Different gonadotropin releasing hormone agonist doses for the final oocyte maturation in high-responder patients undergoing in vitro fertilization/intra-cytoplasmic sperm injection.

CONTEXT: Efficacy of gonadotropin releasing hormone agonists (GnRH-a) for ovulation in high-responders. AIMS: The aim of the current study is to compare the impact of different GnRH-a doses for the final oocyte maturation on cycle outcomes and ovarian hyperstimulation syndrome (OHSS) rates in high-responder patients undergoing ovarian stimulation. SETTINGS AND DESIGNS: Electronic medical records of a private in vitro fertilization center, a retrospective analysis. SUBJECTS AND METHODS: A total of 77 high-responder cases were detected receiving GnRH-a. Group I consisted of 38 patients who received 1 mg of agonist and Group II consisted of 39 patients who received 2 mg of agonist. STATISTICAL ANALYSIS: In order to compare groups, Student's t-test, Mann-Whitney U-test, Pearson's Chi-square test or Fisher's exact test were used where appropriate. A P < 0.05 was considered as statistically significant. RESULTS: Number of retrieved oocytes (17.5 vs. 15.0, P = 0.510), implantation rates (46% vs. 55.1%, P = 0.419) and clinical pregnancy rates (42.1% vs. 38.5%, P = 0.744) were similar among groups. There were no mild or severe OHSS cases detected in Group I. Only 1 mild OHSS case was detected in Group II. CONCLUSION: A volume of 1 or 2 mg leuprolide acetate yields similar outcomes when used for the final oocyte maturation in high-responder patients.

Increased monocyte chemoattractant protein-1 levels indicating early vascular damage in lean young PCOS patients.

Serum levels of monocyte chemoattractant protein-1 and C-reactive protein levels, as early signs of vascular damage and cardiovascular disease, were increased in young, lean patients with polycystic ovary syndrome. Serum monocyte chemoattractant protein-1 levels were positively correlated with serum LH, T, and C-reactive protein levels.

Vaginal vault leiomyoma: 25 years after total abdominal hysterectomy.

Leiomyomas are benign, mesenchymal, monoclonal tumors that typically originate from myometrium smooth-muscle cells, although atypical sites such as the vagina, lungs, vascular structures, and retroperitoneal area have been reported. We present the case of a leiomyoma that originated from the vaginal cuff in a 70-year-old woman, 25 years after total abdominal hysterectomy and bilateral salphingo-oophorectomy.