Dynamic medium produces caprine embryo from preantral follicles grown in vitro

The aim of this study was to develop a dynamic culture medium containing FSH, LH and EGF to promote the in vitro development of oocytes obtained from goat preantral follicles to complete maturation and to improve the capacity of these oocytes for in vitro fertilization (IVF) and embryo production. For experiment I, preantral follicles were cultured for 18 days in medium supplemented with increasing concentrations of FSH (T1 - control) or in control medium added LH alone or in association with EGF: T2 (LH 50 ng/ml), T3 (LH 50 ng/ml + EGF 50 ng/ml), T4 (LH 50 ng/ml + EGF 100 ng/ml), T5 (LH 100 ng/ml), T6 (LH 100 ng/ml + EGF 50 ng/ml) and T7 (LH 100 ng/ml + EGF 100 ng/ml). For experiment II, preantral follicles were cultured only in the culture medium used in T7, and after 18 days, their oocytes underwent in vitro maturation (IVM) followed by IVF. At the end of the culture period, T3, T4 and T7 had a positive influence on the daily follicular growth rate. Oocytes grown in T4 and T7 had a meiosis resumption percentage significantly superior to the other treatments. Two embryos were obtained, in which preantral follicles in medium supplemented with 100 ng/ml LH and 100 ng/ml EGF (T7). In conclusion, our sequential culture system was able to promote the in vitro growth of preantral follicles, promoting their oocyte maturation and caprine embryo production from preantral follicles.     

Full physiological maturation in vitro of immature mouse oocytes induced by sequential treatment with follicle-stimulating hormone and luteinizing hormone

Cumulus cell-enclosed immature mouse oocytes were matured in medium supplemented with various combinations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol. FSH or LH alone stimulated oocyte maturation, resulting in a significant increase in the rate of development to blastocysts following fertilization in vitro and embryo culture. There was no significant difference between FSH and LH. The effect of FSH was neutralized by FSH antiserum, while that of LH was not indicating that the stimulation of maturation by LH was not due to FSH contamination in the LH preparation. When LH was added after 2 hr of culture with FSH (sequential combination), blastocyst development was significantly increased compared with FSH alone, reaching the same level as the in vivo matured oocytes. The addition of estradiol, 0.1 ng/ml to the sequential combination of FSH and LH had no effect, while 0.01 and 1 ng/ml produced a negative effect. The birth rate of normal live offspring following embryo transfer showed no significant difference between embryos derived from oocytes matured in vivo and in vitro (sequential combination with or without 0.1 ng/ml estradiol) or between the two in vitro treatment groups.     

Use of individual human follicles to compare oocyte in vitro fertilization to granulosa cell in vitro luteinization

Granulosa-lutein (G-L) cells from individual follicles aspirated during cycles of in vitro fertilization-embryo transfer were examined after 3 and 6 days in culture. G-L cells from follicles that contained an oocyte that fertilized in vitro were compared with G-L cells from follicles that contained an oocyte that did not fertilize in vitro. Spent culture media was assayed for progesterone at days 3 and 6 of culture and luteinizing hormone/human chorionic gonadotropin (LH/hCG) receptor content of G-L cells was determined at day 6. G-L cell cultures from follicles that contained an oocyte that fertilized in vitro produced significantly more progesterone over 3 and 6 days of culture than those obtained from follicles in which the oocyte did not fertilize. Furthermore, LH/hCG receptor content after 6 days was significantly higher in G-L cells obtained from follicles with fertilized oocytes compared with follicles with unfertilized oocytes. Increased progesterone output and LH/hCG receptor acquisition demonstrate more maturation or "luteinization" by G-L cells aspirated from individual follicles that contain oocytes that fertilized in vitro.     

