Effect of ovarian stimulation protocol and ovarian response on oocyte quality

2008 ◽  
Vol 90 ◽  
pp. S325
Author(s):  
R.d.C.S. Figueira ◽  
D.P.A.F. Braga ◽  
L.S. Francisco ◽  
C. Madaschi ◽  
A. Iaconelli ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Oocyte Quality ◽  
Stimulation Protocol

scholarly journals A flexible short protocol in women with poor ovarian response over 40 years old

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Xinyue Zhang ◽  
Ting Feng ◽  
Jihong Yang ◽  
Yingying Hao ◽  
Suying Li ◽  
...  
Keyword(s):  
Embryo Implantation ◽  
Ovarian Response ◽  
Oocyte Quality ◽  
Poor Ovarian Response ◽  
Stimulation Protocol ◽  
Start Time ◽  
Ovulation Stimulation ◽  
Mild Stimulation ◽  
Successful Clinical Outcome ◽  
Over 40 Years

Abstract Background Ovarian responsiveness to controlled ovarian stimulation is essential for a successful clinical outcome in assisted reproductive technology (ART) cycles. We aimed to find a suitable new ovulation stimulation protocol for poor ovarian response (POR) patients over 40 years old. Methods A retrospective analysis of 488 ART cycles was evaluated from January 2015 to June 2019. Comparisons were made between the flexible short protocol (FSP), routine short protocol and mild stimulation protocol. Results Compared with the routine short protocol, the FSP delayed the gonadotropin start time and reduced the total gonadotropin dose per stimulation cycle. At the same time, compared with the mild stimulation protocol, the FSP improved oocyte quality and embryo quality and improved embryo implantation potential after transfer. Furthermore, the use of the FSP reduced the probability of premature ovulation, as it inhibited the premature luteinizing hormone (LH) surge to a certain extent. Conclusions The FSP yielded better outcomes than other protocols for patients with POR over 40 years old in our study. However, further prospective studies are needed to provide more substantial evidence and to determine whether the FSP can be successful for both patients over 40 years group and younger POR patients.

scholarly journals Anti-müllerian Hormone for the Prediction of Ovarian Response in Progestin-Primed Ovarian Stimulation Protocol for IVF

2019 ◽  
Vol 10 ◽  
Author(s):  
Jialyu Huang ◽  
Jiaying Lin ◽  
Hongyuan Gao ◽  
Yun Wang ◽  
Xiuxian Zhu ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Stimulation Protocol

P–198 Higher rate of direct uneven cleavage (DUC) embryos in women exhibiting high ovarian response

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Schachte. . Safrai ◽  
G Karavani ◽  
E Esh. Broder ◽  
E Levitase ◽  
T Wainstock ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Embryo Quality ◽  
Implantation Rate ◽  
Ovarian Response ◽  
Oocyte Quality ◽  
Similar Rate ◽  
Pregnancy Rates ◽  
Morphokinetic Parameters ◽  
Response Group ◽  
Implantation And Pregnancy Rates

Abstract Study question Does high ovarian response to controlled ovarian stimulation (COS) have a negative effect on oocyte quality? Summary answer High ovarian response is associated with reduced oocyte quality manifested as higher fraction of immature oocytes and higher rate of direct uneven cleavage (DUC) embryos. What is known already The literature regarding the effect of ovarian hyperstimulation on oocyte quality is limited and controversial. Results from several studies suggest that hyper response to controlled ovarian stimulation has a detrimental effect on oocyte and embryo quality, while others failed to confirm the existence of a direct toxic effect on oocyte and embryo quality. The association between temporal embryonal milestones and implantation rate has been previously demonstrated ,offering an additive tool by which oocyte quality, represented by embryo dynamics, can be evaluated. None of the aforementioned studies, however, used time lapse monitoring (TLM) system to evaluate oocyte and embryo quality. Study design, size, duration This study included a retrospective assessment of morphokinetic parameters performed by TLM from three university affiliated medical centers between January 2014 and December 2019. The developmental process and kinetics of 1863 embryos obtained from the study group, referred as the “ high ovarian response” (HOR) group, was compared to 4907 embryos from the control group - the “normal ovarian response” (NOR) group. Participants/materials, setting, methods The study included patients younger than 38 years who underwent COS with consecutive aspiration of either more than 15 oocytes (the HOR group) or 6–15 oocytes (the NOR group). A comparison was made between the groups regarding morphokinetic parameters, including the rate of embryos manifesting direct uneven cleavage (DUC) at first cleavage (DUC–1), as well as implantation and pregnancy rates. Logistic regression was conducted to assess the association between patients’ characteristics and implantation rate. Main results and the role of chance Oocyte maturation rate was significantly lower, and the DUC–1 embryos rate was significantly higher in the high ovarian response group compared to the normal ovarian response group (56.5% Vs 90.0%, p < 0.001 and 16.2% Vs 12.0%, p = <0.001; respectively). Following the exclusion of DUC–1 embryos, embryos from the HOR and the NOR groups reached the consecutive morphokinetic milestones at a similar rate and demonstrated similar implantation and clinical pregnancy rates. In a multivariate analysis preformed, only maternal age was found to be predictive for implantation. Limitations, reasons for caution The groups were not homogenous in their basic characteristics. Important information regarding the maximal dose of GT obtained, previous IVF response and ovarian reserve testing was lacking Wider implications of the findings: Higher oocyte quantity might have an effect on oocyte quality manifested as higher fraction of incompetent oocytes and higher rate of DUC–1 embryos. Once beyond the preliminary developmental stages, embryos from both groups reach the morphokinetic milestones at a similar rate and display similar implantation and pregnancy rates. Trial registration number Not applicable

