Clomiphene Citrate as An Adjuvant to hMG Stimulation of the Ovaries in Mid-to-late Follicular Phase and Subsequently Pregnancy Outcome of Frozen-thawed Embryo Transfers

2013 ◽  
Vol 24 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Yan KANG ◽  
Qing-qing HONG ◽  
Wei-ran CHAI ◽  
Yong-lun FU ◽  
Ai AI ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Clomiphene Citrate ◽  
Follicular Phase ◽  
Late Follicular Phase ◽  
Stimulation Of

scholarly journals A comparative study of ovulation induction with clomiphene versus clomiphene and bromocriptine in follicular phase of normoprolactinemic PCOS women

2017 ◽  
Vol 6 (8) ◽  
pp. 3464
Author(s):  
S. R. Gayathri ◽  
Saswati Tripathy ◽  
M. Muthulakshmi
Keyword(s):  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Follicular Phase ◽  
Serum Prolactin ◽  
Gonadotropin Secretion ◽  
Transient Rise ◽  
Significant Difference ◽  
Hypothalamic Pituitary Axis ◽  
Late Follicular Phase

Background: Hypothalamic pituitary axis dysfunction accounts for majority of ovulatory disorders and a predominant cause of women with PCOS. There is a dopaminergic control on gonadotropin secretion. In normoprolactinemic PCOS patients transient rise in serum prolactin can be observed during the late follicular phase and luteal phase. So, the aim of the study is to know the effect of bromocriptine and clomiphene in ovulation induction as compared to clomiphene alone.Methods: Based on the various inclusion and exclusion criteria, seventy patients were randomly assigned into two groups. The patients in the first group were treated with tablet of clomiphene citrate (100 mg) from day 3 to day 7 of each cycle. The patients in the other group received 100mg of clomiphene citrate from day 3 to day 7 of each cycle and tablet bromocriptine (2.5 mg) from day5 to day14. Both groups were followed up with follicular study for three months. At the end of the three cycles the hormonal statuses of the patients were determined.Results: There was no significant difference found in other hormones like serum FSH, LH and estradiol in both groups. The follicular diameter and the average endometrial thickness was increased to a significant level in the CC+Bcrt group as compared to the CC group. The rate of ovulation and pregnancy rate was higher in combination group.Conclusions: Bromocriptine with clomiphene in follicular phase has an advantage of improving follicular diameter, endometrial thickness and hence ovulation and pregnancy rates. 

CHANGES IN THE CONCENTRATION OF PITUITARY AND STEROID HORMONES IN THE FOLLICULAR FLUID OF HUMAN GRAAFIAN FOLLICLES THROUGHOUT THE MENSTRUAL CYCLE

1975 ◽  
Vol 64 (3) ◽  
pp. 555-571 ◽  
Author(s):  
K. P. McNATTY ◽  
W. M. HUNTER ◽  
A. S. McNEILLY ◽  
R. S. SAWERS
Keyword(s):  
Menstrual Cycle ◽  
Steroid Hormones ◽  
Follicular Fluid ◽  
Follicle Stimulating Hormone ◽  
Secretory Activity ◽  
Follicular Phase ◽  
Hormonal Changes ◽  
Peripheral Plasma ◽  
Before And After ◽  
Late Follicular Phase

SUMMARY The concentrations of FSH, LH, prolactin, oestradiol and progesterone were measured in peripheral plasma and follicular fluid of women throughout the menstrual cycle. With the exception of prolactin, concentrations of pituitary and steroid hormones in follicular fluid correlated with those in peripheral plasma. Follicle-stimulating hormone was present in a greater number of small follicles ( < 8 mm) during or just after the peaks of FSH in peripheral plasma. During the mid-follicular phase the concentration of both FSH and oestradiol in fluid from large follicles ( ≥ 8 mm) was high. During the late follicular phase the large follicles ( ≥ 8 mm) contained high amounts of progesterone in addition to oestradiol, low physiological levels of prolactin, and concentrations of LH and FSH about 30 and 60% respectively of those found in plasma. By contrast no large 'active' follicles ( ≥ 8 mm) were found during the luteal phase although many contained both LH and FSH. Luteinizing hormone was present in a proportion of small follicles ( < 8 mm) during the late follicular and early luteal but not at other stages of the menstrual cycle. It is suggested that a precise sequence of hormonal changes occur within the microenvironment of the developing Graafian follicle; the order in which they occur may be of considerable importance for the growth of that follicle and secretory activity of the granulosa cells both before and after ovulation.

P–615 The effect of late-follicular phase progesterone rise on embryo ploidy, embryo quality and cumulative live birth rates following a freeze-only strategy

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A R Neves ◽  
S Santos-Ribeiro ◽  
S Garcí. Martínez ◽  
S Soares ◽  
J A García-Velasco ◽  
...  
Keyword(s):  
Live Birth ◽  
Embryo Quality ◽  
Mixed Model ◽  
Ovarian Response ◽  
Follicular Phase ◽  
Mixed Model Analysis ◽  
Late Follicular Phase ◽  
Blastulation Rate ◽  
Antagonist Protocol ◽  
Euploidy Rate

