude, Jenny; Hein, Rebecca; Lurie, Galina; Wilkens, Lynne R; Carney, Michael E; Goodman, Marc T; Moysich, Kirsten; Kjaer, Susanne K; Hogdall, Estrid; Jensen, Allan; Goode, Ellen L; Fridley, Brooke L; Larson, Melissa C; Schildkraut, Joellen M; Palmieri, Rachel T; Cramer, Daniel W; Terry, Kathryn L; Vitonis, Allison F; Titus, Linda J; Ziogas, Argyrios; Brewster, Wendy; Anton-Culver, Hoda; Gentry-Maharaj, Alexandra; Ramus, Susan J; Anderson, A Rebecca; Brueggmann, Doerthe; Fasching, Peter A; Gayther, Simon A; Huntsman, David G; Menon, Usha; Ness, Roberta B; Pike, Malcolm C; Risch, Harvey; Wu, Anna H; Berchuck, Andrew

    2012-04-01

    Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, pSmith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Imaging-guided hyperstimulation analgesia in low back pain.

    Science.gov (United States)

    Gorenberg, Miguel; Schwartz, Kobi

    2013-01-01

    Low back pain in patients with myofascial pain syndrome is characterized by painful active myofascial trigger points (ATPs) in muscles. This article reviews a novel, noninvasive modality that combines simultaneous imaging and treatment, thus taking advantage of the electrodermal information available from imaged ATPs to deliver localized neurostimulation, to stimulate peripheral nerve endings (Aδ fibers) and in turn, to release endogenous endorphins. "Hyperstimulation analgesia" with localized, intense, low-rate electrical pulses applied to painful ATPs was found to be effective in 95% patients with chronic nonspecific low back pain, in a clinical validation study.

  14. The type of GnRH analogue used during controlled ovarian stimulation influences early embryo developmental kinetics

    DEFF Research Database (Denmark)

    Muñoz, Manuel; Cruz, María; Humaidan, Peter

    2013-01-01

    OBJECTIVE: To explore if the GnRH analogue used for controlled ovarian stimulation (COS) and the ovulation triggering factor (GnRH agonist+hCG triggering versus GnRH antagonist+GnRH agonist triggering) affect embryo development and kinetics. STUDY DESIGN: In a retrospective cohort study in the In......OBJECTIVE: To explore if the GnRH analogue used for controlled ovarian stimulation (COS) and the ovulation triggering factor (GnRH agonist+hCG triggering versus GnRH antagonist+GnRH agonist triggering) affect embryo development and kinetics. STUDY DESIGN: In a retrospective cohort study...... in the Instituto Valenciano de Infertilidad (IVI) Alicante and the Instituto Universitario-IVI Valencia, Spain, 2817 embryos deriving from 400 couples undergoing oocyte donation were analysed. After controlled ovarian stimulation and IVF/intracytoplamic sperm injection, the timing of embryonic cleavages...

  15. GnRHa trigger and individualized luteal phase hCG support according to ovarian response to stimulation

    DEFF Research Database (Denmark)

    Al Humaidan, Peter Samir Heskjær; Polyzos, N P; Alsbjerg, B

    2013-01-01

    STUDY QUESTION: Does a GnRH agonist (GnRHa) trigger followed by a bolus of 1.500 IU hCG in a group of patients at risk of ovarian hyperstimulation syndrome (OHSS) reduce the OHSS incidence compared with hCG trigger? SUMMARY ANSWER: A GnRHa trigger followed by early luteal hCG support with one bolus...

  16. Fish intake and ovarian cancer risk: a meta-analysis of 15 case-control and cohort studies.

    Directory of Open Access Journals (Sweden)

    Pei-yue Jiang

    Full Text Available BACKGROUND: Previous epidemiological studies have shown that fish consumption may modify the risk of ovarian cancer. However, these studies yielded controversial results. The present meta-analysis was undertaken to evaluate the relationship between fish intake and ovarian cancer risk. METHODS: A literature search was carried out using Pubmed, Embase, and Cochrane Library Central database for all relevant studies up to August 2013. We pooled the relative risks (RR from individual studies using fixed-effect or random-effect model, and carried out heterogeneity and publication bias analyses. RESULTS: A total of 15 (ten case-control, and five cohort studies were included in the present meta-analysis, representing data for 889,033 female subjects and 6,087 ovarian cancer cases. We found that total fish intake was not significantly associated with the risk of ovarian cancer among cohort studies (RR = 1.04 95% CI [0.89, 1.22] as well as case-control studies (RR = 0.90, 95% CI [0.73,1.12]. There was no evidence of publication bias as suggested by Begg's test (P = 0.55 and Egger's test(P = 0.29. CONCLUSIONS: The present meta-analysis showed that total fish consumption was not significantly associated with the risk of ovarian cancer. Further analysis on different fish species and food preparation methods should be conducted in future studies.

  17. 腹腔穿刺留置术治疗重度卵巢过度刺激综合征疗效观察%Observation on the clinical efficacy of transabdominal paracentesis and indwelling catheter drainage in treatment of severe ovarian hyperstimulation syndrome

    Institute of Scientific and Technical Information of China (English)

    黄永刚; 池海虹; 黄朝霞; 侯晓红; 吕杰强

    2011-01-01

    Objective; To explore the clinical efficacy of transabdominal paracentesis and indwelling catheter drainage in treatment of severe ovarian hypeistimulation syndrome ( OHSS) . Methods; 20 patients with severe OHSS were treated with transabdominal paracentesis and indwelling catheter drainage by central venous catheter under the guidance of ultrasound, comprehensive treatment including fluid expansion, anticoagulation, supplement of crystal and colloid. Results; After indwelling catheter drainage, the discomfortable symptoms of all the patients were relieved rapidly, such as abdominal distension, loss of appetite, chest distress and dyspnea, the abdominal circumference and body weight decreased significantly (P <0.001), the volume of 24 - hour urine increased ( P <0.001) , but the level of serum albumin showed a decreasing trend after indwelling catheter drainage (P < 0.05 ) , the average indwelling catheter drainage time was (12. 4 ± 7.7) days, the average hospitalization time was (18.4 ± 11. 6) days. Conclusion; The technique of transabdominal paracentesis and indwelling catheter drainage is rapid and simple in treatment of severe OHSS, which is an effective therapy.%目的:探讨腹腔穿刺留置术在治疗重度卵巢过度刺激综合征(OHSS)的临床疗效.方法:将20例重度OHSS患者在B超定位下采用中心静脉导管(CVC)进行腹腔穿刺并留置持续引流,同时联合扩容、抗凝、补充晶体、胶体等综合治疗.结果:引流后所有患者腹胀、纳差、胸闷、呼吸困难等不适症状均快速缓解,腹围、体重显著下降(P<0.001),24h尿量增多(P<0.001),但血清白蛋白在穿刺后呈下降趋势(P<0.05),平均置管时间为(12.4±7.7)天,平均住院时间为(18.4±11.6)天.结论:腹腔穿刺留置术治疗重度OHSS改善症状迅速,操作灵活,是一种行之有效的治疗方法.

  18. Hormonal, functional and genetic biomarkers in controlled ovarian stimulation: tools for matching patients and protocols

    Directory of Open Access Journals (Sweden)

    Alviggi Carlo

    2012-02-01

    Full Text Available Abstract Variability in the subfertile patient population excludes the possibility of a single approach to controlled ovarian stimulation (COS covering all the requirements of a patient. Modern technology has led to the development of new drugs, treatment options and quantitative methods that can identify single patient characteristics. These could potentially be used to match patients with the right treatment options to optimise efficacy, safety and tolerability during COS. Currently, age and follicle-stimulating hormone (FSH level remain the most commonly used single patient characteristics in clinical practice. These variables only provide a basic prognosis for success and indications for standard COS treatment based on gross patient categorisation. In contrast, the anti-Müllerian hormone level appears to be an accurate predictor of ovarian reserve and response to COS, and could be used successfully to guide COS. The antral follicle count is a functional biomarker that could be useful in determining the dose of FSH necessary during stimulation and the success of treatment. Finally, in the future, genetic screening may allow an individual patient's response to stimulation during COS to be predicted based on genotype. Unfortunately, despite the predictive power of these measures, no single biomarker can stand alone as a guide to determine the best treatment option. In the future, hormonal, functional and genetic biomarkers will be used together to personalise COS.

  19. Hormonal, functional and genetic biomarkers in controlled ovarian stimulation: tools for matching patients and protocols.

    Science.gov (United States)

    Alviggi, Carlo; Humaidan, Peter; Ezcurra, Diego

    2012-02-06

    Variability in the subfertile patient population excludes the possibility of a single approach to controlled ovarian stimulation (COS) covering all the requirements of a patient. Modern technology has led to the development of new drugs, treatment options and quantitative methods that can identify single patient characteristics. These could potentially be used to match patients with the right treatment options to optimise efficacy, safety and tolerability during COS. Currently, age and follicle-stimulating hormone (FSH) level remain the most commonly used single patient characteristics in clinical practice. These variables only provide a basic prognosis for success and indications for standard COS treatment based on gross patient categorisation. In contrast, the anti-Müllerian hormone level appears to be an accurate predictor of ovarian reserve and response to COS, and could be used successfully to guide COS. The antral follicle count is a functional biomarker that could be useful in determining the dose of FSH necessary during stimulation and the success of treatment. Finally, in the future, genetic screening may allow an individual patient's response to stimulation during COS to be predicted based on genotype. Unfortunately, despite the predictive power of these measures, no single biomarker can stand alone as a guide to determine the best treatment option. In the future, hormonal, functional and genetic biomarkers will be used together to personalise COS.

  20. 控制性超促排卵中溢乳症的临床处理分析%Analysis of different clinical treatments on galactorrhea syndrome in controlled ovarian hyperstimulation

    Institute of Scientific and Technical Information of China (English)

    戴芳芳; 张丽晓; 郑波; 郑晓红; 程书清; 许晓立; 王春梅

    2014-01-01

    目的:探讨不同临床处理对体外授精-胚胎移植( in vitro fertilization and embryo transfer, IVF-ET)中伴溢乳症的不孕症患者妊娠结局的影响。方法选择在邢台不孕不育专科医院生殖中心接受IVF-ET的不孕症患者358例,其中伴溢乳症296例,无溢乳症及基础血清催乳素( prolactin,PRL)正常的62例。按有无溢乳症、高PRL血症及其处理方法分为5组,A组为溢乳症不伴有高PRL血症,应用甲磺酸溴隐亭治疗;B组为溢乳症伴有高PRL血症,应用甲磺酸溴隐亭治疗;C组为溢乳症不伴有高PRL血症,应用中药治疗;D组为溢乳症不伴有高PRL血症,未给予药物治疗;E组为无溢乳症及基础血清PRL正常。比较5组不孕症患者外源性促性腺激素( gonadotropin,Gn )启动日 PRL 水平、注射绒毛膜促性腺激素( chorionic gonadotrophin,HCG)日PRL水平、获卵数、可用胚胎数、临床妊娠率。结果5组不孕症患者比较,A组临床妊娠率最低(P<0.05);在Gn启动日和注射HCG日,A组PRL水平低于其他4组(P<0.05)。结论不孕症患者无高PRL血症的溢乳症状无需进行治疗,为改善症状,中药治疗可作为很好的尝试。%Objective To investigate the impact of different clinical treatments on pregnant results in infertility patients underWent vitro fertilization embryo transfer( IVF-ET)accompanying With galactorrhea syndrome. Methods 358 cases of infertility patients Who underWent IVF-ET in The Repraduction Center of Xingtai Infertility Specialized Hospital Were selected,of Whom 296 cases Were With galactorrhea syndrome,62 cases Were of normal serum prolactin( PRL)Without galactorrhea syndrome. The patients Were divided into 5 groups,Group A:patients of normal PRL With galactorrhea syndrome under treatment of bromocriptine mesilate,Group B:patients With hyperprolactinemia and galactorrhea syndrome under treatment of bromocriptine mesilate,Group C:patients of normal PRL With galactorrhea syndrome under treatment of traditional chinese medicine,Group D:patients of normal PRL With galactorrhea syndrome involving no treatment,Group E:patients of normal PRL Without galactorrhea syndrome. PRL level at the start date of eXogenous gonadotropin( Gn),PRL level at the day of injecting chorionic gonadotrophin( HCG),the number of oocyte,the number of available embryos and clinical pregnancy rate of 5 groups Were compared. Results The clinical pregnancy rate of group A Was the loWest(P<0. 05),at the start date of Gn and the day of injecting HCG,the PRL level of group A Was loWer than that of the other 4 groups(P<0. 05). Conclusion There is no need of treatment for infertility patients With galactorrhea syndrome but of normal PRL, traditional chinese medicine can be used to improve symptoms.

  1. Ovarian Stimulation Protocol in IVF: An Up-to-Date Review of the Literature.

    Science.gov (United States)

    Pacchiarotti, Alessandro; Selman, Helmy; Valeri, Claudia; Napoletano, Simona; Sbracia, Marco; Antonini, Gabriele; Biagiotti, Giulio; Pacchiarotti, Arianna

    2016-01-01

    The Assisted Reproductive Technology (ART) was born in order to help couples with infertility issues in having a baby. The first treatments of IVF used the spontaneous cycle of the women, with the retrieval of only one oocyte. Further studies have shown that it is possible to induce ovulation by administrating gonadotropins during the menstrual cycle, in order to obtain a higher number of oocytes. Many stimulation protocols have been introduced for controlled ovarian hyperstimulation of patients undergoing in vitro fertilization treatment. This review describe the different stimulation protocols using follicle-stimulating hormone (FSH) in combination with Gonadotropin releasing hormone (GnRH) either agonist or antagonist, oral supplementations and ovarian triggering. Using GnRH antagonist protocols have been demonstrated to improve significantly the clinical pregnancy rates for expected poor and high-responders, and in those women at high risk of developing ovarian hyperstimulation syndrome (OHSS). Two meta-analyses showed a better outcome in terms of the live birth rate when highly purified human menopausal gonadotropin (HMG) was used for ovarian stimulation compared with recombinant follicle stimulating hormone (rFSH) in the GnRH agonist long protocol. One of the most efficient stimulation protocol is the use of a combined protocol of human derived urinary FSH (uFSH) and rFSH. Combined protocol has resulted in a significant increase in the proportion of mature metaphase II oocytes and grade 1 embryos when compared to either rFSH or uFSH alone. A significantly higher delivery rate was achieved in rFSH+uFSH compared to the other protocols in poor and normal responders. Studying the combination of melatonin with myo-inositol and folic acid has also showed a higher percentage of mature oocytes in the melatonin group and a higher percentage of G1 embryos as well. However, It remains a crucial step to confirm the efficacy of such protocols for clinical application and

  2. Ovarian Cancer

    Science.gov (United States)

    ... deaths than other female reproductive cancers. The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early. Women with ovarian ...

  3. Use of dairy products, lactose, and calcium and risk of ovarian cancer - results from a Danish case-control study

    DEFF Research Database (Denmark)

    Faber, Mette Tuxen; Jensen, Allan; Søgaard, Marie

    2012-01-01

    A number of epidemiological studies have examined the association between use of dairy products and risk of ovarian cancer, but results are conflicting. Using data from a large Danish population-based case-control study we here further examined the association between dairy consumption, lactose...

  4. Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo : a randomized controlled trial

    NARCIS (Netherlands)

    Baart, Esther B.; Martini, Elena; Eijkemans, Marinus J.; Van Opstal, Diane; Beckers, Nicole G. M.; Verhoeff, Arie; Macklon, Nicolas S.; Fauser, Bart C. J. M.

    2007-01-01

    To test whether ovarian stimulation for in-vitro fertilization (IVF) affects oocyte quality and thus chromosome segregation behaviour during meiosis and early embryo development, preimplantation genetic screening of embryos was employed in a prospective, randomized controlled trial, comparing two ov

  5. Women with spontaneous 46,XX primary ovarian insufficiency (hypergonadotropic hypogonadism) have lower perceived social support than control women

    Science.gov (United States)

    Orshan, Susan A.; Ventura, June L.; Covington, Sharon N.; Vanderhoof, Vien H.; Troendle, James F.; Nelson, Lawrence M.

    2009-01-01

    Objective To test the hypothesis that women with spontaneous primary ovarian insufficiency differ from control women with regard to perceived social support and to investigate the relationship between perceived social support and self-esteem. Design Cross-sectional Setting Mark O. Hatfield Clinical Research Center, National Institutes of Health. Patient(s) Women diagnosed with spontaneous primary ovarian insufficiency (N=154) at a mean age of 27 years and healthy control women (N=63). Intervention(s) Administration of validated self-reporting instruments. Main Outcome Measure(s) Personal Resource Questionnaire-85 (PRQ85), Rosenberg Self-Esteem Scale Result(s) Women with primary ovarian insufficiency had significantly lower scores than controls on the perceived social support scale and the self-esteem scale. The findings remained significant after modeling with multivariate regression for differences in age, marital status, and having children. In patients there was a significant positive correlation between self-esteem scores and perceived social support. We found no significant differences in perceived social support or self-esteem related to marital status, whether or not they had children, or time since diagnosis. Conclusion(s) This evidence supports the need for prospective controlled studies. Strategies to improve social support and self-esteem might provide a therapeutic approach to reduce the emotional suffering that accompanies the life-altering diagnosis of spontaneous primary ovarian insufficiency. PMID:18829005

  6. Imaging-guided hyperstimulation analgesia in low back pain

    Directory of Open Access Journals (Sweden)

    Gorenberg M

    2013-06-01

    Full Text Available Miguel Gorenberg,1,2 Kobi Schwartz31Department of Nuclear Medicine, B'nai Zion Medical Center, Haifa, Israel; 2The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; 3Department of Physical Therapy, B'nai Zion Medical Center, Haifa, IsraelAbstract: Low back pain in patients with myofascial pain syndrome is characterized by painful active myofascial trigger points (ATPs in muscles. This article reviews a novel, noninvasive modality that combines simultaneous imaging and treatment, thus taking advantage of the electrodermal information available from imaged ATPs to deliver localized neurostimulation, to stimulate peripheral nerve endings (Aδ fibers and in turn, to release endogenous endorphins. "Hyperstimulation analgesia" with localized, intense, low-rate electrical pulses applied to painful ATPs was found to be effective in 95% patients with chronic nonspecific low back pain, in a clinical validation study.Keywords: myofascial, noninvasive, electrical, impedance

  7. A mathematical model of bimodal epigenetic control of miR-193a in ovarian cancer stem cells.

    Directory of Open Access Journals (Sweden)

    Frank H C Cheng

    Full Text Available Accumulating data indicate that cancer stem cells contribute to tumor chemoresistance and their persistence alters clinical outcome. Our previous study has shown that ovarian cancer may be initiated by ovarian cancer initiating cells (OCIC characterized by surface antigen CD44 and c-KIT (CD117. It has been experimentally demonstrated that a microRNA, namely miR-193a, targets c-KIT mRNA for degradation and could play a crucial role in ovarian cancer development. How miR-193a is regulated is poorly understood and the emerging picture is complex. To unravel this complexity, we propose a mathematical model to explore how estrogen-mediated up-regulation of another target of miR-193a, namely E2F6, can attenuate the function of miR-193a in two ways, one through a competition of E2F6 and c-KIT transcripts for miR-193a, and second by binding of E2F6 protein, in association with a polycomb complex, to the promoter of miR-193a to down-regulate its transcription. Our model predicts that this bimodal control increases the expression of c-KIT and that the second mode of epigenetic regulation is required to generate a switching behavior in c-KIT and E2F6 expressions. Additional analysis of the TCGA ovarian cancer dataset demonstrates that ovarian cancer patients with low expression of EZH2, a polycomb-group family protein, show positive correlation between E2F6 and c-KIT. We conjecture that a simultaneous EZH2 inhibition and anti-estrogen therapy can constitute an effective combined therapeutic strategy against ovarian cancer.

  8. Control of bone resorption by semaphorin 4D is dependent on ovarian function.

    Directory of Open Access Journals (Sweden)

    Romain Dacquin

    Full Text Available Osteoporosis is one of the most common bone pathologies, which are characterized by a decrease in bone mass. It is well established that bone mass, which results from a balanced bone formation and bone resorption, is regulated by many hormonal, environmental and genetic factors. Here we report that the immune semaphorin 4D (Sema4D is a novel factor controlling bone resorption. Sema4D-deficient primary osteoclasts showed impaired spreading, adhesion, migration and resorption due to altered ß3 integrin sub-unit downstream signaling. In apparent accordance with these in vitro results, Sema4D deletion in sexually mature female mice led to a high bone mass phenotype due to defective bone resorption by osteoclasts. Mutant males, however, displayed normal bone mass and the female osteopetrotic phenotype was only detected at the onset of sexual maturity, indicating that, in vivo, this intrinsic osteoclast defect might be overcome in these mice. Using bone marrow cross transplantation, we confirmed that Sema4D controls bone resorption through an indirect mechanism. In addition, we show that Sema4D -/- mice were less fertile than their WT littermates. A decrease in Gnrh1 hypothalamic expression and a reduced number of ovarian follicles can explain this attenuated fertility. Interestingly, ovariectomy abrogated the bone resorption phenotype in Sema4D -/- mice, providing the evidence that the observed high bone mass phenotype is strictly dependent on ovarian function. Altogether, this study reveals that, in vivo, Sema4D is an indirect regulator of bone resorption, which acts via its effect on reproductive function.

  9. Sugary food and beverage consumption and epithelial ovarian cancer risk: a population-based case-control study.

    Science.gov (United States)

    King, Melony G; Olson, Sara H; Paddock, Lisa; Chandran, Urmila; Demissie, Kitaw; Lu, Shou-En; Parekh, Niyati; Rodriguez-Rodriguez, Lorna; Bandera, Elisa V

    2013-02-27

    Ovarian cancer is the deadliest gynecologic cancer in the US. The consumption of refined sugars has increased dramatically over the past few decades, accounting for almost 15% of total energy intake. Yet, there is limited evidence on how sugar consumption affects ovarian cancer risk. We evaluated ovarian cancer risk in relation to sugary foods and beverages, and total and added sugar intakes in a population-based case-control study. Cases were women with newly diagnosed epithelial ovarian cancer, older than 21 years, able to speak English or Spanish, and residents of six counties in New Jersey. Controls met same criteria as cases, but were ineligible if they had both ovaries removed. A total of 205 cases and 390 controls completed a phone interview, food frequency questionnaire, and self-recorded waist and hip measurements. Based on dietary data, we computed the number of servings of dessert foods, non-dessert foods, sugary drinks and total sugary foods and drinks for each participant. Total and added sugar intakes (grams/day) were also calculated. Multiple logistic regression models were used to estimate odds ratios and 95% confidence intervals for food and drink groups and total and added sugar intakes, while adjusting for major risk factors. We did not find evidence of an association between consumption of sugary foods and beverages and risk, although there was a suggestion of increased risk associated with sugary drink intake (servings per 1,000 kcal; OR=1.63, 95% CI: 0.94-2.83). Overall, we found little indication that sugar intake played a major role on ovarian cancer development.

  10. Improving the luteal phase after ovarian stimulation: reviewing new options.

    Science.gov (United States)

    Yding Andersen, C; Vilbour Andersen, K

    2014-05-01

    The human chorionic gonadotrophin (HCG) trigger used for final follicular maturation in connection with assisted reproduction treatment combines ovulation induction and early luteal-phase stimulation of the corpora lutea. The use of a gonadotrophin-releasing hormone agonist (GnRHa) for final follicular maturation has, however, for the first time allowed a separation of the ovulatory signal from the early luteal-phase support. This has generated new information that may improve the currently employed luteal-phase support. Thus, combined results from a number of randomized controlled trials using the GnRHa trigger suggest an association between the reproductive outcome after IVF treatment and the mid-luteal-phase serum progesterone concentration. It appears that a minimum mid-luteal progesterone threshold of approximately 80-100 nmol/l exists, which, when surpassed, results in reduced early pregnancy loss and an increased live birth rate. Further, the trade off between the HCG bolus and the subsequent risk of ovarian hyperstimulation syndrome has resulted in a trend to reduce the HCG bolus from 10,000 IU to 6500-5000 IU, which augments the HCG/LH deficiency during the early/mid-luteal phase. The mid-luteal HCG/LH shortage results in an altered progesterone profile, showing the highest concentration during the early luteal phase, contrasting with the mid-luteal peak seen in the natural menstrual cycle. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  11. DNA methylation profiles of polycystic ovarian syndrome in Chinese women: A case-control study

    DEFF Research Database (Denmark)

    Li, Shuxia; Duan, Hongmei; Zhu, D

    As a universally common endocrinopathy in women of reproductive age, the polycystic ovarian syndrome is characterized by composite clinical phenotypes refl ecting the contributions of reproductive impact of ovarian dysfunction and metabolic abnormalities with widely varying symptoms resulting from...... interference of the genome with the environment through integrative biological mechanisms including epigenetics. We have performed a genome-wide DNA methylation analysis on polycystic ovarian syndrome using Illumina’s HumanMethylation450 BeadChip array. We identifi ed a substantial number of genomic sites diff...

  12. Identification of differentially expressed genes using an annealing control primer system in stage III serous ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Bae Dong-Han

    2010-10-01

    Full Text Available Abstract Background Most patients with ovarian cancer are diagnosed with advanced stage disease (i.e., stage III-IV, which is associated with a poor prognosis. Differentially expressed genes (DEGs in stage III serous ovarian carcinoma compared to normal tissue were screened by a new differential display method, the annealing control primer (ACP system. The potential targets for markers that could be used for diagnosis and prognosis, for stage III serous ovarian cancer, were found by cluster and survival analysis. Methods The ACP-based reverse transcriptase polymerase chain reaction (RT PCR technique was used to identify DEGs in patients with stage III serous ovarian carcinoma. The DEGs identified by the ACP system were confirmed by quantitative real-time PCR. Cluster analysis was performed on the basis of the expression profile produced by quantitative real-time PCR and survival analysis was carried out by the Kaplan-Meier method and Cox proportional hazards multivariate model; the results of gene expression were compared between chemo-resistant and chemo-sensitive groups. Results A total of 114 DEGs were identified by the ACP-based RT PCR technique among patients with stage III serous ovarian carcinoma. The DEGs associated with an apoptosis inhibitory process tended to be up-regulated clones while the DEGs associated with immune response tended to be down-regulated clones. Cluster analysis of the gene expression profile obtained by quantitative real-time PCR revealed two contrasting groups of DEGs. That is, a group of genes including: SSBP1, IFI6 DDT, IFI27, C11orf92, NFKBIA, TNXB, NEAT1 and TFG were up-regulated while another group of genes consisting of: LAMB2, XRCC6, MEF2C, RBM5, FOXP1, NUDCP2, LGALS3, TMEM185A, and C1S were down-regulated in most patients. Survival analysis revealed that the up-regulated genes such as DDAH2, RNase K and TCEAL2 might be associated with a poor prognosis. Furthermore, the prognosis of patients with chemo

  13. Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial

    DEFF Research Database (Denmark)

    Lossl, K; Andersen, C Yding; Loft, A;

    2008-01-01

    Temporary exposure of follicles to increased levels of androgens may augment follicular responsiveness. The present study tested whether short-term androgen priming by aromatase inhibitor and human chorionic gonadotrophin (hCG) before controlled ovarian stimulation (COS) increases the number of top...

  14. Random-start controlled ovarian stimulation for emergency fertility preservation in a patient with myelodysplastic syndrome: a case report

    Directory of Open Access Journals (Sweden)

    H. Cai

    2016-01-01

    Full Text Available This study reports a case of a gonadotropin-releasing hormone agonist trigger in a young female with myelodysplastic syndrome (MDS who underwent fertility preservation using random-start controlled ovarian stimulation. This method involves the stimulation of the ovary regardless of a patient's menstrual-cycle phase. A review of the related literature is also provided. A 17-year-old patient was diagnosed with MDS and required initiation of peripheral blood stem cell transplantation within a maximum of 3 weeks and was in the luteal phase of the menstrual cycle when the possibility of attempting preservation of fertility was presented to her. She opted for a random-start controlled ovarian stimulation with gonadotropins. With successful hemorrhagic prophylaxis, 17 oocytes were retrieved including 10 mature and 7 immature oocytes. Of the immature oocytes, 3 were successfully matured in vitro and a vitrification protocol was used to freeze the 13 mature oocytes.

  15. Movement variation in infants born following IVF/ICSI with and without ovarian hyperstimulation

    NARCIS (Netherlands)

    Schendelaar, Pamela; Heineman, Maas Jan; Jongbloed-Pereboom, Marjolein; La Bastide-Van Gemert, Sacha; Middelburg, Karin J.; Van den Heuvel, Edwin R.; Hadders-Algra, Mijna

    Background: The effect of in vitro fertilisation (LW) on neurodevelopment is not fully understood. Probably, IVF does not affect traditional measures of neurodevelopment in infancy. Recently, an instrument the Infant Motor Profile (IMP), was developed that evaluates the quality of motor behaviour.

  16. [Ovarian hyperstimulation syndrome: experience of a reproductive medicine center 2005-2011].

    Science.gov (United States)

    Lima, Mariana; Sousa, Mário; Oliveira, Cristiano; Silva, Joaquina; Teixeira Da Silva, José; Cunha, Mariana; Viana, Paulo; Barros, Alberto

    2013-01-01

    Introdução: A Síndrome de Hiperestimulação Ovárica é uma complicação da hiperestimulação controlada do ovário realizada nos ciclos de reprodução medicamente assistida . O objetivo deste trabalho foi efetuar uma análise desses ciclos, para melhor compreensão daquela patologia, nomeadamente fatores de risco, formas de prevenção e tratamento da mesma e suas consequências. Materiais e Métodos: Análise retrospetiva de 4870 ciclos de reprodução medicamente assistida (2005 - 2011) com Síndrome de Hiperestimulação moderado (27) e grave (24). Foram estudados, os dados das características dos doentes, protocolos de estimulação, resultados embriológicos e clínicos, e tratamento efetuado. Resultados: No grupo com Síndrome de Hiperestimulação Ovárica a idade média foi inferior, a dose de rFSH + HMG foi mais baixa e os níveis de estradiol foram mais elevados. Nos grupos com Síndrome de Hiperestimulação, as taxas foram significativamente superiores para o número médio de ovócitos e blastocistos obtidos, de gravidez bioquímica e clínica, de implantação e de recém-nascidos. O parto muito pré-termo e a proporção de recém-nascidos com peso baixo e muito baixo foram superiores no grupo com Síndrome de Hiperestimulação Ovárica. As doentes com Síndrome de Hiperestimulação Ovárica grave foram hospitalizadas tendo apenas sido necessária medicação de suporte. Discussão: A Síndrome de Hiperestimulação Ovárica foi associada a condições de risco para o feto, nomeadamente prematuridade e baixo peso ao nascimento, devendo manter-se uma vigilância apertada da gravidez nestes casos. Conclusão: A idade jovem constitui um fator de risco de Síndrome de Hiperestimulação Ovárica e o nível de estradiol elevado foi preditor do mesmo, devendo levar à adoção de estratégias de prevenção.

  17. Major drawbacks and additional benefits of agonist trigger--not ovarian hyperstimulation syndrome related

    DEFF Research Database (Denmark)

    Shapiro, Bruce S; Andersen, Claus Yding

    2015-01-01

    . The agonist trigger might alter other paradigms as well, such as making oocyte donation more efficient per stimulation by virtually eliminating follicular-phase cycle cancellation, coasting, and premature triggering. There are both corresponding potential benefits and drawbacks of using the agonist trigger...

  18. The diabetic β-cell: hyperstimulated vs. hyperexcited.

    Science.gov (United States)

    Nichols, C G; Remedi, M S

    2012-10-01

    Hyperglycaemia has multiple effects on β-cells, some clearly prosecretory, including hyperplasia and elevated insulin content, but eventually, a 'glucotoxic' effect which leads to pancreatic β-cell dysfunction, reduced β-cell mass and insulin deficiency, is an important part of diabetes pathophysiology. Myriad underlying cellular and molecular processes could lead to such dysfunction. High glucose will stimulate glycolysis and oxidative phosphorylation, which will in turn increase β-cell membrane excitability through K(ATP) channel closure. Chronic hyperexcitability will then lead to persistently elevated [Ca(2+)](i), a key trigger to insulin secretion. Thus, at least a part of the consequence of 'hyperstimulation' by glucose has been suggested to be a result of 'hyperexcitability' and chronically elevated [Ca(2+)](i). This link is lost when the [glucose], K(ATP) -channel activity link is broken, either pharmacologically or genetically. In isolated islets, such studies reveal that hyperexcitability causes a largely reversible chronic loss of insulin content, but in vivo chronic hyperexcitability per se does not lead to β-cell death or loss of insulin content. On the other hand, chronic inexcitability in vivo leads to systemic diabetes and consequential β-cell death, even while [Ca(2+)](i) remains low.

  19. Phytoestrogen consumption from foods and supplements and epithelial ovarian cancer risk: a population-based case control study

    Directory of Open Access Journals (Sweden)

    Paddock Lisa E

    2011-09-01

    Full Text Available Abstract Background While there is extensive literature evaluating the impact of phytoestrogen consumption on breast cancer risk, its role on ovarian cancer has received little attention. Methods We conducted a population-based case-control study to evaluate phytoestrogen intake from foods and supplements and epithelial ovarian cancer risk. Cases were identified in six counties in New Jersey through the New Jersey State Cancer Registry. Controls were identified by random digit dialing, CMS (Centers for Medicare and Medicaid Service lists, and area sampling. A total of 205 cases and 390 controls were included in analyses. Unconditional logistic regression analyses were conducted to examine associations with total phytoestrogens, as well as isoflavones (daidzein, genistein, formononetin, and glycitein, lignans (matairesinol, lariciresinol, pinoresinol, secoisolariciresinol, and coumestrol. Results No statistically significant associations were found with any of the phytoestrogens under evaluation. However, there was a suggestion of an inverse association with total phytoestrogen consumption (from foods and supplements, with an odds ratio (OR of 0.62 (95% CI: 0.38-1.00; p for trend: 0.04 for the highest vs. lowest tertile of consumption, after adjusting for reproductive covariates, age, race, education, BMI, and total energy. Further adjustment for smoking and physical activity attenuated risk estimates (OR: 0.66; 95% CI: 0.41-1.08. There was little evidence of an inverse association for isoflavones, lignans, or coumestrol. Conclusions This study provided some suggestion that phytoestrogen consumption may decrease ovarian cancer risk, although results did not reach statistical significance.

  20. Changes in Circulating Levels and Ratios of Angiopoietins during Pregnancy, but not during the Menstrual Cycle and Controlled Ovarian Stimulation

    Science.gov (United States)

    Hurliman, Amanda K.; Speroff, Leon; Stouffer, Richard L.; Patton, Phillip E.; Lee, Annette; Molskness, Theodore A.

    2009-01-01

    OBJECTIVE This study was designed to determine if angiopoietin (ANGPT)-1 and -2 are detectable in the circulation of nonhuman primates and women, and if these levels fluctuate in association with ovarian activity. DESIGN Prospective SETTING National Primate Research Center, medical center and infertility clinic. PATIENTS Adult, female rhesus monkeys; 15 women donating oocytes for infertility treatment. INTERVENTIONS Controlled ovarian stimulation with gonadotropins, removal of the corpus luteum and ovaries, oocyte retrieval and embryo transfer. MAIN OUTCOME MEASURE Circulating levels of ANGPT-1 and ANGPT-2. RESULTS Serum ANGPT-1 and ANGPT-2 levels were detectable and invariant in maintaining an ANGPT1:2 ratio >1 in: (a) macaques over the course of the natural menstrual cycle, during a controlled ovulation protocol and following removal of the corpus luteum or ovaries, and (b) women undergoing controlled ovarian simulation (COS). In contrast, the ANGPT1:2 ratio was markedly decreased (≪1) at mid-to-late gestation in macaques, and in the follicular fluid of women undergoing COS, due to increased levels of ANGPT-2. CONCLUSIONS The ovary and its dominant structures are not major contributors to circulating levels of ANGPT-1 or ANGPT-2. The physiologic importance of the rising levels of ANGPT-2 after the luteal-placental shift in pregnancy is unknown. PMID:19476937

  1. Role of Progesterone Administration on Endometrial Angiogenesis and other Endometrial Quantative Changes in Hyperstimulated Mice at Implantation Period

    Directory of Open Access Journals (Sweden)

    Sedigheh Momeni

    2015-09-01

    Full Text Available Introduction: The vascular parameters changes from the morphological aspects resulted in changes in the rate of the embryo implantation. This event depend on theovarian hormones. In this study, the quantiative changes of the endometrium was assessed after ovarian stimulation followed by progesterone (p4 treatment.Methods: Adult female mice were used in this study. Animals were divided in three groups. pseudopregnancy were induced in the control group. Then in the experimental group1 (ovarian induction groupand experimental group2(p4 treated after ovarian induction, ovarian stimulation was done. P4 treatment was done daily in the experimental group2 after pseudopregnancy. Finally, blood and tissue samples were taken for assessment of the ovarian hormone levels and histogical studies, respectively. Then statistical analysis was done.Results: The results indicated the significant increase in the progesterone level, vascular sections, internal area of vessels, and the diagonal of the glandular lumen in two experimental groups (1&2 compared to the control group (P≤0.05. Also, P4 treatment after ovarian induction resulted in the significant increase in the P4 level and vascular section number in the experimental group 2 compared to the experimental group1 (P≤0.05.Conclusion: P4 treatment after ovarian induction improve the morphological condition of the endomertium compared to the ovarian induction group. Therefore, it may result in an increased rate of successful implantation.

  2. Overriding follicle selection in controlled ovarian stimulation protocols: Quality vs quantity

    Directory of Open Access Journals (Sweden)

    Zelinski-Wooten Mary B

    2004-06-01

    Full Text Available Abstract Selection of the species-specific number of follicles that will develop and ovulate during the ovarian cycle can be overridden by increasing the levels of pituitary gonadotropin hormones, FSH and LH. During controlled ovarian stimulation (COS in nonhuman primates for assisted reproductive technology (ART protocols, the method of choice (but not the only method has been the administration of exogenous gonadotropins, either of nonprimate or primate origin. Due to species-specificity of the primate LH (but not FSH receptor, COS with nonprimate (e.g., PMSG hormones can be attributed to their FSH activity. Elevated levels of FSH alone will produce large antral follicles containing oocytes capable of fertilization in vitro (IVF. However, there is evidence that LH, probably in lesser amounts, increases the rate of follicular development, reduces heterogeneity of the antral follicle pool, and improves the viability and rate of pre-implantation development of IVF-produced embryos. Since an endogenous LH surge typically does not occur during COS cycles (especially when a GnRH antagonist is added, a large dose of an LH-like hormone (i.e., hCG may be given to reinitiate meiosis and produce fertilizable oocytes. Alternate approaches using exogenous LH (or FSH, or GnRH agonist to induce an endogenous LH surge, have received lesser attention. Current protocols will routinely yield dozens of large follicles with fertilizable eggs. However, limitations include non/poor-responding animals, heterogeneity of follicles (and presumably oocytes and subsequent short luteal phases (limiting embryo transfer in COS cycles. However, the most serious limitation to further improvements and expanded use of COS protocols for ART is the lack of availability of nonhuman primate gonadotropins. Human, and even more so, nonprimate gonadotropins are antigenic in monkeys, which limits the number of COS cycles to as few as 1 (PMSG or 3 (recombinant hCG protocols in macaques

  3. Low-dose oral sirolimus and the risk of menstrual-cycle disturbances and ovarian cysts: analysis of the randomized controlled SUISSE ADPKD trial.

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    Matthias Braun

    Full Text Available UNLABELLED: Sirolimus has been approved for clinical use in non proliferative and proliferative disorders. It inhibits the mammalian target of rapamycin (mTOR signaling pathway which is also known to regulate ovarian morphology and function. Preliminary observational data suggest the potential for ovarian toxicity but this issue has not been studied in randomized controlled trials. We reviewed the self-reported occurrence of menstrual cycle disturbances and the appearance of ovarian cysts post hoc in an open label randomized controlled phase II trial conducted at the University Hospital Zürich between March 2006 and March 2010. Adult females with autosomal dominant polycystic kidney disease, an inherited kidney disease not known to affect ovarian morphology and function, were treated with 1.3 to 1.5 mg sirolimus per day for a median of 19 months (N = 21 or standard care (N = 18. Sirolimus increased the risk of both oligoamenorrhea (hazard ratio [HR] 4.3, 95% confidence interval [CI] 1.1 to 29 and ovarian cysts (HR 4.4, CI 1.1 to 26; one patient was cystectomized five months after starting treatment with sirolimus. We also studied mechanisms of sirolimus-associated ovarian toxicity in rats. Sirolimus amplified signaling in rat ovarian follicles through the pro-proliferative phosphatidylinositol 3-kinase pathway. Low dose oral sirolimus increases the risk of menstrual cycle disturbances and ovarian cysts and monitoring of sirolimus-associated ovarian toxicity is warranted and might guide clinical practice with mammalian target of rapamycin inhibitors. TRIAL REGISTRATION: ClinicalTrials.gov NCT00346918.

  4. Ovarian reserve

    NARCIS (Netherlands)

    Macklon, NS; Fauser, BCJM

    2005-01-01

    The tendency to delay childbirth has increased the importance of ovarian reserve as a determinant of infertility treatment outcome. In the context of assisted reproduction technology, effective strategies to overcome the impact of ovarian aging and diminished ovarian reserve on pregnancy chances rem

  5. Ovarian cancer risk and common variation in the sex hormone-binding globulin gene: a population-based case-control study

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    Yeager Meredith

    2007-04-01

    Full Text Available Abstract Background The sex hormone-binding globulin (SHBG is a carrier protein that modulates the bio-availability of serum sex steroid hormones, which may be involved in ovarian cancer. We evaluated whether common genetic variation in SHBG and its 3' neighbor ATP1B2, in linkage disequilibrium, is associated with the risk of epithelial ovarian cancer. Methods The study population included 264 women with ovarian carcinoma and 625 controls participating in a population-based case-control study in Poland. Five common single nucleotide polymorphisms (SNPs in SHGB and five in ATP1B2 were selected to capture most common variation in this region. Results None of the SNPs evaluated was significantly associated with ovarian cancer risk, including the putative functional SNPs SHBG D356N (rs6259 and -67G>A 5'UTR (rs1799941. However, our data were consistent with a decreased ovarian cancer risk associated with the variant alleles for these two SNPs, which have been previously associated with increased circulating levels of SHBG. Conclusion These data do not support a substantial association between common genetic variation in SHBG and ovarian cancer risk.

  6. Adequate ovarian follicular status does not prevent the decrease in pregnancy rates associated with high sperm DNA fragmentation.

    Science.gov (United States)

    Frydman, Nelly; Prisant, Nadia; Hesters, Laetitia; Frydman, René; Tachdjian, Gérard; Cohen-Bacrie, Paul; Fanchin, Rénato

    2008-01-01

    Potential reparation of sperm DNA fragmentation in the oocyte may disturb any relationship between DNA-damaged sperm and the implantation ability of resulting embryos. To rule out this factor, we analyzed the consequences of sperm DNA fragmentation on IVF-ET outcome in women with healthy ovarian function. Prospective study. Teaching hospital, France. All 117 women were <38 years old, who combined normal serum day-3 FSH and inhibin B levels with an adequate response to controlled ovarian hyperstimulation. The DNA fragmentation rate was determined in the raw sperm used for conventional IVF by flow cytometric terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Cycles were sorted into two groups according to whether DNA fragmentation exceeded (high fragmentation [HF], n = 52) or did not exceed (low fragmentation [LF], n = 65) the 50th percentile of values (35%). D2 embryo quality and implantation and ongoing pregnancy rates. Patients' characteristics, raw semen parameters, fertilization rates, and embryology data were similar in HF and LF groups. Clinical (37.5% vs. 62.5%) and ongoing (23.5% vs. 57.8%) pregnancy rates per ET and implantation rates (24.5% vs. 42.4%) were lower in the HF group than in the LF group. High sperm DNA fragmentation spares fertilization and top embryo morphology rates but is associated with decreased IVF-ET outcome.

