scholarly journals Mathematical Modeling and Simulation Provides Evidence for New Strategies of Ovarian Stimulation

2021 ◽  
Vol 12 ◽  
Author(s):  
Sophie Fischer ◽  
Rainald Ehrig ◽  
Stefan Schäfer ◽  
Enrico Tronci ◽  
Toni Mancini ◽  
...  

New approaches to ovarian stimulation protocols, such as luteal start, random start or double stimulation, allow for flexibility in ovarian stimulation at different phases of the menstrual cycle. It has been proposed that the success of these methods is based on the continuous growth of multiple cohorts (“waves”) of follicles throughout the menstrual cycle which leads to the availability of ovarian follicles for ovarian controlled stimulation at several time points. Though several preliminary studies have been published, their scientific evidence has not been considered as being strong enough to integrate these results into routine clinical practice. This work aims at adding further scientific evidence about the efficiency of variable-start protocols and underpinning the theory of follicular waves by using mathematical modeling and numerical simulations. For this purpose, we have modified and coupled two previously published models, one describing the time course of hormones and one describing competitive follicular growth in a normal menstrual cycle. The coupled model is used to test ovarian stimulation protocols in silico. Simulation results show the occurrence of follicles in a wave-like manner during a normal menstrual cycle and qualitatively predict the outcome of ovarian stimulation initiated at different time points of the menstrual cycle.

2002 ◽  
Vol 102 (6) ◽  
pp. 639-644 ◽  
Author(s):  
William H. COOKE ◽  
David A. LUDWIG ◽  
Paul S. HOGG ◽  
Dwain L. ECKBERG ◽  
Victor A. CONVERTINO

The menstrual cycle provokes several physiological changes that could influence autonomic regulatory mechanisms. We studied the carotid-cardiac baroreflex in ten healthy young women on four occasions over the course of their menstrual cycles (days 0-8, 9-14, 15-20 and 21-25). We drew blood during each session for analysis of oestrogen, progesterone and noradrenaline (norepinephrine) levels, and assessed carotid-cardiac baroreflex function by analysing R-R interval responses to graded neck pressure sequences. Oestrogen levels followed a classical two-peak (cubic) response, with elevated levels on days 9-14 and 21-25 compared with days 0-8 and 15-20 (P =0.0032), while progesterone levels increased exponentially from days 9-14 to days 21-25 (P = 0.0063). Noradrenaline levels increased from an average of 137pg/ml during the first three measurement periods to 199pg/ml during days 21-25 (P = 0.0456). Carotid-cardiac baroreflex gain and operational point were not statistically different at any of the time points during the menstrual cycle (P⩾0.18). These findings are consistent with the notion that beat-to-beat vagal-cardiac regulation does not change over the course of the normal menstrual cycle.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4785-4785
Author(s):  
Susan Halimeh ◽  
Hannelore Rott ◽  
Guenther Kappert ◽  
Manuela Siebert

Introduction Von Willebrand disease is the most common bleeding disorder with a prevalence of 1-2% of the population. Nevertheless diagnosis of a von Willebrand Syndrom Typ 1 is still challenging. In a newer publication (1), 30 studies about the haemostatic variables during the menstrual cycle were compared. 11 studies were focused on the von Willebrand parameters but only in one study these parameters in patients with von Willebrand disease were observed. We investigated possible cyclic variations in women with menorrhagia, which can lead to a diagnosis of a coagulation disorder. Samples and Methods We conducted a laboratory workup in 122 women sent to our lab for menorrhagia. The following tests were conducted: Blood count, VWF:RCo, VWF:Ag, VWF:CB, Fibrinogen (Clauss), activities of FII, FV, FVII, FVIII (clotting and chromogenic), FIX, FX, FXI, FXII, FXIII during the menstrual cycle on predefined time points (day 1-6, day 7-11, day 12-18, day 19-23, day 24-28). Results In 51 (40%) patients a von Willebrand disease could be detected, 37% hat other coagulation disorders like p. e. factor-VII-deficieny and factor-XIII-deficiency. 11.5% had an iron deficiency. In 11.5% no coagulation disorder could be found. In patients with von Willebrand disease we found cyclic variations especially in the VWF:Ag (p = 0.02). They showed the lowest level during the ovulation. For other coagulation parameters no significance for variations during the menstrual cycle were found. Conclusion There are cyclic variations in von Willebrand antigen. To investigate women on predefined time points during the menstrual cycle can be useful to diagnose a von Willebrand disease particularly in mild cases in which no other suspicious bleeding symptoms exists. Literature Knol H.M., Kemperman R.F.J., Kluin-Nelemans C., Mulder A.B., Meijer K., Haemostatic variables during normal menstrual cycle, Thrombosis and Haemostasis 107.1/2012 Disclosures: Halimeh: Octapharma AG: Investigator Other, Research Funding.


