100 resultados para Ovarian response prediction index


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Superovulation is an important tool for routine use in equine embryo transfer (ET) in order to reduce the costs and to enhance the efficiency of ET programs. Satisfactory superovulatory answers (2-7 ovulations) have been reported in mares treated with Equine Pituitary Extract (EPE) and more recently using a commercial Equine FSH. However, embryo recovery rates have been inconsistent and below expectations (20-50% embryos/ovulation). Recent studies have shown that superovulatory treatment leads to disturbances in oocyte maturation and transport, especially in mares with a high ovarian response. Higher and more consistent embryo recovery rates per ovulation have been observed in mares treated with lower doses of EPE. This paper presents a review of recent studies related to superovulation in mares.

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Dez vacas multíparas, secas, foram distribuídas aleatoriamente em dois grupos de cinco animais cada. Nos dias 8 a 12 do diestro, o primeiro grupo recebeu 100 ml de anti-soro contra líquido folicular livre de esteróides (anti-LFb) produzido em ovelhas ovariectomizadas. O segundo grupo (controle) recebeu 100 ml de soro de ovelhas não-imunizadas. Seis horas após a aplicação, os dois grupos foram superovulados com FSH (18 NIH-FSH-S1 unidades) e LH (0,29 NIH-LH-S1 unidades) administrados em quantidades decrescentes durante quatro dias. Na manhã do terceiro dia, foi administrada uma dose luteolítica de cloprostenol. Duas inseminações foram realizadas 48 e 60 horas após. Os embriões foram recuperados pelo método cervical 7 dias após a primeira inseminação. Amostras de sangue foram coletadas durante todo o período experimental para determinar, por radioimunoensaio, as concentrações plasmáticas de FSH, LH e progesterona. Todas as vacas do grupo imunizado e 3 do grupo controle apresentaram mais de 2 CL. Não existiu diferença significativa (P>0,05) na taxa de ovulação entre os grupos imunizado e controle (14,4 e 9,9, respectivamente). O número de embriões recuperado não foi significativamente diferente (P>0,05) entre os grupos, embora o grupo imunizado tenha apresentado maior número de embriões transferíveis (3,4 ± 1,0 versus 0,8 ± 0,4, P<0,05). As concentrações de gonadotrofinas plasmáticas não foram correlacionadas com a taxa de ovulação ou com o número de embriões recuperados. As concentrações de progesterona plasmática foram positivamente correlacionadas (r = 0,88, P<0,01) com a taxa de ovulação. Os resultados sugerem que o anti-LFb, aplicado antes da superovulação, não reduz a variabilidade da resposta ovariana.

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Thirteen cows, Bos indicus, of the Nellore breed were superovulated with 22 mg of follicle stimulating hormone (FSH) administered by intramuscular route during four consecutive days (D10, D11, D12 and D13), starting on the 10th day of the estrous cycle (day 0 = estrus). Prostaglandin (PGF2alpha, 1.0 mg, im) was administered on D12, 48 h after the first FSH injection, for the induction of estrus on D14, when artificial insemination was performed. Seven days later (D21 of the cycle), embryos were collected, and evaluated, and the ovarian response was estimated on the basis of number of corpora lutea determined by rectal palpation. Blood samples were obtained for the determination of plasma 17-beta estradiol on D10, D11, D12, D13, D14 and D21 and plasma progesterone on D14 by RIA. The donors were divided into two groups according to progesterone levels on D14, the day of the induced estrus (GI: P4 less-than-or-equal-to 1.00 ng/ml, N = 5 and GII: P4 > 1.00 ng/ml, N = 8). A linear positive correlation was observed between plasma 17-beta estradiol concentration on the day of estrus and viable embryo number. We conclude that plasma 17-beta estradiol and progesterone concentrations on the day of estrus can be used to predict the viability of embryos recovered from Nellore cows superovulated with FSH.

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Deep venous thrombosis is a relatively common disease, which can present pulmonary embolism as a complication in its acute phase, and later the post-thrombotic syndrome. Thus, diagnosis should be made as soon as possible, in order to prevent or minimize such complications. Several studies have shown that the symptoms and the clinical signs are inaccurate for the deep venous thrombosis diagnosis and that complementary exams are necessary. As an attempt to simplify the patients' assessment, Well et al., in 1997, developed a clinical prediction index that combines symptoms, signs and risk factors for deep venous thrombosis and managed to make a simpler approach through an association of this index with the complementary exams. Phlebography has been considered the gold standard of complementary exams. However, since it is an invasive exam and thus subject to complications, other diagnostic methods were introduced aiming at making the diagnostic approach simpler and less invasive. Doppler ultrasound, duplex scan, impedance plethysmography, computed tomography, and blood tests such as the D-dimer are some of the available methods for assessing the patient with suspicion of deep venous thrombosis. Among them, duplex scan has shown excellent accuracy and it is currently widely accepted as the first choice test for approaching the patient with deep venous thrombosis. Several authors have suggested an association of diagnostic methods to simplify and make the assessment of such patients more cost-effective, leading to the introduction of a wide range of diagnostic strategies. The different diagnostic methods used for assessing deep venous thrombosis are discussed, as well as a review of the literature on the accuracy, advantages and disadvantages of these methods. Copyright © 2005 by Sociedade Brasileira de Angiologia e Cirurgia Vascular.

