Maternal and neonatal outcomes after gonadotropin-releasing hormone agonist trigger for final oocyte maturation in patients undergoing in vitro fertilization.

Objective: To compare the rate of congenital anomalies, obstetrical complications, and neonatal complications in antagonist cycles where either GnRH agonist (GnRHa) or hCG was used for final oocyte maturation.

Design: Retrospective cohort study.

Setting: University-based tertiary fertility center.

Luteal phase estradiol versus luteal phase estradiol and antagonist protocol for controlled ovarian stimulation before in vitro fertilization in poor responders.

Luteal phase synchronization of follicular growth has been suggested as a means to improve ovarian response in low responders. We compared luteal E2 and antagonist (n=256) with luteal E2 only (n=57) before antagonist protocol in low responders. The addition of GnRH antagonist to luteal E2 for luteal suppression before ovarian stimulation for IVF does not improve IVF outcomes in poor responders.

Reorganization of the endoplasmic reticulum and development of Ca2+ release mechanisms during meiotic maturation of human oocytes.

Oocyte maturation in rodents is characterized by a dramatic reorganization of the endoplasmic reticulum (ER) and an increase in the ability of an oocyte to release Ca(2+) in response to fertilization or inositol 1,4,5-trisphosphate (IP(3)). We examined if human oocytes undergo similar changes during cytoplasmic meiotic maturation both in vivo and in vitro. Immature, germinal vesicle (GV)-stage oocytes had a fine network of ER throughout the cortex and interior, whereas the ER in the in vivo-matured, metaphase II oocytes was organized in large (diameter, ∼2-3 μm) accumulations throughout the cortex and interior.

Endogenous gonadotropin flare following microdose leuprolide (MDL) stimulation protocol does not correlate with in vitro fertilization (IVF) outcome.

Patients undergoing first IVF cycle using MDL from October 2005 to November 2008 had serum FSH, LH, and estradiol (E2) levels measured prior to and 2 days after initiation of MDL; and evidence of a follicular flare, defined as a doubling in endogenous gonadotropins, was evaluated and correlated with clinical pregnancy, cancellation, implantation, spontaneous abortion, and ongoing pregnancy rate as well as cycle parameters. Although there was no difference in IVF outcomes, higher doses of exogeneous gonadotropins as well as greater days of stimulation were observed in patients with a documented FSH or LH flare.