Induction of preovulatory luteinizing hormone surge and prevention of ovarian hyperstimulation syndrome by gonadotropin-releasing hormone agonist

OBJECTIVE: To use gonadotropin-releasing hormone agonist (GnRH-a) instead of human chorionic gonadotropin (hCG) to induce oocyte maturation for in vitro fertilization (IVF). DESIGN: Pituitary and ovarian responses to GnRH-a and the outcome of IVF were studied prospectively. Data from patients injected with hCG were analyzed retrospectively. SETTING: Program of IVF at the Rambam (Governmental) Hospital, Haifa, Israel. PATIENTS AND INTERVENTIONS: One or two doses of buserelin acetate 250 to 500 micrograms were administered to six patients with moderate response (Estradiol [E2], 1,494 +/- 422 [+/- SD] pg/mL) and 8 patients with exaggerated response (E2, 7,673 +/- 3,028 pg/mL) to gonadotropin stimulation. Progesterone (P) and E2 were administered for luteal support. MAIN OUTCOME MEASURES: Gonadotropin-releasing hormone agonist effectively triggered luteinizing hormone (LH)/follicle-stimulating hormone (FSH) surge. Mature oocytes were recovered in all patients. Luteal E2 and P were lower than in patients injected with hCG. No signs of ovarian hyperstimulation syndrome were observed. RESULTS: Serum LH and FSH rose over 4 and 12 hours, respectively, and were significantly (P less than 0.05) elevated for 24 hours. Of all mature oocytes, 67% fertilized and 82% cleaved. Four pregnancies were obtained. CONCLUSIONS: A bolus of GnRH-a is able to trigger an adequate midcycle LH/FSH surge, resulting in oocyte maturation and pregnancy. Our preliminary results also suggest that it allows a more accurate control of ovarian steroid levels during the luteal phase and may prevent the clinical manifestation of ovarian hyperstimulation syndrome.     

In vitro culture and in vitro maturation of mouse preantral follicles with recombinant gonadotropins

OBJECTIVE: To develop an effective method for in vitro maturation of preantral follicles isolated from mice ovarian tissue. DESIGN: Isolated preantral follicles were randomly allocated to designed experimental groups for study. SETTING: University-based research lab. PATIENT(S): Healthy, normal mice. INTERVENTION(S): Superovulation with pregnant mare serum gonadotropin and hCG. MAIN OUTCOME MEASURE(S): Morphological changes and E(2) production were assessed. RESULT(S): To obtain competent oocytes, preantral follicles must be cultured with medium containing insulin and recombinant gonadotropins (i.e., recombinant FSH and recombinant LH), with a change of medium daily. A high initial recombinant LH or recombinant FSH facilitates E(2) secretion, enhances granulosa cell outgrowth, and has earlier antral formation. However, prolonged culture in high-recombinant LH or recombinant FSH triggers early differentiation and luteinization of granulosa cells, which results in low metaphase II oocyte and blastocyst formation. CONCLUSION(S): We have developed a culture system that allows the successful maturation of preantral follicles in vitro. The matured follicles are a physiologically functional unit that not only secrete E(2) but also generate competent oocytes. In a special condition, 90% of the cultured follicles survived, 53.5% of them produced MII oocytes, and 50% of the derived MII oocytes were fertilized and reached the blastocyst stage after culture in vitro.     

Progesterone production in cultured human granulosa cells: correlation with follicular fluid hormone levels

STUDY OBJECTIVE: To examine the progesterone (P) production by cultured granulosa cells and the hormonal content in the follicular fluid (FF) of ovarian-hyperstimulated women. DESIGN: Retrospective. SETTING: Private Fertility Clinic and National Research Institute. PATIENTS: Eighteen patients undergoing in vitro fertilization or gamete intrafallopian transfer programs. RESULTS: Progesterone levels Measured in the culture medium of granulosa cells decreased sixfold with culture time. Human luteinizing hormone (LH) increased P production only when basal P production was less than 1 microgram/mL. Granulosa cell P production in culture was negatively correlated with FF LH-human chorionic gonadotropin (hCG) levels. Follicular fluid follicle-stimulating hormone (FSH) levels were positively correlated with FF P and 17 beta-estradiol (E2) concentrations. Similar results were found between FF LH (hCG) and E2 levels, but there was no relationship between FF LH (hCG) and FF P values. CONCLUSION: The high dose of hCG administered during gonadotropin treatment could induce a decrease in the in vitro granulosa cell P production.     

In vitro maturation of baboon oocytes retrieved at the time of cesarean section

Objective: To investigate the feasibility of oocyte retrieval at the time of cesarean delivery and the potential of such oocytes to undergo nuclear maturation in vitro using a baboon model and an established culture system.

