The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone（Gn RH） agonist in Gn RH agonist long protocol for in vitro fertilization（IVF）/intracytoplasmic sperm injectio...The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone（Gn RH） agonist in Gn RH agonist long protocol for in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with Gn RH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group（41.2% vs. 43.7%）. The mean luteinizing hormone（LH） level on follicle-stimulating hormone（FSH） starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin（h CG） administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group（12.90±5.82 vs. 13.52±6.97）. There was no significant difference in clinical pregnancy rate between the two groups（50.5% vs. 54.5%）. It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.展开更多
2021年由德国达姆施塔特默克公司组织并发布了关于卵泡发育、垂体抑制、触发排卵和黄体支持的全球性专家共识(德尔菲共识),旨在对2019年欧洲人类生殖和胚胎学学会(European Society for Human Reproduction and Embryology,ESHRE)发布...2021年由德国达姆施塔特默克公司组织并发布了关于卵泡发育、垂体抑制、触发排卵和黄体支持的全球性专家共识(德尔菲共识),旨在对2019年欧洲人类生殖和胚胎学学会(European Society for Human Reproduction and Embryology,ESHRE)发布的关于《体外受精/卵胞浆内单精子注射卵巢刺激的指南》进行补充。与ESHRE指南相比,此共识纳入更多类型研究证据及专家经验,最终专家组在卵泡发育、垂体抑制和触发排卵方面取得了良好的共识,但是对黄体支持仍然有争议。本文拟通过对该共识的解读,为辅助生殖技术(assisted reproductive technology,ART)的优化提供参考。展开更多
We report a case of pituitary-dependent hyperadrenocorticism in a 10-year-old,female,terrier dog.The animal was admitted due to polyphagia,weight gain,polyuria,polydipsia,hair loss,exercise intolerance and panting at ...We report a case of pituitary-dependent hyperadrenocorticism in a 10-year-old,female,terrier dog.The animal was admitted due to polyphagia,weight gain,polyuria,polydipsia,hair loss,exercise intolerance and panting at rest.On physical examination,abdominal distention,truncal and bilaterally symmetric alopecia,thin hypotonic skin,comedones,bruising,hyperpigmentation and calcinosis cutis on the dorsal midline were observed.Hematologic investigations showed stress leukogram,high serum alkaline phosphatase activity,mild to moderate alanine aminotransferase activity,hypercholesterolemia,hypertriglyceridemia and hyperglycemia.Mild generalized interstitial lung patterns and hepatomegaly were detected in the radiographs.Bilaterally symmetric normal-sized adrenal glands were also diagnosed in ultrasonography.Diagnosis of pituitary-dependent hyperadrenocorticism was confirmed with low-dose dexamethasone suppression test.The dog was successfully treated with mitotane.展开更多
Long-term gonadotropin-releasing hormone agonist（Gn RHa） administration before in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） in infertile women with endometriosis or adenomyosis significantl...Long-term gonadotropin-releasing hormone agonist（Gn RHa） administration before in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term Gn RHa treatment might also be beneficial for the idiopathic repeated implantation failure（RIF） patients. In the 21 patients receiving Gn RHa and hormone replacement therapy（G-HRT） protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone（previous protocols）. Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior Gn RHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients.展开更多
