Human chorionic gonadotropin administration is associated with high pregnancy rates during ovarian stimulation and timed intercourse or intrauterine insemination

Background  

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.     

Transcervical artificial insemination in the domestic ferret (Mustela putorius furo)

The research was undertaken to develop a successful nonsurgical procedure for artificially inseminating ferrets. A fiberoptic endoscope used in conjunction with a specially designed speculum and catheter permitted cervical catheterization and intrauterine insemination. Sperm were collected from the cauda epididymides of 10 discarded breeder males; the number of sperm in diluted samples used for insemination ranged from 4.4–13.6 × 10⁶/100 μl with progressive motility of sperm ranging from 40 to 60%. Sperm collected from each male were diluted with an egg-yolk extender (TEST) and used to inseminate 8–12 females, with deposition of sperm intravaginally or transcervically into the uterine body 0 or 24 hr after an ovulatory injection of human chorionic gonadotropin (hCG). The vaginal inseminations were used as a control, and no pregnancies resulted after insemination of 26 females. Intrauterine inseminations resulted in 4/24 (17%) of the ferrets pregnant when hCG administration was coincident with insemination, and 19/24 (79%) of the ferrets were pregnant when inseminations were done 24 hr after hCG administration. All inseminated females were euthanized on day 20 after insemination to count fetuses. The mean number of fetuses was 3.1 (range, 1–8). The number (millions) of motile sperm inseminated (X) had a significant effect on the percentage of fetuses (Y). Regression analysis indicated a linear relationship between the two variables, with an R² value of 0.99 and a line of best fit described by the equation Y = 0.029 + 0.034 X. This paper is the first report of transcervical artificial insemination in the domestic ferret (Mustela putorius furo). The method can serve as a model for application to ferrets and other mammals, particularly endangered species. Zoo Biol 17:393–404, 1998. © 1998 Wiley-Liss, Inc.     

Flow cytometric sorting of human sperm: MicroSort clinical trial update

This report provides a summary of MicroSort^® efficacy in separation of X- from Y-chromosome bearing human sperm (XSort^® and YSort^®, respectively), clinical outcomes, and the sex of the resultant babies when sorted sperm were used for intrauterine insemination (IUI), in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Clinical trial participants were married couples seeking reduced X-linked genetic disorder risk or family balancing. Sperm were stained with Hoechst 33342, sorted by flow cytometry, then used or cryopreserved for subsequent use. Fluorescence in situ hybridization (FISH) analysis determined the post-sort enrichment (purity) for X- and Y-bearing sperm. Birth and pediatric records were evaluated for incidence of congenital malformations. Between June 1994 and January 2007, patients underwent 3629 IUI cycles, 1642 IVF/ICSI cycles with fresh embryo transfer (ET) and 99 frozen embryo transfer (FET) cycles after MicroSort^®. Of 5871 total sorts, 74.9% were XSort^® and 25.1% were YSort^®. IVF/ICSI fertilization rate was 70.7% and 93.8% of 2PN embryos cleaved. The pregnancy rates for IUI, IVF/ICSI, and FET were 15.6, 32.0, and 33.3%, respectively, while miscarriage rates were 15.7, 14.3, and 33.3%, respectively. Post-sort purity averaged 87.9% (XSort^®) and 73.4% (YSort^®). A total of 1125 clinical pregnancies yielded 943 babies born and 167 ongoing pregnancies. For babies born, XSort^® resulted in 92.0% females and YSort^® yielded 81.5% males. Postnatal follow-up showed a 2.6% major congenital malformation rate, with no recurrent pattern or clustering of malformations. FISH results confirmed MicroSort^® enrichment of X- and Y-bearing sperm populations that closely corresponded with the sex of the resultant child. Fertilization, cleavage, spontaneous abortion, and pregnancy rates as well as incidence of major congenital malformations were comparable to those in literature reports utilizing unsorted sperm.     

