scholarly journals Correlation of mature mean follicle on transvaginal ultrasound and serum estradiol levels on day of trigger injection of ovulation in ovarian stimulation cycle of in vitro fertilization with retrieved oocytes

2021 ◽  
Vol 10 (2) ◽  
pp. 466
Author(s):  
Avnika Kapoor ◽  
Garima Sharma ◽  
Rita Bakshi
Keyword(s):  
Ovarian Stimulation ◽  
Transvaginal Ultrasound ◽  
Oocyte Retrieval ◽  
Antral Follicle ◽  
P Value ◽  
Serum Estradiol ◽  
Vitro Fertilization ◽  
Mature Follicle ◽  
Estradiol Levels

Background: Controlled ovarian hyperstimulation aims to obtain mature follicles. The present study was conducted to assess the correlation of mature follicle in transvaginal ultrasound scanning (TVS) and serum estradiol levels on day of trigger injection in ovarian stimulation cycle for IVF with the oocyte yield.Methods: In this prospective study, we evaluated oocyte donor 19 to 45 years of age who underwent oocyte retrieval at our clinic. Outcome variables like number of mature follicles visualized on TVS on the last day of stimulation was noted for all patients. On the same day, serum estradiol levels and number of mature follicles seen on TVS were noted and correlated with the number of oocytes retrieved. Ultrasound guided transvaginal oocyte retrieval was performed and total number of oocytes were noted.Results: During the study period, 20 oocytes donors were included. Mean age of the patients was 27.9±4.7 years. Mean BMI was 26.8±2.3 kg/m2. Mean FSH level was 6.89±1.79 IU/L and mean antral follicle count on day 3 was 14.06±3.56. On the day of trigger, mean mature follicle count seen on TVS was 20.4±13.8, ranging from 8 to 50. On an average, 17.2 oocytes were retrieved. On the day of trigger, mean estradiol level was 4970±203, ranging from 500 to 15,665 pg/ml. It was observed that the number of retrieved oocytes correlated significantly with the serum estradiol levels, (Pearson’s coefficient 0.94, p value<0.001) and number of mature follicles seen on TVS ((Pearson’s coefficient 0.92, p value<0.001).Conclusions: Number of retrieved oocytes correlated significantly with the serum estradiol levels and number of mature follicles seen on TVS on the day of trigger.

scholarly journals Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization

2021 ◽  
Author(s):  
Antonio Palagiano ◽  
Mauro Cozzolino ◽  
Filippo Maria Ubaldi ◽  
Chiara Palagiano ◽  
Maria Elisabetta Coccia
Keyword(s):  
In Vitro Fertilization ◽  
Oocyte Retrieval ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Endometrial Receptivity ◽  
Vitro Fertilization ◽  
Ovid Medline ◽  
Ultrasonographic Guidance

AbstractHydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.

P–613 Adjuvant letrozole in ovarian stimulation for in vitro fertilization does not reduce uterine peristalsis frequency prior to fresh embryo transfer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Dreye. Holt ◽  
A K Warzecha ◽  
N S Bülow ◽  
S O Skouby ◽  
A L M Englund ◽  
...  
Keyword(s):  
Placebo Group ◽  
In Vitro Fertilization ◽  
Adjuvant Treatment ◽  
Serum Estradiol ◽  
Fresh Embryo Transfer ◽  
Vitro Fertilization ◽  
Physiological Serum ◽  
Estradiol Levels ◽  
Uterine Peristalsis

