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The present study was designed to evaluate the effect of administration of lecirelin acetate, hCG and progesterone after AI on ovarian picture, serum progesterone concentrations and first service conception rate in cross-bred cattle. A total of 160 lactating cross bred (Friesian x Sahiwal) cattle were divided into 4 groups after AI. The groups were treated as follows: control (injected i.m with normal saline 2ml, n=40), d 7-LA (injected i.m with lecirelin acetate100 µg, n=40), d 7-hCG (injected with hCG 3300 IU, n=40) and d 7-P4 (injected i.m with Progesterone 0.5 mgdaily for 4 days, n=40) group. The hormonal treatments were given to animals on day 7 after AI. The ultrasonography and blood sampling was done before treatment and then 7 days later. All animals were examined for pregnancy through ultrasonography at 40 ± 1 day after AI. The diameter of SCL on 7 days after treatment was higher (P < 0.01) in group d 7-LA and d 7-hCG group cows as compared to control cows. In contrast, the diameter of SCL in d 7- P4 treated cows did not differ from control cows. Formation of ACL was observed only in 50 % & 80 % cows in d 7-LA and d 7-hCG group respectively. No ACL was observed in control and d 7- P4 cattle on day 7 after treatment. The P4 concentrations were significantly higher (P < 0.01) in d 7-hCG treated cattle as compared to control at 7 days after treatment. As compared to 10 percent First Service Conception Rate (FSCR) in controls, an increase (P < 0.05) of 50 percent and 40 percent was observed in each treatment group (d 7-hCG & d 7-LA), non-significant (P > 0.05) difference in FSCR was observed between control and d 7-P4 group. It was concluded that the use of hCG or LA, 7 days after AI is a beneficial tool to improve conception rate in cross-bred cattle whereas use of parental P4 post-breeding has no effect on SCL diameter and conception rate.

Background: Gestational hypertension (GH) and preeclampsia (PE) are the most common gestational complications. Several placental biochemical markers are used to predict GH/PE, but with conflicting results. Methods: The study aim was to estimate the biochemical markers' ability to predict hypertensive disorders in pregnancy. On the first ultrasonographic examination, 104 healthy pregnant women were recruited. At the regular pregnancy check-ups, BMI, blood pressure, occurrence of gestational hypertension (early or late onset), preeclampsia, eclampsia and other complications were recorded. Serum concentrations (in multiples of median - MoM) of human chorionic gonadotropin (HCG) and pregnancyassociated plasma protein A (PAPPA) were measured from the 11th to 14th gestational week, while HCG, alpha feto protein (AFP), estriol and inhibin were determined between the 16th and 19th gestational week. Results: Hypertensive disorders throughout pregnancy were diagnosed in 20.2% women. Early-onset GH was registered in 7 and PE in 6 patients, while 14 had late-onset GH and 10 additional women PE. There were no significant differences (p>0.05) in biochemical markers concentrations between women with and without GH/PE. PAPPA levels in the first and HCG in the second trimester correlated with early and late GH/PE. Moreover, higher AFP concentrations were registered in women with preeclampsia signs/symptoms. According to ROC analysis, AFP>1.05 MoM properly identified 80% of GH/PE cases. Obtained models imply that HCG, PAPPA and AFP should be used for GH/PE prediction. Conclusions: Biochemical markers HCG, PAPPA and AFP could be useful in predicting gestational hypertension and preeclampsia. However, different markers should be used for early and late onset GH/PE.

Inhibin is a molecule that belongs to peptide hormones and is excreted through pituitary gonadotropins stimulation action on the granulosa cells of the ovaries. However, the differential regulation of inhibin and follicle-stimulating hormone (FSH) on granulosa cell tumor growth in mice inhibin-deficient females is not yet well understood. The objective of this study was to evaluate the role of inhibin and FSH on the granulosa cells of ovarian follicles at the premature antral stage. This study stimulated immature wild-type (WT) and Inhibin-α knockout (Inha−/−) female mice with human chorionic gonadotropin (hCG) and examined hCG-induced gene expression changes in granulosa cells. Also, screening of differentially expressed genes (DEGs) was performed in the two groups under study. In addition, related modules to external traits and key gene drivers were determined through Weighted Gene Co-Expression Network Analysis (WGCNA) algorithm. The results identified a number of 1074 and 931 DEGs and 343 overlapping DEGs (ODEGs) were shared in the two groups. Some 341 ODEGs had high relevance and consistent expression direction, with a significant correlation coefficient (r2 = 0.9145). Additionally, the gene co-expression network of selected 153 genes showed 122 nodes enriched to 21 GO biological processes (BP) and reproduction and 3 genes related to genomic pathways. By using principal component analysis (PCA), the 14 genes in the regulatory network were fixed and the cumulative proportion of fitted top three principal components was 94.64%. In conclusion, this study revealed the novelty of using ODEGs for investigating the inhibin and FSH hormone pathways that might open the way toward gene therapy for granulosa cell tumors. Also, these genes could be used as biomarkers for tracking the changes in inhibin and FSH hormone from the changes in the nutrition pattern.

Background: The failure to retrieve oocytes from mature ovarian follicles is referred to as empty follicle syndrome. There is no exact explanation to this problem and it cannot be predicted using ultrasound or serum hormonal levels. The underlying mechanism of Empty follicle syndrome remains obscure. Objective: In this study, the authors have investigated the relationship between the Beta-Human chorionic gonadotropin (HCG) levels in the follicular fluid with or without the oocyte in the follicles of patients undergoing Intracytoplasmic Sperm Injection. Materials and Methods: Seventy-three infertile couples underwent standard long protocol induction ovulation for Intracytoplasmic sperm injection. On the day of oocyte retrieval, each patient had two samples; follicular fluid including 2–3 follicles with oocyte and follicular fluid including of 2–3 follicles without oocyte were collected in separate tubes. These follicles had similar shape and size. The Samples were transferred to a laboratory for measuring the HCG level, after which the HCG levels were compared to the follicles with and without the oocyte in each patient. Results: In this study, the HCG level of follicular fluid in the follicles containing oocyte was 18.20 (8.35–42.92) IU/L and in the follicles without the oocyte was 13.50 (5.45– 25.81) IU/L. Levels of HCG in the follicular fluids containing the oocyte were higher than without oocytes, This difference was not statistically significant (p = 0.16). Conclusion: It seems that the follicular fluid HCG isn’t caused by empty follicle syndrome, and that dysfunctional folliculogenesis may be the cause of this syndrome.