Evaluation of treatments with hCG and carprofen at embryo transfer in a demi-embryo and recipient virgin heifer model

An in vivo model, combining a low developmental competence embryo (demi-embryo) and a high-fertility recipient (virgin dairy heifer) was used to evaluate the effects of treatment with human chorionic gonadotropin (hCG) and carprofen at embryo transfer (ET) on plasma progesterone (P₄) concentrations of recipients and on embryonic growth and survival. Embryos were bisected and each demi-embryo was transferred to a recipient on Day 7 of the estrous cycle. At ET, heifers (n = 163) were randomly allocated to treatment with hCG (2500 IU im), carprofen (500 mg iv), hCG plus carprofen or to untreated controls. Plasma P₄ concentrations were measured on Days 0, 7, 14 and 21 of all recipients plus on Days 28, 42 and 63 of pregnant recipients. Pregnancy was presumed to be present in recipients with luteal plasma P₄ concentrations until Day 21 and confirmed by using transrectal ultrasonography on Days 28, 42 and 63. Embryonic measurements (crown–rump length and width) were obtained on Day 42. Treatment with hCG induced formation of secondary corpora lutea (CL) in 97% of heifers and increased (P < 0.01) mean plasma P₄ concentrations of non-pregnant recipients on Day 14 and of pregnant heifers on Days 14 to 63. This was associated to a significant decrease in early embryonic mortality. In contrast, subsequent embryonic losses resulted in a non-significant numerical increase by 8% of pregnancies maintained to Day 63. Therefore, treatment with hCG significantly rescued embryos through the maternal recognition of pregnancy window but was not able to support development thereafter. Treatment with carprofen at ET had no significant effects on plasma P₄ concentrations and rate of embryo mortality. Treatment with hCG plus carprofen at ET induced formation of secondary CL in 90% of heifers but decreased the luteotrophic effect of hCG, resulting in no effect on embryo survival. Low developmental competence embryos showed an intrinsic deficiency in overcoming the maternal recognition of pregnancy challenge and in proceeding to further development until Day 28 of pregnancy, whereas mortality beyond this point was residual. Results on pregnancy rates should be confirmed in further experiments involving a larger sample size.     

Improved pregnancy rate with administration of hCG after intrauterine insemination: a pilot study

Background  

In natural cycles, women conceive when intercourse takes place during a six-day period ending on the day of ovulation. The current practice in intrauterine insemination (IUI) cycles is to perform the IUI 24-36 hours after the hCG administration, when the ovulation is already imminent. In this study hCG was administered after the IUI, which more closely resembles the fertilisation process in natural cycles.     

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Background

After hormonal replacement therapy (HRT) including androgen replacement or sequential therapy of estrogen and progesterone, The combination of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) and pulsatile GnRH, is not sufficient to produce sufficient gametes in some patients with Congenital hypogonadotropic hypogonadism (CHH). A Systematic review and meta-analysis was performed to determine that assisted reproductive techniques (ART) can effectively treat different causes of infertility.

Methods

To determine the effect of ART on fertility of CHH patients and investigate whether outcomes are similar to infertility due to other causes, we conducted a systematic review and meta-analysis of retrospective trials.Clinical trials were systematically searched in Medline, Embase, and the Cochrane central register of controlled trials databases. The keywords and major terms covered “hypogonadotropic hypogonadism”, “kallmann syndrome”, “assisted reproductive techniques”, “intrauterine insemination”, “intracytoplasmic sperm injection”, “testicular sperm extraction”, “in vitro fertilization”, “embryo transplantation” and “intra-Fallopian transfer”.

Results

A total of 388 pregnancies occurred among 709 CHH patients who received ART (effectiveness 46, 95% confidence interval 0.39 to 0.53) in the 20 studies we included. The I² in trials assessing overall pregnancy rate (PR) per embryo transfer (ET) cycle was 73.06%. Similar results were observed in subgroup analysis by different gender. Regression indicates pregnancy rate decreases with increasing age. Fertilization, implantation and live birth rates (72, 36 and 40%) showed no significant differences as compared to infertility due to other causes.

Conclusions

Despite CHH patients usually being difficult to generate gametes, their actual chances of fertility are similar to subjects with other non-obstructive infertility. ART is a suitable option for CHH patients who do not conceive after long-term gonadotropin treatment.

