PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 2806623

Ovarian cysts decrease the success of controlled ovarian stimulation and in vitro fertilization.

S S Thatcher·E Jones·A H DeCherney
View original source ↗Export metadata ↓

Abstract

Forty cystic structures, 16 to 60 mm, of probable ovarian origin were found in 126 cycles during an ultrasound scan on day 3 of a cycle in which in vitro fertilization was planned. The response of these patients to exogenous gonadotropin stimulation, oocyte capture, fertilization, cleavage, and pregnancy was studied. Patients with cystic change had significantly lower peak estradiol (E2) levels. Pregnancy rates were lower, but not significantly so. Those patients with structures 16 to 29 mm had more cycles canceled due to precipitous drops in E2, consistent with an untimely surge of luteinizing hormone. Patients with structures 30 to 60 mm had increased numbers of cycles with poor response to stimulation. The importance of an early follicular phase ultrasound scan is stressed, and the management of ovarian cysts in this patient population is discussed.

Explore related subjects

EstradiolFemaleFertilization in VitroHumansMenstrual CycleOvarian CystsOvaryPregnancyTime FactorsJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

S S Thatcher, E Jones, A H DeCherney. 1989. Ovarian cysts decrease the success of controlled ovarian stimulation and in vitro fertilization.. https://doi.org/10.1016/s0015-0282(16)61036-1

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1992

Paradoxical ovarian stimulations in the use of LHRH analogs.

In the case of in vitro fertilization, LHRH analogs are used to induce an hypophysary blockage, before the phase of stimulation, via administration of exogenous gonadotropin. During in vitro fertilization attempts using LHRH analogs, the blockage is controlled after 14 days of treatment through measurement of the plasmatic estradiol and pelvic ultra-sonography. In this retrospective study, which concerned 1075 in vitro fertilization cycles, a paradoxical ovarian stimulation with LHRH analogs was observed in 93 cases (8.7%), with high estradiol levels and follicular growth (detected by ultra-sonography), in spite of low FSH and LH levels. In 4 cases, a follicular puncture was performed, which allowed to collect oocytes from which embryos were obtained, thus confirming the observed follicular growth and maturation. The most probable hypothesis explaining this phenomenon seems to be a direct ovarian stimulation, effectuated in vivo by LHRH analogs. This stimulation is only observed in certain patients, and apparently more frequently, with certain LHRH analogs, probably through a variation in the expression of ovarian LHRH receptors.

Estradiol↗
PubMed1992

Identification of a negative regulatory function for steroid receptors.

This report describes the identification of a negative regulator of estrogen and progesterone receptor function. Using a reconstituted estrogen-responsive transcription system in Saccharomyces cerevisiae, we have identified a "repressor function," which when mutated, increases the transcriptional activity of the estrogen and progesterone receptors. In the case of the estrogen receptor this mutation increases the sensitivity of estrogen-mediated activation by at least four orders of magnitude. Analysis of derivatives of the estrogen receptor indicated that this repressor specifically affects the transcription activity of the TAF1 activation domain of the estrogen receptor. The repressor was cloned by complementation and identified as SSN6, a previously described mediator of glucose repression in yeast. Our results indicate that SSN6 is likely to be involved also in the repression of other cellular activators. Interestingly, deletion of the SSN6 protein allows the antiestrogens ICI 164384 and nafoxidine to behave as more potent agonists of estrogen receptor function, while RU486 also becomes a more potent activator of progesterone receptor function. These data suggest that in wild-type cells the role of hormone is twofold: it promotes DNA binding of the receptor and it also induces a conformational change in the receptor which overcomes the effects of this repressor function.

Estradiol↗