Immature oocytes at GV or MI stages were donated by healthy non-diabetic women aged 25–39 years after signed informed consent. The women were undergoing controlled ovarian stimulation (COH) treatments aimed at oocyte cryopreservation or intracytoplasmic sperm injection (ICSI) at the Department of Reproductive Medicine of Karolinska University Hospital. The standard COS treatments and clinical routines have been previously described (Feichtinger et al, 2017 (link)). Briefly, either a long-protocol, using a nasal GnRH agonist (Nafarelin 800 μg daily; Synarela, Pfizer) or buserelin 1200 μg daily; Suprecur, Sanofi), or a short protocol using GnRH antagonist (0.25 mg once daily, SC ganirelix, Fyremadel, Ferring) initiated routinely on the fifth day of COS were conducted. The dose of COS (75–400 IU daily of recombinant follicle stimulating hormone (Gonal-F Merck or hMG Menopur, Ferring) was individualized to patient’s age, menstrual cycle length, antral follicle count and anti-Mullerian hormone levels. Ovarian follicle growth tracking was performed by scheduled transvaginal ultrasound examinations that lead to the planning timepoint for oocyte maturation triggered by administration of recombinant hCG (250 μg SC Ovitrelle; Merck). Oocyte retrieval was carried out by transvaginal ultrasographically-guided follicular puncture 37 h later.
Synarela
Manufactured by Pfizer
Sourced in United States
Synarela is a laboratory equipment product designed for handling and dispensing various liquids, powders, and other materials in a controlled and precise manner. It is a versatile tool that can be used in a wide range of applications, including research, development, and quality control processes in various industries.
Automatically generated - may contain errors
Lab products found in correlation
Ovitrelle, by Merck Group (3 mentions)
Nafarelin, by Pfizer (2 mentions)
Suprecur, by Sanofi (2 mentions)
Gonal f, by Merck Group (2 mentions)
Fyremadel, by Ferring (1 mentions)
Hmg menopur, by Ferring (1 mentions)
Pergoveris, by Merck Group (1 mentions)
Menogon, by Ferring (1 mentions)
Ovaleap, by Teva Pharmaceuticals (1 mentions)
Pregnyl, by MSD (1 mentions)
Orgalutran, by MSD (1 mentions)
Menopur, by Ferring (1 mentions)
Cetrotide, by Merck Group (1 mentions)
Suprefact, by Sanofi (1 mentions)
4 protocols using synarela
1
Oocyte Donation and Retrieval Protocol
2
Ovarian Stimulation Protocols for In Vitro Fertilization
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In the short protocol, the ovarian stimulation started on the second or third day of the cycle using stimulation pens and injection accessories. The stimulation drugs used in this study were recombinant follicle-stimulating hormone (rFSH; Gonal F, Merck Serono, Darmstadt, Germany or Ovaleap, Teva, Ulm, Germany or Puregon, MSD Sharp & Dohme, Haar, Germany) and/or human menopausal gonadotropin (Menogon; Ferring, Kiel, Germany). Some of the patients also received rFSH and recombinant LH (Pergoveris, Merck Serono).
In the long protocol, a GnRH analogue was administered in the month preceding the stimulation from the middle of the luteal phase. The active ingredient nafarelin (Synarela; Pfizer, New York, NY, USA) was used in a nasal application form at 0.4 mg/day. The subgroup of female patients who underwent a natural cycle received either no stimulation or oral stimulation using clomiphene citrate, a selective estrogen receptor modulator (Clomifen, Ferring).
In the long protocol, a GnRH analogue was administered in the month preceding the stimulation from the middle of the luteal phase. The active ingredient nafarelin (Synarela; Pfizer, New York, NY, USA) was used in a nasal application form at 0.4 mg/day. The subgroup of female patients who underwent a natural cycle received either no stimulation or oral stimulation using clomiphene citrate, a selective estrogen receptor modulator (Clomifen, Ferring).
3
Cryopreservation of Embryos Before Uterine Transplantation
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In vitro fertilization to cryopreserve embryos was performed approximately 1 year before planned UTx by two GnRH agonist cycles. Serum level of antim€ ullerian hormone was 3.3 mg/L, and the antral follicle count was 13. Results of semen analysis of the male partner were normal. Serum P at her first visit indicated luteal phase, and from that day 400 mg GnRH agonist (nafarelin; Synarela, Pfizer) was administered twice daily and after down-regulation reduced to 200 mg for 14 days. Ovarian stimulation was with FSH (Puregon, MSD) 175 IU daily for 11 days. Oocyte maturation was triggered by 250 mg hCG (Ovitrelle, Merck Serono). Eight oocytes were retrieved in this first cycle and fertilized by standard IVF. After culture for 5 days, four blastocysts were vitrified.
A second IVF procedure, with identical protocol as above, was performed 8 weeks later, and this resulted in seven fertilized oocytes. Because the semen sample on this occasion was suboptimal, intracytoplasmic sperm injection was performed. Four day-2 embryos were cryopreserved, and extended culture of remaining embryos resulted in two additional day-5 embryos, which were vitrified. Thus, the patient had six blastocysts and four day-2 embryos cryopreserved before UTx.
A second IVF procedure, with identical protocol as above, was performed 8 weeks later, and this resulted in seven fertilized oocytes. Because the semen sample on this occasion was suboptimal, intracytoplasmic sperm injection was performed. Four day-2 embryos were cryopreserved, and extended culture of remaining embryos resulted in two additional day-5 embryos, which were vitrified. Thus, the patient had six blastocysts and four day-2 embryos cryopreserved before UTx.
4
Controlled Ovarian Stimulation Protocols
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Two types of protocol were used to achieve controlled ovarian stimulation; gonadotropin-releasing hormone (GnRH) antagonist short protocol or GnRH agonist long protocol. Orgalutran (MSD) or Cetrotide (Merck) was used in the antagonist protocol, and Synarela (Pfizer), Suprefact (Sanofi), or Suprecur (Sanofi) was used in the agonist protocol. Ovarian stimulation was performed with recombinant follicle-stimulating hormone (FSH) (Gonal-f; Merck), Puregon (MSD), Menopur (Ferring Pharmaceuticals), or Fostimon (NordicInfu Care), and the dosage was based on the woman's age, ovarian volume, baseline FSH level, and body mass index (BMI). Ovarian response was monitored by vaginal ultrasound to determine the count and size of the follicles. When two follicles had reached 17 mm an injection of human chorionic gonadotropin (hCG) (Ovitrelle, Merck; or Pregnyl, MSD) was given to induce final follicular maturation. Ovum pickup was conducted 35 hours after administration of hCG using a transvaginal ultrasound probe and needle (Cook Australia).
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