     

Serum levels of transforming growth factor β1 and C-reactive protein as possible markers of intra uterine insemination outcome

Objective

Maternal immunity is important for the implantation phase, and exaggerated inflammatory responses may reduce the chance of implantation and pregnancy. Transforming growth factor β1 (TGF-β1) plays a role in the modulation of cellular growth, maturation and differentiation, extracellular matrix formation, immunoregulation, and apoptosis. In this study, we aimed to evaluate the changes in serum TGF-β1 and C-reactive protein (CRP) levels in infertile women following intrauterine insemination (IUI) according to the presence of pregnancy.

Methods

Sixty-three infertile patients were selected for the study in a nine-month period. Clomiphene citrate or recombinant gonadotropins were used for ovulation induction, and all patients underwent IUI following human chorionic gonadotropin (hCG) trigger. The pregnant and non-pregnant groups’ TGF-β1 and CRP levels were measured.

Results

The CRP levels increased significantly from the day of the hCG trigger to the 8th day after hCG trigger in the non-pregnant group (P = 0.003) whereas TGF-β1 levels decreased in the pregnant group (P = 0.001).

Conclusion

Maternal inflammatory responses play an important role in the occurrence of pregnancy. Changes in the levels of TGF-β1 and CRP may have a role in the outcome of IUI. Serial measurements of TGF-β1 and C-reactive protein, if confirmed by larger studies, may become valuable in predicting the outcome of IUI.

     

Pregnancy in the domestic cat after vaginal or transcervical insemination with fresh and frozen semen

The objective was to compare pregnancy rates in domestic cats using fresh semen for intravaginal artificial insemination (IVI), either at the time of hCG treatment for induction of ovulation, or 28 h later, and to compare pregnancy rates following IVI or transcervical intrauterine insemination (IUI) of frozen-thawed semen. Eighteen queens were inseminated during 39 estrus cycles. Fresh semen with 13.5+/-5.4 x 10(6) sperm (range, 6.8-22 x 10(6)) collected by electroejaculation from four male cats was used in Experiment 1, and cryopreserved semen (20 x 10(6) sperm, with 70+/-5% post-thaw motility) from one male cat was used in Experiment 2. Serum concentrations of estradiol-17beta and progesterone were determined in most queens on the day of AI and again 30-40 days later. Treatment with 100 IU of hCG 3 days after the onset of estrus induced ovulation in 95% of treated queens. Pregnancy rates to IVI with fresh semen at the time of hCG administration versus 28 h later were not different (P=0.58); overall 33% (5/15) of the queens became pregnant. For frozen-thawed semen, AI was consistently done 28h after hCG administration; IUI and IVI resulted in pregnancy rates of 41.7% (5/12), whereas no queen (0/12) became pregnant by IVI (P=0.0083). In conclusion, an acceptable pregnancy rate was obtained with frozen-thawed semen in the domestic cat by non-surgical transcervical IUI; this method might also be useful in other small felids.     

双胎妊娠一胎宫内死亡的临床分析

目的:探讨双胎妊娠一胎宫内死亡的原因及处理方法。方法:对本院2013年1月～2017年6月住院分娩的双胎妊娠一胎宫内死亡的病例进行回顾性分析。结果:双胎妊娠一胎宫内死亡28例,占同期双胎分娩的1.63%,占同期双胎胎盘送检的4.33%。6例孕28周,14例孕28～34周,8例孕周34周。全部孕产妇均无出血倾向或发生凝血功能障碍。产妇年龄23～45周岁,平均31.3周岁;初产妇23人,经产妇5人。应用辅助生殖技术受孕5例,自然受孕23例;剖宫产7例,顺产21例;确诊一胎儿死亡时间为孕12周余～34周余。主要致死原因为脐带因素13例次(46.43%),胎盘因素12例次(42.86%),双胎输血综合征及纸样胎共5例次(17.86%),胎儿畸形4例次(18.18%)。结论:孕中晚期双胎之一胎儿宫内死亡妊娠不足34周,应在密切监护母胎情况下行期待治疗,单绒毛膜囊双胎34周后可以分娩,双绒毛膜囊双胎可妊娠至36周。     

