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S R Bird - One of the best experts on this subject based on the ideXlab platform.
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velocity at v o 2 max and peak treadmill velocity are not influenced within or across the Phases of the menstrual cycle
European Journal of Applied Physiology, 2005Co-Authors: M Burrows, S R BirdAbstract:Velocity at VO2 max (vVO2 max) and peak treadmill velocity (PTV) are variables highly predictive of endurance performance. However, how these variables are affected by the menstrual cycle is unknown. The aim of this study was to assess the effect of the menstrual cycle on vVO2 max and PTV. Ten, female runners were studied across three menstrual cycles. Training, menstrual history and mood states were assessed for 2 months, with daily salivary samples taken to detect menstrual Phases. During the third menstrual cycle, participants completed a maximal test to determine VO2 max, vVO2 max and PTV in the early Follicular Phase, late Follicular Phase, early luteal Phase, late luteal Phase and menses. Progesterone increased at the onset of the luteal Phase [mean (SEM); 490 (73.6) pmol l−1] compared to the Follicular Phase [344.6 (59.7) pmol l−1). No significant differences in the psychological mood states between the Phases of the menstrual cycle were found (P>0.05). No significant differences in vVO2 max (P=0.611), or PTV (P=0.472) were found between the Phases of the menstrual cycle. Thus, vVO2 max and PTV are not affected by the monthly menstrual cycle in female endurance runners.
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velocity at v o 2 max and peak treadmill velocity are not influenced within or across the Phases of the menstrual cycle
European Journal of Applied Physiology, 2005Co-Authors: M Burrows, S R BirdAbstract:Velocity at VO2 max (vVO2 max) and peak treadmill velocity (PTV) are variables highly predictive of endurance performance. However, how these variables are affected by the menstrual cycle is unknown. The aim of this study was to assess the effect of the menstrual cycle on vVO2 max and PTV. Ten, female runners were studied across three menstrual cycles. Training, menstrual history and mood states were assessed for 2 months, with daily salivary samples taken to detect menstrual Phases. During the third menstrual cycle, participants completed a maximal test to determine VO2 max, vVO2 max and PTV in the early Follicular Phase, late Follicular Phase, early luteal Phase, late luteal Phase and menses. Progesterone increased at the onset of the luteal Phase [mean (SEM); 490 (73.6) pmol l−1] compared to the Follicular Phase [344.6 (59.7) pmol l−1). No significant differences in the psychological mood states between the Phases of the menstrual cycle were found (P>0.05). No significant differences in vVO2 max (P=0.611), or PTV (P=0.472) were found between the Phases of the menstrual cycle. Thus, vVO2 max and PTV are not affected by the monthly menstrual cycle in female endurance runners.
Jenny A Visser - One of the best experts on this subject based on the ideXlab platform.
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anti mullerian hormone and anti mullerian hormone type ii receptor polymorphisms are associated with Follicular Phase estradiol levels in normo ovulatory women
Human Reproduction, 2007Co-Authors: Marlies E Kevenaar, Barbara Sonntag, Sharon Lie Fong, Manuela Simoni, Axel P N Themmen, Frank H. De Jong, Joop S E Laven, Huibert A P Pols, Andre G Uitterlinden, Jenny A VisserAbstract:textabstractBackground: In mice, anti-Mullerian hormone (AMH) inhibits primordial follicle recruitment and decreases FSH sensitivity. Little is known about the role of AMH in human ovarian physiology. We hypothesize that in women AMH has a similar role in ovarian function as in mice and investigated this using a genetic approach. Methods: The association ofthe AMH Ile49Ser and the AMH type II receptor (AMHR2) -482 A > G polymorphisms with menstrual cycle characteristics was studied in a Dutch (n = 32) and a German (n = 21) cohort of normo-ovulatory women. Results: Carriers of the AMH Ser49allele had higher serum estradiol (E2) levels on menstrual cycle day 3 when compared with non-carriers in the Dutch cohort (P = 0.012) and in the combined Dutch and German cohort (P = 0.03). Carriers of the AMHR2 -482G allele also had higher Follicular Phase E2levels when compared with non-carriers in the Dutch cohort (P = 0.028), the German cohort (P = 0.048) and hence also the combined cohort (P = 0.012). Women carrying both AMH Ser49and AMHR2 -482G alleles had highest E2levels (P = 0.001). For both polymorphisms no association with serum AMH or FSH levels was observed. Conclusions: Polymorphisms in the AMH and AMHR2 genes are associated with Follicular Phase E2levels, suggesting a role for AMH in the regulation of FSH sensitivity in the human ovary.
