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11.
12.
Vasilios Tanos Shevach Friedler Asher Shushan Nurith Strauss Iftach Hetsroni Aby Lewin 《Journal of assisted reproduction and genetics》1995,12(10):715-719
Purpose
Nafarelin acetate is a new gonadotropin releasing (GnRH) agonist analogue with unique potency, intranasal administration, and convenient storage. Hence, nafarelin was considered as an alternative for temporary pituitary suppression in patients undergoing ovulation induction in IVF. A crossover treatment in a prospective study was performed including 40 women with bilateral obstructed tubes and normal ovarian function, treated in 80 ovulation induction cycles using the long protocol. Twenty patients used nafarelin acetate 600 g/daily in their first cycle and received
d-Trp6-LHRH, 0.5 mg/daily, in their following cycle. The other 20 women used decapeptyl in their first cycle and received nafarelin in the second.Results
Estradiol suppression was achieved by both
d-Trp6-LHRH and nafarelin at equal time intervals. The average total number of ampoules (P=0.0005) and the length of administration of hMG required for ovarian stimulation (P=0.0002) and the time interval between GnRHa initiation to oocyte retrieval (P=0.04) was significantly lower in nafarelin cycles. The number and the distribution between large and small follicles as well as the average number of oocytes retrieved did not differ between the two GnRH analogues.Conclusion
Our results demonstrate that nafarelin acetate is comparable to
d-Trp6-LHRH for temporary pituitary suppression used for controlled ovarian stimulation in IVF patients. However, using nafarelin ovarian stimulation was achieved with fewer ampoules of hMG, administered for a shorter period of time, thus with a lesser cost. 相似文献
13.
Richard J. Paulson Mark V. Sauer Rogerio A. Lobo 《Journal of assisted reproduction and genetics》1994,11(1):28-32
Purpose
To describe our preliminary experience with the addition of a GnRH antagonist (Nal-Glu) and exogenous gonadotropins (follicle stimulating hormone; FSH) to unstimulated IVF cycles.Method
Seven spontaneously ovulatory women underwent eight unstimulated IVF cycles at our institution. They were treated with a single dose of Nal-Glu, 50 g/ kg, or with a combination of Nal-Glu, 50 g/kg, and exogenous FSH, 150–300 IU, during the late follicular phase of spontaneous cycles. They then received 10,000 IU of human chorionic gonadotropin (hCG) to time accurately follicle aspiration in unstimulated IVF cycles.Results
Two women underwent three cycles with Nal-Glu alone on the day of hCG administration. One pregnancy resulted. Five women underwent five cycles with 3 to 6 days of daily Nal-Glu and FSH. Four of these cycles resulted in aspiration after the FSH dose was increased to 300 IU. Nal-Glu and FSH allowed continued development of the dominant follicle without the occurrence of luteinizing hormone (LH) surge.Conclusions
(1) Nal-Glu alone given 18 hr prior to hCG did not interfere with continued follicle viability or with the attainment of pregnancy. (2) Simultaneous Nal-Glu and FSH allowed for continued growth and development of the dominant follicle without the occurrence of an LH surge. (3) This preliminary experience confirms the feasibility of this novel approach, which may ultimately enhance the efficacy of unstimulated IVF cycles by eliminating premature ovulation and maximizing control of gonadotropin delivery to the developing follicle.Presented at the 39th Meeting of The Society for Gynecologic Investigation, San Antonio, Texas, March 18–21, 1992. 相似文献
14.
A. ISIDORI 《Andrologia》1981,13(3):187-197
A critical review of the gonadotropin therapy in male infertility or hypofertility is presented. In the author's opinion, the poor and conflicting results so far obtained wih this kind of treatment are mainly due to inadequate selection of the patients admitted to the treatment itself. The author stresses some points concerning the modern knowledge on the physiology of gonadotropin secretion in males; points that must be borne in mind in approaching this type of treatment, and which in some way revolutionize the old concept of "low" or "high" plasma gonadotropin levels. In this concern, the gonadotropin therapy can be applied not only to the hypogonadotropic hypogonadism, as for the past, but also to the spermatogenic arrests and to the idiopathic oligospermiogenesis wtih "normal" gonadotropin levels. The author then exposes the rigid criteria adopted in the Andrologic Center of the 5th Medical Clinic of the University of Rome for the selection of the patients to be admitted to the treatment; criteria which are based on hormonal, morphological and seminal parameters. In the final part the results are reported obtained in the selected patients with a treatment schedule with associated HMG + MCG (150--300 I.U. as FSH per week and 2000--6000 I.U. as LH per week for 12--16 weeks). The results seem very encouraging: in 85% of the patients a quantitative and qualitative amelioration of the spermatogenesis was obtained; in 30% of these cases an outcome of pregnancies in the partner has been documented so far. 相似文献
15.
16.
17.
