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Objective@#Animal-free scaffolds have emerged as a potential foundation for consistent, chemically defined, and low-cost materials. Because of its good potential for high biocompatibility with reproductive tissues and well-characterized scaffold design, we investigated whether polyglycolic acid (PGA) could be used as an animal-free scaffold instead of natural fibrin-agarose, which has been used successfully for three-dimensional human endometrial cell culture. @*Methods@#Isolated primary endometrial cells was cultured on fibrin-agarose and PGA polymers and evaluated various design parameters, such as scaffold porosity and mean fiber diameter. Cytotoxicity, scanning electron microscopy (SEM), and immunostaining experiments were conducted to examine cell activity on fabricated scaffolds. @*Results@#The MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay and SEM results showed that endometrial cells grew and proliferated on both scaffolds. Immunostaining showed cytokeratin and vimentin expression in seeded cells after 7 days of culture. On both scaffolds, an epithelial arrangement of cultured cells was found on the top layer and stromal arrangement matrix on the bottom layer of the scaffolds. Therefore, fibrin-agarose and PGA scaffolds successfully mimicked the human endometrium in a way suitable for in vitro analysis. @*Conclusion@#Both fibrin-agarose and PGA scaffolds could be used to simulate endometrial structures. However, because of environmental and ethical concerns and the low cost of synthetic polymers, we recommend using PGA as a synthetic polymer for scaffolding in research instead of natural biomaterials.
ABSTRACT
Background: We designed the present study to evaluate the simultaneous effect of obesity in couples on in vitro fertilization/intracytoplasmic sperm injection [IVF/ICSI] outcomes
Materials and Methods: In this cross-sectional study, performed at Royan Institute between January 2013 and January 2014, we evaluated the recorded data of all patients during this time period. The study population was limited to couples who underwent ICSI or IVF/ICSI cycles with autologous oocytes and fresh embryo transfers. We recorded the heights and weights of both genders and divided them into groups according to body mass index [BMI]. Multilevel logistic regression analysis was used to determine the odds ratio for live births following ICSI or IVF/ICSI
Results: In total, 990 couples underwent IVF/ICSI cycles during the study period. Among the ovulatory women, a significant difference existed between the BMI groups. There was a 60% decrease [95% confidence interval [CI]: 0.11-0.83] in the odds of a live birth among overweight subjects and 84% [95% CI: 0.02-0.99] decrease among obese subjects. Among the anovulatory women, the association between the BMI and live births presented no clear tendencies. We did not observe any significant relationship between male BMI and live birth rate. The results demonstrated no significant association between the couples' BMI and live birth rate
Conclusion: Based on the present findings, increased female BMI independently and negatively influenced birth rates after ICSI. However, increased male BMI had no impact on live births after ICSI, either alone or combined with in- creased female BMI
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Background: Multiple pregnancies occur more frequently in assisted reproductive technology [ART] compared to normal conception [NC]. It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally
Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations [MCM] in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran's ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome
Results: We found 40 infants with MCM 29 [4.4%] NC infants and 14 [8.3%] ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM [P=0.046]. After adjusting individually for maternal age, infant gender, prior stillbirth, mother's history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority [95.1%] of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization [IVF] and intracytoplasmic sperm injection [ICSI]. We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants
Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip [DDH], and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification
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Objectives: Polycystic ovary syndrome [PCOS] is a common endocrine disorder related to several metabolic consequences. However, there remains uncertainty regarding the metabolic features of various phenotypes. The aim of this study was to explore the relationship between the prevalence of gestational diabetes mellitus [GDM] and metabolic disorders among the four different phenotypes of PCOS
Methods: A crosssectional study was performed in Royan Institute including 208 pregnant women with a history of infertility and PCOS. Using the diagnostic criteria of the American Diabetes Association [ADA], pregnant women with a documented diagnoses of PCOS were further categorized into four different phenotypes [A, B, C, and D] as defined by the Rotterdam criteria
