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

The activation of

Good knowledge of cross section neutron induced reactions on Zr becomes of importance due to the use of zirconium as structural material in reactors, its applicability in neutron dosimetry and the theoretical model testing. Thin Zr foils (0.05 mm thickness, 99.2% purity) were irradiated in the quasi-monoenergetic p-Li neutron fields, the proton beams from NPI CAS variable-energy cyclotron U120M at proton energies 20.33, 22.44, 24.69, 27.64, 29.85, 32.31 and 35.11 MeV. Li target with carbon stopper was used for the generation of neutron flux. The reaction 7Li (p,n) produces the high-energy quasi-monoenergetic neutrons with a tail to lower energies. The flux density and neutron spectra were evaluated by MCNPX code and validated with set of measurements including Time-Of-Flight and Proton recoil Telescope and additional activation monitors. The pneumatic tranfer system enables the investigation of short living isotopes. The foil activity determination was performed by the nuclear spectrometry method employing two calibrated HPGe detectors. The reaction rates for natZr(n,*)89m,89g,89Zr, 87m,87,88,89m,90m,91m,92,93,94,95Y and 87m,91,92Sr were obtained and cross sections were extracted. The preliminary results are discussed

Charged particle induced reactions on beryllium as a fast neutron source for irradiation experiments

Nuclear Physics Institute of the Czech Academy of Sciences (NPI CAS) in Rez operates the compact accelerator-driven NG-2 fast neutron source. The NG-2 neutron source uses proton (up to 35 MeV) and deuteron (up to 20 MeV) beams extracted from the isochronous cyclotron U-120M and beryllium target station for broad neutron spectrum production and lithium target station for quasi-monoenergetic neutron field production (the p+Li(C) reaction on thin target). These sources are primarily focused on nuclear data measurement and validation, especially for the future fusion energetics (DEMO and IFMIF-DONES research programs). To extend their experimental utilization mostly towards some more traditional research reactor applications (such as the neutron activation analysis and material research), the neutron fields generated by the p+Be and d+Be source reactions for various energies of charged particle beams provided by the U-120M cyclotron have been recently studied using the multi-foil activation technique. New neutron fields based on the p(35 MeV)+Be, p(30 MeV)+Be, p(24 MeV)+Be, and p(20 MeV)+Be source reactions as well as the d(20 MeV)+Be, d(15 MeV)+Be, and d(10 MeV)+Be reactions are available at NPI CAS now

Neutron spectrum determination of p+Be reaction for 30 MeV protons using the multi-foil activation technique

At the NPI in Rez, the p + Be source reaction was investigated for 30 MeV proton beam and thick beryllium target. For neutron field determination of the p(30)+Be source reaction in close source-to-sample distance, the multi-foil activation technique with a set of 10 activation materials (Au, Co, Lu, Ti, In, Al, Y, Fe, Ni, Nb) was utilized. From resulting reaction rates, the neutron spectrum was reconstructed using the SAND-II unfolding code. New neutron field of white spectrum up to 28 MeV has an intensity of 8.6 × 1010 cm−2s−1 close to target. The obtained neutron field extends the utilization of cyclotron-based fast neutron sources at the NPI and provides new experimental opportunities for future irradiation experiments such as fast neutron activation analysis, nuclear data validation, and radiation damage study of electronics and materials for nuclear energetics

Neutron spectrum determination of p+Be reaction for 30 MeV protons using the multi-foil activation technique

At the NPI in Rez, the p + Be source reaction was investigated for 30 MeV proton beam and thick beryllium target. For neutron field determination of the p(30)+Be source reaction in close source-to-sample distance, the multi-foil activation technique with a set of 10 activation materials (Au, Co, Lu, Ti, In, Al, Y, Fe, Ni, Nb) was utilized. From resulting reaction rates, the neutron spectrum was reconstructed using the SAND-II unfolding code. New neutron field of white spectrum up to 28 MeV has an intensity of 8.6 × 1010 cm−2s−1 close to target. The obtained neutron field extends the utilization of cyclotron-based fast neutron sources at the NPI and provides new experimental opportunities for future irradiation experiments such as fast neutron activation analysis, nuclear data validation, and radiation damage study of electronics and materials for nuclear energetics

Peak neutron production from the 7Li(p,n) reaction in the 20-35 MeV range

New experimental data on the peak neutron production in the Li-7(p,n) reaction were collected during several irradiation campaigns at the NPI CAS. Time-of-flight method was used to measure the number of the peak neutrons in the forward direction, and the number of produced Be-7 nuclei was determined using gamma-spectrometry. The new measurement results are compared with experimental data from the literature and used for the validation of several different systematics and nuclear data libraries developed over the years

Charged particle activation facility in NPI CAS and in future GANIL/SPIRAL2-NFS

The proton, deuteron and alpha induced reactions are of a great interest for the assessment of induced radioactivity of accelerator components, targets and beam stoppers as well as isotope production for medicine and also to nuclear astrophysics. We present a new irradiation chamber for activation measurements, that forms a prolongation of long-term experimental activities using stacked-foil activation technique in NPI CAS, Řež. The chamber is based on an airlock system and is coupled to a pneumatic transfer system delivered by KIT Karlsruhe. This system is installed in GANIL/SPIRAL2-NFS and will be used for proton, deuteron and alpha particle activation measurements with long- and short-lived isotopes

Charged particle activation facility in NPI CAS and in future GANIL/SPIRAL2-NFS

International audienceThe proton, deuteron and alpha induced reactions are of a great interest for the assessment of induced radioactivity of accelerator components, targets and beam stoppers as well as isotope production for medicine and also to nuclear astrophysics. We present a new irradiation chamber for activation measurements, that forms a prolongation of long-term experimental activities using stacked-foil activation technique in NPI CAS, Řež. The chamber is based on an airlock system and is coupled to a pneumatic transfer system delivered by KIT Karlsruhe. This system is installed in GANIL/SPIRAL2-NFS and will be used for proton, deuteron and alpha particle activation measurements with long- and short-lived isotopes.</jats:p