不同剂量HCG对体外受精-胚胎移植的影响 总被引:2,自引:0,他引:2
目的 :比较使用不同剂量人绒毛膜促性腺激素 (HCG)对体外受精 /胞浆内单精子注射 (IVF/ICSI)的结局及对卵巢过度刺激综合征 (OHSS)发病率的影响。方法 :对在本所接受IVF/ICSI辅助生育的 2 6 2例采用GnRH a长方案促排卵的患者进行回顾性分析 ,按HCG用量分为A组 (HCG 5 0 0 0~ 6 0 0 0U)、B组 (HCG 80 0 0~ 10 0 0 0U)。结果 :两组临床妊娠率分别为 35 .94 %和 38.0 5 % (P >0 .0 5 ) ,OHSS发生率分别为 2 .34%和 4 .4 8% (P >0 .0 5 )。结论 :减少HCG用量后对IVF/ICSI的临床妊娠率无明显影响 ,且可以减少OHSS的发生。 相似文献
18.
Treatment variables in relation to oocyte maturation: Lessons from a clinical micromanipulation-assisted in vitro fertilization program 总被引:1,自引:0,他引:1
Ori M. Avrech Gil A. Goldman Onit Rufas Anat Stein Shoshana Amit Israel Yoles Haim Pinkas Benjamin Fisch 《Journal of assisted reproduction and genetics》1997,14(6):337-342
Objective: In an effort to understand the mechanism underlying the improved pregnancy rate observed in IVF cycles when gonadotropin-releasing
hormone analogues (GnRH-a) are applied, we investigated a possible relationship between treatment variables and oocyte-nuclear
maturity.
Design: Nuclear maturity was retrospectively assessed in cumulus-free, denuded oocytes, obtained from women undergoing micromanipulation-assisted
IVF treatment following controlled ovarian hyperstimulation with GnRH-a and menotropins.
Setting: The setting was the infertility and IVF unit of a tertiary academic medical center.
Participants: Two hundred twenty-one patients underwent 435 treatment cycles.
Main Outcome Measure: This was the proportion of germinal vesicle-intact immature (GVII) oocytes.
Results: One hundred fifty-four of the 3520 oocytes studied (4.4%) were in the GVII stage. These oocytes were found in 66 of the treatment
cycles (15.2%) and in 54 of the patients (24.4%). Cycles in which GVII oocytes were detected did not differ from those in
which all the aspirated oocytes were mature in the following respects: patient age, type and duration of infertility, controlled
ovarian hyperstimulation protocol and time of ovum pickup. However, the GVII group was characterized by a significantly higher
peak estradiol level, as well as a higher number of mature follicles visualized sonographically (diameter, >14 mm) and oocytes
retrieved.
Conclusions: Comparing the present findings with previously published data, it appears that the inclusion of GnRH-a in the stimulation
regimen is associated with a lower proportion of immature oocytes. A higher occurrence of oocyte-nuclear immaturity is apparently
associated with a significantly better ovarian response to stimulation. The high incidence of immature oocytes observed in
patients with normospermic partners and low fertilization rates in previous cycles may suggest that the fertilization failure
in some of these cases is due to oocyte, rather than sperm, dysfunction. 相似文献
19.
20.
Suzanne M. Jacques Faisal Qureshi Barbara J. Doss Adnan Munkarah 《Pediatric and developmental pathology》1998,1(5):380-387
Choriocarcinoma arising in the placenta, or intraplacental choriocarcinoma, has seldom been reported, particularly in the
absence of maternal metastases. Reluctance to diagnose choriocarcinoma in the presence of chorionic villi can delay diagnosis;
however, timely diagnosis of choriocarcinoma is prognostically important, both for the mother and infant. We report the clinicopathologic
findings in five mothers and infants in whom choriocarcinoma was identified in the placenta. None of the mothers had a history
of gestational trophoblastic disease in previous pregnancies. Three placentas were similar with a single small lesion grossly
suggesting a small infarct; microscopically these consisted of infarcted areas surrounded by choriocarcinoma. These three
mothers were unusual in that none had metastatic choriocarcinoma; two were treated with chemotherapy and remained disease-free;
the third was lost to follow-up shortly following delivery. The remaining two mothers had known pulmonary metastases at time
of delivery. One of these latter two placentas contained a large marginal lesion microscopically identified as choriocarcinoma.
The fifth placenta had rare microscopic foci of choriocarcinoma, and sheets of necrotic choriocarcinoma were identified in
“blood clot” submitted with the placenta. In four of the five cases the choriocarcinoma appeared to be arising from otherwise
normal chorionic villi, and in no case was there invasion of the villous stroma. All of the infants survived, and none had
evidence of choriocarcinoma. These cases support the concept that choriocarcinoma associated with otherwise normal pregnancy
arises in the placenta and may be more common than reported.
Received August 11, 1997; accepted December 8, 1997. 相似文献