目的通过全面的症状体征、生化、影像及动态试验分析,探讨垂体促甲状腺激素瘤(TSH瘤)和甲状腺激素抵抗综合征(RTH)的诊断和鉴别诊断。方法回顾性分析2016年7月至2022年9月于郑州大学第一附属医院就诊的14例血清学表现为游离三碘甲状腺...目的通过全面的症状体征、生化、影像及动态试验分析,探讨垂体促甲状腺激素瘤(TSH瘤)和甲状腺激素抵抗综合征(RTH)的诊断和鉴别诊断。方法回顾性分析2016年7月至2022年9月于郑州大学第一附属医院就诊的14例血清学表现为游离三碘甲状腺原氨酸和(或)游离甲状腺素水平升高而促甲状腺激素浓度不低于正常值患者的临床资料。结果TSH瘤7例、RTH 7例,平均确诊年龄分别为40.0岁和26.6岁。13例患者因甲状腺毒症或偶发心慌症状就诊,部分伴垂体占位效应或生长发育异常;1例患者因颈部增粗就诊。3例TSH瘤患者的血清性激素结合球蛋白升高。垂体磁共振成像显示,7例TSH瘤患者均为大腺瘤、1例RTH患者存在微腺瘤。13例患者行奥曲肽抑制试验均被抑制,但TSH瘤和RTH 24 h/2 h TSH抑制率存在明显差异,分别为46.6%~83.9%和4.6%~28.8%。6例RTH患者存在甲状腺激素受体β亚基突变。结论促甲状腺激素不适当分泌综合征临床较为罕见,主要包括TSH瘤和RTH,两者诊断及鉴别需结合家族史、症状体征、检查检验、动态试验及基因检测等综合研判,其中奥曲肽抑制试验24 h/2 h TSH抑制率可有效鉴别TSH瘤与RTH。展开更多
目的总结甲状腺激素抵抗综合征(syndrome of resistance to thyroid hormone,RTH)和垂体促甲状腺激素瘤(thyrotropin-secreting pituitary adenoma,TSH瘤)的病例特点,分析奥曲肽抑制试验和大剂量地塞米松抑制试验对鉴别二者的临床应用价...目的总结甲状腺激素抵抗综合征(syndrome of resistance to thyroid hormone,RTH)和垂体促甲状腺激素瘤(thyrotropin-secreting pituitary adenoma,TSH瘤)的病例特点,分析奥曲肽抑制试验和大剂量地塞米松抑制试验对鉴别二者的临床应用价值,以此提高这两种疾病的诊疗水平。方法纳入2010年10月至2021年12月于湘雅医院住院期间临床诊断为RTH和TSH瘤患者22例,分析总结两种疾病各自的临床特点以及分别对不同试验的反应性。结果(1)TSH瘤患者的瘤体相较于RTH并发垂体瘤患者更大,在影像学上多表现为视交叉受压(P<0.05)。(2)在奥曲肽抑制试验中,RTH患者促甲状腺激素(TSH)抑制率比TSH瘤患者更低(P<0.05);在大剂量地塞米松抑制试验中,RTH患者TSH抑制率比TSH瘤患者更高(P<0.05)。(3)采用受试者工作特征(ROC)曲线计算TSH抑制率,结果显示奥曲肽抑制试验的灵敏度为91.9%,特异度为55.6%,此时TSH抑制率临界值为64.24%;大剂量地塞米松抑制试验的灵敏度为54.4%,特异度为89.0%,此时TSH抑制率临界值为65.73%。两种试验联合的灵敏度为77.8%,特异度为90.9%,具有更好的诊断价值(P<0.05)。结论联合奥曲肽抑制试验和大剂量地塞米松抑制试验对鉴别RTH与TSH瘤有一定的临床价值。TSH瘤比RTH并发垂体瘤更具占位效应和侵袭性。展开更多
基金supported by grants from Milstein Medical Asian American Partnership Foundation Fellowship Award in Reproductive Medicine,National Natural Science Foundation of China(No.81170574 and No.81401177)Guangdong Province Natural Science Foundation of China(No.2015A030313286)Nanfang Hospital High-level Project Matching Funds in 2012(No.G201206)and 2014(No.G2014005)
文摘The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone（Gn RH） agonist in Gn RH agonist long protocol for in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with Gn RH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group（41.2% vs. 43.7%）. The mean luteinizing hormone（LH） level on follicle-stimulating hormone（FSH） starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin（h CG） administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group（12.90±5.82 vs. 13.52±6.97）. There was no significant difference in clinical pregnancy rate between the two groups（50.5% vs. 54.5%）. It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.
文摘2021年由德国达姆施塔特默克公司组织并发布了关于卵泡发育、垂体抑制、触发排卵和黄体支持的全球性专家共识(德尔菲共识),旨在对2019年欧洲人类生殖和胚胎学学会(European Society for Human Reproduction and Embryology,ESHRE)发布的关于《体外受精/卵胞浆内单精子注射卵巢刺激的指南》进行补充。与ESHRE指南相比,此共识纳入更多类型研究证据及专家经验,最终专家组在卵泡发育、垂体抑制和触发排卵方面取得了良好的共识,但是对黄体支持仍然有争议。本文拟通过对该共识的解读,为辅助生殖技术(assisted reproductive technology,ART)的优化提供参考。
基金Support by Shahid Bahonar University of Kerman,Research Council,Kerman,Iran(Grant No.92-GR-VS-02).