The two-step process of ovarian follicular growth and maturation in mammals can be compared to a fruit ripening where quality depends on the second step

2021 ◽  
Author(s):  
Marc-André Sirard
Keyword(s):  
Follicular Development ◽  
Ovarian Response ◽  
Oocyte Quality ◽  
Second Step ◽  
Stimulation Protocol ◽  
Dynamic Nature ◽  
Apple Ripening ◽  
Ovarian Follicular Growth ◽  
Biphasic Process ◽  
Human Ivf

Abstract In human IVF, the main uncertainty factor impacting on success is oocyte quality, which largely depends on the follicular status at the time of collection. Decades of debate ensued to find the perfect stimulation protocol demonstrated the complexity of the ovarian response to exogenous gonadotropins and the dynamic nature of late folliculogenesis. Although several follicular markers, proteins, RNA from granulosa cells or microRNA and follicular fluid metabolites have been associated with outcome, the possibility to influence them during stimulation remains elusive. The heterogeneity of the follicle’s maturity following control ovarian stimulation is also an important factor to explain average poor oocyte quality still observed today. In this review, the analogy between the apple ripening on the tree and follicular development is presented to focus the attention on a biphasic process: growth and differentiation. The molecular analysis of the progressive follicular differentiation indicates 2 competing phenomena: growth and differentiation where a delicate balance must operate from one to the other to ensure proper maturity at ovulation. As long as FSH stimulates growth, follicles remain green, and it is only when FSH is replaced by LH that the ripening process begins, and “apples” become red. Both fruits, follicles and apples, depend on a perfect timing of events to generate offspring.

scholarly journals Mass spectrometry-based glycomic profiling of the total IgG and total proteome N-glycomes isolated from follicular fluid

2020 ◽  
Vol 11 (1) ◽  
pp. 153-171
Author(s):  
Marko Klobučar ◽  
Sanja Dević Pavlić ◽  
Iris Car ◽  
Neda Smiljan Severinski ◽  
Tamara Tramišak Milaković ◽  
...  
Keyword(s):  
Follicular Fluid ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Oocyte Quality ◽  
Fertilization Success ◽  
Success Rates ◽  
Stimulation Protocol ◽  
Total Proteome ◽  
Tof Ms

AbstractCouples with infertility issues have been assisted by in vitro fertilization reproduction technologies with high success rates of 50-80%. However, complications associated with ovarian stimulation remain, such as ovarian hyperstimulation. Oocyte quality is a significant factor impacting the outcome of in vitro fertilization procedures, but other processes are also critical for fertilization success. Increasing evidence points to aberrant inflammation as one of these critical processes reflected in molecular changes, including glycosylation of proteins. Here we report results from a MALDI-TOF-MS-based glycomic profiling of the total IgG and total proteome N-glycomes isolated from the follicular fluid obtained from patients undergoing fertilization through either (1) assisted reproduction by modified natural cycle or (2) controlled ovarian stimulation (GnRH antagonist, GnRH Ant) protocols. Significant inflammatory-related differences between analyzed N-glycomes were observed from samples and correlated with the ovarian stimulation protocol used in patients.

