Successful pregnanacy by in vitro fertilization using corifullitropin alfa (ELONVA) for controlled ovaian stimuation: The first reported local experience

The need for simplified in-vitro fertilization (IVF) treatment approaches with the aim of reducing treatment burden and to prevent drop-outs after a failed IVF cycle can be met by the use of corifollitropin alfa for COS in association with a GnRH antagonist protocol. This is a report of the first local case of a successful pregnancy using corifollitropin alfa in IVF. This is a case of a 33 year-old G3 PO (0030) whose partner has teratozoospermia. COS using corifollitropin alfa yielded eight mature oocytes with no occurrence of OHSS. Six oocytes were fertilized using ICSI with six good quality embryos reaching cleavage stage. Two grade 1 embryos at day 3 cleavage stage were transferred. A clinical pregnancy was documented at 7 weeks age of gestation. Congenital anomaly scanning at 24 weeks age of gestation revealed a grossly normal fetus. Patient delivered a healthy, live, term baby boy. Review of literature suggests that corifollitropin alfa is as effective as rFSH in delivering live birth rate, ongoing pregnancy rate and clinical pregnancy rate. The sustained and higher FSH immunoreactivity concentrations and the inability for dose adjustment after treatment with a single dose of corifollitropin compared with the daily rFSH regimen underscores the need for careful patient selection in the use of corifollitropin alfa.

The changing trends of pregnancy rate among patients seen at a fertility center from 2009-2010

This is a retrospective descriptive study (chart review) which illustrates current demographic trends in patients seeking in vitro fertilization (IVF) consultations and treatment in the first IVF center in the Philippines. Age, occupation, place of residence, religious background, cause of infertility problems of patients seen in 2009-2010 were compared between young patients (defined as those below 40 years old) and those 40 years old and above. Success rates were also compared between the two groups. Trends in these demographics were compared to patient characteristics seen during the center's infancy. Potential reasons for these were then explored.

Repeat IVF among first time failures: A Philippine experience / Philippine Journal of Obstetrics and Gynecology

This is a prevalence study of patients seeking IVF treatment cycle for the second time and includes patients seen from 1996 to 2009. Patients were grouped into two based on the time period of treatment. The first 100 were seen from 1996- 2002 and the second 100 were seen from 2003 to 2009. Of the 200 seen, 11% opted for a second cycle of treatment (5% coming from the first batch increasing to 17% from the second batch). Using chi-square with a P value of 0.007, this 12% difference is significant. Comparing the two groups based on age (regardless of number of IVF procedures administered), there is no significant difference between the two groups (P=0.28). The mean age in both groups was 35 years. Ages of patients ranged from 22-47, most frequent occurring age was 32 years. Of those who had second cycles, there was no significant difference in the mean age of patients in batches 1 & 2 (P=0.29) with the mean age of 35 years and ages ranged from 28-41. In terms of outcome (pregnancy rate), out of the 22 (total from both batches) who received second treatment, 8 achieved pregnancy (36.4% pregnancy rate; 3 from batch 1 and 5 from batch 2). Comparing outcomes between batches, there was no significant difference (P=0.30). Given the small number of subject who had obtained IVF treatment in the Philippines in a span of thirteen years since the first center was put up, the paper then explores the possible reasons for these. Such reasons ranged from economic concerns, government prioritization of national health issues, public awareness and personal biases. Despite the small number of patients seeking IVF, there was a significant rise in number of couples obtaining a second cycle in the second (later) group of subjects studied. Reasons for this also explored and may involve physician-patient rapport, better lay knowledge of the techniques, lesser apprehension and improved facilities and techniques.

Successful human pregnancy by in-vitro fertilization using sperm retrieved by testicular sperm extraction (TESE): the first reported local experience

A 31 year old Filipino male diagnosed with obstructive azoospermia underwent TESE. Other current advanced sperm retrieval techniques include MESA, PESA and TESA confounded with female factors such as advanced maternal age and polycystic ovaries, IVF-ICSI eventually resulted to a successful pregnacy outcome. Several factors contributing to the success of IVF-ICSI eventually resulted to a successful pregnancy outcome. Several factors contributing to the success of IVF-ICSI in this case were also discussed. Although assisted reproductive technology is relatively new in our country, it proved to be promising in our local setting.

Assisted reproductive technology in the local setting

Assisted reproduction is generally defined as infertility treatment in which both oocytes and sperm are handled in the laboratory and is commonly called as in vitro fertilization or test tube baby.