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  1. Fulltext Ovarian hyperstimulation syndrome--two case reports
    Wong KK, Raman S
    Med J Malaysia, 1990 Mar;45(1):81-3.
    PMID: 2152076
    Two cases of ovarian hyperstimulation syndrome (OHSS) following the GIFT procedure are reported. This article highlights the potential dangers of this condition and discusses the classification and management.
    Matched MeSH terms: Ovulation Induction/adverse effects*
  2. Prolonging the interval from ovarian hyperstimulation to laparoscopic ovum pick-up improves oocyte yield, quality, and developmental competence in goats
    Abdullah RB, Liow SL, Rahman AN, Chan WK, Wan-Khadijah WE, Ng SC
    Theriogenology, 2008 Sep 15;70(5):765-71.
    PMID: 18579196 DOI: 10.1016/j.theriogenology.2008.04.052
    The objective was to evaluate the effect of the interval between ovarian hyperstimulation and laparoscopic ovum pick-up (LOPU) on quality and developmental competence of goat oocytes before and after in vitro maturation (IVM) and intracytoplasmic sperm injection (ICSI). Estrus was synchronized with an intravaginal insert containing 0.3g progesterone (CIDR) for 10d, combined with a luteolytic treatment of 125 microg cloprostenol 36 h prior to CIDR removal. Ovaries were hyperstimulated with 70 mg FSH and 500 IU hCG given im 36, 60, or 72 h prior to LOPU (n=15, 16, and 7 does, respectively). For these groups, oocyte retrieval rates (mean+/-S.E.M.) were 24.7+/-2.9, 54.5+/-4.7, and 82.8+/-4.6% (P<0.001), and the proportions of cumulus-oocyte complexes (COC) with more than five layers of cumulus cells were 29.7+/-8.3, 37.6+/-6.9, and 37.3+/-7.0% (P<0.001). The proportion of IVM oocytes was highest at 72 h (82.1+/-2.8%; P<0.05), with no significant difference between 36 and 60 h (57.3+/-8.9% and 69.0+/-8.4%). Cleavage rates of ICSI embryos were 4.2+/-4.2, 70.9+/-8.4, and 78.9+/-8.2% with LOPU 36, 60, and 72 h post FSH/hCG (P<0.01), with a lower proportion of Grade-A embryos (P<0.05) following LOPU at 36 h compared to 60 and 72 h (29.7+/-8.3%, 37.6+/-6.9%, and 37.3+/-7.0%). In summary, a prolonged interval from FSH/hCG to LOPU improved oocyte retrieval rate and oocyte quality. Therefore, under the present conditions, LOPU 60 or 72 h after FSH/hCG optimized yields of good-quality oocytes for IVM and embryo production in goats.
    Matched MeSH terms: Ovulation Induction/veterinary*
  3. Fulltext GnRH agonist and GnRH antagonist in intracytoplasmic injection cycles
    Rashid MR, Ong FB, Omar MH, Ng SP, Nurshaireen A, Sharifah-Teh NS, et al.
    Med J Malaysia, 2008 Jun;63(2):113-7.
    PMID: 18942295 MyJurnal
    The long agonistic protocol for controlled ovarian hyperstimulation (COH) is effective and used most often, thus is considered the gold standard. Therefore any new regimen has to be compared in its results with those obtained with the long protocol. This report compares the efficacy of GnRH agonist and antagonist in a retrospective study of IVF/ICSI carried out in a tertiary teaching hospital from 2003 to 2006. Only the first COH cycle followed by IVF-ICSI from 200 couples (agonist = 120 and antagonist = 80) were analysed. The end points studied included the number of oocytes recovered, number of mature (MII) oocytes, fertilization, cleavage, morphology based embryo quality, pregnancy rate, quantity and cost of gonadotrophin. The average age of female subjects was 35.1 +/- 4.7 years with 50% being 35 years and above. Major infertility factors were tubal blockage, male factor and endometriosis altogether comprising 68%. GnRH agonist and antagonist cycle parameters were comparable except lesser amount of gonadotrophin was used with lower resultant costs (both p < 0.0005) in antagonistic regime. Antagonist regime produce somewhat more good quality embryos (p = 0.065), an insignificant difference. A clinical pregnancy rate per embryo transfer of 16.3% in agonist and 20.6% in antagonist regime was achieved respectively. In conclusion, GnRH antagonist protocol produced a COH response, embryonic development and pregnancy rates on par to GnRH agonist regime. Moreover GnRH antagonist protocol required a shorter stimulation period plus fewer complications. Hence GnRH antagonist regime provided means for a friendlier, convenient and cost effective protocol for patients.