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anti mullerian hormone and anti mullerian hormone type ii receptor polymorphisms are associated with Follicular Phase estradiol levels in normo ovulatory women
Human Reproduction, 2007Co-Authors: Marlies E Kevenaar, Barbara Sonntag, Sharon Lie Fong, Manuela Simoni, Axel P N Themmen, Frank H. De Jong, Joop S E Laven, Huibert A P Pols, Andre G Uitterlinden, Jenny A VisserAbstract:Background: In mice, anti-Mullerian hormone (AMH) inhibits primordial follicle recruitment and decreases FSH sensitivity. Little is known about the role of AMH in human ovarian physiology. We hypothesize that in women AMH has a similar role in ovarian function as in mice and investigated this using a genetic approach. Methods: The association ofthe AMH Ile49Ser and the AMH type II receptor (AMHR2) -482 A > G polymorphisms with menstrual cycle characteristics was studied in a Dutch (n = 32) and a German (n = 21) cohort of normo-ovulatory women. Results: Carriers of the AMH Ser49allele had higher serum estradiol (E2) levels on menstrual cycle day 3 when compared with non-carriers in the Dutch cohort (P = 0.012) and in the combined Dutch and German cohort (P = 0.03). Carriers of the AMHR2 -482G allele also had higher Follicular Phase E2levels when compared with non-carriers in the Dutch cohort (P = 0.028), the German cohort (P = 0.048) and hence also the combined cohort (P = 0.012). Women carrying both AMH Ser49and AMHR2 -482G alleles had highest E2levels (P = 0.001). For both polymorphisms no association with serum AMH or FSH levels was observed. Conclusions: Polymorphisms in the AMH and AMHR2 genes are associated with Follicular Phase E2levels, suggesting a role for AMH in the regulation of FSH sensitivity in the human ovary.
Bart C J M Fauser - One of the best experts on this subject based on the ideXlab platform.
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women with regular menstrual cycles and a poor response to ovarian hyperstimulation for in vitro fertilization exhibit Follicular Phase characteristics suggestive of ovarian aging
Fertility and Sterility, 2002Co-Authors: Nicole G M Beckers, Nick S Macklon, Marinus J C Eijkemans, Bart C J M FauserAbstract:Abstract Objective: To investigate whether Follicular Phase characteristics associated with ovarian aging can be observed in women of normal reproductive age, who had previously shown a poor response to ovarian hyperstimulation for IVF. Design: Observational, prospective study. Setting: Tertiary fertility center. Patient(s): Eleven regularly cycling, ovulatory women, aged 29–40 years who previously presented with fewer than four dominant follicles after ovarian hyperstimulation for IVF. Intervention(s): Frequent serum hormone assessments and transvaginal ultrasound during the Follicular Phase of a spontaneous, unstimulated cycle. Main Outcome Measure(s): Duration of the Follicular Phase; serum LH, FSH, E 2 , P, inhibin A, and inhibin B levels; and number of antral follicles observed by ultrasound. Results were compared with the cycle characteristics of a reference population of 38 healthy normo-ovulatory women aged 20–36 years (as published elsewhere). Result(s): Poor responders had significantly fewer antral follicles than controls. Median FSH concentrations were significantly higher compared with controls, but the majority had FSH levels within the normal range. Follicular Phase P levels were significantly higher in poor responders. Duration of the Follicular Phase, E 2 , and inhibin A and inhibin B serum levels did not differ between poor responders and controls. Conclusion(s): Normo-ovulatory regularly cycling women with a previous poor response to ovarian hyperstimulation for IVF show Follicular Phase characteristics suggestive of ovarian aging.