Design: Randomized, controlled animal study.

Setting: Research foundation and university research laboratory.

Animal(s): Mature pregnant baboons.

Intervention(s): In vitro culture of aspirated oocytes with or without epidermal growth factor (EGF).

Main Outcome Measure(s): Oocyte yield, germinal vesicle breakdown, polar body extrusion.

Result(s): A total of 246 oocytes were retrieved (mean, 35; range, 14–67). Eighty-seven oocytes (35%) underwent germinal vesicle breakdown and 72 oocytes (29%) extruded a polar body. A χ² analysis revealed no significant effect of EGF on outcome parameters. No effect of gestational age or maternal age on oocyte yield or development was observed.

Conclusion(s): A sizeable proportion of oocytes obtained from puerperal primates exhibited the capacity to undergo nuclear maturation in vitro.     

The hormonal micromilieu and oocyte status in the stimulated in vitro fertilization cycle

FSH, LH, PRL, estradiol-17 beta and progesterone were determined in 651 follicular fluids of 173 patients treated by ovarian stimulation for IVF. The stimulation was performed according to 5 different schemes: clomiphene/HCG, HMG (Pergonal)/HCG, HPG (Anthrogon)/HCG, clomiphene/HPG/HCG, Folistiman (heterologeous pituitary gonadotropin)/HCG. The mean levels of hormones of all follicles of each stimulation scheme were determined and differences between the groups were estimated by Student's t-test and the x-square-test. Additionally, in a hierarchy of follicles made depending on the follicular fluid volume the hormonal levels were compared between different rank numbers of one stimulation group and between different groups of stimulation. The maturation of oocytes judged by a maturation index and their ability for cleavage in culture after insemination was investigated in relation to the hormonal content of the follicular fluid. Stimulation by gonadotropins (Pergonal, Anthrogon, Folistiman) led to an decreased mean level of follicular steroids. This was related to an increased part of follicles poor in steroids after stimulation by gonadotropins. Within the follicular population follicles stimulated by clomiphene/HCG had a reduction of the levels of estradiol in higher rank numbers, but there were no clear evidences for such a reduction in the other stimulated groups. In all stimulation groups a significant reduction of progesterone levels was observed in higher rank numbers of follicles. Oocytes with a high maturation index mainly derived from follicles rich in progesterone. After insemination, development of oocytes in culture was compatible even with very high or low levels of hormones. There was no relation of the levels in FSH and LH to cumulus expansion and levels of estradiol of the follicular fluid. There was also no clear correlation between the levels of prolactin in follicular fluid and the cleavage rate.     

Relationship between follicular fluid steroid concentrations and in vitro fertilization

Steroid concentrations were measured in follicular fluid obtained from patients fertilized in vitro. Progesterone and estradiol-17 beta concentrations showed positive correlations with the growth of follicles, whereas the testosterone concentration had negative correlations not only with follicle growth but also with progesterone and estradiol-17 beta concentrations. The testosterone concentration was significantly lower in follicles with cleaved oocytes than in those with uncleaved oocytes or those with cleaved but degenerated oocytes. After the luteinizing hormone (LH) surge, the fluid contained significantly higher progesterone and lower testosterone concentrations than after human chorionic gonadotropin (hCG) injection. These results indicate that steroid concentrations vary with the growth of follicles, and that the oocyte that can cleave well tends to be associated with a low testosterone concentration. Furthermore, the LH surge seems to provide a better hormonal condition for cleavage than does hCG injection.     

Value of suppression with a gonadotropin-releasing hormone agonist prior to gonadotropin stimulation for in vitro fertilization

