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Oliveira J.B.A.,Center for Human Reproduction Prof Franco Jr | Oliveira J.B.A.,Paulista Center for Diagnosis Research and Training | Vagnini L.D.,Paulista Center for Diagnosis Research and Training | Petersen C.G.,Center for Human Reproduction Prof Franco Jr | And 16 more authors.
Reproductive BioMedicine Online | Year: 2016

Certain gene polymorphisms are associated with implantation failure and pregnancy loss. Studies of leukaemia inhibitory factor (LIF) gene polymorphisms are scarce. The LIF single nucleotide polymorphism (SNP) thymine (T)/guanine (G) (rs929271) was studied in women to determine whether an association existed with pregnancy outcomes after intracytoplasmic sperm injection (ICSI); 411 women who underwent ICSI were recruited. DNA was extracted from the peripheral blood, and the LIF gene SNP T/G (rs929271) was genotyped using real-time polymerase chain reaction. Participants were divided into three groups according to their LIF genotype: T/T (n = 168), T/G (n = 202) and G/G (n = 41). All IVF and ICSI procedures were carried out under the same clinical and laboratory conditions. The ICSI cumulative results (from fresh plus frozen cycles) of each genotype group were analysed. The G/G genotype in women was associated with a higher implantation rate (T/T: 15.9%, T/G: 16.2%, G/G: 27.0%; P < 0.05), ongoing pregnancy rate/patient (T/T: 31.5%, T/G: 36.1%, G/G: 53.7%; P < 0.05) and ongoing pregnancy rate/transfer (T/T: 18.5%, T/G: 20.2%, G/G: 36.7%; P < 0.05). LIF SNP T/G (rs929271) seems to be a susceptibility biomarker capable of predicting implantation efficiency and pregnancy outcomes. © 2015 Reproductive Healthcare Ltd. Source


Oliveira J.B.A.,Center For Human Reproduction Prof Franco Junior | Oliveira J.B.A.,Paulista Center for Diagnosis Research and Training | Oliveira J.B.A.,Sao Paulo State University | Baruffi R.L.R.,Center For Human Reproduction Prof Franco Junior | And 15 more authors.
Reproductive Biology and Endocrinology | Year: 2012

Background: The objective was to present a new ovarian response prediction index (ORPI), which was based on anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response.Methods: A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH x AFC)/Patient age).Results: The regression analysis demonstrated significant (P<0.0001) positive correlations between the ORPI and the total number of oocytes and of MII oocytes collected. The logistic regression revealed that the ORPI values were significantly associated with the likelihood of pregnancy (odds ratio (OR): 1.86; P=0.006) and collecting greater than or equal to 4 oocytes (OR: 49.25; P<0.0001), greater than or equal to 4 MII oocytes (OR: 6.26; P<0.0001) and greater than or equal to 15 oocytes (OR: 6.10; P<0.0001). Regarding the probability of collecting greater than or equal to 4 oocytes according to the ORPI value, the ROC curve showed an area under the curve (AUC) of 0.91 and an efficacy of 88% at a cut-off of 0.2. In relation to the probability of collecting greater than or equal to 4 MII oocytes according to the ORPI value, the ROC curve had an AUC of 0.84 and an efficacy of 81% at a cut-off of 0.3. The ROC curve for the probability of collecting greater than or equal to 15 oocytes resulted in an AUC of 0.89 and an efficacy of 82% at a cut-off of 0.9. Finally, regarding the probability of pregnancy occurrence according to the ORPI value, the ROC curve showed an AUC of 0.74 and an efficacy of 62% at a cut-off of 0.3.Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients. © 2012 Oliveira et al.; licensee BioMed Central Ltd. Source


Cavagna M.,Womens Health Reference Center | Paes De Almeida Ferreira Braga D.,Fertility Assisted Fertilization Center | Paes De Almeida Ferreira Braga D.,Sapientiae Institute | Biaggioni Lopes F.,Fertility Assisted Fertilization Center | And 4 more authors.
Archives of Medical Science | Year: 2011