  7. Random-start GnRH antagonist for emergency fertility preservation: a self-controlled trial

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    Checa MA

    2015-02-01

    Full Text Available Miguel A Checa,1,2 Mario Brassesco,2 Margalida Sastre,1 Manuel Gómez,2 Julio Herrero,3 Laura Marque,3 Arturo Brassesco,2 Juan José Espinós3 1Department of Obstetrics and Gynecology, Parc de Salut Mar, Universitat Autònoma de Barcelona, 2Centro de Infertilidad y Reproducción Humana (CIRH, 3Centro de Reproducción Asistida Sagrada Familia, Clínica Sagrada Familia, Barcelona, Spain Abstract: The aim of this study is to evaluate the feasibility and safety of random-start controlled ovarian hyperstimulation (COH for emergency fertility preservation, regardless of the phase of the menstrual cycle. A self-controlled pilot clinical trial (NCT01385332 was performed in an acute-care teaching hospital and in two private reproductive centers in Barcelona, Spain. Eleven egg donors participated in the study. Two random-start gonadotropin-releasing hormone (GnRH antagonist protocols were assessed in which ganirelix was initiated on either day 10 (protocol B or on day 20 (protocol C of the menstrual cycle and was continued until estradiol levels were below 60 pg/dL. These protocols were compared with a standard protocol (protocol A. The main outcome of interest was the number of metaphase 2 oocytes retrieved. Results from this study show that the number of mature oocytes retrieved was comparable across the different protocols (14.3±4.6 in the standard protocol versus 13.0±9.1 and 13.2±5.2 in protocols B and C, respectively; values expressed as mean ± standard deviation. The mean number of days needed for a GnRH antagonist to lower estradiol levels, as well as the ongoing pregnancy rates, were also similar when protocols B (stimulation in follicular phase and C (stimulation on luteal phase were compared with protocol A (standard stimulation. GnRH antagonists can be effectively used for random-start controlled ovarian hyperstimulation with an ovarian response similar to that of standard protocols, and the antagonists appear suitable for emergency

  8. Brain endothelial cells control fertility through ovarian-steroid-dependent release of semaphorin 3A

    NARCIS (Netherlands)

    Giacobini, Paolo; Parkash, Jyoti; Campagne, Céline; Messina, Andrea; Casoni, Filippo; Vanacker, Charlotte; Langlet, Fanny; Hobo, Barbara; Cagnoni, Gabriella; Gallet, Sarah; Hanchate, Naresh Kumar; Mazur, Danièle; Taniguchi, Masahiko; Mazzone, Massimiliano; Verhaagen, J.; Ciofi, Philippe; Bouret, Sébastien G; Tamagnone, Luca; Prevot, Vincent

    2014-01-01

    Neuropilin-1 (Nrp1) guides the development of the nervous and vascular systems, but its role in the mature brain remains to be explored. Here we report that the expression of the 65 kDa isoform of Sema3A, the ligand of Nrp1, by adult vascular endothelial cells, is regulated during the ovarian cycle

  9. MTHFR C677T polymorphism and breast, ovarian cancer risk: a meta-analysis of 19,260 patients and 26,364 controls

    Science.gov (United States)

    He, Lilin; Shen, Yongxiang

    2017-01-01

    Objective Previous studies have found that many gene variations can be detected in both breast cancer and ovarian cancer, which is beneficial for the elaboration of the molecular origin of breast and ovarian cancer. Furthermore, many studies have explored the association of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism with the risk of breast cancer and/or ovarian cancer; however, the results remained inconclusive. Therefore, this study conducted a systematic review and meta-analysis to evaluate the association between MTHFR C677T polymorphism and the risk of breast and ovarian cancer. Materials and methods A total of 50 studies with 19,260 cases and 26,364 controls including 39 studies for breast cancer and 8 studies for ovarian cancer were identified on searching through PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang, and Database of Chinese Scientific and Technical Periodicals (VIP). Allele model, dominant model, recessive model, homozygous model, and co-dominant model were applied to evaluate the association of MTHFR C677T polymorphism with breast cancer and/or ovarian cancer risk. Moreover, the odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of the association between MTHFR C677T polymorphism and breast and ovarian cancer risk. Results A significantly increased breast cancer risk was observed in the overall analysis (for C vs T, OR =1.19, CI: 1.12–1.28, P<0.05; for CC vs TT, OR =1.20, CI: 1.10–1.23, P<0.05; for (CT+CC) vs TT, OR =1.19, CI: 1.11–1.27, P<0.05; for CC vs (CT+TT), OR =1.19, CI: 1.79–1.95, P<0.05), while no significantly increased ovarian cancer risk was detected. In the subgroup analysis based on ethnicity, a significant association of breast cancer and/or ovarian cancer risk with MTHFR C677T polymorphism was observed in Asians. Interestingly, there was no significant association between MTHFR C677T polymorphism and ovarian cancer risk in

  10. Comparison of automated and manual follicle monitoring in an unrestricted population of 100 women undergoing controlled ovarian stimulation for IVF.

    Science.gov (United States)

    Ata, Baris; Seyhan, Ayse; Reinblatt, Shauna Leigh; Shalom-Paz, Einat; Krishnamurthy, Srinivasan; Tan, Seang Lin

    2011-01-01

    Ovarian response to gonadotrophin stimulation is monitored with serial ultrasound (US) examinations. Sonography-based Automated Volume Count (SonoAVC) is a relatively new three-dimensional (3D) US technology, which automatically generates a set of measurements including the mean follicular diameter (MFD) and a volume-based diameter (d(V)) for each follicle in the ovaries. The present study aimed to assess the applicability and reproducibility of this automated follicle measurement method in an IVF programme. For this prospective method comparison study, 100 women undergoing US monitoring of a controlled ovarian stimulation cycle were recruited. Each follicle was manually measured by taking the mean of maximal diameters on three orthogonal planes with two-dimensional (2D) US. A 3D volume of each ovary was then captured. The ovarian volumes were later analysed using SonoAVC. The agreement between the two methods for the numbers of follicles and the size of the leading follicle was assessed with the Bland-Altman method. The reproducibility of SonoAVC measurements was assessed with the intraclass correlation coefficient (ICC). Both SonoAVC-generated MFD and d(V)-based follicle counts, as well as the leading follicle diameter, had good agreement with conventional 2D US measurements. SonoAVC measurements had very good reproducibility, with ICC ≥0.8 for most evaluations. Automated follicle monitoring with SonoAVC can replace or be used interchangeably with conventional 2D measurements. Automated follicle monitoring can save time, provide a method of quality control and create opportunities for developing HCG criteria based on follicular volume or for monitoring patients from a distance.

  11. Detection of RUNX2 gene expression in cumulus cells in women undergoing controlled ovarian stimulation

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    Papamentzelopoulou Myrto

    2012-11-01

    Full Text Available Abstract Background RUNX2 is a transcription factor, whose expression has been recently identified in the mouse ovary. Regulation of RUNX2 expression and its function in the human ovary have not been determined yet. The aim of the present study is the investigation of the possible correlation between RUNX2 gene expression in cumulus cells and controlled ovarian stimulation and pregnancy outcomes after ART treatment. Methods A total of 41 patients undergoing ICSI treatment for male factor infertility were enrolled into a specific ART program, during which cumulus cells were collected. The expression of RUNX2 gene in cumulus cells was examined by real-time PCR. Results Concerning RUNX2 gene expression, 12 out of 41 women were detected with RUNX2 expression, with ratios ranging from 0.84 to 1.00, while 28 out of 41 women had no expression (ratio = 0. Only 1 woman presented a weak RUNX2 gene expression (ratio = 0.52. From 8 women that proceeded to pregnancy, 7 of them did not express RUNX2 gene in cumulus cells, while one was the woman with weak gene expression that also achieved pregnancy. The group of women without RUNX2 expression presented higher number of follicles (p = 0.013, higher number of retrieved oocytes (p = 0.016, higher basal LH serum levels (p = 0.016 and higher peak estradiol levels (p = 0.013, while the number of fertilized oocytes differed marginally between the two groups (p = 0.089. Moreover, RUNX2 expression was negatively associated with LH levels (OR = 0.22, p = 0.021 and E2 levels (OR = 0.25, p = 0.026. Conclusions Consequently, based on the preliminary findings of the present pilot study a potential inhibitory mechanism of RUNX2 gene is observed in the ovary when high mRNA levels are detected, suggesting that RUNX2 could possibly be used as a candidate genetic marker in the monitoring of the outcome of an ART treatment.

  12. Antral follicle count (AFC) can be used in the prediction of ovarian response but cannot predict the oocyte/embryo quality or the in vitro fertilization outcome in an egg donation program.

    Science.gov (United States)

    Melo, Marco Antonio Barreto; Garrido, Nicolás; Alvarez, Claudio; Bellver, José; Meseguer, Marcos; Pellicer, Antonio; Remohí, José

    2009-01-01

    To verify whether the antral follicle count (AFC) could predict ovarian response, oocyte/embryo quality, and IVF outcome. Prospective study. Instituto Universitario-Instituto Valenciano de Infertilidad, Valencia, Spain. One thousand seventy-four donors and 975 oocyte recipient cycles. Controlled ovarian hyperstimulation (COH), endometrial preparation, IVF/intracytoplasmic sperm injection, ET. COH and oocyte/embryo quality parameters and IVF outcome. We observed lower E(2) levels and fewer mature retrieved oocyte numbers among donors who showed an AFC that was <10. These donors also showed significantly higher cancellation and no-donation rates; poor and/or insufficient response was the principal cause (82%). However, there were no differences among the groups regarding embryo development parameters and IVF outcome. AFC is a noninvasive and simple tool that can improve the oocyte donor's selection of an egg donation program. This study suggests that AFC is a good predictor of ovarian response but cannot be used to predict oocyte/embryo quality or IVF outcome.

  13. Transcription factor NF-κB (p50/p50, p65/p65) controls porcine ovarian cells functions.

    Science.gov (United States)

    Pavlová, Silvia; Klucska, Karolina; Vašíček, Dušan; Kotwica, Ján; Sirotkin, Alexander V

    2011-10-01

    The aim of these in vitro studies was to examine the involvement of transcription factor NF-κB (p50/p50, p65/p65) and FSH in control of porcine ovarian granulosa cells functions and the possible role of dimers p50/p50, p65/p65 in mediating FSH actions on these cells. Monolayer of primary granulosa cells was transfected with plasmids encoding human p50 cDNA and p65 cDNA, and cultured with or without addition of FSH (0, 1, 10 or 100 ng/ml). The accumulation of proteins p50 and p65, as well as of proliferation markers (PCNA and MAPK/ERK1,2) and marker of apoptosis (Bax) in cells was detected by using SDS-PAGE-Western immunoblotting and immunocytochemistry. DNA fragmentation was evaluated by TUNEL assay. Release of hormones insulin-like growth factor I (IGF-I), progesterone (P(4)), oxytocin (OT), prostaglandins E(2) (PGE(2)) and F(2α) (PGF(2α)) was measured by using RIA. We observed, that p50/p50 promoted the accumulation of PCNA, MAPK/ERK1,2, the release of OT, PGF(2α); inhibited the occurrence of TdT-positive cells, the release of IGF-I and P(4), and did not influence the accumulation of Bax and the release of PGE(2). p65/p65 enhanced the accumulation of PCNA, MAPK/ERK1,2 and Bax, the release of IGF-I, OT, PGE(2) and PGF(2α); decreased the percentage of cell containing TdT and did not affect the release of P(4). FSH stimulated the accumulation of PCNA, MAPK/ERK1,2 and Bax, the release of IGF-I, OT, P(4), PGE(2); but reduced the proportion of TdT-positive cells and the release of PGF(2α). These observations suggest (1) the involvement of NF-κB (p50/p50) in stimulation of proliferation, inhibition of apoptosis and in either stimulation (OT, PGE(2)) or inhibition (IGF-I, P(4), but not PGF(2)) of hormones release by porcine ovarian granulosa cells; (2) the involvement of NF-κB (p65/p65) in stimulation of proliferation and mitochondrial/Bax-related apoptosis, inhibition of nuclear/TdT-related apoptosis and in stimulation of ovarian hormones (IGF-I, OT, PGE(2), PGF

  14. IL-12 Expressing oncolytic herpes simplex virus promotes anti-tumor activity and immunologic control of metastatic ovarian cancer in mice.

    Science.gov (United States)

    Thomas, Eric D; Meza-Perez, Selene; Bevis, Kerri S; Randall, Troy D; Gillespie, G Yancey; Langford, Catherine; Alvarez, Ronald D

    2016-10-27

    Despite advances in surgical aggressiveness and conventional chemotherapy, ovarian cancer remains the most lethal cause of gynecologic cancer mortality; consequently there is a need for new therapeutic agents and innovative treatment paradigms for the treatment of ovarian cancer. Several studies have demonstrated that ovarian cancer is an immunogenic disease and immunotherapy represents a promising and novel approach that has not been completely evaluated in ovarian cancer. Our objective was to evaluate the anti-tumor activity of an oncolytic herpes simplex virus "armed" with murine interleukin-12 and its ability to elicit tumor-specific immune responses. We evaluated the ability of interleukin-12-expressing and control oncolytic herpes simplex virus to kill murine and human ovarian cancer cell lines in vitro. We also administered interleukin-12-expressing oncolytic herpes simplex virus to the peritoneal cavity of mice that had developed spontaneous, metastatic ovarian cancer and determined overall survival and tumor burden at 95 days. We used flow cytometry to quantify the tumor antigen-specific CD8(+) T cell response in the omentum and peritoneal cavity. All ovarian cancer cell lines demonstrated susceptibility to oncolytic herpes simplex virus in vitro. Compared to controls, mice treated with interleukin-12-expressing oncolytic herpes simplex virus demonstrated a more robust tumor antigen-specific CD8(+) T-cell immune response in the omentum (471.6 cells vs 33.1 cells; p = 0.02) and peritoneal cavity (962.3 cells vs 179.5 cells; p = 0.05). Compared to controls, mice treated with interleukin-12-expressing oncolytic herpes simplex virus were more likely to control ovarian cancer metastases (81.2 % vs 18.2 %; p = 0.008) and had a significantly longer overall survival (p = 0.02). Finally, five of 6 mice treated with interleukin-12-expressing oHSV had no evidence of metastatic tumor when euthanized at 6 months, compared to two of 4 mice treated

  15. Blood cell mitochondrial DNA content and premature ovarian aging.

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    Marco Bonomi

    Full Text Available Primary ovarian insufficiency (POI is a critical fertility defect characterized by an anticipated and silent impairment of the follicular reserve, but its pathogenesis is largely unexplained. The frequent maternal inheritance of POI together with a remarkable dependence of ovarian folliculogenesis upon mitochondrial biogenesis and bioenergetics suggested the possible involvement of a generalized mitochondrial defect. Here, we verified the existence of a significant correlation between blood and ovarian mitochondrial DNA (mtDNA content in a group of women undergoing ovarian hyperstimulation (OH, and then aimed to verify whether mtDNA content was significantly altered in the blood cells of POI women. We recruited 101 women with an impaired ovarian reserve: 59 women with premature ovarian failure (POF and 42 poor responders (PR to OH. A Taqman copy number assay revealed a significant mtDNA depletion (P<0.001 in both POF and PR women in comparison with 43 women of similar age and intact ovarian reserve, or 53 very old women with a previous physiological menopause. No pathogenic variations in the mitochondrial DNA polymerase γ (POLG gene were detected in 57 POF or PR women with low blood mtDNA content. In conclusion, blood cell mtDNA depletion is a frequent finding among women with premature ovarian aging, suggesting that a still undetermined but generalized mitochondrial defect may frequently predispose to POI which could then be considered a form of anticipated aging in which the ovarian defect may represent the first manifestation. The determination of mtDNA content in blood may become an useful tool for the POI risk prediction.

  16. Blood Cell Mitochondrial DNA Content and Premature Ovarian Aging

    Science.gov (United States)

    Cacciatore, Chiara; Busnelli, Marta; Rossetti, Raffaella; Bonetti, Silvia; Paffoni, Alessio; Mari, Daniela; Ragni, Guido; Persani, Luca; Arosio, M.; Beck-Peccoz, P.; Biondi, M.; Bione, S.; Bruni, V.; Brigante, C.; Cannavo`, S.; Cavallo, L.; Cisternino, M.; Colombo, I.; Corbetta, S.; Crosignani, P.G.; D'Avanzo, M.G.; Dalpra, L.; Danesino, C.; Di Battista, E.; Di Prospero, F.; Donti, E.; Einaudi, S.; Falorni, A.; Foresta, C.; Fusi, F.; Garofalo, N.; Giotti, I.; Lanzi, R.; Larizza, D.; Locatelli, N.; Loli, P.; Madaschi, S.; Maghnie, M.; Maiore, S.; Mantero, F.; Marozzi, A.; Marzotti, S.; Migone, N.; Nappi, R.; Palli, D.; Patricelli, M.G.; Pisani, C.; Prontera, P.; Petraglia, F.; Radetti, G.; Renieri, A.; Ricca, I.; Ripamonti, A.; Rossetti, R.; Russo, G.; Russo, S.; Tonacchera, M.; Toniolo, D.; Torricelli, F.; Vegetti, W.; Villa, N.; Vineis, P.; Wasniewsk, M.; Zuffardi, O.

    2012-01-01

    Primary ovarian insufficiency (POI) is a critical fertility defect characterized by an anticipated and silent impairment of the follicular reserve, but its pathogenesis is largely unexplained. The frequent maternal inheritance of POI together with a remarkable dependence of ovarian folliculogenesis upon mitochondrial biogenesis and bioenergetics suggested the possible involvement of a generalized mitochondrial defect. Here, we verified the existence of a significant correlation between blood and ovarian mitochondrial DNA (mtDNA) content in a group of women undergoing ovarian hyperstimulation (OH), and then aimed to verify whether mtDNA content was significantly altered in the blood cells of POI women. We recruited 101 women with an impaired ovarian reserve: 59 women with premature ovarian failure (POF) and 42 poor responders (PR) to OH. A Taqman copy number assay revealed a significant mtDNA depletion (P<0.001) in both POF and PR women in comparison with 43 women of similar age and intact ovarian reserve, or 53 very old women with a previous physiological menopause. No pathogenic variations in the mitochondrial DNA polymerase γ (POLG) gene were detected in 57 POF or PR women with low blood mtDNA content. In conclusion, blood cell mtDNA depletion is a frequent finding among women with premature ovarian aging, suggesting that a still undetermined but generalized mitochondrial defect may frequently predispose to POI which could then be considered a form of anticipated aging in which the ovarian defect may represent the first manifestation. The determination of mtDNA content in blood may become an useful tool for the POI risk prediction. PMID:22879975

  17. European American stratification in ovarian cancer case control data: the utility of genome-wide data for inferring ancestry.

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    Paola Raska

    Full Text Available We investigated the ability of several principal components analysis (PCA-based strategies to detect and control for population stratification using data from a multi-center study of epithelial ovarian cancer among women of European-American ethnicity. These include a correction based on an ancestry informative markers (AIMs panel designed to capture European ancestral variation and corrections utilizing un-thinned genome-wide SNP data; case-control samples were drawn from four geographically distinct North-American sites. The AIMs-only and genome-wide first principal components (PC1 both corresponded to the previously described North or Northwest-Southeast axis of European variation. We found that the genome-wide PCA captured this primary dimension of variation more precisely and identified additional axes of genome-wide variation of relevance to epithelial ovarian cancer. Associations evident between the genome-wide PCs and study site corroborate North American immigration history and suggest that undiscovered dimensions of variation lie within Northern Europe. The structure captured by the genome-wide PCA was also found within control individuals and did not reflect the case-control variation present in the data. The genome-wide PCA highlighted three regions of local LD, corresponding to the lactase (LCT gene on chromosome 2, the human leukocyte antigen system (HLA on chromosome 6 and to a common inversion polymorphism on chromosome 8. These features did not compromise the efficacy of PCs from this analysis for ancestry control. This study concludes that although AIMs panels are a cost-effective way of capturing population structure, genome-wide data should preferably be used when available.

  18. Ovarian Drilling in PCOS: is it really useful!?

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    ISSAM eLEBBI

    2015-07-01

    Full Text Available Polycystic ovary syndrome (PCOS is a frequent disorder, affecting approximately 5 to 10 % of infertile women. It can represent more than 80% of cases of infertility due to anovulation. The main goal of treatment is the induction of mono-ovulatory cycles. A pragmatic management of infertility in PCOS will allow most patients to conceive.Weight loss and clomiphene citrate (CC are the first-line components of patients treatment before gonadotropins are used. However, during gonadotropin administration, there is a high risk of ovarian hyper-stimulation (OHSS and multiple pregnancies. So, surgery with laparoscopic ovarian drilling (LOD is often used before gonadotropins in order to obtain normal ovulatory cycles.

  19. Nomogram to predict the number of oocytes retrieved in controlled ovarian stimulation.

    Science.gov (United States)

    Moon, Kyoung Yong; Kim, Hoon; Lee, Joong Yeup; Lee, Jung Ryeol; Jee, Byung Chul; Suh, Chang Suk; Kim, Ki Chul; Lee, Won Don; Lim, Jin Ho; Kim, Seok Hyun

    2016-06-01

    Ovarian reserve tests are commonly used to predict ovarian response in infertile patients undergoing ovarian stimulation. Although serum markers such as basal follicle-stimulating hormone (FSH) or random anti-Müllerian hormone (AMH) level and ultrasonographic markers (antral follicle count, AFC) are good predictors, no single test has proven to be the best predictor. In this study, we developed appropriate equations and novel nomograms to predict the number of oocytes that will be retrieved using patients' age, serum levels of basal FSH and AMH, and AFC. We analyzed a database containing clinical and laboratory information of 141 stimulated in vitro fertilization (IVF) cycles performed at a university-based hospital between September 2009 and December 2013. We used generalized linear models for prediction of the number of oocytes. Age, basal serum FSH level, serum AMH level, and AFC were significantly related to the number of oocytes retrieved according to the univariate and multivariate analyses. The equations that predicted the number of oocytes retrieved (log scale) were as follows: model (1) 3.21-0.036×(age)+0.089×(AMH), model (2) 3.422-0.03×(age)-0.049×(FSH)+0.08×(AMH), model (3) 2.32-0.017×(age)+0.039×(AMH)+0. 03×(AFC), model (4) 2.584-0.015×(age)-0.035×(FSH)+0.038×(AMH)+0.026×(AFC). model 4 showed the best performance. On the basis of these variables, we developed nomograms to predict the number of oocytes that can be retrieved. Our nomograms helped predict the number of oocytes retrieved in stimulated IVF cycles.

  20. A controlled comparison of ovarian response to controlled stimulation in first generation Asian women compared with white Caucasians undergoing in vitro fertilisation.

    Science.gov (United States)

    Lashen, H; Afnan, M; Sharif, K

    1999-05-01

    To compare ovarian response to controlled stimulation among Asian women from the Indian sub-continent and white Caucasian women undergoing in vitro fertilisation (IVF). Nested case-control study. Assisted Conception Unit, Birmingham Women's Hospital. One hundred and eight first generation Asian patients (born in the Indian sub-continent) and 216 white Caucasian controls, all of whom received IVF treatment in the period 1994 to 1997, were selected for the study. The two groups were matched for age to within one year, early follicular phase follicle stimulating hormone, indication for treatment, gonadotrophin dose and year of treatment. The outcome of treatment was not known when the controls were selected. There was no statistically significant difference between the two groups in the duration of stimulation, egg number, number of embryos produced, fertilisation rate, clinical pregnancy rate, miscarriage rate, cycle cancellation rate and implantation rate. Under the same IVF protocol Asian women's response to controlled ovarian stimulation and IVF outcome are comparable to their white Caucasian peers.

  1. Ovarian Cancer

    Science.gov (United States)

    ... the ovary, fallopian tube, and peritoneum: Epidemiology and risk factors. http://www.uptodate.com/home. Accessed Feb. 18, 2014. Havrilesky LJ, et al. Oral contraceptive pills as primary prevention for ovarian cancer: A systematic ...

  2. Hormonal, functional and genetic biomarkers in controlled ovarian stimulation: tools for matching patients and protocols

    DEFF Research Database (Denmark)

    Alviggi, Carlo; Humaidan, Peter; Ezcurra, Diego

    2012-01-01

    single patient characteristics. These could potentially be used to match patients with the right treatment options to optimise efficacy, safety and tolerability during COS. Currently, age and follicle-stimulating hormone (FSH) level remain the most commonly used single patient characteristics in clinical...... practice. These variables only provide a basic prognosis for success and indications for standard COS treatment based on gross patient categorisation. In contrast, the anti-Müllerian hormone level appears to be an accurate predictor of ovarian reserve and response to COS, and could be used successfully...... based on genotype. Unfortunately, despite the predictive power of these measures, no single biomarker can stand alone as a guide to determine the best treatment option. In the future, hormonal, functional and genetic biomarkers will be used together to personalise COS....

  3. Molecular analysis of genes on Xp controlling Turner syndrome and premature ovarian failure (POF).

    Science.gov (United States)

    Zinn, A R; Ross, J L

    2001-06-01

    Monosomy X has been known to be the chromosomal basis of Turner syndrome (TS) for more than four decades. A large body of cytogenetic data indicates that most TS features are due to reduced dosage of genes on the short arm of the X chromosome (Xp). Phenotype mapping studies using molecular cytogenetic and genetic techniques are beginning to localize the Xp genes that are important for various TS features, and a comprehensive catalog of candidate genes is becoming available through the Human Genome Project and related research. It is now possible to assess the contributions of individual genes to the TS phenotype by mutational analysis of karyotypically normal persons with specific TS features. This strategy has succeeded in identifying a gene involved in short stature and is being applied to premature ovarian failure and other TS phenotypes.

  4. Relationship between Carbachol Hyperstimulation-Induced Pancreatic Acinar Cellular Injury and Trypsinogen or NF-κB Activation in Rats in vitro

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The relationship between M3 cholinergic receptor agonist (carbachol) hyperstimulationinduced pancreatic acinar cellular injury and trypsinogen activation or NF-κB activation in rats was studied in vitro. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor (pefabloc), and NF-κB inhibitor (PDTC) in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar cells. The results showed that as compared with control group, 10-3 mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells (P <0.01) following the treatment with a high concentration of carbachol (10-3 mol/L) in vitro. The addition of 10-2 mol/L PDTC didn't result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol (10-3 mol/L) in vitro (P>0.05). It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-κB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.

  5. CA125 in ovarian cancer

    DEFF Research Database (Denmark)

    Duffy, M J; Bonfrer, J M; Kulpa, J

    2005-01-01

    value in the detection of early ovarian cancer. At present, therefore, CA125, either alone or in combination with other modalities, cannot be recommended for screening for ovarian cancer in asymptomatic women outside the context of a randomized controlled trial. Preoperative levels in postmenopausal...... women, however, may aid the differentiation of benign and malignant pelvic masses. Serial levels during chemotherapy for ovarian cancer are useful for assessing response to treatment. Although serial monitoring following initial chemotherapy can lead to the early detection of recurrent disease......CA125 is currently the most widely used tumor marker for ovarian epithelial cancer. The aim of this article is to provide guidelines for the routine clinical use of CA125 in patients with ovarian cancer. Due to lack of sensitivity for stage I disease and lack of specificity, CA125 is of little...

  6. The emerging role of angiogenic factor dysregulation in the pathogenesis of polycystic ovarian syndrome.

    Science.gov (United States)

    Tal, Reshef; Seifer, David B; Arici, Aydin

    2015-05-01

    Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in reproductive age affecting 5 to 7% of women. It is characterized by anovulatory infertility, hyperandrogenism, and polycystic ovaries. Angiogenesis in the ovary is critical for follicular growth, ovulation, and the subsequent development and regression of the corpus luteum. Accumulating evidence suggests that multiple angiogenic factors are dysregulated in PCOS, including vascular endothelial growth factor, angiopoietins, platelet-derived growth factor, transforming growth factor-β, and basic fibroblast growth factor. This angiogenic factor imbalance likely underlies the increased stromal vascularity observed in PCOS. Angiogenic factor dysregulation may play an important role in the pathophysiology of PCOS and may contribute to ovulatory dysfunction, subfertility, and ovarian hyperstimulation syndrome, which are commonly seen in women with PCOS. Further experimental studies are needed to gain a better understanding of the growth factors that are involved in normal and pathological ovarian angiogenesis, and to assess the potential of angiogenesis-based treatment strategies in PCOS.

  7. Ovarian response in consecutive cycles of ovarian stimulation in normally ovulating women.

    Science.gov (United States)

    Ahmed Ebbiary, N A; Morgan, C; Martin, K; Afnan, M; Newton, J R

    1995-03-01

    Ovarian stimulation combined with intra-uterine insemination (IUI) is an effective treatment of non-tubal infertility but most women undergo several cycles of treatment to achieve a pregnancy. This prospective study was designed to assess the consistency (or variation) of ovarian responses and the effect of various ovarian stimulation protocols on this consistency in consecutive cycles of ovarian stimulation and IUI in women with non-ovulatory infertility. A total of 86 regularly menstruating ovulating patients each completed three to six cycles of ovarian stimulation and IUI (n = 347 cycles). Ovarian stimulation was achieved by sequential clomiphene citrate/human menopausal gonadotrophin (HMG), HMG-only or combined gonadotrophin-releasing hormone analogue--HMG protocols in 33, 29 and 24 patients respectively, and each patient used the same protocol consistently throughout the study. Standard methods were used to monitor ovarian response and to perform IUI. Using each patient as her own control, repeated measurements analysis of variance revealed consistency of ovarian response in consecutive ovarian stimulation cycles, as shown by the number and mean diameter of maturing pre-ovulatory follicles, peak plasma oestradiol, duration of stimulation and mean HMG requirements. This consistency existed using any of the ovarian stimulation protocols. We conclude that regularly menstruating and ovulating women are likely to have similar ovarian responses in consecutive cycles of ovarian stimulation and IUI if the same ovarian stimulation protocol is used consistently.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. The Feasibility and Effects of Acupuncture on Quality of Life Scores During Chemotherapy in Ovarian Cancer: Results from a Pilot, Randomized Sham-Controlled Trial

    Science.gov (United States)

    Matulonis, Ursula A.; Dunn, Julie E.; Lee, Hang; Doherty-Gilman, Anne; Dean-Clower, Elizabeth; Goodman, Annekathryn; Davis, Roger B.; Buring, Julie; Wayne, Peter; Rosenthal, David S.; Penson, Richard T.

    2012-01-01

    Abstract Background Within a pilot trial regarding chemotherapy-induced neutropenia, the secondary aim of the main study was explored. This involved measuring the effects—as shown on two key measurement scales reflecting quality of life (QoL)—of verum versus sham acupuncture on patients with ovarian cancer during chemotherapy. Objective The aim of this substudy was to determine the feasibility of determining the effects of verum acupuncture versus sham acupuncture on QoL in patients with ovarian cancer during chemotherapy. Design This was a randomized, sham-controlled trial. Setting The trial was conducted at two cancer centers. Patients Patients with ovarian cancer (N=21) who were receiving chemotherapy—primarily intravenous carboplatin and paclitaxel—participated in this substudy. Intervention The participants were given either active or sham acupuncture 1 week prior to cycle 2 of chemotherapy. There were ten sessions of acupuncture, with manual and electro-stimulation over a 4-week period. Main Outcome Measures The European Organization for Research and Treatment of Cancer-Quality-of-Life Questionnaire-Core 30 Item (EORTC-QLQ-C30) and the Quality of Life Questionnaire–Ovarian Cancer Module-28 Item (QLQ-OV28) were administered to the patients at baseline and at the end of their acupuncture sessions. Results Of the original 21, 15 patients (71%) completed the study, and 93% of them completed the questionnaires. The EORTC-QLQ-C30 subscores were improved in the acupuncture arm, including the mean scores of social function (SF), pain, and insomnia (p=0.05). However, after adjusting for baseline differences, only the SF score was significantly higher in the active acupuncture arm, compared with the sham acupuncture arm (p=0.03). Conclusions It appears feasible to conduct a randomized sham-controlled acupuncture trial measuring QoL for patients with ovarian cancer who are undergoing chemotherapy. Acupuncture may have a role in improving QoL during

  9. Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls

    Science.gov (United States)

    Terry, Kathryn L.; Karageorgi, Stalo; Shvetsov, Yurii B.; Merritt, Melissa A.; Lurie, Galina; Thompson, Pamela J.; Carney, Michael E.; Weber, Rachel Palmieri; Akushevich, Lucy; Lo-Ciganic, Wei-Hsuan; Cushing-Haugen, Kara; Sieh, Weiva; Moysich, Kirsten; Doherty, Jennifer A.; Nagle, Christina M.; Berchuck, Andrew; Pearce, Celeste L.; Pike, Malcolm; Ness, Roberta B.; Webb, Penelope M.; Rossing, Mary Anne; Schildkraut, Joellen; Risch, Harvey; Goodman, Marc T.

    2013-01-01

    Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital-powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study was collected and harmonized. Lifetime number of genital-powder applications was estimated from duration and frequency of use. Pooled odds ratios were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer (odds ratio 1.24, 95% confidence interval 1.15–1.33) relative to women who never used powder. Risk was elevated for invasive serous (1.20, 1.09–1.32), endometrioid (1.22, 1.04–1.43), and clear cell (1.24, 1.01–1.52) tumors, and for borderline serous tumors (1.46, 1.24–1.72). Among genital powder users, we observed no significant trend (p=0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported non-genital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer. PMID:23761272

  10. Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls.

    Science.gov (United States)

    Terry, Kathryn L; Karageorgi, Stalo; Shvetsov, Yurii B; Merritt, Melissa A; Lurie, Galina; Thompson, Pamela J; Carney, Michael E; Weber, Rachel Palmieri; Akushevich, Lucy; Lo-Ciganic, Wei-Hsuan; Cushing-Haugen, Kara; Sieh, Weiva; Moysich, Kirsten; Doherty, Jennifer A; Nagle, Christina M; Berchuck, Andrew; Pearce, Celeste L; Pike, Malcolm; Ness, Roberta B; Webb, Penelope M; Rossing, Mary Anne; Schildkraut, Joellen; Risch, Harvey; Goodman, Marc T

    2013-08-01

    Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study were collected and harmonized. Lifetime number of genital powder applications was estimated from duration and frequency of use. Pooled ORs were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer [OR, 1.24; 95% confidence interval (CI), 1.15-1.33] relative to women who never used powder. Risk was elevated for invasive serous (OR, 1.20; 95% CI, 1.09-1.32), endometrioid (OR, 1.22; 95% CI, 1.04-1.43), and clear cell (OR, 1.24; 95% CI, 1.01-1.52) tumors, and for borderline serous tumors (OR, 1.46; 95% CI, 1.24-1.72). Among genital powder users, we observed no significant trend (P = 0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported nongenital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer.

  11. Effect of Female Age on Outcomes of IVF-ET during Long Protocols Controlled Ovarian Hyperstimu-lation%年龄对长方案体外受精-胚胎移植助孕的影响

    Institute of Scientific and Technical Information of China (English)

    张静; 孙博; 卜志勤; 孙莹璞

    2014-01-01

    Objective:To investigate the effect of female age on the pregnancy outcomes, as well as ovarian responses, of in vitro fertilization-embryo transfer (IVF-ET), and to find the optimal age range for women undergoing the associated reproduction treatments. Methods:This is a retrospective analysis of all patients firstly undergoing IVF -ET using the standard long protocol for the controlled ovarian hyperstimulation (COH) in our center from May 2011 to May 2012. Patients were divided into four groups according to female age: age of the group A was 20-24 years old(n=170), the group B 25-29 years old(n=741), the group C 30-34 years old(n=866), and the group D over 35 years old(n=691). The laboratory indexes and main clinical outcomes [pregnancy rate, miscarriage rate and live birth rate (LBR)] were compared. Results:The duration of infertility was significantly longer following female age. The basal FSH level of the group D was significantly higher than those of other groups, while AFC and the basal LH level were significantly lower following age. The mean total dose of Gn was increased following age, while the number of mean retrieved oocyte was decreased. The 2PN zygote rate in group A was significantly lowest. The high quality embryo rate was significantly higher in the group B than this in other groups. The biochemical pregnancy rate and LBR were significantly lowered following age, while the spontaneous abortion rate was increased following age. The clinical pregnancy rate of group B is significantly higher than group D. LBR in the group D was significantly lower, and the spontaneous abortion rate was higher when compared with other groups. Conclusions: The oocyte quality and embryo quality in those women aged <25 years undergoing ART are not better than those in women aged 25-29 years, while the pregnancy rates in two groups are similar. The ovarian reserve, and pregnancy outcome of IVF-ET, will reduce following age, especially in those women aged over 35 years.%

  12. Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors

    DEFF Research Database (Denmark)

    Madsen, C; Baandrup, Louise; Dehlendorff, Christian

    2015-01-01

    : Nationwide register-based case-control study. SETTING: Denmark during 1982-2011. POPULATION: Cases were all Danish women diagnosed with epithelial ovarian cancer (n = 13 241) or borderline ovarian tumor (n = 3605) in the study period. Age-matched female population controls were randomly selected by risk set......OBJECTIVE: According to the recent theories on the ovarian cancer origin, any protective effect of tubal ligation may vary with histologic subtype of ovarian cancer. Furthermore, bilateral salpingectomy may represent an opportunity for surgical prevention of serous ovarian cancer. DESIGN...

  13. Ovarian cancer progression is controlled by phenotypic changes in dendritic cells.

    Science.gov (United States)

    Scarlett, Uciane K; Rutkowski, Melanie R; Rauwerdink, Adam M; Fields, Jennifer; Escovar-Fadul, Ximena; Baird, Jason; Cubillos-Ruiz, Juan R; Jacobs, Ana C; Gonzalez, Jorge L; Weaver, John; Fiering, Steven; Conejo-Garcia, Jose R

    2012-03-12

    We characterized the initiation and evolution of the immune response against a new inducible p53-dependent model of aggressive ovarian carcinoma that recapitulates the leukocyte infiltrates and cytokine milieu of advanced human tumors. Unlike other models that initiate tumors before the development of a mature immune system, we detect measurable anti-tumor immunity from very early stages, which is driven by infiltrating dendritic cells (DCs) and prevents steady tumor growth for prolonged periods. Coinciding with a phenotypic switch in expanding DC infiltrates, tumors aggressively progress to terminal disease in a comparatively short time. Notably, tumor cells remain immunogenic at advanced stages, but anti-tumor T cells become less responsive, whereas their enduring activity is abrogated by different microenvironmental immunosuppressive DCs. Correspondingly, depleting DCs early in the disease course accelerates tumor expansion, but DC depletion at advanced stages significantly delays aggressive malignant progression. Our results indicate that phenotypically divergent DCs drive both immunosurveillance and accelerated malignant growth. We provide experimental support for the cancer immunoediting hypothesis, but we also show that aggressive cancer progression after a comparatively long latency period is primarily driven by the mobilization of immunosuppressive microenvironmental leukocytes, rather than loss of tumor immunogenicity.

  14. Ovarian torsion: Case–control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department

    Energy Technology Data Exchange (ETDEWEB)

    Swenson, David W., E-mail: swenson.david.w@gmail.com [Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Lourenco, Ana P. [Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Beaudoin, Francesca L. [Alpert Medical School of Brown University, Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Grand, David J. [Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States); Killelea, Alison G. [Sarasota Emergency Associates, Sarasota Memorial Hospital, 1700 S. Tamiami Trail, Sarasota, FL 34239 (United States); McGregor, Alyson J. [Alpert Medical School of Brown University, Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (United States)

    2014-04-15

    Objective: Evaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic computed tomography (CT) for the identification of ovarian torsion in women presenting to the emergency department with acute lower abdominal or pelvic pain. Materials and methods: This is a retrospective study of 20 cases of ovarian torsion and 20 control patients, all of whom had both US and CT performed in the emergency department. Two radiologists who were blinded to clinical data interpreted all studies as (1) demonstrating an abnormal ovary or not, and (2) suggestive of torsion or not. Sensitivity, specificity and interobserver variation were calculated for each imaging modality. Results: Pelvic US was interpreted as demonstrating an abnormal ovary in 90.0% of ovarian torsion cases by reader 1, and in 100.0% by reader 2, whereas CT was interpreted as revealing an abnormal ovary in 100.0% of torsion cases by both readers. Pelvic US for ovarian torsion was 80.0% sensitive (95% CI, 58.4–91.9%) and 95.0% specific (95% CI, 76.4–99.1%) for reader 1, while 80.0% sensitive (95% CI, 58.4–91.9%) and 85.0% specific (95% CI, 64.0–95.0%) for reader 2. Interobserver agreement for pelvic US was fair (Kappa = 0.60). Abdominopelvic CT for ovarian torsion was 100.0% sensitive (95% CI, 83.9–100.0%) and 85.0% specific (95% CI, 64.0–94.5%) for reader 1, while 90.0% sensitive (95% CI, 69.9–97.2%) and 90.0% specific (95% CI, 69.9–97.2%) for reader 2. Interobserver agreement was excellent (Kappa = 0.85). Conclusion: The diagnostic performance of CT is not shown to be significantly different from that of US in identifying ovarian torsion in this study. These results suggest that when CT demonstrates findings of ovarian torsion, the performance of another imaging exam (i.e. US) that delays therapy is unlikely to improve preoperative diagnostic yield.

  15. Ovarian cancer patients' psychological distress: the role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem.

    Science.gov (United States)

    Norton, Tina R; Manne, Sharon L; Rubin, Stephen; Hernandez, Enrique; Carlson, John; Bergman, Cynthia; Rosenblum, Norman

    2005-03-01

    Although research has indicated that illness-related and interpersonal stress are associated with greater psychological distress among cancer patients, little empirical attention has been given to mechanisms that account for these relationships. In the present study, 2 mechanisms for the association between illness-related stress (physical impairment) and interpersonal stress (family and friend unsupportive responses) and psychological distress of 143 ovarian cancer patients were examined cross-sectionally. Separate structural equation models tested whether physical impairment impacted patients' distress via decrements in perceived control over their illness and whether unsupportive behaviors impacted patients' distress via decrements in patients' self-esteem. Results supported the proposed models and suggest that perceived control and self-esteem are 2 mechanisms for explaining how illness-related and interpersonal stress may be associated with psychological distress among women with ovarian cancer.

  16. Relationship between Carbachol Hyperstimulation-induced Pancreatic Intracelluar Trypsinogen and NF-кB Activation in Rats in vitro

    Institute of Scientific and Technical Information of China (English)

    Chunfang JIANG; Hai ZHENG; Sunan LIU; Kaifeng FANG

    2008-01-01

    The relationship between intracelluar trypsinogen activation and NF-r,B activation in rat pancreatic acinar cells induced by M3 cholinergic receptor agonist (carbachoi) hyperstimulation was studied. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active pro- tease inhibitor (pefabloc) and NF-кB inhibitor (PDTC) in vitro. Intracelluar trypsin activity was measured by using a fluorogenie substrate. The activity of NF-кB was monitored by using electro- phoretic mobility shift assay. The results showed that after pretreatment with 2 mmol/L pefabloc, the activities of trypsin and NF-кB in pancreatic acinar cells treated with high concertrations of carbachol (10-3 mol/L) in vitro was significantly decreased as compared with control group (P<0.01). The addi- tion of 10-2mol/L PDTC resulted in a significant decrease of NF-кB activities in pancreatic acinar cells after treated with high concertrations of carbachol (10-3 mol/L) in vitro, but the intracelluar trypsinogen activity was not obviously inhibited (P>0.05). It was concluded that intracelluar trypsi- nogen activation is likely involved in the regulation of high concertrations of carbachol-induced NF-кB activation in pancreatic acinar cells in vitro. NF-кB activation is likely not necessary for high concertrations of carbachol-induced trypsinogen activation in pancreatic acinar cells in vitro.

