77 research outputs found
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
Renal artery dissection during an in vitro fertilization/intracytoplasmic sperm injection cycle
Stimulation: Selective Activation of Subpopulations of Antibody-Forming Cells**Supported in part by USPHS Research Grant 7-R01-AM13701 and USPHS Training Grant AI-00255.
H-2-RESTRICTED PRESENTATION OF ANTIGEN TO T HELPER CELLS IN VIVO11Supported by USPHS Grants AI-10961, CA-15822 and AI-15393.
The immune response against hapten-autologous protein conjugates in the mouse. I. Specificity of antibodies produced during the primary response against dinitrophenylated mouse serum albumin
Is There Evidence for a Non-Antigen Specific Diffusable Chemical Mediator from the Thymus-Derived Cell in the Initiation of the Immune Response?**Supported by U. S. Public Health Service Research Grant AI-08795-03 and American Cancer Society Research Grant E-395-D.
Analysis of Dose Response of Trinitrochlorobenzene Contact Hypersensitivity Induction in Mice: Pretreatment with Cyclophosphamide Reveals an Optimal Sensitizing Dose
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