Results: The prevalence of GDM failed to demonstrate a significant relationship among the four phenotypes of PCOS. The mean levels of fasting blood sugar, plasma glucose concentrations at three hours [following the 100 g oral glucose tolerance test] and triglyceride levels were significantly higher in phenotype B compared to the remaining phenotypes [p < 0.050]. There was a statistically significant difference between the mean free testosterone level and phenotypes A and C groups [1.8+/-1.6 vs. 1.1+/-1.0, p = 0.003]
Conclusions: Women with a known diagnosis of PCOS who exhibited oligo/ anovulation and hyperandrogenism demonstrated an increase of metabolic disorders. These results suggest that metabolic screening, before conception or in the early stages of pregnancy, can be beneficial particularly in women with PCOS phenotypes A and B. Early screening and identification may justify enhanced maternal fetal surveillance to improve maternal and fetal morbidity among women affected with PCOS
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Objective: Toll like receptors [TLRs] are one of the main components of the innate im-mune system. It has been reported that expression of these receptors are altered in the female reproductive tract [FRT] during menstrual cycle. Here we used a fallopian tube epithelial cell line [OE-E6/E7] to evaluate the effect of two sex hormones in modulating TLR expression
Materials and Methods: In this experimental study, initially TLR gene expression in OE-E6/E7 cells was evaluated and compared with that of fallopian tube tissue using quantitative real time-polymerase chain reaction [qRT-PCR] and immunostaining. Thereafter, OE-E6/E7 cells were cultured with different concentrations of estradiol and progesterone, and combination of both. qRT-PCR was performed to reveal any changes in expression of TLR genes as a result of hormonal treatment
Results: TLR1-10 genes were expressed in human fallopian tube tissue. TLR1-6 genes and their respective proteins were expressed in the OE-E6/E7 cell line. Although estradiol and progesterone separately had no significant effect on TLR expression, their combined treatment altered the expression of TLRs in this cell line. Also, the pattern of TLR expression in preovulation [P], mensturation [M] and window of implantation [W] were the same for all TLRs with no significant differences between P, M and W groups
Conclusion: These data show the significant involvement of the combination of estradiol and progesterone in modulation of TLR gene expression in this human fallopian tube cell line. Further experiments may reveal the regulatory mechanism and signalling pathway behind the effect of sex hormones in modulating TLRs in the human FRT
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Background: Endometriosis affects women's physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women
Materials and Methods: A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis [cases] and 332 infertile women with a normal pelvis [comparison group]. Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis.
Results: Gravidity [odds ratio [OR]: 0.8, confidence interval [CI]: 0.6-0.9, P=0.01], parity [OR: 0.7, CI: 0.6-0.9, P=0.01], family history of endometriosis [OR: 4.9, CI: 2.1-11.3, P0.001], history of galactorrhea [OR: 2.3, CI: 1.5-3.5, P=0.01], history of pelvic surgery [OR: 1.9, CI: 1.3-2.7, P0.001], and shorter menstrual cycle length [OR: 0.9, CI: 0.9-0.9, P=0.04] were associated with endometriosis. Duration of natural menstruation and age of menarche were not correlated with subsequent risk of endometriosis [P>0.05]. Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis
Conclusion: Endometriosis is a considerable public health issue because it affects many women and is associated with the significant morbidity. In this study, we built a prediction model which can be used to predict the risk of endometriosis in infertile women
Subject(s)
Humans , Women , Middle Aged , Adult , Risk Factors , Retrospective Studies , Laparoscopy , Infertility, Female , Pelvic PainABSTRACT
Objectives: This study aimed to assess the influence of coasting duration on the number and quality of oocytes and fertilization rate in male factor infertile women and those with polycystic ovary syndrome [PCOS]
Methods: In this prospective observational follow-up study, 114 patients undergoing coasting [53 women with male factor infertility and 61 women with PCOS] were evaluated at the Royan Institute Research Center, Iran, between 2010 and 2012
Results: The results were analyzed according to the coasting periods of 1-4 days. In normal females, the number of oocytes retrieved was significantly reduced after the second day [p = 0.004]. In addition, a statistically significant drop was observed in the number of metaphase II oocytes and fertilization rate after the third day [p = 0.006 and p = 0.006, respectively]. No significant differences were observed in the number and quality of oocytes retrieved and fertilization rate with regard to coasting days in PCOS patients
