2015 Group Project 2 - Revision history

Z8600021 at 20:00, 23 October 2015

2015-10-23T20:00:57Z

← Older revision		Revision as of 07:00, 24 October 2015
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	<references/>		<references/>


	{{2015ANAT2341 footer}}		{{2015ANAT2341 footer}}

Z8600021 at 19:41, 23 October 2015

2015-10-23T19:41:09Z

← Older revision		Revision as of 06:41, 24 October 2015
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	==References==		==References==

			<references/>

			{{2015ANAT2341 footer}}

Z8600021: Protected "2015 Group Project 2" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

2015-10-23T19:18:18Z

Protected "2015 Group Project 2" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

← Older revision	Revision as of 06:18, 24 October 2015
(No difference)

Z3372824: /* Secondary Prevention */

2015-10-23T17:07:37Z

Secondary Prevention

← Older revision		Revision as of 04:07, 24 October 2015
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	===Secondary Prevention===		===Secondary Prevention===
			[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20μm <ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
			Secondary Prevention aims to prevent progression to OHSS once COS has been initiated and the patient has been found to mount an exaggerated response. <ref name="PMID20416867" />

	~~Secondary Prevention aims to prevent progression to OHSS once COS has been initiated and the patient has been found to mount an exaggerated response. <ref name="PMID20416867" />~~
	[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20μm <ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	'''Coasting'''		'''Coasting'''

Z3372824: /* Secondary Prevention */

2015-10-23T17:06:38Z

Secondary Prevention

← Older revision		Revision as of 04:06, 24 October 2015
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	Secondary Prevention aims to prevent progression to OHSS once COS has been initiated and the patient has been found to mount an exaggerated response. <ref name="PMID20416867" />		Secondary Prevention aims to prevent progression to OHSS once COS has been initiated and the patient has been found to mount an exaggerated response. <ref name="PMID20416867" />
			[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20μm <ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	'''Coasting'''		'''Coasting'''

	[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20μm <ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>		Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>

Z3372824: /* Secondary Prevention */

2015-10-23T16:44:47Z

Secondary Prevention

← Older revision		Revision as of 03:44, 24 October 2015
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	'''Coasting'''		'''Coasting'''

	[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=~~20 μm.b~~<ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]		[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20μm <ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>		Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>

Z3372824: /* Secondary Prevention */

2015-10-23T16:43:14Z

Secondary Prevention

← Older revision		Revision as of 03:43, 24 October 2015
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	'''Coasting'''		'''Coasting'''

	[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|~~Cryopreserved embryos of~~ the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20 μm.b<ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]		[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreservation in the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20 μm.b<ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>		Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>

Z3372824: /* Secondary Prevention */

2015-10-23T16:42:02Z

Secondary Prevention

← Older revision		Revision as of 03:42, 24 October 2015
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	'''Coasting'''		'''Coasting'''

			[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreserved embryos of the swine model: a) mature oocyte b) day 1 embryo c) day 4 embryo d) blastocyst from cryopreserved day 1 embryo with an intact zona pellucida excluding the lipid droplet. Scale bars=20 μm.b<ref name="PMID26309801"><pubmed>26309801</pubmed></ref>]]
	Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>		Coasting is a first-line secondary preventative strategy. It consists of the withdrawal of gonadotrophins when a critical number of follicles and/or E2 concentration is reached. hCG is administered once the E2 concentration reduces to a safe level, before the process of oocyte retrieval commences. This preventative strategy is conducted for a period of less than 3 days in order to avoid compromising IVF outcomes.<ref name="PMID26074966"/>

	~~[[File:Cryopreservation of Porcine Embryos.jpeg\|right\|thumbnail\|300px\|Cryopreserved embryos of the swine model<ref name="PMID26309801"><pubmed>4497712</pubmed></ref>]]~~

	'''Cryopreservation'''		'''Cryopreservation'''

Z3372824: /* Primary Prevention */

2015-10-23T16:32:56Z

Primary Prevention

← Older revision		Revision as of 03:32, 24 October 2015
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	=== Primary Prevention===		=== Primary Prevention===
	[[File:Severe OHSS Prevention.jpeg\|right\|thumbnail\|400px\|GnRH antagonists, embryo cryopreservation and cycle cancellation are key strategies in preventing OHSS progression ~~within~~ high-risk patients <ref name="PMID22938051"><pubmed>22938051</pubmed></ref>]]		[[File:Severe OHSS Prevention.jpeg\|right\|thumbnail\|400px\|GnRH antagonists, embryo cryopreservation and cycle cancellation are key strategies in preventing OHSS progression in high-risk patients <ref name="PMID22938051"><pubmed>22938051</pubmed></ref>]]

	Primary Prevention involves the modification of treatment regimens on the basis of OHSS risk classifications, in order to prevent OHSS occurrence.		Primary Prevention involves the modification of treatment regimens on the basis of OHSS risk classifications, in order to prevent OHSS occurrence.