Successful nonsurgical deep uterine embryo transfer in pigs

At present, it is possible to transfer pig embryos directly into the uterine body of sows by nonsurgical procedures. The aim of this study was to develop a procedure for nonsurgical embryo transfer (ET) into the upper part of one uterine horn in gilts and sows. In experiment 1, 29 gilts and 43 sows were used. Intrauterine insertions took place for each female at days 4-6 of the estrous cycle (D0 = onset of estrus). An artificial insemination (AI) spirette was inserted into the cervix to assist with the guidance of a modified flexible catheter originally developed for deep intrauterine insemination in pigs. The flexible catheter length inserted anterior to the inserted AI spirette was 43.0 +/- 1.7 cm. The time required to complete the procedure was affected by the type of female (P < 0.001) and by the difficulties encountered for inserting the catheter (P < 0.001). However, when no or minor difficulties were encountered during the insertion of the catheter (in approximately 70 and 80% of gilts and sows, respectively), the time required to complete the procedure did not differ between gilts (2.5 +/- 0.1 min) and sows (2.3 +/- 0.1 min). In experiment 2, 24 to 31 fresh morulae and/or blastocysts were transferred to each of 24 recipients. Seventeen animals (70.8%) farrowed an average of 6.9 +/- 0.7 piglets, of which 0.6 +/- 0.3 piglets were born dead. In conclusion, the procedure described in this study offers new possibilities to transfer embryos nonsurgically to the uterine horn of pigs.     

The effect of pre-ovulatory anaesthesia on ovulation in laparoscopically inseminated domestic cats.

Laparoscopic intrauterine artificial insemination (AI) of electroejaculated spermatozoa was used to compare embryo development and conception rates in domestic cats inseminated either before or after ovulation. Females were given a single (100 iu) injection of pregnant mares' serum gonadotrophin (PMSG) followed by either 75 or 100 iu human chorionic gonadotrophin (hCG) 80 h later. Cats were anaesthetized (injectable ketamine HCl/acepromazine plus gaseous halothane) 25-50 h after administration of hCG for laparoscopic assessment of ovarian activity and for transabdominal AI into the proximal aspect of the uterine lumen. At the time of AI, 23 cats were pre-ovulatory (25-33 h after hCG injection) and 30 were post-ovulatory (31-50 h after hCG injection). Pre-ovulatory females produced 10.5 +/- 1.1 follicles and no corpora lutea compared with 1.9 +/- 0.5 follicles and 7.5 +/- 0.9 corpora lutea for the post-ovulatory group (P < 0.05). Six days later, the ovaries of nine pre-ovulatory and 12 post-ovulatory females were re-examined and the reproductive tracts flushed. On this day, pre-ovulatory cats produced fewer corpora lutea (2.8 +/- 1.5; P < 0.05) and embryos (0.4 +/- 0.3; P < 0.05) than post-ovulatory females (18.9 +/- 3.3 corpora lutea; 4.6 +/- 1.2 embryos). Two of the 14 cats (14.3%) inseminated before ovulation and not flushed became pregnant compared with 9 of 18 cats (50.0%) inseminated after ovulation and up to 41 h after hCG injection (P < 0.05). These results indicate that ovulation in cats is compromised by pre-ovulatory ketamine HCl/acepromazine/halothane or laparoscopy or by both and that electroejaculated spermatozoa deposited by laparoscopy in utero, after ovulation, result in a relatively high incidence of pregnancy. Because ovulation usually occurs 25-27 h after injection of hCG, the lifespan for fertilization of the ovulated ovum appears to be at least 14 h in vivo in cats.     