    Matched MeSH terms: Ovulation Induction/methods*
  4. Fulltext Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination
    Tay PY, Raj VR, Kulenthran A, Sitizawiah O
    Med J Malaysia, 2007 Oct;62(4):286-9.
    PMID: 18551930 MyJurnal
    To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.
    Matched MeSH terms: Ovulation Induction*
  5. Fulltext Ovulation induction and ovarian cancer: is there a link?
    Rupinder KR, Pratap K
    Med J Malaysia, 2006 Mar;61(1):132-6; quiz 137.
    PMID: 16708754
    Introduction : Ovarian cancer accounts for approximately 4% of all cancers occurring in women and ranks the fourth most frequent cause of cancer-related death in women. Despite aggressive treatment modalities the 5 year survival rate remains less than 30%'. Almost 2.5% of all live births/ year result from assisted reproductive techniques (ARD2. Concern has been expressed that exposure to fertility drugs (FD) might be associated with a risk of ovarian tumors. Given the grave prognosis of ovarian cancer and the increasing use of ART, for the past several years this has been a subject of much scientific debate. The likely magnitude of risk may be 2 - 3 times that of the general population, which is at most 4-5% in a woman's lifetime. Several case control and cohort epidemiological studies have attempted to address this issue but failed to specifically look at drug treatment as risk factor and research to date demonstrates conflicting results.
    Review of literature : Ovulation induction (Ol) agents are commonly used in the treatment of infertility in patients with or without ovulatory disturbances. These agents include clomiphene citrate (CC), bromocryptine, gonadotropins (Gn), Gonadotropin releasing hormone (GnRH) and its analogues. In in vitro fertilization (IVF), combinations and different drug dosages of FD are given to stimulate production of multiple oocytes. Fertility drugs were first marketed since the 1960's. The first to hit the market was CC in 1967 followed 2 years later by human Menopausal Gonadotropin (hMG) & human Chorionic Gonadotropin (hCG)'. Until 1987, most IVF cycles used CC in combination with HMG followed by hCG. From 1987, GnRH agonists were introduced to replace Cc. From 1990, the main drug regimen was GnRH agonist in combination with HMG or Follicular Stimulating Hormone (FSH) followed by hCG.
    Matched MeSH terms: Ovulation Induction/adverse effects*
  6. Fulltext Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
    Noorashikin M, Ong FB, Omar MH, Zainul-Rashid MR, Murad AZ, Shamsir A, et al.
    J Assist Reprod Genet, 2008 Jul;25(7):297-303.
    PMID: 18654847 DOI: 10.1007/s10815-008-9239-9
    Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime.
    Matched MeSH terms: Ovulation Induction/methods*
  7. Fulltext Comparison of luteal phase ovulation induction and ultra-short gonadotropin-releasing hormone agonist protocols in older patients undergoing in vitro fertilization
    Wang T, Sun Z, Lim JP, Yu Y
    Libyan J Med, 2019 Dec;14(1):1597327.
    PMID: 30935302 DOI: 10.1080/19932820.2019.1597327