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5047-5047
Author(s):  
Susan Halimeh ◽  
Hannelore Rott ◽  
Ihsan Osseiran ◽  
Guenther Kappert ◽  
Manuela Siebert

Abstract Introduction: The blood coagulation can be influenced by different variables like mental stress, physical activity or oral anticoagulants. During the normal menstrual cycle changes have been observed on different time points. A study of Chaireti et al (1) found an association of progesterone and factor II, factor VII and factor X. We investigated the possible influence of the sexual hormones on the coagulation parameters. Samples and methods: We conducted a laboratory work group in 35 women sent to our lab. The following tests were conducted: Blood count, VWF:RCo, VWF:Ag, VWF:CB, Fibrinogen (Clauss), activities of FII, FV, FVII, FVIII (clotting and chromogenic), FIX, FX, FXI, FXII, FXIII, FSH, LH, Progesterone and Oestradiole during the menstrual cycle on predefined time points (day 1-6, day 7-11, day 12-18, day 19-23, day 24-28). Results: We found slight variations in nearly all coagulation parameters but without significance. The box-plots of the Von Willebrand activity shows that the means are relative close together. Clear variations could not be found. The Friedman-Test showed no significance. As expected the changes of the sexual hormones during the menstrual cycle showed highest significance. Conclusion: The influence of sexual hormones on coagulation parameters was not significant. The slight fluctuations may be caused by imprecision of the measurement and intra individual changes from day to day. Changes during the menstrual cycle could not be verified. Nevertheless it is advisable to investigate unclear negative results, when a conspicuous medical history or a corresponding clinic occurs. It is not necessary to regard the time point in the menstrual cycle for the blood collection. Literature: Chaireti R, Gustafsson KM, Byström B, Bremme K, Lindahl TL, Endogenous thromboin potential is higher during the luteal phase than during the follicular phase of a normal menstrual cycle, Hum Repro, 2013 Jul, 28 (7) 1846-52 Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Nikolova ◽  
M Naydenov ◽  
A Apostolov ◽  
I Glogovitis ◽  
M Saare ◽  
...  

Abstract Study question What is the qualitative and quantitative profile of microRNAs (miR) and their sequence variants - isomiRs, and how it changes during the menstrual-cycle phase transitions? Summary answer Time-course analysis of endometrial miR/isomiR profiles has shown that menstrual-phase transitions cause widespread and complex changes in miR gene expression and processing. What is known already Embryo implantation depends on the receptivity of the endometrium during the window of implantation, when ovarian hormones and genetic factors coordinate the development of the uterine lining and prepare it for embryo implantation. The most important factors for successful implantation studied so far are the embryo itself, the histological dating of the endometrium and its molecular genetic characteristics, including miRs. With the rapid development of next-generation sequencing technologies, it has become clear that miR genes have the potential to produce not only miR but also variants (isomiRs) thereof, which can differ in sequence and length and can be functionally significant. Study design, size, duration miR/isomiR landscape was assessed by small RNA sequencing of endometrial biopsy samples at 4 time points of endometrial cycle covering the proliferative and secretory phases. Healthy, fertile, female volunteers took part in the study lasting one and a half years. For accurate phase dating, human chorionic gonadotropin (hCG) was administrated, and ultrasonic, histological and hormonal assessments were done at each time point. Statistically significant data of miR/isomiR identification and expression dynamics was considered for analysis. Participants/materials, setting, methods Participant choice criteria - at least one child born, problem-free pregnancies, no diseases or allergies; hCG application time determined according follicle and endometrium ultrasound scanning, and ovarian hormone levels; endometrial biopsies taken at hGC (before hormone application), hGC+2, hGC+7, hGC+9 time points; small RNAseq completed by Karolinska Institute, Sweden; miR/isomiR identified using local Galaxy instance with an in-built workflow and tools developed by our laboratory; differential expression and target prediction evaluated with DESeq2 and miRDB,resp. Main results and the role of chance Within the cohort of patients, across the four study time points, the small RNAseq data revealed numbers of miRs and isomiRs to be changed. The largest statistically significant changes in their expression were found at LH + 9. The miR families that showed the largest number of members with altered expression were miR125a, miR30d, miR449c, miR92a/b and miR99a. The expression levels tended to decrease in the miR125a and miR92a families and to increase in the miR10a and miR449c families during the three studied time points of the cycle compared to the proliferative phase. Among those affected, the number of isomiRs, including templated and non-templated isomiRs, was much higher than that of miRs. For example, the ratio of the significantly altered miRs/templated isomiRs/non-templated isomiRs was 6/16/11 at LH + 9. Templated isomiRs of hsa-miR–148a–3p, hsa-miR–30d–5p and hsa-miR–449c–5p were among the most upregulated, while several templated and non-templated isomiRs of hsa-miR–125–5p were the most downregulated at LH + 9. Of particular interest are those isomiRs, in which the seed site is shifted compared to the reference miRs and results in altered target transcripts. Target prediction of the most affected isomiR of hsa-miR–449c–5p identified new targets of target scores much higher than of the reference miR. Limitations, reasons for caution IsomiRs are a source of novel biomarkers for clinical diagnosis. An important next step is the validation of the in-silico predicted miRs/isomiRs and their target transcripts by RT-qPCR in larger number of individuals. Expression profiles should be associated with the dominant cell type in the endometrial biopsy preparation. Wider implications of the findings: MiR/isomiR signatures, together with those of their target mRNAs, can be applied to distinguish the endometrial phases, especially the implantation window, as well as for diagnosing endometrial dysfunction. It is worth investigating the possibility of miRs/isomiRs being used as biomarkers not only in endometrial biopsy but also in liquid biopsy. Trial registration number The Bulgarian National Science Fund КП–06 Н31/2