Repeated implantation failures are a constant challenge in reproductive medicine with a significant impact both on health providers and on infertile couples. Several approaches have been proposed so far as effective; however, accumulative data have clarified that most of the treatment options do not have the evidence base for a generalized application to be suggested by the relevant societies. Implantation failures are attributed to either poor quality embryos or to defected endometrial receptivity. The current review aims to summarize in a systematic way all the new trends in managing RIF via interference with endometrial receptivity. The authors focus mainly, but not exclusively, on endometrial injury prior to embryo transfer and endometrial priming with autologous cells or biological agents. To this direction, a systematic search of the Pubmed database has been conducted taking into account the emerged evidence of the last two decades. All the suggested interventions are herein presented and analyzed in terms of reproductive outcomes. It is evident that properly powered and designed randomized trials are needed to support a new standard approach in RIF treatment that will safely be incorporated in national and international guidelines.

Limited information exists on the application of human chorionic gonadotropin (hCG) post insemination in the Indian crossbred dairy cows. This study aimed to evaluate the effect of four hCG administration protocols on luteal characteristics and pregnancy outcomes following artificial insemination (AI). Using block randomization, 50 healthy lactating crossbred cows were allocated in equal numbers (n = 10 cows per group) to receive either 5 mL normal saline (control) or 1500 IU hCG on the day of AI (hGG-0), day 7 post AI (hCG-7), day 14 post AI (hCG-14), or days 0, 7, and 14 post AI (hCG-0,7,14). All cows were scanned using sequential transrectal ultrasound examinations to evaluate primary luteal parameters, development of accessory corpora lutea, and pregnancy. Serial blood samples were collected to measure plasma progesterone concentrations. Data were analyzed using repeated measures ANOVA and Fisher’s exact tests. The mean primary luteal area, total luteal area, and total luteal diameter values were significantly greater in the hCG-treated cows. Compared to the control, the hCG-14 group had a significantly higher percentage of cows with an accessory corpora luteum. However, there were no significant differences in the mean progesterone concentrations or the first service conception rates between any of the groups. Overall, the results of this study indicate that while hCG administration post AI in healthy Indian crossbred cows may enhance primary luteal dimensions or induce the formation of accessory corpora lutea, it does not appear to have any beneficial effect on luteal function or pregnancy. [ABSTRACT FROM AUTHOR]

Background: The expression and overexpression of luteinizing hormone (LH) receptors in the canine adrenal gland cortex have been reported. Therefore, it was hypothesized that a LH-dependent form of Cushing's syndrome (CS) could exist in dogs. Aim: To assess whether the adrenal gland post-ovariectomy (OVx) exhibits a greater response to adrenocorticotrophin (ACTH) stimulation; to evaluate whether the adrenal gland responds to human chorionic gonadotropin (hCG) stimulation by increasing the release of cortisol; and to consider whether hCG stimulus testing would be useful as a diagnosis for possible cases of LH-dependent CS. Methods: Cortisol concentrations were measured from healthy female dogs (n=16) at baseline and following ACTH stimulation before and 2 months after gonadectomy (OVx). Cortisol concentrations were also measured for female dogs with CS (n = 14) following administration of hCG (5000 IU). A post-hCG cortisol concentration greater than 140 nmol/l was used to define dogs with LH-dependent Cushing's syndrome. Results: In normal female dogs, both pre- and post-stimulation cortisol concentrations increased following OVx (p = 0.002 and p = 0.0003, respectively). In female dogs with CS, cortisol concentrations increased following stimulation with hCG in 57% (8/14; p = 0.002). Age at the time of OVx was associated (p = 0.015) with the cortisol response to hCG [8 (5-9) years vs. 3.5 (2-6) years, p = 0.0013). Conclusion: Based on these results, an LH-dependent form of CS occurs in spayed female dogs, and that it is more likely to occur when female dogs are spayed later in life. [ABSTRACT FROM AUTHOR]

This study focused on determining the success of inducing endogenous progesterone source (by formation of accessory corpus luteum) by human chorionic gonadotropin (hCG) administration on day 4 post timed artificial insemination (TAI) and on evaluating the effect of the day of hCG administration (day 4 or 5 post TAI) on pregnancy rates in repeat breeder cows according to their responses to hCG administrations. Non-pregnant cyclic lactating Holstein dairy cows with more than three services despite no clinical reproductive abnormalities were enrolled in the study. All cows (n = 192) received the Ovsynch protocol (GnRH-7d-PGF2α-56h-GnRH-16/18h-TAI) and hCG administration (1500 IU, i.m.) was performed in group hCG4 (n = 64) on day 4 and in group hCG5 (n = 68) on day 5 post TAI. The control group (CON, n = 60) did not receive any hCG treatment. The responses (ovulation rate) to hCG (~64%) were similar on days 4 and 5 post TAI. Pregnancy per AI (P/AI) at 31 days was similar among the groups (48.3% in CON, 48.4% in hCG4, and 42.6% in hCG5). Regardless of the day of the treatment (hCG4 + hCG5), the cows had an ovulatory response to hCG (54.1%), and a greater P/AI (P = 0.007) at 31 days than those without a response (29.8%). The administration of hCG on either day 4 or 5 post TAI did not increase overall pregnancy rates, however, the ovulatory response to the post TAI hCG administration on day 4 improved fertility in repeat breeder cows. Further studies are needed with a larger number of animals to reveal this potentiallly beneficial effect. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cientifica de la Facultade de Veterinaria is the property of Universidad del Zulia, Facultad de Ciencias Veterinarias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Cientifica de la Facultade de Veterinaria is the property of Universidad del Zulia, Facultad de Ciencias Veterinarias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background:Human chorionic gonadotropin (HCG), one of the initial embryonic signals, is probably a major regulator of the embryo-endometrial relationship. This study aims to assess the advantage of HCG supplementation during the secretory phase of hormonally prepared cycles for the transfer of cryopreserved-thawed embryos.Materials and Methods:This study was a randomized clinical trial. Infertile women who were candidates for frozen-thawed embryo transfers entered the study and were divided into two groups, HCG and control. The endometrial preparation method was similar in both groups: all women received estradiol valerate (6 mg) po per day from the second day of the menstrual cycle and progesterone in oil (100 mg) intramuscular (I.M.) when the endometrial thickness reached 8 mm. Estradiol and progesterone were continued until the tenth week of gestation. In the HCG group, patients received an HCG 5000 IU injection on the first day of progesterone administration and the day of embryo transfer.Results:In this study, 126 couples participated: 65 in the HCG group and 61 in the control group. There was no statistically significant difference between groups regarding basic characteristics. Implantation rate, chemical pregnancy, clinical pregnancy, ongoing pregnancy, and abortion rates were similar in both groups.Conclusion:Although HCG has some advantages in assisted reproductive technology (ART) cycles, our study did not show any benefit of HCG supplementation during the secretory phase of frozen cycles (Registration Number: IRCT201107266420N4).

