孕马血清促性腺激素对小鼠受孕的影响

目的观察孕马血清促性腺激素（PMSG）对于小鼠受孕率的影响。方法通过注射PMSG进行超数排卵处理,建立实验组和自然周期组昆明小鼠妊娠模型,比较两组小鼠的受孕率和获得的平均胚胎数。结果在PMSG妊娠小鼠模型中,小鼠妊娠率为75%,平均受孕17个胚胎;自然周期小鼠妊娠率为40%,平均受孕10个胚胎。结论PMSG能促进小鼠排卵,增强小鼠受孕率。     

Does ovarian stimulation affect uterine artery impedance?

Purpose: We evaluated the effect of induction of ovulation on uterine perfusion. Methods: In 42 infertile women transvaginal color Doppler was performed at days 16–21 of a spontaneous ovulatory cycle and prior to embryo transfer in an in vitro fertilization (IVF) cycle. Indication for treatment was mainly tubal or unexplained infertility. Results: Uterine artery pulsatility index was significantly (P<0.001) lower in IVF than in natural cycles, 3.24±0.72 2.64±0.53 (mean ± SD), with a mean reduction of 18%. The reduction was higher, although not significantly, in the women who conceived (20%) than in those who did not (15%), and in those with a basal PI>3.0 (20%) as opposed to those with normal values (16%). The percentage reduction correlated with patient age and with estradiol concentration, number of follicles, and oocytes recruited. Conclusions: Induction of superovulation reduces impedance to flow in the uterine circulation. The amplitude of this effect appears to be regulated partially by patient age and by effectiveness of ovarian stimulation.Presented in part at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, Vienna, Austria, April 3–7, 1995.     

Serum Progesterone in Predicting Pregnancy Outcome After Assisted Reproductive Technology

Purpose: Our purpose was to determine whether serum progesterone predicts pregnancy outcome after superovulation. Methods: One hundred twenty-three consecutively pregnant patients were divided into three groups: group I, 55 patients following superovulation for assisted reproductive technologies; group II, 23 patients after correction of oligoovulation; and group III, 45 patients who conceived spontaneously. When -human chorionic gonadotropin was positive, progesterone was measured on the same serum sample. A serum progesterone level of 45 m/L was set to differentiate between nonviable pregnancy and ongoing pregnancy. Results: In group I, zero (0%) of 38 ongoing pregnancies and 10 (59%) of 17 nonviable pregnancies were observed with a progesterone level of <45 m/L [14.2 ng/ml (P < 0.001)]. In group II, 4 (27%) of 15 ongoing pregnancies and 5 (63%) of 8 nonviable pregnancies had a progesterone level of <45 m/L (P = NS). In group III, 10 (42%) of 24 ongoing pregnancies and 15 (71%) of 21 nonviable pregnancies were observed with a progesterone level of <45 m/L (14.2 ng/ml) (P = NS). Conclusions: A serum progesterone level of <45 nM predicts nonviable pregnancy after superovulation for assisted reproductive technology.     

重组FSH控制下超促排卵和宫腔内人工受精治疗不育患者-202周期

目的观察重组基因的促卵泡生长激素(recombinant follicle stimulating hormone,r-FSH)在非器质原因与非排卵障碍的不育患者中进行控制下超促排卵和宫腔内人工受精的疗效.方法以88名在墨尔本Monash医院确诊的非器质原因与非排卵障碍的不育患者为研究对象,给予r-FSH超促排卵,期望最多得到3个成熟卵泡,注射人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)36 h时,给予宫腔内人工受精.共接受202个周期的治疗.结果周期排卵率95.7%,无排卵率4.3%,周期取消率7.4%,周期妊娠率11.6%,双胎发生率15%,每名患者的妊娠率为22.7%.妊娠周期组与非妊娠周期组相比,在年龄、体重指数、周期治疗天数、成熟卵泡数、内膜厚度、治疗周期等观察指标方面差异无显著性(P＞0.05),但在不孕时间上差异有显著性(P＜0.05),妊娠周期组的不孕时间小于非妊娠周期组.结论对于非器质性原因与非排卵障碍的不育患者,应用超排卵治疗和宫腔内人工受精不失为一种相对廉价、有一定成效的、安全的助孕方法.     

