GnRH agonist versus GnRH antagonist in IVF/ICSI cycles with recombinant LH supplementation: DNA fragmentation and apoptosis in granulosa cells

Objective: To compare the level of apoptosis and DNA fragmentation in the human granulosa cell (GC) layer exposed to an agonist or antagonist of GnRH in intracytoplasmic sperm injection (ICSI) cycles supplemented with recombinant LH (rLH).Study design: Patients without ovulatory dysfunction, aged <= 37 years and in their first ICSI cycle were prospectively randomised to receive either a long GnRH agonist protocol or a multi-dose antagonist protocol. In both groups, recombinant FSH supplemented with rLH was used for ovarian stimulation, and the GCs were collected during oocyte denudation. The GCs were then analysed for DNA fragmentation by TUNEL assay and for apoptosis using the annexin-V assay. The outcomes were given as the percentage of GCs with DNA fragmentation and apoptosis out of the total number of GCs analysed. Comparison of the agonist versus the antagonist group was performed using the Mann-Whitney test.Results: DNA fragmentation: 32 patients were included in either the GnRH agonist group (n = 16) or the antagonist group (n = 16). The percentage of GCs with positive DNA fragmentation did not differ significantly (P = 0.76) between the agonist group (15.5 +/- 9.4%) and the antagonist group (18.8 +/- 13.3%). Apoptosis: 28 patients were included in either the GnRH agonist group (n = 14) or the antagonist group (n = 14). The percentage of GCs positive for apoptosis did not differ significantly (P = 0.78) between the agonist group (34.6 +/- 14.7%) and the antagonist group (36.5 +/- 22%).Conclusions: The results suggest that therapy with either an agonist or antagonist of GnRH is associated with comparable levels of DNA fragmentation and apoptosis in granulosa cells in ICSI cycles supplemented with rLH. (C) 2012 Elsevier B.V. All rights reserved.

Administration of single-dose GnRH agonist in the luteal phase in ICSI cycles: a meta-analysis

Background: The effects of gonadotrophin-releasing hormone agonist (GnRH-a) administered in the luteal phase remains controversial. This meta-analysis aimed to evaluate the effect of the administration of a single-dose of GnRH-a in the luteal phase on ICSI clinical outcomes.Methods: The research strategy included the online search of databases. Only randomized studies were included. The outcomes analyzed were implantation rate, clinical pregnancy rate (CPR) per transfer and ongoing pregnancy rate. The fixed effects model was used for odds ratio. In all trials, a single dose of GnRH-a was administered at day 5/6 after ICSI procedures.Results: All cycles presented statistically significantly higher rates of implantation (P < 0.0001), CPR per transfer (P = 0.006) and ongoing pregnancy (P = 0.02) in the group that received luteal-phase GnRH-a administration than in the control group (without luteal-phase-GnRH-a administration). When meta-analysis was carried out only in trials that had used long GnRH-a ovarian stimulation protocol, CPR per transfer (P = 0.06) and ongoing pregnancy (P = 0.23) rates were not significantly different between the groups, but implantation rate was significant higher (P = 0.02) in the group that received luteal-phase-GnRH-a administration. on the other hand, the results from trials that had used GnRH antagonist multi-dose ovarian stimulation protocol showed statistically significantly higher implantation (P = 0.0002), CPR per transfer (P = 0.04) and ongoing pregnancy rate (P = 0.04) in the luteal-phaseGnRH- a administration group. The majority of the results presented heterogeneity.Conclusions: These findings demonstrate that the luteal-phase single-dose GnRH-a administration can increase implantation rate in all cycles and CPR per transfer and ongoing pregnancy rate in cycles with GnRH antagonist ovarian stimulation protocol. Nevertheless, by considering the heterogeneity between the trials, it seems premature to recommend the use of GnRH-a in the luteal phase. Additional randomized controlled trials are necessary before evidence-based recommendations can be provided.

GnRH agonist versus GnRH antagonist in assisted reproduction cycles: oocyte morphology

