Follicular and endocrine dose responses according to anti-Müllerian hormone levels in IVF patients treated with a novel human recombinant FSH (FE 999049)

Objective: To study the association between serum anti-Mullerian hormone (AMH) levels and follicular development and endocrine responses induced by increasing doses (5.2-12.1 mu g/day) of a novel recombinant human FSH (rhFSH, FE 999049) in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a GnRH antagonist protocol. Design: Secondary analysis of a randomized controlled trial with stratified randomization according to AMH (lower stratum: 5.0-14.9 pmol/l; higher stratum: 15.0-44.9 pmol/l). Patients: Infertile women of good prognosis (n = 265). Measurements: Follicular development and endocrine parameters during controlled ovarian stimulation (COS) with rhFSH. Results: Serum FSH levels increased with increasing rhFSH doses and steady-state levels for each dose were similar in both AMH strata. In the whole study population, significant (P = 12 mm, and serum levels of oestradiol, inhibin B, inhibin A and progesterone at end of stimulation. In comparison with the higher AMH stratum, patients in the lower AMH stratum had significantly different slopes of the dose-response curves for these hormones, and no clear dose-related increase was observed for the number of follicles in these patients. Conclusions: Dose-response relationships between rhFSH and follicular development and endocrine parameters are significantly different for IVF/ICSI patients with lower and higher serum AMH levels at start of COS

A review of fire effects across South American ecosystems: The role of climate and time since fire

Fire is an important driver of ecosystem dynamics worldwide. However, knowledge on broad-scale patterns of ecosystem and organism responses to fires is still scarce. Through a systematic quantitative review of available studies across South America, we assessed fire effects on biodiversity and abundance of different organisms (i.e., plants, fungi, invertebrates, and vertebrates), plant fitness, and soil properties under four climate types, and time since the last fire (i.e., early and late post fire). We addressed: (1) What fire effects have been studied across South America? (2) What are the overall responses of biodiversity, abundance, fitness, and soil properties to fires? (3) How do climate and time since fire modulate those responses? Results: We analyzed 160 articles reporting 1465 fire responses on paired burned and unburned conditions. We found no effect of fire on biodiversity or on invertebrate abundance, a negative effect on woody plant species and vertebrate abundance, and an increase in shrub fitness. Soil in burned areas had higher bulk density and pH, and lower organic matter and nitrogen. Fire effect was significantly more positive at early than at late post fire for plant fitness and for soil phosphorus and available nitrogen. Stronger negative effects in semiarid climate compared to humid warm climate suggest that higher temperatures and water availability allow a faster ecosystem recovery after fire. Conclusions: Our review highlights the complexity of the climate?fire?vegetation feedback when assessing the response of soil properties and different organisms at various levels. The resilience observed in biodiversity may be expected considering the large number of fire-prone ecosystems in South America. The recovery of invertebrate abundance, the reduction of the vertebrate abundance, and the loss of nitrogen and organic matter coincide with the responses found in global reviews at early post-fire times. The strength of these responses was further influenced by climate type and post-fire time. Our synthesis provides the first broad-scale diagnosis of fire effects in South America, helping to visualize strengths, weaknesses, and gaps in fire research. It also brings much needed information for developing adequate land management in a continent where fire plays a prominent socio-ecological role.Fil: Giorgis, Melisa Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Zeballos, Sebastián Rodolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Carbone, Lucas Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Zimmermann, Heike. Leuphana Universität Lüneburg; AlemaniaFil: von Wehrden, Henrik. Leuphana Universität Lüneburg; AlemaniaFil: Aguilar, Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Ferreras, Ana Elisa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Tecco, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Kowaljow, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Barri, Fernando Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Diversidad y Ecología Animal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto de Diversidad y Ecología Animal; ArgentinaFil: Gurvich, Diego Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Villagra, Pablo Eugeni. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Jaureguiberry, Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentin

Recommendations for fertility preservation in patients with lymphoma, leukemia, and breast cancer