Little is known about the effect of punicalagin extracted from pomegranate or in combination with human chorionic gonadotropin on enhancing the productive and reproductive performance in rabbits that gestate for the first time. The impact of punicalagin alone or in combination with human chorionic gonadotropin on maiden doe body weight, progesterone concentrations, conception rate, gestation rate, litter size, and kit weight was investigated in this study. A completely randomized and balanced experimental design was used to allocate 21 naturally mated maiden does at 6 months of age into the following three treatment groups of 7 does each: Control - intramuscular injection with sterilized water only; Treatment 1 - pre-mating intramuscular injection with punicalagin (100 µg/doe) twice a week and once 3 days post-mating; and Treatment 2 - pre-mating intramuscular injection with punicalagin twice a week and human chorionic gonadotropin (25 IU/doe) once 3 days post-mating. Progesterone was assayed from blood samples taken from the ear marginal vein at mating, post-mating, gestation, and post-kindling phases when all does were weighed. Results indicated significantly positive impacts of punicalagin alone or in combination with human chorionic gonadotropin on all doe reproductive traits, birth, and weaning weights of kits. The study clearly demonstrated an improvement in doe fertility, reproductive performance, and kit survival to weaning. In conclusion, PL and PL+HCG improved maternal body weights and their offspring as well as pregnancy outcomes of young rabbits particularly in the 2nd pregnancy, hence findings of this study could be recommended for improving reproductive health and fertility in maiden rabbit does.

This study evaluated the influence of human chorionic gonadotropin on hormonal and haematological profile of postpubertal male albino rats exposed to chronic oral administration of alcohol. Twenty-four mature male albino rats were assigned to four groups (n=6). Group A was the control, given distilled water, Group B was given 30% ethanol (8 ml/kg) orally 3 times a week, Group C was given human chorionic gonadotropin (HcG) (50 IU/kg) subcutaneously 3 times a week and Group D was given HcG (50 IU/kg) subcutaneously + 30% ethanol (8 ml/kg) orally 3 times a week. The study was for 10 weeks, and hormonal profile and haematology were determined. The follicle stimulating hormone of Group B decreased significantly (P

Objective: Gestational trophoblastic disease (GTD) is a group of pregnancy-related disorders that arise from abnormal proliferation of placental trophoblast. Some patients with GTD develop hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. Existing literature on hyperthyroidism in GTD is scant. This review aims to analyse the epidemiology, pathophysiology and management of this phenomenon. Methods: A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed to obtain articles that explored hyperthyroidism in GTD. A total of 405 articles were screened and 228 articles were considered for full-text review. We selected articles that explored epidemiology, pathophysiology and outcomes/management of hyperthyroidism in GTD. Results: The pathophysiology of hyperthyroidism in GTD is well-investigated. Placental trophoblastic tissue secretes excessive hCG, which is structurally similar to thyroid stimulating hormone and also has enhanced thyrotropic activity compared to normal hCG. The incidence and prevalence of hyperthyroidism in GTD varies worldwide, with lower rates associated with high uptake of early antenatal screening and early GTD detection. No clear risk factors for hyperthyroidism in GTD were identified. While hyperthyroidism can be definitively managed with surgical evacuation of the uterus, severe complications associated with hyperthyroidism in GTD have been reported, including thyroid storm-induced multi-organ failure, ARDS, and pulmonary hypertension. Conclusion: Early detection of GTD is critical to prevent development of hyperthyroidism and its associated complications. Hyperthyroidism should be recognised as an important perioperative consideration for women undergoing surgery for GTD, and requires appropriate management. Future studies should explore risk factors for hyperthyroidism in GTD, which may facilitate earlier identification of high-risk women. [ABSTRACT FROM AUTHOR]

The objective of this study was to use luteinizing hormone-releasing hormone A3 (LRH-A3) and human chorionic gonadotrophin (HCG) to improve pregnancy rate of dairy cows during timed artificial insemination (TAI). In experiment 1, the TAI process (0 d, GnRH, 100 µg; 7 d, PGF2a, 0.4 mg; 56 hr, GnRH, 100 µg; 16 hr, AI) was applied to 160 dairy cows on 50th and 60th days after parturition respectively. In experiment 2, 320 postpartum dairy cows were treated with TAI (Group A), TAI + 25 µg LRH-A3 (Group B), TAI + 1,500 IU HCG 5 days after AI (Group C), and TAI + 25 µg LRH-A3 + 1,500 IU HCG 5 days after AI (Group D). In experiment 3, endometrial cells were treated with HCG. The results showed that TAI did not affect the pregnancy rate, while LRH-A3 and HCG increased the pregnancy rate of the cow. HCG of 5 IU/ml and 10 IU/ml increased the expressions of leukemia inhibitory factor but decreased those of interleukin-6, epidermal growth factor and vascular endothelial growth factor in endometrial cells. This study provided a plan for the use of LRH-A3 and HCG to increase pregnancy rate during TAI in dairy cows. [ABSTRACT FROM AUTHOR]

