Objective To determine the impact of circulating LH concentrations du ring cont rolled ovarian hyperstimulation on the outcome of IVF. Design Retrospective stud y. Setting University hospital. Patient(s) Two-hundred s...Objective To determine the impact of circulating LH concentrations du ring cont rolled ovarian hyperstimulation on the outcome of IVF. Design Retrospective stud y. Setting University hospital. Patient(s) Two-hundred seventy women who had a short stimulation protocol with GnRH antagonist and ovarian stimulation with rec ombinant FSH (rFSH). Intervention( s)GnRHantagonist and rFSH were administered S C; blood samples were collected on the day of GnRH antagonist administration, 1 day after, and on the day of hCG administration. Main outcome measure(s) A thres hold of 0.5 IU/L on the day of hCG was chosen to discriminate between women with LH concentrations ≤0.5 IU/L (group A, n = 119) or >0.5 IU/L (group B, n = 151) . Result(s) The two groups were comparable with regard to the clinical parameter s. In group A, significantly lower LH concentrations were observed on day 9 of t he cycle and on the day of hCG administration. The numbers of oocytes retrieved, embryos obtained, and embryos cryopreserved were significantly higher in group A compared with group B. The proportion of clinical pregnancieswas similar in th e two groups (21.1%vs. 22.7 %per ET). Conclusion(s) In GnRH antagonist and rFS H protocols, suppressed serum LH concentrations do not have any influence on the final stages of follicular maturation, pregnancy rates, or outcomes.展开更多
To evaluate oxidative stress indices in follicular fluid (FF)by a novel thermochemiluminescence (TCL) assay and investigate the correlation between TCL and IVF cycle parameters. Prospective, crosssectional study. IV...To evaluate oxidative stress indices in follicular fluid (FF)by a novel thermochemiluminescence (TCL) assay and investigate the correlation between TCL and IVF cycle parameters. Prospective, crosssectional study. IVF Unit of an Obstetrics and Gynecology Department in a universityaffiliated hospital. One hundred eightynine women undergoing consecutive IVF treatment cycles during 2001. After oocyte retrieval, pooled FF was centrifuged and the supernatant was tested in the TCL assay. Maximal serum E2 levels, number of gonadotropin ampoules, retrieved oocytes, mature oocytes, fertilization and cleavage rates, number of available embryos and cryopreserved embryos, and clinical pregnancy rates and correlation with TCL indices. The TCL curve slope of FF positively correlated with maximal serum E2 levels, number of mature oocytes, and number of cleaved embryos and was inversely correlated with the womens ages and the number of gonadotropin ampoules. Follicular fluid TCL amplitude at 50 seconds ranged from 294 to 711 cps, but all pregnancies (n = 50; 28.1%) occurred within the range of 347-569 cps. With 385 and 569 cps as cutoff levels for the occurrence of pregnancy, the negative predictive value beyond this range was 96%and the positive predictive value within this range was 32%. The TCL results may reflect the agerelated increase in free radical activity and is associated with parameters of ovarian responsiveness and IVF outcome. A certain threshold of oxidative stress may be required for the occurrence of conception in IVF. TCL is a potential tool to evaluate, treat, and monitor antioxidant therapy in IVF treatments.展开更多
文摘Objective To determine the impact of circulating LH concentrations du ring cont rolled ovarian hyperstimulation on the outcome of IVF. Design Retrospective stud y. Setting University hospital. Patient(s) Two-hundred seventy women who had a short stimulation protocol with GnRH antagonist and ovarian stimulation with rec ombinant FSH (rFSH). Intervention( s)GnRHantagonist and rFSH were administered S C; blood samples were collected on the day of GnRH antagonist administration, 1 day after, and on the day of hCG administration. Main outcome measure(s) A thres hold of 0.5 IU/L on the day of hCG was chosen to discriminate between women with LH concentrations ≤0.5 IU/L (group A, n = 119) or >0.5 IU/L (group B, n = 151) . Result(s) The two groups were comparable with regard to the clinical parameter s. In group A, significantly lower LH concentrations were observed on day 9 of t he cycle and on the day of hCG administration. The numbers of oocytes retrieved, embryos obtained, and embryos cryopreserved were significantly higher in group A compared with group B. The proportion of clinical pregnancieswas similar in th e two groups (21.1%vs. 22.7 %per ET). Conclusion(s) In GnRH antagonist and rFS H protocols, suppressed serum LH concentrations do not have any influence on the final stages of follicular maturation, pregnancy rates, or outcomes.
文摘To evaluate oxidative stress indices in follicular fluid (FF)by a novel thermochemiluminescence (TCL) assay and investigate the correlation between TCL and IVF cycle parameters. Prospective, crosssectional study. IVF Unit of an Obstetrics and Gynecology Department in a universityaffiliated hospital. One hundred eightynine women undergoing consecutive IVF treatment cycles during 2001. After oocyte retrieval, pooled FF was centrifuged and the supernatant was tested in the TCL assay. Maximal serum E2 levels, number of gonadotropin ampoules, retrieved oocytes, mature oocytes, fertilization and cleavage rates, number of available embryos and cryopreserved embryos, and clinical pregnancy rates and correlation with TCL indices. The TCL curve slope of FF positively correlated with maximal serum E2 levels, number of mature oocytes, and number of cleaved embryos and was inversely correlated with the womens ages and the number of gonadotropin ampoules. Follicular fluid TCL amplitude at 50 seconds ranged from 294 to 711 cps, but all pregnancies (n = 50; 28.1%) occurred within the range of 347-569 cps. With 385 and 569 cps as cutoff levels for the occurrence of pregnancy, the negative predictive value beyond this range was 96%and the positive predictive value within this range was 32%. The TCL results may reflect the agerelated increase in free radical activity and is associated with parameters of ovarian responsiveness and IVF outcome. A certain threshold of oxidative stress may be required for the occurrence of conception in IVF. TCL is a potential tool to evaluate, treat, and monitor antioxidant therapy in IVF treatments.
