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Kisspeptin - Neurokinin B - Dynorphin (KNDy) Pathways
Preoptic area
+
adipose
Kisspeptin neurones
infundibular nucleus
+
GABA, NPY, glutamate
Basal forebrain
GNRH neurones
GNRH
pituitary
FSH LH
Neurokinin B Dynorphin neurones
ovary
Skorupskaite, George & Anderson, HRU 2014; 20: 485 Abbara et al Clin Endocrinol 2018
KISS1
+
Kisspeptin-54
More physiological pattern of LH/FSH secretion
Reduced risk of OHSS
Conventional IVF
0 7 14 21 28 35
In Vitro Maturation (IVM)
Gonadotrophin hCG OR ET
GnRH ago
nis
t
hort
progesterone
•
S
•R 4
63
Walls et al, Hum Reprod 2015; 88 Siristatidis et al, Cochrane Database 2013
2
4
9
5
quires go
Reduce OHSS in PCOM
Not widely practiced (0.2% cycles Europe)
Collection - transfer Different protocols
No RCTs
Clinical PR approx 30%, similar with frozen cycles
e
o
d labor
a
tory
6
0 7
progesterone oestradiol
OR ET
• •
• • •
14 21 28
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