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The purpose of this investigation was to make a systematic review of the medical literature in order to compare the efficacy of GnRH antagonists and agonists for poor responders to ovarian stimulation. According to the data collected, the use of GnRH antagonist protocols showed better results in comparison to long protocols with a GnRH agonist regarding the following aspects: lower cycle cancellation rate due to poor ovarian response; higher number of oocytes retrieved; higher clinical pregnancy rate per initiated cycle. Nevertheless, these results were not observed when the flare-up protocols of GnRH agonists were used. Moreover the number of oocytes retrieved with GnRH agonist was significantly higher in relation to the GnRH antagonist.

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Objective: To evaluate if identified loci associated with normal age of menopause variation and early menopause can account for the poor response to controlled ovarian stimulation. Methods: A total of 71 patients, with age ≤ 35 years old, undergoing intracytoplasmic sperm injection were tested for three of the four newly identified genetic variants associated with normal variation in menopausal age and early menopause. Patients were divided into two groups: poor responder group (PR group, n=21) and normoresponder group (NR group, n=50). The influence of risk allele frequency on the response to controlled ovarian stimulation (COS) was evaluated. Logistic regression models were used. Results: There was no significant difference in the incidence of the genetic variants between NR and PR group. The risk allele for chromosome 19 variant (rs4806660) demonstrated a protective effect. The presence of a risk allele, either in homozygosis or in heterozygosis, was associated with an increased response to COS, resulting in an elevated number of follicles (Coef: 2.54, P= 0.041) and retrieved oocytes (Coef: 1.41, P= 0.041). Conclusions: Genetic variants rs244715, rs9379896 and rs4806660 are not risk factors for poor ovarian response. Instead, rs4806660 is associated with higher number of follicles and retrieved oocytes. It could be hypothesized that rs4806660 is associated with an increased response to gonadotrophin stimulus. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Medicina Veterinária - FMVZ

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Pós-graduação em Medicina Veterinária - FMVZ

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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OBJECTIVE: To estimate the response in lung growth and vascularity after fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia in the prediction of neonatal survival.METHODS: Between January 2006 and December 2010, fetal lung parameters (observed-to-expected lung-to-head ratio; observed-to-expected lung volume; and contralateral lung vascularization index) were evaluated before fetal tracheal occlusion and were evaluated longitudinally every 2 weeks in 72 fetuses with severe isolated congenital diaphragmatic hernia. Thirty-five fetuses underwent fetal endoscopic tracheal occlusion and 37 cases did not.RESULTS: Survival rate was significantly higher in the fetal endoscopic tracheal occlusion group (54.3%) than in the no fetal endoscopic tracheal occlusion group (5.4%, P<.01). Fetal endoscopic tracheal occlusion resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with fetuses that did not go to the fetal intervention (increase of the observed-to-expected lung-to-head ratio, observed-to-expected total lung volume, and contralateral pulmonary vascularization index 56.2% compared with 0.3%, 37.9% compared with 0.1%, and 98.6% compared with 0.0%, respectively; P<.01). Receiver operating characteristic curves indicated that the observed-to-expected total fetal lung volume was the single best predictor of neonatal survival before fetal endoscopic tracheal occlusion (cutoff 0.23, area under the curve [AUC] 0.88, relative risk 5.3, 95% confidence interval [CI] 1.4-19.7). However, the contralateral lung vascularization index at 4 weeks after fetal endoscopic tracheal occlusion was more accurate in the prediction of neonatal outcome (cutoff 24.0%, AUC 0.98, relative risk 9.9, 95% CI 1.5-66.9) with the combination of observed-to-expected lung volumes and contralateral lung vascularization index at 4 weeks being the best predictor of outcome (AUC 0.98, relative risk 16.6, 95% CI 2.5-112.3).CONCLUSION: Fetal endoscopic tracheal occlusion improves survival rate by increasing the lung size and pulmonary vascularity in fetuses with severe congenital diaphragmatic hernia. The pulmonary response after fetal endoscopic tracheal occlusion can be used to predict neonatal survival. (Obstet Gynecol 2012; 119: 93-101) DOI: 10.1097/AOG.0b013e31823d3aea

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In this paper, we extend the use of the variance dispersion graph (VDG) to experiments in which the response surface (RS) design must be blocked. Through several examples we evaluate the prediction performances of RS designs in non-orthogonal block designs compared with the equivalent unblocked designs and orthogonally blocked designs. These examples illustrate that good prediction performance of designs in small blocks can be expected in practice. Most importantly, we show that the allocation of the treatment set to blocks can seriously affect the prediction properties of designs; thus, much care is needed in performing this allocation.