ABSTRACT
Background and Objective: Evaluation of patient who responds poorly to exogenous gonadotropin is an important challenges in ovulation induction in assisted reproductive technology [ART] that will end with cancelled cycle. The aim of this study was to predict and discuss the causes of cycle cancellation in IVF program and thus prevent such situation so that these could be directed towards a more appropriate stimulation regimen
Methods: One hundred-sixty patients were enrolled in an IVF program for treatment their infertility at Institute for Embryo Research and Infertility Treatment/ Al-Nahrain University [Baghdad] from March 2002 to January 2003. The causes for infertility were [1] tubal factor infertility [41%], [2] male factor infertility [32%], [3] unexplained infertility [20%], [4] endometriosis [7%]. Ovulation induction was performed using gonadotropin releasing hormone analogue [GnRH-a] suppression followed by gonadotropin stimulation [long protocol]
Results: Based on ultrasound and estradiol [E2], 31 patients showed undesired response and 129 patients had in vitro fertililazation and embryo transfer [IVF-ET] performed. The causes of cycle cancellation were: 1- Poor follicular growth [n=15], 2- Poor ovarian reserve[n=6], 3- Ovarian hyper-stimulation syndrome[n=5], 4- Premature luteinization[n=4], 5- Misunderstanding of patients[n=1]
Conclusion: Analysis and determination of these causes enable investigators to prevent repeated unsuccessful IVF cycles and offer an alternative treatment