GnRH agonist Lupron (leuprolide acetate) pre-treatments prevent ovulation in response to gonadotropin stimulation in the clouded leopard (Neofelis nebulosa)

In many species, controlling the ovary prior to induction of ovulation improves the success of ovarian response and artificial insemination (AI). We assessed the impact of suppression of estrus with the GnRH agonist, Lupron, on ovarian sensitivity to equine chorionic gonadotropin (eCG) and human chorionic gonadotropin (hCG) in the clouded leopard. Seven female clouded leopards were given two injections of Lupron (3.75 mg IM) 23 d apart, followed 44 d later by eCG and hCG. Daily fecal samples were collected from 60 d before Lupron to 60 d after hCG. Fecal metabolites of estrogen (E) and progesterone (P) were measured by radioimmunoassay. Lupron decreased (P < 0.05) the number of E peaks during Lupron treatment compared to pre-Lupron. All females had baseline E and six of seven (86%) had nadir P on day of eCG. Exogenous gonadotropins induced E elevations in all females. However, mean E in the gonadotropin-provoked estrus was decreased (P < 0.05) compared to pre-Lupron estrous periods. Only one of seven (14%) females ovulated after eCG/hCG. In conclusion, estrous cycle control with Lupron resulted in predictable ovarian suppression prior to gonadotropin stimulation but altered ovarian sensitivity by an as yet unknown mechanism so that ovulation was inhibited, even when using a proven exogenous gonadotropin protocol.     

Successful ovulation induction and laparoscopic intrauterine artificial insemination in the clouded leopard (Neofelis nebulosa)

Exogenous gonadotropins and a laparoscopic intrauterine artificial insemination (AI) technique were assessed for effectiveness in the clouded leopard (Neofelis nebulosa), a species difficult to breed in captivity due to severe mate incompatibility. Fourteen hormone trials using 10 female clouded leopards were performed to evaluate the ability of 50, 100, or 200 i.u. pregnant mares' serum gonadotropin (PMSG) and 75 or 100 i.u. human chorionic gonadotropin (hCG) to induce folliculogenesis and ovulation, respectively. Laparoscopic evaluation of ovarian activity was conducted at 29–48 hr after hCG administration. Time of ovulation in PMSG/hCG-treated clouded leopards was approximately 38–39 hr after hCG. Excessive follicular development was observed using the high hormone dosages (200 i.u. PMSG/100 i.u. hCG), whereas the lower dosages avoided ovarian hyperstimulation. Previous ovulation sites and mature corpora lutea were detected upon laparoscopic examinations in two of the 10 females housed alone, indicating that this species occasionally spontaneously ovulates. Five females were inseminated by depositing electroejaculated, washed sperm transabdominally into the proximal aspect of each uterine horn. One postovulatory female, previously treated with 100 i.u. PMSG and 75 i.u. hCG and inseminated in utero with 88 × 10⁶ motile sperm at 45 hr post-hCG, produced a pregnancy and two live cubs after an 89 day gestation. These results demonstrate: (1) an exquisite ovarian sensitivity to exogenous gonadotropins in clouded leopards; and (2) that artificial insemination has the potential of resulting in offspring in this species. (This article is a US Government work and, as such, is in the public domain in the United States of America.) © 1996 Wiley-Liss, Inc.     

Effect of the addition of beta-mercaptoethanol to a thawing solution supplemented with caffeine on the function of frozen-thawed boar sperm and on the fertility of sows after artificial insemination

We have reported that artificial insemination (AI) with frozen-thawed boar semen supplemented with caffeine increased the number of uterine sperm by inhibiting the migration of polymorphonuclear leukocytes (PMNs) into the uterine lumen, thereby improving the fertility of gilts and sows. The objective of the present study was to examine the effects of the addition of the antioxidant beta-mercaptoethanol (bME) and caffeine to the thawing solution on the function of frozen-thawed sperm, on the phagocytic activity of PMNs for sperm, and on the fertility of sows after AI. When frozen-thawed sperm were cultured in the presence of 25 or 50 μm bME, sperm capacitation and spontaneous acrosome reactions were inhibited (P < 0.01). There was no effect of bME on phagocytic activity of PMNs for sperm in vitro. When hormonally treated (400 IU of equine chorionic gonadotropin + 200 IU of human chorionic gonadotropin) weaned sows experienced a single intrauterine insemination with frozen-thawed sperm (25 × 10⁸ sperm per 50 ml dose) 40 h after subsequent hCG administration, pregnancy and farrowing rates were unaffected by the addition of 50 μm bME (pregnancy rate, 20 vs 21% in controls; farrowing rate, 20 vs 21%; n = 15 and 14, respectively). However, litter size tended to be higher than in the presence of 50 μm bME compared to its absence (10.0 ± 1.0 vs 5.7 ± 1.5, respectively; P < 0.07). Thus, the addition of bME to the thawing solution containing caffeine could be of benefit for improving the function of frozen-thawed sperm without influencing the phagocytic activity of PMNs for sperm. Although there were no statistically significant effects of bME on pregnancy or farrowing rates, the litter size tended to be higher in the sows subjected to a fixed-time single AI treatment with synchronized ovulation.     

