User:Z3462124

ANAT2341 Course Work

--Mark Hill (talk) 20:29, 6 August 2015 (AEST) Thanks for setting up your page. We will be talking more about this in the Practical on Friday.

Lab attendance

--Z3462124 (talk) 13:46, 7 August 2015 (AEST)

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

Glossary Links

Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link

Test Student 2015

Lab 1

Assessment 1: Find two recent research references on fertilisation or in vitro fertilisation and write a summary of the research article method and findings.

PMID 11396377 Clinical Pregnancy Rates in an IVF Program. Use of the flare-up protocol after failure with long regimens of GnRH-a.

The aim of this study was to examine the effectiveness of flare-up protocols in patients who had no response to a long term protocol using GnRH-a. This was measured by the average number of oocytes obtained, successfully fertilised and implanted and the pregnancy rate and birth rate per cycle.

Method:

Restrospective study

Total number of patients: 144

Group 1: 111 patients; all of which had not responded to ovulation induction with long-term down-regulation with GnRH-a (also known as the long protocol)

Group 2: 33 patients; all of which had responded to ovulation induction with at least four follicles, but failed to conceive after embryo transfer.

Average age of patients: 37.3 +/- 3.9 years (range, 28-43) and 36.5 +/- 3.7 (range, 24-44) respectively.

Within six months of failing with a long-term protocol, all patients underwent a fare-up protocol using GnRH-a on day two and received at least six ampules of gonadotropins on day three. Fewer than three developing follicles on day 7, with an estradiol level < 200 pg/mL was defined as unresponsive. Patients with FSH levels >15IU/mL on day two, before GnRH-a initiation were excluded from the flare-up protocol.

Average day 2 FSH levels: 9.1 +/- 3.0 in group I and 7.1 +/- 2.0 in group II.

Results:

Group 1: Of the 111 patients in group 1, 36.9% were unresponsive even after an increase in the dose of gonadotropins. In the remaining 60.4%, an average of 7.2 +/- 2.3 oocytes were obtained. Embryo transfer was performed on 64 patients and an average of 3.2+/- 0.6 embryos were transferred and fertilised. Fertilisation did not occur in the 3 remaining patients. Within the 64 patients with successful embryo transfer, 11 patients conceived, 8 patients miscarried and 3 gave birth. Therefore, Group 1 had a pregnancy rate per cycle of 9.9% and a birth rate of 2.5%.

Group 2: In 28 patients, the average number of oocytes obtained was 6.9+/- 3.9. Embryo transfer was performed on these 28 patients, and the average number of embryos transferred was 2.7+/- 1.0. Within this group of 28 patients with successful fertilisation, 6 patients conceived and 6 patients miscarried. Therefore, Group 2 had a pregnancy rate per cycle of 18.1% with no live births.

From these results, the researchers found that although the pregnancy rate per cycle increased slightly after the flare-up protocol was initiated, the live birth rate does not improve among poor responders.

PMID 26264981 Aging-related premature luteinization of granulosa cells is avoided by early oocyte retrieval.

This study compared the grnaulosa cell function across three different age groups; young oocyte donors (21-29 y.o.a) middle aged oocyte donors (30-37 y.o.a) and older infertile patients (43-47 y.o.a).

Methods:

Total Number of Patients: 136

Group 1: ages 21-29; 31 patients

Group 2: ages 30-37; 64 patients

Group 3: ages 43-47; 41 patients

All subjects underwent controlled hyperstimulation and oocyte maturation, followed by a transvaginal ultrasound-guided oocyte retrieval. Oocyte donors were stimulated in a long gonadotropin releasing hormone agonist cycle and infertile patients were stimulated in microdose agonist cycles. Oocytes collected at retrievals were cultured and those classified as mature (presence on 1 polar body) were fertilised and further cultured in Blastocyst medium for three days. Real time PCR and western blot in the granulosa cells collected from follicular fluid were used to analyse the relationship between gene expression and gonadotropin activity, steriodogenesis, apoptosis and luteinization.

Results:

It was demonstrated by a down regulation of FSH receptor (FSHR), aromatase (CYP19A1) and 17β-hydroxysteroid dehydrogenase (HSD17B) expression and an up regulation of LH receptor (LHCGR), P450scc (CYP11A1) and progesterone receptor (PGR) with increasing age of patients that age related functional decline in granulosa cells were consistent with premature luteinization. Patients who received earlier retrieval to avoid premature luteinization demonstrated a marginal increase in oocyte prematurity, however, exhibited improved embryo numbers and quality as well as satisfactory clinical pregnancy rates.

From these results, the researches concluded that earlier retrieval of oocytes can be utilised to avoid premature follicular luteinzation, which is a key contributor to the rapidly declining successful IVF results in women over 43.

References

PMID 26244658

look at this

Here's the list

2. PMID 11396377 <pubmed>11396377</pubmed></ref>

3. PMID 26264981 <pubmed>26264981</pubmed></ref>