The effect of prostaglandin and gonadotrophins (GnRH and hCG) combined with the ram effect on the progesterone (P4) concentrations and reproductive performance of Karakul ewes was investigated during non‐breeding season. Ewes (n = 93) received a male effect and were divided into two treatment groups including GnRH ‐ hCG (hCG, n = 32), GnRH ‐ GnRH (GnRH, n = 30) and a control (n = 31) group. This study was carried out from April (hormonal injection) to October (lambing). The first doses of GnRH (4.2 μg, Buserelin) were injected at the beginning of the study in treatment groups. These ewes were treated with hCG (250 IU) or the second GnRH dose five days later. All animals received two injections (ten days apart) of 150 μg PGF2α five days after the hCG or the second GnRH injection. Mating was initiated two days after the second prostaglandin injection and lasted for 34 days. Blood samples were collected by jugular venipuncture on days −10, −5, 0 (first PGF2α injection), 17 and 30 during the study. Pregnancy diagnosis was performed through transabdominal ultrasonography on day 40 after the removing of ram. Conception rate was 93.8, 90 and 87.1% in the hCG, GnRH and control groups, respectively. Lambing rate tended to increase in the hCG group compared with the control group (87.1 versus 58.1%; p <.1). There was no significant difference in P4 concentrations among studied groups in identical sampling times (p >.05). In conclusion, the administration of prostaglandin and hCG in combination with the ram effect tended to decrease lambing period. In other words this protocol tended to increase lambing rate at the first cycle. Treatment with hCG or GnRH did not increase serum P4 concentrations of treated Karakul ewes during the non‐breeding season. [ABSTRACT FROM AUTHOR]

Mesenchymal Stem/Stromal Cells (MSCs) have been applied to modulate various immune-mediated conditions. Prolonged culture of MSCs in vitro reduces their therapeutic efficacy. Pretreatment of the cells with some chemical agents during in vitro expansion could overcome this limitation. This study intended to determine whether pretreatment of adipose-derived MSCs (ASCs) with Human chorionic gonadotrophin (hCG), a glycoprotein hormone, and Vitamin E, an antioxidant, will improve their immunomodulatory ability. In this regard, ASCs were harvested from human processed lipoaspirate. LPS-induced ASCs were preconditioned with 1 mg of hCG and 600 µM of vitamin E for 24h. TSG-6, COX-2, IL-1β, and IL-6 were assessed at the mRNA level in preconditioned and control groups. ASCs were also co-cultured with peripheral blood mononuclear cells (PBMCs) in vitro to determine the functionality of these cells. Results showed that hCG and vitamin E significantly downregulate the pro-inflammatory COX-2, IL-1β, and IL-6 gene expression, while they did not significantly increase TSG-6 expression. Besides, the co-culturing of pretreated ASCs with PBMCs demonstrated that the amount of PBMCs in treated groups (with hCG and vitamin E) was significantly lower than in control groups. These findings revealed that the preconditioning of ASCs with hCG and vitamin E might enhance their immunoregulatory capacity. [ABSTRACT FROM AUTHOR]

We hypothesized that the hCG modulates the expression of IFNT-pathway and ISGs in bovine endometrium during early pregnancy. The aim of the current study is to evaluate the effect of hCG on IFNT-pathway signals and ISGs expression in endometrial cells. For this, 29 non-lactating cross-bread cows were used in the study and submitted to a 9-day fixed-time artificial insemination (FTAI) protocol. The day of the AI was considered Day 0 (D0), and five days (D5) after the FTAI, the cows were allocated into two groups: Control and hCG group, when a hCG group received a single dose of 2.500UI of hCG. On day 18 after FTAI (D18) cows were slaughtered and endometrial tissue samples were collected. There was no difference between the embryo recovery rate of the cows in C compared to the hCG. The hCG group increased the accessory corpus luteum formation rate. The hCG resulted in greater serum progesterone concentration in the hCG group compared to the C on Day 14. Only the expression of IFNAR2 and STAT1 were upregulated on pregnant cows of the hCG group compared to the C group. The pathway genes (JAK1, STAT2, and IRF9) were not regulated. The mRNA abundance of ISG15, MX1, MX2, and OAS1 was upregulated in pregnant cows for hCG group, compared to C group. The results show that the administration of hCG, 5 days after AI, in addition to increasing the serum progesterone, modulates the expression of IFNT-pathway and ISGs on bovine endometrium on Day 18 of pregnancy., Competing Interests: Conflicts of interest: The authors have no conflict of interest to declare.

In vitro maturation (IVM) of oocytes retrieved at germinal vesicle stage, followed by vitrification of mature oocytes, has emerged as a fertility preservation (FP) option. This technique was first developed for patients with polycystic ovarian syndrome. In this population, providing LH activity prior to oocyte collection has been associated with better IVM outcomes. However, the benefit of this treatment in normo-ovulatory breast cancer (BC) patients undergoing IVM for FP purpose has never been investigated. To assess if the absence of therapeutic intervention prior to oocyte retrieval for IVM modifies IVM outcomes in BC patients undergoing urgent FP, we performed a non-inferiority, randomized controlled trial. The main outcome was the total number of mature oocytes obtained and cryopreserved after IVM. A total of 172 normo-ovulatory women, suffering from BC, 18 to 39 years of age received no injection or a subcutaneous injection of hCG or GnRH agonist (GnRHa) 36 h before oocytes retrieval according to randomized allocation. The total number of cryopreserved oocytes were 5.1 ± 3.8, 5.4 ± 3.8, and 6.0 ± 4.2 oocytes, respectively in the without, hCG and GnRHa groups. Mean differences were not significant between the three groups (− 0.5; CI 97.5% [− 2.03:1.02] and − 0.22; CI 97.5% [− 1.75:1.32], respectively). Intention to treat analyses failed to show non-inferiority in the "without injection group" in comparison with hCG or GnRHa groups. Our results are not conclusive enough to modify our practices and to stop administering hCG or GnRHa before IVM cycles for FP. The study was retrospectively registered to clinical trial (ID NCT03954197) in May 2019. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effects of hormonal support on the pregnancy rate in repeat breeder cows. Prostaglandin F2α + Ovsynch oestrus synchronization protocol was applied to the cows. Following the fixed time insemination (day 0), the cows were divided into 4 groups. In Group 1 (n = 42), progesterone releasing intravaginal device (PRID) was placed vaginally at 84 h and removed on the 9th day after the artificial insemination. In Group 2 (n = 40), the cows were administered human chorionic gonadotropin (hCG) on the 7th day. Group 3 (n = 45) was applied a combination of progesterone and hCG. Group 4 (n = 42) was not given any treatment. Blood samples were collected from all cows 4 times on days 3.5, 7, 12, and 18 to evaluate progesterone concentrations. The pregnancy rates were 40.47%, 37.50%, 44.44%, and 30.95% in Group 1, 2, 3, and 4, respectively (P > 0.05). In addition, in cows with progesterone concentrations < 2 ng/ml on day 3.5, the pregnancy rates were found to be lower than in the cows with progesterone concentrations > 2 ng/ml in Group 4 (P < 0.05). Progesterone supplementation in cows with progesterone concentrations < 2 ng/ml appeared to increase pregnancy rates (P < 0.05) in Groups 1 and 3. As a result, post-insemination hormonal applications in the repeat breeder cows did not increase the pregnancy rate. However, it was concluded that determination of progesterone concentrations on day 3.5 following artificial insemination and then hormonal support in the cows with low concentrations would increased the pregnancy rate. [ABSTRACT FROM AUTHOR]