文摘We report a case of pituitary-dependent hyperadrenocorticism in a 10-year-old,female,terrier dog.The animal was admitted due to polyphagia,weight gain,polyuria,polydipsia,hair loss,exercise intolerance and panting at rest.On physical examination,abdominal distention,truncal and bilaterally symmetric alopecia,thin hypotonic skin,comedones,bruising,hyperpigmentation and calcinosis cutis on the dorsal midline were observed.Hematologic investigations showed stress leukogram,high serum alkaline phosphatase activity,mild to moderate alanine aminotransferase activity,hypercholesterolemia,hypertriglyceridemia and hyperglycemia.Mild generalized interstitial lung patterns and hepatomegaly were detected in the radiographs.Bilaterally symmetric normal-sized adrenal glands were also diagnosed in ultrasonography.Diagnosis of pituitary-dependent hyperadrenocorticism was confirmed with low-dose dexamethasone suppression test.The dog was successfully treated with mitotane.
基金supported by grants from the National Natural Science Foundation of China(No.81100401 and No.81470063)Guangdong Natural Science Foundation of China(No.2014A030313129)the Doctoral Fund of the Ministry of Education of China(No.20110171120096)
文摘Long-term gonadotropin-releasing hormone agonist（Gn RHa） administration before in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term Gn RHa treatment might also be beneficial for the idiopathic repeated implantation failure（RIF） patients. In the 21 patients receiving Gn RHa and hormone replacement therapy（G-HRT） protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone（previous protocols）. Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior Gn RHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients.
文摘目的通过全面的症状体征、生化、影像及动态试验分析,探讨垂体促甲状腺激素瘤(TSH瘤)和甲状腺激素抵抗综合征(RTH)的诊断和鉴别诊断。方法回顾性分析2016年7月至2022年9月于郑州大学第一附属医院就诊的14例血清学表现为游离三碘甲状腺原氨酸和(或)游离甲状腺素水平升高而促甲状腺激素浓度不低于正常值患者的临床资料。结果TSH瘤7例、RTH 7例,平均确诊年龄分别为40.0岁和26.6岁。13例患者因甲状腺毒症或偶发心慌症状就诊,部分伴垂体占位效应或生长发育异常;1例患者因颈部增粗就诊。3例TSH瘤患者的血清性激素结合球蛋白升高。垂体磁共振成像显示,7例TSH瘤患者均为大腺瘤、1例RTH患者存在微腺瘤。13例患者行奥曲肽抑制试验均被抑制,但TSH瘤和RTH 24 h/2 h TSH抑制率存在明显差异,分别为46.6%~83.9%和4.6%~28.8%。6例RTH患者存在甲状腺激素受体β亚基突变。结论促甲状腺激素不适当分泌综合征临床较为罕见,主要包括TSH瘤和RTH,两者诊断及鉴别需结合家族史、症状体征、检查检验、动态试验及基因检测等综合研判,其中奥曲肽抑制试验24 h/2 h TSH抑制率可有效鉴别TSH瘤与RTH。
文摘目的总结甲状腺激素抵抗综合征(syndrome of resistance to thyroid hormone,RTH)和垂体促甲状腺激素瘤(thyrotropin-secreting pituitary adenoma,TSH瘤)的病例特点,分析奥曲肽抑制试验和大剂量地塞米松抑制试验对鉴别二者的临床应用价值,以此提高这两种疾病的诊疗水平。方法纳入2010年10月至2021年12月于湘雅医院住院期间临床诊断为RTH和TSH瘤患者22例,分析总结两种疾病各自的临床特点以及分别对不同试验的反应性。结果(1)TSH瘤患者的瘤体相较于RTH并发垂体瘤患者更大,在影像学上多表现为视交叉受压(P<0.05)。(2)在奥曲肽抑制试验中,RTH患者促甲状腺激素(TSH)抑制率比TSH瘤患者更低(P<0.05);在大剂量地塞米松抑制试验中,RTH患者TSH抑制率比TSH瘤患者更高(P<0.05)。(3)采用受试者工作特征(ROC)曲线计算TSH抑制率,结果显示奥曲肽抑制试验的灵敏度为91.9%,特异度为55.6%,此时TSH抑制率临界值为64.24%;大剂量地塞米松抑制试验的灵敏度为54.4%,特异度为89.0%,此时TSH抑制率临界值为65.73%。两种试验联合的灵敏度为77.8%,特异度为90.9%,具有更好的诊断价值(P<0.05)。结论联合奥曲肽抑制试验和大剂量地塞米松抑制试验对鉴别RTH与TSH瘤有一定的临床价值。TSH瘤比RTH并发垂体瘤更具占位效应和侵袭性。
