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--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 12:07, 21 August 2015 (AEST)
--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 12:07, 21 August 2015 (AEST)
--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 13:03, 28 August 2015 (AEST)


[[Test Student 2015]]
[[Test Student 2015]]

Revision as of 14:04, 28 August 2015

Lab Attendance

--Z3415911 (talk) 13:46, 7 August 2015 (AEST)

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--Z3415911 (talk) 13:03, 28 August 2015 (AEST)

Test Student 2015

Lab 1 Assessment

Article 1 PMID 6241855 [1]

The aim of this study was to look at in vitro Maturation (IVM) in women with Polycycsitc Ovarian Syndrome (PCOS) undergoing in vitro fertilization (IVF) compared to women who do not have PCOS. To do this the authors of the article wanted too analyse past studies regarding IVM and PCOS so created an algorithm to aid in their search, with the end of the search date being October 15th 2013. Studies deemed eligible for use in this research compared the rates of various outcomes such as live births and cycle cancellations between people with PCOS, PCO and control women undergoing IVM. Animal studies, case reports and trials on ovum recipients were excluded. An excel spreadsheet was created by 3 of the authors to record and sort their data.

The extent of publication bias was not assessed as it was deemed not necessary due to the small study pool per outcome. To evaluate the quality of the data used in this study, the authors used the nine-item Newcastle Ottawa Quality scale. The main outcome measured was live births per women and per cycle. Other measures included clinical pregnancy per woman, miscarriage rate and fertilization rate. Based on the frequencies of the outcomes between the 3 groups, 95% confidence intervals (CI's) were calculated. Two additional analyses were conducted with regards to clinical pregnancy and live births, namely one based on women and the other on cycles. Statistical analysis was done using STATA Software/SE 13.

268 PCOS, 100 PCO and 440 control patients were included in the analysis. The authors found that live birth rates did not differ between PCOS and non-PCOS women was seen in the cycle-based analysis but in the women-based analysis, a slightly higher birth rate was seen for PCOS women. According to both the woman and cycle based approaches, higher rates of clinical pregnancy were seen for PCOS women compared to non-PCOS women. The same trend was seen for implantation rates in women with PCOS compared to women without PCOS. Cancellation rates were lower in women with PCOS in both subgroups however maturation and miscarriage rates did not differ between the 3 groups assessed. Fertilization rates were minimally lower between women with PCOS compared to non-PCOS women.

A higher rate of clinical pregnancy rates were seen in women with PCOS who have undergone stimulation with FSH and hCG priming during both women and cycle based analysis. No pattern between the 3 groups was seen when there was a lack of priming with hCG. When rating the quality of the studies,the scores ranged between 5 and 9, with older studies receiving a lower score compared to newer studies. To conclude, it was found that IVM appears to be a good approach when it comes to treating women with PCOS during IVF as opposed to women without PCOS. It is an efficient treatment option in terms of implantation, clinical pregnancy and cycle cancellation rates.

Article 2 PMID 26238449 [2]

The aim of this article was to evaluate the effects of progesterone elevation as a result of human chorionic gonadotropin (hCG) administration on the outcome of IVF with transferred embryos at various stages of development. The study looked at an excess of 10,000 women undergoing day 3 cleavage-stage embryo transfer and an additional 1146 women undergoing day 5 blastocyst-stage embryo transfer. Both groups of women underwent controlled ovarian stimulation using gonadotropin and GnRH agonist. Certain exclusion criteria were set for participants in the study, including the exclusion of couples in which either member had chromosomal abnormalities. Various patient characteristics were evaluated, such as BMI, cause of infertility and basal FSH levels. Ovarian stimulation was controlled by patients doctor on a case by case basis, assigning them either standard long GnRH agonist or modified prolonged GnRH agonist protocol. Serum levels of FSH and LH were suppressed using triptorelin acetate. Doses were adjusted after 4 days depending on how the ovary had responded and when more than 3 follicles had reached 17mm, GnRH was injected into the patient and after ~36 hours, oocytes were retrieved. The cleavage-stage embryos were graded against a criteria for quality and women with 3 or more quality embryos were selected to go onto blastocyst stage development. A grading criteria was also used for the blastocyst-stage embryos.

2-4 days prior to IVF, basal FSH levels were measured. Throughout the ovarian stimulation, the levels of hormones such as LH and progesterone were assessed while fasting. A clinical pregnancy (CP) was considered to be present is if, upon ultrasound, cardiac pulsations were heard and a intrauterine gestational sac is present, 35-45 days post embryo transfer. Patients in both groups were divided into subgroups based on their serum progesterone levels due to the fact that the relationship between pregnancy rate and serum progesterone levels was thought to be non-linear. Various statistical analyses were then carried out to establish results for the aims. These included Mantel-Haenszel test for trend analysis and 95% confidence intervals.

