RESEARCH QUESTIONCan inadvertent pregnancies go unnoticed when initiating random-start ovarian stimulation (RSOS) despite monitoring?DESIGNCase series at a university-based tertiary care fertility clinic.RESULTSBetween June 2022 and December 2023, two cases of undetected early pregnancy at the onset of RSOS were identified, both leading to severe ovarian hyperstimulation syndrome (OHSS) with hospitalization.CONCLUSIONRSOS protocols add flexibility in fertility clinics when there is no intention of a fresh embryo transfer, but may be associated with insidious risk of OHSS. The authors advocate for comprehensive consultation and serial monitoring of human chorionic gonadotrophin during ovarian stimulation, while cautioning against over-reliance on baseline hormone concentrations when initiating RSOS. If the benefits of RSOS seem limited, healthcare providers should consider delaying ovarian stimulation to avert health, but also medicolegal and financial, complications.

30 Apr 2024·Molecular Human Reproduction

In vivo effect of vaginal seminal plasma application on the human endometrial transcriptome: a randomized controlled trial

Article

Author: Catalini, Laura ; Fedder, Jens ; Eskildsen, Tilde V ; Egeberg, Dorte L ; Burton, Mark ; Thomassen, Mads

AbstractStudies in humans and animals suggest that seminal plasma, the acellular seminal fluid component, stimulates the endometrium to promote immune tolerance and facilitate implantation. We designed a randomized, double-blinded, placebo-controlled trial to investigate changes in the endometrial transcriptomic profile after vaginal application of seminal plasma. The study participants were randomized into two groups. Five women received a vaginal application of seminal plasma, and four received a placebo application with saline solution. The application was performed 2 days after HCG-triggered ovulation in an unstimulated cycle. After 5–8 days, an endometrial biopsy was collected to analyze differences in the endometrial transcriptomic profile using microarray analyses. A differential gene expression analysis and a gene set analysis were performed. The gene set enrichment analysis showed a positive enrichment of pathways associated with the immune response, cell viability, proliferation, and cellular movement. Moreover, pathways involved in implantation, embryo development, oocyte maturation, and angiogenesis were positively enriched. The differential gene expression analysis, after adjusting for multiple testing, showed no significantly differentially expressed genes between the two groups. A comparative analysis was also performed with similar studies conducted in other animals or in vitro using human endometrial cells. The comparative analysis showed that the effect of seminal plasma effect on the endometrium is similar in pigs, mice, and in vitro human endometrial cells. The present study provides evidence that seminal plasma might impact the endometrium during the implantation window, with potential to affect endometrial receptivity and embryo development.

01 Mar 2024·Reproductive BioMedicine Online

Oocyte in-vitro maturation primed with letrozole-HCG versus FSH-HCG in women with oocyte maturation abnormalities: a retrospective study

Article

Author: Tan, Seang Lin ; Hatirnaz, Ebru ; Calıskan, Canan Soyer ; Hatirnaz, Kaan ; Hatirnaz, Safak ; Celik, Samettin ; Dahan, Michael H ; Urkmez, Sebati Sinan ; Cao, Mingju

RESEARCH QUESTIONAre there differences between in-vitro maturation (IVM) primed with letrozole-human chorionic gonadotrophin (HCG) and IVM primed with FSH-HCG in women with oocyte maturation abnormalities (OMAs), defined as at least two failed IVF cycles where immature oocytes were retrieved?DESIGNThis retrospective study was conducted at a private fertility clinic from January 2009 to April 2023. The final analysis included 75 women in Group 1 (IVM primed with FSH-HCG) and 52 women in Group 2 (IVM primed with letrozole-HCG).RESULTSA significantly higher median number of oocytes was obtained in Group 1 compared with Group 2 {9 [interquartile range (IQR) 1-5] versus 5 (IQR 1-18); P < 0.001}. However, no differences in oocyte maturation stage at collection were found between the groups (P > 0.05). At the end of IVM, Group 1 had 73/666 mature oocytes and Group 2 had 106/322 mature oocytes, and the median metaphase II oocyte rate per patient was higher in Group 2 [33.3% (IQR 66.7-100.0%) versus 0.0% (IQR 0.0-22.2%); P < 0.001]. Moreover, Group 2 demonstrated a higher median fertilization rate [66.7% (IQR 50.0-100.0%) versus 50.0% (IQR 0.0-66.7%); P = 0.027]. Group 2 had a higher proportion of Grade 2 embryos (58.5% versus 6.3%), and Group 1 had a higher proportion of Grade 3 embryos (93.8% vs 24.4%; P < 0.001). Notably, all pregnancies obtained in the study were in Group 2 (5 versus 0; P = 0.042).CONCLUSIONSIVM primed with letrozole-HCG in women with prior failed IVF cycles due to OMAs may result in mature oocytes, clinical pregnancies and live births. The effectiveness of letrozole priming for the subtypes of OMAs needs further investigation, with studies including greater numbers of cases.

100 Deals associated with Human Chorionic Gonadotrophin(ASKA Pharmaceutical)

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Indication	Country/Location	Organization	Date
Gonadal Disorders	Japan	Takeda Pharmaceutical Co., Ltd.	01 Sep 2008
Gonadal Disorders	Japan	ASKA Pharmaceutical Co., Ltd.	01 Sep 2008
Abortion, Habitual	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Abortion, Habitual	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Abortion, Threatened	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Abortion, Threatened	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Anovulation	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Cryptorchidism	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Cryptorchidism	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Delayed Puberty	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Delayed Puberty	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Hypogonadism	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Hypogonadism	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Infertility, Female	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Infertility, Female	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Infertility, Male	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960
Infertility, Male	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Metrorrhagia	Japan	ASKA Pharmaceutical Co., Ltd.	22 Apr 1960
Metrorrhagia	Japan	Takeda Pharmaceutical Co., Ltd.	22 Apr 1960

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