The impact of ovarian stimulation protocol on oocyte quality, subsequent in vitro embryo development, and pregnancy after transfer to recipients in Eld's deer ( Rucervus eldii thamin )

2017 ◽  
Vol 91 ◽  
pp. 134-144 ◽  
Author(s):  
Ampika Thongphakdee ◽  
Debra K. Berg ◽  
Theerawat Tharasanit ◽  
Nikorn Thongtip ◽  
Wanlaya Tipkantha ◽  
...  
Keyword(s):  
Embryo Development ◽  
Ovarian Stimulation ◽  
Oocyte Quality ◽  
Stimulation Protocol ◽  
The Impact

scholarly journals Luteal-phase protocol in poor ovarian response: a comparative study with an antagonist protocol

2017 ◽  
Vol 45 (6) ◽  
pp. 1731-1738 ◽  
Author(s):  
Yan Wu ◽  
Fu-Chun Zhao ◽  
Yong Sun ◽  
Pei-Shu Liu
Keyword(s):  
Ovarian Stimulation ◽  
Luteal Phase ◽  
Gnrh Antagonist ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Stimulation Protocol ◽  
The Mean ◽  
Gnrh Antagonist Protocol ◽  
Antagonist Protocol ◽  
Luteal Phase Ovarian Stimulation

Objective This retrospective study compared the effect of the luteal phase ovarian stimulation protocol (LP group) with the gonadotrophin-releasing hormone (GnRH) antagonist protocol (AN group) in women with poor ovarian responses. Methods Ovarian stimulation was initiated with 225 IU of human gonadotrophin (hMG) daily. When the dominant follicle diameter exceeded 13 mm, 0.25 mg of a GnRH antagonist was used daily until human chorionic gonadotrophin (HCG) administration in the AN group. A GnRH antagonist was not used in the LP group. Ovulation was induced with HCG for all patients when at least one follicle reached a diameter of 16 mm or one dominant follicle reached 18 mm. The highest quality embryos were transferred or cryopreserved for later transfer. Results From January 2013 to December 2015, 274 women with poor ovarian response were included. A total of 108 patients underwent the luteal phase ovarian stimulation protocol while 166 patients underwent the GnRH antagonist protocol. hMG was used for more total days in the LP group was than in the AN group. Oestradiol levels on the day of HCG administration in the LP group were significantly lower than those in the AN group. The mean number of oocytes retrieved in the LP and AN groups was 3.5 ± 2.5 and 3.5 ± 2.9, respectively. The mean number of embryos of the highest quality was 1.7 ± 1.2 and 1.7 ± 1.5, respectively. The clinical pregnancy and implantation rates in the LP and AN groups were 26.2% (22/84) and 25% (29/116), and 15.5% (24/155) and 16.3% (35/215), respectively. Conclusions The luteal phase ovarian stimulation protocol can be applied in women with poor ovarian response and attain comparable clinical pregnancy and implantation rates to those of the GnRH antagonist protocol.

scholarly journals A direct action for GH in improvement of oocyte quality in poor-responder patients

Reproduction ◽  
2015 ◽  
Vol 149 (2) ◽  
pp. 147-154 ◽  
Author(s):  
B M Weall ◽  
S Al-Samerria ◽  
J Conceicao ◽  
J L Yovich ◽  
G Almahbobi
Keyword(s):  
Ovarian Stimulation ◽  
Direct Action ◽  
Scientific Evidence ◽  
Ovarian Response ◽  
Poor Responder ◽  
Oocyte Quality ◽  
Human Oocyte ◽  
Mitochondrial Activity ◽  
Gh Treatment ◽  
Computer Based

Declining female fecundity at later age and the increasing tendency for women to delay childbirth have lead to a drastic rise in the number of women seeking assisted reproductive technology. Many women fail to respond adequately to standard ovarian stimulation regimens, raising a significant therapeutic challenge. Recently, we have demonstrated that the administration of GH, as an adjunct to ovarian stimulation, has improved the clinical outcomes by enhancing the oocyte quality. However, the mechanism(s) by which GH facilitated this improvement is yet to be understood. This study aimed to determine these potential mechanism(s) through the use of immunofluorescent localisation of GH receptors (GHRs) on the human oocyte and unbiased computer-based quantification to assess and compare oocyte quality between women of varying ages, with or without GH treatment. This study demonstrates for the first time, the presence of GHRs on the human oocyte. The oocytes retrieved from older women showed significant decrease in the expression of GHRs and amount of functional mitochondria when compared with those from younger patients. More interestingly, when older patients were treated with GH, a significant increase in functional mitochondria was observed in their oocytes. We conclude that GH exerts a direct mode of action, enabling the improvement of oocyte quality observed in our previous study, via the upregulation of its own receptors and enhancement of mitochondrial activity. This result, together with recent observations, provides scientific evidence in support of the use of GH supplementation for the clinical management of poor ovarian response.

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