  17. Risk factors for epithelial ovarian cancer in the female population of Belgrade, Serbia: A case-control study

    Directory of Open Access Journals (Sweden)

    Gazibara Tatjana

    2013-01-01

    Full Text Available Background/Aim. Ovarian cancer (OC comprises 3% of all cancers, but it is the fifth most common cause of cancer death in women. The aim of this case-control study was to determine the risk factors for OC in the female population of Belgrade, Serbia. Methods. A total of 80 consecutive patients were enrolled in the study between 2006 and 2008 in two national referral centers for OC in Serbia. The control subjects were recruited during the regular gynecological check-ups in the Public Health Center of the corresponding municipalities. All the study participants were interviewed during their visits to the above mentioned institutions by two physicians using the same questionnaire. In order to analyze the influence of specific exposure to the risk of the disease, we categorized variables according to the cut-off values. Odds ratios (OR and 95% confidence intervals (95% CI were calculated separately for each variable using univariate conditional logistic regression analysis. Results. There were no statistically significant differences in educational level, years of schooling, occupational and employment status between patients with OC and women in the control group. Oral contraceptives use and other contraceptive methods (condoms, mechanical contraceptive devices were highly statistically significantly more frequent among women in the control group (OR = 0.2, 95% CI 0.1-0.7, p = 0.005; OR = 0.1, 95% CI 0.01-0.5, p = 0.001, respectively. The patients with OC practiced sports for 6.3 ± 2.1 years, and controls for 11.8 ± 9.9 years. Sport and recreation activities were statistically significantly protective (OR = 0.2, p = 0.011; OR = 0.4, p = 0.019. Tea consumption on daily basis had a highly statistically significant protective effect (OR = 0.3, p = 0.001. Conclusions. Oral contraceptives use and physical activity were independent protective factors for OC in this study.

  18. Validating genetic risk associations for ovarian cancer through the international Ovarian Cancer Association Consortium

    DEFF Research Database (Denmark)

    Pearce, C L; Near, A M; Van Den Berg, D J;

    2009-01-01

    The search for genetic variants associated with ovarian cancer risk has focused on pathways including sex steroid hormones, DNA repair, and cell cycle control. The Ovarian Cancer Association Consortium (OCAC) identified 10 single-nucleotide polymorphisms (SNPs) in genes in these pathways, which had...... been genotyped by Consortium members and a pooled analysis of these data was conducted. Three of the 10 SNPs showed evidence of an association with ovarian cancer at P... and risk of ovarian cancer suggests that this pathway may be involved in ovarian carcinogenesis. Additional follow-up is warranted....

  19. The type of GnRH analogue used during controlled ovarian stimulation influences early embryo developmental kinetics: a time-lapse study.

    Science.gov (United States)

    Muñoz, Manuel; Cruz, María; Humaidan, Peter; Garrido, Nicolás; Pérez-Cano, Inmaculada; Meseguer, Marcos

    2013-06-01

    To explore if the GnRH analogue used for controlled ovarian stimulation (COS) and the ovulation triggering factor (GnRH agonist + hCG triggering versus GnRH antagonist + GnRH agonist triggering) affect embryo development and kinetics. In a retrospective cohort study in the Instituto Valenciano de Infertilidad (IVI) Alicante and the Instituto Universitario-IVI Valencia, Spain, 2817 embryos deriving from 400 couples undergoing oocyte donation were analysed. After controlled ovarian stimulation and IVF/intracytoplamic sperm injection, the timing of embryonic cleavages was assessed by a video time-lapse system. The results were analysed using Student's t test for comparison of timings (hours) and Chi-squared test for comparison of proportions. A p-value < 0.05 was considered to be statistically significant. Embryos from cycles co-treated with GnRH antagonist + GnRH agonist (n = 2101) cleaved faster than embryos deriving from patients co-treated with GnRH agonist + hCG (n = 716): these differences were significant at the first stages of development but they disappeared as long as the embryo developed. Assessing embryo quality in terms of morphokinetic characteristics, we did not find significant differences between the two groups. By adopting a time-lapse video system, we can suggest that the type of protocol used for controlled ovarian stimulation influences embryo kinetics of development but these variations are not reflected in embryo quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. How Is Ovarian Cancer Diagnosed?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging How Is Ovarian Cancer Diagnosed? If you have symptoms of ovarian cancer ... Ask Your Doctor About Ovarian Cancer? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  1. Ovarian response markers lead to appropriate and effective use of corifollitropin alpha in assisted reproduction.

    Science.gov (United States)

    La Marca, Antonio; D'Ippolito, Giovanni

    2014-02-01

    Corifollitropin alpha is a highly effective gonadotrophin, which maintains multifollicular growth for a week. The advantages of its administration include ease of use of the drug, making the treatment more patient friendly, resulting in a lower level of distress for the patient. At the same time, the pregnancy rate resulting from its use in IVF/intracytoplasmic sperm injection cycles is similar to that found when daily recombinant FSH is administered. The ovarian response to corifollitropin alpha is dependent on clinically established predictors such as baseline FSH, antral follicle count (AFC) and age. There is a general trend towards a higher ovarian response with an increasing AFC and the number of oocytes per attempt decreased with increasing baseline FSH and age. Even if the risk of ovarian hyperstimulation syndrome following corifollitropin alpha is very similar to the rate reported in literature for young women undergoing IVF, the risk of overstimulation may be reduced by avoiding maximal ovarian stimulation in women anticipated to be hyperresponders. High basal anti-Müllerian hormone and/or AFC can identify women with enhanced functional ovarian reserve at risk of overstimulation, and the risk is even higher if maximally stimulated with corifollitropin alpha or high dose of daily recombinant FSH. Corifollitropin alpha is a highly effective gonadotrophin which maintains multifollicular growth for a week. The ovarian response to corifollitropin was demonstrated to be dependent on clinically established predictors such as baseline FSH, antral follicle count (AFC) and age. There was a general trend toward a higher ovarian response with an increasing AFC and the mean number of oocytes per attempt decreased with increasing baseline FSH and age. Even if the risk of ovarian hyperstimulation syndrome (OHSS) following corifollitropin alpha is very similar to the rate of OHSS reported in literature for young women undergoing IVF, the risk of overstimulation may be

  2. Effect of holistic yoga program on anxiety symptoms in adolescent girls with polycystic ovarian syndrome: A randomized control trial.

    Science.gov (United States)

    Nidhi, Ram; Padmalatha, Venkatram; Nagarathna, Raghuram; Amritanshu, Ram

    2012-07-01

    Yoga techniques practiced for varying durations have been shown to reduce state anxiety. This was never assessed in adolescents with polycystic ovarian syndrome (PCOS). To compare the effect of a holistic yoga program with the conventional exercise program on anxiety level in adolescents with PCOS. Ninety adolescent (15-18 years) girls from a residential college in Andhra Pradesh, who satisfied the Rotterdam criteria, were randomized into two groups. Anxiety levels were assessed at inclusion and after 12 weeks of intervention wherein yoga group practiced a holistic yoga module while the control group practiced a matching set of physical exercises (1 h/day, for 12 weeks). Mann-Whitney U test was used to compare difference scores (delta change) between the two groups Changes in state anxiety after the intervention were nonsignificantly different between the two groups (P=0.243), while changes after the intervention were significantly different between the two groups (P=0.002) for trait anxiety. Twelve weeks of a holistic yoga program in adolescents with PCOS is significantly better than physical exercise program in reducing anxiety symptoms.

  3. Ovarian cancer: epidemiology and risk factors.

    Science.gov (United States)

    La Vecchia, Carlo

    2017-01-01

    The present overview of ovarian cancer epidemiology summarizes the main results for a network of case-control studies in Italy and from the Collaborative Group on Epidemiological Studies of Ovarian Cancer. There are consistent inverse relations between parity, oral contraceptive use and the risk of ovarian cancer. For other menstrual and hormonal factors (i.e. early age at menarche and late menopause), there are established associations, but of limited impact on ovarian cancer incidence on a population level. Serous and endometrioid ovarian cancers (but not mucinous or clear cell types) are related to current and recent use of hormone replacement therapy in menopause. There are no strong associations with alcohol and tobacco overall, but a direct link for tobacco with (borderline) mucinous cancers, of limited impact, however, on overall ovarian cancer mortality. There are direct associations of ovarian cancer risk with height and BMI, as well as possible relations with selected dietary factors - in the absence, however, of consistent findings - and a possible inverse association with physical activity. There is a strong association with a family history of ovarian cancer (and a few selected other neoplasms, including colorectum and endometrium). Recognized risk factors explain only a limited proportion of ovarian cancer cases on a population level. A key reason for the recent favourable trends of ovarian cancer incidence and mortality in several high-income countries is the widespread use of oral contraceptive in the generations born after 1930.

  4. Effect of GnRH antagonist on follicular development and uterine biophysical profile in controlled ovarian stimulation

    Directory of Open Access Journals (Sweden)

    Bhawana Tiwary

    2015-02-01

    Full Text Available Background: Objective of current study was to assess the effect of GnRH antagonist on follicular development, premature luteinization, uterine biophysical profile and pregnancy rate in controlled ovarian stimulation with clomiphene and gonadotropins for intrauterine insemination in women with unexplained infertility. Methods: Randomised controlled trial. Minimal stimulation protocol with or without GnRH antagonist was compared. Setting: Infertility clinic, PGIMER, Chandigarh. Patients: Couples with unexplained infertility, age of female partner between 20-39 years. Intervention: GnRH antagonist 0.25 mg since follicle size 14 mm till hCG administration. Main outcome measures: Follicle characteristics, premature luteinisation, uterine biophysical profile and pregnancy rate. Results: The mean number of follicles recruited in group A was 2.32 +/- 1.01 while that in group B (receiving GnRH antagonist it was 4.10 +/- 1.69. Statistically significant increase in total biophysical profile score was observed in periovulatory phase in the antagonist group. 40% women in group A had premature luteinization whereas only 4% women in group B suffered from premature luteinization. 20% women who received GnRH antagonist conceived against only 6% in group A, this difference however was not statistically significant Conclusions: GnRH antagonist has a role in increasing the number of follicles recruited. Furthermore, GnRH antagonist can improve the total uterine biophysical profile score by improving the endometrial thickness, endometrial pattern, blood flow and decreasing the impedance to the blood flow in uterine artery. The drug can potentially help in improving pregnancy rates by decreasing the rate of premature luteinisation. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 157-163

  5. Effects of a holistic yoga program on endocrine parameters in adolescents with polycystic ovarian syndrome: a randomized controlled trial.

    Science.gov (United States)

    Nidhi, Ram; Padmalatha, Venkatram; Nagarathna, Raghuram; Amritanshu, Ram

    2013-02-01

    The objectives of this trial were to compare the effects of a holistic yoga program with the conventional exercise program in adolescent polycystic ovarian syndrome (PCOS). This was a prospective, randomized, active controlled trial. Ninety (90) adolescent (15-18 years) girls from a residential college in Andhra Pradesh who satisfied the Rotterdam criteria were randomized into two groups. The yoga group practiced a holistic yoga module, while the control group practiced a matching set of physical exercises (1 hour/day, for 12 weeks). Anti-müllerian hormone (AMH-primary outcome), luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, prolactin, body-mass index (BMI), hirsutism, and menstrual frequency were measured at inclusion and after 12 weeks. Mann-Whitney test on difference score shows that changes in AMH (Y=-2.51, C=-0.49, p=0.006), LH, and LH/FSH ratio (LH: Y=-4.09, C=3.00, p=0.005; LH/FSH: Y=-1.17, C=0.49, p=0.015) were significantly different between the two intervention groups. Also, changes in testosterone (Y=-6.01, C=2.61, p=0.014) and Modified Ferriman and Gallway (mFG) score (Y=-1.14, C=+0.06, p=0.002) were significantly different between the two groups. On the other hand, changes in FSH and prolactin postintervention were nonsignificantly different between the two groups. Also, body weight and BMI showed nonsignificantly different changes between the two groups, while changes in menstrual frequency were significantly different between the two groups (Y=0.89, C=0.49, p=0.049). A holistic yoga program for 12 weeks is significantly better than physical exercise in reducing AMH, LH, and testosterone, mFG score for hirsutism, and improving menstrual frequency with nonsignificant changes in body weight, FSH, and prolactin in adolescent PCOS.

  6. Correlation of Serum Lipoprotein Ratios with Insulin Resistance in Infertile Women with Polycystic Ovarian Syndrome: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Aisa Ghaffarzad

    2016-05-01

    Full Text Available Background: Dyslipidemia and insulin resistance (IR, occurring in most infertile women with polycystic ovarian syndrome (PCOS, increase the risk of cardiovascular disease (CVD and type 2 diabetes. This study aimed to assess the relationships between lipoprotein ratios and IR in PCOS women. Materials and Methods: Thirty six infertile women with PCOS selected based on Androgen Excess Society (AES criteria and 29 healthy women matched for age were recruited to this case-control study. After physical measurements, fasting serum glucose (Glu, insulin and lipid profile levels [triglycerides (TGs, total cholesterol (TC, low-density lipoproteincholesterol (LDL-C and high-density lipoprotein-cholesterol (HDL-C] were measured, while lipoprotein ratios (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C were calculated. IR was also calculated using homeostasis model assessment (HOMA-IR. The optimal cutoffs of lipoprotein ratios in relation to HOMA-IR were calculated based on the Receiver Operating Characteristics (ROC curve analysis using the area under curve (AUC. Results: Waist circumference (WC, insulin levels, HOMA-IR, TG levels, and all lipoprotein ratios were significantly higher, while HDL-C was lower in PCOS group as compared to healthy controls. All lipoprotein ratios, TG levels, and WC are significantly correlated with insulin levels and HOMA-IR. Among lipoprotein ratios, the highest AUC of the ROC belonged to TG/HDL-C ratio with sensitivity of 63.6% and specificity of 84.4% (TG/HDL-C>3.19 as a marker of IR in infert ile PCOS women. Conclusion: Lipoprotein ratios, particularly TG/HDL-C, are directly correlated with insulin levels and can be used as a marker of IR (HOMA-IR in infertile PCOS patients.

  7. Statin use and risk for ovarian cancer

    DEFF Research Database (Denmark)

    Baandrup, L; Dehlendorff, C; Friis, Søren

    2015-01-01

    BACKGROUND: Limited data suggest that statin use reduces the risk for ovarian cancer. METHODS: Using Danish nationwide registries, we identified 4103 cases of epithelial ovarian cancer during 2000-2011 and age-matched them to 58,706 risk-set sampled controls. Conditional logistic regression...... was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for epithelial ovarian cancer overall, and for histological types, associated with statin use. RESULTS: We observed a neutral association between ever use of statins and epithelial ovarian cancer risk (OR=0.98, 95% CI=0.......87-1.10), and no apparent risk variation according to duration, intensity or type of statin use. Decreased ORs associated with statin use were seen for mucinous ovarian cancer (ever statin use: OR=0.63, 95% CI=0.39-1.00). CONCLUSIONS: Statin use was not associated with overall risk for epithelial ovarian cancer...

  8. Ovarian cancer immunotherapy: opportunities, progresses and challenges

    Directory of Open Access Journals (Sweden)

    Stevens Richard

    2010-02-01

    Full Text Available Abstract Due to the low survival rates from invasive ovarian cancer, new effective treatment modalities are urgently needed. Compelling evidence indicates that the immune response against ovarian cancer may play an important role in controlling this disease. We herein summarize multiple immune-based strategies that have been proposed and tested for potential therapeutic benefit against advanced stage ovarian cancer. We will examine the evidence for the premise that an effective therapeutic vaccine against ovarian cancer is useful not only for inducing remission of the disease but also for preventing disease relapse. We will also highlight the questions and challenges in the development of ovarian cancer vaccines, and critically discuss the limitations of some of the existing immunotherapeutic strategies. Finally, we will summarize our own experience on the use of patient-specific tumor-derived heat shock protein-peptide complex for the treatment of advanced ovarian cancer.

  9. Ovarian Autoantibodies Predict Ovarian Cancer

    Science.gov (United States)

    2010-11-01

    of carcinogenesis is supported by literature reports; for example, in patients with chronic hepatitis (which predisposes to liver cancer) specific...Immunohistochemical 502 expression of molecular markers in an avian model: a potential model for preclinical evaluation 503 of agents for ovarian cancer... avian S1P1, we 180 used a commercially available polyclonal antibody against human S1P1 for Western blotting and 181 immunohistochemical experiments

  10. Intrafollicular endocrine milieu after addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization.

    Science.gov (United States)

    Thuesen, L L; Andersen, A Nyboe; Loft, A; Smitz, J

    2014-02-01

    The role of human chorionic gonadotropin (hCG) supplementation on the intrafollicular steroid milieu has been studied. The objective of the study was to assess the impact on steroid levels in follicular fluids (FFs) after different doses of hCG supplementation to recombinant FSH for controlled ovarian stimulation. This was a prospective randomized dose-response study conducted at Copenhagen University Hospital, Rigshospitalet, Denmark. From 62 in vitro fertilization patients, 334 FFs were selected for analyses. Patients were treated using a GnRH agonist protocol with recombinant FSH 150 IU/d and randomized from stimulation day 1 to supplementation with hCG: D0, 0 IU/d; D50, 50 IU/d; D100, 100 IU/d; and D150, 150 IU/d. Intrafollicular hormone concentrations in relation to treatment groups, follicular sizes, and embryo quality were measured. In large follicles, hCG supplementation induced a nearly 3-fold increase of estradiol (nanomoles per liter) [D0: 1496; D50: 3138; D100: 4338; D150: 4009 (P D100: 72; D150: 56 (P D100 and the highest in D0. Large follicles giving rise to good-quality embryos had significantly higher estradiol and progesterone levels and estradiol to T, estradiol to androstenedione, and progesterone to estradiol ratios, compared with small follicles, leading to poor-quality embryos. Increasing doses of hCG supplementation markedly stimulated the intrafollicular concentration of both estradiol and androgens, with a shift toward a more androgenic milieu. In large follicles with oocytes giving rise to good-quality embryos, the FFs were significantly more estrogenic than in small follicles with oocytes developing into poor quality embryos.

  11. Transcapillary fluid dynamics during ovarian stimulation for in vitro fertilization.

    Science.gov (United States)

    Tollan, A; Holst, N; Forsdahl, F; Fadnes, H O; Oian, P; Maltau, J M

    1990-02-01

    Transcapillary fluid dynamics were studied in 10 women during ovarian stimulation for in vitro fertilization. The examinations were done on the first day of stimulation (day 3 of the menstrual cycle, mean serum estradiol concentration 0.2 nmol/L), and the day before oocyte aspiration (day 10 to 12, mean serum estradiol concentration 6.8 nmol/L). Interstitial colloid osmotic pressure was measured on the thorax at heart level by the "wick" method, and interstitial hydrostatic pressure by the "wick-in-needle" method. Plasma colloid osmotic pressure decreased (mean, 2.0 mm Hg; p less than 0.002) and interstitial colloid osmotic pressure increased (mean, 1.0 mm Hg; p less than 0.02) during hormonal stimulation. This implies a reduced transcapillary colloid osmotic gradient (plasma colloid osmotic pressure--interstitial colloid osmotic pressure), probably because of increased capillary permeability to plasma proteins. Hemoglobin and hematocrit were significantly reduced, and body weight and foot volume significantly increased. These results demonstrate that during ovarian stimulation there are both water retention and augmented filtration of fluid from the vascular to the interstitial compartment. This may be of significance for the pathophysiologic condition in the ovarian hyperstimulation syndrome.

  12. A randomized controlled trial comparing the efficacy and safety of two HMG preparations gaining their LH bioactivity from different HCG sources

    DEFF Research Database (Denmark)

    Lockwood, Gillian; Cometti, Barbara; Bogstad, Jeanette

    2017-01-01

    In this prospective, controlled, randomized, multicentre, non-inferiority study, efficacy and safety of two HMG preparations (Menopur(®)- Ferring and Meriofert®- IBSA Institut Biochimique SA) for ovarian stimulation were compared (270 women undergoing IVF aged between 18 and 39 years; BMI 30 kg/m(2......) or less; less than three prior completed assisted reproduction technique cycles). A standard long down-regulation with gonadotrophin-releasing hormone agonist protocol, with HCG triggering was used; primary end-point was total number of oocytes retrieved; attention was paid toovarian hyperstimulation...... syndrome (OHSS). No statistically significant differences between the treatment groups were reported for most of the clinically significant end-points, including embryo quality, fertilization rate, implantation rate, ongoing pregnancy rate and live birth rate. Total number of oocytes retrieved was higher...

  13. microRNA-309 targets the Homeobox gene SIX4 and controls ovarian development in the mosquito Aedes aegypti

    Science.gov (United States)

    Zhang, Yang; Zhao, Bo; Roy, Sourav; Saha, Tusar T.; Kokoza, Vladimir A.; Li, Ming; Raikhel, Alexander S.

    2016-01-01

    Obligatory blood-triggered reproductive strategy is an evolutionary adaptation of mosquitoes for rapid egg development. It contributes to the vectorial capacity of these insects. Therefore, understanding the molecular mechanisms underlying reproductive processes is of particular importance. Here, we report that microRNA-309 (miR-309) plays a critical role in mosquito reproduction. A spatiotemporal expression profile of miR-309 displayed its blood feeding-dependent onset and ovary-specific manifestation in female Aedes aegypti mosquitoes. Antagomir silencing of miR-309 impaired ovarian development and resulted in nonsynchronized follicle growth. Furthermore, the genetic disruption of miR-309 by CRISPR/Cas9 system led to the developmental failure of primary follicle formation. Examination of genomic responses to miR-309 depletion revealed that several pathways associated with ovarian development are down-regulated. Comparative analysis of genes obtained from the high-throughput RNA sequencing of ovarian tissue from the miR-309 antagomir-silenced mosquitoes with those from the in silico computation target prediction identified that the gene-encoding SIX homeobox 4 protein (SIX4) is a putative target of miR-309. Reporter assay and RNA immunoprecipitation confirmed that SIX4 is a direct target of miR-309. RNA interference of SIX4 was able to rescue phenotypic manifestations caused by miR-309 depletion. Thus, miR-309 plays a critical role in mosquito reproduction by targeting SIX4 in the ovary and serves as a regulatory switch permitting a stage-specific degradation of the ovarian SIX4 mRNA. In turn, this microRNA (miRNA)-targeted degradation is required for appropriate initiation of a blood feeding-triggered phase of ovarian development, highlighting involvement of this miRNA in mosquito reproduction. PMID:27489347

  14. Ovarian hormones and obesity.

    Science.gov (United States)

    Leeners, Brigitte; Geary, Nori; Tobler, Philippe N; Asarian, Lori

    2017-05-01

    central action of estrogens to increase the satiating potency of the gastrointestinal hormone cholecystokinin. Another mechanism involves a decrease in the preference for sweet foods during the follicular phase. Genetic defects in brain α-melanocycte-stimulating hormone-melanocortin receptor (melanocortin 4 receptor, MC4R) signaling lead to a syndrome of overeating and obesity that is particularly pronounced in women and in female animals. The syndrome appears around puberty in mice with genetic deletions of MC4R, suggesting a role of ovarian hormones. Emerging functional brain-imaging data indicates that fluctuations in ovarian hormones affect eating by influencing striatal dopaminergic processing of flavor hedonics and lateral prefrontal cortex processing of cognitive inhibitory controls of eating. There is a dearth of research on the neuroendocrine control of eating after menopause. There is also comparatively little research on the effects of ovarian hormones on EE, although changes in ovarian hormone levels during the menstrual cycle do affect resting EE. The markedly greater obesity burden in women makes understanding the diverse effects of ovarian hormones on eating, EE and body adiposity urgent research challenges. A variety of research modalities can be used to investigate these effects in women, and most of the mechanisms reviewed are accessible in animal models. Therefore, human and translational research on the roles of ovarian hormones in women's obesity and its causes should be intensified to gain further mechanistic insights that may ultimately be translated into novel anti-obesity therapies and thereby improve women's health.

  15. Fructose content of low calorie diets: effect on cardiometabolic risk factors in obese women with polycystic ovarian syndrome: a randomized controlled trial

    OpenAIRE

    Johnson, Line K; Holven, Kirsten B.; Nordstrand, Njord; Mellembakken, Jan R.; Tanbo, Tom; Hjelmesæth, Jøran

    2015-01-01

    We aimed to examine whether a whole-grain crispbread (CB) low-fructose, low-calorie diet (LCD) might be superior to a traditional LCD based on fructose-rich liquid meal replacements (LMRs) with respect to improvement of various cardiometabolic risk factors and reproductive hormones. Parallel-group randomised controlled clinical trial. Morbidly obese women with polycystic ovarian syndrome (PCOS) were randomised to either an 8-week CB-LCD or LMR-LCD (900–1100 kcal/day, fructose 17 g/day or 85 g...

  16. Control of ovarian follicular and corpus luteum development for the synchronization of ovulation in cattle.

    Science.gov (United States)

    Thatcher, W W; Santos, J E P

    2007-01-01

    The objective of this review is to integrate strategies to optimize an ovulatory control program which then serves as a platform to improve the reproductive performance of lactating dairy cows. Programmed management of follicle growth, regression of the CL and induction of ovulation led to development of the Ovsynch program. Pre-synchronization of estrous cycles followed 12 to 14 days later with the Ovsynch program increased pregnancy rates to timed inseminations. Initiation of the Ovsynch program on day 3 of the estrous cycle reduced ovulation to GnRH and resulted in a smaller proportion of excellent and good quality embryos following timed insemination. The pregnancy rate to a timed insemination of Ovsynch was greater when cows ovulated to the first injection of GnRH. The Presynch-Ovsynch program provided a platform to identify factors regulating reproductive performance; such as, parity, body condition score and anovulation. Treatment with hCG at day 5 after insemination increased pregnancy rate in lactating dairy cows. Injection of bovine somatotropin at insemination increased pregnancy rate, conceptus length and interferon-tau content in uterine luminal flushings and altered endometrial gene expression at day 17 of pregnancy. During heat stress, timed embryo transfer increased pregnancy rate and using embryos cultured with IGF-I and transferred fresh resulted in a greater pregnancy rate. Induction of ovulation with estradiol cypionate, as a component of a timed insemination program, increased fertility. Manipulation of the estrous cycle to improve follicle/oocyte competence and management of the post-ovulatory dialogue between embryonic and uterine tissues should enhance embryo development and survival.

  17. Medical management of clomiphene-resistant polycystic ovarian syndrome: an update

    Directory of Open Access Journals (Sweden)

    Sharonjeet Kaur

    2014-02-01

    Full Text Available Clomiphene citrate is the traditional first-line treatment for chronic anovulation that characterizes polycystic ovary syndrome (PCOS. A gold standard therapy has always been Clomiphene Citrate (CC. However, 20%-25% of PCOS women fail to ovulate with incremental doses of CC. A good body of evidence suggest that alternatives for PCOS women with CC-resistant anovulation include insulin sensitizers like metformin and pioglitazone. Insulin sensitizers improves pregnancy outcome and ovulation rate by and acts by ameliorating insulin sensitivity and hyperandrogenemia. Metformin is preferred in obese women. Gonadotropins induce ovulation and maintain optimal follicle growth via controlled administration of follicle stimulation hormone. Two regimens are used which includes high and low dose regimen. Low dose regimen is preferred but is associated adverse effects like ovarian hyperstimulation syndrome (OHSS and increased cost. Extending clomiphene therapy reduces cost and improves pregnancy outcome. Glucocorticoids are preferably used when serum Dehydroepiandrosterone levels are > 200µg/dL. Bromocriptine improves ovulation rate by decreasing prolactin levels. Human Chorionic Gonadotropin restores ovulation but its use is limited during intrauterine insemination. Tamoxifen acts in a similar way as CC but has lesser antiestrogenic effect on the endometrium, cervical mucus, and granulosa cells, hence an added advantage of monofollicular ovulation. Aromatase inhibitors block conversion androstenedione and testosterone to estrogen in ovary and improves ovulation rate. Added advantage includes lesser cost, simple to use, no danger of multiple pregnancies and convenient for patient. Combination of GnRH analogues and Gonadotropins are associated with increased risk of OHSS. D-chiro-inositol, N-Acetylcysteine, melatonin and acarbose are tried with little success. [Int J Basic Clin Pharmacol 2014; 3(1.000: 1-9

  18. How Is Ovarian Cancer Staged?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging How Is Ovarian Cancer Staged? Staging is the process of finding out ... Ask Your Doctor About Ovarian Cancer? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  19. Hemodynamic Consequences of Malignant Ascites in Epithelial Ovarian Cancer Surgery*: A Prospective Substudy of a Randomized Controlled Trial.

    Science.gov (United States)

    Hunsicker, Oliver; Fotopoulou, Christina; Pietzner, Klaus; Koch, Mandy; Krannich, Alexander; Sehouli, Jalid; Spies, Claudia; Feldheiser, Aarne

    2015-12-01

    Malignant ascites (MA) is most commonly observed in patients scheduled for epithelial ovarian cancer (EOC) surgery and is supposed as a major risk factor promoting perioperative hemodynamic deterioration. We aimed to assess the hemodynamic consequences of MA on systemic circulation in patients undergoing cytoreductive EOC surgery.This study is a predefined post-hoc analysis of a randomized controlled pilot trial comparing intravenous solutions within a goal-directed algorithm to optimize hemodynamic therapy in patients undergoing cytoreductive EOC surgery. Ascites was used to stratify the EOC patients prior to randomization in the main study. We analyzed 2 groups according to the amount of ascites (NLAS: none or low ascites [500 mL]). Differences in hemodynamic variables with respect to time were analyzed using nonparametric analysis for longitudinal data and multivariate generalized estimating equation adjusting the analysis for the randomized study groups of the main study.A total of 31 patients in the NLAS and 16 patients in the HAS group were analyzed. Although cardiac output was not different between groups suggesting a similar circulatory blood flow, the HAS group revealed higher heart rates and lower stroke volumes during surgery. There were no differences in pressure-based hemodynamic variables. In the HAS group, fluid demands, reflected by the time to reindication of a fluid challenge after preload optimization, increased steadily, whereas stroke volume could not be maintained at baseline resulting in hemodynamic instability after 1.5 h of surgery. In contrast, in the NLAS group fluid demands were stable and stroke volume could be maintained during surgery. Clinically relevant associations of the type of fluid replacement with hemodynamic consequences were particularly observed in the HAS group, in which transfusion of fresh frozen plasma (FFP) was associated to an improved circulatory flow and reduced vasopressor and fluid demands, whereas the

  20. The Meaning-Making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: a randomized controlled pilot study.

    Science.gov (United States)

    Henry, Melissa; Cohen, S Robin; Lee, Virginia; Sauthier, Philippe; Provencher, Diane; Drouin, Pierre; Gauthier, Philippe; Gotlieb, Walter; Lau, Susie; Drummond, Nancy; Gilbert, Lucy; Stanimir, Gerald; Sturgeon, Jeremy; Chasen, Martin; Mitchell, Julie; Huang, Lina Nuoxin; Ferland, Mira-Klode; Mayo, Nancy

    2010-12-01

    This pilot study aimed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention (MMi) in patients newly diagnosed with Stage III or IV ovarian cancer, and to provide estimates of parameters needed to design a full-scale study. A randomized controlled trial with 24 patients (12 experimental and 12 control) was conducted. Existential well-being (primary outcome), overall quality of life, distress, anxiety, depression and self-efficacy were measured. Compared to the control group, patients in the experimental group had a better sense of meaning in life at one and three months post-intervention. The MMi seems a promising intervention for advanced cancer patients, and a full randomized controlled trial is warranted to further investigate its efficacy.

  1. Improved control of nausea and emesis with a new bromazepam-containing ondansetron regimen in ovarian cancer patients receiving chemotherapy with carboplatin and cyclophosphamide.

    Science.gov (United States)

    Meden, H; Meissner, O; Conrad, A; Kuhn, W

    1996-01-01

    Ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin. Its role in milder emetogenic regimes has not been fully defined. This study investigated the efficacy of two different antiemetic regimes in thirty-five patients with ovarian cancer receiving 68 cycles of chemotherapy with carboplatin (350 mg/m2) and cyclophosphamide (600 mg/m2). Ondansetron (3 x 8 mg i.v.) was compared to a bromazepam-containing ondansetron regimen. Nausea was absent in 65% of chemotherapy courses in patients receiving the combination of ondansetron and bromazepam and in 38% of chemotherapy courses in patients receiving ondansetron alone. Complete control of emesis was achieved in 93% of the courses in patients receiving the combination and in 81% of the courses using ondansetron alone. The addition of bromazepam to ondansetron, and the extension of antiemetic prophylaxis to the day before and the day after chemotherapy improves the control of nausea and emesis compared to ondansetron monotherapy in patients with ovarian cancer.

  2. Ovarian volume and antral follicle count for the prediction of low and hyper responders with in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Elting Mariet E

    2007-03-01

    Full Text Available Abstract Background The current study was designed to compare antral follicle count (AFC and basal ovarian volume (BOV, the exogenous FSH ovarian reserve test (EFORT and the clomiphene citrate challenge test (CCCT, with respect to their ability to predict poor and hyper responders. Methods One hundred and ten regularly menstruating patients, aged 18–39 years, participated in this prospective study, randomized, by a computer designed 4-blocks system study into two groups. Fifty six patients underwent a CCCT, and 54 patients underwent an EFORT. All patients underwent a transvaginal sonography to measure the basal ovarian volume and count of basal antral follicle. In all patients, the test was followed by a standard IVF treatment. The result of ovarian hyperstimulation during IVF treatment, expressed by the total number of follicles, was used as gold standard. Results The best prediction of ovarian reserve (Y was seen in a multiple regression prediction model that included, AFC, Inhibin B-increment in the EFORT and BOV simultaneously (Y = -3.161 + 0.805 × AFC (0.258-1.352 + 0.034 × Inh. B-incr. (0.007-0.601 + 0.511 BOV (0.480-0.974 (r = 0.848, p Conclusion In conclusion AFC performs well as a test for ovarian response being superior or at least similar to complex expensive and time consuming endocrine tests. It is therefore likely to be the test for general practise.

  3. Cancer-associated autoantibodies to MUC1 and MUC4--a blinded case–control study of colorectal cancer in UK collaborative trial of ovarian cancer screening

    DEFF Research Database (Denmark)

    Pedersen, Johannes W; Gentry-Maharaj, Aleksandra; Nøstdal, Alexander;

    2014-01-01

    of colorectal cancer diagnosis and healthy controls. Subsequently, the selected biomarkers were evaluated in a blinded nested case–control study using stored serum samples from among the 50,640 women randomized to the multimodal arm of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), where...... women gave annual blood samples for several years. Cases were 97 postmenopausal women who developed colorectal cancer after recruitment and were age-matched to 97 women without any history of cancer. MUC1-STn and MUC1-Core3 IgG autoantibodies identified cases with 8.2 and 13.4% sensitivity, respectively......, at 95% specificity. IgA to MUC4 glycoforms were unable to discriminate between cases and controls in the UKCTOCS sera. Additional analysis was undertaken by combining the data of MUC1-STn and MUC1-Core3 with previously generated data on autoantibodies to p53 peptides, which increased the sensitivity...

  4. A comparison of three controlled ovarian stimulation protocols in decreased ovarian reserve patients%三种促排卵方案对卵巢功能减退患者的促排卵效果比较

    Institute of Scientific and Technical Information of China (English)

    李莹; 贾婵维; 张军; 刘英; 马延敏; 王树玉; 杨晓葵

    2013-01-01

    目的 比较辅助生殖技术中促性腺激素释放激素激动剂(GnRH-a)长方案、短方案和促性腺激素释放激素拮抗剂(GnRH-ant)方案对卵巢功能减退患者的促排卵效果及其对临床结局的影响.方法 回顾性分析因输卵管因素和/或男方因素在我院生殖中心进行IVF/ICSI助孕且窦卵泡数少于5的患者的临床资料,共169个促排卵周期,比较不同的促排卵方案中患者的一般特点、内分泌激素水平、促性腺激素(Gn)的用药持续时间和药量、获卵数、受精数及临床结局.结果在三组促排卵方案中,患者的一般情况、激素水平、获卵数、受精数之间无统计学差异(P>0.05);短方案和拮抗剂方案组中Gn的用药天数和用药量明显少于长方案组.长方案、短方案及拮抗剂方案的临床妊娠率分别为29.57%、23.45%、33.69%,三组无统计学差异(P>0.05).结论 拮抗剂方案可能是卵巢功能减退患者进行控制性促排卵治疗的一种较好的选择.%Objective:To compare the stimulation effects and the clinical outcomes of GnRH agonist long protocol,GnRH agonist short protocol and GnRH antagonist protocol regimens in decreased ovarian reserve patients in IVF/ICSI cycles.Method:Women for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)-embryo transfer (ET) therapy due to the tubal and/or male factors were included in this study.169 controlled ovarian stimulation cycles were analyzed.Women general characteristics,basal and hCG day hormones,oocytes retrieved,fertilization,transfer embryos,duration of COS,dosage of ganadotropins and pregnant outcomes were evaluated.Results:There was no significant difference on the general characteristics,hormone levels,retrieved oocytes and fertilization gametes in three protocols (P > 0.05).The usage of gonadotropins and duration of COS in GnRH agonist short protocol and GnRH antagonist protocol groups were significantly less than Gn

  5. Screening for Ovarian Cancer

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Ovarian Cancer The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Ovarian Cancer . This recommendation is for ...

  6. Bone mineral density in young women with primary ovarian insufficiency: results of a three-year randomized controlled trial of physiological transdermal estradiol and testosterone replacement.

    Science.gov (United States)

    Popat, Vaishali B; Calis, Karim A; Kalantaridou, Sophia N; Vanderhoof, Vien H; Koziol, Deloris; Troendle, James F; Reynolds, James C; Nelson, Lawrence M

    2014-09-01

    Women with primary ovarian insufficiency have significantly lower serum estradiol and T levels compared with regularly menstruating women. They also have significantly reduced bone mineral density (BMD). The objective of the study was to evaluate the efficacy of hormone replacement in maintaining BMD in these young women. This was a randomized, double-blind, single-center, placebo-controlled clinical trial at the National Institutes of Health clinical center (Bethesda, Maryland). Young women with primary ovarian insufficiency participated in the study. We compared the effect of estradiol and progestin replacement (n = 72) vs estradiol, progestin, and T replacement (n = 73) on BMD. We also compared findings with a contemporaneous control group of normal women (n = 70). All patients received transdermal estradiol (100 μg/d) plus oral medroxyprogesterone acetate 10 mg/d (12 d/mo) for a 3-month run-in period before being randomized in a double-blinded fashion to the addition of transdermal T (150 μg/d) or placebo. Change in BMD at the femoral neck was measured by dual-energy x-ray absorptiometry. At screening, patients had significantly lower femoral neck BMD compared with control women (0.77 vs 0.81 g/cm(2), P = .001) and did not differ in body mass index, age at menarche, or education level. Normal control women lost femoral neck BMD over the study period, whereas patients on estradiol and progestin therapy gained BMD; and at the end of the study period, femoral neck BMD of patients on estradiol and progestin therapy did not differ from that of control women (0.80 g/cm(2) in both groups, P = .9). The addition of T showed no further benefit (percentage change in BMD 3.9 vs 2.4, respectively, P = .9). Nonetheless, using a repeated-measures model, the T group achieved a mean BMD in the femoral neck 0.015 g/cm(2) higher than the placebo group at 3 years (95% confidence interval -0.005 to 0.034, P = .13). Similar findings were observed in the lumbar spine BMD as well

  7. 卵巢非功能性囊肿对短方案超促排卵结局的影响%Effect of Non-functional Ovarian Cysts in Outcome of IVF-ET with Short COH Protocol

    Institute of Scientific and Technical Information of China (English)

    杨岳州; 陈华; 彭献东; 董曦; 韩金兰; 孙晓溪

    2011-01-01

    Objective: To investigate the difference in the outcome of short protocol IVF-ET between the patients with and without non-functional ovarian cyst on starting day of controlled ovarian hyperstimulation (COH). Methods: A comparatively retrospective analysis was performed between two groups who underwent IVF including 307 cycles with and 4 010 cycles without non-functional ovarian cyst. Results: The rate of appearance of non-functional ovarian cysts on day 2 or day 3 of the menstrual cycle was 7.11%. There was no statistically significant difference in the duration of stimulation, ampoules of Gn, E2 level and endometrial thickness on the day of hCG administration, number of oocytes retrieved, fertilization rate, number of usable embryos, number of high quality embryos, implantation rate and clinical pregnancy rate between the two groups. Conclusion: Non-functional ovarian cysts did not affect the clinical response to short protocol COH in IVF-ET.%目的:探讨短方案超促排卵(COH)启动日卵巢非功能性囊肿对COH结局的影响.方法:回顾性分析行短方案COH治疗的4317例患者的资料,其中COH启动日有卵巢非功能性囊肿的307例为研究组,其余4010例为对照组,比较分析患者的COH结局.结果:研究组与对照组在促性腺激素的用药天数、用药量、hCG注射日雌二醇(E2)水平、hCG注射日子宫内膜厚度、获卵数、受精卵数、可用胚胎数、优质胚胎教、种植率及临床妊娠率均无显著性差异(P>0.05).结论:卵巢非功能性囊肿不影响短方案COH治疗的结局.

  8. Effect of Controlled Ovarian Hyperstimulation on Levels of Leukemia Inhibitory Factor in Pregnant Mice and Regulatory Effect of Chinese Herbs%超排卵对小鼠着床期白血病抑制因子的影响及中药的调节作用

    Institute of Scientific and Technical Information of China (English)

    张明敏; 李豫峰; 张锦金

    2009-01-01

    目的 检测超排卵小鼠着床期子宫内膜白血病抑制因子(leukemia inhibitory factor,LIF)的表达水平,探讨补肾安胎方对超排卵小鼠着床期子宫内膜容受性的影响.方法 将120只小鼠随机分为正常组、模型组、中药组.模型组和中药组注射PMSG和HCG造成小鼠超排模型后合笼,正常组注射等体积生理盐水后合笼.中药组给予补肾安胎方,正常组和模型组灌服等量蒸馏水.于妊娠第4天(Pregnancy day 4,Pd4)、第五天(Pd5)留取妊娠子宫;采用免疫组化技术检测LIF蛋白表达,采用RT-PCR技术检测LIF mRNA表达.结果 免疫组化SP法检测结果显示3组小鼠LIF蛋白表达空间分布无明显差异.RT-PCR技术检测结果显示正常组Pd4 LIF表达呈强阳性,Pd5表达下降,与模型组同期比较差异有统计学意义(P<0.05),中药治疗后与模型组同期比较差异有统计学意义(P<0.05).结论 补肾安胎方能协调由于控制性超排卵所致的子宫内膜LIF表达水平,从而提高小鼠着床期子宫内膜容受性.

  9. 77 FR 55095 - National Ovarian Cancer Awareness Month, 2012

    Science.gov (United States)

    2012-09-06

    ... their lives to ovarian cancer. They are mothers and daughters, sisters and grandmothers, community... treatments. Through the Centers for Disease Control's Inside Knowledge campaign, we are working to...

  10. Ovarian cancer and smoking

    DEFF Research Database (Denmark)

    Beral, V; Gaitskell, K; Hermon, C

    2012-01-01

    Smoking has been linked to mucinous ovarian cancer, but its effects on other ovarian cancer subtypes and on overall ovarian cancer risk are unclear, and the findings from most studies with relevant data are unpublished. To assess these associations, we review the published and unpublished evidence....

