Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3...Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3G in ovarian stimulation and focused on their experimental verification and analysis. Methods: A prospective, observational pilot study was conducted involving 54 patients who underwent 54 cycles of ovarian stimulation. The goal was to establish the growth rate of urinary E1-3G during the course of stimulation and to determine the daily upper and lower limits of growth rates at which stimulation is appropriate and safe. Controlled ovarian stimulation was performed using two different stimulation protocols—an antagonist protocol in 25 cases and a progestin-primed ovarian stimulation protocol (PPOS) in 29 cases, with fixed doses of gonadotropins. From the second day of stimulation, patients self-measured their daily urine E1-3G levels at home using a portable analyzer. In parallel, a standard ultrasound follow-up protocol accompanied by a determination of E2, LH, and P levels was applied to optimally control stimulation. Results: The average daily growth rates in both groups were about 50%. The daily increase in E1-3G for the antagonist protocol ranged from 14% to 79%, while they were 28% to 79% for the PPOS protocol. Conclusion: This is the first study to analyze the dynamics of E1-3G in two different protocols and to estimate the limits of its increase during the entire course of the stimulation. The results confirm our theoretical model for the viability of using urinary E1-3G for monitoring ovarian stimulation.展开更多
Background: With the accumulating evidence of semen difference between distinct populations we decided to conduct a population-based prospective study to assess the reproductive capabilities of the Bulgarian males. Ob...Background: With the accumulating evidence of semen difference between distinct populations we decided to conduct a population-based prospective study to assess the reproductive capabilities of the Bulgarian males. Objective: To evaluate the semen parameters in men from the general population of Bulgaria. To analyze the effects of BMI (Body mass index) and tobacco smoking on semen characteristics. Methods: 482 males without history of reproductive problems were included for the purpose of this study. The duration of our study was from April to May in 2016 and April in 2017. The volunteers were subdivided based on their smoking status and on their BMI. After semen collection, a conventional semen analysis was carried out manually by trained embryologists in an andrology laboratory according to WHO recommendations. The results were statistically analyzed and presented with their mean values. Result(s): After semen analysis we report a mean of 3.29 ml for semen volume, 40.68 × 106/ml for spermatozoa concentration, 128.38 × 106 for total sperm count, 52.54% of total motile spermatozoa in the ejaculate and a mean percentage of morphologically normal sperm standing at 9.6%. We did not find a negative effect of tobacco smoking on semen quality;however higher BMI is associated with lower sperm concentration per ml. Discussion and Conclusion(s): This is the first contemporary study, assessing semen quality in Bulgarians. The results obtained here show the lower quality of semen in Bulgaria, compared to other countries. No statistical differences were found between the semen quality of nonsmokers and smokers. Higher BMI was found to be associated with lower sperm concentration per milliliter.展开更多
文摘Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3G in ovarian stimulation and focused on their experimental verification and analysis. Methods: A prospective, observational pilot study was conducted involving 54 patients who underwent 54 cycles of ovarian stimulation. The goal was to establish the growth rate of urinary E1-3G during the course of stimulation and to determine the daily upper and lower limits of growth rates at which stimulation is appropriate and safe. Controlled ovarian stimulation was performed using two different stimulation protocols—an antagonist protocol in 25 cases and a progestin-primed ovarian stimulation protocol (PPOS) in 29 cases, with fixed doses of gonadotropins. From the second day of stimulation, patients self-measured their daily urine E1-3G levels at home using a portable analyzer. In parallel, a standard ultrasound follow-up protocol accompanied by a determination of E2, LH, and P levels was applied to optimally control stimulation. Results: The average daily growth rates in both groups were about 50%. The daily increase in E1-3G for the antagonist protocol ranged from 14% to 79%, while they were 28% to 79% for the PPOS protocol. Conclusion: This is the first study to analyze the dynamics of E1-3G in two different protocols and to estimate the limits of its increase during the entire course of the stimulation. The results confirm our theoretical model for the viability of using urinary E1-3G for monitoring ovarian stimulation.
文摘Background: With the accumulating evidence of semen difference between distinct populations we decided to conduct a population-based prospective study to assess the reproductive capabilities of the Bulgarian males. Objective: To evaluate the semen parameters in men from the general population of Bulgaria. To analyze the effects of BMI (Body mass index) and tobacco smoking on semen characteristics. Methods: 482 males without history of reproductive problems were included for the purpose of this study. The duration of our study was from April to May in 2016 and April in 2017. The volunteers were subdivided based on their smoking status and on their BMI. After semen collection, a conventional semen analysis was carried out manually by trained embryologists in an andrology laboratory according to WHO recommendations. The results were statistically analyzed and presented with their mean values. Result(s): After semen analysis we report a mean of 3.29 ml for semen volume, 40.68 × 106/ml for spermatozoa concentration, 128.38 × 106 for total sperm count, 52.54% of total motile spermatozoa in the ejaculate and a mean percentage of morphologically normal sperm standing at 9.6%. We did not find a negative effect of tobacco smoking on semen quality;however higher BMI is associated with lower sperm concentration per ml. Discussion and Conclusion(s): This is the first contemporary study, assessing semen quality in Bulgarians. The results obtained here show the lower quality of semen in Bulgaria, compared to other countries. No statistical differences were found between the semen quality of nonsmokers and smokers. Higher BMI was found to be associated with lower sperm concentration per milliliter.
