scholarly journals Influence of short-term ovarian stimulation on bone metabolism in women undergoing fertility treatment

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Ritzinger ◽  
Monika Schmidmayr ◽  
Bernd Lesoine ◽  
Vanadin Seifert-Klauss
Keyword(s):  
Bone Resorption ◽  
Bone Metabolism ◽  
Ovarian Stimulation ◽  
Luteal Phase ◽  
Influencing Factor ◽  
Controlled Ovarian Hyperstimulation ◽  
Fertility Treatment ◽  
Ovarian Hyperstimulation ◽  
Short Term ◽  
Down Regulation

Abstract Objectives Hormonal disturbances during menopause are an established influencing factor on bone health, but the role of controlled ovarian hyperstimulation for fertility treatment remains unclear. To evaluate the influence of ovarian stimulation on bone metabolism with particular regard to serum follicle-stimulating hormone (FSH) levels this prospective observational study was conducted. Methods A total of 71 women underwent controlled ovarian hyperstimulation with recombinant FSH (rFSH) or human menopausal gonadotropin (HMG) (FSH + LH) administered in individual doses, with gonadotropin-releasing hormone (GnRH) agonist down-regulation initiated in the luteal phase of the previous cycle. At four time points (start of down-regulation [T1], start of ovarian stimulation [T2], oocyte retrieval [T3] and luteal phase of the stimulation cycle [T4]), luteinizing hormone (LH), FSH, estradiol (E2), osteocalcin (OC), bone-specific alkaline phosphatase (BAP), as well as the bone resorption markers β-isomerized C-terminal telopeptide of type I collagen (β-CTX) and tartrate-resistant acid phosphatase (TRACP) were measured. Results The cyclic variations in FSH levels had a positive effect on the concentration profile of the bone resorption marker β-CTX (p=0.0001). Supraphysiologic estradiol levels showed a negative association with osteocalcin concentrations (p=0.017), and significantly lower OC and TRACP levels were observed at T4 compared to T1. By group comparison, women treated with rFSH presented with a higher bone turnover than the HMG group at the end of a stimulation cycle (T4). Conclusions Our results show that FSH is a significant influencing factor of bone metabolism. Overall, there was no evidence of enhanced bone resorption under short-term ovarian stimulation therapy. Further studies with bigger sample sizes are warranted to validate these results.

Does serum follicle-stimulating hormone during controlled ovarian hyperstimulation predict to ovarian response and reproduction potential in IVF/ICSI clinical practice?

2020 ◽  
Author(s):  
Yujia Ma ◽  
Bo Sun ◽  
Linli Hu ◽  
Fang Wang ◽  
Ying-Pu Sun
Keyword(s):  
Clinical Practice ◽  
Ovarian Stimulation ◽  
Follicle Stimulating Hormone ◽  
Treatment Protocol ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
Fixed Dose ◽  
Ovarian Hyperstimulation ◽  
The Difference ◽  
Stimulating Hormone

Abstract Background: Although serum basal follicle stimulating hormone (FSH) is widely used to evaluate the ovarian response, the necessity of levels of serum FSH during the controlled ovarian hyperstimulation (COH) is controversy. When the ovarian response to COH is suboptimal due to the insufficient dose of FSH, which is often adjusted in subsequent treatment accordingly, we could detect serum FSH levels and considering that exogenous FSH is inadequate to optimal FSH threshold. We, therefore, aim to evaluate the association between the ovarian response and the difference value of serum FSH concentration in the first five days of ovarian stimulation. Methods: In this retrospective single-center study, patients were enrolled for first IVF/ICSI during the period from August 2015 to December 2017. The COH only included gonadotrophin-releasing hormone agonist (GnRH-a) protocols in which endogenous serum FSH values were suppressed, and stimulated with 150IU fixed-dose recombinant FSH (rFSH) during the first five days. Patients met all inclusion criteria were selected: age ≤ 40 years, body mass index (BMI) ≤ 32 kg/m2, regular menstruation cycle of 21-35 days and non-ovarian factor infertility. Groups were divided by the amount of oocytes collection as follows: (A) poor responders (n=27), (B) normal responders (n=638), (C) hyper responders (n=205). A multivariable logistic regression model was performed to evaluate the relationship between the ovarian response and difference value of serum FSH levels during the first five days of ovarian stimulation.Result(s): The difference value of serum FSH level (ΔFSH) between the sixth day and the first day during ovarian stimulation was measured as the primary outcome. Mean serum ΔFSH levels between groups B and C were 7.45 and 6.87, which had significant differences (p=0.0259). ΔFSH was stratified in quartiles as below: (a) ΔFSH≤5.16, (b) ΔFSH 5.16-7.11, (c) 7.11-9.09, (d) ΔFSH˃9.09. After adjusted by potential confounding factors, there was no relationship exists between ΔFSH levels and ovarian response.Conclusion(s): There is no relevance between the ovarian response and ΔFSH in the 150 IU fixed dose rFSH treatment protocol during COH. Serum FSH might not be used as an effective predictor for ovarian response and reproduction potential in IVF/ICSI clinical practice.