  11. Acrylamide and glycidamide hemoglobin adducts and epithelial ovarian cancer: a nested case-control study in non-smoking postmenopausal women from the EPIC cohort

    Science.gov (United States)

    Obón-Santacana, Mireia; Lujan-Barroso, Leila; Travis, Ruth C.; Freisling, Heinz; Ferrari, Pietro; Severi, Gianluca; Baglietto, Laura; Boutron-Ruault, Marie-Christine; Fortner, Renée T.; Ose, Jennifer; Boeing, Heiner; Menéndez, Virginia; Sánchez-Cantalejo, Emilio; Chamosa, Saioa; Huerta Castaño, José María; Ardanaz, Eva; Khaw, Kay-Tee; Wareham, Nick; Merritt, Melissa A.; Gunter, Marc J.; Trichopoulou, Antonia; Papatesta, Eleni-Maria; Klinaki, Eleni; Saieva, Calogero; Tagliabue, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Mattiello, Amalia; Bueno-de-Mesquita, H.B.; Peeters, Petra H.; Onland-Moret, N. Charlotte; Idahl, Annika; Lundin, Eva; Weiderpass, Elisabete; Vesper, Hubert W.; Riboli, Elio; Duell, Eric J

    2015-01-01

    Background Acrylamide was classified as ‘probably carcinogenic to humans (group 2A)’ by the International Agency for Research on Cancer. Epithelial ovarian cancer (EOC) is the fourth cause of cancer mortality in women. Five epidemiological studies have evaluated the association between EOC risk and dietary acrylamide intake assessed using food frequency questionnaires, and one nested case-control study evaluated hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA) and EOC risk; the results of these studies were inconsistent. Methods A nested case-control study in non-smoking postmenopausal women (334 cases, 417 controls) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between HbAA, HbGA, HbAA+HbGA, and HbGA/HbAA and EOC and invasive serous EOC risk. Results No overall associations were observed between biomarkers of acrylamide exposure analyzed in quintiles and EOC risk; however, positive associations were observed between some middle quintiles of HbGA and HbAA+HbGA. Elevated but non-statistically significant ORs for serous EOC were observed for HbGA and HbAA+HbGA (ORQ5vsQ1:1.91, 95%CI:0.96-3.81 and ORQ5vsQ1:1.90, 95%CI:0.94-3.83, respectively); however, no linear dose-response trends were observed. Conclusion This EPIC nested case-control study failed to observe a clear association between biomarkers of acrylamide exposure and the risk of EOC or invasive serous EOC. Impact It is unlikely that dietary acrylamide exposure increases ovarian cancer risk; however, additional studies with larger sample size should be performed to exclude any possible association with EOC risk. PMID:26376083

  12. Acrylamide and Glycidamide Hemoglobin Adducts and Epithelial Ovarian Cancer: A Nested Case-Control Study in Nonsmoking Postmenopausal Women from the EPIC Cohort.

    Science.gov (United States)

    Obón-Santacana, Mireia; Lujan-Barroso, Leila; Travis, Ruth C; Freisling, Heinz; Ferrari, Pietro; Severi, Gianluca; Baglietto, Laura; Boutron-Ruault, Marie-Christine; Fortner, Renée T; Ose, Jennifer; Boeing, Heiner; Menéndez, Virginia; Sánchez-Cantalejo, Emilio; Chamosa, Saioa; Castaño, José María Huerta; Ardanaz, Eva; Khaw, Kay-Tee; Wareham, Nick; Merritt, Melissa A; Gunter, Marc J; Trichopoulou, Antonia; Papatesta, Eleni-Maria; Klinaki, Eleni; Saieva, Calogero; Tagliabue, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Mattiello, Amalia; Bueno-de-Mesquita, H B; Peeters, Petra H; Onland-Moret, N Charlotte; Idahl, Annika; Lundin, Eva; Weiderpass, Elisabete; Vesper, Hubert W; Riboli, Elio; Duell, Eric J

    2016-01-01

    Acrylamide was classified as "probably carcinogenic to humans (group 2A)" by the International Agency for Research on Cancer. Epithelial ovarian cancer (EOC) is the fourth cause of cancer mortality in women. Five epidemiological studies have evaluated the association between EOC risk and dietary acrylamide intake assessed using food frequency questionnaires, and one nested case-control study evaluated hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA) and EOC risk; the results of these studies were inconsistent. A nested case-control study in nonsmoking postmenopausal women (334 cases, 417 controls) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Unconditional logistic regression models were used to estimate ORs and 95% confidence intervals (CI) for the association between HbAA, HbGA, HbAA+HbGA, and HbGA/HbAA and EOC and invasive serous EOC risk. No overall associations were observed between biomarkers of acrylamide exposure analyzed in quintiles and EOC risk; however, positive associations were observed between some middle quintiles of HbGA and HbAA+HbGA. Elevated but nonstatistically significant ORs for serous EOC were observed for HbGA and HbAA+HbGA (ORQ5vsQ1, 1.91; 95% CI, 0.96-3.81 and ORQ5vsQ1, 1.90; 95% CI, 0.94-3.83, respectively); however, no linear dose-response trends were observed. This EPIC nested case-control study failed to observe a clear association between biomarkers of acrylamide exposure and the risk of EOC or invasive serous EOC. It is unlikely that dietary acrylamide exposure increases ovarian cancer risk; however, additional studies with larger sample size should be performed to exclude any possible association with EOC risk. ©2015 American Association for Cancer Research.

  13. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study.

    Science.gov (United States)

    Rasmussen, Emma L Kaderly; Hannibal, Charlotte Gerd; Dehlendorff, Christian; Baandrup, Louise; Junge, Jette; Vang, Russell; Kurman, Robert J; Kjaer, Susanne K

    2017-03-01

    Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. This nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978-2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (pinfertility (OR=3.31; 95% CI: 2.44-4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR=1.32; 95% CI: 1.02-1.72), whereas OC use decreased the risk (OR=0.40; 95% CI: 0.26-0.62). Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Proteomic analysis of ovarian cancer cells during epithelial-mesenchymal transition (EMT) induced by epidermal growth factor (EGF) reveals mechanisms of cell cycle control.

    Science.gov (United States)

    Grassi, Mariana Lopes; Palma, Camila de Souza; Thomé, Carolina Hassibe; Lanfredi, Guilherme Pauperio; Poersch, Aline; Faça, Vitor Marcel

    2017-01-16

    Epithelial to mesenchymal transition (EMT) is a well-orchestrated process that culminates with loss of epithelial phenotype and gain of a mesenchymal and migratory phenotype. EMT enhances cancer cell invasiveness and drug resistance, favoring metastasis. Dysregulation of transcription factors, signaling pathways, miRNAs and growth factors including EGF, TGF-beta and HGF can trigger EMT. In ovarian cancer, overexpression of the EGFR family is associated with more aggressive clinical behavior. Here, the ovarian adenocarcinoma cell line Caov-3 was induced to EMT with EGF in order to identify specific mechanisms controlled by this process. Caov-3 cells induced to EMT were thoroughly validated and a combination of subcellular proteome enrichment, GEL-LC-MS/MS and SILAC strategy allowed consistent proteome identification and quantitation. Protein network analysis of differentially expressed proteins highlighted regulation of metabolism and cell cycle. Activation of relevant signaling pathways, such as PI3K/Akt/mTOR and Ras/Erk MAPK, in response to EGF-induced EMT was validated. Also, EMT did not affected the proliferation rate of Caov-3 cells, but led to cell cycle arrest in G1 phase regulated by increased levels of p21Waf1/Cip1, independently of p53. Furthermore, a decrease in G1 and G2 checkpoint proteins was observed, supporting the involvement of EGF-induced EMT in cell cycle control. Cancer is a complex multistep process characterized by accumulation of several hallmarks including epithelial to mesenchymal transition (EMT), which promotes cellular and microenvironmental changes resulting in invasion and migration to distant sites, favoring metastasis. EMT can be triggered by different extracellular stimuli, including growth factors such as EGF. In ovarian cancer, the most lethal gynecological cancer, overexpression of the EGFR family is associated with more aggressive clinical behavior, increasing mortality rate caused by metastasis. Our proteomic data, together

  15. Ovarian volume throughout life

    DEFF Research Database (Denmark)

    Kelsey, Thomas W; Dodwell, Sarah K; Wilkinson, A Graham

    2013-01-01

    cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n=59,994) we have generated and robustly validated the first model of ovarian volume from...... to about 2.8 mL (95% CI 2.7-2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis...

  16. Synergistic effect of DHT and IGF-1 hyperstimulation in human peripheral blood lymphocytes.

    Science.gov (United States)

    Imperlini, Esther; Spaziani, Sara; Mancini, Annamaria; Caterino, Marianna; Buono, Pasqualina; Orrù, Stefania

    2015-06-01

    The abuse of mixed or combined performance-enhancing drugs is widespread among athletes and amateurs, adults and adolescents. Clinical studies demonstrated that misuse of these doping agents is associated with serious adverse effects to many organs in human. Previously, we demonstrated in human peripheral blood lymphocytes that high doses of anabolic androgenic steroids, such as dihydrotestosterone (DHT) and growth factors, such as insulin-like growth factor-1 (IGF-1), have effects at gene and protein levels. Supraphysiological treatments of DHT and IGF-1 affected the expression of genes involved in skeletal muscle disorders as well as in cell-mediated immunological response. At protein level, DHT hyperdosage affects cell motility and apoptosis; IGF-1 hyperstimulation triggers an active cytoskeletal reorganization and an overproduction of immune response- and inflammation-related cytokines. In this study, we investigate the combined effects of DHT and IGF-1 hyperdosage in peripheral blood lymphocytes using a differential proteomic approach. DHT and IGF-1 combined treatment affects cell adhesion, migration, and survival through modulation of expression levels of cytokines and paxillin-signaling-related proteins, and activation of several pathways downstream focal adhesion kinase. Our results indicate a synergistic effect of DHT and IGF-1 which has potential implications for health risk factors. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls

    National Research Council Canada - National Science Library

    Terry, Kathryn L; Karageorgi, Stalo; Shvetsov, Yurii B; Merritt, Melissa A; Lurie, Galina; Thompson, Pamela J; Carney, Michael E; Weber, Rachel Palmieri; Akushevich, Lucy; Lo-Ciganic, Wei-Hsuan; Cushing-Haugen, Kara; Sieh, Weiva; Moysich, Kirsten; Doherty, Jennifer A; Nagle, Christina M; Berchuck, Andrew; Pearce, Celeste L; Pike, Malcolm; Ness, Roberta B; Webb, Penelope M; Rossing, Mary Anne; Schildkraut, Joellen; Risch, Harvey; Goodman, Marc T

    2013-01-01

    Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found...

  18. ELF5 in epithelial ovarian carcinoma tissues and biological behavior in ovarian carcinoma cells.

    Science.gov (United States)

    Yan, Hongchao; Qiu, Linglin; Xie, Xiaolei; Yang, He; Liu, Yongli; Lin, Xiaoman; Huang, Hongxiang

    2017-03-01

    The expression of E74-like factor 5 (ELF5) in epithelial ovarian carcinoma tissues and its effects on biological behavior in ovarian carcinoma cells were assessed in search for a new approach for gene treatment of epithelial ovarian carcinoma. RT-PCR technology was applied to detect the expression of ELF5 mRNA in epithelial ovarian carcinoma (n=49), borderline ovarian epithelial tumor (n=19), benign ovarian epithelial tumor (n=31) and normal ovarian tissues (n=40). Then, we transfected recombinant plasmid pcDNA3.1‑ELF5+EGFP into human ovarian carcinoma SKOV3 cells (recombinant plasmid group) in vitro and screened out stably transfected cells to conduct multiplication culture. Western blot analysis was performed to detect the expression of ELF5 protein in the different groups. Flow cytometry was employed to detect cell apoptosis and cycles. ELF5 mRNA in epithelial ovarian carcinoma and borderline ovarian epithelial tumor tissues were significantly lower (Pepithelial tumor and normal ovarian tissues. ELF5 protein expression in the cells of recombinant plasmid group was significantly higher compared with empty plasmid and blank control groups. The capacity of cell reproductive recombinant plasmid group at each time point decreased (P<0.05). Flow cytometry detection showed that 67.03% of cells in recombinant plasmid group was blocked in G0/G1 phase (P<0.05), compared with empty plasmid group (37.17%) and blank control group (38.24%). Apoptotic rate of recombinant plasmid group was significantly lower (31.4±1.9%; P<0.05), compared with that of empty plasmid group (9.1±2.2%) and blank control group (8.7±1.5%), and the differences were statistically significant. In conclusion, ELF5 interfered with cell cycle of human ovarian carcinoma SKOV3 cells and promoted apoptosis of human ovarian carcinoma SKOV3 cells inhibiting their growth and invasive capacity; and thus providing a new approach to gene treatment of ovarian carcinoma.

  19. Embryo retrieval after hormonal treatment to control ovarian function and non-surgical artificial insemination in African lions (Panthera leo).

    Science.gov (United States)

    Goeritz, F; Painer, J; Jewgenow, K; Hermes, R; Rasmussen, K; Dehnhard, M; Hildebrandt, T B

    2012-12-01

    Assisted reproduction technologies are essential for propagating endangered wild felids. Artificial insemination (AI) has been reported in several wild feline species, but pregnancy rates are low, partially owing to failures of current hormonal stimulation protocols. Therefore, this study describes the application of reliable methods to monitor ovarian activity and the development of an effective hormonal protocol to induce oestrus and ovulation in African lions. Application of porcine FSH and porcine LH was shown to be effective for inducing follicular growth and ovulation, and this regimen appeared to be superior to protocols described earlier in terms of ovulation and fertilization rates. Furthermore, non-surgical AI was performed successfully in lions, and uterine-stage embryos were collected and cryopreserved. African lions may serve as a valuable model to develop assisted reproduction for propagation of relic zoo populations in the critically endangered Asian lion or Barbary lion. © 2012 Blackwell Verlag GmbH.

  20. Coffee, tea, and caffeine consumption and risk of epithelial ovarian cancer and borderline ovarian tumors

    DEFF Research Database (Denmark)

    Gosvig, Camilla F; Kjaer, Susanne K; Blaakær, Jan

    2015-01-01

    BACKGROUND: Epidemiological studies that have investigated the association between coffee, tea and caffeine consumption and ovarian cancer risk have produced conflicting results. Furthermore, only few studies have examined the role of coffee and tea consumption separately for borderline ovarian...... tumors. By use of data from a large Danish population-based case-control study, we examined the risk of ovarian tumors associated with coffee, tea, and caffeine consumption with a particular focus on characterizing risks by tumor behavior and histology. MATERIAL AND METHODS: From 1995 through 1999, we....... RESULTS: Both coffee (OR = 0.90; 95% CI 0.84-0.97 per cup/day) and total caffeine consumption from coffee and tea combined (OR = 0.93; 95% CI 0.88-0.98 per 100 mg/day) decreased the risk of ovarian cancer. These associations were significant only for the serous and "other" subtypes of ovarian cancer...

  1. Concomitant use of FSH and low-dose recombinant hCG during the late follicular phase versus conventional controlled ovarian stimulation for intracytoplasmic sperm injection cycles.

    Science.gov (United States)

    Iaconelli, Carla Andrade Rebello; Setti, Amanda Souza; Braga, Daniela Paes Almeida Ferreira; Maldonado, Luiz Guilherme Louzada; Iaconelli, Assumpto; Borges, Edson; Aoki, Tsutomu

    2017-03-22

    The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n = 178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n = 152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group. A significantly higher fertilization rate, high-quality embryo rate and blastocyst formation rate were observed in the low-dose hCG group as compared to the control group. The miscarriage rate was significantly higher in the control group compared to the low-dose hCG group. A significantly lower incidence of OHSS was observed in the low-dose hCG group. There was also a significantly lower gonadotropin cost in the low-dose hCG group as compared to the control group ($1235.0 ± 239.0×$1763.0 ± 405.3, p hCG and FSH results in a lower abortion rate and increased number of mature oocytes retrieved, as well as improved oocyte quality, embryo quality and blastocyst formation and reduced FSH requirements.

  2. Multiple metastases from ovarian cancer

    African Journals Online (AJOL)

    Epithelial ovarian cancer is one of the most common ovarian tumours. Ovarian cancer affects women ... manifested by parenchymal liver or lung metastases, or .... Primary central nervous system recurrence after paclitaxel therapy for epithelial ...

  3. Obesity and risk of ovarian cancer subtypes

    DEFF Research Database (Denmark)

    Olsen, Catherine M; Nagle, Christina M; Whiteman, David C

    2013-01-01

    Whilst previous studies have reported that higher BMI increases a woman's risk of developing ovarian cancer, associations for the different histological subtypes have not been well defined. As the prevalence of obesity has increased dramatically, and classification of ovarian histology has improved......-grade serous invasive tumours (1.13, 1.03–1.25) and in pre-menopausal women (1.11; 1.04–1.18). Among post-menopausal women, the associations did not differ between hormone replacement therapy users and non-users. Whilst obesity appears to increase risk of the less common histological subtypes of ovarian cancer......, it does not increase risk of high-grade invasive serous cancers, and reducing BMI is therefore unlikely to prevent the majority of ovarian cancer deaths. Other modifiable factors must be identified to control this disease....

  4. [Right ovarian vein syndrome].

    Science.gov (United States)

    Arvis, G

    1985-01-01

    Right ovarian vein syndrome is revealed in pregnancy by right lumbar pains, and even by nephritic colics. It results from a congenital malposition of the right ovarian vein, which presses the right ureter on the external iliac artery. Diagnosis is by intravenous urography and retrograde ureteral pyelography. If pain persists despite treatment by analgesics, it may be necessary to place a double-J catheter, and to operate after delivery to ligate the ovarian vein.

  5. Pathobiology of ovarian carcinomas

    Institute of Scientific and Technical Information of China (English)

    Mojgan Devouassoux-Shisheboran; Catherine Genestie

    2015-01-01

    Ovarian tumors comprise a heterogeneous group of lesions, displaying distinct tumor pathology and oncogenic potentiel. These tumors are subdivided into three main categories: epithelial, germ cell, and sex-cord stromal tumors. We report herein the newly described molecular abnormalities in epithelial ovarian cancers (carcinomas). Immunohistochemistry and molecular testing help pathologists to decipher the significant heterogeneity of this disease. Our better understanding of the molecular basis of ovarian carcinomas represents the first step in the development of targeted therapies in the near future.

  6. Comparison of early versus late initiation of GnRH antagonist co-treatment for controlled ovarian stimulation in IVF: a randomized controlled trial.

    Science.gov (United States)

    Hamdine, O; Macklon, N S; Eijkemans, M J C; Laven, J S E; Cohlen, B J; Verhoeff, A; van Dop, P A; Bernardus, R E; Lambalk, C B; Oosterhuis, G J E; Holleboom, C A G; van den Dool-Maasland, G C; Verburg, H J; van der Heijden, P F M; Blankhart, A; Fauser, B C J M; Broekmans, F J

    2013-12-01

    What is the impact of initiating GnRH antagonist co-treatment for in vitro fertilization (IVF) on cycle day (CD) 2 compared with CD 6 on live birth rate (LBR) per started cycle and on the cumulative live birth rate (CLBR)? Early initiation of GnRH antagonist does not appear to improve clinical outcomes of IVF compared with midfollicular initiation. During ovarian stimulation for IVF, GnRH antagonist co-treatment is usually administered from the midfollicular phase onwards. Earlier initiation may improve the follicular phase hormonal milieu and therefore overall clinical outcomes. This open-label, multicentre randomized controlled trial was conducted between September 2009 and July 2011. A web-based program was used for randomization and 617 IVF-intracytoplasmic sperm injection (ICSI) patients were included. Recombinant FSH (150-225 IU) was administered daily from CD 2 onwards in both groups. The study group (CD2; n = 308) started GnRH antagonist co-treatment on CD 2, whereas the control group (CD6; n = 309) started on CD 6. There were no significant differences in clinical outcomes between the two groups. A non-significant trend towards a higher LBR per started cycle and CLBR was observed in the CD6 group compared with the CD2 group (LBR: 24.0 versus 21.5%, P = 0.5; CLBR: 29.9 versus 26.7%, P = 0.6). The study was terminated prematurely because no significant difference was observed in clinical outcomes after 617 inclusions. A much larger study population would be needed to detect a small significant difference in favour of either study arm, which raises the question of whether this would be relevant for clinical practice. The present study shows that the additional treatment burden and costs of starting GnRH antagonist on CD 2 instead of on CD 6 are not justified, as early initiation of GnRH antagonist does not improve LBRs. This study was partially supported by a grant from Merck Serono. O.H., M.J.C.E, A.V., P.A.D., R.E.B., G.J.E.O., C.A.G.H., G.C.D.M., H.J.V., P

  7. A multi-center population-based case-control study of ovarian cancer in African-American women: the African American Cancer Epidemiology Study (AACES).

    Science.gov (United States)

    Schildkraut, Joellen M; Alberg, Anthony J; Bandera, Elisa V; Barnholtz-Sloan, Jill; Bondy, Melissa; Cote, Michelle L; Funkhouser, Ellen; Peters, Edward; Schwartz, Ann G; Terry, Paul; Wallace, Kristin; Akushevich, Lucy; Wang, Frances; Crankshaw, Sydnee; Moorman, Patricia G

    2014-09-22

    Ovarian cancer (OVCA) is the leading cause of death from gynecological cancer, with poorer survival for African American (AA) women compared to whites. However, little is known about risk factors for OVCA in AA. To study the epidemiology of OVCA in this population, we started a collaborative effort in 10 sites in the US. Here we describe the study and highlight the challenges of conducting a study of a lethal disease in a minority population. The African American Cancer Epidemiology Study (AACES) is an ongoing, population-based case-control study of OVCA in AA in 10 geographic locations, aiming to recruit 850 women with invasive epithelial OVCA and 850 controls age- and geographically-matched to cases. Rapid case ascertainment and random-digit-dialing systems are in place to ascertain cases and controls, respectively. A telephone survey focuses on risk factors as well as factors of particular relevance for AAs. Food-frequency questionnaires, follow-up surveys, biospecimens and medical records are also obtained. Current accrual of 403 AA OVCA cases and 639 controls exceeds that of any existing study to date. We observed a high proportion (15%) of deceased non-responders among the cases that in part is explained by advanced stage at diagnosis. A logistic regression model did not support that socio-economic status was a factor in advanced stage at diagnosis. Most risk factor associations were in the expected direction and magnitude. High BMI was associated with ovarian cancer risk, with multivariable adjusted ORs and 95% CIs of 1.50 (0.99-2.27) for obese and 1.27 (0.85- 1.91) for morbidly obese women compared to normal/underweight women. AACES targets a rare tumor in AAs and addresses issues most relevant to this population. The importance of the study is accentuated by the high proportion of OVCA cases ascertained as deceased. Our analyses indicated that obesity, highly prevalent in this population (>60% of the cases), was associated with increased OVCA risk. While

  8. Ovarian Cysts

    Science.gov (United States)

    ... the-counter medicine or prescribe stronger medicine for pain relief. Prescribe hormonal birth control if you have cysts often. Hormonal birth ... the-counter medicine or prescribe stronger medicine for pain relief. Prescribe hormonal birth control if you have cysts often. Hormonal birth ...

  9. Gonadotropin-releasing hormone agonists cotreatment during chemotherapy in borderline ovarian tumor and ovarian cancer patients

    Institute of Scientific and Technical Information of China (English)

    ZHU Hong-lan; WANG Yan; LI Xiao-ping; WANG Chao-hua; WANG Yue; CUI Heng; WANG Jian-liu

    2013-01-01

    Background Recently,conservative surgery is acceptable in young patients with borderline ovarian tumor and ovarian cancer.The preservation of these patients' future fertility has been the focus of recent interest.This study aimed to observe the effect of gonadotropin-releasing hormone agonists (GnRHa) cotreatment during chemotherapy in borderline ovarian tumor and ovarian cancer patients.Methods Sixteen patients who were treated with fertility preservation surgery for borderline ovarian tumor and ovarian cancer and then administered GnRHa during chemotherapy in Peking University People's Hospital from January 2006 to July 2010 were retrospectively analyzed.This group was compared with a control group of 16 women who were treated concurrently with similar chemotherapy (n=5) without GnRHa or were historical controls (n=11).The disease recurrence,the menstruation status and reproductive outcome were followed up and compared between the two groups.Results There were no significant differences between both groups regarding age,body weight,height,marriage status,classification of the tumors,stage of the disease,as were the cumulative doses of each chemotherapeutic agent.One (1/16) patient in the study group while 2 (2/16) patients in the control group relapsed 2 years after conclusion of the primary treatment (P >0.05).All of the 16 women in the study group compared with 11 of the 16 patients in the control group resumed normal menses 6 months after the termination of the treatment (P <0.05).There were 4 spontaneous pregnancies in the study group while 2 in the control group,all of the neonates were healthy.Conclusions GnRHa administration before and during chemotherapy in borderline ovarian tumor and ovarian cancer patients who had undergone fertility preservation operation may bring up higher rates of spontaneous resumption of menses and a better pregnancy rate.Long-term follow up and large scale clinical studies are required.

  10. Ovarian reserve parameters

    DEFF Research Database (Denmark)

    Bentzen, J G; Forman, Julie Lyng; Pinborg, Anja;

    2012-01-01

    was observed between duration of hormonal-contraception use and ovarian reserve parameters. No dose-response relation was found between the dose of ethinyloestradiol and AMH or AFC. This study indicates that ovarian reserve markers are lower in women using sex steroids for contraception. Thus, AMH...

  11. Ovarian Cancer Stage II

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage II Add to My Pictures View /Download : ... 1650x675 View Download Large: 3300x1350 View Download Title: Ovarian Cancer Stage II Description: Three-panel drawing of stage ...

  12. Ovarian Cancer Stage IIIC

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage IIIC Add to My Pictures View /Download : ... 1530x1350 View Download Large: 3060x2700 View Download Title: Ovarian Cancer Stage IIIC Description: Drawing of stage IIIC shows ...

  13. Symptoms of Ovarian Cancer

    Science.gov (United States)

    ... Informed Cancer Home What Are the Symptoms of Ovarian Cancer? Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Gynecologic cancer symptoms diaries Ovarian cancer may cause the following signs and symptoms— Vaginal ...

  14. Ovarian Cancer Stage I

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Ovarian Cancer Stage I Add to My Pictures View /Download : ... 1650x675 View Download Large: 3300x1350 View Download Title: Ovarian Cancer Stage I Description: Three-panel drawing of stage ...

  15. What Is Ovarian Cancer?

    Science.gov (United States)

    ... based on how much it looks like normal tissue on a scale of 1, 2, or 3. Grade 1 epithelial ovarian carcinomas look more like normal tissue and tend to have a better prognosis (outlook). Grade 3 epithelial ovarian carcinomas look less like normal tissue and ...

  16. Management of ovarian cysts

    DEFF Research Database (Denmark)

    Knudsen, Ulla Breth; Tabor, Ann; Mosgaard, Berit Jul

    2004-01-01

    BACKGROUND: The treatment of an ovarian cyst relies on its nature, and accurate preoperative discrimination of benign and malignant cysts is therefore of crucial importance. This study was undertaken to review the literature concerning the preoperative diagnosis and treatment of ovarian cysts. ME...

  17. Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome.

    Science.gov (United States)

    Pacchiarotti, Alessandro; Carlomagno, Gianfranco; Antonini, Gabriele; Pacchiarotti, Arianna

    2016-01-01

    Polycystic ovarian syndrome (PCOS) induces anovulation in women of reproductive age, and is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Indeed, PCOS women are characterized by poor quality oocytes. Therefore, a treatment for enhancing oocyte quality becomes crucial for these patients. Myo-Inositol and melatonin proved to be efficient predictors for positive IVF outcomes, correlating with high oocyte quality. We tested the synergistic effect of myo-inositol and melatonin in IVF protocols with PCOS patients in a randomized, controlled, double-blind trial. Five-hundred twenty-six PCOS women were divided into three groups: Controls (only folic acid: 400 mcg), Group A (Inofolic® plus, a daily dose of myo-inositol: 4000 mg, folic acid: 400 mcg, and melatonin: 3 mg), and Group B (Inofolic®, a daily dose of myo-inositol: 4000 mg, and folic acid: 400 mcg). The main outcome measures were oocyte and embryo quality, clinical pregnancy and implantation rates. The treatment lasted from the first day of the cycle until 14 days after embryo transfer. Myo-inositol and melatonin have shown to enhance, synergistically, oocyte and embryo quality. In consideration of the beneficial effect observed in our trial and on the bases of previous studies, we decided to integrate routinely MI and M supplementation in the IVF protocols. The same treatment should be taken carefully in consideration in all procedures of this kind.

  18. Ovarian response prediction in GnRH antagonist treatment for IVF using anti-Mullerian hormone

    NARCIS (Netherlands)

    Hamdine, O.; Eijkemans, M.J.; Lentjes, E.W.; Torrance, H.L.; Macklon, N.S.; Fauser, B.C.; Broekmans, F.J.

    2015-01-01

    STUDY QUESTION: What is the clinical value of anti-Mullerian hormone (AMH) for the prediction of high or low ovarian response in controlled ovarian stimulation for IVF using GnRH antagonist treatment? SUMMARY ANSWER: AMH as a single test has substantial accuracy for ovarian response prediction in Gn

  19. File list: InP.Gon.05.AllAg.Ovarian_Follicle [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Gon.05.AllAg.Ovarian_Follicle mm9 Input control Gonad Ovarian Follicle SRX73700...9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Gon.05.AllAg.Ovarian_Follicle.bed ...

  20. File list: InP.Gon.20.AllAg.Ovarian_Follicle [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Gon.20.AllAg.Ovarian_Follicle mm9 Input control Gonad Ovarian Follicle SRX73700...9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Gon.20.AllAg.Ovarian_Follicle.bed ...

  1. File list: InP.Gon.50.AllAg.Ovarian_Follicle [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Gon.50.AllAg.Ovarian_Follicle mm9 Input control Gonad Ovarian Follicle SRX73700...9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Gon.50.AllAg.Ovarian_Follicle.bed ...

  2. File list: InP.Gon.10.AllAg.Ovarian_Follicle [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Gon.10.AllAg.Ovarian_Follicle mm9 Input control Gonad Ovarian Follicle SRX73700...9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Gon.10.AllAg.Ovarian_Follicle.bed ...

  3. Genome-wide significant risk associations for mucinous ovarian carcinoma

    DEFF Research Database (Denmark)

    Kelemen, Linda E; Lawrenson, Kate; Tyrer, Jonathan;

    2015-01-01

    Genome-wide association studies have identified several risk associations for ovarian carcinomas but not for mucinous ovarian carcinomas (MOCs). Our analysis of 1,644 MOC cases and 21,693 controls with imputation identified 3 new risk associations: rs752590 at 2q13 (P = 3.3 × 10(-8)), rs711830 at...

  4. A multi-centre phase 3 study comparing efficacy and safety of Bemfola® versus Gonal-f® in women undergoing ovarian stimulation for IVF

    DEFF Research Database (Denmark)

    Rettenbacher, M; Andersen, A N; Garcia-Velasco, J A

    2015-01-01

    injection (n = 372) showed Bemfola yielding similar efficacy and safety profiles to Gonal-f. Women aged 20-38 years of age were randomized 2:1 to receive a single, daily, subcutaneous 150 IU dose of either Bemfola or Gonal-f. This study tested equivalence in the number of retrieved oocytes using a pre...... pregnancy rate per embryo transfer in first and second cycles (Bemfola: 40.2% and 38.5%, respectively; Gonal-f: 48.2% and 27.8%, respectively). No difference in severe ovarian hyperstimulation syndrome was observed between treatment groups (Bemfola: 0.8%; Gonal-f: 0.8%). This study demonstrates similar...... clinical efficacy and safety profiles between Bemfola and Gonal-f, and suggests that Bemfola can be an appropriate alternative in ovarian stimulation protocols....

  5. Metformin administration versus laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: a prospective parallel randomized double-blind placebo-controlled trial.

    Science.gov (United States)

    Palomba, Stefano; Orio, Francesco; Nardo, Luciano Giovanni; Falbo, Angela; Russo, Tiziana; Corea, Domenico; Doldo, Patrizia; Lombardi, Gaetano; Tolino, Achille; Colao, Annamaria; Zullo, Fulvio

    2004-10-01

    At present, it is unclear what the role is of laparoscopic ovarian diathermy (LOD) and of metformin administration as second-line treatments for ovulation induction in women with polycystic ovary syndrome (PCOS) after failure of clomiphene citrate (CC) treatment. The aim of the present study was to compare in a randomized double-blind placebo-controlled fashion the effectiveness of LOD with metformin administration in the treatment of CC-resistant women with PCOS. A total of 120 overweight primary infertile anovulatory CC-resistant women with PCOS were enrolled and randomized into two groups of treatment. Group A underwent diagnostic laparoscopy, whereas group B underwent LOD. At hospital discharge, the patients were treated for 6 months with metformin cloridrate (group A; 850 mg twice daily) or with multivitamins (group B). The ovulation, pregnancy, abortion, and live-birth rates were evaluated. At the end of the study, the total ovulation rate was not statistically different between both treatment groups (54.8 vs. 53.2% [correction] in groups A and B, respectively), whereas the pregnancy (21.8 [correction] vs. 13.4%), the abortion (9.3 [correction] vs. 29.0%), and the live-birth (86.0 [correction] vs. 64.5%) rates were significantly (P < 0.05) different between the two groups. Our data show that metformin administration is more effective than LOD in overall reproductive outcomes in overweight infertile CC-resistant women with PCOS.

  6. Bio-equivalent doses of recombinant HCG and recombinant LH during ovarian stimulation result in similar oestradiol output: a randomized controlled study.

    Science.gov (United States)

    Alsbjerg, Birgit; Elbaek, Helle Olesen; Laursen, Rita Jakubcionyte; Povlsen, Betina Boel; Haahr, Thor; Yding Andersen, Claus; Humaidan, Peter

    2017-08-01

    In nature, HCG is secreted by the implanting embryo from peri-implantation and onwards. In contrast, LH is mandatory for steroidogenesis and follicular development during the follicular phase, working in synergy with FSH. Moreover, LH is mandatory for the function of the corpus luteum. Although LH and HCG bind to the same receptor, significant molecular, structural and functional differences exist, inducing differences in bioactivity. This randomized controlled study compared the effect of recombinant FSH stimulation combined with daily either micro-dose recombinant HCG or recombinant LH supplementation in a 1:1 bioactivity ratio from day 1 of stimulation in a long gonadotrophin releasing hormone agonist down regulation protocol. A total of 100 patients from a public clinic completed the study. The primary end-point was the oestradiol level on the day of ovulation trigger and the median oestradiol level in the HCG supplemented group was 8662 pmol/l versus 9203 pmol/l in the recombinant LH supplemented group; therefore, no significant difference was found. Moreover, no differences were observed in the number of oocytes retrieved or in the live birth rate. We conclude that recombinant HCG and recombinant LH are equally effective in boosting oestradiol synthesis during ovarian stimulation when used in a 1:1 bioactivity ratio. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Biomarkers of Ovarian Reserve

    Directory of Open Access Journals (Sweden)

    William E. Roudebush

    2008-01-01

    Full Text Available The primary function of the female ovary is the production of a mature and viable oocyte capable of fertilization and subsequent embryo development and implantation. At birth, the ovary contains a finite number of oocytes available for folliculogenesis. This finite number of available oocytes is termed “the ovarian reserve”. The determination of ovarian reserve is important in the assessment and treatment of infertility. As the ovary ages, the ovarian reserve will decline. Infertility affects approximately 15-20% of reproductive aged couples. The most commonly used biomarker assay to assess ovarian reserve is the measurement of follicle stimulating hormone (FSH on day 3 of the menstrual cycle. However, antimüllerian hormone and inhibin-B are other biomarkers of ovarian reserve that are gaining in popularity since they provide direct determination of ovarian status, whereas day 3 FSH is an indirect measurement. This review examines the physical tools and the hormone biomarkers used to evaluate ovarian reserve.

  8. Tamoxifen with ovarian function suppression versus tamoxifen alone as an adjuvant treatment for premenopausal breast cancer: a meta-analysis of published randomized controlled trials

    Science.gov (United States)

    Yan, Shunchao; Li, Kai; Jiao, Xin; Zou, Huawei

    2015-01-01

    Background Ovarian function suppression (OFS) significantly downregulates the concentration of plasma estrogens. However, it is unclear whether it offers any survival benefits if combined with adjuvant tamoxifen treatment in premenopausal women. This meta-analysis was designed to assess data from previous studies involving adjuvant tamoxifen treatment plus OFS in premenopausal breast cancer. Methods Electronic literature databases (PubMed, Embase, the Web of Science, and the Cochrane Library) were searched for relevant randomized controlled trials published prior to February 1, 2015. Only randomized controlled trials that compared tamoxifen alone with tamoxifen plus OFS for premenopausal women with breast cancer were selected. The evaluated endpoints were disease-free survival and overall survival. Results Four randomized controlled trials comprising 6,279 patients (OFS combination, n=3,133; tamoxifen alone, n=3,146) were included in the meta-analysis. There was no significant improvement in disease-free survival or overall survival with addition of OFS in either the whole population or the hormone receptor-positive subgroup. The risk of distant recurrence was not reduced with the addition of OFS in the whole population. A subgroup analysis showed that addition of OFS significantly improved overall survival in patients who were administered chemotherapy. Conclusion Based on the available studies, concurrent administration of OFS and adjuvant tamoxifen treatment for premenopausal women with breast cancer has no effect on prolonging disease-free survival and overall survival, excluding patients who were administered chemotherapy. It should not be widely recommended, except perhaps for women who were hormone-receptor positive and who were also administered adjuvant chemotherapy. PMID:26109867

  9. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a

  10. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  11. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  12. Can Ovarian Cancer Be Found Early?

    Science.gov (United States)

    ... Ovarian Cancer Early Detection, Diagnosis, and Staging Can Ovarian Cancer Be Found Early? About 20% of ovarian cancers ... cancer in its earliest stage. Ways to find ovarian cancer early Regular women's health exams During a pelvic ...

  13. Primary ovarian insufficiency in classic galactosemia: role of FSH dysfunction and timing of the lesion.

    Science.gov (United States)

    Gubbels, Cynthia S; Land, Jolande A; Evers, Johannes L H; Bierau, Jörgen; Menheere, Paul P C A; Robben, Simon G F; Rubio-Gozalbo, M Estela

    2013-01-01

    FSH inactivity due to secondary hypoglycosylation has been suggested as a potential mechanism for primary ovarian insufficiency in classic galactosemia. To investigate the role of FSH and to gain insight in the timing of the damage, ovarian stimulation tests were performed and data on ovarian imaging collected. Fifteen patients with primary ovarian insufficiency underwent ovarian stimulation with gonadotropins. Only one patient showed a normal increase in estradiol level, all the others had a low or no estradiol response. Anti-Müllerian hormone measurement in all girls and women showed levels below the detection limit of 0.10 μg/l. Ovarian volumes were evaluated by MRI in 14 patients and compared to age matched controls, prepubertal controls and postmenopausal controls. The ovarian volumes of the galactosemic girls were smaller than those of the age matched controls (p = 0.001) and the prepubertal ovaries (p = 0.008), and did not differ significantly from postmenopausal ovarian volumes (p = 0.161). In conclusion we found no evidence that FSH inactivity plays a role in primary ovarian insufficiency in classic galactosemia. Moreover, ovarian imaging results point to an early onset of ovarian failure in this disease.

  14. Real-time imaging of resident T cells in human lung and ovarian carcinomas reveals how different tumor microenvironments control T lymphocyte migration

    Directory of Open Access Journals (Sweden)

    Houcine eBougherara

    2015-10-01

    Full Text Available T cells play a key role in the battle against cancer. To perform their antitumor activities, T cells need to adequately respond to tumor antigens by establishing contact with either malignant cells or antigen-presenting cells. These latter functions rely on a series of migratory steps that go from entry of T cells into the tumor followed by their locomotion in the tumor stroma. Our knowledge of how T cells migrate within tumors mainly comes from experiments performed in mouse models. Whereas such systems have greatly advanced our understanding, they do not always faithfully recapitulate the disease observed in cancer patients. We previously described a technique based on tissue slices that enables to track with real-time imaging microscopy the motile behavior of fluorescent T cells plated onto fresh sections of human lung tumors. We have now refined this approach to monitor the locomotion of resident tumor-infiltrating CD8 T cells labeled with fluorescently-coupled antibodies. Using this approach, our findings reveal that CD8 T cells accumulate in the stroma of ovarian and lung carcinomas but move slowly in this compartment. Conversely, even though less populated, tumors islets were found to be zones of faster migration for resident CD8 T cells. We also confirm the key role played by collagen fibers which, by their orientation, spacing and density, control the distribution and migration of resident CD8 T cells within the tumor stroma. We have subsequently demonstrated that under some physical tissue constraints CD8 T cells exhibited a mode of migration characterized by alternate forward and backward movements. In sum, using an ex vivo assay to track CD8 T cells in fresh human tumor tissues, we have identified the extracellular matrix as a major stromal component in influencing T cell migration, thereby impacting control of tumor growth. This approach will aid in the development and testing of novel immunotherapy strategies to promote T cell

  15. Ovarian Cancer and Comorbidity

    DEFF Research Database (Denmark)

    Noer, Mette Calundann; Sperling, Cecilie Dyg; Ottesen, Bent

    2017-01-01

    OBJECTIVES: Comorbidity influences survival in ovarian cancer, but the causal relations between prognosis and comorbidity are not well characterized. The aim of this study was to investigate the associations between comorbidity, system delay, the choice of primary treatment, and survival in Danish...... ovarian cancer patients. METHODS: This population-based study was conducted on data from 5317 ovarian cancer patients registered in the Danish Gynecological Cancer Database. Comorbidity was classified according to the Charlson Comorbidity Index and the Ovarian Cancer Comorbidity Index. Pearson χ test...... and multivariate logistic regression analyses were used to investigate the association between comorbidity and primary outcome measures: primary treatment ("primary debulking surgery" vs "no primary surgery") and system delay (more vs less than required by the National Cancer Patient Pathways [NCPPs]). Cox...

  16. Ovarian Cancer Stage IV

    Science.gov (United States)

    ... organs and tissues outside the abdomen, including the lung, liver, bone, and lymph nodes in the groin. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Ovarian Cancer Cells or Tissue -- ...

  17. Ovarian Cancer FAQ

    Science.gov (United States)

    ... increased risk of breast cancer and ovarian cancer. CA 125: A substance in the blood that may increase in the presence of some cancerous tumors. Colonoscopy: An exam of the entire colon using a small, lighted instrument. Computed Tomography: A ...

  18. Ovarian cancer epidemiology in the era of collaborative team science.

    Science.gov (United States)

    Cannioto, Rikki A; Trabert, Britton; Poole, Elizabeth M; Schildkraut, Joellen M

    2017-05-01

    Over the past decade, a number of consortia have formed to further investigate genetic associations, pathogenesis, and epidemiologic risk and prognostic factors for ovarian cancer. Here, we review the benefits that ovarian cancer consortia provide as well as challenges that have arisen. Methods for managing key challenges are also discussed. We review the structural organization and some of the milestone epidemiologic publications of five consortia dedicated to the study of ovarian cancer, including the Ovarian Cancer Association Consortium (OCAC), the Ovarian Tumor Tissue Analysis (OTTA) Consortium, the Ovarian Cancer Cohort Consortium (OC3), the Collaborative Group on Epidemiological Studies of Ovarian Cancer (The Oxford Collaborative Group), and the Ovarian Cancer in Women of African Ancestry (OCWAA) consortium. As ovarian cancer is a rare and heterogeneous disease, consortia have made important contributions in the study of risk factors by improving statistical power beyond what any single study, or even a few studies, would provide. Thus, a major accomplishment of consortial research is enhanced characterization of histotype-specific risk factor associations. In addition, consortia have facilitated impressive synergy between researchers across many institutions, spawning new collaborative research. Importantly, through these efforts, many challenges have been met, including difficulties with data harmonization and analysis, laying a road map for future collaborations. While ovarian cancer consortia have made valuable contributions to the ovarian cancer epidemiological literature over the past decade, additional efforts comprising of new, well-designed case-control studies are needed to further elucidate novel, histotype-specific risk, and prognostic factors which are not consistently available in existing studies.

  19. What's New in Ovarian Cancer Research and Treatment?

    Science.gov (United States)

    ... Ovarian Cancer About Ovarian Cancer What's New in Ovarian Cancer Research and Treatment? Risk factors and causes Scientists ... in Ovarian Cancer Research and Treatment? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  20. What Are the Key Statistics about Ovarian Cancer?