• PFOS or PFBS did not seem to interrupt placental syntiotrophoblast formation through syncytins. • PFOS but not PFBS decreased the gene expression of PlGF and increased the gene expression of FLT1. • PFOS or PFBS significantly decreased the production of CGB7 and hCG in syntiotrophoblast. • PFOS but not PFBS increased the gene expression of CRH and both did not affect 11β-HSD2 expression. • These novel findings contribute to our knowledge of the reproductive toxicity of PFOS and PFBS. Poly- and per-fluoroalkyl substances (PFAS) have attracted widespread attention in recent years due to their bioaccumulation, toxicity, and ubiquitous nature. We and others have reported that maternal exposure to PFAS is associated with adverse birth outcomes due to altered placental functions. In this study, we investigated the effects of two major PFAS compounds, perfluorobutane sulfonate (PFBS) and perfluorooctanesulfonic acid (PFOS), on the regulation of the production of angiogenic factors and stress response in placental multinucleated syncytial BeWo cells using qRT-PCR and ELISA. Using this in vitro model, we showed that 1) PFOS or PFBS treatment did not seem to interrupt BeWo cell fusion through syncytins; 2) Exposure to PFOS at 10 μM decreased a potent angiogenic factor PlGF gene expression, which is implicated in preeclampsia; 3) Exposure to either PFOS or PFBS significantly decreased the production of CGB7 and hCG except hCG secretion in PFOS (10 nM) and PFBS (100 nM) treatment groups; 4) Exposure to PFOS (10 μM) increased the gene expression of the stress response molecules CRH while neither PFOS nor PFBS treatment affected a stress mitigation factor 11β-HSD2 expression. Our results demonstrate that exposure to PFOS or PFBS impacts several key pathways involved in placental cell functions. PFOS seems more potent than PFBS. These novel findings provide a potential explanation for the adverse reproductive complications associated with prenatal exposure to PFOS or PFBS, including preeclampsia and contribute to our knowledge of the reproductive toxicity of PFAS, specifically PFOS and PFBS. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Animal & Poultry Production is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Gonadotropin-releasing hormone agonist (GnRH-a) serves as an alternative to human chorionic gonadotropin (hCG) to trigger final oocyte maturation, while it significantly reduces the risk of ovarian hyperstimulation syndrome (OHSS), probably by attenuating vascular/endothelial activation.Objectives: The objectives of this work are to compare the effect of different modes of final follicular maturation (hCG vs GnRH-a) following ovarian stimulation (OS) for in vitro fertilization (IVF) on endothelial function.Design and Setting: A prospective cohort study was conducted at a tertiary medical center.Participants: Patients age 37 years or younger, undergoing OS for IVF, were allocated into 2 groups according to the type of final follicle maturation: the hCG group (n = 7) or the GnRH-a group (n = 8).Intervention: Endothelial function was assessed by measurement of the peripheral arterial tonometry in reaction to temporary ischemia at 3 study points: day 3 of menstrual cycle (day 0), day of hCG/GnRH-a administration (day trigger) and day of oocyte pick-up (day OPU). The ratio of arterial tonometry readings before and after ischemia is called the reactive hyperemia index (RHI). Decreased RHI (< 1.67) indicates endothelial dysfunction.Main Outcome Measures: The main outcomes measures of this study included endothelial function at 3 study points during OS with different modes of triggering final follicular maturation.Results: The mean RHI values at day 0 were within the normal range for all patients and comparable between both groups (hCG: 1.7 ± 0.3 vs GnRH-a: 1.79 ± 0.4, P = .6). All patients presented a decrease in RHI values on day trigger, which did not differ between the 2 groups (1.62 ± 0.3 vs 1.4 ± 0.2, respectively, P = .2). However, the hCG group demonstrated a further decrease in RHI on day OPU, whereas patients who received GnRH-a had restored normal endothelial function reflected by increased RHI values (1.4 ± 0.2 vs 1.75 ± 0.2, respectively, P = .03).Conclusions: Triggering final follicular maturation with GnRH-a restored normal endothelial function, whereas hCG trigger resulted in a decrease in endothelial function. [ABSTRACT FROM AUTHOR]

ObjectivesAntagonists in the debate over whether the maternal stress response during pregnancy damages or culls fetuses have invoked the theory of selection in utero to support opposing positions. We describe how these opposing arguments arise from the same theory and offer a novel test to discriminate between them. Our test, rooted in reports from population endocrinology that human chorionic gonadotropin (hCG) signals fetal fitness, contributes not only to the debate over the fetal origins of illness, but also to the more basic literature concerned with whether and how natural selection in utero affects contemporary human populations.MethodsWe linked maternal serum hCG measurements from prenatal screening tests with data from the California Department of Public Health birth registry for the years 2001–2007. We used time series analysis to test the association between the number of live born male singletons and median hCG concentration among males in monthly gestational cohorts.ResultsAmong the 1.56 million gestations in our analysis, we find that median hCG levels among male survivors of monthly conception cohorts rise as the number of male survivors falls.ConclusionsElevated median hCG among relatively small male birth cohorts supports the theory of selection in utero and suggests that the maternal stress response culls cohorts in gestation by raising the fitness criterion for survival to birth.