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low dose exogenous fsh initiated during the early mid or late Follicular Phase can induce multiple dominant follicle development
Human Reproduction, 2001Co-Authors: F P Hohmann, Marinus J C Eijkemans, F H De Jong, Joop S E Laven, Bart C J M FauserAbstract:This prospective, randomized trial in normo-ovulatory women was designed to test whether administration of low-dose exogenous FSH initiated during the early, mid to late Follicular Phase can induce multiple dominant follicle development. Forty normal weight women (age 19-35 years, cycle length 25-32 days) participated. A fixed dose (75 IU/day) of recombinant FSH was started on either cycle day 3 (n = 13), 5 (n = 13) or 7 (n = 14) until the induction of ovulation with human chorionic gonadotrophin. Frequent transvaginal ultrasound scans and blood sampling were performed. MultiFollicular growth occurred in all groups (overall in 60%), although day 7 starters showed less multiFollicular growth. Age, cycle length and initial FSH and inhibin B concentrations were similar between subjects with single or multiple follicle development. However, for all women the lower the body mass index (BMI), the more follicles emerged (r = -0.44, P = 0.007). If multiFollicular growth occurred, the length of the luteal Phase was reduced (P = 0.002) and midluteal serum concentrations of LH (P = 0.03) and FSH (P = 0.004) were decreased and oestradiol (P = 0.002) and inhibin A (P = 0.01) were increased. In conclusion, interference with decremental serum FSH concentrations by administration of low dose FSH starting on cycle day 3, 5 or as late as day 7, is capable of disrupting single dominant follicle selection. The role of BMI in determining ovarian response suggests that differences in pharmacokinetics of exogenous FSH are involved. MultiFollicular growth per se has a distinct effect on luteal Phase characteristics. These observations may be relevant for the design of mild ovarian stimulation protocols.
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dynamics of the development of multiple follicles during ovarian stimulation for in vitro fertilization using recombinant follicle stimulating hormone puregon and various doses of the gonadotropin releasing hormone antagonist ganirelix orgalutran ant
Fertility and Sterility, 2001Co-Authors: Diederick De Jong, Nick S Macklon, Marinus J C Eijkemans, Bernadette Mannaerts, Herjan Coelingh J T Bennink, Bart C J M FauserAbstract:Abstract Objective: To investigate relations between dose of GnRH antagonist and Follicular Phase characteristics. Design: Randomized controlled multicenter trial. Setting: Tertiary referral fertility centers. Patient(s): Three hundred and twenty-nine IVF patients. Intervention(s): Ovarian stimulation for IVF with recombinant FSH starting on cycle day 2. From cycle day 7 onwards, cotreatment was provided with 0.0625, 0.125, 0.25, 0.5, 1.0, or 2.0 mg/d GnRH antagonist. Main Outcome Measure(s): Number of follicles, total Follicular surface area, gonadotropin, and serum steroid concentrations. Result(s): In 311 patients, similar Follicular growth was observed in all treatment groups. FSH levels increased during the Follicular Phase. Late Follicular Phase LH, androstenedione (AD), and E 2 levels showed a GnRH antagonist dose-related decrease ( P 2 levels correlated with total Follicular surface area, AD, LH, and FSH (all P 2 levels. Conclusion(s): Follicular growth was unaffected by the dose of GnRH antagonist. A rise in Follicular Phase FSH serum concentrations during the Follicular Phase, largely related to exogenous FSH, enabled ongoing Follicular growth in all treatment groups. The effect of GnRH antagonist on late Follicular Phase E 2 levels could not be exclusively attributed to suppression of LH.