    Many undergoing in vitro fertilization-embryo transfer (IVF-ET) procedures treatments have been tried for older infertile patients, but still can not reverse the aging effect on oocyte, and infertility treatment is expensive, even for people in developed countries. The study aimed to compare outcomes following the application of luteal phase ovulation induction (LPOI) and ultra-short gonadotropin-releasing hormone agonist (GnRH-a) protocols in patients aged more than 40 years undergoing IVF-ET and to examine the effectiveness and feasibility of LPOI. A total of 266 IVF-ET cycles in 155 patients aged 40 years and over were retrospectively analyzed. Of these patients, 105 underwent the ultra-short GnRH-a protocol (GnRH-a group) and 50 underwent LPOI (LPOI group). Various clinical outcomes were compared between these two groups using either t-tests or the chi-square test. The study showed patients in the LPOI group required a higher dosage of human menopausal gonadotropin and a lower dosage of recombinant follicle stimulating hormone than those in the GnRH-a group. Furthermore, though the total dosage of gonadotropin was higher in the LPOI, its cost was lower. Finally, fertilization rates were higher and high-quality embryo rates were lower in the LPOI group, and the live birth rate of LPOI group is higher than (GnRH-a group) . These between-group differences were all significant (P
    Matched MeSH terms: Ovulation Induction/methods*
  8. Oncofertility Treatment Among Breast Cancer Women: A Paradigm Shift of Practice After a Decade of Service
    Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, et al.
    J Adolesc Young Adult Oncol, 2020 08;9(4):496-501.
    PMID: 32283045 DOI: 10.1089/jayao.2019.0177
    Purpose:
    Our center is known as a pioneer center initiating oncofertility service since 2010 in Japan. We demonstrate our transition of this service in regional university hospitals ingenuously.
    Methods:
    We compared two phases of service: initial phase (2011 and 2012) and current phase (2019). The comparison included the number of women attending the oncofertility unit, diversity of breast cancer cases, the acceptability of preservation service, and the type of fertility preservation (FP) option offered in between these phases.
    Results:
    A total of 58 women were seen during the initial phase as compared with 41 women in the later phase. The mean age at diagnosis was not significantly different between the two periods. The majority of them were married and diagnosed with stage II luminar type. The current phase had a tendency to have a higher anti-Müllerian hormone level although not reaching significance. At least 50% of them declined FP and 84.5% never received ovarian control stimulation in the initial phase. Otherwise, 61% used aromatase inhibitor in the current phase. Only 15.5% in the initial phase received control ovarian stimulation whereas 63.4% in the current phase received it. The ovarian tissue cryopreservation was highly chosen during the initial phase (25.9%), whereas embryo cryopreservation (39%) was highly opted for during the current phase. All of our parameters are comparable between these two phases (p > 0.05).
    Conclusion:
    The significant changes of oncofertility practice were observed mainly due to the understanding of the oncofertility concept among reproductive physicians and the acceptance environment, including standard guidelines, supportive society, as well as advancements in cryobiology technique.
    Matched MeSH terms: Ovulation Induction
  9. Unexplained subfertility: active or conservative management?
    Ahmad SM, Mat Jin N, Ahmad MF, Abdul Karim AK, Abu MA
    Horm Mol Biol Clin Investig, 2023 Dec 01;44(4):379-384.
    PMID: 38124670 DOI: 10.1515/hmbci-2022-0087
    OBJECTIVES: Unexplained subfertility (UEI) describes a couple whose standard subfertility workout consider acceptable but unable to conceived.

