CXC Ligand 5 cytokine serum level in women with polycystic ovary syndrome and normal body mass index: a case-control study

Background: Polycystic ovary syndrome [PCOS] is the most common endocrine disease and associated with insulin resistance. CXC Ligand 5 [CXCL5] is a new cytokine which is secreted from white adipose tissue during obesity and by blocking insulin signaling pathway inhibits the activity of insulin and promotes insulin resistance

Objective: The aim of this study was to assess serum level of CXCL5 in PCOS women with normal body mass index

Materials and Methods: In this case-control study, 30 PCOS women with normal body mass index as the case group and 30 non-PCOS women as the controls were enrolled. Serum levels of CXCL5, insulin and other hormones factors related with PCOS were measured by ELISA method, also the biochemical parameters were measured by auto analyzer

Results: Significant increases in serum insulin concentration, homeostasis model assessments of insulin resistance, luteinizing hormone, luteinizing hormone/follicle-stimulating hormone, fasting blood sugar, testosterone, and prolactin were observed in the case group compared to the controls. were in the serum level of CXCL5, cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, dehydroepi and roster one-sulfate, creatinine, and homeostasis model assessment of beta cell function between these two groups

Conclusion: In this study, no significant change was observed in serum concentrations of CXCL5 in PCOS women with normal BMI

Evaluation of clinical factors influencing pregnancy rate in frozen embryo transfer

Frozen embryo transfer [FET] is one of the most important supplementary procedures in the treatment of infertile couples. While general information concerning the outcome of fresh embryo transfer has been documented, paucity of investigations has addressed the clinical factors influenced on pregnancy rates in FET. In this study, we performed a retrospective analysis of clinical factors that potentially influence the outcome of FET. We reviewed the data from 372 women who were subjected to FET registered from April 2009-2011 at the Research and clinical center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Baseline data and pregnancy rate were collected. The data were analyzed statistically using the Kolmogorov-Smirnov, and Mann-Whitney tests. The clinical pregnancy rate was 57.7 and 29.2% in women <35 years old, and women >35 years old, respectively [p<0.0001]. Clinical pregnancy rates in women with FSH <10 IU/ml, and FSH >10 IU/ml were 56.3% and 17.5%, respectively [p<0.0001]. Whereas the other clinical parameters consist of reason of fetus freezing, primary IVF protocol, IVF procedure, endometrial thickness, treatment duration to fetal transfer found to be unrelated to FET outcomes [p>0.05]. Female age and basal FSH level are the most important factors influencing the clinical pregnancy rate following FET

Surrogacy as a good option for treatment of repeated implantation failure: a case series

Background: repeated implantation failure [RIF] is defined as pregnancy failure after two to six times with at least ten high grade embryo transfer to uterus. A variety of causes have been anticipated for RIF, including anatomical, autoimmune, genetics, endocrine and thrombotic anomalies. Factors responsible for RIF have important implication regarding treatment however in many couples a perfect cause cannot be found

Cases: in these case series, we reported nine couples with RIF that after investigation no definitive etiology was found for RIF and empirical therapy by heparin, aspirin and or immunotherapy was not effective. In these cases we recommended transfer of embryos to surrogate uterus. Nine patients were studied and six of them developed a normal pregnancy [pregnancy rate=66.66%]

Conclusion: this study showed that surrogacy is a good option for treatment of RIF

Comparison of pregnancy outcome in half-dose triptorelin and short-acting decapeptyl in long protocol in ART cycles: a randomized clinical trial

Background: gonadotrophin-releasing hormone [GnRH] agonist is used for controlling ovarian stimulation in assisted reproductive technology [ART] cycles which has some benefits

Objective: to compare the efficacy of two different formulations of GnRH agonist: short-acting and long-acting, for ART protocols

Materials and Methods: in a prospective randomized study, one hundred women who underwent ART cycles were randomly divided into two groups. In group I, the patients received one single injection of 1.87 mg Triptorelin in previous mid-luteal phase. In group II, Decapeptyl 0.1 mg per day started from previous mid-luteal phase. Pregnancy outcome in in vitro fertilization [IVF] cycle was compared between two groups

Results: there were no statistically significant differences in the number of retrieved oocyte [p=0.545], fertilization [p=0.876], implantation [p=0.716] and pregnancy rate [p=0.727] between the two groups

Conclusion: there were not any advantages in IVF outcome between half-dose long-acting and short-acting GnRH agonist groups in ART cycle

Effect of progesterone supplementation on natural frozen-thawed embryo transfer cycles: a randomized controlled trial