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lack of correlation between maximum early Follicular Phase serum follicle stimulating hormone concentrations and menstrual cycle characteristics in women under the age of 35 years
Human Reproduction, 1998Co-Authors: Inger B Schipper, F H De Jong, Bart C J M FauserAbstract:The gradual increase in follicle stimulating hormone (FSH) concentrations in women approaching menopause results from the depletion of the ovarian Follicular pool, a process referred to as ‘ovarian ageing’. This study investigates whether variable endogenous FSH concentrations, as have been observed in normo-ovulatory young women, are related to menstrual cycle characteristics, including predictors of ovarian ageing. Serum concentrations of immunoreactive FSH, oestradiol, and inhibin-A and inhibin-B were measured, and Follicular growth was assessed by transvaginal ultrasound throughout the Follicular Phase in 39 healthy volunteers (20‐35 years) with regular menstrual cycles. Median serum FSH concentration on cycle day 3 was 5.1 IU/l (range 3.6‐11.2), and median maximum Follicular Phase FSH was 6.2 IU/l (range 4.3‐11.2), observed on cycle day 6 (range 2‐15). Maximum FSH concentrations were not correlated with age or cycle length, nor with maximum inhibin-B. The number of small (,10 mm) antral follicles on cycle day 3 was 11 (range 4‐21) and was not correlated with age, nor with maximum FSH. InhibinA remained low until a significant rise on cycle day 9 (range 3‐12), which was significantly correlated with the late Follicular rise in oestradiol ( r J 0.56, P J 0.01). These observations indicate a lack of correlation between maximum Follicular Phase serum FSH concentrations and parameters of ovarian ageing in women under the age of 35 years. In addition, FSH concentrations assessed on cycle day 3 represent an underestimation of maximum early Follicular Phase FSH. Distinct individual differences in intra-ovarian modification of FSH action, resulting in differences in the FSH threshold for stimulation of ovarian function, may be operative.
Michael R Soules - One of the best experts on this subject based on the ideXlab platform.
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is the short Follicular Phase in older women secondary to advanced or accelerated dominant follicle development
The Journal of Clinical Endocrinology and Metabolism, 2002Co-Authors: Nancy A Klein, Andrew J Harper, Brenda S Houmard, Patrick M Sluss, Michael R SoulesAbstract:This study sought to determine whether the shortened Follicular Phase in ovulatory older women is secondary to advanced (i.e. earlier) or accelerated (i.e. more rapid) folliculogenesis. Normal ovulatory women, aged 40–45 yr (n = 15) and 20–25 yr (n = 13), underwent daily venipuncture and transvaginal ultrasonography throughout the Follicular Phase of a spontaneous menstrual cycle (control cycle) and after pituitary down-regulation with a GnRH agonist (study cycle). As expected, the older subjects in the control cycles demonstrated an elevated d 3 FSH and a shortened Follicular Phase compared with the younger subjects. After release from hypothalamic-pituitary-ovarian axis suppression, the early Follicular Phase FSH peak occurred earlier (6.8 vs. 9.8 d; P < 0.01) and was of a greater magnitude (12.1 vs. 6.5 mIU/ml; P < 0.01) in the older subjects. The time from release of suppression until the subsequent LH surge was also shorter (17.5 vs. 20.8 d; P < 0.01) in the older group. However, the time from FSH pe...
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is the short Follicular Phase in older women secondary to advanced or accelerated dominant follicle development
The Journal of Clinical Endocrinology and Metabolism, 2002Co-Authors: Nancy A Klein, Andrew J Harper, Brenda S Houmard, Patrick M Sluss, Michael R SoulesAbstract:This study sought to determine whether the shortened Follicular Phase in ovulatory older women is secondary to advanced (i.e. earlier) or accelerated (i.e. more rapid) folliculogenesis. Normal ovulatory women, aged 40-45 yr (n = 15) and 20-25 yr (n = 13), underwent daily venipuncture and transvaginal ultrasonography throughout the Follicular Phase of a spontaneous menstrual cycle (control cycle) and after pituitary down-regulation with a GnRH agonist (study cycle). As expected, the older subjects in the control cycles demonstrated an elevated d 3 FSH and a shortened Follicular Phase compared with the younger subjects. After release from hypothalamic-pituitary-ovarian axis suppression, the early Follicular Phase FSH peak occurred earlier (6.8 vs. 9.8 d; P < 0.01) and was of a greater magnitude (12.1 vs. 6.5 mIU/ml; P < 0.01) in the older subjects. The time from release of suppression until the subsequent LH surge was also shorter (17.5 vs. 20.8 d; P < 0.01) in the older group. However, the time from FSH peak to LH surge was similar in the older and younger groups (10.7 vs. 11.0 d; P = 0.74). Compared with younger women, older subjects had normal Follicular Phase levels of estradiol and inhibin A and lower levels of inhibin B in both control and study cycles. We conclude that the shortened Follicular Phase observed in older ovulatory women is due to earlier dominant follicle selection, independent of hormonal influences from the preceding luteal Phase.