2020 ◽  
Vol 91 (11) ◽  
pp. 892-896
Author(s):  
Janine En Qi Loi ◽  
Magdalene Li Ling Lee ◽  
Benjamin Boon Chuan Tan ◽  
Brian See

INTRODUCTION: This study sought to determine the incidence, severity, and time-course of simulator sickness (SS) among Asian military pilots following flight simulator training.METHODS: A survey was conducted on Republic of Singapore Air Force pilots undergoing simulator training. Each subject completed a questionnaire immediately after (0H), and at the 3-h (3H) and 6-h (6H) marks. The questionnaire included the simulator sickness questionnaire (SSQ) and a subjective scale to rate their confidence to fly.RESULTS: In this study, 258 pilots with a median age of 31.50 yr (range, 2155 yr) and mean age of 32.61 6.56 yr participated. The prevalence of SS was 48.1% at 0H, 30.8% at 3H, and 16.4% at 6H. Based on a threshold of an SSQ score >10, the prevalence of operationally significant SS was 33.3% at 0H, 13.2% at 3H, and 8.1% at 6H. The most frequent symptoms were fatigue (38.1%), eye strain (29.0%), and fullness of head (19.9%). There was no significant difference in mean scores between rotary and fixed wing pilots. Older, more experienced pilots had greater scores at 0H, but this association did not persist. A correlation was found between SSQ score and self-reported confidence.DISCUSSION: To our knowledge, this study is the first to report the prevalence of operationally significant SS in Asian military pilots over serial time points. Most pilots with SS are able to subjectively judge their fitness to fly. Sensitivity analysis suggests the true prevalence of SS symptoms at 3H and 6H to be closer to 23.8% and 12.0%, respectively.Loi JEQ, Lee MLL, Tan BBC, See B. Time course of simulator sickness in Asian military pilots. Aerosp Med Hum Perform. 2020; 91(11):892896.


1957 ◽  
Vol 24 (3_Suppl) ◽  
pp. S207
Author(s):  
A. Klopper

Abstract The changes in view on the significance and amount of urinary pregnanediol in the menstrual cycle are reviewed; in particular the effects of the discovery that the adrenals in both sexes normally contribute to the urinary pregnanediol. Pregnanediol excretion during the menstrual cycle was studied by means of a new method of assay (Klopper et al., 1955) and the results applied to present day concepts of the growth and duration of the corpus luteum. The relationship between pregnanediol excretion and ovulation or the onset of menstrual bleeding was studied. A new view is put forward on the influence of age and parity on the production of progesterone by the corpus luteum.


Reproduction ◽  
1971 ◽  
Vol 27 (3) ◽  
pp. 481-484 ◽  
Author(s):  
J Newton ◽  
D Joyce ◽  
B Pearce ◽  
C Revell ◽  
J Tyler

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