Abstract Study question Is late-follicular phase progesterone elevation (PE) associated with a deleterious effect on embryo euploidy, embryo blastulation and cumulative live birth rates (CLBRs)? Summary answer Late-follicular phase PE has no impact on impact on embryo euploidy rate, embryo blastulation rate nor on the CLBR. What is known already The effect of PE in ART outcomes has been extensively studied, yielding so far conflicting results. While some authors claim it is only detrimental to endometrial receptivity, others have suggested that it may also impair oocyte/embryo quality. Moreover, little is known regarding the potential effect PE may have on embryo ploidy and, consequently, CLBR. Study design, size, duration A multicenter retrospective cross-sectional study was performed between August 2017 and December 2019. A total of 1495 ICSI cycles coupled with preimplantation genetic diagnosis for aneuploidies (PGT-A) and deferred frozen embryo transfer (FET) were analyzed. Participants/materials, setting, methods All patients underwent ovarian stimulation with GnRH antagonist protocol and performed a serum progesterone measurement at one of the participating private fertility clinics on the day of trigger. The sample was stratified according to the progesterone levels: normal (≤1.50 ng/ml) and high (&gt;1.50 ng/ml). The primary outcome was the embryo euploidy rate. Secondary outcomes were the number of euploid blastocysts, the blastulation rate and CLBR. Main results and the role of chance Late-follicular phase PE was associated with higher late-follicular estradiol levels (2847.56±1091.10 pg/ml vs. 2240.94± 996.37 pg/ml, p &lt; 0.001) and more oocytes retrieved (17.67±8.86 vs. 12.70±7.00, p &lt; 0.001). The number of euploid embryos was higher in the PE group (2.32±1.74 vs. 1.86±1.42, p &lt; 0.001), whereas the embryo euploidy rate (48.3% [44.9%–51.7%] vs. 49.1% [47.7%–50.6%] and blastulation rate (47.1% [43.7%–50.5%] vs. 51.0% [49.7%–52.4%]) were comparable between the two groups. Likewise, no significant differences were found regarding the live birth rate (LBR) after the first FET (34.1% vs. 31.1%, p = 0.427) nor the CLBRs (38.9% vs. 37.0%, p = 0.637). Mixed-model analysis was performed in order to account for the clustering of cycles in the same patient. Adjusting for patients’ age, PE and BMI, PE failed to demonstrate any effect on the embryo euploidy rate (OR 1.03 [95% CI 0.89–1.20]). Mixed-model analysis for the number of euploid embryos was also performed. After adjusting for PE, age, BMI and ovarian response, PE did not affect the number of euploid embryos (0.02 [95%CI –0.21;0.25]. Multivariate logistic regression adjusted for PE, age, BMI and ovarian response revealed that PE was not associated with the CLBR (adjOR 0.96 [95% CI 0.66–1.38]). Limitations, reasons for caution Limitations of the study include its retrospective nature. Moreover, including only GnRH antagonist protocol and ICSI does not allow the extrapolation of these results to other populations. Wider implications of the findings: Our findings question results from previous studies claiming a detrimental effect of PE on embryo implantation potential. According to our results, PE has no impact on embryo euploidy rate, blastulation rate nor on CLBRs. Trial registration number Not applicable

scholarly journals Injury Incidence Across the Menstrual Cycle in International Footballers

2021 ◽  
Vol 3 ◽  
Author(s):  
Dan Martin ◽  
Kate Timmins ◽  
Charlotte Cowie ◽  
Jon Alty ◽  
Ritan Mehta ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Incidence Rate ◽  
Luteal Phase ◽  
Incidence Rates ◽  
Follicular Phase ◽  
Tendon Injuries ◽  
Cycle Phase ◽  
Injury Incidence ◽  
Rate Ratios ◽  
Late Follicular Phase

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.

scholarly journals Lipid Profiling of Peri-implantation Endometrium in Patients With Premature Progesterone Rise in the Late Follicular Phase

2019 ◽  
Vol 104 (11) ◽  
pp. 5555-5565 ◽  
Author(s):  
Jingjie Li ◽  
Yue Gao ◽  
Lihuan Guan ◽  
Huizhen Zhang ◽  
Pan Chen ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
High Resolution Mass Spectrometry ◽  
Follicular Phase ◽  
Lipid Profiling ◽  
Male Factor ◽  
Serum Progesterone ◽  
Late Follicular Phase

Abstract Context Late follicular phase elevation in serum progesterone (P) during controlled ovarian hyperstimulation negatively affects the outcome of assisted reproductive technology by contributing to endometrial-embryo asynchrony. There are still no data on lipid metabolite alterations during this process. Objectives To investigate alterations in the lipid profile during the window of implantation in patients with premature P rise. Design Lipidomic variations in the endometrium were evaluated by ultrahigh-performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry. Setting University assisted reproductive medicine unit. Patients or Other Participants Forty-three patients undergoing in vitro fertilization/intracytoplasmic sperm injection because of a tubal factor or male factor infertility were included in this study. The patients were divided into a high P group (P ≥ 1.5 ng/mL, 15 patients) and a normal P group (P < 1.5 ng/mL, 28 patients) on the day of human chorionic gonadotropin administration. Interventions The endometrial tissues were obtained by Pipelle biopsy 7 days after human chorionic gonadotropin administration. Main Outcome Measures Alterations in lipid metabolites. Results A total of 1026 ions were identified, and 25 lipids were significantly upregulated. The endometrial lipid profile was characterized by substantial increases in the concentrations of phosphatidylcholine, phosphatidylethanolamine, lysophosphatidylcholine, diacylglycerol, ceramide, phosphatidylinositol, and phosphatidylserine in patients with a premature P rise at the end of the follicular phase. The correlation analysis between P levels and lipids showed a stronger negative correlation between phosphatidylethanolamine or phosphatidylserine and P levels. Conclusions Premature P elevation disrupts the lipid homeostasis of the endometrium during the peri-implantation period. The altered lipid levels may impair endometrial receptivity and early embryo implantation.

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