Hormonal Management for the Induction of Luteolysis and Ovulation in Andalusian Jennies: Effect on Reproductive Performance, Embryo Quality and Recovery Rate

Two prostanglandins (luprostiol, LUP, and dinoprost, DIN) and two ovulation-inducing agents (human Chorionic Gonadotropin, hCG, and deslorelin, DES) were evaluated for luteolysis and estrus induction, and for ovulation induction, respectively, in embryo donor jennies. Twenty-six fertile Andalusian jennies were used. In Experiment 1, jennies (n = 112 cycles) were randomly treated with either LUP or DIN after embryo flushing. In Experiment 2, donors (n = 84 cycles) were randomly treated with either hCG or DES to induce ovulation. No differences were found between prostaglandins for all variables studied (prostaglandin–ovulation interval (POI), interovulatory interval (IOI), embryo recovery rate (ERR), positive flushing rate (PFR) and embryo grade (EG)). The ovulation rate was similar for hCG and DES (60.9% vs. 78.7%). However, the interval to ovulation (ITO) was affected (62.61 ± 7.20 vs. 48.79 ± 2.69 h). None of the other variables studied (ERR, PFR and EG) were affected (p > 0.05), except for embryo quality (p = 0.009). In short, both prostaglandins evaluated are adequate to induce luteolysis and estrus. Both ovulation-inducing agents hastened ovulation, but DES seems to be more effective than hCG. Follicular diameter affected the interval from treatment to ovulation, and high uterine edema was related to low embryo quality.

Clomiphene citrate plus letrozole versus clomiphene citrate alone for ovulation induction in infertile women with chronic anovulation: A randomized controlled trial

Objective To compare the efficacy of combination clomiphene citrate (CC) plus letrozole with that of CC alone for ovulation induction in infertile women with chronic anovulation. Material and methods This randomized controlled trial was conducted at the Infertility and Reproductive Biology Unit of the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during the August 2020-September 2021 study period. Anovulatory women aged 18-40 years were equally allocated into either the CC 50 mg plus letrozole 2.5 mg once daily group or the CC 50 mg once daily group. The study drugs were administered on days 3-7 of each study patient’s menstrual cycle. The primary outcome was the ovulation rate defined by serum progesterone >3 ng/mL at mid-luteal phase. The secondary outcomes were menstrual cycle characteristics, endometrial thickness, conception rate, and adverse events. Results One hundred women (50 per group) were enrolled. The mean age and prevalence of polycystic ovary syndrome were non-significantly different between groups. The ovulation rate according to intention-to-treat analysis was 78% and 70% in the combination and CC alone groups, respectively (p>0.05). There was no significant difference between groups for either mean endometrial thickness or number of dominant follicles. No serious adverse events were observed in either group. Conclusion There was no significant difference between combination CC plus letrozole and CC alone relative to their ability to induce ovulation in infertile women with chronic anovulation. The small number of live births (1 per group) was too low to be statistically analyzed.

A study on outcome of controlled ovarian hyperstimulation and intrauterine insemination (husband) in a medical college in Kolkata

Background: A combination of controlled ovarian hyperstimulation and intrauterine insemination (IUI) remains an important treatment option for couple having infertility. Success rate of IUI with ovulation induction ranges from 8-20% depending on many factors. Aims and Objectives: To assess the factors affecting the success rate of IUI and to evaluate the success of ovulation Induction by different methods of controlled stimulation protocol. Materials and Methods: It is a duration-based prospective cross-sectional study where total of 67 couples were included by inclusion and exclusion criteria. They underwent 90 cycles of IUI with each couple having a maximum of three cycles. Ovulation induction was done by clomiphene citrate or letrozole or gonadotrophins. Semen preparation was done by density gradient method. The outcomewas measured by positive urine pregnancy test. Range, percentage, confidence interval, mean with standard deviation, median, range, and P-value were calculated. P<0.05 was taken as statistically significant. Results: Out of 90 IUI cycles 8 were successful resulting in a success rate of 8.8% per cycle and 11.9% per couple. Factors that had a positive impact were follicle size >21 sqmm, endometrial thickness >9 mm, post wash count >15 million/ml, >2 cycles of IUI and on the number of follicles 2 or more on the day of trigger. Conclusion: The study concluded that IUI after ovulation induction can be a simple and safe cost-effective procedure in selected group of infertile couple. Clinical significance IUI following ovulation induction can be a successful approach for specific indications in a low-resource setting where options for other ART interventions are absent or limited.

Physiology and modulation factors of ovulation in rabbit reproduction management

Rabbit is an induced ovulatory species, so ovulation takes place after mating. Traditionally, exogenous and synthetic hormonal factors (administered by intramuscular and intravaginal route) such as GnRH and analogues, or different physical procedures (i.e. stimulation by intravaginal cannula) have been used to induce ovulation in females when artificial insemination is applied in rabbit farms. Restriction and public rejection of the use of hormones is leading to the study of the seminal plasma components with potential action on ovulation induction. The aim of the present review is to collect and summarise the strategies used in recent years to trigger ovulation and improve rabbit fertility management with respect to more animal-friendly manipulation methods. Furthermore, special attention has been paid to the use of a semen component (as endogen molecule) such as beta nerve growth factor (β-NGF) in male and female rabbit reproductive physiology. This neurotrophin and its receptors (TrKA and p75NTR) are abundantly distributed in both male and female rabbit reproductive tracts, and it seems to have an important physiological role in sperm maturation and behaviour (velocity, apoptosis and capacitation), as well as a modulatory factor of ovulation. Endogen β-NGF is diluted in the seminal doses with the extenders; hence it could be considered an innovative and alternative strategy to avoid the current exogenous (by intramuscular route) and stressful hormonal treatments used in ovulation induction. Their addition in seminal dose could be more physiological and improve animal welfare in rabbit farms.

Two modified natural in vitro fertilisation (IVF) protocols compared to conventional IVF treatment: Retrospective data from one Danish Fertility Centre

Aim of study: Over the last decade, laboratory procedures in in vitro fertilisation (IVF) have improved. Hyperstimulated ovaries cause an overload of surplus embryos. The present study was designed to evaluate the efficiency of two different modified IVF cycle protocols trying to reduce the load of medication used for IVF: simple IVF (S-IVF), Tamoxifen 40 mg daily from day 2 in the cycle to ovulation induction) and mild IVF (M-IVF), Tamoxifen 40 mg daily and every secondary 150 IU Gonal F until ovulation induction. The study aims to evaluate their efficiency compared with our conventional IVF (C-IVF) using a short antagonist protocol. Methods: A retrospective cohort study including all patients admitted to IVF for unexplained infertility, tubal factor, and male factor. In all stimulated cycles patients aimed at having fresh embryos transferred and surplus good embryos cryopreserved. All patients were recruited in the same period and allocated to the different treatments on their own request. The study was conducted between June 2019 and February 2021. Results: In total the study included 976 IVF cycles. 651 cycles from C-IVF, 145 cycles from S-IVF and 180 cycles from M-IVF. Mean age in the groups were comparable. Mean number of eggs retrieved was 6.1 (C-IVF), 1.2 (S-IVF) and 3.0 (M-IVF). Pregnancy rate per fresh transfer was found to be 29% for C-IVF, 26% in the S-IVF group and for the M-IVF 20%. Conclusion: Modified IVF stimulation protocols may be an important step towards a simpler assisted reproductive technology (ART) approach. More tolerable for women, easier and cheaper for patients and society they maintain acceptable clinical pregnancy rates. Large prospective studies need to be performed in the future.