    METHODS: This retrospective study was conducted in the Advanced Reproductive Centre, UKM Hospital, Kuala Lumpur, from January 2016 to December 2019. The data of 268 UEI couples were obtained from the clinical database. Women aged 21-45 years old was included and further divided into four groups according to the female partner's age and subfertility duration: group A (age <35 years and subfertility <2 years), group B (age <35 years and subfertility >2 years), group C (age >35 years and subfertility <2 years), and group D (age >35 years and subfertility <2 years). All statistical analyses were performed using SPSS 22.0 for Windows.

    RESULTS: A total of 255 cases were included in this study. The mean age of the women was 32.9 ± 4.04 years, and the mean subfertility duration was 5.04 ± 2.9 years. A total of 51 (20 %) cases underwent timed sexual intercourse, 147 (57.6 %) cases had intrauterine insemination (IUI), whereas 57 (22.4 %) cases opted for in vitro fertilization (IVF). A total of 204 cases underwent active management (IUI/IVF), which showed a significant difference (p<0.05). Out of eight clinical pregnancies, half of them were from group B.

    CONCLUSIONS: Active management in younger women with a shorter subfertility duration revealed a better pregnancy outcome. Otherwise, individualized treatment should be considered in selecting a suitable treatment plan.

    Matched MeSH terms: Ovulation Induction
  10. Fulltext The empty follicle syndrome
    Ng SP, Jamil MA, Nurshaireen A, Zainul MR
    Med J Malaysia, 2006 Oct;61(4):499-500.
    PMID: 17243533 MyJurnal
    The empty follicle syndrome (EFS) is a rare complication of in vitro fertilization (IVF) treatment, leading to cycle cancellation. Low human chorionic gonadotropin (hCG) bioavailability and ovarian dysfunction have been implicated with this condition. This case report illustrates a typical case of EFS and several strategies suggested to overcome this problem.
    Matched MeSH terms: Ovulation Induction/methods
  11. Fulltext A retrospective review comparing the use of Gonal-F and Metrodin-HP for in-vitro fertilisation (IVF)
    Lee C, Mak FS, Keith J, Welsh D, Yapp P, Chin R
    Med J Malaysia, 2003 Mar;58(1):94-8.
    PMID: 14556331
    All cycles of IVF with pituitary down-regulation (n = 57) done at the Damansara Fertility Centre in the year 2000 were studied. All the 57 patients had controlled ovarian hyperstimulation, either using Metrodin HP (n = 27) or Gonal-F (n = 30). Of these, 53 patients reached oocyte pick-up, 26 patients in Metrodin HP group and 27 patients in Gonal-F group. Gonal-F resulted in a higher clinical pregnancy rate of 66.6% compared to Metrodin HP 38.5% (p < 0.05). The live birth rate tends to be higher in Gonal-F group (40.7%) compared to Metrodin HP (30.8%), (p > 0.05).
    Matched MeSH terms: Ovulation Induction*
  12. Fulltext Assessing the status of intrauterine insemination before forming a medically assisted conception unit
    Omar MH, Ong FB, Adeeb NN, Sharif JM, Nasri N, Yassin MJ
    Med J Malaysia, 1999 Mar;54(1):65-71.
    PMID: 10972007
    A survey in 1996 of our female patients suggest that the three commonest causes of infertility were endometriosis, anovulation and idiopathic which comprises of about 70% of all the patients. In the male patients, sperm morphology evaluation by critical criteria showed that abnormal morphology was present in 71% while 87% of all the semen analysis were abnormal. The objective of this study was to assess the status of IUI before proceeding to formulate patient protocols for IVF in a tertiary infertility referral unit. A retrospective study of patients data was done from Jan 1995 to Dec 1996. Ovarian stimulation by clomiphene for anovulatory and idiopathic patients was performed on couples with at least one patent fallopian tube. Ovulation induction was by an intramuscular injection of 5000 i.u of HCG after follicular maturation. IUI was performed approximately 36-40 hours later. A total of 74 couples received 114 treatment cycles producing a total of 9 conceptions. The conception rate of IUI was therefore 7.89% per cycle and 12.16% per couple with the cumulative pregnancy rate of 28.21%. Associated success features of IUI found in this study were the age of the woman and the semen parameters of the husband.
    Matched MeSH terms: Ovulation Induction/methods
  13. Maternal thyroid function in women undergoing controlled ovarian hyperstimulation during in-vitro fertilization and its relation to reproductive outcome
    Abdul Karim AK, Azrai Abu M, Chelliah B, Mohd Razi ZR, Omar MH, Othman H, et al.
    Minerva Ginecol, 2017 Oct;69(5):431-437.
    PMID: 28447444 DOI: 10.23736/S0026-4784.17.04069-2
    BACKGROUND: We conducted a study to evaluate the changes in thyroid function during controlled ovarian hyperstimulation (COH) and its association with the outcome of assisted reproductive technique (ART).

    METHODS: This is a prospective cohort study done in University Hospital Fertility Clinic for one year duration. A total of 88 euthyroid women who underwent COH as part of planned in-vitro fertilization (IVF) were invited to participate in this study. Serum thyroid function of each women will be monitored before stimulation (T1), day 10-13 of cycle (T2), during oocyte retrieval (T3), one week following embryo transfer (T4), and at four weeks after embryo transfer (T5). Reproductive outcome of IVF will be observed and documented.

    RESULTS: Nine women had ongoing singleton pregnancy, seven suffered from miscarriage, while the rest had implantation failure. Serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) increased throughout stimulation, peaking at 32-36 hours after hCG administration compared to baseline (1.250 vs. 1.740 mIU/L and 13.94 vs. 15.25 pmol/L). It remains elevated until one week following embryo transfer. The increment of serum TSH exceeded the upper limit, acceptable for first trimester (<1.60 mIU/L). However, the evolution of serum TSH and fT4 did not significantly differ with pregnancy outcome.