Conclusion: Coasting with duration of more than three days should be performed with caution in normal females who are at risk of developing ovarian hyperstimulation syndrome
ABSTRACT
To compare the pregnancy outcomes after two embryos versus three embryos transfers [ETs] in women undergoing in vitro fertilization [IVF] intracytoplasmic sperm injection [ICSI] cycles. This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and ET3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ETS groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality [grade A] was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy
ABSTRACT
Background: Although the risk factors of ectopic pregnancy have been determined in previous studies, the main risk factors of ectopic pregnancy are different in various countries due to different cultural and social characteristics. Determination of main risk factors of ectopic pregnancy leads to a rapid diagnosis and an improvement in strategies for its prevention. The purpose of this study was to determine the main risk factors of ectopic pregnancy in a sample of Iranian women
Materials and Methods: We designed a case-control study to include 150 cases and 300 controls and to compare them by the following factors: socio-demographic characteristics, contraceptive methods, prior tubal surgery, tubal pathology, prior ectopic pregnancy, prior caesarean section, prior abortion, prior infertility, and prior abdominal/pelvic surgery
Results: The case and control groups were significantly similar in term of education and parity. There was an association between ectopic pregnancy and age which was disappeared after controlling for the main risk factors [adjusted OR=2.45, 95% CI: 0.86-6.97]. There was no statistically significant relation between ectopic pregnancy and prior tubal surgery, tubal pathology, prior abortion, prior infertility, assisted reproductive technology, and oral contraceptive method [p>0.05]. However, there was a significant association between prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior abdominal/pelvic surgery with ectopic pregnancy [p<0.05]. The risk of ectopic pregnancy increased with the use of intrauterine device and tubal ligation, whereas decreased with use of oral contraception
Conclusion: This study identified prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior pelvic/abdominal surgery as the main risk factors for ectopic pregnancy in a sample of Iranian women. Our findings can be useful for early diagnosis of ectopic pregnancy and for improvement in strategies of its prevention through medical therapy instead of unnecessarily surgical treatment
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Background: Childbearing for the first time is a unique experience. Quality of life is an important indicator in health studies. This study aimed to assess the quality of life of women who were conceived by ARTs and had successful childbirth for the first time and to compare it with quality of life in women who become pregnant naturally and similarly had successful childbirth for the first time
Materials and Methods: This was a cross sectional comparative study. The accessible sample was recruited from patients attending an infertility clinic and two obstetric and gynecology clinics in Tehran, Iran, during March 2010 to March 2011. In all 276 patients were approached. Of these, 162 women [76 women in natural conception group and 86 women in assisted reproduction technologies group] who met the inclusion criteria were entered into the study. Quality of life was assessed using the 36-item Short Form Health Survey [SF-36]. Women completed the questionnaire at two time points: i. last trimester and ii. first month after delivery. Comparison was made between two groups using Mann-Whitney U test and paired samples t test
Results: Comparing the SF-36 scores between women in natural conception group and ARTs group before childbirth, it was found that natural group had better condition on physical functioning, role limitation due to physical problems, bodily pain and social functioning, while the ARTs group reported better status on general health, vitality, role limitation due to emotional problems, and mental health. However, after childbirth, the ARTs group reported a better condition almost on all measures, except for physical functioning. Comparing differences in obtained scores between two groups before and after childbirth, the results showed that improvements in health related quality of life measures for the ARTs group were greater in all measures, expect for general health