This study examined the use of gonadotropin-releasing hormone agonist (GnRHa) suppression before gonadotropin stimulation in 26 patients with failed prior in vitro fertilization (IVF) attempts and variable basal serum gonadotropin levels. Leuprolide, 1 mg subcutaneously per day, was administered from the midluteal phase of the cycle before IVF treatment. Concomitantly, stimulation was initiated on cycle day 3 with human menopausal gonadotropin (hMG) and follicle stimulating hormone (FSH). Based on their prior IVF attempts and serum gonadotropin levels on cycle day 3, 9 patients were high responders with elevated mean basal luteinizing hormone (LH)/FSH, 8 were low responders with elevated mean basal FSH/LH, 7 were intermediate responders with normal mean basal FSH/LH and a history of premature LH surge, and 2 had elevated (perimenopausal) mean FSH and LH. Leuprolide was discontinued on the day of human chorionic gonadotropin (hCG) administration. Prior IVF attempts in the same patients with the same protocol, but without GnRHa suppression, were used as controls. The mean number of ampules of hMG and FSH was significantly higher in leuprolide cycles than in controls. The mean day of hCG administration was also higher for leuprolide cycles than for controls. The mean LH and progesterone levels on the day of hCG were significantly lower in leuprolide cycles. The mean number of preovulatory oocytes aspirated and transferred was higher in leuprolide cycles. Cancellation and pregnancy rates were improved in leuprolide cycles. It is concluded that prior GnRHa suppression is beneficial for follicular recruitment for IVF. More patients with variable basal serum gonadotropin levels need to be studied before definite recommendations are made.     

Hemodynamic changes induced by urinary human chorionic gonadotropin and recombinant luteinizing hormone used for inducing final follicular maturation and luteinization

OBJECTIVE: To compare the safety of recombinant human luteinizing hormone (LH) with that of urinary hCG in terms of the hemodynamic changes when they are used to induce final follicular maturation in patients undergoing in vitro fertilization (IVF). A secondary end point was efficacy in terms of IVF outcome. DESIGN: Prospective, randomized clinical trial. SETTING: University teaching hospital. PATIENT(S): Thirty IVF patients. INTERVENTION(S): Ovarian stimulation was induced with FSH under pituitary suppression. Patients were randomized to receive either hCG or recombinant human LH as a trigger of oocyte maturation (5,000 IU) and for luteal phase support (5,000 IU, 2,500 IU, and 2,500 IU on the day of follicular aspiration, 2 days later, and 5 days later, respectively). MAIN OUTCOME MEASURE(S): Mean arterial pressure, cardiac output, peripheral vascular resistance, and serum levels of progesterone, plasma concentrations of aldosterone, norepinephrine, and plasma renin activity were measured in all patients on postovulatory day 7 of the spontaneous menstrual cycle preceding IVF (baseline) and 7 days after the hCG/recombinant human LH ovulatory injection during the IVF cycle. RESULT(S): Ovarian response and IVF outcome (pregnancy rate, 60%) were similar in both treatment groups. On the seventh day after hCG/recombinant human LH administration, the peripheral vascular resistance was significantly lower and serum progesterone concentrations significantly higher in the hCG group as compared with the recombinant human LH group. The percentage change from baseline values during IVF cycles in all hemodynamic and neurohormonal variables investigated was higher (albeit not statistically different) in the group treated with hCG vs. the group treated with recombinant human LH. CONCLUSION(S): Recombinant human LH is associated with less intense circulatory changes than hCG when it is given to induce final follicular maturation and luteal phase support in IVF procedures.     

Reduced In Vitro Fertilization of Human Oocytes Correlates with Raised Circulating FSH Levels During Ovarian Stimulation in Normogonadotropic Women Downregulated with GnRH-Analogues

Purpose: The possible effects of circulating FSH levels as used during IVF treatment on oocyte maturation and subsequent preembryo development were evaluated. Methods: Serum levels of FSH and LH on days 1 and 8 of ovarian stimulation and on the day of oocyte retrieval (OR) were correlated with subsequent preembryo development in vitro. After pituitary downregulation, 244 normogonadotropic women followed a fixed protocol for the first 7 days of stimulation. Results: The average FSH concentration on day 8 of stimulation was 11.5 IU/L and exceeded the expected midcycle surge of FSH by more than 25%. In contrast, levels of LH were below an average of 2 IU/L throughout the stimulation period. The concentration of FSH on day 8 and on the day of OR showed a significant inverse correlation with cleavage rate, whereas levels of LH, age, and body mass index showed no such correlation. Conclusions: Supraphysiologic levels of FSH seems to affect oocyte maturation negatively. Premature resumption of meiosis, leading to retrieval of postmature oocytes with a reduced developmental potential, is suggested as the underlying mechanism.     