The results were logged based on a variety of criteria including patients characteristics. They found the average basal FSH levels of patients to be 7.16 with the majority of patients being in their first IVF cycles. Advanced age and PCOS were two of several causes of infertility found. In the 3 day ET group, an inverse relationship between serum progesterone levels (SPL) and CP's was seen, however, a decrease in CP's was seen when the SPL reached >1.0ng/ml, indicating a detrimental affect on the likelihood of pregnancy when the progesterone reaches a certain threshold and exponentially worsens with increasing levels of progesterone. A similar pattern was seen in the 5 day ET group which showed an inverse relationship between SPL and CP's until SPL's reached >1.75ng/ml

Various factors were shown to be significantly associated with CP's through a multivariate logistic regression analysis. For example, in the 3 day ET group, a negative relationship was seen between CP's and serum progesterone levels where as a positive one was seen between CP's and the transfer of top-quality embryos. A similar trend was seen for the 5 day ET, however, female age was negatively associated with CP. The conclusion of this study showed that administration of progesterone on the day oh hCG administration decreased the rate of clinical pregnancies in both cleavage and blastocyst embryo stages whilst the woman underwent controlled ovarian stimulation.

--Mark Hill (talk) 19:21, 27 August 2015 (AEST) these are good summaries of these 2 papers. (5/5)

Lab 2 Assessment

Uploading Images in 5 Easy Steps  
First Read the help page Images and Copyright Tutorial.
Hint - This exercise is best done by using separate tabs on your browser so that you can keep all the relevant pages easily available. You can also use your own discussion page to copy and paste links, text. PMIDs etc that you will need in this process.
  1. Find an image .
    1. Search PubMed using an appropriate search term. Note that there is a special library of complete (full online) article and review texts called PubMed Central (PMC). Be very careful, while some of these PMC papers allow reuse, not all do and to add the reference link to your image you will still need to use the PMID.
    2. You can also make your own search term. In this link example PMC is searched for images related to "embryo+implantation" http://www.ncbi.nlm.nih.gov/pmc/?term=embryo+implantation&report=imagesdocsum. simply replace "embryo+implantation" with your own search term, but remember not everything in PMC can be reused, you will still need to find the "copyright notice" on the full paper, no notice, no reuse.
    3. Where else can I look? BioMed Central is a separate online database of journals that allow reuse of article content. Also look at the local page Journals that provides additional resources.
    4. You have found an image, go to step 2.
  2. Check the Copyright. I cannot emphasise enough the importance of this second step.
    1. The rule is unless there is an obvious copyright statement that clearly allows reuse (there are several different kinds of copyright, some do not) located in the article or on the article page, move on and find another resource. Not complying with this is a serious academic infringement equivalent to plagiarism."Plagiarism at UNSW is defined as using the words or ideas of others and passing them off as your own." (extract from UNSW statement on Academic Honesty and Plagiarism)
    2. You have found the statement and it allows reuse, go to step 3.
  3. Downloading your image.
    1. Download the image to your own computer. Either use the download image on the page or right click the image.
    2. To find the downloaded image you may have to look in your computer downloads folder, or the default location for downloaded files.
    3. The image file will have its own original name, that you will not be using on the wiki. You can rename it now (see renaming below), but you should also make a note of the original name.
    4. Make sure you have everything ready then for the
    5. You have the image file on your computer, go to step 4.
  4. Uploading your image.
    1. First make sure you have all the information you want to use with the file readily available. There is also a detailed description below.
    2. Towards the bottom of the lefthand menuunder “Toolbox” click Upload file. This will open a new window.
    3. In the top window "Source file", click "Choose file" and then navigate to find the file on the computer. and select the image.
    4. If you have done this correctly the upload window will now have your image file shown in choose file and also in the lower window "File description" in "Destination filename:" DO NOT CLICK UPLOAD FILE YET.
    5. Rename your file in "Destination filename:" this should be a brief filename that describes the image. Not any of the following - the original file name, image, file, my image, your ZID, etc. Many of the common embryology names may have already been used, but you can add a number (01, 02, 03, etc) or the PMID number to the filename to make it unique.
    6. If the filename or image has already been used or exists it will be shown on the upload page. If another student has already uploaded that image you will have to find another file. Duplicated images will not receive a mark, so check before you upload as you cannot delete images.
    7. In the "Summary" window for now just paste the PMID. You will come back and edit this information.
    8. Now click "Upload image" at the bottom of the window, go to step 4.
  5. Edit and Add to your page.
    1. Edit - Open the image with the "Edit" tab at the top of its page. You should see the PMID you had pasted earlier in the new edit window. Add the following information to the summary box.
      1. Image Title as a sub-heading. Under this title add the original figure legend or your own description of the image.
      2. Image Reference sub-sub-heading. Use the PMID link method shown in Lab 1 and you can also have a direct link to the original Journal article.
      3. Image Copyright sub-sub-heading. Add the copyright information under this sub-sub-heading exactly as shown in the original paper.
      4. Student Image template, as shown here {{Template:Student Image}} to show that it is a student uploaded image.
    2. Add - Now add your image to your own page under a subheading for Lab 2 Assessment including a description and a reference link. If still stuck with this last step, look at the example on the Test Student page.
    3. Done!

