Journal ArticleDOI
In Estimated Good Prognosis Patients Could Unexpected "Hyporesponse" to Controlled Ovarian Stimulation be Related to Genetic Polymorphisms of FSH Receptor?
Carlo Alviggi,Alessandro Conforti,Francesca Caprio,Salvatore Gizzo,Marco Noventa,Ida Strina,Tiziana Pagano,Pasquale De Rosa,Floriana Ilma Carbone,Nicola Colacurci,Giuseppe De Placido +10 more
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TLDR
Based on the results, an association between the FSH-R polymorphisms and a “hyporesponse” to exogenous FSH is hypothesized.Abstract:
It has been reported that 10% to 15% of young normogonadotrophic women show suboptimal response to standard gonadotropin-releasing hormone—a long protocol. These patients require higher doses of exogenous follicle-stimulating hormone (FSH). This phenomenon could be associated with genetic characteristics. In this study, FSH receptor polymorphism was retrospectively evaluated in 42 normoresponder young women undergoing an in vitro fertilization/intracytoplasmic sperm injection cycle; patients were stratified according to recombinant human FSH (r-hFSH) consumption. We selected 17 normoresponder young patients who required a cumulative dose of recombinant FSH (rFSH) >2500 UI (group A). A control group was randomly selected among patients who required a cumulative dose of rFSH <2500 UI (group B). Follicle-stimulating hormone receptor (FSH-R) 307Ala and 680Ser variants were analyzed in all our patients. Our results show that the mean number of rFSH vials (36.3 ± 7.5 vs 28.6 ± 4.5, P = .0001) and days of stimulation (12.7 ± 2.4 vs 10.8 ± 2.8, P = .03) were significantly lower in group B, whereas the number of oocytes retrieved (7.1 ± 1.5 vs 9.6 ± 2.4; P = .0005) and the average number of embryos transferred (2.1 ± 0.7 vs 2.7 ± 0.4; P = .001) were significantly lower in group A. Estradiol serum levels on the human chorionic gonadotrophin day were significantly lower in group A (997.8 ± 384.9 pg/mL vs 1749.1 ± 644.4; P = .0001). The incidence of the Ser/Ser genotype was higher in patients with higher r-hFSH consumption (group A; P = .02). Based on our results, we hypothesize an association between the FSH-R polymorphisms and a “hyporesponse” to exogenous FSH.read more
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Defining Low Prognosis Patients Undergoing Assisted Reproductive Technology: POSEIDON Criteria-The Why.
Sandro C. Esteves,Matheus Roque,Giuliano Bedoschi,Alessandro Conforti,Peter Humaidan,Carlo Alviggi +5 more
TL;DR: A critical appraisal of the existing criteria that standardize the definition of POR is provided and the primary reasons for the development of the POSEIDON criteria are explained.
Journal ArticleDOI
Understanding Ovarian Hypo-Response to Exogenous Gonadotropin in Ovarian Stimulation and Its New Proposed Marker-The Follicle-To-Oocyte (FOI) Index.
Carlo Alviggi,Alessandro Conforti,Sandro C. Esteves,Roberta Vallone,Roberta Venturella,Sonia Staiano,Emanuele Castaldo,Claus Yding Andersen,Giuseppe De Placido +8 more
TL;DR: The role of FOI is contextualized as a parameter to identify this condition, the underlying mechanisms potentially implicated in the pathogenesis of hypo-response are discussed, and possible treatment strategies to overcome hyper-responsiveness to gonadotropin stimulation are appraised.
Journal ArticleDOI
Clinical relevance of genetic variants of gonadotrophins and their receptors in controlled ovarian stimulation: a systematic review and meta-analysis.
Carlo Alviggi,Alessandro Conforti,Daniele Santi,Sandro C. Esteves,Claus Yding Andersen,Peter Humaidan,Paolo Chiodini,Giuseppe De Placido,Manuela Simoni +8 more
TL;DR: The clinical relevance of specific genotype profiles on reproductive outcome is supported and further studies are required to determine their application in a pharmacogenomic approach to ovarian stimulation.
Journal ArticleDOI
Recombinant luteinizing hormone supplementation in assisted reproductive technology: a systematic review.
Carlo Alviggi,Alessandro Conforti,Sandro C. Esteves,Claus Yding Andersen,Ernesto Bosch,Klaus Bühler,Anna Pia Ferraretti,Giuseppe De Placido,Antonio Mollo,Robert Fischer,Peter Humaidan +10 more
TL;DR: Recombinant hLH supplementation appears to be beneficial in two subgroups of patients: women with adequate prestimulation ovarian reserve parameters and an unexpected hyporesponse to r-hFSH monotherapy; and women 36-39 years of age.
Journal ArticleDOI
Ultrasound-guided embryo transfer: summary of the evidence and new perspectives. A systematic review and meta-analysis.
Mauro Cozzolino,Amerigo Vitagliano,Maria Valentina Di Giovanni,Antonio Simone Laganà,Salvatore Giovanni Vitale,Mija Blaganje,Kristina Drusany Starič,Kobal Borut,Tito Silvio Patrelli,Marco Noventa +9 more
TL;DR: A meta-analysis based exclusively on evidence from published randomized controlled trials analysing the effect of trans-abdominal ultrasound guidance during embryo transfer versus clinical touch and of transvaginal ultrasound Guidance (TV-US) versus the trans-ABdominal approach on IVF outcomes found a moderate quality of evidence supporting the beneficial effects.
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Journal ArticleDOI
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TL;DR: This work presents a detailed description of the structure-function relationships and models of FSH-FSH Receptor interaction, and some of the mechanisms behind the interaction between the FSH and FSH receptor have been described.