Effect of Growth Hormone on Uterine Receptivity in Women With RIF in an Oocyte Donation Program...
Female Infertility105 infertile women are enrolled in the randomized controlled trial: 70 women with a history of RIF with donated oocytes and 35 infertile women undergoing the first oocyte donation attempt. Women receiving donated oocytes are treated with progressively increasing doses of oral estradiol followed by intravaginal progesterone after previous pituitary desensitization with GnRH agonist. 35 RIF patients are treated with GH (GH patients) while the rest 35 RIF patients (non-GH patients) and 35 first-attempt patients (positive control group) are not.
Uterine Transplant in Absolute Uterine Infertility (AUIF)
Female InfertilityThis study will examine the feasibility of initiating a uterine transplant program for Absolute Uterine Factor Infertility (AUFI) at Brigham and Women's Hospital. The investigators plan to screen 30 patients with a goal of enrolling 10 patients. (5 donors and 5 recipients) After careful screening, appropriate candidates will undergo IVF, Uterine Transplantation, Embryo Transfer, Pregnancy and Delivery. Once the uterus is explanted, five years of follow-up is planned.
Double Trigger in Patients With Low Proportion of Mature Oocytes
InfertilityFemaleThe aim of this randomized controlled trial is to determine whether co-administration of GnRH agonist and hCG for final oocyte maturation ( 40 and 34 h prior to oocyte retrieval , respectively) can increase the number of mature oocytes in patients with history of low proportion of mature oocytes in previous IVF cycle triggered by HCG.
Intracytoplasmic Sperm Injection in Non-male Factor Infertility in Advanced Maternal Age
InfertilityFemale1 moreThis will be a prospective, randomized (1:1 ratio) clinical trial for non-male factor infertility in advanced maternal age with or without intracytoplasmic sperm injection(ICSI). Qualified 1422 patients are randomized into either of two groups: group A will undergo conventional in-vitro fertilization(IVF)(711 cases), Group B will undergo intracytoplasmic sperm injection (ICSI) (711 cases). All participants will receive the same protocol for ovarian stimulation and standardized luteal phase support. The target population will be patients with non-male factor infertility aged ≥38years with FSH ≤15. Women with other reasons of infertility (eg. anovulation, endometriosis, and premature ovarian failure) are excluded. The randomization will take place before controlled ovarian stimulation by a computer randomization system. The accumulated live birth rate , pregnancy complications will be followed up by checking medical records and telephone calls.
Effects of SNP of GnRH Receptor Genes in IVF Patients
InfertilityFemaleGonadotropin-releasing hormone analogue (GnRH-a) "long protocol" is a protocol for pituitary down-regulation in IVF. However, it is common in clinic that some patients are hypersensitive to pituitary down-regulation and have pituitary oversuppression, resulting in prolonged ovarian stimulation and increased consumption of exogenous gonadotropin(Gn). On the other hand, some patients may have insufficient pituitary down-regulation, which can affect the synchronization of ovarian follicles and consequently reduce the number of oocytes retrievable and lower the pregnancy rate. The differences in responses to GnRH-a among patients may be associated with the SNP of their GnRH receptor genes. It has been reported that mutations in GnRH receptor genes could change their binding affinity to the ligands, thus affecting the outcome of pituitary down-regulation. So far 20 non-synonymous mutations on the GnRH receptor genes have been reported, which can affect the function of GnRH receptor and are highly associated with disorders such as endometriosis and sexual precocity. However, the correlation between the SNP of GnRH receptor genes and the outcome of pituitary down-regulation in IVF has not been reported. The purpose of this study is to analyze the correlation between single nucleotide polymorphism (SNP) of GnRH receptor genes in infertile female patients and the extent of pituitary down-regulation by short-acting GnRH-a long protocol, with the goal to achieve individual down-regulation protocols based on the patients' SNP haplotypes of GnRH receptor genes and to improve the success rate of assisted reproductive technology.
the Effect of Endometrial Compaction Caused by Progesterone Effect on Pregnancy Outcomes
InfertilityFemale Infertility1 moreThe purpose of this prospective cohort study is to assess the effect of endometrial compaction caused by progesterone effect on pregnancy outcomes
A Cross Sectional Evaluation of Vitamin D Status and Ovarian Reserve Markers
SubfertilityFemaleEvaluation of the association between vitamin D (VD) deficiency and ovarian reserve markers in a group of Pakistani sub fertile women was conducted
Pro-inflammatory Cytokines and Implantation Process in Women With Primary Idiopathic Infertility...
