0000000000003570
AUTHOR
C.e. Busso
Obesity and assisted reproductive technology outcomes.
Obesity is a rising health problem in Western societies. It has been related to increased morbidity and mortality rates due to several pathologies. In the field of gynaecology and reproduction, obesity is associated with menstrual disorders, hirsutism, infertility, miscarriage and obstetric complications. It is known to impair human reproduction through different mechanisms such as insulin resistance, hyperandrogenism and elevated leptin levels. Weight management and dietary intervention can reverse this situation and improve reproductive function. Obesity can also impair the outcome of assisted reproductive technologies. The lower probability of a healthy live birth described in obese wome…
Prevention of OHSS: Current strategies and new insights
Abstract Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic and potentially life threatening condition that affects young healthy patients. Many strategies have been proposed to prevent this syndrome. However, to avoid OHSS without compromising on IVF outcome is still a challenge. The most important action is to identify patients at risk even before ovarian stimulation is initiated and to give them special attention. Coasting is the most popular method to avoid/minimize OHSS. Cycle cancellation, cryopreservation, GnRH antagonists, GnRH agonists, i.v. albumin are other strategies that can provide some kind of benefit but do not completely avoid both early and late forms of OHSS and/or…
GnRH agonist versus recombinant HCG in an oocyte donation programme: a randomized, prospective, controlled, assessor-blind study.
The use of gonadotrophin-releasing hormone (GnRH) agonists for triggering ovulation remains controversial. The primary objective of this study was to evaluate the incidence of ovarian hyperstimulation syndrome (OHSS) following GnRH agonist versus recombinant human chorionic gonadotrophin (HCG) as methods for triggering ovulation. A second aim was to compare the clinical outcome and embryo quality according to the two procedures. The cycle characteristics of 100 oocyte donors undergoing ovarian stimulation and IVF outcomes of their 100 oocyte recipients were analysed. Donors were prospectively randomized into two groups on the last day of ovarian stimulation: Group I received a single bolus …
Physiology and Pathology of Ovarian Hyperstimulation Syndrome
Ovarian hyperstimulation syndrome (OHSS) occurs when ovaries primed with follicle-stimulating hormone/leuteinizing hormone (LH) are subsequently exposed to human chorionic gonadotropin (hCG). The ultimate pathophysiological step underlying this clinical picture is increased vascular permeability (VP). With the administration of hCG, the expression vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGFR-2) mRNA increases significantly rising to a maximum coinciding with peaked VP. Immunohistochemistry shows the presence of VEGF and VEGFR-2 proteins in the granulosa-lutein and endothelial cells of the entire corpus luteum. These findings suggest that the syndrome can be prevented…