Can blood and semen presepsin levels in males predict pregnancy in couples undergoing intra-cytoplasmic sperm injection?

Objective: To determine whether semen and plasma presepsin values measured in men with normozoospermia and oligoasthenospermia undergoing invitro-fertilization would be helpful in predicting ongoing pregnancy and live birth

Methods: Group-I was defined as patients who had pregnancy after treatment and Group-II comprised those with no pregnancy. Semen and blood presepsin values were subsequently compared between the groups. Parametric comparisons were performed using Student's t-test, and non-parametric comparisons were conducted using the Mann-Whitney U test

Results: There were 42 patients in Group-I and 72 in Group-II. In the context of successful pregnancy and live birth, semen presepsin values were statistically significantly higher in Group-I than in Group-II [p= 0.004 and p= 0.037, respectively]. The most appropriate semen presepsin cut-off value for predicting both ongoing pregnancy and live birth was calculated as 199 pg/mL. Accordingly, their sensitivity was 64.5% to 59.3%, their specificity was 57.0% to 54.2%, and their positive predictive value was 37.0% to 29.6%, respectively; their negative predictive value was 80.4% in both instances

Conclusion: Semen presepsin values could be a new marker that may enable the prediction of successful pregnancy and/or live birth. Its negative predictive values are especially high

Association between serum estradiol level on the hCG administration day and IVF-ICSI outcome

Estradiol [E[2]] is required for follicular development and lay an important role in embryo implantation. The aim of this study was to assess the impact of serum E[2] levels on the day of hCG administration in IVF-ICSI patients who are performed controlled ovarian hyperstimulation [COH]. A total of 203 women who were undergone one time IVF cyclus were evaluated in this cross sectional study. All the patients were treated either with long protocol or with microdose flare protocol. The patients were categorized into five groups according to the serum E[2] levels on the day of hCG administration. The mean number of the retrieved oocytes was [NRO] 10.6 +/- 6.7, mean fertilization rate was 55.7 +/- 24.8, and implantation rate was 9.0 +/- 19.2. Of 203 patients, 43 [21%] patients were pregnant. When the overall results are examined, the number of the retrieved oocytes and the number of transferred embryos were better in patients with serum E[2] levels >4000 pg/ml and these values were statistically significant. There were no statistical difference in patients 37 years or older. In women 4000 pg/ml. In site of the lack of high quality evidence to support a positive association between serum E[2] levels and IVF-ICSI outcomes, this study shows that high E[2] levels during COH might be associated with an increased potential of pregnancy depending on better ovarian response. When the overall results are examined, the best scores were in patients with serum E[2] levels >4000 pg/ml

Comparison of the efficacy and cost-effectiveness of highly purified urinary follicle stimulating hormone [HP-uFSH] and recombinant follicle stimulating hormone [rFSH] in Poor Responders

We aimed to compare the clinical results and effectiveness of two gonadothropin treatment protocols; HP-uFSH and rFSH in poor responders. While HP-uFSH was given to 58 patients, rFSH was given to 62 patients. The patient selection criteria were the same [FSH value>15 iu/l or antral follicle number<4, on the second day of menstruation]. Endometrial thickness on hCG day [mm] was 9.0 +/- 2.7 and 7.8 +/- 2.7 in HP-uFSH group and rFSH group, respectively and this difference was statistically significant. Contrarily, fertilization rate [%] was better in rFSH than HP-uFSH [76.6 +/- 15.9 vs. 68.2 +/- 17.8] and this value was also statistically significant. Percentage of cancelled cycles [%] was 14 +/- 34 in HP-uFSH group and this parameter was significantly lower than rFSH group [29 +/- 45]. rFSH is as efficacious as HP-uFSH in poor responders. Fertilization rate was better in rFSH than HP-uFSH. Since rFSH is more expensive, the final treatment cost with rFSH to obtain a pregnancy was slightly higher, but this difference was not statistically significant [20060 TL vs. 17150 TL]