Conclusion: The findings from this study suggest that health-related quality of life was improved in women who became a mother for the first time by either method. Comparing to women who became mother by natural conception, women who received ARTs showed better quality of life from this first successful experience
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Background: Poor ovarian response [POR] to gonadotropin stimulation has led to a significant decline in success rate of fertility treatment. The immune system may play an important role in pathophysiology of POR by dysfunctions of cytokines and the growth factor network, and the presence of ovarian auto-antibodies. The aim of this study is to investigate the expression of toll-like receptors [TLR] 1, 2, 4, 5, 6 and cyclooxygenase [COX] 2 genes in follicular cells and concentration of interleukin [IL]-6, IL-8 and macrophage migration inhibitory factor [MIF], as major parts of innate immunity, in follicular fluid [FF] obtained from POR women in comparison with normal women
Materials and Methods: In this case-control study, 20 infertile POR patients and 20 normal women took part in this study and underwent controlled ovarian stimulation. The FF was obtained from the largest follicle [>18 mm]. The FF was centrifuged and cellular pellet was then used for evaluation of expression of TLRs and COX2 genes by real-time PCR. FF was used for quantitative analysis for IL-6, IL-8 and MIF by enzyme-linked immunosorbent assay [ELISA]
Results: TLR1, 2, 4, 5, 6 and COX2 gene expression were significantly higher in POR [p<0.05]. Concentration of IL-6, IL-8 and MIF proteins was significantly increased in POR compared with normal women [p<0.05]
Conclusion: These findings support the hypothesis that the immune system may be involved in pathophysiology of POR through TLRs
ABSTRACT
Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles [IVF]. In this prospective cohort study, we followed 103 patients who underwent intra-cytoplasmic sperm injection [ICSI] procedures over a 24-months period. The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild male factor infertility was candidate for ICSI treatment during the same time period as the study groups. Both groups were compared for number of oocytes retrieved, grades of oocytes, as well as embryo quantity and quality. Our results showed similar follicle numbers, good embryo grades [A or B] and pregnancy rates in the compared groups. However, patients with endometrioma had higher gonadotropin consumption than the control group. The mean number of retrieved oocytes in patients with endometrioma was significantly lower than control group [6.6 +/- 3.74 vs. 10.4 +/- 5.25] [p<0.001]. In addition, patients with endometrioma had significantly lower numbers of metaphase II [MII] oocytes [5 +/- 3.21] than controls [8.2 +/- 5.4] [p<0.001]. In patients with unilateral endometrioma, there were no significant differences in main outcome measures between normal and involved ovaries in the patients with endometrioma. Patients with ovarian endometrioma had poor outcome. They showed poor ovarian response with lower total numbers of retrieved oocytes and lower MII oocytes during the stimulation phase; however, it does not affect the total number of embryos transferred per patient, quality of embryos, and pregnancy rate per patient
Subject(s)
Humans , Female , Pregnancy Rate , Fertilization in Vitro , Endometriosis/pathology , Ovulation Induction , Prospective Studies , Cohort Studies , Embryonic Structures , Infertility, Female , Oocytes/cytologyABSTRACT
Different success rate of Intracytoplasmic Sperm injection [ICSI] has been observed in various causes of infertility. In this study, we evaluated the relation between ICSI outcome and different causes of infertility. We also aimed to examine parameters that might predict the pregnancy success rate following ICSI. This cross sectional study included1492 infertile women referred to Infertility Center of Royan Institute between 2010 and 2011. We assigned two groups including pregnant [n=504] and non-pregnant [n=988], while all participants underwent ICSI cycles. All statistics were performed by SPSS program. Statistical Analysis was carried out using Chi-square and t test. Logistic regression was done to build a prediction model in ICSI cycles. The overall clinical pregnancy rate in our study was 33.9% [n=1492]. There was a statistically significant difference in mean serum concentration on day 3 after application of luteinizing hormone [LH] between the pregnant and the non-pregnant groups [p<0.05]. However, There were no significant differences between two groups in the serum concentrations on day 3 after application of the following hormones: follicle-stimulating hormone [FSH], thyroid-stimulating hormone [TSH], and metoclopramide-stimulated prolactin [PRL] . We found no association between different causes of infertility and clinical outcomes . The number of metaphase II [MII] oocytes, embryo transfer, number of good embryo [grade A, B, AB], total dose of gonadotropin, endometrial thickness, maternal age, number of previous cycle were statistically significant between two groups [p<0.05]. Our results indicate that ICSI in an effective option in couples with different causes of infertility. These variables were integrated into a statistical model to allow the prediction for the chance of pregnancy following ICSI cycles. It is required that each infertility center gather enough information about the causes of infertility in order to provide more information and better assistance to patients. Therefore, we suggest that physicians prepare adequate training and required information regarding these procedures for infertile couples in order to improve their knowledge
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The objective of this study was to identify the prognostic factors that influence the outcome of ovarian stimulation with intrauterine insemination [IUI] cycles in couples with different infertility etiology. This retrospective study was performed in data of 1348 IUI cycles with ovarian stimulation by clomiphene citrate [CC] and/or gonadotropins in 632 women with five different infertility etiology subgroups at Akbarabbadi Hospital, Tehran, Iran. The pregnancy rate [PR]/ cycle was highest [19.9%] among couples with unexplained infertility and lowest [10.6%] in couples with multiple factors infertility. In cases of unexplained infertility, the best PR[s] were seen after CC plus gonadotropins stimulation [26.3%] and with inseminated motile sperm count>30×10[6] [21.9%], but the tendency didn't reach statistical significant. In the ovarian factor group, the best PR[s] were observed in women aged between 30 and 34 years [20.8%], with 2-3 preovulatory follicles [37.8%] and infertility duration between 1and 3 years [20.8%], while only infertility duration [p=0.03] and number of preovulatory follicles [p=0.01] were statistically significant. Multiple logistic regression analysis determined that number of preovulatory follicles [p=0.02], duration of infertility [p=0.015], age [p=0.019], infertility etiology [p=0.05] and stimulation regimen [p=0.01] were significant independent factors in order to predict overall clinical PR. The etiology of infertility is important to achieve remarkable IUI success. It is worth mentioning that within different etiologies of infertility, the demographic and cycles characteristics of couples did not show the same effect. Favorable variables for treatment success are as follows: age <40, duration of infertility
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Polycystic ovary syndrome [PCOS] is a disorder that affects various body organs and requires comprehensive long term evaluation and management. The aim of this study was to evaluate effect of Flutamide on ovulation induction in PCOS patients. This prospective study applied triple blind method, a simple convenience sampling method, to induce ovulations of the ninety six PCOS patients. Patients were divided into two groups; group A included 53 subjects [received Flutamide + Clomiphene Citrate] and group B included 43 subjects [received placebo + Clomiphene Citrate]. Ultrasound was carried to determine the size of follicles and growth rate of them during follicular phase of the menstrual cycle. Also, progesterone levels were measured on days 19 and 21 of the menstrual cycle. In this study, ninety six PCOS patients, in two treatment and control groups, were evaluated regarding to body mass index [BMI], cycle irregularity, age and number of dominant follicles, duration of stimulation, endocrine profile and score of hirsutism. The obtained results revealed no significant differences between two groups. Flutamide does not affect ovulation improvement in PCOS patients undergoing induction
Subject(s)
Humans , Female , Adolescent , Adult , Ovulation Induction , Flutamide , Clomiphene , Prospective StudiesABSTRACT
Obejective [s]: infertile couples receiving IVF / ICSI treatment may be at higher risk of developing psychological or health-related problems. Identification of these groups at risk may enable better allocation for appropriate counseling
Methods: a total of 1028 [516 women and 512 men] were invited to complete health survey short form [SF-36] questionnaire prior to initiating IVF / ICSI treatment in Vali.e.Asr hospital and Rooyan infertility center.The patient's demographic and clinical characteristics were also recorded
Results: male SF-36 scores were higher than those reported by women. Quality of life increased with advancing age, level of education, economic status, in working women and infertality due to male factor
Conclusion: Infertile couples are at risk of a sub- optimal quality of life. Psychological counselling, especially support psychotherapy, must be regarded for patients in order to increase their quality of life
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Menopause is a step of a woman's life when hormonal changes cause menstruation to stop permanently. Menopausal symptoms can affect women's health and differ between different races and societies. The aim of this study was to survey the symptoms associated with menopause among Iranian women living in Tehran, Iran. In this cross sectional study which has been done between 2004 and 2005, women aged equal or more than 35 years old living in districts of Tehran were selected by multistage randomized cluster sampling. For each woman a questionnaire was completed. The data gained from each questionnaire was analyzed by using SPSS version 13. At time of study, 2462 women were naturally menopause. The mean age of natural menopause onset was 47.71 [SE=0.11] years. In 52.9% of cases, the onset of menopause was sudden. The symptoms associated with menopause were night sweats [61.2%], joint and muscle pain [59.9%], hot flashes [53.1%], fatigue [45.6%], decreased libido [33.9%], insomnia [33.7%], weight gain [30.1%], forgetfulness [24.9%] and urinary symptoms [17.4%]. This study showed that night sweats, joint and muscle pain and hot flashes are the most common symptoms associated with menopause
Subject(s)
Humans , Female , Cross-Sectional Studies , Random Allocation , Hot Flashes , Sweating , Libido , Hormone Replacement Therapy , Surveys and QuestionnairesABSTRACT
Parental anxiety while waiting for the results of amniocentesis has been investigated by many authors. It seems that the implementation of faster techniques such as fluorescence in-situ hybridization [FISH] will have some benefits in reducing this anxiety. Besides the patients' attitudes to choosing this method, gynecologists who are the persons responsible for treatment, must feel comfortable about prescribing FISH techniques. This study, using a simple methodology, was undertaken to evaluate the results of FISH tests on the amniotic fluid from 40 pregnant women undergoing cesarean surgery. Two sets of probes including X/Y cocktail and 13, 21 and 18 were applied on different slides. The results of FISH tests were compared with the reports of the pediatrician about the health condition of the newborn. Complete conformity between the two sets of findings, have convinced our gynecologists of the benefit of prescribing this method to reduce the anxiety of patients at risk of having abnormal offspring due to chromosomal anuploidies. As has been documented by many authors, conventional chromosome analysis has great advantages over fluorescence in situ hybridization of interphase amniocytes, but reducing the anxiety of parents is a good reason for employing the FISH technique
Subject(s)
Male , Female , Interphase , In Situ Hybridization, Fluorescence , Prenatal Diagnosis , Amniocentesis , Polymerase Chain ReactionABSTRACT
The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate. We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 [582 patients] or on day 3 [387 patients] post-insemination over a 10-month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed. The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically and we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 [40.72%] than patients who had transferred on day 2 [38.96%], but this difference was not significant. proportion of embryos with 2-3 cells, four cells, and 5-7 cells, which selected for transfer, showed significant difference between day 2 and day 3 [p<0.05]. There was also significant difference between pregnant and non-pregnant women based on embryo cell numbers on day two [p<0.011]. Extending the embryo culture period from 2 to 3 days had no adverse effect on pregnancy rate. Embryo transfer could be done on days 2 or 3 according to the convenience of the patient and the medical team
Subject(s)
Humans , Female , Pregnancy Outcome , Embryo Transfer , Cross-Sectional Studies , Retrospective StudiesABSTRACT
With aging, the ovarian reserve is decreased and that is a major contributor to poor ovarian response to exogenous gonadotropins. The aim of the present study is to evaluate the role of Dexamethasone on ovarian response in infertile patients aged over 35 years undergoing IVF/ICSI cycles. In this triple blind placbo-control clinical trial study, a total of 72 infertile women over age 35, undergoing IVF/ICSI cycles, referred to Royan Institute from May 2000 to May 2002 were selected. Dexamethasone co-treatment [1mgld] was started on the 21st of their preceding menstrual cycle and it was continued until oocyte aspiration. The main outcome measures were number of retrieved oocytes, number of fertilized and transferred embryos, number of used HMG, serum E2 level on HCG injection day, and pregnancy rate. There was no significant statistical difference in age, duration of infertility, Body mass index, hormonal tests, number of retrieved oocytes and transferred embryos. However, the number of used HMG was significantly lower in Dexamethasone group compared to placebo group [30.6 +/- 13.39 versus 41.64 +/- 18.34] [p<0.05]. The addition of dexamethasone 1mgld to standard long protocol decreased the number of itme used in patients over 35 years who hold known risk of low ovarian response