Piglets born after non-surgical deep intrauterine transfer of vitrified blastocysts in gilts

The aims of this study were: (1) to evaluate the effect of the number of previous estrus of recipient gilts on effectiveness of intrauterine insertion of a flexible catheter designed for non-surgical deep intrauterine catheterization during diestrus in pigs; and (2) to determine the farrowing rate and the litter size after non-surgical deep intrauterine embryo transfer (ET) of porcine blastocysts vitrified by the open pulled straw (OPS) method. In experiment 1, 27 large white hyperprolific gilts (LWh) with 2-6 previous estrus were used. Intrauterine insertions of the flexible catheter were carried out at day 5.5-6 of the estrous cycle (D0=onset of estrus). During insertions, no or only moderate reactions were observed in 88.9% of gilts and was not related (P >0.05) to the number of estrus prior to the insertion periods. The number of the estrus had a significant effect (P <0.05) on the difficulties found during the procedure. In the 100% of gilts with two estrus (N=6) it was not possible to insert the flexible catheter through the cervix. In gilts with three or more estrus, it was possible to pass the cervix and to progress along a uterine horn in 80.9% of the cases. In 86.7% of the gilts, the tip of the flexible catheter achieved the second or third quarter of the uterine horn. In experiment 2, following non-surgical deep intrauterine transfer of 20 vitrified/warmed blastocysts, 9 Meishan recipients (42.9%) farrowed an average of 5.4 +/- 0.8 piglets (range 3-9) of which 0.6 +/- 0.3 piglets (range 0-2) were born dead. In conclusion, this study shows that it is possible to obtain birth of piglets following non-surgical deep intrauterine embryo transfer (ET) of vitrified/warmed blastocysts. Non-surgical deep intrauterine ET and OPS vitrification methods are promising procedures to be used together for the introduction of new genetic material in a farm.     

Response of dairy heifers to Prostaglandin F2alpha after treatment with human chorionic gonadotropin

After the observation of estrus following administration of Prostaglandin F(2alpha) (PGF(2alpha)), 79 dairy heifers were randomly either injected with 2500 IU of human chorionic gonadotropin (hCG) 48 h postestrus or maintained as controls with no injection at that time. Five to 9 d later, after a blood sample for progesterone determination was taken, all heifers were injected with 25 mg of PGF(2alpha). Heifers observed in estrus within the next 5 d were inseminated about 12 h after initial observation and were palpated for pregnancy 45 to 60 d postinsemination. Heifers treated with hCG had higher progesterone concentrations, reduced and delayed estrual responses, and lower insemination fertility rates when compared with control heifers.     

逆行射精精子冷冻保存在宫腔内人工授精技术中的应用

目的:探讨逆行射精患者尿液中回收精子的冷冻保存及其在宫腔内人工授精(IUI)周期中的应用效果。方法:2008年12月至2011年1月逆行射精患者共计7例,嘱其按要求留取射精后的尿液,充分洗涤后实施液氮蒸汽法超低温精子冷冻,共冻存精液标本14人份。IUI周期时将冻存精子解冻、优化后行宫腔内人工授精。结果:冷冻前、解冻后前向运动精子总数分别为(19.9±10.4)×106和(6.9±4.2)×106,存在显著性差异(P<0.05),解冻优化后前向运动精子总数为(2.6±1.7)×106,实施IUI 8个周期,临床妊娠1例。结论:超低温冷冻会明显降低前向运动精子总数,但多次冷冻后一次复苏行IUI可能是治疗逆行射精所致不育的一种较为理想的方法。     