Background: The selection of developmentally competent human gametes may increase the efficiency of assisted reproduction. Spermatozoa and oocytes are usually assessed according to morphological criteria. Oocyte morphology can be affected by the age, genetic characteristics, and factors related to controlled ovarian stimulation. However, there is a lack of evidence in the literature concerning the effect of gonadotropin-releasing hormone (GnRH) analogues, either agonists or antagonists, on oocyte morphology. The aim of this randomized study was to investigate whether the prevalence of oocyte dysmorphism is influenced by the type of pituitary suppression used in ovarian stimulation.Methods: A total of 64 patients in the first intracytoplasmic sperm injection (ICSI) cycle were prospectively randomized to receive treatment with either a GnRH agonist with a long-term protocol (n: 32) or a GnRH antagonist with a multi-dose protocol (n: 32). Before being subjected to ICSI, the oocytes at metaphase II from both groups were morphologically analyzed under an inverted light microscope at 400x magnification. The oocytes were classified as follows: normal or with cytoplasmic dysmorphism, extracytoplasmic dysmorphism, or both. The number of dysmorphic oocytes per total number of oocytes was analyzed.Results: Out of a total of 681 oocytes, 189 (27.8 %) were morphologically normal, 220 (32.3 %) showed cytoplasmic dysmorphism, 124 (18.2%) showed extracytoplasmic alterations, and 148 (21.7%) exhibited both types of dysmorphism. No significant difference in oocyte dysmorphism was observed between the agonist- and antagonist- treated groups (P > 0.05). Analysis for each dysmorphism revealed that the most common conditions were alterations in polar body shape (31.3%) and the presence of diffuse cytoplasmic granulations (22.8%), refractile bodies (18.5%) and central cytoplasmic granulations (13.6%). There was no significant difference among individual oocyte dysmorphisms in the agonist- and antagonist-treated groups (P > 0.05).Conclusions: Our randomized data indicate that in terms of the quality of oocyte morphology, there is no difference between the antagonist multi-dose protocol and the long-term agonist protocol. If a GnRH analogue used for pituitary suppression in IVF cycles influences the prevalence of oocyte dysmorphisms, there does not appear to be a difference between the use of an agonist as opposed to an antagonist.

Flexural strength of acrylic resins polymerized by different cycles

Despite the large number of studies addressing the effect of microwave polymerization on the properties of acrylic resin, this method has received limited clinical acceptance. This study evaluated the influence of microwave polymerization on the flexural strength of a denture base resin. A conventional heat-polymerized (Classico), a microwave-polymerized (Onda-Cryl) and a autopolymerizing acrylic (Jet) resins were used. Five groups were established, according to polymerization cycles: A, B and C (Onda-Cryl, short cycle - 500W/3 min, long - 90W/13 min + 500W/90 see, and manufacturing microwave cycle - 320W/3 min + OW/3 min + 720W/3 min); T(Classico, water bath cycle - 74 degrees C/9h) and Q (Jet, press chamber cycle - 50 degrees C/15 min at 2 bar). Ten specimens (65 x 10 x 3.3 mm) were prepared for each cycle. The flexural strength of the five groups was measured using a three-point bending test at a cross-head speed of 5 mm/min. Flexural strength values were analyzed by one-way ANOVA and the Tukey's test was performed to identify the groups that were significantly different at 5% level. The microwave-polymerized groups showed the highest means (p<0.05) for flexural strength (MPa) (A = 106.97 +/- 5.31; B = 107.57 +/- 3.99; C = 109.63 +/- 5.19), and there were no significant differences among them. The heat-polymerized group (T) showed the lowest flexural strength means (84.40 +/- 1.68), and differ significantly from all groups. The specimens of a microwavable denture base resin could be polymerized by different microwave cycles without risk of decreasing the flexural strength.

The effect of long-term disinfection procedures on hardness property of resin denture teeth

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

Long-Lasting Oscillations in the Electro-Oxidation of Formic Acid on PtSn Intermetallic Surfaces

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

SURFACE ROUGHNESS AND CANDIDA ALBICANS BIOFILM FORMATION ON A RELINE RESIN AFTER LONG-TERM CHEMICAL DISINFECTION AND TOOTHBRUSHING

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

Evaluation of tensile tetention of Y-TZP crowns after long-term aging: Effect of the core substrate and crown surface conditioning

This study evaluated the effect of the core substrate type (dentin and composite resin) on the retention of crowns made of yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP), submitted to three inner surface conditionings. For this purpose, 72 freshly extracted molars were embedded in acrylic resin, perpendicular to the long axis, and prepared for full crowns: 36 specimens had crown preparations in dentin; the remaining 36 teeth had the crowns removed, and crown preparations were reconstructed with composite resin plus fiber posts with dimensions identical to the prepared dentin. The preparations were impressed using addition silicone, and 72 Y-TZP copings for the tensile test were produced. Cementation was performed with a dual-cured cement containing phosphate monomers. For cementation, the crown preparation (dentin or resin) was conditioned with the adhesive system, and the ceramic was subjected to one of three surface treatments: isopropyl alcohol, tribochemical silica coating, or thin low-fusing glassy porcelain layer application plus silanization. After 24 hours, all specimens were submitted to thermocycling (6000 cycles) and placed in a special tensile testing device in a universal testing machine to determine failure loads. The failure modes of all samples were analyzed under a stereomicroscope. Two-way analysis of variance showed that the surface treatment and substrate type (alpha=0.05) affected the tensile retention results. The dentin substrate presented the highest tensile retention values, regardless of the surface treatment. When the substrate was resin, the tribochemical silica coating and low-fusing glaze application plus silanization groups showed the higher retention values.