Objective The aim of this study was to evaluate rates of preterm birth (PTB) and obstetric complication with maternal serum analytes > 2.5 multiples of the median (MoM) by degree of elevation. Study Design Retrospective cohort study of singleton live-births participating in the California Prenatal Screening Program (2005–2011) examining PTB and obstetric complication for α-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (INH) by analyte subgroup (2.5 to 2.5 MoM confer an increased risk of PTB and, except for uE3, obstetric complication, and risks for each are not uniformly linear. These data can help guide patient counseling and antenatal management.

Objective: To evaluate the effect of human chorionic gonadotropin (hCG) trigger ovulation on pregnancy outcomes in natural IUI cycles with donor sperm.Methods: This retrospective cohort study included 5,610 first-natural IUI cycles with donor sperm in infertile couples during the period from January 2012 to December 2017. To control for other confounding factors, our analysis was restricted to normo-ovulatory women without tubal infertility. The main outcome measure was live birth rate; the secondary outcomes included rates of clinical pregnancy and miscarriage.Results: In the crude analysis, both the clinical pregnancy (27.40 vs. 22.73%; P = 0.001) and live birth rates (24.52 vs. 20.13%; P = 0.007) were significantly higher for the hCG group than for the spontaneous LH group. After adjustment for a number of confounding factors, the reproductive outcomes were still significantly worse for the spontaneous ovulatory group.Conclusions: Among women undergoing natural cycle IUI with donor sperm, hCG triggered ovulation for timing insemination offers beneficial impacts on both clinical pregnancy rates and live birth rates.

As the male reproductive organ, the main task of the testis is the production of fertile, haploid spermatozoa. This process, named spermatogenesis, starts with spermatogonial stem cells, which undergo a species-specific number of mitotic divisions until starting meiosis and further morphological maturation. The pituitary gonadotropins, luteinizing hormone, and follicle stimulating hormone, are indispensable for vertebrate spermatogenesis, but we are still far from fully understanding the complex regulatory networks involved in this process. Therefore, we developed an ex vivo testis cultivation system which allows evaluating the occurring changes in histology and gene expression. The experimental circulatory flow-through setup described in this work provides the possibility to study the function of the male tilapia gonads on a cellular and transcriptional level for at least 7 days. After 1 week of culture, tilapia testis slices kept their structure and all stages of spermatogenesis could be detected histologically. Without pituitary extract (tilPE) however, fibrotic structures appeared, whereas addition of tilPE preserved spermatogenic cysts and somatic interstitium completely. We could show that tilPE has a stimulatory effect on spermatogonia proliferation in our culture system. In the presence of tilPE or hCG, the gene expression of steroidogenesis related genes (cyp11b2 and stAR2) were notably increased. Other testicular genes like piwil1, amh, or dmrt1 were not expressed differentially in the presence or absence of gonadotropins or gonadotropin containing tilPE. We established a suitable system for studying tilapia spermatogenesis ex vivo with promise for future applications.

Background: Influence of pre-retrieval human chorionic gonadotropin (HCG) priming on outcomes of in vitro maturation (IVM) remains controversial. This study aimed to evaluate the effect of HCG priming before oocyte retrieval on clinical outcomes of IVM cycles in patients with polycystic ovarian syndrome (PCOS).Methods: This was a retrospective cohort study analyzing data from the first IVM cycles of unstimulated PCOS patients in a reproductive center of university affiliated hospital from January 2006 to December 2017. Patients received HCG injection before oocyte retrieval were assigned to HCG priming group and those without HCG administration were categorized as none HCG priming (Non-HCG) group. Main outcomes included oocyte maturation rate, number of embryos available, clinical pregnancy rate, and live birth rate. Candidate factors of clinical pregnancy rate was explored by univariate analysis and multivariate logistic regression analysis.Results: There were 324 patients meeting the inclusion and exclusion criteria. Among them, 129 women received HCG priming and 195 other did not. Women in HCG group had significantly lower basal FSH level (5.17 ± 1.63 vs. 5.80 ± 2.38) than Non-HCG group. Both FSH levels were

Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hCG RNA is transcribed as early as the eight-cell stage, and the blastocyst produces the protein before its implantation. hCG in the uterine microenvironment binds with its cognate receptor, luteinizing hormone/choriogonadotropin receptor (LHCGR), on the endometrial surface. This binding stimulates leukemia inhibitory factor (LIF) production and inhibits interleukin-6 (IL-6) production by epithelial cells of the endometrium. These effects ensure essential help in the preparation of the endometrium for initial embryo implantation. hCG also effects angiogenic and immunomodulatory actions as reported in many articles by our laboratories and other ones. By stimulating angiogenesis and vasculogenesis, hCG provides the placenta with an adequate maternal blood supply and optimal embryo nutrition during the invasion of the uterine endometrium. The immunomodulatory properties of hCG are numerous and important for programming maternal immune tolerance toward the embryo. The reported effects of hCG on uterine NK, Treg, and B cells, three major cell populations for the maintenance of pregnancy, demonstrate the role of this embryonic signal as a crucial immune regulator in the course of pregnancy. Human embryo rejection for hCG-related immunological reasons has been studied in different ways, and a sufficient dose of hCG seems to be necessary to maintain maternal tolerance. Different teams have studied the addition of hCG in patients suffering from recurrent miscarriages or implantation failures. hCG could also have a beneficial or a negative impact on autoimmune diseases during pregnancy. In this review, we will discuss the immunological impacts of hCG during pregnancy and if this hormone might be used therapeutically.