Students cannot delete images once uploaded. You will need to email me with the full image name and request deletion, that I am happy to do with no penalty if done before I assess.

Non-Table version of this page

Stress Relief....

<html5media height="480" width="640">http://www.youtube.com/watch?v=i9Hwn2DOgKo</html5media>

Embryo development from pro-nuclei stage to blastocyst stage.jpeg

Embryo development from pro-nuclei stage to blastocyst stage[3]

PMID 25510244

--Mark Hill (talk) 19:21, 27 August 2015 (AEST) Image uploaded correctly with all required information. (5/5)

Lab 3 Assessment

Topic: Ovarian Hyper-stimulation Syndrome

Subtopic: Symptoms and Diagnosis

PMID 22416285 [4]

Initially women with OHSS will present with abdominal bloating, as a result of fluid in the peritoneal cavity and an increase in ovary size. Whilst symptoms can occur as soon as 24 hours post hCG administration, they are usually seen in women 7-10 days post administration. When women present with severe OHSS they are often dehydrated, due to increased vascular permeability, and have hemoconcentration. The above results in a decrease in intravascular volume, leading to oligouria.

A key diagnostic tool for clinicians regarding women who are taking gonadotropins is to identify if they are at an increased risk of developing OHSS. Some risk factors include woman aged less than 30, women who have polycystic ovaries, woman with a previous history of OHSS and women who have greater than 20 oocytes retrieved. After a history of the patient is taken, the next step is to perform a physical exam on the woman. Women who present with abdominal bloating will produce a shifting dullness upon abdominal percussion. If the clinician further suspects a women of having OHSS, a ultrasound can be done.The intraperitoneal fluid is best images via vaginal ultrasound due to the enlarged ovaries making it difficult to image the pelvis using transabdominal ultrasound.

Once a women has been diagnosed as having OHSS, they are classified based on a criteria from mild, moderate and severe

PMID 24996451 [5]

This article is good because it goes into OHSS well in the background and it speaks about predictive factors for OHSS and how they affect recovery. This article ties in well with treatment and recovery and touches on the protocol used for Ovarian Hyper-Stimulation.

PMID 23378404 [6]

This article is good because it speaks generlly and specifically about OHSS and ties in well with the complications of the syndrome e.g. thromboembolism, which can also be used as a diagnostic factor depending on when the women present to a health care professional.

--Mark Hill (talk) 19:21, 27 August 2015 (AEST) These are relevant to Ovarian Hyper-stimulation Syndrome. Would have been good to have a one line description of the papers here and on project page. (5/5)

References

PMID 26244658 [7]

  1. <pubmed>26241855</pubmed>
  2. <pubmed>26238449</pubmed>
  3. <pubmed>25510244</pubmed>| ReproductiveTechnologyandEndocrinology
  4. <pubmed>22416285</pubmed>
  5. <pubmed>24996451</pubmed>
  6. <pubmed>23378404</pubmed>
  7. <pubmed>26244658</pubmed>


Please do not use your real name on this website, use only your student number.

2015 Course: Week 2 Lecture 1 Lecture 2 Lab 1 | Week 3 Lecture 3 Lecture 4 Lab 2 | Week 4 Lecture 5 Lecture 6 Lab 3 | Week 5 Lecture 7 Lecture 8 Lab 4 | Week 6 Lecture 9 Lecture 10 Lab 5 | Week 7 Lecture 11 Lecture 12 Lab 6 | Week 8 Lecture 13 Lecture 14 Lab 7 | Week 9 Lecture 15 Lecture 16 Lab 8 | Week 10 Lecture 17 Lecture 18 Lab 9 | Week 11 Lecture 19 Lecture 20 Lab 10 | Week 12 Lecture 21 Lecture 22 Lab 11 | Week 13 Lecture 23 Lecture 24 Lab 12 | 2015 Projects: Three Person Embryos | Ovarian Hyper-stimulation Syndrome | Polycystic Ovarian Syndrome | Male Infertility | Oncofertility | Preimplantation Genetic Diagnosis | Students | Student Designed Quiz Questions | Moodle page

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