    Science.gov (United States)

    ... Ovarian Cancer What Are the Key Statistics About Ovarian Cancer? The American Cancer Society estimates for ovarian cancer ... in Ovarian Cancer Research and Treatment? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  1. Insulin-like growth factor binding protein 2 promotes ovarian cancer cell invasion

    Directory of Open Access Journals (Sweden)

    Liu Jinsong

    2005-02-01

    Full Text Available Abstract Background Insulin-like growth factor binding protein 2 (IGFBP2 is overexpressed in ovarian malignant tissues and in the serum and cystic fluid of ovarian cancer patients, suggesting an important role of IGFBP2 in the biology of ovarian cancer. The purpose of this study was to assess the role of increased IGFBP2 in ovarian cancer cells. Results Using western blotting and tissue microarray analyses, we showed that IGFBP2 was frequently overexpressed in ovarian carcinomas compared with normal ovarian tissues. Furthermore, IGFBP2 was significantly overexpressed in invasive serous ovarian carcinomas compared with borderline serous ovarian tumors. To test whether increased IGFBP2 contributes to the highly invasive nature of ovarian cancer cells, we generated IGFBP2-overexpressing cells from an SKOV3 ovarian cancer cell line, which has a very low level of endogenous IGFBP2. A Matrigel invasion assay showed that these IGFBP2-overexpressing cells were more invasive than the control cells. We then designed small interference RNA (siRNA molecules that attenuated IGFBP2 expression in PA-1 ovarian cancer cells, which have a high level of endogenous IGFBP2. The Matrigel invasion assay showed that the attenuation of IGFBP2 expression indeed decreased the invasiveness of PA-1 cells. Conclusions We therefore showed that IGFBP2 enhances the invasion capacity of ovarian cancer cells. Blockage of IGFBP2 may thus constitute a viable strategy for targeted cancer therapy.

  2. Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

    OpenAIRE

    2014-01-01

    Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T...

  3. Hedgehog signaling pathway and ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    Qi Chen; Guolan Gao; Shiwen Luo

    2013-01-01

    Epithelial ovarian carcinoma (EOC) is the most common form of ovarian malignancies and the most lethal gynecologic malignancy in the United States.To date,in spite of treatment to it with the extensive surgical debulking and chemotherapy,the prognosis of EOC remains dismal.Recently,it has become increasingly clear that in many instances,the signaling and molecular players that control development are the same,and when inappropriately regulated,drive tumorigenesis and cancer development.Here,we discuss the possible involvement of Hedgehog (Hh) pathway in the cellular regulation and development of cancer in the ovaries.Using the in vitro and in vivo assays developed has facilitated the dissection of the mechanisms behind Hh-driven ovarian cancers formation and growth.Based on recent studies,we propose that the inhibition of Hh signaling may interfere with spheroid-like structures in ovarian cancers.The components of the Hh signaling may provide novel drug targets,which could be explored as crucial combinatorial strategies for the treatment of ovarian cancers.

  4. HE4 Gene Overexpression in Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    A Shahi

    2016-03-01

    Full Text Available Introduction: Ovarian cancer is one of the common malignancies within women and the fifth cause of cancer death in women all over the world. Recent developments in Genomics and Proteomics technologies have led to the identification of unknown candidate markers for the diagnosis of ovarian cancer. Human epididymis protein 4 (HE4 has recently been supported to monitor the recurrence or the progression of epithelial ovarian cancer. Therefore, this study aimed to measure the expression of HE4 in women suffering from ovarian cancer. Methods: In this study, 20 paraffin-embedded tissue samples from women with ovarian cancer and 10 normal samples were collected from Imam Khomeini Hospital in Tehran. After removing paraffin, RNA extraction was performed with RNAPlus solution. cDNA was synthesized through reverse transcription by MMULV enzyme. Gene expression was measured by Relative Real time PCR method. Glyceraldehyde phosphate dehydrogenase gene (GAPDH was used as an internal control. Results: The HE4 was expressed in normal and cancerous tissues, though its expression was observed more in tumor tissues (4.083 than noncancerous tissues. The study results also revealed that the expression level of HE4 increased with the advancement of the disease. Conclusion: According to the results, it can be concluded that HE4 expression levels greatly increases in tumor samples. Therefore, HE4 gene expression measurements can serve as a valuable prognostic factor for early detection and treatment management of the disease.

  5. Proteomics Analysis for Finding Serum Markers of Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Yushan Cheng

    2014-01-01

    Full Text Available A combination of peptide ligand library beads (PLLB and 1D gel liquid chromatography-mass spectrometry/mass spectrometry (1DGel-LC-MS/MS was employed to analyze serum samples from patients with ovarian cancer and from healthy controls. Proteomic analysis identified 1200 serum proteins, among which 57 proteins were upregulated and 10 were downregulated in the sera from cancer patients. Retinol binding protein 4 (RBP4 is highly upregulated in the ovarian cancer serum samples. ELISA was employed to measure plasma concentrations of RBP4 in 80 samples from ovarian cancer patients, healthy individuals, myoma patients, and patients with benign ovarian tumor, respectively. The plasma concentrations of RBP4 ranging from 76.91 to 120.08 ng/mL with the mean value 89.13±1.67 ng/mL in ovarian cancer patients are significantly higher than those in healthy individuals (10.85±2.38 ng/mL. Results were further confirmed with immunohistochemistry, demonstrating that RBP4 expression levels in normal ovarian tissue were lower than those in ovarian cancer tissues. Our results suggested that RBP4 is a potential biomarker for diagnostic of screening ovarian cancer.

  6. A high response to controlled ovarian stimulation induces premature luteinization with a negative impact on pregnancy outcomes in a gonadotropin-releasing hormone antagonist cycle.

    Science.gov (United States)

    Koo, Hwa Seon; Cha, Sun Hwa; Kim, Hye Ok; Song, In Ok; Min, Eung Gi; Yang, Kwang Moon; Park, Chan Woo

    2015-12-01

    The goal of this study was to investigate the relationship between serum progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration and the pregnancy rate among women undergoing controlled ovarian stimulation for in vitro fertilization (IVF) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) using a flexible antagonist protocol. This prospective study included 200 IVF and ICSI-ET cycles in which a flexible antagonist protocol was used. The patients were divided into five distinct groups according to their serum P4 levels at the time of hCG administration (0.80, 0.85, 0.90, 0.95, and 1.00 ng/mL). The clinical pregnancy rate (CPR) was calculated for each P4 interval. Statistically significant differences were observed at a serum P4 level of 0.9 ng/mL. These data suggest that a serum P4 concentration of 0.9 ng/mL may represent the optimal threshold level for defining premature luteinization (PL) based on the presence of a significant negative impact on the CPR. The CPR for each round of ET was significantly lower in the PL group defined using this threshold (25.8% vs. 41.8%; p=0.019), and the number of oocytes retrieved was significantly higher than in the non-PL group (17.3±7.2 vs. 11.0±7.2; p=0.001). Elevated serum P4 levels on the day of hCG administration were associated with a reduced CPR, despite the retrieval of many oocytes. Measuring serum P4 values at the time of hCG administration is necessary in order to determine the optimal strategy for embryo transfer.

  7. Ovarian Germ Cell Tumors Treatment

    Science.gov (United States)

    ... ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause. Ovarian germ cell ... if you have either of the following: Swollen abdomen without weight gain in other parts of the ...

  8. Neoadjuvant chemotherapy in advanced ovarian cancer:a Meta analysis of randomized controlled trials%晚期卵巢癌新辅助化疗的Meta分析

    Institute of Scientific and Technical Information of China (English)

    黄琳娟; 孔北华; 何丽

    2013-01-01

    Objective:To evaluate whether neoadjuvant chemotherapy will improve pro-gession free survival (PFS) and overall survival (OS) in advanced ovarian cancer patients. Methods: We search PubMed database, Medline database, Embas database, Cochrane Library, WANFANG database, CNKI and CBM in the internet. We also hand-search 5 journals of Obstetrics and Gynecology (Chinese Journal of Obstetrics and Gynecology, Chinese Journal of Practical Gynecology and Obstetrics, Journal of Practical Obstetrics and Gynecology, Reproduction and Contraception, Progress in Obstetrics and Gynecology). The experimental group accepted platinum-based adjuvant chemotherapy before cytoreductive surgery and the control group accepted primary cytoreductive surgery following adjuvant chemotherapy. Results: Totally 3 articles were included. Meta-analysis on the selected literature was processed by Revman 5.0. According to the results of fixed-effect model,the RR of OS was 0. 96 (95% CI,0. 90 ~ 1. 03 ). Because there was heterogeneity in PFS, the result adopt random-effect model, the RR of PFS was 1.00 (95% Cl 0. 93 ~ 1. 09). Conclusion: Neoadjuvant chemotherapy don't improve the outcome for advanced ovarian cancer.%目的:评价新辅助化疗对晚期卵巢癌患者总生存期及无进展生存期的影响,探讨新辅助化疗在晚期卵巢癌的应用价值.方法:计算机检索PubMed数据库、Med-line数据库、EMbas数据库、Cochrane Library数据库、万方数据库、中国学术文献总库(CNKI)、中国生物医学文献数据库(CBM),手工检索《中华妇产科杂志》,《中国实用妇科与产科杂志》,《实用妇产科杂志》,《生殖与避孕》,《现代妇产科进展》5本妇产科杂志.语言种类为中文和英文,网上检索时间不限.试验组行新辅助化疗,即以铂类为基础的化疗后行细胞减灭术;对照组行传统治疗,即细胞减灭术后行规范性化疗.结果:共纳入3篇文献,提取数据后,Review Manager5.0软件进

  9. Standard first-line chemotherapy with or without nintedanib for advanced ovarian cancer (AGO-OVAR 12): a randomised, double-blind, placebo-controlled phase 3 trial

    NARCIS (Netherlands)

    Bois, A. du; Kristensen, G.; Ray-Coquard, I.; Reuss, A.; Pignata, S.; Colombo, N.; Denison, U.; Vergote, I.; Campo, J.M. Del; Ottevanger, P.B.; Heubner, M.; Minarik, T.; Sevin, E.; Gregorio, N. de; Bidzinski, M.; Pfisterer, J.; Malander, S.; Hilpert, F.; Mirza, M.R.; Scambia, G.; Meier, W.; Nicoletto, M.O.; Bjorge, L.; Lortholary, A.; Sailer, M.O.; Merger, M.; Harter, P.

    2016-01-01

    BACKGROUND: Angiogenesis is a target in the treatment of ovarian cancer. Nintedanib, an oral triple angiokinase inhibitor of VEGF receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has shown activity in phase 2 trials in this setting. We investigated the combin

  10. Is There a Relationship between Ovarian Epithelial Dysplasia and Infertility?

    Directory of Open Access Journals (Sweden)

    Gautier Chene

    2012-01-01

    Full Text Available Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups—an exposed group to ovulation induction (n = 30, an infertile group without stimulation (n = 35, and a spontaneously fertile control group (n = 62—in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls. In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group. Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.

  11. Ovarian follicular development and oocyte quality in anestrous ewes treated with melatonin, a controlled internal drug release (CIDR) device and follicle stimulating hormone.

    Science.gov (United States)

    Luther, Justin S; Redmer, Dale A; Reynolds, Lawrence P; Choi, Jong Tae; Pant, Disha; Navanukraw, Chainarong; Arnold, Daniel R; Scheaffer, Abraham N; Borowicz, Pawel; Kirsch, James D; Weigl, Robert M; Kraft, Kim C; Grazul-Bilska, Anna T

    2005-05-01

    The objective of the current study was to determine the effects of hormonal treatments on ovarian follicular development and oocyte quality in anestrous ewes. Multiparous crossbred (RambouilletxTarghee) ewes were given melatonin implants (MEL) and/or controlled internal drug release (CIDR) devices in conjunction with follicle stimulating hormone (FSH) during anestrus (March-May). In Experiment 1, ewes (n=25) were assigned randomly to four groups (n=4-7/group) in a 2x2 factorial arrangement [+/-MEL and +/-CIDR], resulting in Control (no treatment), CIDR, MEL, and MEL/CIDR groups, respectively. Ewes received an implant containing 18 mg of melatonin (Melovine) on Day 42 and/or a CIDR from Days 7 to 2 (Day 0: oocyte collection). In Experiment 2, ewes (n=12) were assigned randomly to two groups (n=6/group; 1CIDR or 2CIDR) and received the same type of melatonin implant on Day 60. All ewes received a CIDR device from Days -22 to -17 and 2CIDR ewes received an additional CIDR device from Days -10 to -2. In both experiments, ewes were given FSH im twice daily (morning and evening) on Days -2 and -1 (Day -2: 5 units/injection; Day -1: 4 units/injection). On the morning of Day 0, ovaries were removed, follicles>or=1 mm were counted, and oocytes were collected. Thereafter oocytes were matured and fertilized in vitro. In Experiment 1, the number of visible follicles and the rates of oocyte recovery and in vitro maturation were similar (P>0.10) for Control, CIDR, MEL and MEL/CIDR (overall 29.7+/-2.9%, 89.9+/-7.1% and 95.0+/-2.0%, respectively). The rates of in vitro fertilization (IVF) were lower (P0.10) for 1CIDR and 2CIDR groups (overall 27.3+/-3.2%, 92.1+/-2.7% and 90.2+/-1.9%, respectively). However, the rates of IVF were lower (P<0.01) for 2CIDR than 1CIDR group (30.2% versus 58.0%, respectively). In summary, when treatment with P4 commenced only 2 d before oocyte collection, rates of IVF were reduced in both experiments. Therefore, progestin treatment protocols used in

  12. Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

    Directory of Open Access Journals (Sweden)

    René Rodríguez-Gutiérrez

    2014-01-01

    Full Text Available Background. Although the association between human chorionic gonadotropin (hCG and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM. Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001. Free testosterone (T and dehydroepiandrosterone sulfate (DHEA-S were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL (P=0.0001 and 0.001, respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78; P≤0.001, r=0.74;  P≤0.001, and r=0.71;  P≤0.001, respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001 and free T and DHEA-S declined significantly (P=0.0002 and 0.009. Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.

  13. Vitamin D receptor rs2228570 polymorphism and invasive ovarian carcinoma risk: pooled analysis in five studies within the Ovarian Cancer Association Consortium

    DEFF Research Database (Denmark)

    Lurie, Galina; Wilkens, Lynne R; Thompson, Pamela J

    2011-01-01

    The association of invasive ovarian carcinoma risk with the functional polymorphism rs2228570 (aka rs10735810; FokI polymorphism) in the vitamin D receptor (VDR) gene was examined in 1820 white non-Hispanic cases and 3479 controls in a pooled analysis of five population-based case-control studies...... within the Ovarian Cancer Association Consortium. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Carriers of the rare T allele were at increased risk of ovarian carcinoma compared to women with the CC genotype in all studies combined; each...... analysis provides further evidence that the VDR rs2228570 polymorphism might influence ovarian cancer susceptibility....

  14. File list: InP.Utr.50.AllAg.Ovarian_granulosa_cells [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Utr.50.AllAg.Ovarian_granulosa_cells hg19 Input control Uterus Ovarian granulos...a cells http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/InP.Utr.50.AllAg.Ovarian_granulosa_cells.bed ...

  15. File list: InP.Utr.20.AllAg.Ovarian_granulosa_cells [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Utr.20.AllAg.Ovarian_granulosa_cells hg19 Input control Uterus Ovarian granulos...a cells http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/InP.Utr.20.AllAg.Ovarian_granulosa_cells.bed ...

  16. File list: InP.Utr.10.AllAg.Ovarian_granulosa_cells [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Utr.10.AllAg.Ovarian_granulosa_cells hg19 Input control Uterus Ovarian granulos...a cells http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/InP.Utr.10.AllAg.Ovarian_granulosa_cells.bed ...

  17. File list: InP.Utr.05.AllAg.Ovarian_granulosa_cells [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Utr.05.AllAg.Ovarian_granulosa_cells hg19 Input control Uterus Ovarian granulos...a cells http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/InP.Utr.05.AllAg.Ovarian_granulosa_cells.bed ...

  18. Ovarian response prediction in GnRH antagonist treatment for IVF using anti-Müllerian hormone

    NARCIS (Netherlands)

    Hamdine, O.; Eijkemans, M. J C; Lentjes, E. W G; Torrance, H. L.; Macklon, N. S.; Fauser, B. C J M; Broekmans, F. J.

    2015-01-01

    STUDY QUESTION What is the clinical value of anti-Müllerian hormone (AMH) for the prediction of high or low ovarian response in controlled ovarian stimulation for IVF using GnRH antagonist treatment? SUMMARY ANSWER AMH as a single test has substantial accuracy for ovarian response prediction in GnRH

  19. A genome-wide association study identifies susceptibility loci for ovarian cancer at 2q31 and 8q24

    DEFF Research Database (Denmark)

    Goode, Ellen L; Chenevix-Trench, Georgia; Song, Honglin

    2010-01-01

    Ovarian cancer accounts for more deaths than all other gynecological cancers combined. To identify common low-penetrance ovarian cancer susceptibility genes, we conducted a genome-wide association study of 507,094 SNPs in 1,768 individuals with ovarian cancer (cases) and 2,354 controls, with foll...

  20. Ovarian tubercular abscess mimicking ovarian carcinoma: A rare case report

    Directory of Open Access Journals (Sweden)

    Abinash Agarwala

    2015-01-01

    Full Text Available Although genito-urinary tuberculosis is common, reports of isolated ovarian tubercular abscess are rare. Ovarian tubercular abscess may mimics that of an ovarian tumor, leading to diagnostic difficulties. We reported a case report of 35 years woman presented with chronic pain abdomen, weight loss, low-grade fever and a right ovarian mass on ultrasound, with a significantly elevated CA-125 level. On clinical and radiological evidence, diagnosis of ovarian carcinoma was made, and laparotomy was performed with resection of the ovary. Postoperative specimen sent for histological examination that revealed classic epithelioid granuloma and acid-fast bacilli were present in Ziehl-Neelsen stain. Patient was put on antitubercular regimen from our Dots center. She is improving clinical after taking antitubercular drug and is on regular follow up at our chest outpatient department. Ovarian tubercular abscess is common in young women living in endemic zones, but case report of isolated tubercular abscess is rarely reported. CA-125 can be raised in both ovarian tubercular abscess and ovarian carcinoma, and only imaging is not always conclusive. Laparotomy followed by tissue diagnosis can be helpful in this situation. As the prognosis and treatment outcome of ovarian tubercular abscess and ovarian carcinoma is different, proper diagnosis by laparotomy should be done. Early diagnosis of ovarian tubercular abscess is vital as untreated disease can lead to infertility.

  1. Ovarian stimulation in patients with breast cancer.

    Science.gov (United States)

    Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García

    2015-01-01

    Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer

  2. Effect of medroxyprogesterone acetate (Provera) on ovarian radiosensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Jarrell, J.; YoungLai, E.V.; McMahon, A.; Barr, R.; O' Connell, G.; Belbec, L.

    1989-04-01

    Medroxyprogesterone acetate (Provera) is a drug that is commonly given to young women with cancer during chemotherapy and radiation to control heavy bleeding associated with anovulation. Because hypothalamic-pituitary-ovarian suppression has been associated with ovarian protection from the effects of chemotherapy and medroxyprogesterone acetate has been identified as a radiosensitizing agent, we explored the effects of medroxyprogesterone acetate on a rat model with known radiation injury characteristics. Sprague-Dawley rats were treated with medroxyprogesterone acetate or vehicle from day 22 to day 37 of life and were either irradiated or sham-irradiated on day 30 of life and then killed on day 44. Radiation with medroxyprogesterone acetate administration produced a greater loss in preantral and healthy control follicles than in control follicles. No suppression of luteinizing hormone or follicle-stimulating hormone had occurred by day 30 but ovarian glutathione content was reduced. These findings indicate that the administration of medroxyprogesterone acetate with radiotherapy may enhance ovarian injury.

  3. Hormonal, follicular and endometrial dynamics in letrozole-treated versus natural cycles in patients undergoing controlled ovarian stimulation

    Directory of Open Access Journals (Sweden)

    Brunengraber Lisa N

    2011-06-01

    Full Text Available Abstract The objective of this study was to compare letrozole-stimulated cycles to natural cycles in 208 patients undergoing intrauterine insemination (IUI between July of 2004 and January of 2007. Group I (n = 47 received cycle monitoring only (natural group, Group II (n = 125 received letrozole 2.5 mg/day on cycle days three to seven, and Group III (n = 36 received letrozole 5 mg/day on cycle days three to seven. There were no differences between the groups in endometrial thickness or P4 on the day of hCG. Estradiol levels had higher variation in the second half of the follicular phase in both letrozole-treated groups compared to the control group. Estradiol per preovulatory follicle was similar in both letrozole cycles to that observed in the natural cycles. LH was lower on the day of hCG administration in the letrozole 2.5 mg/day group vs. the natural group. In summary, letrozole results in some minor changes in follicular, hormonal and endometrial dynamics compared to natural cycles. Increased folliculogenesis and pregnancy rates were observed in the letrozole-treated groups compared to the natural group. These findings need to be confirmed in larger, prospective studies.

  4. The Groningen ART cohort study : the effects of ovarian hyperstimulation and the IVF laboratory procedures on neurological condition at 2 years

    NARCIS (Netherlands)

    Schendelaar, P.; Middelburg, K. J.; Bos, A. F.; Heineman, M. J.; Jongbloed-Pereboom, M.; Hadders-Algra, M.

    2011-01-01

    BACKGROUND: Up to 4% of children are born following assisted reproduction techniques (ART) yet relatively little is known on neurodevelopmental outcome of these children after 18 months of age. Only a limited number of long-term follow-up studies with adequate methodological quality have been report

  5. Ovarian cancer surgery

    DEFF Research Database (Denmark)

    Seibaek, Lene; Blaakaer, Jan; Petersen, Lone Kjeld

    2013-01-01

    PURPOSE: The study objective was to survey general health and coping in women undergoing ovarian cancer surgery, and subsequently to develop and test a supportive care intervention. METHODS/MATERIALS: Women who underwent surgery on the suspicion of ovarian cancer participated in a follow...... standard levels. Concerning mental health, levels were below standard during the entire period, but did improve with time, also in women in whom the potential cancer diagnosis was refuted. The preoperative differences between these groups leveled out postoperatively in terms of physical health. At the end...

  6. Identification of new ovulation-related genes in humans by comparing the transcriptome of granulosa cells before and after ovulation triggering in the same controlled ovarian stimulation cycle

    DEFF Research Database (Denmark)

    Wissing, M L; Kristensen, S G; Andersen, C Y

    2014-01-01

    with ovarian cancer, while down-regulated genes mainly represented cell cycle and proliferation. WHAT IS KNOWN ALREADY: Radical changes occur in the follicle during final follicle maturation after the ovulatory trigger: these range from ensuring an optimal milieu for the oocyte in meiotic arrest to the release...... of a mature oocyte and remodeling into a corpus luteum. A wide range of mediators of final follicle maturation has been identified in rodents, non-human primates and cows. STUDY DESIGN, SIZE, DURATION: Prospective cohort study including 24 women undergoing ovarian stimulation with the long gonadotrophin-releasing...... hormone agonist protocol during 2010-2012 at Holbæk Fertility Clinic. Nine paired samples of GC and 24 paired samples of follicular fluid (FF) were obtained before and after recombinant human chorionic gonadotrophin (rhCG) administration. PARTICIPANTS/MATERIALS, SETTING, METHODS: Nine paired (nine arrays...

  7. Effective Referral of Low-Income Women at Risk for Hereditary Breast and Ovarian Cancer to Genetic Counseling: A Randomized Delayed Intervention Control Trial.

    Science.gov (United States)

    Pasick, Rena J; Joseph, Galen; Stewart, Susan; Kaplan, Celia; Lee, Robin; Luce, Judith; Davis, Sharon; Marquez, Titas; Nguyen, Tung; Guerra, Claudia

    2016-10-01

    To determine the effectiveness of a statewide telephone service in identifying low-income women at risk for hereditary breast and ovarian cancer and referring them to free genetic counseling. From June 2010 through August 2011, eligible callers to California's toll-free breast and cervical cancer telephone service were screened for their family histories of breast and ovarian cancer. High-risk women were identified and called for a baseline survey and randomization to an immediate offer of genetic counseling or a mailed brochure on how to obtain counseling. Clinic records were used to assess receipt of genetic counseling after 2 months. Among 1212 eligible callers, 709 (58.5%) agreed to answer family history questions; 102 (14%) were at high risk (25% Hispanic, 46% White, 10% Black, 16% Asian, 3% of other racial/ethnic backgrounds). Of the high-risk women offered an immediate appointment, 39% received counseling during the intervention period, as compared with 4.5% of those receiving the brochure. A public health approach to the rare but serious risk of hereditary breast and ovarian cancer can be successful when integrated into the efforts of existing safety net organizations.

  8. Natural history of autoimmune primary ovarian insufficiency in patients with Addison's disease: from normal ovarian function to overt ovarian dysfunction.

    Science.gov (United States)

    De Bellis, Annamaria; Bellastella, Giuseppe; Falorni, Alberto; Aitella, Ernesto; Barrasso, Mariluce; Maiorino, Maria Ida; Bizzarro, Elio; Bellastella, Antonio; Giugliano, Dario; Esposito, Katherine

    2017-10-01

    Women with autoimmune Addison's disease with normal ovulatory cycles but positive for steroid cell antibodies (StCA) have been considered at risk of premature ovarian insufficiency (POI). Thirty-three women younger than 40 years, with subclinical-clinical autoimmune Addison's disease but with normally ovulatory menses, were followed up for 10 years to evaluate the long-term time-related variations of StCA, ovarian function and follicular reserve. All patients and 27 control women were investigated at the start and every year for the presence and titre of StCA (by indirect immunofluorescence), serum concentrations of anti-Mullerian hormone (AMH) and ovarian function at four consecutive menses every year. At the start of the study StCA were present in 16 women (group 1), at low/middle titres (≤1:32) in seven of them (43.8%, group 1A), at high titres (>1:32) in the remaining nine patients (group 1B, 56.2%), while they were absent from 17 patients (group 2). During the follow-up period, all women in group 1A remained StCA-positive at low/middle titres with normal ovulatory menses and normal gonadotrophin and AMH levels, while all patients in group 1B showed a further increase of StCA titres (1:128-1:256) and progressed through three stages of ovarian function. None of the patients in group 2 and controls showed the appearance of StCA or ovarian dysfunction during the follow-up. The presence of StCA at high titres can be considered a good predictive marker of subsequent development of autoimmune POI. To single out the stages of autoimmune POI may allow a timely therapeutic choice in the subclinical and early clinical stages. © 2017 European Society of Endocrinology.

  9. Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

    Directory of Open Access Journals (Sweden)

    Pimentel Anita M

    2012-01-01

    Full Text Available Abstract Background Some techniques of transvaginal ovarian drilling have been previously described. Nevertheless a monopolar transvaginal ovarian cauterization, that use the expertise and safety of transvaginal puncture for oocyte captation seems to be an easier and feasible approach. The aim of this study was to develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control, and to evaluate the safety of the transvaginal ovarian monopolar cauterization, female sheep at reproductive age were used as an experimental model. Findings An experimental study was performed in a university research center. Seventeen female sheep (15 Corriedale e 2 Suffolk in reproductive age were submitted to transvaginal ovarian cauterization with a monopolar Valleylab Force 2 electrocautery. Macroscopic and microscopic lesions were assessed. Ovarian size were 1.31 cm2 ± 0,43 (Corriedale and 3.41 cm2 ± 0,64 (Suffolk. From 30 ovaries from Corriedale sheep punctured, only 3 were cauterized, presenting macroscopic and typical microscopic lesion. In the Suffolk sheep group, only one ovary was cauterized. No lesion could be found in the needle path. Conclusions This is the first experimental animal model described for ovarian cauterization needle guided by transvaginal ultrasound. The sheep does not seem to be the ideal animal model to study this technique. Another animal model, whose ovaries are better identified by transvaginal ultrasound should be sought for this technique, theoretically less invasive, before it could be offered safely to women with polycystic ovary syndrome.

  10. Shared genetics underlying epidemiological association between endometriosis and ovarian cancer

    DEFF Research Database (Denmark)

    Lu, Yi; Cuellar-Partida, Gabriel; Painter, Jodie N;

    2015-01-01

    Epidemiological studies have demonstrated associations between endometriosis and certain histotypes of ovarian cancer, including clear cell, low-grade serous and endometrioid carcinomas. We aimed to determine whether the observed associations might be due to shared genetic aetiology. To address...... this, we used two endometriosis datasets genotyped on common arrays with full-genome coverage (3194 cases and 7060 controls) and a large ovarian cancer dataset genotyped on the customized Illumina Infinium iSelect (iCOGS) arrays (10 065 cases and 21 663 controls). Previous work has suggested...... that a large number of genetic variants contribute to endometriosis and ovarian cancer (all histotypes combined) susceptibility. Here, using the iCOGS data, we confirmed polygenic architecture for most histotypes of ovarian cancer. This led us to evaluate if the polygenic effects are shared across diseases. We...

  11. Ovarian Volume in Turkish Women with Normal and Polycystic Ovaries

    Directory of Open Access Journals (Sweden)

    Cem Celik

    2013-10-01

    Full Text Available Aim: We aimed to investigate possibility of different ovarian volume threshold and to study diagnostic thresholds for polycystic ovary in Turkish women, since the literature on this subject is very limited. Material and Method: Clinical study carried out Namik Kemal University School of Medicine, Tekirdag, Turkey.This case-control study included 132 patients with polycystic ovary syndrome (PCOS, diagnosed according to Rotterdam criteria and 75 controls. Comparison of ovarian volumes between PCOS patients and control group. Results: We found a mean ovarian volume of 9.44 ± 4.3 cm3 in PCOS cases and 7.63 ± 3.66 cm3 in control cases. The area under curve (AUC for mean ovarian volume (MOV was 0.633. The analysis showed that setting the threshold of MOV at 8.2 cm3 offered the best compromise between specificity (61.3% and sensitivity (53.8%. Discussion: Optimum threshold of ovarian volume to distinguish the PCOS from normal women and the mean ovarian volume in Turkish PCOS patients remain beneath the criteria by Rotterdam.

  12. Managing hereditary ovarian cancer

    NARCIS (Netherlands)

    Mourits, M. J.; de Bock, G. H.

    2009-01-01

    In this review we present an overview of recent developments in the management of hereditary ovarian cancer. Until recently, intensive screening of the ovaries was recommended to mutation carriers and their first-degree female relatives. However, since screening is not effective in detecting early-s

  13. [Ovarian vein syndrome].

    Science.gov (United States)

    Ferrero Doria, R; Guzmán Valls, P; López Alba, J; Tomás Ros, M; Rico Galiano, J L; Fontana Compiano, L O

    1996-04-01

    The Ovarian Vein Syndrome has been the subject of controversy ever since first described as such by Clark in 1964. This is an uncommon entity within urologic sings and symptoms which appears as a recurrent nephritic colic coinciding with menstruation or during the immediately preceding days. The authors review a clinical case from our Urology Service, including some considerations on the case.

  14. Ovarian Cancer FAQ

    Science.gov (United States)

    ... Gyn): A physician with special skills, training, and education in women’s health. Ovarian Cancer: Cancer that affects one or both of the ovaries. Ovaries: The paired organs in the female reproductive system that contain the eggs released at ovulation ...

  15. Pattern of thyroid function during early pregnancy in women diagnosed with subclinical hypothyroidism and treated with l-thyroxine is similar to that in euthyroid controls.

    Science.gov (United States)

    De Geyter, Christian; Steimann, Sabine; Müller, Beat; Kränzlin, Marius E; Meier, Christian

    2009-01-01

    Subclinical hypothyroidism (SCH) is associated with a higher miscarriage rate. It is unclear how the thyroid function in SCH differs from that in euthyroidism during early pregnancy. We intended to determine the regulation of thyroid function in women with SCH receiving constant l-thyroxine (T4) replacement during early pregnancy as compared to euthyroid controls. This was a prospective cohort study with weekly serum sampling in eight women in early pregnancy with SCH and eight euthyroid women from week 5 to week 12 of pregnancy. Thyroid function was assessed before pregnancy. Women with SCH were treated with T4 (50 microg daily) and continued on an unchanged dose until week 12. The following parameters were measured weekly: thyrotropin (TSH), thyroglobulin, thyroxine, triiodothyronine, free thyroxine (FT4), free triiodothyronine (FT3), estradiol, progesterone, human chorionic gonadotropin, and prolactin. Although the pregestational levels of TSH were significantly higher among women with SCH as compared to euthyroid controls, the self-limited estrogen-induced increment of TSH during early pregnancy was similar in both groups. Although both SCH and ovarian hyperstimulation were associated with an intermediate rise in TSH, the pattern of thyroid function followed similar changes as in euthyroid controls and is unlikely to cause the higher miscarriage rate observed in SCH.

  16. Epithelial ovarian cancer: testing the 'androgens hypothesis'.

    Science.gov (United States)

    Olsen, Catherine M; Green, Adèle C; Nagle, Christina M; Jordan, Susan J; Whiteman, David C; Bain, Christopher J; Webb, Penelope M

    2008-12-01

    In 1998, Risch proposed a hypothesis for the pathogenesis of ovarian cancer relating to the role of androgens in stimulating epithelial cell proliferation. Although this hypothesis has been widely discussed, direct evidence to support it is scant. To address this issue, we have conducted a detailed analysis of factors possibly associated with high circulating levels of androgens, including polycystic ovary syndrome (PCOS), hirsutism and acne (all clinically associated with hyperandrogenism) using the data collected in an Australia-wide, population-based case-control study. Cases aged 18-79 years with a new diagnosis of invasive epithelial ovarian cancer (n=1276) or borderline malignant tumour (n=315) were identified through a network of clinics and cancer registries throughout Australia. Controls (n=1508) were selected from the National Electoral Roll. Women self-reported a history of PCOS, acne, hirsutism and also use of testosterone supplements or the androgenic medication Danazol. We found no evidence that a history of PCOS, acne or hirsutism was associated with ovarian cancer overall, or with specific subtypes, with the exception of serous borderline tumours that were positively associated with a history of PCOS (OR 2.6; 95% CI 1.0-6.1). Women who had ever used testosterone supplements had an increased risk of ovarian cancer (OR 3.7; 95% CI 1.1-12.0); however, use of the androgenic medication Danazol did not increase risk (OR 1.0; 95% CI 0.4-2.9). Overall, our results do not support the hypothesis that androgen-related disorders increase the risk of ovarian cancer.

  17. What Will Happen After Treatment for Ovarian Cancer?

    Science.gov (United States)

    ... After Treatment What Will Happen After Treatment for Ovarian Cancer? For some people with ovarian cancer, treatment may ... If Ovarian Cancer Treatment Stops Working More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  18. Targeting Midbodies in Ovarian Cancer Stem Cells as a Therapeutic Strategy

    Science.gov (United States)

    2013-10-01

    can be retained, accumulated and increased with tumor grade . The long-term goal of this project is to identify putative MB-containing ovarian cancer...increase with increasing ovarian tumor grade . During these analyses, we unexpectedly discovered that a large number of canonical ovarian oncogenes...software was used for equipment control, image acquisition, and image analysis. Tracking Vesicle Movement GFP-FIP3 particles were semiautomatically

  19. Serum tetranectin is a significant prognostic marker in ovarian cancer patients

    DEFF Research Database (Denmark)

    Begum, Farah Diba; Høgdall, Estrid; Christensen, Ib Jarle

    2010-01-01

    To evaluate the prognostic value of preoperative serum tetranectin (TN) in Danish ovarian cancer (OvCa) patients. Design. Population-based, multidisciplinary Danish case-control study of OvCa.......To evaluate the prognostic value of preoperative serum tetranectin (TN) in Danish ovarian cancer (OvCa) patients. Design. Population-based, multidisciplinary Danish case-control study of OvCa....

  20. Comparison of the effects of human and chicken ghrelin on chicken ovarian hormone release.

    Science.gov (United States)

    Sirotkin, Alexander V; Harrath, Abdel Halim; Grossmann, Roland

    2016-11-01

    The aim of the present experiments was to examine the species-specific and cell-specific effects of ghrelin on chicken ovarian hormone release. For this purpose, we compared the effects of chicken and human ghrelin on the release of estradiol (E), testosterone (T), progesterone (P) and arginine-vasotocin (AVT) by cultured fragments of chicken ovarian follicles and on the release of T and AVT by cultured ovarian granulosa cells. In cultured chicken ovarian fragments, both human and chicken ghrelin promoted E release. T output was stimulated by chicken ghrelin but not by human ghrelin. No effect of either human or chicken ghrelin on P release was observed. Human ghrelin promoted but chicken ghrelin suppressed AVT release by chicken ovarian fragments. In cultured ovarian granulosa cells, human ghrelin inhibited while chicken ghrelin stimulated T release. Both human and chicken ghrelin suppressed AVT output by chicken granulosa cells. These data confirm the involvement of ghrelin in the control of ovarian secretory activity and demonstrate that the effect of ghrelin is species-specific. The similarity of avian ghrelin on avian ovarian granulosa cells and ovarian fragments (containing both granulosa and theca cells) suggests that ghrelin can influence chicken ovarian hormones primarily by acting on granulosa cells.

  1. Genetic analysis of the early natural history of epithelial ovarian carcinoma.

    Directory of Open Access Journals (Sweden)

    Bhavana Pothuri

    Full Text Available BACKGROUND: The high mortality rate associated with epithelial ovarian carcinoma (EOC reflects diagnosis commonly at an advanced stage, but improved early detection is hindered by uncertainty as to the histologic origin and early natural history of this malignancy. METHODOLOGY/PRINCIPAL FINDINGS: Here we report combined molecular genetic and morphologic analyses of normal human ovarian tissues and early stage cancers, from both BRCA mutation carriers and the general population, indicating that EOCs frequently arise from dysplastic precursor lesions within epithelial inclusion cysts. In pathologically normal ovaries, molecular evidence of oncogenic stress was observed specifically within epithelial inclusion cysts. To further explore potential very early events in ovarian tumorigenesis, ovarian tissues from women not known to be at high risk for ovarian cancer were subjected to laser catapult microdissection and gene expression profiling. These studies revealed a quasi-neoplastic expression signature in benign ovarian cystic inclusion epithelium compared to surface epithelium, specifically with respect to genes affecting signal transduction, cell cycle control, and mitotic spindle formation. Consistent with this gene expression profile, a significantly higher cell proliferation index (increased cell proliferation and decreased apoptosis was observed in histopathologically normal ovarian cystic compared to surface epithelium. Furthermore, aneuploidy was frequently identified in normal ovarian cystic epithelium but not in surface epithelium. CONCLUSIONS/SIGNIFICANCE: Together, these data indicate that EOC frequently arises in ovarian cystic inclusions, is preceded by an identifiable dysplastic precursor lesion, and that increased cell proliferation, decreased apoptosis, and aneuploidy are likely to represent very early aberrations in ovarian tumorigenesis.

  2. Ovarian fluid allows directional cryptic female choice despite external fertilization.

    Science.gov (United States)

    Alonzo, Suzanne H; Stiver, Kelly A; Marsh-Rollo, Susan E

    2016-08-16

    In species with internal fertilization, females can favour certain males over others, not only before mating but also within the female's reproductive tract after mating. Here, we ask whether such directional post-mating (that is, cryptic) female mate choice can also occur in species with external fertilization. Using an in vitro sperm competition experiment, we demonstrate that female ovarian fluid (ovarian fluid) changes the outcome of sperm competition by decreasing the importance of sperm number thereby increasing the relative importance of sperm velocity. We further show that ovarian fluid does not differentially affect sperm from alternative male phenotypes, but generally enhances sperm velocity, motility, straightness and chemoattraction. Under natural conditions, female ovarian fluid likely increases the paternity of the preferred parental male phenotype, as these males release fewer but faster sperm. These results imply females have greater control over fertilization and potential to exert selection on males in species with external fertilization than previously thought possible.

  3. Association of vitamin D levels and risk of ovarian cancer

    DEFF Research Database (Denmark)

    Ong, Jue-Sheng; Cuellar-Partida, Gabriel; Lu, Yi

    2016-01-01

    BACKGROUND: In vitro and observational epidemiological studies suggest that vitamin D may play a role in cancer prevention. However, the relationship between vitamin D and ovarian cancer is uncertain, with observational studies generating conflicting findings. A potential limitation.......19, 2.01). CONCLUSIONS: Genetically lowered 25-hydroxyvitamin D concentrations were associated with higher ovarian cancer susceptibility in Europeans. These findings suggest that increasing plasma vitamin D levels may reduce risk of ovarian cancer....... of observational studies is inadequate control of confounding. To overcome this problem, we used Mendelian randomization (MR) to evaluate the association between single nucleotide polymorphisms (SNPs) associated with circulating 25-hydroxyvitamin D [25(OH)D] concentration and risk of ovarian cancer. METHODS: We...

  4. Antiangiogenic therapies in ovarian cancer

    OpenAIRE

    Reinthaller, Alexander

    2016-01-01

    Summary Angiogenesis plays a pivotal role in normal ovarian physiology as well as in the formation and progression of ovarian cancer. Several well-designed phase II and III trials studied the efficacy of antiangiogenic agents in advanced ovarian cancer. The results of these trials demonstrated significantly prolonged progression-free survival when antiangiogenic agents were used as a maintenance therapy. To date, no effect on overall survival could be ascertained. The most widely studied anti...

  5. Ovarian pregnancy: an unusual presentation

    Directory of Open Access Journals (Sweden)

    Ayesha Arif Hussain

    2016-08-01

    Full Text Available Ovarian pregnancy is a rare type of ectopic pregnancy and usually, it ends with rupture before the end of the first trimester. The clinical picture generally mimics that of ruptured tubal ectopic pregnancy and hemorrhagic ovarian cyst. Transvaginal sonography may be helpful. We report a rare primary ruptured ovarian pregnancy in a 23 years lady. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2888-2890

  6. FAU regulates carboplatin resistance in ovarian cancer.

    Science.gov (United States)

    Moss, Esther L; Mourtada-Maarabouni, Mirna; Pickard, Mark R; Redman, Charles W; Williams, Gwyn T

    2010-01-01

    The development of chemotherapy resistance by cancer cells is complex, using different mechanisms and pathways. The gene FAU (Finkel-Biskis-Reilly murine sarcoma virus (FBR-MuSV)-associated ubiquitously expressed gene) was identified through functional expression cloning and previous data have shown that overexpression enhances apoptosis in several cell types. We demonstrate that the expression of FAU was reduced in the A2780cis (cisplatin resistant subclone of A2780) cell line compared with the A2780 ovarian cancer cell line, and was directly related to the cell line's sensitivity to carboplatin. Downregulation of FAU in the A2780 cell line by transfection with two predesigned short-interfering RNAs (siRNAs) to FAU resulted in a significant increase in resistance to carboplatin-induced cell death. Downregulation resulted in increased cell viability and reduced apoptosis after 72 hr of drug treatment compared with the negative controls (Kruskal-Wallis P = 0.0002). Transfection of the A2780cis cell line with the pcDNA3 plasmid containing FAU was associated with increased sensitivity to carboplatin-induced apoptosis, with decreased cell viability and increased apoptosis (Mann Whitney P FAU was examined by quantitative real-time reverse transcriptase polymerase chain reaction in normal and malignant ovarian tissue. A significant reduction in the expression of FAU was seen in the malignant compared with normal ovarian samples (Kruskal-Wallis P = 0.0261). These data support a role for FAU in the regulation of platinum-resistance in ovarian cancer. Further research is needed into the apoptotic pathway containing FAU to investigate the potential for targeted therapies to increase or restore the platinum sensitivity of ovarian cancer.

  7. Poor ovarian reserve

    Directory of Open Access Journals (Sweden)

    Padma Rekha Jirge

    2016-01-01

    Full Text Available Poor ovarian reserve (POR is an important limiting factor for the success of any treatment modality for infertility. It indicates a reduction in quantity and quality of oocytes in women of reproductive age group. It may be age related as seen in advanced years of reproductive life or may occur in young women due to diverse etiological factors. Evaluating ovarian reserve and individualizing the therapeutic strategies are very important for optimizing the success rate. Majority or women with POR need to undergo in vitro fertilization to achieve pregnancy. However, pregnancy rate remains low despite a plethora of interventions and is associated with high pregnancy loss. Early detection and active management are essential to minimize the need for egg donation in these women.