Pregnancy in the domestic cat after vaginal or transcervical insemination with fresh and frozen semen

The objective was to compare pregnancy rates in domestic cats using fresh semen for intravaginal artificial insemination (IVI), either at the time of hCG treatment for induction of ovulation, or 28 h later, and to compare pregnancy rates following IVI or transcervical intrauterine insemination (IUI) of frozen–thawed semen. Eighteen queens were inseminated during 39 estrus cycles. Fresh semen with 13.5 ± 5.4 × 10⁶ sperm (range, 6.8–22 × 10⁶) collected by electroejaculation from four male cats was used in Experiment 1, and cryopreserved semen (20 × 10⁶ sperm, with 70 ± 5% post-thaw motility) from one male cat was used in Experiment 2. Serum concentrations of estradiol-17β and progesterone were determined in most queens on the day of AI and again 30–40 days later. Treatment with 100 IU of hCG 3 days after the onset of estrus induced ovulation in 95% of treated queens. Pregnancy rates to IVI with fresh semen at the time of hCG administration versus 28 h later were not different (P = 0.58); overall 33% (5/15) of the queens became pregnant. For frozen–thawed semen, AI was consistently done 28 h after hCG administration; IUI and IVI resulted in pregnancy rates of 41.7% (5/12), whereas no queen (0/12) became pregnant by IVI (P = 0.0083). In conclusion, an acceptable pregnancy rate was obtained with frozen–thawed semen in the domestic cat by non-surgical transcervical IUI; this method might also be useful in other small felids.     

Significance of the maternal levels of serum alpha-fetoprotein, human chorionic gonadotropin and unconjugated estriol in various congenital developmental defects in pregnancy trimester II]

Maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG) and unconjugated oestriol (uE3) concentrations were measured in maternal serum samples from 21 pregnancies with neural-tube defects, 4 pregnancies with ventral wall defects (VWD) and 1662 unaffected pregnancies in women. These congenital malformations were confirmed by ultrasound scanning. The mean multiplate of the median (MoM) for AFP and uE3 was significantly different from the control values in cases of open NTD (AFP median MoM = 5.95, p < 0.001, uE3 median MoM = 0.2, p < 0.001), while hCG values did not differ from those of matched controls (hCG median MoM = 0.9). The biological basis of altered levels of uE3 in pregnancies with fetal NTDs is unclear.     

Effectiveness of GnRH Antagonist in the Management of Subfertile Couples Undergoing Controlled Ovarian Stimulation and Intrauterine Insemination: A Meta-Analysis

Background

Recent studies have indicated the use of gonadotropin-releasing hormone antagonists (GnRH-ant) as an adjuvant treatment to prevent premature luteinization (PL) and improve the clinical outcomes in patients undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI). However, the results of these studies are conflicting.

Methods

We conducted a systematic review and meta-analysis of randomized trials aiming to compare the clinical efficacy of GnRH-ant in COS/IUI cycles. Twelve studies were identified that met inclusion criteria and comprised 2,577 cycles assigned to COS/IUI combined GnRH-ant or COS/IUI alone.

Results

Meta-analysis results suggested that GnRH-ant can significantly increase the clinical pregnancy rate (CPR) (OR = 1.42; 95% CI, 1.13–1.78) and decrease the PL rate (OR = 0.22, 95% CI, 0.16–0.30) in COS/IUI cycles. Subgroup analysis results suggested statistically significant improvement in the CPR in non-PCOS patients (OR = 1.54; 95% CI, 1.03–2.31) but not in the PCOS population (OR = 1.65; 95% CI, 0.93–2.94) and multiple mature follicle cycles (OR = 1.87; 95% CI, 0.27–12.66). There were no difference in the miscarriage and multiple pregnancy rates between the groups.

Conclusion

This meta-analysis suggested that GnRH-ant can reduce the incidence of PL and increase the CPR when used in COS/IUI cycles, and it was especially useful for non-PCOS patients. However, evidence to support its use in PCOS patients is still insufficient