来曲唑/FSH促排卵中GnRHa与hCG诱发卵泡成熟效果的比较

目的:比较曲普瑞林和hCG在来曲唑(LE)/FSH促排卵行IVF-ET治疗中诱发卵泡成熟的效果。方法:391个IVF-ET治疗周期随机分成促性腺激素激动剂(GnRHa)组(n=267)和hCG组(n=124),所有患者均采用LE/FSH促排卵方案,当主导卵泡平均直径达18～20mm时,GnRHa组患者采用达菲林0.1mg诱导卵泡成熟,hCG组采用hCG10000IU诱导卵泡成熟,比较组间的获卵数、MII卵率、受精率、卵裂率、优胚率、临床妊娠率和中-重度卵巢过度刺激综合症(OHSS)发生率。同时比较两组患者诱导日(d0)、取卵日(d2)、胚胎移植前日(d4)和胚胎移植后第4日(d9)的血清E2、P、LH水平。结果:hCG组Gn使用总量、MII卵率、卵裂率、中-重度OHSS发生率显著高于GnRHa组(P<0.05)。Gn使用天数、获卵数、受精率、种植率、临床妊娠率、流产率组间无统计学差异(P>0.05)。GnRHa组d0LH、d2LH、d9LH水平显著高于hCG组(P<0.05),而d2P、d4E2、d4P、d4LH、d9E2、d9P水平显著低于hCG组(P<0.05)。结论:在LE/FSH促排卵方案中可以用GnRHa替代hCG诱导卵泡成熟,而不影响IVF结局,并显著降低OHSS发生率。GnRHa诱导卵泡成熟的IVF周期其黄体期存在黄体功能不全,需适当补充外源性hCG加强黄体支持。     

Intracytoplasmic sperm injection pregnancy after low-dose human chorionic gonadotropin alone to support ovarian folliculogenesis

OBJECTIVE: To prove that several days of low-dose hCG alone can be used to stimulate folliculogenesis, complete FSH-initiated follicle/oocyte maturation, and achieve pregnancy in assisted reproduction technology. DESIGN: Case report. SETTING: Reproductive endocrinology center at an academic institution. PATIENT(S): A 35-year-old female patient and her partner with male-related infertility. INTERVENTION(S): After an 8-day priming with hMG (225 IU/d), we administered low-dose hCG (200 IU/d) alone for 5 days in one GnRH-agonist suppressed patient until proper follicle development was obtained and intracytoplasmic sperm injection was performed. MAIN OUTCOME MEASURE(S): Daily serum levels of LH, FSH, hCG, E(2), P, and T; measurements of follicle number and size; oocytes retrieved and fertilized; pregnancy. RESULT(S): Although FSH levels rapidly declined after hMG discontinuation, E(2) and large follicles increased during hCG-only administration. Several good quality oocytes were retrieved and fertilized by intracytoplasmic sperm injection; three embryos were transferred and a twin pregnancy ensued. CONCLUSION(S): Replacement of FSH with low-dose hCG for several days in the late ovulation induction stages of assisted reproduction technology resulted in: [1] continued growth of large ovarian follicles and E(2); [2] an optimal preovulatory follicle pattern consisting of many large and few medium and small follicles; and [3] reproductively competent oocytes and pregnancy.     

The clinical therapeutic window for luteinizing hormone in controlled ovarian stimulation

Objective: To discuss the clinical therapeutic window for LH during the follicular phase.

Design: Review of selected papers that were retrieved through a Medline search and a review of clinical trials, the results of which are in the process of publication.

Patient(s): Women undergoing infertility treatment.

Intervention(s): Recombinant human LH (r-hLH) was administered SC as a supplement to FSH during controlled ovarian hyperstimulation.

Main Outcome Measure(s): Follicular development, E₂ production, and endometrial thickness.

Result(s): Optimal follicular maturation is the result of both FSH and LH stimulation. In patients with hypogonadotropic hypogonadism, 75 IU of r-hLH and 150 IU of FSH per day resulted in more follicles and provided sufficient E₂ for optimal endometrial proliferation. Additional r-hLH (>250 IU/day), in patients with either hypogonadotropic hypogonadism or polycystic ovary disease, may precipitate a series of deleterious physiological actions leading to atresia of developing follicles. Adding r-hLH to FSH in women treated with GnRH agonist showed no benefits in terms of number of mature oocytes, fertilization, and cleavage. However, those who experience profound pituitary desensitization may benefit from adding LH to the stimulation protocol. No obvious clinical criteria have been established to define this group of patients.