  8. Ovarian Fibrosis: A Phenomenon of Concern

    Science.gov (United States)

    Zhou, Feng; Shi, Li-Bing; Zhang, Song-Ying

    2017-01-01

    Objective: Ovarian fibrosis is characterized by excessive proliferation of ovarian fibroblasts and deposition of extracellular matrix (ECM) and it is one of the principal reasons for ovarian dysfunction. This review aimed to investigate the pathogenetic mechanism of ovarian fibrosis and to clarify the relationship between ovarian diseases and fibrosis. Data Sources: We searched PubMed for English language articles published up to November 2016. The search terms included ovarian fibrosis OR fibrosis, ovarian chocolate cyst OR ovarian endometrioma, polycystic ovarian syndrome (PCOS), premature ovarian failure, ECM, matrix metalloproteinases (MMPs), tissue inhibitors of matrix metalloproteinases (TIMPs), transforming growth factor-beta 1 (TGF-β1), connective tissue growth factor (CTGF), peroxisome proliferator-activated receptor gamma (PPAR-γ), vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), and combinations of these terms. Study Selection: Articles were obtained and reviewed to analyze the pathogenic mechanism of ovarian fibrosis and related ovarian diseases. Results: Many cytokines, such as MMPs, TIMPs, TGF-β1, CTGF, PPAR-γ, VEGF, and ET-1, are involved in ovarian fibrogenesis. Ovarian fibrogenesis is associated with various ovarian diseases, including ovarian chocolate cyst, PCOS, and premature ovarian failure. One finding of particular interest is that fibrogenesis in peripheral tissues around an ovarian chocolate cyst commonly causes ovarian function diminution, and therefore, this medical problem should arouse widespread concern in clinicians worldwide. Conclusions: Patients with ovarian fibrosis are susceptible to infertility and tend to have decreased responses to assisted fertility treatment. Thus, protection of ovarian function should be a priority for women who wish to reproduce when making therapeutic decisions about ovarian fibrosis-related diseases. PMID:28139522

  9. The ameliorative effect of propolis against methoxychlor induced ovarian toxicity in rat.

    Science.gov (United States)

    El-Sharkawy, Eman E; Kames, Amany O G; Sayed, S M; Nisr, Neveen A E L; Wahba, Nahed M; Elsherif, Walaa M; Nafady, Allam M; Abdel-Hafeez, M M; Aamer, A A

    2014-12-01

    A study was designed to evaluate ameliorative effect of propolis against methoxychlor (MXC) induced ovarian toxicity in rat. The organochlorine pesticide (MXC) is a known endocrine disruptor with estrogenic, anti-estrogenic, and anti-androgenic properties. To investigate whether chronic exposure to MXC could cause ovarian dysfunction, two groups of Sprague-Dawley adult female rats were exposed to MXC alone in a dose of 200mg/kg, twice/weekly, orally or MXC dose as previous plus propolis in a dose of 200mg/l/day, in drinking water for 10 months. Another two groups of rat were given corn oil (control) or propolis. Multiple reproductive parameters, ovarian weight, serum hormone levels, ovarian oxidative status and ovarian morphology were examined. In MXC-exposed group, there is a significant decrease in body and ovarian weight vs. control. MXC decreases serum estradiol and progesterone levels. A significant increase in the levels of lipid peroxidation was obtained while a significant decrease of the total antioxidant was recorded. Ovarian histopathology showed primary, secondary and vesicular follicles displaying an atretic morphology. Increase in the ovarian surface epithelium height accompanied with vacuolated, pyknotic oocytes were obtained. The previous toxic effects were neutralized by the administration of propolis in MXC+propolis group. The present results suggest that propolis may be effective in decreasing of MXC-induced ovarian toxicity in rat.

  10. ASSOCIATION BETWEEN OVARIAN CANCER RISK AND CONTRACEPTIVE METHODS- AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Bessy Binu Sam

    2017-03-01

    Full Text Available BACKGROUND Ovarian cancer is the most lethal malignancy of the female reproductive system. Risk of ovarian cancer increases with age, but the rate of increase slows after the menopause. Use of contraceptives confers long-term protection against ovarian cancer. This observational study examines the correlation between ovarian cancer risks with different contraceptive methods. MATERIALS AND METHODS This study was conducted at Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, for a period of one year. Information was collected from 112 women diagnosed with ovarian cancer as treatment group and 336 women without ovarian cancer as control group. The Chi-square test was done to find the association of ovarian cancer risk with different contraceptive methods. RESULTS In the sample of 112 women with ovarian cancer, 53.6% women were using any of the contraceptive methods, whereas in the control group, only 5.1% women were using contraceptive methods. Our study found out a significant association of ovarian cancer risk with oral contraceptives and tubal ligation. There was no significant association of ovarian cancer risk with IUCD, sheath and vasectomy. CONCLUSION Tubal ligation and oral contraceptives reduce the risk of ovarian cancer. The dual benefits of tubal ligation need to be made aware among the public and tubal sterilisation rates have to be enhanced. Oral contraceptive pill use has to be propagated as a temporary contraceptive method due to its added advantage. We recommend future research on the association of ovarian cancer risk and contraceptive methods using large samples comparable to those done in developed countries.

  11. Clinical significance of plasma lysophosphatidic acid levels in the differential diagnosis of ovarian cancer

    Directory of Open Access Journals (Sweden)

    Yun-Jie Zhang

    2015-01-01

    Full Text Available Objective: To investigate the value of lysophosphatidic acid (LPA in the diagnosis of ovarian cancer. Materials and Methods: We first performed a hospital-based, case-control study involving 123 ovarian cancer patients and 101 benign ovarian tumor patients, and then conducted a meta-analysis with 19 case-control studies to assess the correlation between ovarian cancer and plasma LPA levels. Results: The case-control study results demonstrated that ovarian cancer patients have increased LPA and cancer antigen (CA-125 levels compared to patients with benign ovarian tumor (LPA: Ovarian cancer vs benign ovarian tumor: 5.28 ± 1.52 vs 1.82 ± 0.77 μmol/L; CA-125: Ovarian cancer vs benign ovarian tumor: 87.17 ± 45.81 vs. 14.03 ± 10.14 U/mL, which showed statistically significant differences (both P < 0.05. LPA with advanced sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of diagnosis excelled CA-125 in the diagnosis of ovarian cancer (both P < 0.05. The areas under the receiver operating characteristic (ROC curve in the diagnosis of ovarian cancer (LPA: 0.983; CA-125: 0.910 were statistically significant compared with the reference (both P < 0.001 and the difference of the areas of ROC curve between LPA and CA-125 in the diagnosis of ovarian cancer showed statistically significant difference (P < 0.05. The meta-analysis results suggested that plasma LPA levels were higher in ovarian cancer tissues than in benign tissues (standardized mean difference (SMD =2.36, 95% confidence interval (CI: 1.61-3.11, P < 0.001 and normal tissues (SMD = 2.32, 95% CI: 1.77-2.87, P < 0.001. Conclusion: LPA shows greater value in the diagnosis of ovarian cancer compared to CA-125 and may be employed as a biological index to diagnose ovarian cancer.

  12. A randomized controlled dose-response pilot study of addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization

    DEFF Research Database (Denmark)

    Loft, A; Egeberg, Anne Noes; Smitz, J;

    2012-01-01

    Is it possible to define an optimal dose of hCG in combination with rFSH from the first day of stimulation in the GnRH agonist protocol applied to IVF? SUMMARY ANSWER: Supplementation with hCG from the first day of stimulation may increase the number of top-quality embryos per patient. Daily doses...... of hCG up to 150 IU are compatible with good live birth rates. A ceiling level of estradiol (E(2)) was reached with hCG doses above 100 IU/day. A positive dose-response was seen for pre-ovulatory progesterone, but concentrations remained below values for which an impairment of endometrial receptivity...... has been previously reported. We suggest a large clinical trial to be proceeded with a group given 100 IU hCG daily versus a control group. WHAT IS KNOWN AND WHAT THIS PAPER ADDS: Prospective multicentre studies have indicated increased live birth rates and increased number of top-quality embryos when...

  13. TP53 and ovarian cancer

    NARCIS (Netherlands)

    M. Schuijer (Monique); P.M.J.J. Berns (Els)

    2003-01-01

    textabstractOvarian cancer represents the fourth most frequent type of cancer among females and is the leading cause of death from gynecological cancer in the western world. This review describes gene alterations in ovarian cancer. Specific emphasis is placed on genetic alterations and the prevalenc

  14. Imunotherapy opportunities in ovarian cancer

    Directory of Open Access Journals (Sweden)

    I. Zh. Shubina

    2013-01-01

    Full Text Available In the last decade, accumulated evidence in favor of that ovarian cancer is an immunogenic tumor. Immunotherapy is aimed at stimulating the innate and adaptive immunity, may cause an effective response in patients with ovarian cancer. Various approaches immunotherapy include cytokinetherapy, use of monoclonal antibodies and cell therapy.

  15. A randomized controlled dose-response pilot study of addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization.

    Science.gov (United States)

    Thuesen, L L; Loft, A; Egeberg, A N; Smitz, J; Petersen, J H; Andersen, A Nyboe

    2012-10-01

    Is it possible to define an optimal dose of hCG in combination with rFSH from the first day of stimulation in the GnRH agonist protocol applied to IVF? Supplementation with hCG from the first day of stimulation may increase the number of top-quality embryos per patient. Daily doses of hCG up to 150 IU are compatible with good live birth rates. A ceiling level of estradiol (E(2)) was reached with hCG doses above 100 IU/day. A positive dose-response was seen for pre-ovulatory progesterone, but concentrations remained below values for which an impairment of endometrial receptivity has been previously reported. We suggest a large clinical trial to be proceeded with a group given 100 IU hCG daily versus a control group. Prospective multicentre studies have indicated increased live birth rates and increased number of top-quality embryos when low doses of hCG were associated with FSH. We analysed the clinical, embryological and endocrine aspects of adding increasing doses of hCG to rFSH from the first day of stimulation for IVF. A prospective randomized, controlled, open-label dose-response pilot study was conducted between February 2009 and June 2010 at Copenhagen University Hospital, Rigshospitalet, Denmark. Adequate allocation concealment was assured from sequentially numbered, opaque, sealed envelopes prepared from a computer-generated list. Scoring of the embryos was done in an assessor-blinded way. Endocrinologically normal IVF patients aged 25-37 years, BMI 18-30 kg/m(2), regular cycles and FSH D100; n= 16) and Dose 150 (D150; n= 15). Two patients in D150 were withdrawn after randomization because of major (10- to 30-fold) hCG dosing errors, leaving 13 patients in this group. Thus, the results are based on the per protocol population. The mean numbers of top-quality embryos per patient were D0: 0.8 ± 1.2, D50: 0.5 ± 0.7, D100: 1.2 ± 1.7 and D150: 1.5 ± 1.7 (P= 0.04). All pregnancies were singleton gestations, and the live birth rates per started cycle were D0

  16. Dietary supplementation of yucca (Yucca schidigera) affects ovine ovarian functions.

    Science.gov (United States)

    Vlčková, Radoslava; Sopková, Drahomíra; Andrejčáková, Zuzana; Valocký, Igor; Kádasi, Attila; Harrath, Abdel Halim; Petrilla, Vladimír; Sirotkin, Alexander V

    2017-01-15

    Yucca (Yucca schidigera) is a popular medicinal plant due to its many positive effects on animal and human physiology, including their reproductive systems. To examine the effect of supplemental yucca feeding on sheep reproduction, including ovarian functions and their hormonal regulators, ewes were fed (or not fed, control) yucca powder (1.5 g/head/day, 30 days). Macromorphometric indexes of the oviduct, ovary, and ovarian folliculogenesis were measured. Reproductive hormone levels in the blood were measured using a radioimmunoassay. Granulosa cells were aspirated from the ovary, and their proliferation and apoptosis were detected using immunocytochemistry. To assess secretory activity and its response to gonadotropin, ovarian fragments of treated and control ewes were cultured with and without follicle-stimulating hormone (FSH; 0, 0.1, 1, 10, or 100 IU/mL), and the release of reproductive hormones into the culture medium was evaluated. Finally, to examine the direct action of yucca on the ovary, ovarian fragments from control ewes were cultured with and without yucca extract (1, 10, or 100 μg/mL), and the release of reproductive hormones was measured. Yucca supplementation significantly decreased the size of small antral follicles (2 to yucca supplementation did not affect the size of larger follicles and number of follicles, volume and weight of ovaries, length and weight of oviducts, caspase 3 accumulation, cell proliferation, testosterone (T) or IGF-I serum levels, or T or E2 release by cultured ovarian fragments and their response to FSH. Yucca addition to culture medium inhibited P4 and IGF-I, but not T or E2 release at the lowest (1 μg/mL) dose, and stimulated P4, but not T, E2, or IGF-I release at the highest (100 μg/mL) dose. These data suggest that yucca supplementation can reduce small antral ovarian follicle development possibly via the stimulation of apoptosis of their granulosa cells, suppression of ovarian P4 and E2 release, and

  17. Morphokinetic Characteristics and Developmental Potential of In Vitro Cultured Embryos from Natural Cycles in Patients with Poor Ovarian Response

    Directory of Open Access Journals (Sweden)

    N. Hojnik

    2016-01-01

    Full Text Available Background. Patients with poor ovarian response to ovarian hyperstimulation represent an interesting group for studying the impact of embryo cleavage irregularities on clinical outcome since all embryos, regardless of their quality, are usually transferred to the uterus. The aim of our study was to follow the morphokinetics of fertilized oocytes from natural cycles in poor responders. Methods. Zygotes from 53 cycles were cultured in vitro for 3 days. The morphokinetics of their development and transfer outcomes were retrospectively analyzed for the normally and irregularly cleaved embryos. Results. Of all embryos, 30.2% had single and 20.8% multiple cleavage irregularities with the following prevalence: developmental arrest 30.2%, direct cleavage to more than two cells 24.5%, chaotic cleavage 13.2%, and reverse cleavage 11.3%. These embryos had longer pronuclear phases, first cytokinesis, second embryo cell cycles, and less synchronized divisions. The transfer of normally developing embryos resulted in an implantation rate of 30.8% and a delivery rate of 23.1%, but irregularly cleaved embryos did not implant. Conclusions. The use of time-lapse microscopy in poor responder patients identified embryos with cleavage abnormalities that are related with no or extremely low implantation potential. Gained information about embryo quality is important for counselling patients about their expectations.

  18. Hormone therapy and ovarian cancer

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Løkkegaard, Ellen; Andreasen, Anne Helms

    2009-01-01

    CONTEXT: Studies have suggested an increased risk of ovarian cancer among women taking postmenopausal hormone therapy. Data are sparse on the differential effects of formulations, regimens, and routes of administration. OBJECTIVE: To assess risk of ovarian cancer in perimenopausal...... of Medicinal Product Statistics provided individually updated exposure information. The National Cancer Register and Pathology Register provided ovarian cancer incidence data. Information on confounding factors and effect modifiers was from other national registers. Poisson regression analyses with 5-year age...... bands included hormone exposures as time-dependent covariates. PARTICIPANTS: A total of 909,946 women without hormone-sensitive cancer or bilateral oophorectomy. MAIN OUTCOME MEASURE: Ovarian cancer. RESULTS: In an average of 8.0 years of follow-up (7.3 million women-years), 3068 incident ovarian...

  19. Risk Prediction for Epithelial Ovarian Cancer in 11 United States-Based Case-Control Studies: Incorporation of Epidemiologic Risk Factors and 17 Confirmed Genetic Loci.

    Science.gov (United States)

    Clyde, Merlise A; Palmieri Weber, Rachel; Iversen, Edwin S; Poole, Elizabeth M; Doherty, Jennifer A; Goodman, Marc T; Ness, Roberta B; Risch, Harvey A; Rossing, Mary Anne; Terry, Kathryn L; Wentzensen, Nicolas; Whittemore, Alice S; Anton-Culver, Hoda; Bandera, Elisa V; Berchuck, Andrew; Carney, Michael E; Cramer, Daniel W; Cunningham, Julie M; Cushing-Haugen, Kara L; Edwards, Robert P; Fridley, Brooke L; Goode, Ellen L; Lurie, Galina; McGuire, Valerie; Modugno, Francesmary; Moysich, Kirsten B; Olson, Sara H; Pearce, Celeste Leigh; Pike, Malcolm C; Rothstein, Joseph H; Sellers, Thomas A; Sieh, Weiva; Stram, Daniel; Thompson, Pamela J; Vierkant, Robert A; Wicklund, Kristine G; Wu, Anna H; Ziogas, Argyrios; Tworoger, Shelley S; Schildkraut, Joellen M

    2016-10-15

    Previously developed models for predicting absolute risk of invasive epithelial ovarian cancer have included a limited number of risk factors and have had low discriminatory power (area under the receiver operating characteristic curve (AUC) best predictive power was obtained in the full model among women younger than 50 years of age (AUC = 0.714); however, the addition of SNPs increased the AUC the most for women older than 50 years of age (AUC = 0.638 vs. 0.616). Adapting this improved model to estimate absolute risk and evaluating it in prospective data sets is warranted. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. The Brain as a Target for Environmental Toxicants that alter Ovarian Function.

    Science.gov (United States)

    In this review we discuss the ovarian cycle of the laboratory rat in order to familiarize the reader with the well-understood timing of the neuroendocrine events controlling ovarian function. This is followed by a discussion of the location and function of the estrogen and proges...

  1. Ovarian cysts in users of Implanon and Jadelle subdermal contraceptive implants.

    Science.gov (United States)

    Hidalgo, Maria Margarete; Lisondo, Claudio; Juliato, Cássia Teatin; Espejo-Arce, Ximena; Monteiro, Ilza; Bahamondes, Luis

    2006-05-01

    To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC). A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon), the levonorgestrel-releasing implant (Jadelle) or the TCu380A IUC. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3-, 6- and 12-month visits of asymptomatic women. Women with ovarian cysts (or enlarged ovarian follicles > or = 25 mm) were assessed weekly until disappearance or reduction of the image [including estradiol (E2) and progesterone (P) measurement], and women with no ovarian enlargement underwent the same evaluation for the same period of time. Ovarian cysts were detected in 5.2%, 13.0% and 1.9% of users of Implanon, Jadelle and IUC, respectively, at 3 months. At 6 months of use, prevalence was 7.2%, 8.0% and 2.1%, whereas 12-month rates were 26.7%, 14.6% and 1.2% in the three groups, respectively. E2 levels were significantly higher among users with ovarian cysts than controls. The time until disappearance of the ovarian cyst was similar in all three groups. There were more cases of menorrhagia in users of implants who had ovarian cysts than in those with no ovarian enlargement. The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.

  2. Conditional Deletion of the Retinoblastoma (Rb) Gene in Ovarian Granulosa Cells Leads to Premature Ovarian Failure

    Science.gov (United States)

    Andreu-Vieyra, Claudia; Chen, Ruihong; Matzuk, Martin M.

    2008-01-01

    The retinoblastoma protein (RB) regulates cell proliferation and survival by binding to the E2F family of transcription factors. Recent studies suggest that RB also regulates differentiation in a variety of cell types, including myocytes, neurons, adipocytes, and chondrocytes. Rb mutations have been found in ovarian cancer; however, the role of RB in normal and abnormal ovarian function remains unclear. To test the hypothesis that loss of Rb induces ovarian tumorigenesis, we generated an ovarian granulosa cell conditional knockout of Rb (Rb cKO) using the Cre/lox recombination system. Rb cKO females showed 100% survival and no ovarian tumor formation through 9 months of age, but they developed progressive infertility. Prepubertal Rb cKO females showed increased ovulation rates compared with controls, correlating with increased follicle recruitment, higher Fshr and Kitl mRNA levels, and lower anti-Müllerian hormone levels. In contrast, the ovulation rate of 6-wk-old females was similar to that of controls. Morphometric analysis of Rb cKO ovaries from 6-wk-old and older females showed increased follicular atresia and apoptosis. Rb cKO ovaries and preantral follicles had abnormal levels of known direct and indirect target genes of RB, including Rbl2/p130, E2f1, Ccne2, Myc, Fos, and Tgfb2. In addition, preantral follicles showed increased expression of the granulosa cell differentiation marker Inha, decreased levels of Foxl2 and Cyp19a1 aromatase, and abnormal expression of the nuclear receptors Nr5a1, Nr5a2, and Nr0b1. Taken together, our results suggest that RB is required for the temporal-specific pattern of expression of key genes involved in follicular development. PMID:18599617

  3. Subtypes of Ovarian Cancer and Ovarian Cancer Screening

    Science.gov (United States)

    Koshiyama, Masafumi; Matsumura, Noriomi; Konishi, Ikuo

    2017-01-01

    Ovarian cancer is the foremost cause of gynecological cancer death in the developed world, as it is usually diagnosed at an advanced stage. In this paper we discuss current issues, the efficacy and problems associated with ovarian cancer screening, and compare the characteristics of ovarian cancer subtypes. There are two types of ovarian cancer: Type I carcinomas, which are slow-growing, indolent neoplasms thought to arise from a precursor lesion, which are relatively common in Asia; and Type II carcinomas, which are clinically aggressive neoplasms that can develop de novo from serous tubal intraepithelial carcinomas (STIC) and/or ovarian surface epithelium and are common in Europe and the USA. One of the most famous studies on the subject reported that annual screening using CA125/transvaginal sonography (TVS) did not reduce the ovarian cancer mortality rate in the USA. In contrast, a recent study in the UK showed an overall average mortality reduction of 20% in the screening group. Another two studies further reported that the screening was associated with decreased stage at detection. Theoretically, annual screening using CA125/TVS could easily detect precursor lesions and could be more effective in Asia than in Europe and the USA. The detection of Type II ovarian carcinoma at an early stage remains an unresolved issue. The resolving power of CA125 or TVS screening alone is unlikely to be successful at resolving STICs. Biomarkers for the early detection of Type II carcinomas such as STICs need to be developed. PMID:28257098

  4. Total ovulating period: any contribution to ovarian carcinogenesis?

    Science.gov (United States)

    Odukogbe, A A; Adebamowo, C A; Adeniji, A O; Omigbodun, A O; Olayemi, O; Oladokun, A; Owolabi, M S; Aimakhu, C; Adewole, I F; Owoaje, E

    2005-09-01

    The etiology of ovarian cancer has many postulates including that of incessant ovulation. Women of high parity especially those that breastfeed in addition are supposed to be protected. Ovarian cancer patients in the developing world are of higher parity than their Caucasian counterparts. Our study compared the length of reproductive career (LRC), the physiological ovulation free period (PFP) and the total ovulating period (TOP) amongst histologically proven ovarian cancer patients and age - matched controls. This is a questionnaire survey of 21 ovarian cancer patients managed by us between 1st December 1998 and 31st July 2002 and 42 gynaecological patients not known to have ovarian cancer. The mean age among the patients was 45.7+16.9 years while among the controls it was 45.4 +/- 16.1 years. The mean parity of the patients was 3.6 +/- 2.2 compared to 3.4 +/- 2.9 in the controls. The patients had a mean LRC of 23.8 +/- 11.2 years while in the controls it was 25.7+10.8 years. The mean PFP of the patients was 7.4 +/- 5.6 years and for the controls 7.1 +/- 6.5 years. The patients had a mean TOP of 15.8 +/- 8.8 years while this was 18.6 +/- 8.1 years for the controls. None of these differences was statistically significant. Our study revealed no statistically significant differences in the total ovulating periods between ovarian cancer patients and age-matched controls. Further studies will be necessary.

  5. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors

    DEFF Research Database (Denmark)

    Rasmussen, Christina B; Kjaer, Susanne K; Albieri, Vanna

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according...

  6. Zinc and homocysteine levels in polycystic ovarian syndrome patients with insulin resistance.

    Science.gov (United States)

    Guler, Ismail; Himmetoglu, Ozdemir; Turp, Ahmet; Erdem, Ahmet; Erdem, Mehmet; Onan, M Anıl; Taskiran, Cagatay; Taslipinar, Mine Yavuz; Guner, Haldun

    2014-06-01

    In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and prognostic marker in patients with polycystic ovarian syndrome. We conducted a prospective study, including 53 women with polycystic ovarian syndrome and 33 healthy controls. We compared serum zinc levels, as well as clinical and metabolic features, of the cases. We also compared serum zinc levels between patients with polycystic ovarian syndrome with insulin resistance. Mean zinc levels were found to be significantly lower in patients with polycystic ovarian syndrome than healthy controls. Multiple logistic regression analysis of significant metabolic variables between polycystic ovarian syndrome and control groups (serum zinc level, body mass index, the ratio of triglyceride/high-density lipoprotein cholesterol, and homocysteine) revealed that zinc level was the most significant variable to predict polycystic ovarian syndrome. Mean serum zinc levels tended to be lower in patients with polycystic ovarian syndrome with impaired glucose tolerance than patients with normal glucose tolerance, but the difference was not statistically significant. In conclusion, zinc deficiency may play a role in the pathogenesis of polycystic ovarian syndrome and may be related with its long-term metabolic complications.

  7. Ovarian cancer: the neglected diagnosis.

    Science.gov (United States)

    Yawn, Barbara P; Barrette, Brigitte A; Wollan, Peter C

    2004-10-01

    To investigate presenting signs and symptoms of ovarian cancer and stage of tumor in a community cohort of women with the diagnosis of ovarian cancer. We reviewed retrospectively the medical records of all women who sought primary and specialty care in Olmsted County, Minnesota, between January 1, 1985, and December 31, 1997, to evaluate presenting symptoms, time from first symptom to diagnosis of ovarian cancer, and stage of tumor at diagnosis. Of 107 women with a diagnosis of ovarian cancer, the most commonly documented presenting symptom was crampy abdominal pain. Urinary symptoms and abdominal pain were the most commonly documented presenting symptom in patients with stage I and II ovarian cancers, whereas abdominal pain and increased abdominal girth were the most commonly documented symptoms in patients with stage III and IV cancer. Approximately 15% of tumors (n = 15) were found during routine evaluations or during a procedure for another problem. Less than 25% of presenting symptoms (n = 24 women) related directly to the pelvis or were more traditional gynecologic symptoms. Delays in women seeking medical care, health care system issues, competing medical conditions, physicians' failure to follow up, and women not returning for follow-up were associated with longer time to diagnosis. Both stage I and II cancer are associated with symptoms, but few symptoms are directly related to the reproductive pelvic organs or unique to ovarian cancer. A longer interval from first sign or symptom to diagnosis of ovarian cancer is associated with both patient and health care system factors.

  8. Ovarian Cysts in Users of Two Kinds of Progestin-only Contraceptives Implants

    Institute of Scientific and Technical Information of China (English)

    Luis Bahamondes; Maria-Margarete Hidalgo; Cássia T. Juliato; M. Valeria Bahamondes

    2006-01-01

    Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants.Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant (Implanon(R)) and the levonorgestrel-releasing implant (Jadelle(R)).Bimanual pelvic examination and vaginal ultrasound were performed during routine3, 6 and 12-month visits of asymptomatic women(control group). Women with ovarian cysts (or enlarged ovarian follicles >25 mm) (cysts group) were assessed weekly until disappearence or reduction of the image (including estradiol (E2) and progesterone measurement) and women with no ovarian enlargement underwent same evaluation for the same period of time.Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon(R) and Jadelle(R), respectively, at 3rd month. At the 6th month of use, prevalences were 7.1%and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups,respectively. E2 levels were significantly higher in cysts group than in control group.The time until disappearance of the ovarian cyst was similar in Implanon(R) and Jadelle(R)group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement.Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon(R) and Jadelle(R) implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.

  9. Patterns of ovarian morphology in polycystic ovary syndrome: a study utilising magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Thomas M.; Smith, Rachel; Marland, Anne; Wass, John A.H. [Churchill Hospital, Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford (United Kingdom); Alvey, Christopher [John Radcliffe Hospital, Oxford MRI Centre, Oxford (United Kingdom); Greenslade, Tessa [John Radcliffe Hospital, Department of Medicine, Oxford (United Kingdom); Gooding, Mark [University of Oxford, Department of Engineering, Oxford (United Kingdom); Barber, Debbie; Child, Tim [John Radcliffe Hospital, Department of Obstetrics and Gynaecology, Oxford (United Kingdom); McCarthy, Mark I. [Churchill Hospital, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford (United Kingdom); Franks, Stephen [Imperial College (Hammersmith Campus), Institute of Reproductive and Developmental Biology, London (United Kingdom); Golding, Stephen J. [John Radcliffe Hospital, Oxford MRI Centre, Oxford (United Kingdom); University of Oxford, Department of Engineering, Oxford (United Kingdom)

    2010-05-15

    To evaluate and compare MRI-based ovarian morphology in groups of women with polycystic ovary syndrome (PCOS) and controls. All PCOS cases (n = 44) had oligo-amenorrhoea and hyperandrogenism irrespective of ovarian morphology, and fulfilled NIH/Rotterdam diagnostic criteria for PCOS. All control women (n = 40) had normal menses and normoandrogenaemia. All subjects were of white British/Irish origin and pre-menopausal. Group comparisons were based on independent-sample t tests. Polycystic ovarian morphology was defined by at least 12 follicles 2-9 mm in diameter and/or an ovarian volume greater than 10 cm{sup 3}. Ovarian morphology differed significantly in PCOS cases and controls (follicle number geometric mean [SD range] 18.6 [9.9, 35.0] vs 6.6 [3.1, 14.2], unadjusted P = 1.3 x 10{sup -16}; calculated ovarian volume 8.8 cm{sup 3} [5.0, 15.5] vs 5.1 cm{sup 3} [2.5, 10.3], unadjusted P = 3.0 x 10{sup -7}; peripheral follicle location in 55% vs 18% of ovaries, P = 7.9 x 10{sup -6}; visible central ovarian stroma in 61% vs 24% of ovaries, P = 2.3 x 10{sup -5}). Follicle number and calculated ovarian volume were not concordant with clinical/biochemical assignment of PCOS/control status in 36 (23%) and 52 (34%) of ovaries, respectively. Ovarian morphology overlaps in PCOS cases and controls, emphasising the importance of considering clinical/biochemical presentation together with imaging ovarian morphology in the diagnosis of PCOS. (orig.)

  10. Decidualized Ovarian Mass Mimicking Malignancy

    Directory of Open Access Journals (Sweden)

    Lufee Wong

    2015-01-01

    Full Text Available Deciduosis classically occurs in the context of known endometriosis in the pelvis, most commonly in the ovaries, but also in the peritoneum. However, ovarian deciduosis outside the context of endometriosis is rare and makes diagnosis difficult, especially as the sonographic appearance suggests a malignant process. We report a case of decidualized ovarian mass in a patient without prior history of endometriosis that mimicked an ovarian malignancy. MRI may be a useful imaging modality to monitor these lesions and guide management. Consultation with a multidisciplinary team accustomed to such conditions will help to tailor the management to each individual.

  11. Value of anti-Müllerian hormone on predicting ovarian response during intracytoplasmic sperm injection cycles%抗苗勒激素对ICSI治疗中卵巢反应的预测价值

    Institute of Scientific and Technical Information of China (English)

    韩巍巍; Schaffrath M; Holze V; Pollow K; Seufert R; 童晓文

    2011-01-01

    RH agonist protocol, and AMH concentrations in serum and FF on OPU day of two stimulation protocols correlated positively with retrieved oocytes account (total and M Ⅱ oocytes).Serum and FF AMH levels were observed to have negative correlations with the maternal age and the total gonadotropin administration dose.No statistically significant correlation was found between AMH levels and fertilization rate (FR).Conclusion AMH concentrations in serum and FF during controlled ovarian hyperstimulation could predict ovarian response in patients undergoing ICSI procedure.

  12. What Should You Ask Your Doctor about Ovarian Cancer?

    Science.gov (United States)

    ... Staging What Should You Ask Your Doctor About Ovarian Cancer? It is important for you to have honest, ... Ask Your Doctor About Ovarian Cancer? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  13. Serous ovarian, fallopian tube and primary peritoneal cancers

    DEFF Research Database (Denmark)

    Sørensen, Rie D; Schnack, Tine H; Karlsen, Mona A

    2015-01-01

    OBJECTIVE: The aim of this systematic review is to analyze data on risk factors, epidemiology, clinicopathology and molecular biology from studies comparing primary peritoneal cancer, fallopian tube cancer and ovarian cancer of serous histology, in order to achieve a greater understanding...... of whether or not these disorders should be considered as separate entities. METHODS: A systematic literature search was conducted in PubMed and MEDLINE. Case-control studies comparing primary serous peritoneal or fallopian tube carcinomas with primary serous ovarian carcinomas or a control group were...... included. RESULTS: Twenty-eight studies were found eligible. Primary peritoneal cancer patients were older, had higher parity, were more often obese and had poorer survival compared to ovarian cancer patients. Differences in protein expression patterns of Her2/neu, estrogen and progestin receptors...

  14. Premature ovarian failure risk factors in an Iranian population

    Directory of Open Access Journals (Sweden)

    Ghassemzadeh A

    2012-04-01

    Full Text Available Alieh Ghassemzadeh1,2, Laya Farzadi1,2, Elaheh Beyhaghi1,21Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Alzahra University Hospital, Department of Obstetrics and Gynecology, Tabriz University of Medical Sciences, Tabriz, IranBackground: The aim of this study was to determine possible correlates of premature ovarian failure (POF in an Iranian population.Methods: In a case-control study, 80 patients with POF were compared with 80 controls enrolled from the same setting during 2007–2008. A food diary was used to assess food consumption habits.Results: Mean age of starting ovarian failure symptoms was 19.3 ± 5.7 years and mean age of menopause was 22.6 ± 6.3 years. Familial coincidence was observed in 16 POF patients versus no one in the control group (P < 0.05. POF patients had lower frequency of both eating red meat and fish when compared with controls (P < 0.001. POF and control subjects consumed similar amounts of dairy products, being 5.3 ± 3.2 times per week in POF and 5.6 ± 2.1 times in the control groups.Conclusion: In this study, an association between POF and lower red meat or fish consumption was found.Keywords: POF, etiology, case-control, nutrition, premature menopause, premature ovarian dysfunction, primary ovarian insufficiency

  15. ESR1/SYNE1 polymorphism and invasive epithelial ovarian cancer risk: an Ovarian Cancer Association Consortium study

    DEFF Research Database (Denmark)

    Doherty, Jennifer A; Rossing, Mary Anne; Cushing-Haugen, Kara L

    2010-01-01

    We genotyped 13 single nucleotide polymorphisms (SNPs) in the estrogen receptor alpha gene (ESR1) region in three population-based case-control studies of epithelial ovarian cancer conducted in the United States, comprising a total of 1,128 and 1,866 non-Hispanic white invasive cases and controls...... was not associated with risk. These data provide suggestive evidence that the rs2295190 T allele, or another allele in linkage disequilibrium with it, may be associated with increased risk of invasive ovarian cancer....

  16. Ovarian cancer risk and nonisoflavone flavonoids intake: A systematic review of epidemiological studies

    Science.gov (United States)

    Mohammadi, Vida; Dehghani, Sirous; Larijani, Bagher; Azadbakht, Leila

    2016-01-01

    Background: Although several studies have investigated the association between ovarian cancer risk and nonisoflavone flavonoids intake, these findings are inconsistent. This systematic review of published epidemiological studies was conducted to summarize and clarify the evidence on the association between ovarian cancer incidence and nonisoflavone flavonoids intake. Materials and Methods: PubMed, Scopus, Google Scholar, and EMBASE databases were searched based on MeSH term (ovarian neoplasm in combination with flavonoids) to identify related English and non-English papers published up to June 2016. We summarized the results of the relevant studies in this review. Results: In total, seven studies (four with cohort and three with case–control design) included in this review. The results of conducted cohort studies show no relation between ovarian cancer risk and total nonisoflavone flavonoids intake, and only one study reported a significant reduction between ovarian cancer incidence and kaempferol and luteolin intake. Similar to those in the cohort studies, also in case–control studies, no association was found between total nonisoflavone flavonoids intake and ovarian cancer risk, just an inverse association between flavonols intake and ovarian cancer was reported. Conclusion: Several studies investigated the relation of nonisoflavone flavonoids intake and ovarian cancer risk; none of them reported any association for total nonisoflavone flavonoids intake, but some reported an inverse association between certain subclasses or individual flavonoids. These findings are limited, and there is a need for further and more accurate researches to be confirmed.

  17. Folate Intake and Methylenetetrahydrofolate Reductase Gene Polymorphisms as Predictive and Prognostic Biomarkers for Ovarian Cancer Risk

    Directory of Open Access Journals (Sweden)

    Ke Wang

    2012-03-01

    Full Text Available Folic acid and methylenetetrahydrofolate reductase (MTHFR may affect the development of human cancer. However, few studies have evaluated folate intake and MTHFR in susceptibility to and prognosis of patients with ovarian cancer. We conducted a prospective case-control study in 215 ovarian cancer patients and 218 controls (all Chinese between Jan. 2004 and Jan. 2007. MTHFR C677T genotyping was done by PCR-RFLP. All patients were followed up until Dec. 2010. We found a 2.43-fold increased risk of ovarian cancer among MTHFR 677TT carriers, and a decreased risk of ovarian cancer in individuals with high folate intake (OR = 0.54, 95% CI = 0.32–0.94. Cox regression survival analysis showed that among the ovarian cancer patients, those carrying the 677TT genotype had a higher risk of death (HR = 2.17, 95% CI = 1.20–4.79, while high folate intake was associated with a lower risk of death (HR = 0.43, 95% CI = 0.33–0.88. Moreover, MTHFR 677CC carriers with higher folate intake showed a lower risk of death from ovarian cancer (HR = 0.32, 95% CI = 0.27–0.82. In summary, high folate intake may lessen susceptibility and improve the prognosis of ovarian cancer patients, while the MTHFR 677TT genotype appears to increase ovarian cancer risk and worsen its prognosis in a Chinese population.

  18. Genetic Causes in Adrenal or Ovarian Hyperandrogenism in the Reproductive Years

    Directory of Open Access Journals (Sweden)

    Bals-Pratsch M

    2009-01-01

    Full Text Available Hyperandrogenism and androgenisation frequently occur within families so that a monogenic cause such as congenital adrenal hyperplasia (CAH must be considered. For the most part, classical CAH is first diagnosed and treated on the basis of common sex development disorders in early childhood by pediatric endocrinologists. In contrast, the non-classic "late-onset CAH" is mostly symptomatic by androgenisation from the age of puberty. For both forms, the final diagnosis relies on the evidence of a CYP21 gene mutation. Even though the incidence of CAH in newborns with a ratio of 1:5000 is rare, the frequency of heterozygotes in central Europe is relatively prevalent with 1:50. In patients with hyperandrogenism of adrenal origin who desire children, a CYP21 mutation should therefore be excluded. In case of a known mutation carrier, the CYP21 gene diagnostic also should be applied on the partner. If both partners are genetic carriers, a dexamethasone (DEX therapy of the pregnant woman should be considered very early in each case immediately after determining a pregnancy to prevent serious virilization of the external genitalia of female CAH fetuses. A common differential diagnosis is androgenisation through ovarian hyperandrogenism. For many years, candidate genes for the polycystic ovary syndrome (PCOS have been investigated. The search focuses on genes involved in the regulation of insulin, follicle maturation as well as androgen secretion and regulation. Especially promising is a gene polymorphism on chromosome 19p13.2 in association with insulin resistance and disordered β-cell functions. Examinations of polymorphisms in FSH receptor genes make one expect that the effective gonadotropin dose in ovarian stimulation can be individually determined before treatment. Thus, severe hyperstimulation syndromes in PCOS patients possibly can be avoided. One might anticipate that new results in molecular genetic PCOS research in the upcoming years will lead

  19. Ultrasound in evaluating ovarian reserve

    OpenAIRE

    Eman Ahmaed Shawky Sabek; Ola I. Saleh; Howida A. Ahmed

    2015-01-01

    The objective of this study was to compare the diagnostic accuracy of transvaginal ultrasound (TVS), as a less invasive technique instead of hormonal assay to evaluate the ovarian reserve. This study included fifty-five females with breast cancer and we compared the ovarian reserve for these patients by hormonal assay through measuring the serum AntiMullerian Hormone (AMH) level and follicular stimulating hormone (FSH) level before and after chemotherapy, and by transvaginal ultrasound throug...

  20. Molecular Imaging of Ovarian Cancer

    OpenAIRE

    Sharma, Sai Kiran; Nemieboka, Brandon; Sala, Evis; Lewis, Jason S.; Zeglis, Brian M

    2016-01-01

    Ovarian cancer is the most lethal gynecologic malignancy and the fifth leading cause of cancer-related death in women. Over the past decade, medical imaging has played an increasingly valuable role in the diagnosis, staging, and treatment planning of the disease. In this “Focus on Molecular Imaging” review, we seek to provide a brief yet informative survey of the current state of the molecular imaging of ovarian cancer. The article is divided into sections according to modality, covering rece...

  1. Premature ovarian failure.

    Science.gov (United States)

    Shelling, Andrew N

    2010-11-01

    Premature ovarian failure (POF) is a common cause of infertility in women, and is characterised by amenorrhoea, hypo-oestrogenism and elevated gonadotrophin levels in women under the age of 40. Known causes include iatrogenic agents that cause permanent damage to the ovaries, such as chemotherapy, radiation therapy and surgery, autoimmune conditions, X-chromosome abnormalities and autosomal genetic conditions. However, few genes have been identified that can explain a substantial proportion of cases of POF. Most women with POF are deeply upset by the diagnosis, partly due to the unexpected menopausal symptoms, but also due to infertility. Therefore, early detection would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help to direct potential targets for future treatment.

  2. [Oxaliplatin and ovarian cancer].

    Science.gov (United States)

    Dieras, Véronique; Girre, Véronique; Guilhaume, Marie-Noëlle; Laurence, Valérie; Mignot, Laurent

    2006-02-01

    Oxaliplatin was brought into clinical evaluation in ovarian cancer because of the in vitro and in vivo antitumor activity observed in experimental models resistant to cisplatin. As single agent at 130 mg/m2 every 3 weeks, the objective response rates rage from 16% to 29% in patients treated after failure of one or two regimens. As first line, in a randomized trial cyclophosphamide-cisplatin versus cyclophosphamide-oxaliplatine, no significant statistical differences were observed in efficacy parameters (response rate, progression free survival and overall survival). The toxicity profile seemed to favor the oxaliplatin arm. Many associations with other available active drugs as taxanes, gemcitabine and liposomal doxorubicin were performed with promising results.

  3. Polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Nina Madnani

    2013-01-01

    Full Text Available Polycystic ovarian syndrome (PCOS is a "multispeciality" disorder suspected in patients with irregular menses and clinical signs of hyperandrogenism such as acne, seborrhoea, hirsutism, irregular menses, infertility, and alopecia. Recently, PCOS has been associated with the metabolic syndrome. Patients may develop obesity, insulin resistance, acanthosis nigricans, Type 2 diabetes, dyslipidemias, hypertension, non-alcoholic liver disease, and obstructive sleep apnoea. Good clinical examination with hematological and radiological investigations is required for clinical evaluation. Management is a combined effort involving a dermatologist, endocrinologist, gynecologist, and nutritionist. Morbidity in addition includes a low "self image" and poor quality of life. Long term medications and lifestyle changes are essential for a successful outcome. This article focuses on understanding the normal and abnormal endocrine functions involved in the pathogenesis of PCOS. Proper diagnosis and management of the patient is discussed.

  4. Premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2012-01-01

    Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

  5. Tamoxifen and ovarian function.

    Directory of Open Access Journals (Sweden)

    Martine Berliere

    Full Text Available BACKGROUND: Some studies suggest that the clinical parameter "amenorrhea" is insufficient to define the menopausal status of women treated with chemotherapy or tamoxifen. In this study, we investigated and compared the ovarian function defined either by clinical or biological parameters in pre-menopausal breast cancer patients treated with tamoxifen administered as adjuvant therapy. MATERIALS AND METHODS: Between 1999 and 2003, 138 premenopausal patients consecutively treated for early breast cancer were included. Sixty-eight received tamoxifen in monotherapy as the only adjuvant systemic treatment (Group I and 70 were treated with tamoxifen after adjuvant chemotherapy (Group II. All patients had a confirmed premenopausal status based on clinical parameters and hormonal values at study entry. They were followed prospectively every 3 months for 3 years: menses data, physical examination and blood tests (LH, FSH, 17-beta-estradiol. Vaginal ultrasonography was carried out every 6 months. After 3 years, prospective evaluation was completed and monitoring of ovarian function was performed as usual in our institution (1x/year. All data were retrospectively evaluated in 2011. RESULTS: Three patients were excluded from the study in group I and 2 were excluded in group II. Patients were divided into 4 subgroups according to clinical data, i.e. menses patterns. These patterns were assessed by questionnaires. a: Regular menses (>10 cycles/year b: Oligomenorrhea (5 to 9 cycles/year c: Severe oligomenorrhea (1 to 4 cycles/year d: Complete amenorrhea Estrogen levels did not appear to have any impact on disease-free survival rates after 3 or 8 years. FSH values were also documented and analyzed. They exhibited the same profile as estradiol values. CONCLUSIONS: Amenorrhea is an insufficient parameter to define menopausal status in patients receiving tamoxifen. Low estradiol levels must be coupled with other biological parameters to characterize endocrine status

  6. Doxorubicin-induced ovarian toxicity

    Directory of Open Access Journals (Sweden)

    Rizel Shulamith

    2010-03-01

    Full Text Available Abstract Background Young cancer patients may occasionally face infertility and premature gonadal failure. Apart from its direct effect on follicles and oocytes, chemotherapy may induce ovarian toxicity via an impact on the entire ovary. The role of doxorubicin in potential ovarian failure remains obscure. Our intention was to elucidate doxorubicin-related toxicity within ovaries. Methods Female mice were injected intraperitoneally with 7.5 or 10 mg/kg doxorubicin and their ovaries were visualized in vivo by high resolution MRI, one day and one month following treatment. Ovaries of other treated mice were excised and weighed at the same post-treatment intervals. Ovarian histological sections were stained for TUNEL or active caspase-3 and follicles were counted and categorized. Ovulation rates were evaluated in superovulated female mice treated with doxorubicin. Results A single injection of doxorubicin resulted in a major reduction in both ovarian size and weight that lasted even one month post treatment. A dramatic reduction in ovulation rate was observed one week after treatment, followed by a partial recovery at one month. Histological examination revealed positive staining of TUNEL and active caspase-3. We observed a significant reduction in the population of secondary and primordial follicles one month following treatment. Conclusions Our results may imply a mechanism of chemotherapy-induced ovarian toxicity, manifested by reduced ovulation and accompanied by a reduction in ovarian size, caused probably by an acute insult to the ovary.

  7. Speckle-type POZ (pox virus and zinc finger protein) protein gene deletion in ovarian cancer: Fluorescence in situ hybridization analysis of a tissue microarray.

    Science.gov (United States)

    Hu, Xiaoyu; Yang, Zhu; Zeng, Manman; Liu, Y I; Yang, Xiaotao; Li, Yanan; Li, X U; Yu, Qiubo

    2016-07-01

    The aim of the present study was to investigate the status of speckle-type POZ (pox virus and zinc finger protein) protein (SPOP) gene located on chromosome 17q21 in ovarian cancer (OC). The present study evaluated a tissue microarray, which contained 90 samples of ovarian cancer and 10 samples of normal ovarian tissue, using fluorescence in situ hybridization (FISH). FISH is a method where a SPOP-specific DNA red fluorescence probe was used for the experimental group and a centromere-specific DNA green fluorescence probe for chromosome 17 was used for the control group. The present study demonstrated that a deletion of the SPOP gene was observed in 52.27% (46/88) of the ovarian cancer tissues, but was not identified in normal ovarian tissues. Simultaneously, monosomy 17 was frequently identified in the ovarian cancer tissues, but not in the normal ovarian tissues. Furthermore, the present data revealed that the ovarian cancer histological subtype and grade were significantly associated with a deletion of the SPOP gene, which was assessed by the appearance of monosomy 17 in the ovarian cancer samples; the deletion of the SPOP gene was observed in a large proportion of serous epithelial ovarian cancer (41/61; 67.21%), particularly in grade 3 (31/37; 83.78%). In conclusion, deletion of the SPOP gene on chromosome 17 in ovarian cancer samples, which results from monosomy 17, indicates that the SPOP gene may serve as a tumor suppressor gene in ovarian cancer.

  8. 血清抗苗勒管激素水平检测在预测卵巢低反应中的应用价值%Value of serum anti-Müllerian hormone levels for predicting low ovarian response

    Institute of Scientific and Technical Information of China (English)

    廖月婵; 吴日然; 柯玩娜; 林晓丽; 叶云; 杜彦; 杜静; 林秀峰

    2012-01-01

    Objective: To evaluate the value of serum anti-Mullerian hormone (AMH) in predicting ovarian response to controlled ovarian hyperstimulation (COH) during in vitro fertilization. Methods: A total of 335 COH cycles including 6,5 cycles with poor ovarian response (the number of retrieved oocytes ≤5) and 243 cycles with normal response (the number of retrieved oocytes ≥5) were retrospectively evaluated from January to June, 2010. The serum levels of AMH, FSH, LH and E2 were measured on day 2-5 in spontaneous menstrual cycle of the patients. The patients were received transvagi-nal ultrasound examination, and their antral follicle count (AFC) was assayed. Results: The number of retrieved oocytes was correlated with AMH, AFC, age, FSH/LH, basal FSH levels, basal LH levels, and there is a gradual tendency from strong to weak. The area under the receive operating characteristic curve (ROC) of AMH, AFC, basal FSH levels, FSH/LH, age, basal LH levels, basal E2 levels was from large to small. The cut-off value of anti-Mullerian hormone for predicting ovarian response was equal or more than 2. 21 μg/L with 77% of sensitivity and 80% of specificity. Conclusions: Serum AMH levels might be a better parameter for predicting ovarian response. It could be used as a parameter for selecting the scheme of COH to reduce the cancellation rate of poor responders.%目的 探讨血清抗苗勒管激素(AMH)水平对于卵巢储备功能低下患者在控制性超排卵(COH)中卵巢反应的应用价值. 方法 回顾性分析2010年1月至6月在本中心接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的308周期.患者分为卵巢低反应组(65例)和卵巢正常反应组(243例).清晨空腹静脉血测定AMH(无月经周期限制)和卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平(月经第2~5天),同时行阴道B超检查测定窦卵泡数(AFC),以获卵数为评价标准. 结果 与获卵数的相关性由强到弱是AMH水平

  9. Factors affecting the association of oral contraceptives and ovarian cancer.

    Science.gov (United States)

    Cramer, D W; Hutchison, G B; Welch, W R; Scully, R E; Knapp, R C

    1982-10-21

    We investigated the relation between epithelial ovarian cancer and the use of oral contraceptives in a case-control study of 144 white women under the age of 60 who had ovarian cancer and 139 white women under 60 who were selected from the general population. We observed a decreased risk for ovarian cancer associated with the use of oral contraceptives in subjects 40 through 59 years of age at the time of the study. The relative risk, adjusted for parity, was 0.11, with 95 per cent confidence limits of 0.04 to 0.33. In contrast to the findings in older women, a decreased risk for ovarian cancer associated with oral-contraceptive use was not found in women under 40. In this group, the adjusted relative risk associated with any use of oral contraceptives was 1.98, with 95 per cent confidence limits of 0.74 to 5.27. The lowest risk for ovarian cancer associated with the use of oral contraceptives was observed in older parous subjects and in women who had discontinued use more than 10 years previously.

  10. Polymorphic variation of genes in the fibrinolytic system and the risk of ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Yaakov Bentov

    Full Text Available INTRODUCTION: The etiology of ovarian cancer is largely unknown. One hypothesis is that the inefficient removal of the blood clots and fibrin products which are deposited in the vicinity of the ovary by retrograde menstruation might be associated with an increased risk of ovarian cancer. Several single nucleotide polymorphisms within genes which comprise the fibrinolytic system have been shown to have functional effects on the rate of blood clot degradation. These were considered to be candidate genes in the present study. AIM: We studied the genotype distributions of 12 functional SNPs of four genes (tPA, uPA PAI1 and TAFI among 775 ovarian cancer cases and 889 controls. RESULTS: No significant associations were seen between any of the ten SNPs and the risk of ovarian cancer as a whole, or in any histologic subgroup. DISCUSSION: Germline known functional variants of genes in the fibrinolytic system are not associated with risk of ovarian cancer.

  11. The potential role of infectious agents and pelvic inflammatory disease in ovarian carcinogenesis

    DEFF Research Database (Denmark)

    Ingerslev, Kasper; Hogdall, Estrid; Schnack, Tine Henrichsen

    2017-01-01

    BACKGROUND: The etiological cause of ovarian cancer is poorly understood. It has been theorized that bacterial or viral infection as well as pelvic inflammatory disease could play a role in ovarian carcinogenesis. AIM: To review the literature on studies examining the association between ovarian...... cancer and bacterial or viral infection or pelvic inflammatory disease. METHODS: Database search through MEDLINE, applying the medical subject headings: "Ovarian neoplasms", AND "Chlamydia infections", "Neisseria gonorrhoeae", "Mycoplasma genitalium", "Papillomaviridae", or "pelvic inflammatory disease...... than in studies from Western countries. Cytomegalovirus was the only other virus to be detected and was found in 50% of cases in a case-control study. The association between ovarian cancer and pelvic inflammatory disease was examined in seven epidemiological studies, two of which, reported...

  12. Prescription Use of Paracetamol and Risk for Ovarian Cancer in Denmark

    DEFF Research Database (Denmark)

    Baandrup, Louise; Friis, Søren; Dehlendorff, Christian

    2014-01-01

    It has been suggested that paracetamol reduces the risk for ovarian cancer. We examined the association between prescription use of paracetamol and ovarian cancer risk in a nationwide case-control study nested within the Danish female population. Case patients (n = 3471) were all women with a first......% confidence intervals (CIs) for ovarian cancer associated with use of paracetamol or nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs). All statistical tests were two-sided. Use of paracetamol was associated with a reduced odds ratio for ovarian cancer (OR = 0.82; 95% CI = 0.74 to 0.92; P ...) compared with nonuse, and the odds ratio decreased further with long-term (≥10 years), high-intensity paracetamol use (OR = 0.45; 95% CI = 0.24 to 0.86; P = .02). Use of nonaspirin NSAIDs was not associated with ovarian cancer risk....

  13. Variance of serum prolactin in controlled ovarian stimulafion%控制性卵巢刺激治疗中血清催乳素水平的变化特点

    Institute of Scientific and Technical Information of China (English)

    梁晓燕; 熊永崂; 庄广伦

    2008-01-01

    Objective To investigate the variance of peripheral blood prolactin(PRL)in controlled ovarian stimulation.Methods Seventy-two patients,with totally 106 cycles receiving a long protocol of gonadotropin-releasing hormone agonist combined with gonadotropin(Gn)were randomly enrolled in this retrospective study.During controlled ovarian stimulation,peripheral blood hormones were measured by chemiluminescent microparticle immunoassay.Results Prolactin was positively correlated with estradiol (r=0.5897.P<0.01)while there was no significant correlation between luteinizing hormone and PRLProgesterone had a positive relation with prolactin(r=0.1412,P<0.01).Conclusions During controlled ovarian stimulation,prolactin secretion is not affected by Gn but may be stimulated by estradiol.Progesterone has a positive relation with prolactin.%目的 探讨控制性卵巢刺激(COS)治疗中血清催乳素水平的变化特点.方法 收集接收体外受精-胚胎移植的患者72例,共115个周期,采用促性腺激素释放激素激动剂结合促性腺激素(Gn)长、短方案促排卵治疗,定时经阴道B超监测卵泡发育情况及子宫内膜厚度,并采用酶联免疫发光法检测不同时间点血清雌二醇、黄体生成素(LH)、孕酮和催乳素的水平,分析患者雌二醇、LH、孕酮水平与催乳素水平之间的相关性.结果 对催乳素与雌二醇水平进行相关和回归分析发现,随着雌二醇水平的上升,催乳素水平有显著上升的趋势,两者呈显著正相关关系(r=0.5897,P<0.01).对催乳素与孕酮水平进行相关和回归分析发现,孕酮水平随催乳素水平的升高而升高,两者呈显著正相关关系(r=0.1412,P<0.01).但是LH水平与催乳素水平之间未见明显关联.结论 在控制性卵巢刺激治疗中,催乳素的分泌不受Gn的影响,而雌二醇水平的升高可能刺激催乳素的分泌,且催乳素与孕酮水平呈正相关关系.

  14. Estimulação ovariana controlada e inseminação intrauterina: uma terapia atual? Controlled ovarian stimulation and intrauterine insemination: an actual therapy?

    Directory of Open Access Journals (Sweden)

    Joana Palmira Martins Almeida

    2011-11-01

    Full Text Available OBJETIVO: Analisar a taxa de gravidez na inseminação intrauterina (IIU, aferindo eventuais fatores prognósticos de sucesso. MÉTODOS: Estudo retrospectivo de ciclos de IIU ocorridos de janeiro de 2007 a julho de 2010 em uma Unidade de Medicina da Reprodução do Hospital Vila Nova de Gaia. Os ciclos foram precedidos por estimulação ovárica controlada e monitorizada por ecografia endovaginal. Avaliou-se a taxa de gravidez em função da idade da mulher, tipo e duração da infertilidade, motilidade no espermograma, número de folículos e fármaco usado na estimulação ovárica. A análise estatística foi efetuada com o Statistical Package for the Social Sciences (SPSS 17, com um nível de significância 5% (pPURPOSE: To evaluate the pregnancy rate in intrauterine insemination (IUI, and to determine possible prognostic factors of successful pregnancy. METHODS: A retrospective study of IUI cycles performed in the Reproductive Medicine Unit of Vila Nova de Gaia Hospital, between January 2007 and July 2010. The IUI cycles were preceded by ovarian stimulation and monitored by vaginal ultrasound. Clinical pregnancy rates were analyzed according to the woman’s age, type and duration of infertility, spermatozoa parameters assessed in the spermogram, number of mature follicles and the drug used for ovarian stimulation. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS17, with the level of significance set at p<0.05. RESULTS: The study comprised 139 couples who underwent 220 IUI cycles. The absolute pregnancy rate per cycle was 18.6%. Of the 41 clinical pregnancies, 5 were twin pregnancies (12.1%. The pregnancy rate was higher at ages <30 years (28.5 vs 15.7%; p=0.024, duration of infertility <3 years (23.8 vs 13.9%; p=0.05, normal sperm motility (23.2 vs 10.3%; p=0.01 and with two follicles at the time of insemination (27.7 vs 14.2% for monofollicular growth; p=0.030. The pregnancy rates obtained

  15. Clinical outcome of one-third-dose depot triptorelin is the same as half-dose depot triptorelin in the long protocol of controlled ovarian stimulation

    Directory of Open Access Journals (Sweden)

    Yu Li

    2012-01-01

    Full Text Available Objective: Appropriate dosage of the long-acting depot gonadotrophin releasing hormone (GnRH agonist has not been determined in long protocol for IVF, and one-third-dose depot triptorelin was compared with half-dose in a luteal long protocol of in-vitro fertilization/ intra cytoplasmic sperm injection (IVF/ICSI treatment in this study. Materials and Methods: This is a prospective, randomized, open clinical trial. 100 patients were randomized into two groups. Group I received one-third-dose (1.25 mg depot triptorelin. Group II received half-dose (1.87 mg. The clinical and experimental parameters were compared between the two groups. Results: There was no premature luteinizing hormone (LH surge in both groups. On Day 3-5 of menstrual cycle after down-regulation, fewer patients showed low-level LH (<1.0 IU/L and estradiol (<30 pg/mL in group I (P <0.05. There were fewer oocytes retrieved (P =0.086, fewer total embryos and available embryos for cryopreservation in Group I (P <0.05, while good-quality embryo rate was higher in group I (P <0.05. The length and dose of ovarian stimulation was lower in Group I, but not significantly. The clinical pregnancy (52% versus 40%, implantation (48% versus 37.5%, delivery (46% versus 32%, or live birth (42% versus 32% rates and the abortion (8% versus 20% rates showed no significant differences. Conclusion: Depot triptorelin 1.25 mg can be successfully used with reduced pituitary suppression and lower cost in a long protocol for in-vitro fertilization.

  16. Androgen receptor gene CAG repeat polymorphism and ovarian cancer risk: A meta-analysis.

    Science.gov (United States)

    Deng, Yang; Wang, Jue; Wang, Ling; Du, Yan

    2017-02-28

    Ovarian cancer is one of the common gynecological malignancies worldwide. It is usually diagnosed at a later stage, thus missing the best opportunity for treatment. Despite the advancement of ovarian cancer treatment, the prognosis is still poor. Androgen receptor (AR) may play a role in ovarian carcinogenesis. Previous studies regarding the association between AR CAG repeat length and ovarian cancer risk reported inconsistent results. Therefore, we conducted a meta-analysis to evaluate the association between AR CAG repeat length and ovarian cancer risk following the MOOSE guidelines. PubMed, Web of Science, EBSCO and other databases were searched up to September 15(th) 2016. Case control studies with clear definition of CAG repeat length and detailed genotype information were included. Two authors independently reviewed and extracted data. Pooled analysis and subgroup analysis stratified by ethnicity were performed for different genetic models. Begg's funnel plot and Egger's test were performed for publication bias estimation. Overall, there was no association between the AR CAG repeat polymorphism and ovarian cancer risk. However, short CAG repeat polymorphism was associated with increased ovarian cancer risk in African Americans and Chinese under the dominant model, whereas a reverse association was observed in Caucasians and Italians under the other three models. Our study results should be interpreted with caution. Further well-designed epidemiological and functional studies are needed to elucidate the role of AR in ovarian carcinogenesis.

  17. The TGFβ pathway stimulates ovarian cancer cell proliferation by increasing IGF1R levels.

    Science.gov (United States)

    Alsina-Sanchis, Elisenda; Figueras, Agnès; Lahiguera, Álvaro; Vidal, August; Casanovas, Oriol; Graupera, Mariona; Villanueva, Alberto; Viñals, Francesc

    2016-10-15

    In a search for new therapeutic targets for treating epithelial ovarian cancer, we analyzed the Transforming Growth Factor Beta (TGFβ) signaling pathway in these tumors. Using a TMA with patient samples we found high Smad2 phosphorylation in ovarian cancer tumoral cells, independently of tumor subtype (high-grade serous or endometrioid). To evaluate the impact of TGFβ receptor inhibition on tumoral growth, we used different models of human ovarian cancer orthotopically grown in nude mice (OVAs). Treatment with a TGFβRI&II dual inhibitor, LY2109761, caused a significant reduction in tumor size in all these models, affecting cell proliferation rate. We identified Insulin Growth Factor (IGF)1 receptor as the signal positively regulated by TGFβ implicated in ovarian tumor cell proliferation. Inhibition of IGF1R activity by treatment with a blocker antibody (IMC-A12) or with a tyrosine kinase inhibitor (linsitinib) inhibited ovarian tumoral growth in vivo. When IGF1R levels were decreased by shRNA treatment, LY2109761 lost its capacity to block tumoral ovarian cell proliferation. At the molecular level TGFβ induced mRNA IGF1R levels. Overall, our results suggest an important role for the TGFβ signaling pathway in ovarian tumor cell growth through the control of IGF1R signaling pathway. Moreover, it identifies anti-TGFβ inhibitors as being of potential use in new therapies for ovarian cancer patients as an alternative to IGF1R inhibition.

  18. Pelvic inflammatory disease and risk of invasive ovarian cancer and ovarian borderline tumors

    DEFF Research Database (Denmark)

    Rasmussen, Christina B; Faber, Mette T; Jensen, Allan;

    2013-01-01

    The aim of the study was to examine the potential association between a history of pelvic inflammatory disease (PID) and risk of epithelial ovarian cancer or ovarian borderline tumors.......The aim of the study was to examine the potential association between a history of pelvic inflammatory disease (PID) and risk of epithelial ovarian cancer or ovarian borderline tumors....

  19. Survivorship Care Planning in Improving Quality of Life in Survivors of Ovarian Cancer

    Science.gov (United States)

    2017-02-19

    Cancer Survivor; Stage IA Ovarian Epithelial Cancer; Stage IB Ovarian Epithelial Cancer; Stage IC Ovarian Epithelial Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIC Ovarian Epithelial Cancer

  20. Survival of oocytes recovered from vitrified sheep ovarian tissues.

    Science.gov (United States)

    Al-aghbari, A M; Menino, A R

    2002-05-15

    The objective of this work was to develop an effective vitrification technique for cryopreserving oocytes in sheep ovarian tissues. Ovaries were surgically recovered from 15 pubertal ewes and the ovarian cortex was cut into sections. Ovarian tissues were placed in equilibration medium consisting of 4% (v/v) ethylene glycol (EG) and 20% (v/v) FBS in TCM-199 on ice for 30 min and transferred to vitrification solution (35% EG, 5% polyvinylpyrrolidone, 0.4M trehalose and 20% FBS in TCM-199) for 5 min. Ovarian tissues were vitrified by dropping the tissue on the surface of a steel cube cooled by liquid nitrogen. Cumulus-enclosed oocyte complexes (COC) were also collected and vitrified following the procedure used for ovarian tissues. After 2-3 weeks of storage in liquid nitrogen, ovarian tissues and COC were thawed at 37 degrees C in 0.3M trehalose and COC in ovarian tissues were mechanically and enzymatically isolated. Vitrified COC and freshly collected COC were washed twice in maturation medium (TCM-199 supplemented with 0.255 mM pyruvate and 10% heat-treated estrus cow serum) and cultured in 50 microl drops of maturation medium under paraffin oil for 23-25h at 39 degrees C in a humidified atmosphere of 5% CO(2) in air. After culture, cumulus cells were removed by hyaluronidase treatment and vortexing and oocytes were fixed and stained. No significant differences were observed between vitrified oocytes, oocytes recovered from vitrified ovarian tissues and non-vitrified control oocytes in the percentage of oocytes with acceptable staining per total number of oocytes fixed or with visible chromatin per total number of oocytes with acceptable staining. However, fewer (P0.05) were observed due to treatment in the percentages of oocytes developing to metaphase II. These results demonstrate that sheep oocytes can be successfully cryopreserved by vitrification of ovarian tissues and exhibit in vitro maturation rates similar to that of vitrified and non-vitrified oocytes.

  1. An epigenetic signature in peripheral blood predicts active ovarian cancer.

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    Andrew E Teschendorff

    Full Text Available BACKGROUND: Recent studies have shown that DNA methylation (DNAm markers in peripheral blood may hold promise as diagnostic or early detection/risk markers for epithelial cancers. However, to date no study has evaluated the diagnostic and predictive potential of such markers in a large case control cohort and on a genome-wide basis. PRINCIPAL FINDINGS: By performing genome-wide DNAm profiling of a large ovarian cancer case control cohort, we here demonstrate that active ovarian cancer has a significant impact on the DNAm pattern in peripheral blood. Specifically, by measuring the methylation levels of over 27,000 CpGs in blood cells from 148 healthy individuals and 113 age-matched pre-treatment ovarian cancer cases, we derive a DNAm signature that can predict the presence of active ovarian cancer in blind test sets with an AUC of 0.8 (95% CI (0.74-0.87. We further validate our findings in another independent set of 122 post-treatment cases (AUC = 0.76 (0.72-0.81. In addition, we provide evidence for a significant number of candidate risk or early detection markers for ovarian cancer. Furthermore, by comparing the pattern of methylation with gene expression data from major blood cell types, we here demonstrate that age and cancer elicit common changes in the composition of peripheral blood, with a myeloid skewing that increases with age and which is further aggravated in the presence of ovarian cancer. Finally, we show that most cancer and age associated methylation variability is found at CpGs located outside of CpG islands. SIGNIFICANCE: Our results underscore the potential of DNAm profiling in peripheral blood as a tool for detection or risk-prediction of epithelial cancers, and warrants further in-depth and higher CpG coverage studies to further elucidate this role.

  2. Treatment Option Overview (Ovarian Germ Cell Tumors)

    Science.gov (United States)

    ... ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause. Ovarian germ cell ... if you have either of the following: Swollen abdomen without weight gain in other parts of the ...

  3. General Information about Ovarian Germ Cell Tumors

    Science.gov (United States)

    ... ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause. Ovarian germ cell ... if you have either of the following: Swollen abdomen without weight gain in other parts of the ...

  4. Stage at diagnosis and ovarian cancer survival

    DEFF Research Database (Denmark)

    Maringe, Camille; Walters, Sarah; Butler, John;

    2012-01-01

    We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival.......We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival....

  5. Dock180 expression in epithelial ovarian tumors

    Institute of Scientific and Technical Information of China (English)

    Hui Wang; Huhua Ling; Zhenwei Yao

    2012-01-01

    Objective: The aim of our study was to investigate the expression of guanine nucleotide exchange factor Dock180 in ovarian tumor, and its significance in the initiation and progression of ovarian cancer.Methods: Immunohistochemical staining with SP method was conducted to identify the expression of Dock180 protein in epithelial ovarian tumor in 68 cases.Results: Dock180 present with higher expression in ovarian cancer, as compared with than that in low malignant tumor and benign ovarian tumor (P < 0.01).In ovarian cancer, Dock180 expression was increased with the increased FIGO stage and grade.Conclusion: Dock180 overexpression may play an important role in the development and progression of ovarian cancer and it could be used as a new measurement of malignant biological behavior of ovarian cancer.

  6. Pregnancy following laparoscopy ovarian drilling for clomiphene ...

    African Journals Online (AJOL)

    She achieved pregnancy following Laparoscopic Ovarian Drilling at the Assisted ... Conception following ovarian drilling. Omokanye .... advocated as this will drastically reduce the time to achieve ... laparoscopic laser diathermy in polycystic.

  7. MEIS and PBX homeobox proteins in ovarian cancer

    NARCIS (Netherlands)

    Crijns, A. P. G.; de Graeff, P.; Geerts, D.; ten Hoor, K. A.; Hollema, H.; van der Sluis, T.; Hofstra, R. M. W.; de Bock, G. H.; de Jong, S.; van der Zee, A. G. J.; de Vries, E. G. E.

    2007-01-01

    Three amino-acid loop extension (TALE) homeobox proteins MEIS and PBX are cofactors for HOX-class homeobox proteins, which control growth and differentiation during embryogenesis and homeostasis. We showed that MEIS and PBX expression are related to cisplatin resistance in ovarian cancer cell lines.

  8. The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

    Directory of Open Access Journals (Sweden)

    Şimşek M

    2015-03-01

    Full Text Available Mehmet Şimşek,1 Tuncay Kuloğlu,2 Şehmus Pala,3 Abdullah Boztosun,4 Behzat Can,1 Remzi Atilgan1 1Department of Obstetrics and Gynecology, 2Department of Histology, Firat University School of Medicine, Elazig, Turkey; 3Clinic of Obstetrics and Gynecology, Batman Yasam Hospital, Batman, Turkey; 4Department of Obstetrics and Gynecology, Akdeniz University School of Medicine, Antalya, Turkey Objectives: To examine the effect of 95% ethanol sclerotherapy (EST administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model. Materials and methods: In order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20 between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70% were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14 were assigned into two groups in a prospective and single-blinded manner: group 1 (G1 (n=7, control rats; and group 2 (G2 (n=7, 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann–Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant. Results

  9. Tubo-ovarian Actinomycosis Mimicking Ovarian Malignancy: Case Report

    Directory of Open Access Journals (Sweden)

    Faten Limaiem

    2015-09-01

    Full Text Available Actinomycosis is a chronic suppurative granulomatous infection caused by Actinomyces israelii, an anaerobic Gram-positive microorganism. Pelvic actinomycosis is rare and constitutes 3% of all human actinomycosis infections. Pre-operative diagnosis is usually difficult with the majority of cases being diagnosed after the histological and bacteriological examination of the resected specimen. In this paper, the authors report a new case of tubo-ovarian actinomycosis in a 42-year-old woman that was misdiagnosed pre-operatively as ovarian malignancy. Tubo-ovarian actinomycosis should be considered in patients with a pelvic mass especially in ones using intra-uterine devices. Surgeons should be aware of this infection in order to avoid excessive surgical procedures. [J Interdiscipl Histopathol 2015; 3(3.000: 117-119

  10. A retrospective study of ovarian cysts

    Directory of Open Access Journals (Sweden)

    Shivaji Neelgund

    2016-06-01

    Conclusions: Unilocular simple ovarian cysts are usually functional ovarian cysts and resolve spontaneously. Therapy by 3 to 6 months of Oral Contraceptives, usually resolves them and this also helps to distinguish between physiological and pathological ovarian cysts [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1969-1973

  11. The potential role of infectious agents and pelvic inflammatory disease in ovarian carcinogenesis.

    Science.gov (United States)

    Ingerslev, Kasper; Hogdall, Estrid; Schnack, Tine Henrichsen; Skovrider-Ruminski, Wojciech; Hogdall, Claus; Blaakaer, Jan

    2017-01-01

    The etiological cause of ovarian cancer is poorly understood. It has been theorized that bacterial or viral infection as well as pelvic inflammatory disease could play a role in ovarian carcinogenesis. To review the literature on studies examining the association between ovarian cancer and bacterial or viral infection or pelvic inflammatory disease. Database search through MEDLINE, applying the medical subject headings: "Ovarian neoplasms", AND "Chlamydia infections", "Neisseria gonorrhoeae", "Mycoplasma genitalium", "Papillomaviridae", or "pelvic inflammatory disease". Corresponding searches were performed in EMBASE, and Web of Science. The literature search identified 935 articles of which 40 were eligible for inclusion in this review. Seven studies examined the association between bacterial infection and ovarian cancer. A single study found a significant association between chlamydial infection and ovarian cancer, while another study identified Mycoplasma genitalium in a large proportion of ovarian cancer cases. The remaining studies found no association. Human papillomavirus detection rates varied from 0 to 67% and were generally higher in the Asian studies than in studies from Western countries. Cytomegalovirus was the only other virus to be detected and was found in 50% of cases in a case-control study. The association between ovarian cancer and pelvic inflammatory disease was examined in seven epidemiological studies, two of which, reported a statistically significant association. Data indicate a potential association between pelvic inflammatory disease and ovarian cancer. An association between ovarian cancer and high-risk human papillomavirus genotypes may exist in Asia, whereas an association in Western countries seems unlikely due to the low reported prevalence. Potential carcinogenic bacteria were found, but results were inconsistent, and further research is warranted.

  12. Mass spectrometric profiling reveals association of N-glycan patterns with epithelial ovarian cancer progression.

    Science.gov (United States)

    Chen, Huanhuan; Deng, Zaian; Huang, Chuncui; Wu, Hongmei; Zhao, Xia; Li, Yan

    2017-07-01

    Aberrant changes of N-glycan modifications on proteins have been linked to various diseases including different cancers, suggesting possible avenue for exploring their etiologies based on N-glycomic analysis. Changes in N-glycan patterns during epithelial ovarian cancer development have so far been investigated mainly using serum, plasma, ascites, and cell lines. However, changes in patterns of N-glycans in tumor tissues during epithelial ovarian cancer progression have remained largely undefined. To investigate whether changes in N-glycan patterns correlate with oncogenesis and progression of epithelial ovarian cancer, we profiled N-glycans from formalin-fixed paraffin-embedded tissue slides using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and quantitatively compared among different pathological grades of epithelial ovarian cancer and healthy controls. Our results show that among the 80 compositions of N-glycan detected, expression levels of high-mannose type were higher in epithelial ovarian cancer samples than that observed in healthy controls, accompanied by reduced levels of hybrid-type glycans. By applying receiver operating characteristic analysis, we show that a combined panel composed of four high-mannose and three fucosylated neutral complex N-glycans allows for good discrimination of epithelial ovarian cancer from healthy controls. Furthermore, using a statistical analysis of variance assay, we found that different N-glycan patterns, including 2 high-mannose-type, 2 fucosylated and sialylated complex structures, and 10 fucosylated neutral complex N-glycans, exhibited specific changes in N-glycan abundance across epithelial ovarian cancer grades. Together, our results provide strong evidence that N-glycomic changes are a strong indicator for epithelial ovarian cancer pathological grades and should provide avenues to identify novel biomarkers for epithelial ovarian cancer diagnosis and monitoring.

  13. Imaging diagnostics in ovarian cancer

    DEFF Research Database (Denmark)

    Fog, Sigrid Marie Kasper Kasper; Dueholm, Margit; Marinovskij, Edvard;

    2017-01-01

    OBJECTIVE: To analyze the ability of magnetic resonance imaging (MRI) and systematic evaluation at surgery to predict optimal cytoreduction in primary advanced ovarian cancer and to develop a preoperative scoring system for cancer staging. STUDY DESIGN: Preoperative MRI and standard laparotomy were...... performed in 99 women with either ovarian or primary peritoneal cancer. Using univariate and multivariate logistic regression analysis of a systematic description of the tumor in nine abdominal compartments obtained by MRI and during surgery plus clinical parameters, a scoring system was designed....... MRI is able to assess ovarian cancer with peritoneal carcinomatosis with satisfactory concordance with laparotomic findings. This scoring system could be useful as a clinical guideline and should be evaluated and developed further in larger studies....

  14. A pooled analysis of 12 cohort studies of dietary fat, cholesterol and egg intake and ovarian cancer

    NARCIS (Netherlands)

    Genkinger, J.M.; Hunter, D.J.; Spiegelman, D.; Anderson, K.E.; Beeson, W.L.; Buring, J.E.; Colditz, G.A.; Fraser, G.E.; Freudenheim, J.L.; Goldbohm, R.A.; Hankinson, S.E.; Koenig, K.L.; Larsson, S.C.; Leitzmann, M.; McCullough, M.L.; Miller, A.B.; Rodriguez, C.; Rohan, T.E.; Ross, J.A.; Schatzkin, A.; Schouten, L.J.; Smit, E.; Willett, W.C.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2006-01-01

    Fat and cholesterol are theorized to promote ovarian carcinogenesis by increasing circulating estrogen levels. Although case-control studies have reported positive associations between total and saturated fat intake and ovarian cancer risk, two cohort studies have observed null associations. Dietary

  15. Modified Goff Symptom Index; Simple triage tool for ovarian malignancy

    Directory of Open Access Journals (Sweden)

    Jyothi Shetty

    2015-08-01

    Full Text Available Objectives: Ovarian cancer often goes undiagnosed or misdiagnosed in the early stages. The present study aimed to validate a modified version of the Goff Symptom Index (GSI in an Indian population. Methods: This prospective case-control study was conducted between July 2010 and June 2012 in a university hospital in Manipal, Karnataka, India. A total of 305 inpatients admitted for ovarian pathology investigations and outpatients undergoing routine gynaecological check-ups were included in the study. The modified GSI (MGSI was used to investigate the presence, severity, frequency and duration of 10 ovarian cancer symptoms on a scale of 1–5. Four additional symptoms were included with those of the original GSI (two symptoms from a previous MGSI and two new symptoms. Patients were regarded as positive for ovarian cancer if symptoms occurred >12 times per month and time since onset was <1 year. Histopathology confirmed the diagnosis of ovarian tumours. Results: A total of 13 patients were excluded. The final sample (n = 292 was divided into a test group (n = 74 and a control group (n = 218 based on histopathology. Within the controls, 144 women were found to have benign tumours. The MGSI was positive in 71.6% of the test group as opposed to only 11.5% of the control group. The addition of two symptoms (loss of appetite and weight to the GSI increased the test’s sensitivity from 71.6% to 77% without compromising specificity (88.5%. Conclusion: Based on these findings, the addition of two new symptoms (loss of appetite and weight to the GSI is proposed in order to increase the test’s sensitivity. However, the addition of urinary symptoms to the GSI requires further validation.

  16. MUC1 in endometriosis and ovarian cancer.

    Science.gov (United States)

    Vlad, Anda M; Diaconu, Iulia; Gantt, Kira R

    2006-01-01

    Endometriosis is a chronic, debilitating disease, associated with pelvic pain and infertility. Recent epidemiological studies suggest that women with endometriosis are at increased risk for ovarian cancer. Although the causative factors for both endometriosis and ovarian cancer remain largely unknown, several similarities between the proposed etiology of ovarian cancer and the observed pathophysiology of endometriosis have been reported. MUC1 glycoprotein is present in endometriotic lesions and overexpressed in epithelial ovarian tumors. We are currently studying immunity to MUC1 antigen in newly emerging preclinical models for endometriosis and ovarian cancer and exploring the potential for immune therapy/prevention with MUC1 in both diseases.

  17. Genetic Modifiers of Ovarian Cancer

    Science.gov (United States)

    2014-08-01

    variants and cancer risk in Mendelian cancer syndromes. Curr Opin Genet Dev 20: 299–307. S0959-437X(10)00044-4 [pii];10.1016/j.gde.2010.03.010 [doi]. 3...AWARD NUMBER: W81XWH-10-1-0341 TITLE: Genetic Modifiers of Ovarian Cancer PRINCIPAL INVESTIGATOR: Fergus J. Couch, Ph.D. CONTRACTING...DATE AUG 2014 2. REPORT TYPE Final 3. DATES COVERED 15MAY2010 - 14MAY2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Genetic Modifiers of Ovarian

  18. PARP inhibitors in ovarian cancer.

    Science.gov (United States)

    Ledermann, J A

    2016-04-01

    Slow progress in improving the outcome of ovarian cancer with chemotherapy over the last decade has stimulated research into molecularly targeted therapy. Poly(ADP-ribose) polymerase (PARP) inhibitors target DNA repair and are specifically active in cells that have impaired repair of DNA by the homologous recombination (HR) pathway. Cells with mutated BRCA function have HR deficiency (HRD), which is also present in a significant proportion of non-BRCA-mutated ovarian cancer. In the last decade, olaparib, the first and most-investigated oral PARP inhibitor, has undergone phase I-III trials as a single agent, in comparison with and in addition to chemotherapy, and as a maintenance therapy following chemotherapy. The greatest benefit to-date has been in the maintenance setting, prolonging the progression-free survival of high-grade serous ovarian cancer with a BRCA1/2 mutation. In this group of patients, olaparib has received approval as maintenance following chemotherapy from the EMA, and accelerated approval as a single agent in women who have had three or more lines of therapy. Olaparib can be given for a prolonged period with few significant side-effects in most patients. Similar trials with other PARP inhibitors (rucaparib, niraparib and veliparib) are in progress and include non-BRCA-mutated ovarian cancer. Second-generation studies are exploring the combination of PARP inhibitors with anti-angiogenic drugs. PARP inhibitors represent a step change in the management of ovarian cancer. BRCA mutations are the first genotypic predictive markers in ovarian cancer and can be used to select patients who will most likely benefit from PARP inhibitors. BRCA testing is now becoming a routine part of the evaluation of women with ovarian cancer, and tests for HRD are being used to evaluate PARP inhibitors in an extended population of non-BRCA-mutated ovarian cancer. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical

  19. Increased WD-repeat containing protein 1 in interstitial fluid from ovarian carcinomas shown by comparative proteomic analysis of malignant and healthy gynecological tissue.

    Science.gov (United States)

    Haslene-Hox, Hanne; Oveland, Eystein; Woie, Kathrine; Salvesen, Helga B; Wiig, Helge; Tenstad, Olav

    2013-11-01

    We aimed to identify differentially expressed proteins in interstitial fluid from ovarian cancer employing multiple fractioning and high resolution mass spectrometry-based proteomic analysis, and asked whether specific proteins that may serve as biomarker candidates or therapeutic targets could be identified. High throughput proteomics was conducted on immunodepleted and fractioned interstitial fluid from pooled samples of ovarian carcinomas, using endometrial carcinomas and healthy ovarian tissue as controls. Differential analysis revealed the up-regulation of extracellular proteasomes in tumor interstitial fluid compared to the healthy control. Moreover, a number of differentially expressed proteins in interstitial fluid from ovarian carcinomas compared with control tissues were identified. Detection of proteasome 20S related proteins in TIF compared to IF from healthy tissue indicates that the 20S proteasome can have a role in the tumor microenvironment. Six selected proteins, CEACAM5, FREM2, MUC5AC, TFF3, PYCARD and WDR1, were independently validated in individual tumor lysates from ovarian carcinomas by multiple reaction monitoring initiated detection and sequence analysis, Western blot and/or selected reaction monitoring. Quantification of specific proteins revealed substantial heterogeneity between individual samples. Nevertheless, WD repeat-containing protein 1 was confirmed as being significantly overexpressed in interstitial fluid from ovarian carcinomas compared to healthy ovarian tissue by Orbitrap analysis of individual native interstitial fluid from ovarian and endometrial carcinomas and healthy ovarian tissue. We suggest that this protein should be explored as a therapeutic target in ovarian carcinomas. This article is part of a Special Issue entitled: An Updated Secretome.

  20. Genome-wide significant risk associations for mucinous ovarian carcinoma

    Science.gov (United States)

    Kelemen, Linda E.; Lawrenson, Kate; Tyrer, Jonathan; Li, Qiyuan; M. Lee, Janet; Seo, Ji-Heui; Phelan, Catherine M.; Beesley, Jonathan; Chen, Xiaoqin; Spindler, Tassja J.; Aben, Katja K.H.; Anton-Culver, Hoda; Antonenkova, Natalia; Baker, Helen; Bandera, Elisa V.; Bean, Yukie; Beckmann, Matthias W.; Bisogna, Maria; Bjorge, Line; Bogdanova, Natalia; Brinton, Louise A.; Brooks-Wilson, Angela; Bruinsma, Fiona; Butzow, Ralf; Campbell, Ian G.; Carty, Karen; Chang-Claude, Jenny; Chen, Y. Ann; Chen, Zhihua; Cook, Linda S.; Cramer, Daniel W.; Cunningham, Julie M.; Cybulski, Cezary; Dansonka-Mieszkowska, Agnieszka; Dennis, Joe; Dicks, Ed; Doherty, Jennifer A.; Dörk, Thilo; du Bois, Andreas; Dürst, Matthias; Eccles, Diana; Easton, Douglas T.; Edwards, Robert P.; Eilber, Ursula; Ekici, Arif B.; Engelholm, Svend Aage; Fasching, Peter A.; Fridley, Brooke L.; Gao, Yu-Tang; Gentry-Maharaj, Aleksandra; Giles, Graham G.; Glasspool, Rosalind; Goode, Ellen L.; Goodman, Marc T.; Grownwald, Jacek; Harrington, Patricia; Harter, Philipp; Hasmad, Hanis Nazihah; Hein, Alexander; Heitz, Florian; Hildebrandt, Michelle A.T.; Hillemanns, Peter; Hogdall, Estrid; Hogdall, Claus; Hosono, Satoyo; Iversen, Edwin S.; Jakubowska, Anna; Jensen, Allan; Ji, Bu-Tian; Karlan, Beth Y; Kellar, Melissa; Kelley, Joseph L.; Kiemeney, Lambertus A.; Krakstad, Camilla; Kjaer, Susanne K.; Kupryjanczyk, Jolanta; Lambrechts, Diether; Lambrechts, Sandrina; Le, Nhu D.; Lee, Alice W.; Lele, Shashi; Leminen, Arto; Lester, Jenny; Levine, Douglas A.; Liang, Dong; Lissowska, Jolanta; Lu, Karen; Lubinski, Jan; Lundvall, Lene; Massuger, Leon F.A.G.; Matsuo, Keitaro; McGuire, Valerie; McLaughlin, John R.; McNeish, Iain; Menon, Usha; Modugno, Francesmary; Moes-Sosnowska, Joanna; Moysich, Kirsten B.; Narod, Steven A.; Nedergaard, Lotte; Ness, Roberta B.; Nevanlinna, Heli; Azmi, Mat Adenan Noor; Odunsi, Kunle; Olson, Sara H.; Orlow, Irene; Orsulic, Sandra; Weber, Rachel Palmieri; Paul, James; Pearce, Celeste Leigh; Pejovic, Tanja; Pelttari, Liisa M.; Permuth-Wey, Jennifer; Pike, Malcolm C.; Poole, Elizabeth M.; Ramus, Susan J.; Risch, Harvey A.; Rosen, Barry; Rossing, Mary Anne; Rothstein, Joseph H.; Rudolph, Anja; Runnebaum, Ingo B.; Rzepecka, Iwona K.; Salvesen, Helga B.; Schildkraut, Joellen M.; Schwaab, Ira; Shu, Xiao-Ou; Shvetsov, Yurii B; Siddiqui, Nadeem; Sieh, Weiva; Song, Honglin; Southey, Melissa C.; Sucheston, Lara; Tangen, Ingvild L.; Teo, Soo-Hwang; Terry, Kathryn L.; Thompson, Pamela J; Tworoger, Shelley S.; van Altena, Anne M.; Van Nieuwenhuysen, Els; Vergote, Ignace; Vierkant, Robert A.; Wang-Gohrke, Shan; Walsh, Christine; Wentzensen, Nicolas; Whittemore, Alice S.; Wicklund, Kristine G.; Wilkens, Lynne R.; Wlodzimierz, Sawicki; Woo, Yin-Ling; Wu, Xifeng; Wu, Anna H.; Yang, Hannah; Zheng, Wei; Ziogas, Argyrios; Sellers, Thomas A.; Freedman, Matthew L.; Chenevix-Trench, Georgia; Pharoah, Paul D.; Gayther, Simon A.; Berchuck, Andrew

    2015-01-01

    Genome-wide association studies have identified several risk associations for ovarian carcinomas (OC) but not for mucinous ovarian carcinomas (MOC). Genotypes from OC cases and controls were imputed into the 1000 Genomes Project reference panel. Analysis of 1,644 MOC cases and 21,693 controls identified three novel risk associations: rs752590 at 2q13 (P = 3.3 × 10−8), rs711830 at 2q31.1 (P = 7.5 × 10−12) and rs688187 at 19q13.2 (P = 6.8 × 10−13). Expression Quantitative Trait Locus (eQTL) analysis in ovarian and colorectal tumors (which are histologically similar to MOC) identified significant eQTL associations for HOXD9 at 2q31.1 in ovarian (P = 4.95 × 10−4, FDR = 0.003) and colorectal (P = 0.01, FDR = 0.09) tumors, and for PAX8 at 2q13 in colorectal tumors (P = 0.03, FDR = 0.09). Chromosome conformation capture analysis identified interactions between the HOXD9 promoter and risk SNPs at 2q31.1. Overexpressing HOXD9 in MOC cells augmented the neoplastic phenotype. These findings provide the first evidence for MOC susceptibility variants and insights into the underlying biology of the disease. PMID:26075790

  1. Disrupting Ovarian Cancer Metastatic Colonization: Insights from Metastasis Suppressor Studies

    Directory of Open Access Journals (Sweden)

    Shaheena Khan

    2010-01-01

    Full Text Available Ovarian cancer affects approximately 25,000 women in the United States each year and remains one of the most lethal female malignancies. A standard approach to therapy is surgical cytoreduction, after which the remaining microscopic residual disease is treated with chemotherapy. The vast majority of patients have disease recurrence, underscoring the crucial need for approaches to control the regrowth, or colonization, of tissues after local treatment. Improved therapies require mechanistic information about the process of metastatic colonization, the final step in metastasis, in which cancer cells undergo progressive growth at secondary sites. Studies of metastasis suppressors are providing insights into events controlling metastatic colonization. This paper reviews our laboratory's approach to the identification, characterization, and functional testing of the JNKK1/MKK4 metastasis suppressor in ovarian cancer metastatic colonization. Specifically, we demonstrate that interaction of ovarian caner cells with the omental microenvironment activates JNKK1/MKK4 resulting in decreased proliferation without affecting apoptosis. The potential role of the omental microenvironment, specifically milky spot structures, is also described. It is our goal to provide this work as a usable paradigm that will enable others to study metastasis suppressors in clinical and experimental ovarian cancer metastases.