Abstract Study question Does adjuvant letrozole in ovarian stimulation (OS) for in vitro fertilization (IVF) decrease the uterine peristalsis frequency (UPF) prior to fresh embryo transfer (ET)? Summary answer Adjuvant letrozole in (OS) for IVF does not reduce the UPF significantly prior to fresh ET. What is known already Throughout the cycle UPF aids spermatozoa transport to the fallopian tube and may affect implantation. At fresh, ET UPF is negatively correlated with implantation- and clinical pregnancy rates and is believed to be modulated by estradiol and progesterone. High levels of estradiol, from multiple follicular development, in OS have been reported to increase UPF, whereas progesterone is considered to be utero-relaxant. The influence of androgens is unclear. Co-treatment with letrozole during gonadotropin OS limits the estradiol rise the supra-physiological estradiol and may therefore reduce UPF prior to fresh ET. Study design, size, duration: This single centre study was nested within a multicentre double blinded RCT investigating the impact of letrozole co-treatment during gonadotropin OS for IVF on late follicular and luteal estradiol, progesterone and testosterone levels. Between 2016 and 2017, 39 women expected normal responders were randomised to co-treatment with letrozole or placebo. Of these, 33 women completed this element of the study. The study was carried out according to the Helsinki Declaration and the ICH-Good-Clinical-Practice. Participants/materials, setting, methods Eligible women were randomised 1:1 to adjuvant treatment with letrozole 5 mg/day or placebo in an antagonist protocol using a fixed dose of recFSH 150 IU/day. Final maturation was triggered with rhCG 6,500 IU and luteal support with vaginal progesterone was administered from the day following oocyte aspiration. Less than one hour prior to fresh ET, six minute duration transvaginal ultrasound recordings of the uterus in sagittal section were performed and blood samples were drawn. Main results and the role of chance A total of 33 women completed the study (letrozole n = 17; placebo n = 16). Age, BMI, and ovarian reserve markers were similar between the groups. On day of ET, serum estradiol levels were significantly suppressed in the letrozole group to mean 867 ± 827 pmol/L compared to 3,110 ± 1,528 pmol/L in the placebo group (P &lt; 0.0001). Mean UPF prior to fresh ET did not differ between the intervention and control group (3.3 ± 0.36 versus 3.5 ± 0.51 per minute respectively, P = 0.108). UPF was assessed and agreed by two observers who were blind to adjuvant treatment. Two patients were excluded due to poor quality of the ultra sound recording. Supra-physiological serum estradiol in the placebo group was negatively correlated with UPF (P = 0.014; R = –0.62), but the more physiological serum estradiol levels in the letrozole group showed no correlation with UPF (P = 0.567; R = 0.15). Serum progesterone levels were similar in both groups and did not show any significant correlation with UPF. Testosterone levels were significantly higher in the letrozole group (P = 0.005) and showed a non-significant trend negatively correlated with UPF in the placebo group (P-value=0.07, R= –0.48). Limitations, reasons for caution The limited sample size risks masking minor effects. Wider implications of the findings: The supra-physiological levels of estradiol were significantly supressed in the intervention group, but UPF prior to fresh ET was similar in both groups. UPF is not strongly correlated to luteal phase sex steroid levels. Any beneficial effect of adjuvant letrozole during OS is not through an impact of UPF. Trial registration number NCT02939898

Anesthesia for In Vitro Fertilization

2011 ◽  
pp. 198-205
Author(s):  
Patricia M. Sequeira
Keyword(s):  
In Vitro Fertilization ◽  
Transvaginal Ultrasound ◽  
Oocyte Retrieval ◽  
Laboratory Setting ◽  
Vitro Fertilization ◽  
Vaginal Ultrasound ◽  
Broad Term ◽  
Oocyte Aspiration ◽  
Fertilized Egg

In vitro fertilization (IVF) is a broad term used to describe the process of obtaining an egg and uniting it with sperm in a laboratory setting, and subsequently placing the fertilized egg into the uterus in hopes of achieving a live birth. In terms of anesthesiology, IVF primarily means oocyte retrieval. Historically the oocytes were retrieved laparoscopically. With the introduction of the vaginal ultrasound, the method of retrieval changed to a less invasive and costly procedure. Transvaginal ultrasound-guided oocyte aspiration changed the requirements of anesthesia. In this chapter, the anesthesia for oocyte retrieval and related IVF procedures are described.

scholarly journals Relative Potencies of Anastrozole and Letrozole to Suppress Estradiol in Breast Cancer Patients Undergoing Ovarian Stimulation before in Vitro Fertilization

2007 ◽  
Vol 92 (6) ◽  
pp. 2197-2200 ◽  
Author(s):  
Amr A. Azim ◽  
Maria Costantini-Ferrando ◽  
K. Lostritto ◽  
Kutluk Oktay
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Ovarian Stimulation ◽  
Area Under The Curve ◽  
Oocyte Retrieval ◽  
Embryo Cryopreservation ◽  
Breast Cancer Patients ◽  
Vitro Fertilization ◽  
The Mean

Abstract Context: Breast cancer patients undergoing controlled ovarian hyperstimulation (COH) for embryo or oocyte cryopreservation should be induced by the method that leads to the least increase in estradiol (E2) levels. Objective: The aim of the study was to determine the potency of anastrozole to suppress serum E2 levels in breast cancer patients undergoing COH. Design and Setting: A prospective sequential cohort study was conducted in an academic center for reproductive medicine between May 2003 and November 2005 for letrozole and between December 2005 and April 2006 for anastrozole. Patients: Breast cancer patients presenting for fertility preservation participated in the study. Intervention: COH using FSH and letrozole (n = 47) or anastrozole (n = 7) was followed by oocyte retrieval and embryo cryopreservation. Main Outcome Measures: Serum E2 levels, area under the curve for E2, and outcomes of COH cycles were measured. Results: There were no significant differences between the two groups regarding length of stimulation, total gonadotropin dose, number of follicles larger than 17 mm, and the lead follicle size on human chorionic gonadotropin (hCG) day and number of embryos cryopreserved. The mean E2 levels on the day of hCG and post-hCG days were higher in the anastrozole group compared to the letrozole group (1325.89 ± 833.17 and 2515.07 ± 1368.52 vs. 427.78 ± 278.24 and 714.38 ± 440.83 pg·d/ml; P ≤ 0.01), respectively, even when anastrozole dose was increased up to 10 mg/d. The mean area under the curve was significantly higher in the anastrozole group compared to the letrozole group (4402.93 ± 1526.7 vs. 1287.48 ± 732.17 pg·d/ml; P &lt;0.004). Conclusions: Breast cancer patients who underwent ovarian stimulation with anastrozole had a significantly higher exposure to E2 than those who were stimulated with letrozole.