Introduction: Ovarian stimulation is employed in assisted reproduction techniques in order to obtain as many oocytes as possible. The early rise in oestradiol levels may lead to the premature end of the respective cycle. In order to avoid such an effect, pituitary suppression has been employed. The aim of this study was to evaluate whether maintenance or replacement of the type of GnRH analogue (i.e., agonist or antagonist) employed for pituitary suppression in the consecutive intracytoplasmic sperm injection (ICSI) cycle would negatively influence oocyte quality and ICSI outcome. Material and methods: A retrospective observational study was conducted including 181 women with primary infertility. Patients were divided into four different groups according to the GnRH analogue used for pituitary suppression in the first and consecutive cycle. Results: When a GnRH agonist was employed for pituitary suppression in the first cycle, the consecutive cycle showed comparable outcomes when performed with either a GnRH agonist or a GnRH antagonist. When the first cycle was performed with a GnRH antagonist, the use of the GnRH agonist in the successive cycle led to an increased number of oocytes retrieved (7.5% vs. 10.3%, p = 0.032) and the production of a higher number of embryos (4.5% vs. 6.3%, p = 0.036). Conclusions: When the first cycle is carried out with a GnRH antagonist, the use of a GnRH agonist in the successive cycle would lead to increased numbers of oocytes collected and embryos produced. Source


Rossetto L.A.,Federal University of Sao Paulo | Abla L.E.F.,Womens Health Reference Center | Vidal R.,Federal University of Sao Paulo | Garcia E.B.,Unifesp EPM | And 5 more authors.
European Journal of Plastic Surgery | Year: 2010

The purpose of this study was to evaluate the correlation between risk factors and hernia or bulge formation at the donor site of the transverse rectus abdominis myocutaneous (TRAM) flap. A retrospective study was conducted between September 2005 and December 2008 in 206 patients who underwent breast reconstruction with pedicled TRAM flap. Eight (3.9%) of these patients had abdominal wall hernia and 26 (12.6%) had abdominal bulging. The incidence of hernia was significantly higher (P∈<∈0.05) among patients with body mass index (BMI)∈ ∈30 kg/m 2 (hernia incidence, 15.0%) than that among patients with BMI∈<30 kg/m 2 (hernia incidence, 3.2%), while the incidence of abdominal bulge was significantly lower (P∈<∈0.05) among patients with BMI∈ ∈30 kg/m 2 (abdominal bulge incidence, 5.0%) than that among patients with BMI∈ ∈30 kg/m 2 (abdominal bulge incidence, 19.1%). Therefore, obesity was identified as a risk factor for abdominal wall hernia. It was also found that the use of mesh to reinforce the abdominal wall significantly reduced (P∈<∈0.025) the incidence of hernia (use of mesh (hernia incidence, 2.5%) versus non-mesh (hernia incidence, 5.9%)) and abdominal bulge (use of mesh (abdominal bulge incidence, 9.9%) versus non-mesh (abdominal bulge incidence, 17.3%)) among the patients. © 2010 The Author(s). Source


Cavagna M.,Womens Health Reference Center | Dzik A.,Womens Health Reference Center
Reproductive BioMedicine Online | Year: 2011

This report describes the case of a 27-year-old woman with breast cancer who underwent ovarian stimulation for fertility preservation with recombinant FSH in conjunction with a gonadotrophin-releasing hormone (GnRH) antagonist and an aromatase inhibitor from the beginning of the treatment. A 3.75-mg triptorelin depot formulation was given intramuscularly when the follicular diameter of three follicles reached ≥20 mm and a total of 13 follicles reached ≥15 mm. Oocyte retrieval was scheduled for 36 h later and 10 mature oocytes were collected and vitrified. This case report demonstrates that a depot GnRH-agonist trigger effectively leads to mature oocyte retrieval, with the advantage of initiating ovarian suppression for the purpose of fertility preservation during adjuvant chemotherapy in breast-cancer patients. © 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source

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