Endocrine Abstracts

Historically, the sole desired outcome of IVF is that of a pregnancy. The worlds first successful IVF pregnancy was Louise Brown who was born in 1978. Over the last 34 years IVF has changed immeasurably, not only in becoming significantly more successful, but also that the desired outcome is now not just a pregnancy, but that of a healthy pregnancy both for mother and baby. Unusually in medicine, most patients requiring IVF are otherwise healthy, and therefore the notion of pr...

Aim: PCOS is associated with peripheral insulin resistance and we have previously shown that glucose uptake and metabolism are impaired in granulosa lutein (GL) cells of anovulatory women with PCOS (anovPCO). The aim of this study was to delineate insulin-signalling pathways in GL cells from women with anovPCO and to compare the response to insulin with that in GL cells from ovulatory women with (ovPCO) and without polycystic ovaries (controls).Methods: ...

Background: Anti-Müllerian Hormone (AMH) and Antral Follicle Count (AFC) are both principally used as markers of ovarian reserve and available in all UK hospitals. The utility of these markers in the binary diagnosis of Polycystic Ovarian Syndrome (PCOS) by published criteria, such as Rotterdam, has been previously reported. We evaluated their utility in the evaluation of oligo/amenorrhoea in healthy young non-obese women.Methods: Women with both ov...

A decade ago, genetic disruption of the kisspeptin signalling pathway was observed to cause hypogonadotrophic hypogonadism. Hypothalamic kisspeptin acts by stimulating secretion of endogenous GnRH. Our research has investigated the physiological effects of kisspeptin in women, with the overarching aim of determining if kisspeptin could be used to treat women with infertility.We initially observed that s.c. bolus injection of kisspeptin acutely stimulated...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...

Background: In vitro fertilisation is an effective therapy for infertility, but can result in the potentially life-threatening complication, Ovarian Hyper-Stimulation Syndrome (OHSS). We have previously reported that a single injection of kisspeptin results in an LH surge of ~12–14 hrs duration, sufficient to safely induce oocyte maturation, but eliminate OHSS. However, the physiological LH surge in a normal menstrual cycle has a plateaux lasting 24–28 hrs. ...

Context: IVF treatment is an effective therapy for infertility, but can result in the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’ (OHSS).Objective: To investigate whether kisspeptin-54 can be used to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS.Design: Phase 2 multi-dose open label randomised clinical trial.<p class...

Background: In vitro fertilisation (IVF) is an effective treatment for infertility, but can cause the ovarian hyper-stimulation syndrome (OHSS), which is associated with serous effusions, circulatory collapse, and even death. The use of human chorionic gonadotrophin (hCG) stimulates oocyte maturation during IVF, but is also the major cause of OHSS. The hypothalamic neuropeptide kisspeptin stimulates endogenous LH secretion in a GnRH-dependent manner. A more physiologi...

Background: IVF is an effective treatment for infertility, but can cause the ovarian hyper-stimulation syndrome (OHSS), which is associated with serous effusions, cardiac tamponade, circulatory collapse, and even death. Injection of human chorionic gonadotrophin (hCG) stimulates oocyte maturation during IVF, but is also the major cause of OHSS. The hypothalamic neuropeptide kisspeptin, stimulates endogenous LH secretion in a GnRH-dependent manner. A more physiological stimulus...

Background: Hypothalamic amenorrhoea (HA) accounts for over 30% of cases of amenorrhoea in women of reproductive age. Current treatments have limited success rates and side effects. We have recently shown that a single injection of the novel hormone kisspeptin potently stimulates reproductive hormone release in women with HA. However, twice-daily kisspeptin administration to women with HA, results in tachyphylaxis due to desensitisation of the kisspeptin receptor. This suggest...