小剂量GnRHa在IVF-ET促超排卵中的探讨

目的:探讨在体外受精-胚胎移植(IVF-ET)超排卵方案中GnRHa降调节的最低有效剂量。方法:回顾分析采用长方案的148个IVF周期,分为1/2剂量组(A组)42例,每日皮下注射短效曲普瑞林1/2支(0.05mg/d);1/3剂量组(B组)44例,一次性皮下注射曲普瑞林缓释型1.25mg;小剂量组(C组)62例,每日皮下注射短效曲普瑞林1/2支(0.05mg/d)至月经来潮d3减量至1/4支(0.025mg/d),比较其治疗效果。结果:C组促性腺激素(Gn)用量、用药时间明显少于A组(P<0.05)和B组(P<0.01),hCG注射日血LH水平明显高于其他两组(P<0.05)。三组降调后E2、hCG注射日E2水平、受精率、优质胚胎率、临床妊娠率均无显著性差异(P>0.05)。三组均无内源性LH峰出现。结论:小剂量短效GnRHa的应用能减少Gn用量及缩短疗程,且不影响IVF结局,与缓释型GnRHa制剂相比还有能灵活调整使用剂量的优点。     

Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination

OBJECTIVE: To investigate the effects of letrozole in patients undergoing superovulation with gonadotropins and IUI. DESIGN: Retrospective analysis. SETTING: Academic teaching hospital. PATIENT(S): Women younger than 40 years of age with patent fallopian tubes and infertility of more than 1 year in duration who were undergoing IUI and gonadotropin therapy. INTERVENTION(S): Gonadotropins alone administered from day 3 or a combination of letrozole, 5 mg/d on day 3 to 7, and gonadotropins starting on day 5 of the menstrual cycle. Ultrasonography was performed before initiation of treatment, on day 9 of menstrual cycle, and as required thereafter until the dominant follicle reached 18 mm in diameter. Ovulation was triggered with 10,000 IU of hCG, and IUI was performed 24 and 48 hours later. MAIN OUTCOME MEASURE(S): Gonadotropin requirements, endometrial thickness, number of follicles, and pregnancy rate. RESULT(S): All 205 IUI treatment cycles conducted from March 2001 to March 2002 were included. Gonadotropins alone were used in 145 cycles and combination therapy was used in 60 cycles. Patients cotreated with letrozole required fewer gonadotropin administrations (median difference, 300 IU [95% confidence interval (CI), 225-375 IU]), developed more follicles larger than 14 mm (median difference, 1 follicle [95% CI, 1-2 follicles), and had a thinner endometrium (median difference, 1 mm [95% CI, 0.4-1.6 mm]). The pregnancy rate did not differ between patients using gonadotropin alone and those using gonadotropin plus letrozole (20.9% vs. 21.6%). CONCLUSION(S): The addition of letrozole to gonadotropins decreases gonadotropin requirements, increases the number of pre-ovulatory follicles and decreases endometrial thickness, without a negative effect on pregnancy rates.     

Comparison of the effectiveness of single intrauterine insemination (IUI) versus double IUI per cycle in infertile patients

OBJECTIVE: To compare a single periovulatory intrauterine insemination (IUI) with a regimen based on double IUI, performed during preovulatory and periovulatory periods, in patients undergoing controlled ovarian hyperstimulation (COH). DESIGN: Prospective, randomized study. SETTING: Infertility and endocrinology units of a medical university. PATIENT(S): One hundred ten patients with male factor, cervical factor, and unexplained infertility who were undergoing 486 cycles of COH with IUI. INTERVENTION(S): The patients were randomly divided into two groups. One group underwent single IUI in the first cycle and double IUI in the second cycle; this alternating pattern was continued up to six cycles unless pregnancy occurred. For patients in the second group, double IUI was performed in the first cycle and single IUI in the second cycle; this pattern was repeated as in the first group. MAIN OUTCOME MEASURE(S): Relationship of single and double IUI to rates of clinical pregnancy and abortion. RESULT(S): Forty-two women became pregnant, with an overall pregnancy rate per cycle of 8.6% and pregnancy rate per couple of 38.2%. Pregnancy rate per cycle was 7.9% in single IUI cycles and was 9.4% in double IUI cycles; these findings were not statistically significant. CONCLUSION(S): Among patients undergoing COH-IUI, results of single and double IUI do not statistically differ.     