Conclusion(s): A “threshold” and “ceiling” level for LH (therapeutic window) is proposed, below which E₂ production is not adequate and above which LH may be detrimental to follicular development.     

A randomized,placebo-controlled trial of the effects of continuous combined hormone replacement therapy on coagulation and fibrinolytic systems in healthy postmenopausal women

Objective: To characterize the chronology of hemodynamic changes in in vitro fertilization (IVF) cycles and its relationship with circulating ovarian steroids, cytokines, and their mediator nitric oxide.

Design: Prospective, cross-sectional study.

Setting: University teaching hospital.

Patient(s): Eighty-eight IVF patients.

Intervention(s): Ovarian stimulation with FSH under pituitary suppression.

Main Outcome Measure(s): Circulating levels of estradiol, progesterone, nitrite/nitrate, interleukin-6, vascular endothelial growth factor, tumor necrosis factor , aldosterone, norepinephrine, as well as measurements of plasma renin activity and mean arterial pressure.

Result(s): The maximal stimulation of the renin-aldosterone and sympathetic nervous systems was seen 7 days after hCG administration, although values still remained elevated over normal control values on day of hCG + 11. Mean arterial pressure in IVF patients remained significantly reduced throughout the luteal phase. Changes in the stimulation of the renin-aldosterone system correlated temporally with progesterone but not estradiol levels. No significant changes were observed in circulating concentrations of cytokines investigated or nitric oxide.

Conclusion(s): The circulatory changes and the homeostatic activation of the renin-aldosterone system and sympathetic nervous system that consistently develop in patients undergoing controlled ovarian hyperstimulation for IVF is a feature associated with the luteinization process. These hemodynamic changes occur in the absence of variations in the circulating levels of cytokines potentially involved in ovarian hyperstimulation syndrome.     

Endocrine modifications associated with final oocyte maturation with gonadotropin-releasing hormone agonists vs. human chorionic gonadotropin in women undergoing intrauterine insemination

OBJECTIVE: To compare the hormonal profile when using triptorelin vs. human chorionic gonadotropin (hCG) to trigger ovulation in intrauterine insemination (IUI) cycles. STUDY DESIGN: Twenty-five patients who underwent 48 cycles were enrolled in a prospective, randomized, crossover study. After ovulation induction with recombinant follicle-stimulating hormone (FSH), couples were randomly allocated to a first cycle with a single dose of 0.2 mg of triptorelin or 5,000 IU of urinary hCG to trigger ovulation; if pregnancy did not occur, a second cycle was carried out, and the patient was crossed over to the other treatment group. Blood was collected the day of hCG/triptorelin administration and both days after IUI. RESULTS: Patients treated with triptorelin showed a significantly higher FSH and luteinizing hormone (LH) rise 24 hours after the injection when compared to hCG. Serum progesterone was significantly increased 48 hours after hCG administration, although estradiol levels were comparable between the groups. CONCLUSION: A higher LH and FSH peak than that induced by hCG was observed. Considering that serum progesterone levels were suboptimal in both protocols and taking into account the lower progesterone production in gonadotropin releasing hormone analogue cycles, corpus luteum supplementation in the luteal phase should be recommended for these patients.     

Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern

OBJECTIVE: To investigate the role of endometrial thickness and pattern on the day of human chorionic gonadotropin (hCG) administration on in vitro fertilization (IVF)/intracytoplasmic injection (ICSI) outcome. STUDY DESIGN: A total of 150 infertile women undergoing embryo transfer after IVF/ICSI cycles were studied in a prospective survey. Sonographic features of the endometrium (thickness and pattern) on the day of hCG administration, hormonal profile (progesterone, estradiol, FSH, LH) and various other variables (maternal age, causes and duration of infertility, duration of treatment, number of human menopausal gonadotropin (hMG) ampoules administered, and number of oocytes retrieved) were evaluated. These variables in pregnant and nonpregnant patients were compared. RESULTS: There was no difference between pregnant and nonpregnant patients in mean endometrium thickness (10.1+/-1 versus 10.2+/-2, p=0.79). Pregnancies occurred only in patients with an endometrial thickness of 9-12 mm (p=0.036). Duration of treatment, number of hMG ampoules administered, number of oocytes retrieved, estradiol concentration, and estradiol/progesterone ratio on the day of hCG differed significantly between pregnant and nonpregnant patients. There was no correlation between endometrial pattern and pregnancy rate. The receiver-operating characteristic (ROC) curve and multiple logistic regression showed no significant effect of endometrial thickness in the outcome of IVF/ICSI. CONCLUSION: The sonographic features of the endometrium (thickness and pattern) on the day of hCG administration did not differ between pregnant and nonpregnant patients. The pregnancy rate declined beyond two limits of endometrial thickness.     

Comparison of different regimens of human gonadotropins for superovulation of rhesus monkeys: Ovulatory response and subsequent luteal function

This study was designed to identify suitable treatment regimens of human gonadotropin for superovulation of rhesus monkeys. At menses, female monkeys were given one of three regimens: Plan A [days 1 to 6, 60 IU human follicle-stimulating hormone (hFSH); days 7 to 9, 60 IU hFSH/60 IU human luteinizing hormone (hLH)], Plan B [days 1 to 3, 75 IU FSH/20 IU LH; days 4 to 6, 60 IU FSH/20 IU LH; days 7 to 9, 45 IU FSH/45 IU LH], or Plan C [days 1 to 9, 60 IU FSH/60 IU LH]. On day 10, human chorionic gonadotropin (hCG; 1000 IU) was administered. Serum estrogen levels peaked on the day of hCG treatment (day 10) in Plans A and C but earlier (day 8) in Plan B. An oviduct lavage recovered 1 to 3 oocytes in Plan B but 3 to 13 oocytes in the other treatment groups. Peak progesterone levels in the luteal phase were greater (P<0.05) in animals receiving Plan A or C than Plan B. Regardless of treatment group, progesterone levels declined abruptly 7 days after ovulation induction; the length of the luteal phase in all groups was significantly less than that of normal menstrual cycles. We conclude that regimens of hFSH and hLH (i.e., Plans A and C), followed by hCG, reliably superovulate rhesus monkeys. However, the premature decline in luteal function around the typical time of implantation may compromise pregnancy initiation and maintenance.     

人类不成熟卵母细胞体外成熟影响的因素初探

为研究在自然月经周期中获得的人类不成熟卵母细胞 -放射冠 -卵丘细胞复合体体外成熟培养条件 ,作者从手术切除的卵巢组织获取不成熟卵母细胞 -放射冠 -卵丘细胞复合体 ,分别置于 90 % Ham' F-1 0 + 1 0 %灭活人血清 + FSH+ h CG(模拟卵泡液 )与 5 0 %Ham' F-1 0 + 5 0 %人类成熟卵泡液中培养 48h。结果显示 ,卵母细胞 -放射冠 -卵丘细胞复合体在两种体外成熟培养基中培养 48h后 ,成熟率分别为 41 .8%和 2 1 .1 % ,两者之间存在统计学差异 (P<0 .0 5 )。作者还比较了在前一种培养基中卵母细胞 -放射冠 -卵丘细胞复合体和裸卵的体外成熟率 ,分别为 41 .8%和 7.6% ,两者间存在统计学差异 (P<0 .0 0 5 )。将获取的不成熟卵母细胞 -放射冠 -卵丘细胞复合体按供者年龄分成 2 5～ 3 5岁组和 3 6～46岁组 ,比较此两组卵母细胞在前一种培养基中成熟率 ,分别为 5 7.1 %和 2 5 .0 % ,两者间在统计学上有显著性差异 (P<0 .0 1 )。结果提示 :不成熟卵母细胞 -放射冠 -卵丘细胞复合体可在模拟卵泡液中培养成熟 ,优于 5 0 % Ham' F-1 0 + 5 0 %人类成熟卵泡液 ;卵丘细胞包裹对于卵母细胞体外成熟有重要作用 ;供卵者年龄可影响卵母细胞的体外成熟率。