Abstract Background Studies have commonly assessed the endocrinolgical status of women once miscarriage is threatened or suspected; few studies have explored the antecedent hormonal environment or used a longitudinal strategy. Using refined statistical techniques, we sought to re-evaluate whether gestational hormone trajectories in early pregnancy can identify future miscarriage in asymptomatic pregnancies. Methods This prospective cohort study followed 105 women over-conception; 72 had normal term pregnancy outcomes while 33 experienced early pregnancy failure between 35 and 115 days of gestation. Participants attended a pre-conception and antenatal clinic at Newcastle University, United Kingdom (UK). Evaluation methods included ultrasound, clinical assessments of pregnancy progress and serial measurements of gestational hormones by radioimmunoassays. Linear mixed-effects regression analysis examined hormone relationships with pregnancy outcomes. Results Detailed longitudinal illustration of gestational hormones, antecedent to miscarriage indications, revealed early pathophysiological trends. In particular, oestradiol showed as marked a deviation from normal as progesterone before miscarriage was evident, reflecting a deficiency in the ovarian response to rising human chorionic gonadotrophin (hCG) levels. Regression analysis provided equations for gestational hormone slopes that significantly differentiated asymptomatic women with subsequent early pregnancy failure, compared to women with normal term pregnancies. Both progesterone and oestradiol displayed negative mean slopes in pregnancies destined for failure; in this group, both human placental lactogen (hPL) and hCG revealed mean positive trajectories that imitated normal pregnancies but at slower rates of increase. Conclusions Oestradiol, progesterone and hCG trajectories, from 50 days of gestation, have good potential for revealing pathophysiology and for identifying which asymptomatic pregnancies are destined for subsequent failure. In asymptomatic patients where there is concern about viability and ultrasound diagnosis is ambiguous, a combined hormonal profile could contribute to guiding patient care decisions.

Abstract Background Spontaneous abortion is one of the most common complications in early pregnancy. A preventive test to identify women who will experience a miscarriage, even before first symptoms occur, is not established. Activation of maternal immunological tolerance seems to be essential for early fetal development and various cytokines have been described in different stages of pregnancy. Therefore, we aimed to investigate if chemokine levels at the time of pregnancy testing relative to human Choriogonadotropin (hCG) are altered in patients who will experience a miscarriage in this pregnancy. Methods We obtained blood samples from 39 women. Dependent on the follow-up, patients with a positive pregnancy test were subsequently divided in two groups: ongoing pregnancy (n = 22) and miscarriage (n = 17) in this pregnancy. Immunological and endocrine profiling of maternal plasma at the time of pregnancy testing (5th week of gestation) was performed for each group at the time of pregnancy test using Multiplex and ELISA analysis. Results hCG was significantly decreased in patients with abortion whereas levels of IL-1ra, MIP-1a and TNF-alpha were significantly increased. GCSF/ IL-1ra-ratio was 1.66-fold increased in patients with ongoing pregnancy. TGF-beta /MIP1a-ratio was significantly 3.45-times higher in patients with miscarriage. Comparing patients with ongoing pregnancy to patients experiencing a miscarriage, we could demonstrate significant alterations of the ratios MIP1a/hCG, IL-1ra/hCG, TNFalpha/hCG, MCP1/hCG, IL-6/hCG, TPO/hCG and TGF-beta1/hCG. The strongest effects were seen for the ratio MIP1a/hCG, IL-1ra/hCG and TNFalpha/hCG. Conclusions We have shown that cytokines in relation to hCG after 4 weeks of gestation are significantly altered in women with miscarriage, promising potential as a prognostic biomarker.

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

Objective: To investigate the effect of human chorionic gonadotropin (hCG) on the motility of rat sperm and the fertilization rate following in vitro fertilization. Methods: hCG concentrations of 25, 50, 75 and 100 ng/mL with incubation time of 1 h and 2 h were used in medium to study sperm motility. Then, 25 and 100 ng/mL of hCG with incubation time of 2 h were applied for in vitro fertilization. After 6 h, the number of two pronuclei was counted. Obtained data was subjected to one way ANOVA and Bonferroni-Dun hoc-post test. Results: Total motility and progressive motility of sperms were increased significantly (P

Research question: Gonadotrophin releasing hormone (GnRH) agonist trigger after GnRH antagonist-based ovarian stimulation protocol for IVF is gaining popularity, because it prevents ovarian hyperstimulation syndrome and allows for near physiological LH and FSH surges. A small dose of HCG (1500 IU) on the day of oocyte retrieval, followed by daily progesterone administration, is currently the preferred way to secure adequate luteal support after GnRH agonist trigger. In the present study, the possibility that a bolus of 1500 IU HCG, given 2 days after oocyte retrieval, may be sufficient to sustain adequate luteal support without additional progesterone treatment was questioned. Design: A non-interventional retrospective cohort study between conducted between April 2017 and August 2018. A total of 154 consecutive patients treated with GnRH agonist trigger followed by day-2 HCG (1500 IU) support only (study group) were included. Data were compared with 155 consecutive patients who were treated with HCG (6500 IU) trigger followed by conventional progesterone luteal support (control group). Results: Pregnancy, miscarriage and live birth rates were comparable between the study and control groups. In patients who became pregnant, mean oestradiol level 14 days after oocyte retrieval was 4719 pmol/l and 2672 pmol/l in the study and control group, respectively (P < 0.001), reflecting robust luteal activity in the study group. Conclusions: A bolus of 1500 IU HCG, administered 2 days after retrieval, can provide excellent luteal support, without the need for further progesterone supplementation. [ABSTRACT FROM AUTHOR]