    CONCLUSIONS: In euthyroid women, thyroid function changed significantly during COH, but these changes were not different between the three reproductive outcomes. Thus, we do not suggest continuous thyroid function monitoring during COH.

    Matched MeSH terms: Ovulation Induction/methods*
  14. Fulltext Inhibition of progesterone secretion by oestradiol administered in the luteal phase of assisted conception cycles
    Tay PYS, Lenton EA
    Med J Malaysia, 2003 Jun;58(2):187-95.
    PMID: 14569738
    A prospective randomised study was done to assess the effect of supplemental oestradiol in addition to progesterone on the luteal steroid profiles and pregnancy outcome in stimulated cycles with and without pituitary down regulation. Women undergoing stimulated cycle IVF with GnRH-a and FSH (Group A, n = 63) or stimulated intrauterine insemination using CC and FSH (Group B, n = 55) were studied. These subjects were randomly allocated to receive either 400 mg daily of vaginally administrated Cyclogest (progesterone) alone or in combination with 2 mg daily of oral Oestradiol Valerate (E2V) during the luteal phase. Significant lower concentrations of plasma progesterone were observed in those subjects supplemented with both E2V and progesterone compared to those in whom progesterone only was given during the luteal phase (P < 0.05). Exogenous E2V had a minimal impact on plasma oestradiol concentrations and did not disguise the characterised mid luteal decline in oestradiol secretion. The suppressive effect of E2V on plasma progesterone was lost if implantation occurred normally because any small change in steroid concentrations was reversed by the rapidly increasing concentrations of HCG. Similar pregnancy rates were observed among subjects supplemented with or without oestradiol. The addition of oestradiol to the luteal supplement suppresses endogenous corpus luteum progesterone secretion irrespective of the type of assisted conception cycle and that its use is unlikely to be beneficial to the process of implantation.
    Matched MeSH terms: Ovulation Induction/methods*
  15. Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients
    Mustafa KB, Keane KN, Walz NL, Mitrovic KI, Hinchliffe PM, Yovich JL
    Reprod Biol, 2017 Mar;17(1):34-41.
    PMID: 27964842 DOI: 10.1016/j.repbio.2016.11.004
    This seven-year retrospective study analysed the live birth rate (LBR) for women undergoing IVF treatment with various antral follicle counts (AFC). The LBR decreased with lower AFC ratings, and in 290 treatment cycles for women in the poorest AFC category, ≤4 follicles (group E), the LBR was the lowest at 10.7%. The pregnancy loss rate (PLR) significantly increased with poorer AFC categories, from 21.8% in AFC group A (≥20 follicles), to 54.4% in AFC group E (p<0.0001). This trend was repeated with advancing age, from 21.6% for younger women (<35years), to 32.9, 48.5 and 100% for ages 35-39, 40-44 and ≥45 years, respectively (p<0.0001). However, LBR within the specific AFC group E cohort was also age-dependent and decreased significantly from 30.0% for <35 years old, to 13.3, 3.9 and 0% for patients aged 35-39, 40-44 and ≥45 years, respectively. Most, importantly, LBR rates within these age groups were not dependent on the number of IVF attempts (1st, 2nd, 3rd or ≥4 cycles), which indicated that cycle number should not be the primary deciding factor for cessation of IVF treatment in responding women <45years old.
    Matched MeSH terms: Ovulation Induction*
  16. Embryo culture conditions are significantly improved during uninterrupted incubation: A randomized controlled trial
    Alhelou Y, Mat Adenan NA, Ali J
    Reprod Biol, 2018 Mar;18(1):40-45.
    PMID: 29279181 DOI: 10.1016/j.repbio.2017.12.003
    A parallel group superiority prospective randomised controlled trial was devised to compare the culture characteristics of human pre-implantation stage embryos during uninterrupted culture in a time lapse incubator (TLI) versus the conventional model of interrupted culture in a standard incubator (SI) under low oxygen tension using a single step medium. 221 patients aged 35-and-under, 124 patients aged between 36 and 39 and 86 patients aged 40-and-over years were randomised and cultured either in a SI or in a TLI. Patients in the three age groups were distributed between the TLI and SI in a 1:1 ratio. The development of embryos on days 2, 3 and 5, and the clinical pregnancy and implantation rates were recorded. The fertilisation rate, development of day 2 and clinical pregnancy rates were similar in both treatments but the 8-cell development rate in all age groups combined (p = 0.016), blastocyst development rate (p = 0.0022) and the implantation rate (p = 0.0022) was significantly higher for the uninterrupted culture. These findings demonstrated significant differences between the two incubation groups. It also indicated less efficacious embryonic development with age in both treatments which appeared more pronounced in the conventional incubator. In conclusion uninterrupted culture is superior compared to the interrupted incubation culture system.
    Matched MeSH terms: Ovulation Induction
  17. Fulltext Comparison between hCG and GnRH Agonist for Ovulation Trigger in GnRH Antagonist In-Vitro Fertilization Cycles in a Tertiary Hospital in Malaysia: An observational study
    Aziz NA, Ibrahim A, Ramli R, Yaacob N, Rahman SNA, Ismail EHE, et al.
    JBRA Assist Reprod, 2024 Feb 26;28(1):21-26.
    PMID: 38224580 DOI: 10.5935/1518-0557.20230066
    OBJECTIVE: hCG is commonly used as an ovulation trigger in IVF. Its usage is associated with OHSS. GnRH agonist is an alternative to hCG and is associated with reduced incidence of OHSS. This study compared the cycle outcomes of GnRH agonists with hCG as an ovulation trigger in IVF cycles.