InfertilityFemale2 moreInfertility is a common, worldwide problem. In about 20% of couples, the causative agent of infertility cannot be identified after routine diagnostic tests. One of the causes of idiopathic infertility may be implantation disorders. Implantation can take place at a strictly defined moment in the menstrual cycle, when the capacity of the blastocyst to implant is overlapped with readiness for its acceptance by the endometrium, the so-called endometrial receptivity.The time interval in which the endometrium exhibits this property is called the implantation window. The acquisition of receptivity by the endometrium is reflected in cellular and structural changes.The changes taking place at the cellular and molecular levels within the endometrium are compared to processes such as wound healing and degradation of the matrix during the neoplastic process.In considering the role of local inflammation in fertility, it is essential to distinguish between acute and chronic inflammation of moderate or low intensity.The profile of the molecules seen in a given inflammation depends on the severity, duration and mechanisms involved in the inflammation process, as well as the ability of the body's immune system to respond and adapt.IL-18 is a pro-inflammatory cytokine that mediates a type 1 cellular response. In the context of fertilization, IL-18 is a bivalent cytokine. Outside of the implantation window, IL-18 acts as an IFN-gamma inducer and is seen as a detrimental factor in the implantation process. During the implantation window, IL-18 becomes one of the main factors involved in the proper preparation of the spiral arteries. Histamine meets all the criteria of an inflammatory mediator. Histamine expression is also expressed in the endometrium, where it plays the role of a paracrine messenger during embryo decision-making and implantation. Adequate glucose uptake and metabolism are essential for the proper differentiation of the uterine endometrium towards a receptive state that allows the implantation of the embryo. The best described and most abundant glucose transporter in the endometrial stroma is GLUT1. However, there are no data on the role of GLUT4 in undetermined infertility. GLUT4 is one of the better studied transporters because of its major role in whole body glucose homeostasis and the pathogenesis of type II diabetes. Aims:1. Analysis of the level of interleukin 18 and histamine as molecules with a postulated role in the implantation process in the receptive endometrium in women with primary infertility of unknown etiology and comparing it to the group of women with naturally conceived offspring. 2. Assessment of the correlation of the levels of interleukin 18 and histamine in the receptive endometrium and in the blood as an attempt to find a diagnostic useful marker of receptivity. 3. Analysis of GLUT4 level in the receptive endometrium between two groups. Materials and Methods: Patients recruited from among women hospitalized at the CMUJ Gynecological Endocrinology Clinic for hormonal diagnostics. The patient's visit during the implantation window (appropriate time of the cycle determined on the basis of ultrasound ovulation monitoring) Endometrial aspiration biopsy, venous blood collection (5 ml). Preparation of material. Analysis of the collected material.
RCT to Assess the Impact of Microbiome Status in Infertile IVF Patients at Their First IVF/ICSI...
InfertilityFemale1 moreAlthough the endometrium has been traditionally considered free of bacteria, recent studies have documented the presence of an endometrial microbiome. The uterine microbiome can be defined as Lactobacillus-dominated (<90% Lactobacillus spp.) or non-Lactobacillus-dominated (<90% Lactobacillus spp. with >10% of other bacteria). The presence of a pathogenic microbiota in endometrium was associated with significant decrease in implantation, pregnancy, ongoing pregnancy and live birth rates. Some of these pathogens microorganisms can also produce infection and inflammation that may lead to chronic endometritis. Nowadays, the endometrial microbiome can be investigated with the EMMA test and the most known pathogens related with chronic endometritis can be detected with the ALICE test,both of them developed by Igenomix group. Our goal in this project is to investigate at what extent, if any, the analysis of the endometrial factor, at a microbiome level, in patients at their first IVF cycle improves their clinical outcome.
Retrospective Study on the Use, Efficiency, and Safety of the At-home Mosie Kit
InfertilityInfertility3 moreThis study examines the experience of people who have selected to use the at-home insemination Mosie Kit to understand the user's experience, the perceived safety and the efficiency. People who have recently purchased and voluntarily selected to use the Mosie Kit will be invited to complete a one-time online anonymous survey. The results of the survey will be analyzed to understand their experiences.