Fertility issues should be addressed to all patients in reproductive age before cancer treatment. In men, cryopreservation of sperm should be offered to all cancer patients in reproductive age regardless of the risk of gonadal failure. In women, the recommendation of fertility preservation should be individualized based on multiple factors such as the urgency of treatment, the age of the patient, the marital status, the regimen and dosage of cancer treatment

Individualized versus conventional ovarian stimulation for in vitro fertilization: a multicenter, randomized, controlled, assessor-blinded, phase 3 noninferiority trial

Objective To compare the efficacy and safety of follitropin delta, a new human recombinant FSH with individualized dosing based on serum antimüllerian hormone (AMH) and body weight, with conventional follitropin alfa dosing for ovarian stimulation in women undergoing IVF. Design Randomized, multicenter, assessor-blinded, noninferiority trial (ESTHER-1). Setting Reproductive medicine clinics. Patient(s) A total of 1,329 women (aged 18â40 years). Intervention(s) Follitropin delta (AMH <15 pmol/L: 12 μg/d; AMH â¥15 pmol/L: 0.10â0.19 μg/kg/d; maximum 12 μg/d), or follitropin alfa (150 IU/d for 5 days, potential subsequent dose adjustments; maximum 450 IU/d). Main Outcomes Measure(s) Ongoing pregnancy and ongoing implantation rates; noninferiority margins â8.0%. Result(s) Ongoing pregnancy (30.7% vs. 31.6%; difference â0.9% [95% confidence interval (CI) â5.9% to 4.1%]), ongoing implantation (35.2% vs. 35.8%; â0.6% [95% CI â6.1% to 4.8%]), and live birth (29.8% vs. 30.7%; â0.9% [95% CI â5.8% to 4.0%]) rates were similar for individualized follitropin delta and conventional follitropin alfa. Individualized follitropin delta resulted in more women with target response (8â14 oocytes) (43.3% vs. 38.4%), fewer poor responses (fewer than four oocytes in patients with AMH <15 pmol/L) (11.8% vs. 17.9%), fewer excessive responses (â¥15 or â¥20 oocytes in patients with AMH â¥15 pmol/L) (27.9% vs. 35.1% and 10.1% vs. 15.6%, respectively), and fewer measures taken to prevent ovarian hyperstimulation syndrome (2.3% vs. 4.5%), despite similar oocyte yield (10.0 ± 5.6 vs. 10.4 ± 6.5) and similar blastocyst numbers (3.3 ± 2.8 vs. 3.5 ± 3.2), and less gonadotropin use (90.0 ± 25.3 vs. 103.7 ± 33.6 μg). Conclusion(s) Optimizing ovarian response in IVF by individualized dosing according to pretreatment patient characteristics results in similar efficacy and improved safety compared with conventional ovarian stimulation. Clinical Trial Registration Number NCT01956110

Conmemorando el Premio Nobel 2010 de Medicina. Transferencia selectiva de un embrión como prevención del embarazo múltiple

The development of Assisted Reproduction Techniques represents an important advance in the treatment of human infertility. However, their great effectiveness has brought with it an excessive increase in multiple pregnancy rates with the serious medical, financial and social consequences that they entail. Now, the scientific societies, the health professionals, and the infertile couples themselves are aware of these risks and have worked together to implement various strategies to deal with this situation. The result that is being obtained from the strategy of selectively reducing the number of embryos transferred is obvious. The pandemic of multiple pregnancies is being brought under control and so we have effective prevention of the obstetric and neonatal complications arising from it. It is to be hoped that it will also contribute to significantly reducing the rates of prematurity and thus of severe neonatal complications.El desarrollo de las Técnicas de Reproducción Asistida ha representado un importante avance en el tratamiento de la infertilidad humana. Sin embargo, la alta eficacia de las mismas ha traído consigo un incremento excesivo de las tasas de embarazo múltiple con las graves consecuencias médicas, económicas y sociales que ello comporta. Actualmente tanto las sociedades científicas como los profesionales de la salud como las propias parejas estériles son conscientes de estos riesgos y de forma coordinada se han establecido diversas estrategias para hacer frente a esta situación. El resultado que se está obteniendo de la estrategia de reducir selectivamente el número de embriones transferidos es evidente. La pandemia de embarazos múltiple se está controlando y con ello estamos haciendo una prevención eficaz de las complicaciones obstétricas y neonatales derivadas de los mismos. Esperamos que ello contribuirá también a reducir significativamente las tasas de prematuridad y por tanto de complicaciones neonatales severa