Z3372824 at 16:29, 23 October 2015

2015-10-23T16:29:53Z

← Older revision		Revision as of 03:29, 24 October 2015
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	=== Primary Prevention===		=== Primary Prevention===
			[[File:Severe OHSS Prevention.jpeg\|right\|thumbnail\|400px\|GnRH antagonists, embryo cryopreservation and cycle cancellation are key strategies in preventing OHSS progression within high-risk patients <ref name="PMID22938051"><pubmed>22938051</pubmed></ref>]]

	Primary Prevention involves the modification of treatment regimens on the basis of OHSS risk classifications, in order to prevent OHSS occurrence.		Primary Prevention involves the modification of treatment regimens on the basis of OHSS risk classifications, in order to prevent OHSS occurrence.
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	'''Ovulation Induction'''		'''Ovulation Induction'''

	Unifollicular Ovulation Induction through Ovulation Induction (OI) is a primary means of avoiding OHSS in women with Polycystic Ovarian Syndrome, who are at an increased risk. In order to promote unifollicular development, the ovaries are stimulated with a low starting dose of FSH (75 IU).<ref name="PMID20416867"><pubmed>20416867</pubmed></ref> Studies suggests that a minimum gonadotropin dose lowers OHSS risk and thus a step-up regimen is utilised to achieve an ovarian response, whereby the FSH dosage is increased every 7 days until follicular development of greater than 10mm is noted.<ref name="PMID26074966" /> Alternatively, a step-down regimen may be followed, whereby a high initial FSH dosage is lowered according to the ovarian response. Another method to increase FSH levels during OI, is through '''Aromatase Inhibitors''' which promote folliculogenesis by increasing pituitary secretion of FSH, and downregulate oestrogen production through a negative feedback loop. However, Aromatase Inhibitors have not been shown to reduce OHSS incidence in comparison to other methods of OI.<ref name="PMID26074966" /> During OI, a key objective is to prevent early cycle cancellation due to premature luteinisation from pituitary secretion of LH. In order to downregulate LH secretion, Gonadotropin-releasing hormone agonists '''GnRHa~~'''~~ are administered in addition to gonadotropins. Alternatively, '''GnRH antagonists''', which have a rapid onset of action, may be administered to downregulate endogenous LH secretion..<ref name="PMID20416867" /> Comparative studies have shown that the GnRH antagonist protocol has a greater effect in lowering the incidence of mild to severe OHSS. However due to the rare nature of OHSS, and insufficient sample sizes, the difference was not found to be significant. <ref name="PMID21082508"><pubmed>21082508</pubmed></ref>. Generally, the duration of exposure to gonadotropins and subsequent risk of OHSS may be minimised through mild stimulation protocols which administer FSH only in the mid to late follicular phase.<ref name="PMID20416867" />		Unifollicular Ovulation Induction through Ovulation Induction (OI) is a primary means of avoiding OHSS in women with Polycystic Ovarian Syndrome, who are at an increased risk. In order to promote unifollicular development, the ovaries are stimulated with a low starting dose of FSH (75 IU).<ref name="PMID20416867"><pubmed>20416867</pubmed></ref> Studies suggests that a minimum gonadotropin dose lowers OHSS risk and thus a step-up regimen is utilised to achieve an ovarian response, whereby the FSH dosage is increased every 7 days until follicular development of greater than 10mm is noted.<ref name="PMID26074966" /> Alternatively, a step-down regimen may be followed, whereby a high initial FSH dosage is lowered according to the ovarian response. Another method to increase FSH levels during OI, is through '''Aromatase Inhibitors''' which promote folliculogenesis by increasing pituitary secretion of FSH, and downregulate oestrogen production through a negative feedback loop. However, Aromatase Inhibitors have not been shown to reduce OHSS incidence in comparison to other methods of OI.<ref name="PMID26074966" /> During OI, a key objective is to prevent early cycle cancellation due to premature luteinisation from pituitary secretion of LH. In order to downregulate LH secretion, '''Gonadotropin-releasing hormone agonists''' (GnRHa) are administered in addition to gonadotropins. Alternatively, '''GnRH antagonists''', which have a rapid onset of action, may be administered to downregulate endogenous LH secretion, with relative success as depicted in the diagram to the right.<ref name="PMID20416867" /> Comparative studies have shown that the GnRH antagonist protocol has a greater effect in lowering the incidence of mild to severe OHSS. However due to the rare nature of OHSS, and insufficient sample sizes, the difference was not found to be significant. <ref name="PMID21082508"><pubmed>21082508</pubmed></ref>. Generally, the duration of exposure to gonadotropins and subsequent risk of OHSS may be minimised through mild stimulation protocols which administer FSH only in the mid to late follicular phase.<ref name="PMID20416867" />

	'''Adjuvant Metformin Therapy'''		'''Adjuvant Metformin Therapy'''