Uterine glandular area during the menstrual cycle and the effects of different in-vitro fertilization related hormonal treatments

The human uterine glandular epithelium undergoes a sequenceof well characterized changes during the menstrual cycle thatpresumably play an important role in preparation for blastocystimplantation. The aim of this study was to measure objectivelyglandular volume over the entire menstrual cycle and comparethe results with eight different clinical superovulation orhormone replacement therapy (HRT) subject groups. Endometrialbiopsies were taken from control normal menstrual cycle subjects(n = 96), and eight other smaller groups of women who had receiveddifferent in-vitro fertilization (TVF) related treatments. Thetotal area of glandular epithelium was objectively measuredfrom routine histological slides using computerized image analysis.Control menstrual cycle results showed a significantly greatergland area in the early secretory stage of the cycle than atany time between the early proliferative through to the mid-lateproliferative stages (P < 0.05). FVF patients receiving clomiphenecitrate and human menopausal gonadotrophin had a significantlysmaller glandular area than those in the control groups at equivalentstages of the menstrual cycle. The use of progesterone supplementationremoved this significant difference. Patients on the ‘Flare"regime had the highest gland area, although this was not significantlydifferent from controls. Buserelin down-regulation gave a glandarea that was closest to the normal cycle controls. The threeHRT groups showed high variability in gland volume between patients.The results from this study demonstrate that superovulationcan cause significant alterations in endometrial gland volume,but that these do not necessarily preclude implantation.     

Use of follicle-stimulating hormone (FSH) to increase the in vitro fertilization (IVF) efficiency of mice

Purpose The possibility of increasing the efficiency of an in vitro fertilization system (IVF) for Swiss OF1 mice was studied. The experimental protocol proposed analyzed the use of FSH as a superovulatory inducing hormone in comparison to traditional PMSG treatment. At the same time, the quality of IVF-derived embryos was evaluated both in vitro, with culture in CZB medium and fixation in advanced stages of development, and in vivo, by transfer to female recipients.Results Treatment with FSH induced a much higher ovulation number compared to PMSG (64.26 vs 33.85; P<0.01). With this gonadotropin, IVF provided a positive tendency to normal fecundation (67.76 vs 64.72; P<0.1) and a much lower index of abnormal division in embryos (10.57 vs 15.11; P<0.05). The viability of embryos obtained from donors treated with hormones was similar, although differences did exist regarding embryo origin: those obtained following natural fertilization showed a higher developmental capacity both in vitro (P<0.05) and in vivo (P<0.05).Conclusions We conclude that FSH is an improved superovulation alternative treatment in comparison to PMSG for IVF. It provides a higher number of embryos with the same in vitro and in vivo viability as those obtained from PMSG.     

Effect of total cholesterol,glucose and blood urea nitrogen on embryo quality in post-partum superovulated suckling Japanese Black cattle

Aim:  This study was conducted to examine the effect of blood metabolites on embryo quality in post-partum suckling Japanese Black cattle.
Methods:  Blood samples were taken from 23 cows 30 days before, at and 30 days after parturition. Cows were synchronized 40 or 41 days after calving (day 0) and divided into three groups: control ( n  = 6), gonadotropin-releasing hormone ([GnRH] n  = 10) and estradiol benzoate ([EB] n  = 7). All groups received a controlled internal drug release (CIDR) device intravaginally together with 2 mg EB i.m. on day 0 and superovulation was induced in all groups from days 5–7 with a gradually decreasing dose of follicle-stimulating hormone (FSH). Two milligrams of EB was given on day 8 and GnRH (0.1 mg) was given on day 9 of insertion of the CIDR in the EB and GnRH groups. Cows were inseminated twice after the onset of estrus and embryos were recovered 7–8 days after artificial insemination.
Results:  The number of corpus luteum detected by ultrasonography in the EB group was significantly higher ( P <  0.05) than that in the GnRH group. The number and rate of transferable and freezable embryos did not differ significantly among the groups. Regardless of the treatments, the total cholesterol level from parturition until 30 days after parturition was significantly higher ( P <  0.01) in the good category than in the poor category of cows.
Conclusions:  The number of transferable embryos produced by post-partum superovulated suckling Japanese Black cattle was affected by the level of total cholesterol from parturition until 30 days after parturition. Moreover, administration of EB in CIDR-treated cows increased the numbers of corpus luteum and yielded better rates of transferable and freezable embryos. (Reprod Med Biol 2008; 7 : 55–62)