Beliefs, attitudes and funding of assisted reproductive technology : Public perception of over 6,000 respondents from 6 European countries

Background: Fertility rates in Europe are among the lowest in the world, which may be attributed to both biological and lifestyle factors. Cost and reimbursement of fertility treatments vary across Europe, although its citizens enjoy wide access to fertility care. Since few regional studies evaluating public support for fertility treatment exist, we conducted the Listening IVF and Fertility in Europe (LIFE) survey to ascertain public perception of in vitro fertilization (IVF) and gamete donation as a treatment for infertility among European men and women. Methods and findings: This survey was distributed via an online questionnaire to 8,682 individuals who were voluntary participants in an online research panel residing in France, Germany, Italy, Spain, Sweden, or the UK. The survey covered items to determine respondents' beliefs regarding IVF and its success, the need for public funding, the use of IVF among modern families with different lifestyles, and the support for gamete donation. Results were analyzed by age, country of origin, sex, and sexual orientation. A total of 6,110 (70% of total) men and women responded. Among all respondents, 10% had undergone IVF treatment and 48% had considered or would consider IVF in case of infertility. Respondents estimated IVF mean success rate to be 47% and over half of respondents believed that availability of IVF would encourage people to delay conception. Although 93% of respondents believed that IVF treatment should be publicly funded to some extent, a majority believed that secondary infertility or use of fertility treatments allowing to delay parenthood should be financed privately. Survey respondents believed that the mean number of stimulated IVF cycles funded publicly should be limited 2 to 3 (average 2.4). 79% of respondents were willing to pay for IVF if needed with a mean amount of 5,400 € for a child brought to life through IVF. According to respondents, mean minimum and maximum ages for IVF should be 29 and 42 years old, respectively. The current survey showed support for egg and sperm donation (78%), for IVF in single women (61%) and for same-sex female couples (64%). When analyzing the results per group (i.e., sex, age, sexual orientation, and countries), youngest age groups, homosexuals, bisexuals, German respondents, and men had similar overall positive attitudes and beliefs toward IVF and opinions on public funding. Perceived limits to availability were stronger in women. Conclusion: Overall, the survey results demonstrate a positive attitude among respondents in an online panel toward IVF, gamete donation, and support for public funding for fertility treatment. These findings could potentially drive discussions between patients and prescribers to explore IVF treatment and among legislators and payers to support public funding for these procedures

Green Biphasic Synthesis, X-Ray Diffraction Structure and Conformational Analysis of O-Glycosylmethyl Isoxazoles: Potential Substrates of GLUT-1 Glucose Transporter

An efficient synthesis of new 1-O-β-glycosylmethyl isoxazoles is described. The title compounds are obtained by cycloaddition of nitrile oxides generated in situ in 2-MeTHF/sodium hypochlorite solution. The developed approach provides the first use of this green methodology to prepare isoxazole derivatives. X-ray diffraction structure and conformational analysis in solution show that glycosyl isoxazoles possess the structural features required to be substrates of GLUT-1.Fil: Le Pors, Macarena Soledad. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Laboratorio de Estudio de Compuestos Orgánicos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Barri, Ivan Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Laboratorio de Estudio de Compuestos Orgánicos; ArgentinaFil: Riafrecha, Leonardo Ezequiel. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Laboratorio de Estudio de Compuestos Orgánicos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Echeverría, Gustavo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física La Plata; ArgentinaFil: Piro, Oscar Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física La Plata; ArgentinaFil: Colinas, Pedro Alfonso. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Química. Laboratorio de Estudio de Compuestos Orgánicos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentin