Results of 2426 in vitro fertilization cycles from King Faisal specialist hospital and research centre, 1986-1992

The report consists of summary in vitro fertilization [IVF] results for the period of 1986 to 1992, concerning 2426 IVF cycles on 954 patients. Tubal factor accounted for 48.7% of cases; male factor, 15.2%; unexplained factors, 15.8%; tubal plus male factor, 12.2%; with 7.7% miscellaneous pathologies. Stimulation regimes were of seven varieties over the period described. All cycles were monitored by transvaginal ultrasound and serum estradiol/LH. All oocyte retrievals were carried out at 34 hours post-HCG. Standard laboratory procedures were utilized for oocyte and pre-embryo culture and a maximum of four embryos were replaced approximately 48 hours after ovum pickup [OPU]. Luteal support was by either progesterone suppository or intramuscular injection for 14 days following embryo transfer. Average number of oocytes per retrieval was 7.8, with a fertilization rate of 54% over all groups. Two hundred and sixty-eight pregnancies were initiated [16.1% per embryo transfer [ET]] with 53 of these being biochemical. Pregnancy rates followed a learning curve in the early years with a plateau at 17.8% per ET. Thus, the IVF program has evolved to yield acceptable results after refinement of stimulation regimes, laboratory techniques [especially with regard to sperm preparation], ET techniques and luteal support, thereby tailoring its protocols to suit the local population

High prevalence of obesity in a Saudi infertility population

A menstrual history was taken from the female partners of all new infertility couples seen in our clinic between 1988 and 1990. The body mass index [Kg/M[2]] was measured in all females. The ovulatory status was studied using a combination of serial transvaginal ultrasound investigations and progesterone measurements in the second half of the cycle in females with regular menstrual cycles or progesterone measurements one week before the expected onset of menstruation in females with oligomenorrhea. Amenorrheic patients were considered anovulatory if no anatomical abnormality was found. Out of the 1755 patients, only 17% were in the normal weight category [BMI 19-24], 42% were overweight [BMI25-29] and 38% were obese [BMI 30 or more], while the remaining 3% were underweight. With increasing BMI, the percentage of oligomenorrhea increased from 18% to 32%, the percentage of amenorrhea increased from 2% to 13%. The overall percentage of anovulation increased from 32% to 55%

Predictive power of sperm motion analysis in in vitro fertilization

The correlation between sperm motion characteristics and in vitro fertilization was studied in 160 cycles, divided in two groups: those with male subfertility [N=42] and those with tubal disease [N=118]. The group with male subfertility showed inferior performance, as indicated by a lower fertilization rate per oocyte [40% versus 66%] and per pick-up cycle [67% versus 93%]. These two groups exhibited no significant difference in the mean sperm velocity, linearity, amplitude of lateral head displacement, and beat cross frequency in the pre swim-up and post swim-up specimens. The two groups differed in pre and post swim-up sperm motility, pre and post swim-up concentration, pre swim-up cumulative velocity at 110 to 140 micro m/sec and post swim-up cumulative velocity at 130 micro m/sec. Logistic regression analysis was used to determine those variables that would predict fertilization; pre swim-up count and post swim-up motility proved to be the significant determinants. The results indicate that assessment of motion by automated semen analyzers does not supplement conventional semen analysis in the ability to predict fertilization