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Lab Assessment 1

Article 1

PMID 25197669

Summary

Poor response to controlled ovarian hyperstimulation (COH) is still a major problem in IVF. Many protocols have been tested yet the results have always shown a poor outcome. Poor ovarian responders (PORs) exhibit reduced levels of oocyte quantity and may also exhibit a compromised oocyte quality as there is a high risk of failing to implant.

This article proposes a novel treatment in the form of a luteinizing hormone (LH) pretreatment with the aim of using its ability as an androgen modulating agent to increase androgen accumulation in pre-antral and small antral follicles.

The study consisted of two sections. The first section included a randomised controlled trial with 43 young women who had a poor response to ovarian stimulation in at least two previous cycles. These patients were randomly allocated to 2 groups. Group A was the control group which received FSH stimulation while Group B received pretreatment with LH followed by the administration of FSH to fulfill the agonist downregulation protocol. The second section of the study entailed a treatment of 65 patients with the new protocol and then a comparison of these results to those from previous cycles.

The study's results indicated that LH pretreatment was successfully able to reduce cancellations in both the RCT and historical control study groups. The new protocol was also seen to have improved the oocyte's performance in vitro and also increased the live birth rate.

[1]

Article 2

PMID 24760136

Summary

Given that there are now more than 5 million children worldwide that have been born through assisted reproductive technologies, there is growing concern over emerging evidence that IVF children have increased risk of developing metabolic and cardiovascular diseases later in life.

The study investigates the effects of different dietary conditions and the process of IVF on the glucose metabolism of young adults humans and in adult male C57BL/6J mice conceived by IVF versus their naturally conceived (NC) counterparts. 14 IVF young adult patients and 20 control subjects were fed an energy balanced diet (30% fat) for 3 days. After baseline metabolic tests had taken place, they were subjected to 3 days of overfeeding (45% fat). Concurrently, a study with C57BL/6J mice examined the effects of IVF and and natural conception in adult male offspring on significant metabolic factors. To divide the effects of ovarian stimulation (OS) and embryo culture, the study also examined mice that were conceived after OS alone.

The results showed that peripheral insulin sensitivity was lower in IVF patients than in NC patients after the energy balanced diet and that that the systolic pressure was higher in IVF patients than in NC patients. The parallel study on the C57BL/6J mice indicated that both mice conceived after 0S alone and IVF mice had weights that were significantly less than their controls at birth. Metabolic tests shows that only mice conceived with IVF displayed higher fasting glucose levels, impaired glucose tolerance and a reduction in Akt phosphorlation in the liver following insulin stimulation after an 8 week chow or high fat diet (60% fat).

These findings suggest that humans conceived by IVF have higher insulin resistance and are more metabolically susceptible to high fat overfeeding. Data from mice suggest that it is the process of embryo culture rather than OS that leads to an impairment in glucose metabolism. Thus, these findings suggest that IVF conceived offspring may present with an increased risk of developing metabolic and cardiovascular diseases in later stages of life.


[2]


Lab Assessment 2

Ovary1.gif

Human Ovary [3]

PMID 26250560


Lab Assessment 3

Impact of physical activity on ovarian reserve markers in normal, overweight and obese reproductive age women

<pubmed>25509968</pubmed> This study focuses on the effect of physical activity on fertility in three groups of women at reproductive age; normal, overweight and obese. The results from the study suggest that there was a marked improvement in fertility as shown by the ovarian reserve markers for all 3 groups, however it was most significant in the overweight and obese groups. This study is relevant to our project as it gives an insight into the preventative measures that can be taken for infertility.

Risk factors of polycystic ovarian syndrome among Li People

<pubmed>26276294</pubmed> This study examined the risk factors entailed in Polycystic Ovarian Syndrdome (PCOS) amoung Li people. Using the method of a case control study, questionnaires were given to female Li people with and without PCOS. Analysis of the questionnaires showed that family history of diabetes, family history of infertility, bad mood, lack of physical exercise are all high risk factors of PCOS. As a result, management of these risk factors can be taken into consideration when preventing infertility through PCOS.

Vitamin D and female fertility

<pubmed>24717915</pubmed> This article is a review focusing on research regarding Vitamin D and fertility over the past year. The review found that the levels of Vitamin D is crucial for women undergoing in-vitro fertilisation. It was also found that Vitamin D was beneficial for women with PCOS and carried a protective effect against endometriosis. These observations suggest that having sufficient Vitamin D in your body can be preventative for problems associated with fertility.

Lab Assessment 4

Mesoderm Development

1 Which of the following components is responsible for somatogenesis:

Intermediate Mesoderm
Extraembryonic Mesoderm
Paraxial Mesoderm
Lateral Plate Mesoderm

2 Which of the following statements regarding somites is incorrect:

Somites occur in a rostrocaudal direction on either side of the notochord
Compartmentalisation of the somites is mediated by the pattern of expression of the Pax gene
The first pair of somites can be seen in day 20
Somite initially forms the sclerotome and myotome
The paraxial mesoderm only segments into somites at the level of the body

3 Which of the following statements regarding lateral plate mesoderm is most correct:

The somatic mesoderm is closest to the endoderm
The intraembryonic coelom divides the lateral plate into 2 parts in day 18-19 of development
The splanchnic mesoderm gives rise to the connective tissue of body wall
The lateral plate mesoderm contributes to somatogenesis
The somatic mesoderm differentiates into the smooth muscles of the GIT


Lab Assessment 5

What is the difference between gastroschisis and omphalocele?

Gastroschisis is characterized by a defect in the anterior abdominal wall of infants and occurs in approximately 1 in every 12 000 live births. Being one of the two most common anterior abdominal wall malformations, it involves the protrusion of the small intestine outside of the body without the protection of a membranous sac. It can also involve the stomach and the colon. The defect in the abdominal wall is usually 3-4 cm and in almost all cases is located to the right of the umbilicus.

While the intestines are outside the peritoneal cavity, the amniotic fluid in which they are suspended in causes irritation on the intestine wall and local inflammation of tissues surrounding the viscera, known as perivisceritis. Other complications involve poor peristalsis of the intestine and a large imbalance in nutrient absorption.


Omphalocele is the other most common anterior abdominal wall defect and occurs in approximately one in every 4000 live births. Unlike Gastroschisis, the defect is more central and occurs between the abdominal muscle and the edges of the rectus. The abdominal contents that lie outside of the body include small intestine, liver and other organs.Initially they are covered by a thin transparent membrane which becomes more opaque as it comes into contact with air.


References

  1. <pubmed>25197669</pubmed>
  2. <pubmed>24760136</pubmed>
  3. <pubmed>26250560</pubmed>


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