scholarly journals Comparison of Automated Anti-Müllerian Hormone Assays and Antral Follicle Count in Predicting Ovarian Response During Ovarian Stimulation

2019 ◽  
Vol 01 (02) ◽  
pp. 99-105
Author(s):  
Eek Chaw Tan ◽  
Pallavi Chincholkar ◽  
Su Ling Yu ◽  
Serene Liqing Lim ◽  
Rajkumaralal Renuka ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
High Response ◽  
Controlled Ovarian Stimulation ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
And Performance

Objective: Various parameters had been used to predict ovarian response. Among them, Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) demonstrate the most favourable analytical and performance characteristics. In this pilot study, we aim to determine the cut-off levels of AMH using automated AMH assays and AFC in the prediction of poor and high responders. Study Design: Prospective study of 43 women between 21 to 45 years old scheduled for assisted reproduction. AMH levels on day 3 of menstruation were analysed using two immunoassay kits, namely the Beckman Coulter Access AMH and the Roche Elecsys AMH on the two automated analysers Beckman Coulter DxI 800 and Roche Cobas e602 respectively. AFC was also assessed on day 3 of menstruation prior to in vitro fertilization (IVF). These were compared with the number of oocytes retrieved after controlled ovarian stimulation. Results: AMH (Beckman Coulter Access AMH and Roche Elecsys AMH) highly correlated with AFC and the number of oocytes retrieved after ovarian stimulation. Beckman Coulter Access AMH was the better predictor for poor ovarian response with ROC [Formula: see text] of 0.83. For the prediction of a high response, AFC had a higher ROC [Formula: see text] of 0.95. Through ROC, the AMH cut-off level for poor ovarian response was 2.23 ng/ml with Beckman Coulter Access AMH and 2.02 ng/ml with Roche Elecsys AMH, while the AMH cut-off for a high ovarian response was 5.19 ng/ml with Beckman Coulter Access AMH and 4.60 ng/ml with Roche Elecsys AMH. For AFC, the cut-off for poor ovarian response was 18 and for high response was 34. Conclusion: AMH and AFC are reliable predictors of ovarian response. Establishment of specific levels may improve individualised controlled ovarian stimulation and optimise the oocyte yield. Larger studies are required to establish these findings.

scholarly journals Does Unilateral Oocyte Retrieval due to Transvaginally Inaccessible Ovaries, Contrary to Common Beliefs, Affect IVF/ICSI Treatment Outcomes That Much?

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Safak Olgan ◽  
Sezcan Mumusoglu ◽  
Gurkan Bozdag
Keyword(s):  
Treatment Outcomes ◽  
Oocyte Retrieval ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Clinical Pregnancy ◽  
Roc Curve Analysis ◽  
Vitro Fertilization ◽  
Follicular Aspiration ◽  
Single Ovary

Objective. To investigate in vitro fertilization (IVF) treatment outcomes of unilateral oocyte retrieval in patients with transvaginally inaccessible ovaries.Study Design. Ninety-two women who underwent unilateral oocyte retrieval were retrospectively matched for age, antral follicle count, and body mass index with 184 women who underwent bilateral oocyte retrieval. Each patient in bilateral oocyte retrieval group had the same number of cumulus oophorus complexes (COCs) from single ovary and had comparable number of follicles (±2) on contralateral site where follicular aspiration was performed.Results. The number of COCs, metaphase-2 oocytes, 2-pronuclei, and top-quality embryos was significantly lower in unilateral oocyte retrieval group. However, proportion of patients with an embryo transfer of at least one top-quality embryo was found to be comparable between unilateral and bilateral oocyte retrieval. Subsequently, clinical pregnancy and live birth rates were found to be similar between the groups. The ROC curve analysis revealed (AUC = 0.74, 95% CI 0.63–0.86,p=0.001) that retrieved COCs ≥ 5 from single ovary had sensitivity of 76.0% and specificity of 64.2% for occurrence of a clinical pregnancy.Conclusion. The patients with unilateral oocyte retrieval have reasonable chance of success with IVF. The retrieval of ≥5 COCs from accessible ovary might result in better treatment outcomes among these patients.

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