The transfer of cryopreserved embryos can be timed with ovulation in a natural cycle or after artificially preparing the endometrium with exogenous hormones. Progesterone is essential for the secretory transformation of the endometrium that permits implantation as well as maintenance of early pregnancy. The purpose of this study is to assess the effect of luteal phase supplementation on pregnancy rates in natural frozen-thawed cycles. The study was designed as a prospective randomized clinical trial of 102 women who underwent embryo transfers in natural cycles. The women in the interventional group [n=51] received intra muscular [IM] progesterone 50 mg twice a day starting from 36 hours after hCG administration. The control group [n=51] did not receive any progesterone support. There were no significant differences in demographic characteristics between the groups and no statistically significant differences were observed between study and control groups in clinical pregnancy rate [33.3% vs. 27.5%, p=0.66]. There were no differences in implantation rate or spontaneous abortion rate. Our results suggest that luteal phase support does not affect clinical pregnancy rates in natural frozen-thawed embryo transfer cycles [Registration Number: IRCT201108044339N6]

Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: a randomized clinical trial

Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence. Laparotomy or laparoscopy is the standard surgery for the large endometrioma. Also, sclerotherapy is basically used to treat different diseases one of which is endometrioma. The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma. In a randomized clinical trial, an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma. The patients were followed up first after one and two weeks and then after one, two, and three months. If the patients had no endometrioma, they were treated with in vitro fertilization [IVF] [standard long protocol]. A control group of 20 patients with endometrioma were enrolled for an IVF protocol. They had no treatment by ethanol sclerotherapy. IVF parameters, pregnancy rates, and implantation rates were compared in both groups. The demographic data showed no difference between the two groups. The initial mean endometria size was 41.45 +/- 15.9 cm, the recurrence rate after 6 months was 4 [20%], FSH before and after sclerotherapy was 6.97 +/- 2.25 IU/L and 6.78 +/- 1.88 IU/L [p=0.343]. The clinical pregnancy rate was 6 [33.3%] vs. 3 [15%], [p=0.616]. The fertilization rate emerged 63.06% in study group vs. 60.38%, [p=0.57]. The implantation rate turned out 12.9% in study group vs. 7.5%, [p=0.52]. None of these results were significant. However, the data pointed to a better trend toward the ethanol sclerotherapy group. Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF

Effect of adding human chorionic gonadotropin to the endometrial preparation protocol in frozen embryo transfer cycles

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. 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. In this study, 130 couples participated: 65 in the HCG group and 65 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. 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].

efficacy of recombinant versus urinary HCG in ART outcome

Human chorionic gonadotropin [HCG] has been used as a replacement for the mid-cycle luteinizing hormone [LH] surge for several years. The recent arrival of recombinant DNA technology has made recombinant HCG [rHCG] accessible. To assess efficacy of rHCG compared to urinary HCG [uHCG] for triggering of ovulation and induction of final oocyte maturation in assisted reproductive cycles. 200 patients who were candidate for ICSI were randomly divided in two groups. In group I [rHCG], patients received 250micro g of rHCG for final oocyte maturation, and in group II [uHCG] the patients received 10000 IU of uHCG. Measured outcomes were number of retrieved oocyte and mature oocyte, maturation rate of oocyte, fertilization rate and clinical pregnancy rate. The rates of oocyte maturity were similar in both groups. Fertilization rate was similar in two groups [58.58% in rHCG group versus 60.58% in uHCG group p=0.666]. The clinical pregnancy rate per cycle was similar in both group 34.0% in rHCG group versus 39% in uHCG group [p=0.310]. We demonstrated that rHCG is as effective as uHCG, when it is used for final oocyte maturation in ICSI cycles. The numbers of retrieved oocyte and maturation rates were similar in both groups; also fertilization and clinical pregnancy rates were similar

Outcome of cryopreserved-thawed embryo transfer in the GnRH agonist versus antagonist protocol

GnRH agonist and antagonist were developed to control the premature release of LH surge. There is some difference between two protocols. We compared the outcome of frozen-thawed embryo transfer in infertile women who used GnRH agonist or antagonist protocol for previous COH cycle and evaluation of any adverse effect of GnRH antagonist on oocyte and embryo. The study group included all infertile women who referred to Yazd Research and Clinical Center for Infertility. Overall 20-35 years old women who were candidate for frozen-thawed embryo transfer with regard to inclusion and exclusion criteria were participated in the study. The patients based on previous control ovarian stimulation [COH] protocol divided in to two groups: GnRH agonist long protocol [n=165] and GnRH antagonist multiple dose protocol [n=165]. Frozen-thawed embryos were transferred after endometrial preparation in both groups. Main outcome measures were: implantation, chemical and clinical pregnancy rate. The implantation and clinical pregnancy rate following cryopreserved embryo transfer in GnRH agonist group and antagonist group were 16.3% vs. 15.7% [p=0.806] and 38.1% [63/165] vs. 36.9% [61/165] [p=0.915] and chemical pregnancy rate was 44.8% [74/165] vs. 43.6% [72/165] [p=0.915] respectively. There was no statistically difference between two groups in terms of implantation and pregnancy rate. Although pregnancy rate in fresh embryo transfer in antagonist cycles was lower than agonist groups, Therefore decrease in these parameters might be due to detrimental effect of GnRH antagonist on the endometrium, not embryo or oocyte