  2. Diazinon-Induced Ovarian Toxicity and Protection by Vitamins E

    Directory of Open Access Journals (Sweden)

    Zinat Sargazi

    2014-09-01

    Full Text Available Background: DZN (diazinon is an organophosphate insecticide that had been used in agriculture and for domestic and veterinary use for several years and caused many negative effects on plants and animal species, especially on human. The aim of present study was to evaluate the effects of DZN on MDA (malondialdehyde and GSH (glutathione levels in female rat reproductive tissue (ovary and to assess the protective role of vitamin E. Methods: A total of 30 adult female Wistar rats were divided into five groups: control group (without any intervention, sham group (received only pure corn oil, as solvent, experimental group 1 (DZN+corn oil, 60 mg/kg, experimental group 2 (vitamin E, 200 mg/kg, and experimental group 3 (DZN+vitamin E, the same dosage. All drugs were injected intraperitoneally, except vitamin E which was administrated by gavage. The animals were scarified after two weeks and MDA as a marker of lipid peroxidation and GSH content were measured in ovarian tissue. Results: DZN reduced GSH content and increased MDA level in ovary compared with the control group (P<0.001. Vitamin E plus DZN increased GSH content but decreased DZN-induced MDA elevation in rat ovarian tissue. Conclusion: Oxidative stress contributes to DZN-induced ovarian toxicity. The results of this study suggested that vitamin E may have a protective effect on DZN-induced ovarian toxicity.

  3. Asthma and asthma medication use among 4-year-old offspring of subfertile couples--association with IVF?

    Science.gov (United States)

    Kuiper, Derk B; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike L; Roseboom, Tessa J; Heineman, Maas J; Hadders-Algra, Mijna

    2015-11-01

    This study evaluated the prevalence of asthma and asthma medication use in 213 4-year-old singletons followed from birth onwards, including three groups of children born following: (i) controlled ovarian hyperstimulation IVF/intracytoplasmic sperm injection (ICSI); (ii) modified natural cycle IVF/ICSI; and (iii) natural conception in subfertile couples. The rate of asthma medication was higher in the ovarian hyperstimulation-IVF/ICSI than in the subfertile group (adjusted odds ratios [aOR]: 1.96 [1.00-3.84]). Time to pregnancy, a proxy for the severity of subfertility, was not associated with asthma and asthma medication. In conclusion, controlled ovarian hyperstimulation-IVF/ICSI is associated with the use of asthma medication in 4-year-old offspring of subfertile couples.

  4. Palliative Care in Improving Quality of Life and Symptoms in Patients With Stage III-IV Pancreatic or Ovarian Cancer

    Science.gov (United States)

    2014-12-18

    Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Stage III Pancreatic Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer

  5. The diagnostic value of multiple tumor markers in malignant ovarian neoplasms

    Institute of Scientific and Technical Information of China (English)

    Wang Xiaoli; Zhang Youzhong; Cui Baoxia; Jiang Jianting

    2005-01-01

    Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.

  6. Hyperprolactinemia after laparoscopic ovarian drilling: An unknown phenomenon

    Directory of Open Access Journals (Sweden)

    Omrani Gholamhossein R

    2005-08-01

    Full Text Available Abstract Background The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome. Methods This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test". Results Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011. The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981 respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6–10 weeks after the procedure. Conclusion Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended.

  7. DETECTION OF OXIDATIVE STRESS, APOPTOSIS AND MOLECULAR LESIONS IN HUMAN OVARIAN CANCER CELLS

    Directory of Open Access Journals (Sweden)

    H. I. Falfushynska

    2016-05-01

    Full Text Available Background. Ovarian cancer has the highest mortality rate of gynaecological cancers. This is partly due to the lack of effective screening markers. Indices of oxidative stress are well-recognized prognostic criteria for tumorous transformation of tissue, but their value depends on the type of tumor and the stage of its development. Objective. The aim of this study is to clarify the relationship between antioxidant/pro-oxidant ratio and the signs of molecular lesions and apoptosis rate in blood of ovarian cancer patients and non-cancer ones. Results. The ovarian cancer group is marked by antioxidant/prooxidant balance shifting to oxidative damage in blood as the consequence of overexpression of oxyradicals (by 300%. Higher level of glutathione (by 366%, lower level of metallothioneins (by 65% as well as higher level of lipid peroxidation (by 174% and protein carbonyls (by 186% in blood of ovarian cancer patients compared to the normal ovarian group have been observed. The signs of cytotoxicity are determined in blood of ovarian cancer patients: an increased (compared to control level of DNA fragmentation (by 160%, choline esterase (up to twice, higher rate of both caspase dependent and caspase independent lysosomal mediated apoptosis. Conclusions. Cathepsin D activity both total and free, choline esterase activity, TBA-reactive substance and protein carbonyls level in blood could be used as the predictive markers of worse prognosis and the signs of human ovarian cancer.

  8. Serial Patterns of Ovarian Cancer Biomarkers in a Prediagnosis Longitudinal Dataset

    Directory of Open Access Journals (Sweden)

    Oleg Blyuss

    2015-01-01

    Full Text Available Early detection of ovarian cancer through screening may have impact on mortality from the disease. Approaches based on CA125 cut-off have not been effective. Longitudinal algorithms such as the Risk of Ovarian Cancer Algorithm (ROCA to interpret CA125 have been shown to have higher sensitivity and specificity than a single cut-off. The aim of this study was to investigate whether other ovarian cancer-related biomarkers, Human Epididymis 4 (HE4, glycodelin, mesothelin, matrix metalloproteinase 7 (MMP7, and cytokeratin 19 fragment (CYFRA 21-1, could improve the performance of CA125 in detecting ovarian cancer earlier. Serum samples (single and serial predating diagnosis from 47 women taking part in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS who went on to develop primary invasive ovarian, fallopian tube, or peritoneal cancer (index cancer (170 samples and 179 matched controls (893 samples were included in the study. A multiplex immunobased assay platform (Becton Dickinson allowing simultaneous measurement of the six serum markers was used. The area under the ROC curve for the panel of three biomarkers (CA125, HE4, and glycodelin was higher than for CA125 alone for all analysed time groups, indicating that these markers can improve on sensitivity of CA125 alone for ovarian cancer detection.

  9. Overexpression of receptor for advanced glycation end products (RAGE) in ovarian cancer.

    Science.gov (United States)

    Rahimi, Farzaneh; Karimi, Jamshid; Goodarzi, Mohammad Taghi; Saidijam, Massoud; Khodadadi, Iraj; Razavi, Amir Nader Emami; Nankali, Maryam

    2017-01-01

    Ovarian cancer is one of the important challenges in the field of gynecologic oncology because of some problems in understanding its etiology and pathogenesis. Receptor for advanced glycation end products (RAGE) is a multiligand trans-membranous receptor which is upregulated in some human cancers. Mechanisms of RAGE involvement in carcinogenesis of ovarian cancer are unknown. This study aimed to investigate the expression of RAGE in ovarian cancers and its association with clinicopathological characteristics. The RAGE expression level in ovarian cancer and corresponding noncancerous tissues were analyzed by real time quantitative RT-PCR and immunohistochemistry techniques. Results indicated that RAGE gene was overexpressed in ovarian cancer tissue compared with adjacent noncancerous tissue (p RAGE expression and tumor size (p = 0.04), depth of stromal invasion (p = 0.031), lymphovascular invasion (p = 0.041) and stage of cancer (p = 0.041) was observed. The receiver operating characteristic (ROC) analyses yielded the area under the curve (AUC) values of 0.86 for RAGE in discriminating ovarian cancer samples from non-cancer controls. In conclusion overexpression of RAGE in ovarian cancer may be a useful biomarker to predict tumor progression.

  10. Common Genetic Variation in Circadian Rhythm Genes and Risk of Epithelial Ovarian Cancer (EOC)

    DEFF Research Database (Denmark)

    Jim, Heather S L; Lin, Hui-Yi; Tyrer, Jonathan P

    2015-01-01

    single nucleotide polymorphisms (SNPs) in circadian genes BMAL1, CRY2, CSNK1E, NPAS2, PER3, REV1 and TIMELESS and downstream transcription factors KLF10 and SENP3 as predictors of risk of epithelial ovarian cancer (EOC) and histopathologic subtypes. The study included a test set of 3,761 EOC cases and 2......,722 controls and a validation set of 44,308 samples including 18,174 (10,316 serous) cases and 26,134 controls from 43 studies participating in the Ovarian Cancer Association Consortium (OCAC). Analysis of genotype data from 36 genotyped SNPs and 4600 imputed SNPs indicated that the most significant...... where they regulate ovulation; circadian disruption is associated with several ovarian cancer risk factors (e.g., endometriosis). However, no studies have examined variation in germline circadian genes as predictors of ovarian cancer risk and invasiveness. The goal of the current study was to examine...

  11. Common Genetic Variation in Circadian Rhythm Genes and Risk of Epithelial Ovarian Cancer (EOC)

    DEFF Research Database (Denmark)

    Jim, Heather S L; Lin, Hui-Yi; Tyrer, Jonathan P

    2016-01-01

    single nucleotide polymorphisms (SNPs) in circadian genes BMAL1, CRY2, CSNK1E, NPAS2, PER3, REV1 and TIMELESS and downstream transcription factors KLF10 and SENP3 as predictors of risk of epithelial ovarian cancer (EOC) and histopathologic subtypes. The study included a test set of 3,761 EOC cases and 2......,722 controls and a validation set of 44,308 samples including 18,174 (10,316 serous) cases and 26,134 controls from 43 studies participating in the Ovarian Cancer Association Consortium (OCAC). Analysis of genotype data from 36 genotyped SNPs and 4600 imputed SNPs indicated that the most significant...... where they regulate ovulation; circadian disruption is associated with several ovarian cancer risk factors (e.g., endometriosis). However, no studies have examined variation in germline circadian genes as predictors of ovarian cancer risk and invasiveness. The goal of the current study was to examine...

  12. Correlation between epithelial ovarian cancer and thrombocytosis%卵巢上皮性癌和血小板计数增高相关性分析

    Institute of Scientific and Technical Information of China (English)

    Zhiyi Liang; Hong Zhang

    2009-01-01

    Objective: To evaluate the clinical significance of platelet (PLT) count in epithelial ovarian cancer, and to inves-tigate the correlation between thrombocytosis and the incidence of epithelial ovarian cancer. Methods: We evaluated 220 epithelial ovarian tumor patients divided into early stage epithelial ovarian cancer group (n = 80), advanced stage epithelial ovarian cancer group (n = 50) and benign ovarian tumor group (n = 90) as controls, who underwent primary surgical treatment. Three groups were evaluated with the relationship between platelet counts and preoperative and postoperative CA125, histo-pathology, abdominal edema, residual tumor, and lymph node metastasis. Epithelial ovarian cancer patients were evaluated whether platelet count was decreased after surgery. Results: The mean platelet counts were (234.55±71.51)×109/L in the early stage epithelial ovarian cancer group, (308.12±111.95)×10/L in the advanced stage epithelial ovarian cancer group,and (206.28±52.62)×109/L in the benign ovarian tumor group, with a significant difference among the 3 groups (P<0.05).In the early stage epithelial ovarian cancer group, the platelet count was correlated with histopathology. In the advanced stage epithelial ovarian cancer group, there was a correlation between thrombocytosis and the incidence of that residual tumor diameter was greater than 2 cm. But there was no relationship between platelet count and histopathology, CA125, abdominal edema, or lymph node metastasis. In general the platelet count was decreased after surgery. Conclusion: An increased platelet count is commonly seen in patients with epithelial ovarian cancer, but it usually decreases after surgery. Patients with thrombocytosis have poor prognosis. Platelet count can be used as a marker for the development and prognosis of epithelial ovarian cancer.

  13. Can Ovarian Cancer Be Prevented?

    Science.gov (United States)

    ... need to be removed by the time the woman is 35. Some women who have a high risk of ovarian cancer due to BRCA gene mutations feel that having their ovaries and fallopian tubes removed is not right for them. Often doctors recommend that those women ...

  14. Ovarian cancer and body size

    DEFF Research Database (Denmark)

    Mosgaard, Berit Jul

    2012-01-01

    Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished...

  15. Genetics Home Reference: ovarian cancer

    Science.gov (United States)

    ... mutations, are not inherited. Somatic mutations in the TP53 gene occur in almost half of all ovarian ... PALB2 PIK3CA PMS2 PRKN RAD50 RAD51C RAD51D STK11 TP53 Related Information What is a gene? What is ...

  16. Ultrasound in evaluating ovarian reserve

    Directory of Open Access Journals (Sweden)

    Eman Ahmaed Shawky Sabek

    2015-12-01

    Full Text Available The objective of this study was to compare the diagnostic accuracy of transvaginal ultrasound (TVS, as a less invasive technique instead of hormonal assay to evaluate the ovarian reserve. This study included fifty-five females with breast cancer and we compared the ovarian reserve for these patients by hormonal assay through measuring the serum AntiMullerian Hormone (AMH level and follicular stimulating hormone (FSH level before and after chemotherapy, and by transvaginal ultrasound through the ovarian volume (OV calculation and counting the Antral follicles (AFC before and after chemotherapy treatment. There was decline in the AntiMullerian Hormone level after chemotherapy by 27 ± 11.19% and decrease in the Antral follicle counts by 21 ± 13.43%. In conclusion there was strong relation between AMH level and AFC which makes the use of transvaginal ultrasound is a reliable alternative method to the hormonal assay to detect the ovarian reserve.

  17. Ovarian Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing ovarian cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  18. Ovarian stimulation and embryo quality

    NARCIS (Netherlands)

    Baart, Esther; Macklon, Nick S.; Fauser, Bart J. C. M.

    2009-01-01

    To Study the effects of different ovarian stimulation approaches on oocyte and embryo quality, it is imperative to assess embryo quality with a reliable and objective method. Embryos rated as high quality by standardized morphological assessment are associated with higher implantation and pregnancy

  19. Early Detection of Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Donna Badgwell

    2007-01-01

    Full Text Available Despite advances in therapy, ovarian cancer remains the most deadly of the gynecological cancers. Less than 30% of women with advanced stage disease survive long-term. When diagnosed in stage I, up to 90% of patients can be cured with conventional surgery and chemotherapy. At present, only 25% of ovarian cancers are detected in stage I due, in part, to the absence of specific symptoms and to lack of an effective screening strategy. Early detection of ovarian cancer might significantly improve the overall survival rate of women with ovarian cancer if 1 most cancers are clonal and unifocal, arising in the ovary rather than in the peritoneum, 2 metastatic disease results from progression of clinically detectable stage I lesions, and 3 cancers remain localized for a sufficient interval to permit cost-effective screening. Given the prevalence of ovarian cancer, strategies for early detection must have high sensitivity for early stage disease (> 75%, but must have extremely high specificity (99.6% to attain a positive predictive value of at least 10%. Transvaginal sonography (TVS, serum markers and a combination of the two modalities have been evaluated for early detection of ovarian cancer. Among the serum markers, CA125 has received the most attention, but lacks the sensitivity or specificity to function alone as a screening test. Greater specificity can be achieved by combining CA125 and TVS and/or by monitoring CA125 over time. Two stage screening strategies promise to be cost effective, where abnormal serum assays prompt TVS to detect lesions that require laparotomy. Accrual has been completed for a 200,000 woman trial in the United Kingdom that will test the ability of a rising CA125 to trigger TVS and subsequent exploratory surgery. Given the heterogeneity of ovarian cancer, it is unlikely that any single marker will be sufficiently sensitive to provide an effective initial screen. Sensitivity of serum assays might be enhanced by utilizing a

  20. Acute Abdomen in the 17th Week of Twin Pregnancy due to Ovarian Torsion – A Late Complication of IVF

    Science.gov (United States)

    Habek, D.; Bauman, R.; Rukavina Kralj, L.; Hafner, T.; Turudic, T.; Vujisic, S.

    2016-01-01

    Background: A 32-year-old woman with tubal factor infertility due to bilateral laparoscopic salpingectomy conceived twins with in vitro fertilization (IVF). She developed moderate ovarian hyperstimulation syndrome which was treated with anticoagulant therapy. The subsequent course of the twin pregnancy was normal until the 17th week of gestation when she presented to hospital because of a sharp pain in the right lower abdomen which ceased after admission. Case: Except for a single incident of vomiting, patient had no other subjective symptoms. The clinical examination showed tenderness of the lower right abdominal segment on palpation. The surgeon and the urologist found no signs of an acute surgical or urologic condition, and laboratory findings were within normal reference ranges for pregnant women. Two days after admission the pain reappeared; it was now much stronger and colic-like. The pain was initially located supraumbilically but subsequently spread diffusely across the lower abdomen. Abdominal guarding was present and laboratory findings showed an increase in inflammatory parameters. An enlarged and edematous right ovary was found on transvaginal ultrasound. Conclusion: Exploratory laparotomy via a vertical midline abdominal transection revealed a torqued necrotic right ovary with elements of inflammation and inflammatory adhesions involving the entire pelvis. The patient underwent right-sided ovariectomy and adhesiolysis. Recovered was normal and the patient was delivered of healthy twins in the 37th week of gestation. PMID:28017976

  1. A phase 2, randomized, double-blind, placebo-controlled trial of clinical activity and safety of subcutaneous Å6 in women with asymptomatic CA125 progression after first-line chemotherapy of epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Ghamande, Sharad A.; Silverman, Michael H.; Huh, Warner

    2008-01-01

    OBJECTIVES: A6 is a novel peptide that interferes with single-chain urokinase plasminogen activator activity and has shown anti-angiogenic, anti-migratory, and anti-invasive properties. We evaluated clinical efficacy and safety of subcutaneously administered A6 in women with epithelial ovarian...... cancer. METHODS: Women with epithelial ovarian, fallopian tube, or primary peritoneal cancer in clinical remission after first-line chemotherapy with 2 consecutive increases of CA125 values above normal but with no disease on physical examination or imaging studies were randomly assigned to receive daily...

  2. Cruciferous vegetables consumption and the risk of ovarian cancer: a meta-analysis of observational studies

    OpenAIRE

    Han, Bo; Li, Xuepeng; Yu, Tao

    2014-01-01

    Background To quantify the effect of cruciferous vegetable consumption on the incidence of ovarian cancer by meta-analyzing the existing observational studies and provides quantitative and high-level evidence. Methods A detailed literature search of Medline and EMBASE for all relevant papers published. A meta-analysis was conducted for the association between cruciferous vegetable consumption and risk of ovarian cancer. Results A total of 4,306 cases in 375,562 controls in 11 independent stud...

  3. Paraneoplastic thrombocytosis in ovarian cancer.

    Science.gov (United States)

    Stone, Rebecca L; Nick, Alpa M; McNeish, Iain A; Balkwill, Frances; Han, Hee Dong; Bottsford-Miller, Justin; Rupairmoole, Rajesha; Armaiz-Pena, Guillermo N; Pecot, Chad V; Coward, Jermaine; Deavers, Michael T; Vasquez, Hernan G; Urbauer, Diana; Landen, Charles N; Hu, Wei; Gershenson, Hannah; Matsuo, Koji; Shahzad, Mian M K; King, Erin R; Tekedereli, Ibrahim; Ozpolat, Bulent; Ahn, Edward H; Bond, Virginia K; Wang, Rui; Drew, Angela F; Gushiken, Francisca; Lamkin, Donald; Collins, Katherine; DeGeest, Koen; Lutgendorf, Susan K; Chiu, Wah; Lopez-Berestein, Gabriel; Afshar-Kharghan, Vahid; Sood, Anil K

    2012-02-16

    The mechanisms of paraneoplastic thrombocytosis in ovarian cancer and the role that platelets play in abetting cancer growth are unclear. We analyzed clinical data on 619 patients with epithelial ovarian cancer to test associations between platelet counts and disease outcome. Human samples and mouse models of epithelial ovarian cancer were used to explore the underlying mechanisms of paraneoplastic thrombocytosis. The effects of platelets on tumor growth and angiogenesis were ascertained. Thrombocytosis was significantly associated with advanced disease and shortened survival. Plasma levels of thrombopoietin and interleukin-6 were significantly elevated in patients who had thrombocytosis as compared with those who did not. In mouse models, increased hepatic thrombopoietin synthesis in response to tumor-derived interleukin-6 was an underlying mechanism of paraneoplastic thrombocytosis. Tumor-derived interleukin-6 and hepatic thrombopoietin were also linked to thrombocytosis in patients. Silencing thrombopoietin and interleukin-6 abrogated thrombocytosis in tumor-bearing mice. Anti-interleukin-6 antibody treatment significantly reduced platelet counts in tumor-bearing mice and in patients with epithelial ovarian cancer. In addition, neutralizing interleukin-6 significantly enhanced the therapeutic efficacy of paclitaxel in mouse models of epithelial ovarian cancer. The use of an antiplatelet antibody to halve platelet counts in tumor-bearing mice significantly reduced tumor growth and angiogenesis. These findings support the existence of a paracrine circuit wherein increased production of thrombopoietic cytokines in tumor and host tissue leads to paraneoplastic thrombocytosis, which fuels tumor growth. We speculate that countering paraneoplastic thrombocytosis either directly or indirectly by targeting these cytokines may have therapeutic potential. (Funded by the National Cancer Institute and others.).

  4. Ovarian cysts on prenatal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, Ursula [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Nemec, Stefan F., E-mail: stefan.nemec@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Medical Genetics Institute, Cedars Sinai Medical Center, 8700 Beverly Boulevard, PACT Suite 400, Los Angeles, CA 90048 (United States); Bettelheim, Dieter [Department of Obstetrics and Gynaecology, Division of Prenatal Diagnosis and Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University Vienna, Waehringerstrasse 13, A-1090 Vienna (Austria); Horcher, Ernst [Department of Pediatric Surgery, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Schoepf, Veronika [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Graham, John M.; Rimoin, David L. [Medical Genetics Institute, Cedars Sinai Medical Center, 8700 Beverly Boulevard, PACT Suite 400, Los Angeles, CA 90048 (United States); Weber, Michael; Prayer, Daniela [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2012-08-15

    Objective: Ovarian cysts are the most frequently encountered intra-abdominal masses in females in utero. They may, at times, require perinatal intervention. Using magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US) in prenatal diagnosis, we sought to demonstrate the ability to visualize ovarian cysts on prenatal MRI. Materials and methods: This retrospective study included 17 fetal MRI scans from 16 female fetuses (23-37 gestational weeks) with an MRI diagnosis of ovarian cysts after suspicious US findings. A multiplanar MRI protocol was applied to image and to characterize the cysts. The US and MRI findings were compared, and the prenatal findings were compared with postnatal imaging findings or histopathology. Results: Simple ovarian cysts were found in 10/16 cases and complex cysts in 7/16 cases, including one case with both. In 11/16 (69%) cases, US and MRI diagnoses were in agreement, and, in 5/16 (31%) cases, MRI specified or expanded the US diagnosis. In 6/16 cases, postnatal US showed that the cysts spontaneously resolved or decreased in size, and in 1/16 cases, postnatal imaging confirmed a hemorrhagic cyst. In 4/16 cases, the prenatal diagnoses were confirmed by surgery/histopathology, and for the rest, postnatal correlation was not available. Conclusion: Our results illustrate the MRI visualization of ovarian cysts in utero. In most cases, MRI will confirm the US diagnosis. In certain cases, MRI may provide further diagnostic information, additional to US, which is the standard technique for diagnosis, monitoring, and treatment planning.

  5. Genital powder exposure and the risk of epithelial ovarian cancer

    Science.gov (United States)

    Rosenblatt, Karin A.; Weiss, Noel S.; Cushing-Haugen, Kara L.; Wicklund, Kristine G.; Rossing, Mary Anne

    2011-01-01

    Background We conducted a population-based, case–control study to examine the association between the use of genital powder and ovarian cancer risk, including measures of extent and timing of exposure. We also assessed the relationship of powder use with risk of disease subtypes according to histology and degree of malignancy. Methods Information was collected during in-person interviews with 812 women with epithelial ovarian cancer diagnosed in western Washington State from 2002 to 2005 and 1,313 controls. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Overall, the perineal use of powder after bathing was associated with a slightly increased ovarian cancer risk (OR = 1.27, 95% CI: 0.97–1.66), which was most evident among women with borderline tumors (OR = 1.55, 95% CI: 1.02–2.37). We noted no clear pattern of risk increase on the basis of the extent of use, assessed as years in which powder was used, or as lifetime number of applications for invasive or borderline tumors, or their histologic subtypes. There was no alteration in the risk of ovarian cancer associated with other types of powder exposure (e.g., on sanitary napkins or diaphragms). Conclusions The International Agency for Research on Cancer has designated perineal exposure to talc (via the application of genital powders) as a possible carcinogen in women. A modest association of ovarian cancer with this exposure was seen in our study and in some previous ones, but that association generally has not been consistent within or among studies. Therefore, no stronger adjective than “possible” appears warranted at this time. PMID:21516319

  6. Inhibitory effect of ginsenoside Rg3 on ovarian cancer metastasis

    Institute of Scientific and Technical Information of China (English)

    XU Tian-min; CUI Man-hua; XIN Ying; GU Li-ping; JIANG Xin; SU Man-man; WANG Ding-ding; WANG Wen-jia

    2008-01-01

    Background Ginsenosides are main components extracted from ginseng, and ginsenoside Rg3 is one of the most important parts. Ginsenoside Rg3 has been found to inhibit several kinds of tumor growth and metastasis. The present study was undertaken to investigate the effect of ginsenoside Rg3 on human ovarian cancer metastasis and the possible mechanism.Methods The experimental lung metastasis models of ovarian cancer SKOV-3 and the assay of tumor-induced angiogenesis were used to observe the inhibitory effects of Rg3 on tumor metastasis and angiogenesis. The effect of Rg3 on invasive ability of SKOV-3 cells in vitro was detected by Boyden chamber, and immunofluorescence staining was used to recognize the expression of matrix metalloproteinase 9 (MMP-9) in SKOV-3 cells.Results In the experimental lung metastasis models of ovarian cancer, the number of tumor colonies in the lung and vessels oriented toward the tumor mass in each ginsenoside Rg3 group, was lower than that of control group. The invasive ability and MMP-9 expression of SKOV-3 cells decreased significantly after treatment with ginsenoside Rg3.Conclusions Ginsenoside Rg3 can significantly inhibit the metastasis of ovarian cancer. The inhibitory effect is partially due to inhibition of tumor-induced angiogenesis and decrease of invasive ability and MMP-9 expression of SKOV-3 cells.

  7. Low Programmed Cell Death 5 Expression is a Prognostic Factor in Ovarian Cancer

    Institute of Scientific and Technical Information of China (English)

    Li Gao; Xue Ye; Rui-Qiong Ma; Hong-Yan Cheng; Hong-Jing Han; Heng Cui; Li-Hui Wei

    2015-01-01

    Background:Ovarian cancer is a leading gynecological malignancy.We investigated the prognostic value of programmed cell death 5 (PDCD5) in patients with ovarian cancer.Methods:Expression levels ofPDCD5 mRNA and protein were examined in six ovarian cancer cell lines (SKOV3,CAOV3,ES2,OV1,3AO,and HOC1A) and one normal ovarian epithelial cell line (T29) using reverse transcription polymerase chain reaction,Westem blotting,and flow cytometry.After inducing PDCD5 induction in SKOV3 cells or treating this cell line with taxol or doxorubicin (either alone or combined),apoptosis was measured by Annexin V-FITC/propidium iodide staining.Correlations between PDCD5 protein expression and pathological features,histological grade,FIGO stage,effective cytoreductive surgery,and serum cancer antigen-125 values were evaluated in patients with ovarian cancer.Results:PDCD5 mRNA and protein expression were downregulated in ovarian cancer cells.Recombinant human PDCD5 increased doxorubicin-induced apoptosis in SKOV3 cells (15.96 ± 2.07%,vs.3.17 ± 1.45% in controls).In patients with ovarian cancer,PDCD5 expression was inversely correlated with FIGO stage,pathological grade,and patient survival (P < 0.05,R =0.7139 for survival).Conclusions:PDCD5 expression is negatively correlated with disease progression and stage in ovarian cancer.Therefore,measuring PDCD5 expression may be a good method of determining the prognosis of ovarian cancer patients.

  8. Effect of Previous Chemotherapy on the Quality of Cryopreserved Human Ovarian Tissue In Vitro.

    Directory of Open Access Journals (Sweden)

    Babak Asadi Azarbaijani

    Full Text Available Cryopreservation of ovarian tissue has been widely accepted as an option for fertility preservation among cancer patients. Some patients are exposed to chemotherapy prior to ovarian tissue cryopreservation. Consequently, assessment of the developmental capacity of human ovarian tissue after chemotherapy is of primary importance.In order to study the impact of previous chemotherapy on in vitro development and viability of ovarian follicles, quality control samples from 34 female cancer patients at median age of 15 years (range 1‒35, cryopreserved for fertility preservation before (n = 14 or after (n = 20 initiation of chemotherapy, were thawed and cultured for 7 days. The morphology and developmental stages of ovarian follicles were studied by light microscopy before and after culture. Possible associations between follicular densities, age and exposure to alkylating agents, expressed as cyclophosphamide equivalent dose (CED were tested.Exposure to chemotherapy significantly impaired the survival and development of ovarian follicles in culture. After seven days, significantly higher densities of intermediary, primary and secondary follicles and lower densities of atretic follicles was detected in the samples collected before chemotherapy. Increasing dose of alkylating agents was identified by multivariate linear regression analysis as an independent predictor of a higher density of atretic follicles, whereas increasing age of the patient predicted a better outcome with less follicle atresia and a higher density of maturing follicles.This study provides quantitative in vitro evidence of the impact of chemotherapy on developmental capacity of cryopreserved human ovarian tissue. The results indicate that fertility preservation should be carried out, if possible, before initiation of alkylating agents in order to guarantee better in vitro survival of ovarian follicles. In addition, ovarian samples from younger girls show lower viability and fewer

  9. Ovarian stromal hyperplasia and ovarian vein steroid levels in relation to endometrioid endometrial cancer

    NARCIS (Netherlands)

    Jongen, VHWM; Hollema, H; van der Zee, AGJ; Santema, JG; Heineman, MJ

    2003-01-01

    Objective To study the relationship between the presence of endometrioid endometrial cancer, the degree of ovarian stromal hyperplasia and ovarian steroid production in postmenopausal women. Design Retrospective and prospective study, respectively. Setting Medical Centre Leeuwarden and the Universit

  10. What Are the Risk Factors for Ovarian Cancer?

    Science.gov (United States)

    ... and Prevention What Are the Risk Factors for Ovarian Cancer? A risk factor is anything that changes your ... taking both estrogen and progesterone. Family history of ovarian cancer, breast cancer, or colorectal cancer Ovarian cancer can ...

  11. Risks of Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening

    Science.gov (United States)

    ... Screening Research Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... ovarian cancer. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening Key Points Tests are used to screen for ...

  12. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening

    Science.gov (United States)

    ... Screening Research Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... ovarian cancer. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening Key Points Tests are used to screen for ...

  13. Efficacy of ovarian tissue cryopreservation in a major European center

    NARCIS (Netherlands)

    Bastings, L.; Liebenthron, J.; Westphal, J.R.; Beerendonk, C.C.M.; Ven, H. van de; Meinecke, B.; Montag, M.; Braat, D.D.M.; Peek, R.

    2014-01-01

    PURPOSE: To evaluate the effect of cryopreservation and thawing of ovarian tissue from oncological patients opting for fertility preservation on ovarian tissue viability. METHODS: In this prospective cohort study, the ovarian tissue viability before and after cryopreservation and thawing was

  14. Estrogen receptor beta rs1271572 polymorphism and invasive ovarian carcinoma risk: pooled analysis within the Ovarian Cancer Association Consortium.

    Directory of Open Access Journals (Sweden)

    Galina Lurie

    Full Text Available The association of ovarian carcinoma risk with the polymorphism rs1271572 in the estrogen receptor beta (ESR2 gene was examined in 4946 women with primary invasive ovarian carcinoma and 6582 controls in a pooled analysis of ten case-control studies within the Ovarian Cancer Association Consortium (OCAC. All participants were non-Hispanic white women. Odds ratios (ORs and 95% confidence intervals (CIs were estimated using unconditional logistic regression adjusted for site and age. Women with the TT genotype were at increased risk of ovarian carcinoma compared to carriers of the G allele (OR = 1.10; 95%; CI: 1.01-1.21; p = 0.04; the OR was 1.09 (CI: 0.99-1.20; p = 0.07 after excluding data from the center (Hawaii that nominated this SNP for OCAC genotyping A stronger association of rs1271572 TT versus GT/GG with risk was observed among women aged ≤50 years versus older women (OR = 1.35; CI: 1.12-1.62; p = 0.002; p for interaction = 0.02 that remained statistically significant after excluding Hawaii data (OR = 1.34; CI: 1.11-1.61; p = 0.009. No heterogeneity of the association was observed by study, menopausal status, gravidity, parity, use of contraceptive or menopausal hormones, tumor histological type, or stage at diagnosis. This pooled analysis suggests that rs1271572 might influence the risk of ovarian cancer, in particular among younger women.

  15. Long-Term Moderate Oxidative Stress Decreased Ovarian Reproductive Function by Reducing Follicle Quality and Progesterone Production

    Science.gov (United States)

    Lai, Zhiwen; Tian, Yong; Fang, Li; Wu, Meng; Xiong, Jiaqiang; Qin, Xian; Luo, Aiyue; Wang, Shixuan

    2016-01-01

    Ovarian aging is a long-term and complex process associated with a decrease in follicular quantity and quality. The damaging effects of reactive oxygen species (ROS) in ovarian aging and ovarian aging-associated disorders have received relatively little attention. Thus, we assessed if the oxidative stress induced by long-term (defined by the Environmental Protection Agency as at least 30 days in duration) moderate ozone inhalation reduced ovarian reserves, decreased ovarian function and induced ovarian aging-associated disorders. The expression of oxidative stress markers and antioxidant enzymes was used to determine the degree of oxidative stress. Ultrastructural changes in ovarian cells were examined via electron microscopy. The ovarian reserve was assessed by measuring multiple parameters, such as the size of the primordial follicle pool and anti-Müllerian hormone (AMH) expression. The estrous cycle, hormone levels and fertility status were investigated to assess ovarian function. To investigate ovarian aging-associated disorders, we utilized bone density and cardiovascular ultrasonography in mice. The levels of oxidized metabolites, such as 8-hydroxy-2´-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE) and nitrotyrosine (NTY), significantly increased in ovarian cells in response to increased oxidative stress. The ultrastructural analysis indicated that lipid droplet formation and the proportion of mitochondria with damaged membranes in granulosa cells were markedly increased in ozone-exposed mice when compared with the control group. Ozone exposure did not change the size of the primordial follicle pool or anti-Müllerian hormone (AMH) expression. The estrogen concentration remained normal; however, progesterone and testosterone levels decreased. The mice exposed to ozone inhalation exhibited a substantial decrease in fertility and fecundity. No differences were revealed by the bone density or cardiovascular ultrasounds. These findings suggest that the

  16. Bilateral Ovarian Torsion during Follow-up for Antenatally Detected Ovarian Cysts.

    Science.gov (United States)

    Zupancic, Bozidar; Baskovic, Marko; Sovic, Ljudevit; Habek, Dubravko

    2017-01-01

    Ovarian torsion is a surgical emergency demanding timely diagnosis and treatment to prevent loss of the ovaries which if happens may result in functional and emotional consequences. Simple (less than 5cm in size) ovarian cysts require follow-up for potential self-resolution. We describe a case of antenatally detected bilateral ovarian cysts that developed bilateral ovarian torsions on follow-up, postnatally.

  17. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue

    DEFF Research Database (Denmark)

    Donnez, Jacques; Dolmans, Marie-Madeleine; Pellicer, Antonio

    2013-01-01

    to preserve fertility in cancer patients. The present review reports the results of 60 orthotopic reimplantations of cryopreserved ovarian tissue performed by three teams, as well as 24 live births reported in the literature to date. Restoration of ovarian activity occurred in almost all cases in the three...... of ovarian tissue may be combined with removal, via puncture, of small antral follicles, making it possible to freeze both ovarian tissue and isolated immature oocytes....

  18. Genetic profiles distinguish different types of hereditary ovarian cancer

    DEFF Research Database (Denmark)

    Domanska, Katarina; Malander, Susanne; Staaf, Johan

    2010-01-01

    Heredity represents the strongest risk factor for ovarian cancer with disease predisposing mutations identified in 15% of the tumors. With the aim to identify genetic classifiers for hereditary ovarian cancer, we profiled hereditary ovarian cancers linked to the hereditary breast and ovarian canc...... that HBOC and HNPCC associated ovarian cancer develop along distinct genetic pathways and genetic profiles can thus be applied to distinguish between different types of hereditary ovarian cancer....

  19. Rare ovarian lesion in an adolescent girl

    Directory of Open Access Journals (Sweden)

    Ramasamy Senthilnathan

    2008-01-01

    Full Text Available Large solid ovarian lesions are considered malignant in nature in pediatric and adolescent age group. We present an adolescent girl who had large solid ovarian lesion, with negative tumor markers. She underwent laparotomy and right oopherectomy. Histopathology revealed that the lesion was massive ovarian edema. This is an extremely rare lesion of ovary and is benign in nature. Very few case reports are available in English literature. Hence we suggest that massive ovarian edema should be considred as one of the differential diagnosis in all the patients having large solid ovarian lesions with ngative tumor marker assay. Ovarian preservation with the help of frozen section analysis should always be considred in these patients.

  20. Management of ovarian cysts in infants

    Directory of Open Access Journals (Sweden)

    Yan Xue-qiang

    2015-01-01

    Full Text Available Background: To discuss the experience of diagnosis and treatment of ovarian cyst in infants. Materials and Methods: A retrospective review was conducted on 20 infants who suffered from ovarian cyst. Results: There were no dysplasia ovarian was found in children which were preoperatively diagnosed simplex cyst. Within thirteen children preoperatively detected mixed cystic-solid lesion, six cases ovarian cysts disappeared and two cases underwent poor blood supply in the following time. Conclusion: Adverse effects for ovarian cyst in infants can be prevented by agressive surgical intervention. Harmful effects of ovarian cyst can be prevented by positive surgical intervention despite the diagnostic difficulties in children with clinical symptoms of this condition.

  1. Ovarian-Sparing Surgery in Pediatric Benign Ovarian Tumors.

    Science.gov (United States)

    Abbas, Paulette I; Dietrich, Jennifer E; Francis, Jessica A; Brandt, Mary L; Cass, Darrell L; Lopez, Monica E

    2016-10-01

    To evaluate outcomes of children after ovarian-sparing surgery (OSS) for non-neoplastic and benign neoplastic ovarian lesions. Retrospective cohort study from January 2003 to January 2012. Single, high-volume, tertiary care hospital. Children 18 years of age and younger. None. Postoperative complications and tumor recurrence after OSS. One hundred nine patients underwent OSS with a median age of 13.3 years (interquartile range [IQR], 11.4-15.1 years). Eighty-two patients were treated laparoscopically with 4 conversions to an open procedure. Postoperative complications included surgical site infections in 7 patients (6%). Pathology most commonly revealed functional ovarian cysts (n = 57) and mature teratomas (n = 37). Ninety-four patients (86%) were followed for a median of 10.4 months (IQR, 0.72-30.8 months). Fifty-five patients (60%) had subsequent imaging surveillance a median of 7.6 months postoperatively (IQR, 3.9-13 months). Ten patients (10%) developed a second ipsilateral lesion within a median time of 11 months (IQR, 7.7-24 months), of whom 5 girls had repeated surgery for mass enlargement or persistent abdominal pain at a median time of 10.5 months (IQR, 8.0-12.65 months). Fifty-eight patients (63%) began or resumed menses at their most recent follow-up. Three girls became pregnant after OSS at a median follow-up of 5 years (range, 2.4-6.7 years). Benign ovarian lesions in children can be treated successfully with OSS with low recurrence and repeat surgery rates. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  2. Screening of the residual normal ovarian tissue adjacent to orthotopic epithelial ovarian carcinomas in nude mice.

    Science.gov (United States)

    Zhu, G H; Wang, S T; Yao, M Z; Cai, J H; Chen, C Y; Yang, Z X; Hong, L; Yang, S Y

    2014-04-16

    The objective of this study was to explore the feasibility and methods of screening the residual normal ovarian tissue adjacent to orthotopic ovarian carcinomas in nude mice. Human epithelial ovarian cancer cells (OVCAR3) were subcutaneously implanted for a tumor source and ovarian orthotopic transplantation. The cancer tissue, proximal paraneoplastic tissue, middle paraneoplastic tissue, remote paraneoplastic tissue, and normal ovarian tissue were removed. CK-7, CA125, p53, survivin, MMP-2, and TIMP-2 expression was detected by reverse transcription polymerase chain reaction. We obtained 35 paraneoplastic residual ovarian tissues with normal biopsies from 40 cases of an orthotopic epithelial ovarian carcinoma model (87.5%). CK-7, CA125, p53, survivin, MMP-2, and TIMP-2 expression was lower in proximal paraneoplastic tissue than in cancer tissue (P tissue (P tissue as well as among residual normal ovarian tissues with different severity (P > 0.05). In ovarian tissues of 20 normal nude mice, the expression of CK- 7, CA125, p53, survivin, MMP-2, and TIMP-2 was negative. Overa