scholarly journals Short-term effects of dietary sodium intake on bone metabolism in postmenopausal women measured using urinary deoxypyridinoline excretion

1997 ◽  
Vol 78 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Georg Lietz ◽  
Alison Avenell ◽  
Simon P Robins
Keyword(s):  
Parathyroid Hormone ◽  
Bone Resorption ◽  
Bone Metabolism ◽  
Postmenopausal Women ◽  
Significant Relationship ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Intact Parathyroid Hormone ◽  
Short Term ◽  
Significant Difference

The influence of Na load on bone metabolism was investigated in postmenopausal women using urinary deoxypyridinoline (DPD) as a marker of bone resorption. In a cross-over study, fourteen postmenopausal women were divided into two groups of seven. A fixed diet providing 816 mg Ca/d with either 60 or 170 mmol Na/d was consumed. At the end of an 8 d period the groups switched diets for a further 8d period. Urine was collected daily for the last 4d of each period. There was no significant difference in DPD excretion between high-Na and low-Na diets (129 nmol/d v. 132 nmol/d; P = 0·18). There was, however, a significant relationship (P = 0·02) between the changes in DPD excretion and urinary Ca. Plasma Mg fell from 0·83 to 0·81mmol/l on the high Na intake (P<0·001), but there was no significant effect on plasma Ca or intact parathyroid hormone levels. It is concluded that varying dietary Na intake may affect Ca and Mg metabolism, but we were unable to demonstrate an effect on bone resorption at the levels of intake used

scholarly journals Controlled Ovarian Hyperstimulation Protocol in Infertile Patients During the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Li ◽  
HuiXia Zhang ◽  
WeiYi Shi ◽  
YiFang Wu ◽  
Ye Tian ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Management Strategies ◽  
Implantation Rate ◽  
Controlled Ovarian Hyperstimulation ◽  
Ovarian Hyperstimulation ◽  
Down Regulation ◽  
Cycle Number ◽  
Full Dose ◽  
Infertility Patients

Objectives: To explore the appropriate controlled ovarian hyperstimulation (COH) protocols in infertility patients who received the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments during the COVID-19 pandemic.Materials and Methods: This retrospective cohort study evaluated the efficiency of the early follicular-phase long-acting GnRH-agonist long (EFLL) protocol (a new protocol developed by Chinese clinicians), prolonged pituitary down-regulation of EFLL protocol (Pro-EFLL), and the GnRH-ant protocol for couples meeting the study criteria between February 2020 and June 2020 who were treated by the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic, and compared the pregnancy rates and miscarriage rates per fresh transfer cycle, number of retrieved oocytes, endometrial thickness on the day of hCG injection and the number of fertilized oocytes, mature oocytes, fertilized oocytes, and transferable embryos among the three protocols.Results: We found that the prolonged pituitary down-regulation during the COVID-19 pandemic by utilizing a full-dose of GnRH-a administrated in infertility patients were no differences in clinical outcomes than other protocols, The prolonged pituitary down-regulation protocol and EFLL protocol were associated with a higher Endometrial thickness on the day of hCG injection (12.67 ± 2.21 vs. 12.09 ± 2.35 vs. 10.79 ± 2.38, P &lt; 0.001), retrieved oocytes (14.49 ± 6.30 vs. 15.02 ± 7.93 vs. 10.06 ± 7.63, P &lt; 0.001), mature oocytes (11.60 ± 5.71 vs. 11.96 ± 6.00 vs. 7.63 ± 6.50, P &lt; 0.001), fertilized oocytes (9.14 ± 5.43 vs. 8.44 ± 5.34 vs. 5.42 ± 5.20, P &lt; 0.001), and transferable embryos (4.87 ± 2.96 vs. 6.47 ± 5.12 vs. 3.00 ± 3.28 vs. P &lt; 0.001) in the GnRH-antagonist protocol.Conclusion: We recommend that patients start Gn injections 33–42 days after a pituitary downregulated full dose (3.75 mg) of gonadotropin-releasing hormone agonist during the COVID-19 pandemic, even a delay of 2–4 weeks does not affect the implantation rate. The study can provide a more detailed estimate and clinical management strategies for infertile couples during the COVID-19 pandemic.

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