ABSTRACT
The largest percentage of failed invitro fertilization [IVF] cycles, are due to lack of implantation. As hereditary thrombophilia can cause in placentation failure, it may have a role in recurrent IVF failure. Aim of this case-control study was to determine whether hereditary thrombophilia is more prevalent in women with recurrent IVF failures. Case group comprised 96 infertile women, with a history of recurrent IVF failure. Control group was comprised of 95 healthy women with proven fertility who had conceived spontaneously. All participants were assessed for the presence of inherited thrombophilias including: factor V Leiden, methilen tetrahydrofolate reductase [MTHFR] mutation, prothrombin mutation, homocystein level, protein S and C deficiency, antithrombin III [AT-III] deficiency and plasminogen activator inhibitor-1 [PAI-1] mutation. Presence of thrombophilia was compared between groups. Having at least one thrombophilia known as a risk factor for recurrent IVF failure [95% CI=1.74-5.70, OR=3.15, p=0.00]. Mutation of factor V Leiden [95% CI=1.26-10.27, OR=3.06, P=0.01] and homozygote form of MTHFR mutation [95% CI=1.55-97.86, OR=12.33, p=0.05] were also risk factors for recurrent IVF failure. However, we could not find significant difference in other inherited thrombophilia's. Inherited thrombophilia is more prevalent in women with recurrent IVF failure compared with healthy women. Having at least one thrombophilia, mutation of factor V Leiden and homozygote form of MTHFR mutation were risk factors for recurrent IVF failure
ABSTRACT
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