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reproductive aging accelerated ovarian Follicular development associated with a monotropic follicle stimulating hormone rise in normal older women
The Journal of Clinical Endocrinology and Metabolism, 1996Co-Authors: Nancy A Klein, David E Battaglia, Victor Y Fujimoto, Gretchen S Davis, William J Bremner, Michael R SoulesAbstract:Women experience a decline in fertility that precedes the menopause by several years. Previous studies have demonstrated a monotropic rise in FSH associated with reproductive aging: however, the mechanism of this rise and its role in the aging process are poorly understood. The purpose of this study was to characterize ovarian Follicular development and ovarian hormone secretion in older reproductive age women. Sixteen women, aged 40-45 yr, with regular ovulatory cycles were studied. The control group consisted of 12 ovulatory women, aged 20-25 yr. Serum obtained by daily blood sampling was analyzed for FSH, LH, estradiol (E), progesterone, and inhibin (Monash polyclonal assay). Follicle growth and ovulation were documented by transvaginal ultrasound. Older women had significantly higher levels of FSH throughout the menstrual cycle. E, progesterone, LH, and inhibin levels did not differ between the two age groups when compared relative to the day of the LH surge. Ultrasound revealed normal growth, size, and collapse of a dominant follicle in all subjects. Older women had significantly shorter Follicular Phase length associated with an early acute rise in Follicular Phase E, reflecting accelerated development of a dominant follicle. We conclude that older reproductive age women have accelerated development of a dominant follicle in the presence of the monotropic FSH rise. This is manifested as a shortened Follicular Phase and elevated Follicular Phase E. The fact that ovarian steroid and inhibin secretion were similar to those in the younger women suggests that elevated FSH in women of advanced reproductive age may represent a primary neuroendocrine change associated with reproductive aging.
P Devroey - One of the best experts on this subject based on the ideXlab platform.
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can 200 iu of hcg replace recombinant fsh in the late Follicular Phase in a gnrh antagonist cycle a pilot study
Human Reproduction, 2009Co-Authors: Christophe Blockeel, W Verpoest, D Stoop, Patrick Haentjens, P DevroeyAbstract:BACKGROUND: GnRH-antagonist protocols shorten the treatment period and reduce inconvenience for IVF patients. This randomised controlled trial (RCT) further explored whether low-dose hCG can be used clinically to replace recombinant FSH (rFSH) during the late Follicular Phase in a GnRH-antagonist protocol. METHODS: Seventy ICSI patients undergoing controlled ovarian stimulation (COS) in a GnRH-antagonist protocol was randomized into two groups. The control group received a standard treatment with rFSH (Puregon) plus a GnRH-antagonist, daily from Day 6 of stimulation. In the study group, rFSH was discontinued when six follicles ≥ 12 mm were observed and estradiol levels were >600 ng/l; rFSH was subsequently replaced by low-dose hCG (200 lU/l daily). RESULTS: Mean values (SD) for dose and duration of rFSH treatment in the control versus low-dose hCG group were 1617 (280) versus 1273 (260) IU rFSH [between-group difference -344, 95% confidence interval (Cl) -483 to -205; P< 0.001] and 8.2 (1.6) versus 6.4 (1.3) days (— 1.8, -2.6 to - 1.1; P< 0.001), respectively. The mean number of metaPhase II oocytes of 10.1 versus 8.9 (between-group difference - 1.2, 95% Cl - 3.9 to 1.5) and the ongoing pregnancy rates of 10/35 (29%) versus 13 /35 (37%) (between-group difference 8.6%; 95% Cl - 13.0 to 29.1%; P = 0.45) for control versus hCG, respectively, did not differ. CONCLUSION: In this pilot trial, substitution of rFSH by low-dose hCG in the final days of COS leads to a reduction of FSH consumption whereas ICSI outcome, in terms of oocyte yield and ongoing pregnancy rate, remains comparable to the traditional regimen (ClinicalTrials.-gov, trial number: NCT00750100).
