Lesbian Women Undergoing Assisted Reproduction: Diverse, But Not Different.

The use of assisted reproduction among women in relationships with other women has increased in the United States over the past decade as a result of increased legal access and social acceptance. Despite this shift, limited studies currently exist to guide optimal fertility care for this growing patient population of women seeking assisted reproduction. In this Commentary, assisted reproduction will be meant to include ovulation induction, intrauterine insemination (IUI), and in vitro fertilization (IVF).

A comparison of live birth rates and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos.

Purpose: Prior studies suggest that pregnancy outcomes after autologous oocyte cryopreservation are similar to fresh in vitro fertilization (IVF) cycles. It is unknown whether there are differences in pregnancy and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos.

Methods: This is a retrospective cohort study comparing pregnancy and perinatal outcomes between oocyte and embryo cryopreservation at a university-based fertility center.

Low-dose human chorionic gonadotropin alone can complete follicle maturity: successful application to modified natural cycle in vitro fertilization.

Objective: To investigate the feasibility of utilizing low-dose hCG alone to complete follicle maturity in a natural cycle, without the need for antecedent exogenous FSH stimulation.

Design: Case series.

Setting: Academic fertility program.

Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers.

Purpose: In fresh IVF cycles, embryos reaching the eight-cell stage on day 3 of development are thought to have a higher chance of implantation than those reaching this stage on day 4. To determine whether this difference persists after cryopreservation, we compared pregnancy and implantation rates between frozen embryo transfer (FET) cycles using delayed cleavage-stage embryos (cryopreserved day 4) and normal cleavage-stage embryos (cryopreserved day 3).

Methods: Participants underwent FET between 2008 and 2012 using embryos cryopreserved on either day 3 (n = 76) or day 4 (n = 48), depending on the length of time needed to achieve the eight-cell stage.

Luteal phase bleeding after IVF cycles: comparison between progesterone vaginal gel and intramuscular progesterone and correlation with pregnancy outcomes.

Background: To compare luteal phase bleeding and pregnancy outcomes in normogonadotropic patients receiving progesterone vaginal gel (PVG) or intramuscular progesterone (IMP) injections.

Methods: In this retrospective cohort study, data from 270 patients (292 cycles) undergoing day-3 fresh embryo transfer were analyzed. PVG, 90 mg daily (170 cycles) or IMP, 50 mg daily (122 cycles) began at egg retrieval.

In vitro fertilization in the PCOS patient: clinical considerations.

Of all the patients undergoing in vitro fertilization, the patient with polycystic ovary syndrome (PCOS) is probably the most challenging. This is due to the fact that the majority of patients exhibit exaggerated responses to exogenous gonadotropins, frequently leading to an increased rate of cancellation of a treatment cycle. Even those who proceed to oocyte retrieval, and in spite of an increased number of oocytes retrieved, poor fertilization rates may be encountered, probably secondary to an increased rate of oocyte immaturity.

Human skin is a steroidogenic tissue: steroidogenic enzymes and cofactors are expressed in epidermis, normal sebocytes, and an immortalized sebocyte cell line (SEB-1).

Although the human sebaceous gland can synthesize cholesterol from acetate and can further metabolize steroids such as dehydroepiandrosterone into potent androgens, the de novo production of steroids from cholesterol has not been demonstrated in human skin. The goal of this study was to delineate the steroidogenic pathway upstream from dehydroepiandrosterone by documenting the presence of members of the P450 side chain cleavage system (P450scc). This system catalyzes the initial step in steroid hormone synthesis following translocation of cholesterol to the inner mitochondrial membrane.

Is Rh immune globulin needed in early first-trimester abortion? A review.

The prophylactic use of Rh immune globulin has been a medical success, protecting women who could be at risk from exposure to the Rh(D) antigen. Thus, it is not surprising that Rh(D) immunoprophylaxis has been extended from women with term pregnancies to all women with miscarriages, abortions, and ectopic pregnancies. In this article we review the existing medical literature to assess the risks of fetomaternal hemorrhage and Rh isoimmunization after complications of a first-trimester pregnancy, induced abortion, or ectopic pregnancy.

Stromal cells of the human postmenopausal ovary display a distinctive biochemical and molecular phenotype.

The stroma of the human postmenopausal ovary is postulated to produce androgens, but evidence for and against this idea exits in the literature. The purpose of this study was to determine whether key steroidogenic enzymes involved in androgen synthesis are expressed in the postmenopausal ovarian stroma. Stromal cells were isolated from postmenopausal ovaries and expression for genes involved in steroidogenesis [steroidogenic acute regulatory protein (StAR), P450scc, 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) P450c17, and P450c27] as well as for several growth factor binding proteins [gremlin, IGF binding protein-4, follistatin, and secreted frizzled-related protein (sFRP)-1 and -4], were compared with cultured human theca cells and dermal fibroblasts.

Reliability of clinicians versus radiologists for detecting abnormalities on hysterosalpingogram films.

Objective: To evaluate the consistency of the identification of abnormal findings on hysterosalpingogram (HSG) and compare the reliability of clinicians to that of radiologists.

Design: Evaluation of reliability of diagnostic test.

Patient(s): Women undergoing evaluation for infertility.