    METHODS: The medical notes of 209 IVF cycles receiving GnRH agonist and hCG as ovulation trigger over 18 months were reviewed in this retrospective study. The number and quality of mature oocytes, the number and quality of embryos, pregnancy rates, and outcomes were compared using Independent T-test or One-way ANOVA for normal distribution. The Mann-Whitney test or Kruskal-Wallis test was used for not normally distributed. p<0.05 was considered statistically significant.

    RESULTS: The cycle outcomes of 107 GnRH agonist-trigger and 102 hCG-trigger were compared. The MII oocytes retrieved and 2PN count was significantly higher in the GnRH agonist trigger group (p<0.001). Clinical pregnancy rate and ongoing pregnancy were higher in the GnRH agonist trigger group but were not statistically significant. The GnRH agonist trigger group was associated with low OHSS than the hCG trigger group (n=2(1.9%) and n=12(11.8%) respectively, p=0.004).

    CONCLUSION: GnRH agonist trigger is an option as a final maturation trigger in high-responder women undergoing IVF or ICSI cycles.

    Matched MeSH terms: Ovulation Induction
  18. Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial
    Zain MM, Jamaluddin R, Ibrahim A, Norman RJ
    Fertil Steril, 2009 Feb;91(2):514-21.
    PMID: 18321486 DOI: 10.1016/j.fertnstert.2007.12.002
    To determine the first-line medication to be used in anovulatory patients with polycystic ovary syndrome (PCOS) for ovulation induction and pregnancy achievement.
    Matched MeSH terms: Ovulation Induction/methods*
  19. Expression of ADR-α1, 2 and ADR-β2 in cumulus cell culture of infertile women with polycystic ovary syndrome and poor responder who are a candidate for IVF: the novel strategic role of clonidine in this expression
    Zangeneh FZ, Bagheri M, Shoushtari MS, Naghizadeh MM
    J Recept Signal Transduct Res, 2021 Jun;41(3):263-272.
    PMID: 32878560 DOI: 10.1080/10799893.2020.1806320
    OBJECTIVE: Alpha and beta-adrenoceptors (ADR-α1, 2, and β2) play a regulatory role in the folliculogenesis and steroidogenesis in the ovarian follicles. This study aimed to measure these adrenoceptors mRNA and its protein levels in cumulus cells (CCs) culture of poor ovarian reserve (POR) and polycystic ovarian syndrome (PCOS) infertile women (IVF candidate) and the effect of clonidine treatment at CCs culture.

    METHODS: This case/control study was conducted in 2017 includes a control (donation oocytes) and two studies (PCO and POR) groups. The ovulation induction drugs were prescribed in all groups. After the oocyte puncture, the follicular fluid was collected and CCs were isolated were cultured. RNA was extracted and cDNA was synthesized and designed the primer for the ADR-α1, 2 and ADR-β2 gene expression. The protein levels were investigated by Western Blot.

    RESULTS: The results showed a high level of three adrenergic expressions in PCO women compared to the control group (p-value

    Matched MeSH terms: Ovulation Induction
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