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steroid receptor expression in late Follicular Phase endometrium in gnrh antagonist ivf cycles is already altered indicating initiation of early luteal Phase transformation in the absence of secretory changes
Human Reproduction, 2005Co-Authors: E G Papanikolaou, Efstratios M Kolibianakis, Herman Tournaye, C Bourgain, P DevroeyAbstract:BACKGROUND: Ovarian stimulation for IVF profoundly alters the early luteal Phase endometrial development. It has been hypothesized that this process has already started in the late Follicular Phase, as the endometrium has already been exposed to high steroid concentrations since that Phase. The aim of the present study was to prospectively investigate the effect of multi-Follicular ovarian stimulation for IVF on the late Follicular Phase endometrium histology and the expression of estrogen receptor (ER) and progesterone receptor (PR). METHODS: In a crossover study, 11 infertile women with normal ovulatory function, participating in an IVF programme and treated with GnRH antagonist/recombinant FSH ovarian stimulation, were enrolled in the study. Endometrial biopsies were taken in a natural cycle on the day of the onset of the surge of the LH, and in a subsequent stimulation cycle on the day of hCG administration for final oocyte maturation. Endometrial histological dating was carried out according to Noyes’ criteria. Immunohistochemistry was performed, using commercially available antibodies for ER and PR endometrial expression. The immunohistochemical signal was recorded in 1000 epithelial cells in each compartment (glands and stroma). Endometrial expression for each of the two receptors was graded on a scale of 0‐3, based on the intensity of nuclear staining. Then a score range between 0 and 3000 was recorded, and expressed as a mean score per 1000 stroma or glandular cells per sample (range: 0‐3). RESULTS: Histological examination of biopsies both in natural and stimulated cycles showed no secretory changes. However, in stimulated cycles, PR expression was significantly up-regulated compared to natural cycles in both glands (1.67 versus 1.34, P< 0.05) and stroma (1.98 versus 1.62, P< 0.05), whereas ER was down-regulated in glands (1.15 versus 1.43, P< 0.05). In IVF cycles, the progesterone measurements, although within normal values (range 0.8‐1.4mg/l), were significantly higher than in natural cycles (0.99 vs 0.63mg/l, respectively, P 5 0.008). An ongoing pregnancy rate of 37.5% was achieved in the stimulated cycles. DISCUSSION: Although the current study found no early secretory transformation in stimulated endometria before hCG administration, the ER and PR expression in these endometria is similar to the one described during the first days of the luteal Phase in natural cycles. Supraphysiological concentrations of estradol and subtle progesterone rises in the late Follicular Phase might be responsible for this modulated steroid receptor profile. This phenomenon indicates accentuated maturation of the endometrium in IVF cycles from the pre-ovulatory Phase onwards.