Context. The grey mullet, Mugil cephalus, is an edible fish of high economic importance. Breeding biology with reference to hormonal/growth factor regulation of oocyte maturation needs to be known for its commercial production. Objective. The present study was conducted to examine the potency of maturation inducing hormones, chorionic gonadotropin (hCG), bovine-insulin, and insulin like growth factor1 (h-IGF-1) I on ovarian steroidogenesis and oocyte maturation. Design. The role of hormones and growth factors on steroidogenesis and oocyte maturation was investigated using specific inhibitors, Wortmannin for phosphatidylinositol-3 (PI3) kinase, trilostane for 3β-hydroxysteroid dehydrogenase, 1-octanol and 1-heptanol for gap junctions, actinomycin D for transcription and cycloheximide for translation of signal molecules. Methods. Actions of hormonal and growth factors were examined for steroidogenesis, by radioimmunoassay and oocyte maturation by germinal vesicle breakdown (GVBD). Specific inhibitors were used to determine the cell signaling pathways, PI3 kinase. Results. All the inhibitors attenuated the hCGinduced oocyte maturation (GVBD%), steroidogenesis including transcription, translation, gap junctions and PI3 kinase signaling. These inhibitors failed to inhibit h-IGF-I and b-insulin-induced oocyte maturation, steroidogenesis, translation and PI3 kinase signaling. Conclusion. hCG induces oocyte maturation via steroid dependent pathway involving gap junctions, transcription, translation and PI3 kinase signaling, unlike h-IGF-I and b-insulin in the mullet. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of human chorionic gonadotropin on hormonal and haematological profile of postpubertal male albino rats exposed to chronic oral administration of alcohol. Twenty-four mature male albino rats were assigned to four groups (n=6). Group A was the control, given distilled water, Group B was given 30% ethanol (8 ml/kg) orally 3 times a week, Group C was given human chorionic gonadotropin (HcG) (50 IU/kg) subcutaneously 3 times a week and Group D was given HcG (50 IU/kg) subcutaneously + 30% ethanol (8 ml/kg) orally 3 times a week. The study was for 10 weeks, and hormonal profile and haematology were determined. The follicle stimulating hormone of Group B decreased significantly (P<0.05) when compared to Groups A, C and D. The luteinizing hormone was significantly lower (P<0.05) in Group B when compared to Groups A, C and D. The testosterone level was significantly higher (P<0.05) in Group D when compared to Groups A, B and C. The results obtained from haematology indicated that haemoglobin concentration of Group B was significantly lower (P<0.05) when compared to Groups A, C and D. Ethanol significantly reduced (P<0.05) platelets when compared to Groups A, C and D. There was a significant reduction (P<0.05) in the neutrophils and lymphocytes in Group B when compared to Groups A, C and D. The study showed that HcG improves the level of male hormones and haematology in postpubertal albino rats exposed to chronic alcohol administration. [ABSTRACT FROM AUTHOR]

Intrauterine insemination is amongst the foremost recommended procedures to reinforce the probability of pregnancy in couples with infertility. The success rate of this system depends on numerous factors, one among which is that the quality of the luteal phase which could be due to insufficient production of progesterone. To study the impact of luteal phase GnRH agonist versus HCG supplementation on pregnancy rates in females undergoing intrauterine insemination. This study was performed on random 40 infertile couples. Basal hormones measurement of FSH, LH, E2 and progesterone was done before undergoing ovarian stimulation by letrozole or clomiphene citrate. In the mid cycle transvaginal ultrasound was done to measure the dominate follicle/s and endometrial thickness (ET). Assessment of progesterone and E2 was done on the trigger day. Triggering of ovulation was done by the HCG injection (5000IU). IUI for all females included in the study then they were divided into two groups of 20. Group A were supplemented with GnRH agonist injections (0.1 mg) on day 9,10,11,12 post IUI plus progesterone suppositories 400 mg for 14 days while group B were supplemented with HCG injections 1500IU on day 1, 4, 7 post IUI plus progesterone suppositories 400 mg for 14 days. Then Progesterone level was re measured at day 21 of the cycle. Chemical pregnancy rate was done and recorded. The hormonal levels showed no significant difference in baseline serum FSH, LH and estradiol (E2) (P > 0.05); however, there was significant difference in mean serum baseline progesterone between protocol groups (p= 0.024); additionally, there was no significant difference in mean serum estradiol (E2) and progesterone at day 12 (p> 0.05), but the difference in mean serum progesterone at day 21 was highly significant (p < 0.001); its level was highest in group B than A. The pregnancy rate of infertile women in groupA (who used GnRH as supportive to luteal phase) was higher (40.0 %). Conclusions: Luteal phase support by GnRH injection (Decapeptyl 0.1mg) significantly increased pregnancy rate in infertile females undergoing intrauterine insemination compared to HCG injection (1500IU) in spite of significant elevation in progesterone hormone at 21the day in HCG group. [ABSTRACT FROM AUTHOR]

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The World Health Organization (WHO) describes infertility as a disability for couples in childbirth to attain pregnancy within 12 months of daily sexual intercourse. Infertility affects 13-20 per cent of couples worldwide, regardless of race or ethnicity. Human chorionic gonadotropin (hCG), also known as the "pregnancy hormone," plays a significant role in human reproduction. The present study was conducted in the departments of biochemistry and dept. of obstetrics and gynaecology. The study was conducted on two groups of 40 infertile Females and 40 healthy controls. Blood sample was collected for the estimation of prolactin and hCG was assessed by dry chemistry analyzer. Serum prolactin levels in infertile females is 33.96±11.46 and hCG levels was86.38±12.45 which was higher in infertile female as compare to healthy control with a p value of<0.05. Present study concludes that hyperprolactinemia is a major contributing hormonal factor in infertility among infertile women and, as such, prolactin and hCG should be measured in infertile women. [ABSTRACT FROM AUTHOR]

Morbidly adherent placenta is a serious and life-threatening condition. High index of suspicion for placenta accreta can save patient from undergoing hysterectomy. Timely and appropriate treatment modality is key in reducing morbidity of the patient Reporting herewith a case of 22-24 weeks intrauterine fetal demise in a primigravida patient who was diagnosed with Placenta accreta. Ultrasonography and MRI confirmed the diagnosis. Primigravida with no live issue, no active bleeding and stable vital parameters favored the option of conservative management in the form of "single dose methotrexate regime". Patient was then given Injection methotrexate 50 mg IM on day 1. Regularly monitored with CBC(complete blood count),LFT(Liver Function Test),KFT(kidney Function Test), beta HCG, USG and pelvic doppler. On day 7 piecemeal removal of complete placenta accrete was successful under USG guidance. [ABSTRACT FROM AUTHOR]