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- Written by Dominique de Ziegler, MD, Université Paris Descartes – Assistance Publique Hôpitaux de Paris, CHU Cochin, Dept Of Ob Gyn and Reproductive Medicine II, Paris, France.
Abstract
Three decades of clinical experience with assisted reproductive technologies (ART) led to an intimate intertwining between the responses to controlled ovarian stimulation (COS) and actual ART outcome. In turn the functional testing that predicts COS responses – dubbed ‘ovarian reserve’ – was mistakenly seen as foretelling the degree of remaining fecundity. The highly publicized ‘ovarian reserve’ concept has now sparked an emerging business of advanced or ‘provisional’ ART for the purpose of saving cryopreserved oocytes for later use in women whose ovarian reserve is diminished.
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More than 50% of colleagues worldwide are not flushing follicles during egg collection. The primary reason for this are studies, published in the early nineties, comparing egg retrievals using two needles with the same outer diameter (Single Lumen Needles and Double Lumen Needles). All of the authors concluded that that they harvested the same number of oocytes with either needle, but the duration of egg collection procedure took 2 to 3 times longer using the double lumen needles.
- Details
More than 50% of colleagues worldwide are not flushing follicles during egg collection. The primary reason for this are studies, published in the early nineties, comparing egg retrievals using two needles with the same outer diameter (Single Lumen Needles and Double Lumen Needles). All of the authors concluded that that they harvested the same number of oocytes with either needle, but the duration of egg collection procedure took 2 to 3 times longer using the double lumen needles.
- Details
The small amount of progesterone (P) released by human follicles at their very final stage of maturation plays a central role in the human reproduction. It may anticipate the expansion of the cumulus even before the LH peak and, once the oocyte-cumulus complex has been released into the fallopian tube, it attracts the sperms toward the oocyte 1allowing its fecundation. While facilitating the fecundation process, follicular P also plays as the main trigger of the mid-cycle gonadotropin surge. Indeed, under raising estradiol concentration, hypothalamic cells expose P receptors (PR). These P receptors are extremely sensitive and may react to the very small amounts of hormone, either synthesized within the brain or released from the end stage follicle. The activation of hypothalamic PR triggers the release of a peak of GnRH, which in turn triggers the midcycle gonadotropin surge 2.
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It is with pleasure that we announce the launch of the IVF-Worldwide blog. This blog will provide physicians and other professionals in the field of IVF a platform to stay informed, share ideas and is intended to fuel discussions on burning topics and developments in our field.
In addition, the IVF-Worldwide blog will serve as a tool to disseminate new research publications and offer an opportunity to review books and products.
Leading experts in fields such as of IVF, gynecology, technology, internet and marketing will serve as guest bloggers and will lead discussions and address topics that are relevant to all who practice in our field.
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