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prolongation of the Follicular Phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonists
Fertility and Sterility, 2004Co-Authors: Efstratios M Kolibianakis, Carola Albano, Michel Camus, Herman Tournaye, Andre Van Steirteghem, P DevroeyAbstract:Abstract Objective To assess the effect of altering the timing of hCG administration on ongoing pregnancy rates in patients stimulated with recombinant FSH (rec-FSH) and GnRH antagonists for IVF. Design Prospective, randomized, controlled trial. Setting Tertiary referral center. Patient(s) Four hundred thirteen patients undergoing IVF. Intervention(s) Rec-FSH stimulation starting on day 2 of the cycle combined with daily GnRH antagonist starting on day 6 of stimulation. Patients were randomized to receive 10,000 IU of hCG either as soon as at least three follicles were ≥17 mm on ultrasound (early-hCG group, 208 patients) or 2 days later after this criterion was met (late-hCG group, 205 patients). Main outcome measure(s) Ongoing pregnancy rate. Result(s) Fertilization rates and number and quality of embryos transferred did not differ between the two groups. However, a significantly lower ongoing pregnancy rate was present in the late-hCG as compared with the early-hCG group (25.0% vs. 35.6%, respectively). Conclusion(s) Prolongation of the Follicular Phase in patients stimulated with rec-FSH and GnRH antagonists for IVF does not affect oocyte or embryo quality but is associated with a significantly lower ongoing pregnancy rate.
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exposure to high levels of luteinizing hormone and estradiol in the early Follicular Phase of gonadotropin releasing hormone antagonist cycles is associated with a reduced chance of pregnancy
Fertility and Sterility, 2003Co-Authors: Efstratios M Kolibianakis, Carola Albano, Jarl A Kahn, Michel Camus, Herman Tournaye, Andre Van Steirteghem, P DevroeyAbstract:Abstract Objective To compare ongoing implantation rates under two different GnRH antagonist protocols. Design Randomized controlled trial. Setting Tertiary referral center. Patient(s) One hundred eleven women undergoing ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Intervention(s) Ovarian stimulation with 150 IU recombinant-FSH (rec-FSH) starting on day 2 of the cycle and GnRH antagonist starting either on day 6 of stimulation (fixed group) or when a follicle of ≥15 mm was present after at least 5 days of stimulation (flexible group). In the flexible group, the rec-FSH dose was increased to 250 IU when the antagonist was initiated. Main outcome measure(s) Ongoing implantation and pregnancy rate. Result(s) In patients with no follicle of ≥15 mm present on day 6 of stimulation, a significantly lower ongoing implantation rate was observed if the flexible scheme was applied as compared with the fixed scheme of administration (8.8% vs. 23.9%, respectively). Exposure of the genital tract to LH or E 2 from initiation of stimulation to antagonist administration was able to distinguish between pregnant and nonpregnant patients in the population studied. Conclusion(s) High exposure of the genital tract to LH and E 2 in the early Follicular Phase is associated with a reduced chance of pregnancy in cycles stimulated with recombinant FSH and GnRH antagonist for IVF/ICSI.
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Exposure to high levels of luteinizing hormone and estradiol in the early Follicular Phase of gonadotropin-releasing hormone antagonist cycles is associated with a reduced chance of pregnancy
Fertility and Sterility, 2003Co-Authors: Efstratios M Kolibianakis, Carola Albano, Jarl A Kahn, Michel Camus, Herman Tournaye, André Van Steirteghem, P DevroeyAbstract:Abstract Objective To compare ongoing implantation rates under two different GnRH antagonist protocols. Design Randomized controlled trial. Setting Tertiary referral center. Patient(s) One hundred eleven women undergoing ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Intervention(s) Ovarian stimulation with 150 IU recombinant-FSH (rec-FSH) starting on day 2 of the cycle and GnRH antagonist starting either on day 6 of stimulation (fixed group) or when a follicle of ≥15 mm was present after at least 5 days of stimulation (flexible group). In the flexible group, the rec-FSH dose was increased to 250 IU when the antagonist was initiated. Main outcome measure(s) Ongoing implantation and pregnancy rate. Result(s) In patients with no follicle of ≥15 mm present on day 6 of stimulation, a significantly lower ongoing implantation rate was observed if the flexible scheme was applied as compared with the fixed scheme of administration (8.8% vs. 23.9%, respectively). Exposure of the genital tract to LH or E 2 from initiation of stimulation to antagonist administration was able to distinguish between pregnant and nonpregnant patients in the population studied. Conclusion(s) High exposure of the genital tract to LH and E 2 in the early Follicular Phase is associated with a reduced chance of pregnancy in cycles stimulated with recombinant FSH and GnRH antagonist for IVF/ICSI.