Effect of administration of single dose GnRH agonist in luteal phase on outcome of ICSI-ET cycles in women with previous history of IVF/ICSI failure: a randomized controlled trial

GnRH agonist administration in the luteal phase has been suggested to beneficially affect the outcome of intracytoplasmic sperm injection [ICSI] and embryo transfer [ET] cycles. This blind randomized controlled study evaluates the effect of GnRH [Gonadotropine Releasing Hormone] agonist administration on ICSI outcome in GnRH antagonist ovarian stimulation protocol in women with 2 or more previous IVF/ICSI-ET failures. One hundred IVF failure women who underwent ICSI cycles and stimulated with GnRH antagonist ovarian stimulation protocol, were included in the study. Women were randomly assigned to intervention [received a single dose injection of GnRH agonist [0.1 mg of Decapeptil] subcutaneously 6 days after oocyte retrieval] and control [did not receive GnRH agonist] groups. Implantation and clinical pregnancy rates were the primary outcome measures. Although the age of women, the number of embryos transferred in the current cycle and the quality of the transferred embryos were similar in the two groups, there was a significantly higher rate of implantation [Mann Whitney test, p=0.041] and pregnancy [32.6% vs. 12.5%, p=0.030, OR=3.3, 95%CI, 1.08 to 10.4] in the in-tervention group. Our results suggested that, in addition to routine luteal phase support using progesterone, administration of 0.1 mg of Decapeptil 6 days after oocyte re-trieval in women with previous history of 2 or more IVF/ICSI failures led to a signif-icant improvement in implantation and pregnancy rates after ICSI following ovarian stimulation with GnRH antagonist protocol

ART outcomes in GnRH antagonist protocol [flexible] and long GnRH agonist protocol during early follicular phase in patients with polycystic ovary syndrome: a randomized clinical trial

Since increased LH in the early follicular phase in PCOS patients especially in GnRH antagonist protocol could be associated with reduced oocyte quality and pregnancy and impared implantation. The current study was conducted to determine ART outcomes in GnRH antagonist protocol [flexible] and long GnRH agonist protocol and compare them with adding GnRH antagonist in GnRH antagonist [flexible] protocol during early follicular phase in patients with polycystic ovary syndrome undergoing ICSI. In this randomized clinical trial, 150 patients with polycystic ovary syndrome undergoing ICSI were enrolled from 2012 to 2014 and randomly assigned to receive either GnRH antagonist protocol during early and late follicular phase or GnRH antagonist protocol [flexible] or long GnRH agonist protocol. The clinical and laboratory pregnancy in three groups was determined and compared. In this context, the chi-square and Fisher's exact test and ANOVA were used for data analysis. Statistical significance was defined as p<0.05. There was no statistically significant difference with respect to chemical pregnancy and clinical pregnancy between the three groups. Also, other indices such as number and quality of oocytes and embryos were alike. Totally, according to our results, GnRH antagonist protocol during early and late follicular phase and GnRH antagonist protocol [flexible] and long GnRH agonist protocol in patients with polycystic ovary syndrome undergoing ICSI are similarly effective and use of each one based on patients' condition and physicians' opinion could be considered

Anti-mullerian hormone as a predictive factor in assisted reproductive technique of polycystic ovary syndrome patients

This study aimed to assess the relationship between the serum levels of anti-mullerian hormone [AMH] and other hormonal markers and results of assisted reproductive techniques [ART] in polycystic ovary syndrome [PCOS] patients. This cohort study was conducted on 60 PCOS patients who were candidates for assisted reproductive techniques. In all patients the serum levels of AMH, follicle stimulating hormone [FSH] and luteinizing hormone [LH], estradiol [E2], free testosterone [fT], testosterone [T] and inhibin B were measured in the 3rd day of menstrual cycle. The relationship between serum level of measured hormonal markers with retrieved oocytes, mature oocytes, the number of transferred fetus and pregnancy rate were assessed. The cut-off value for the serum level of AMH and retrieved oocytes were determined. There was a significant direct correlation between the serum mullerian inhibiting substance [MIS] level with number of total picked up oocytes [r=0.412], mature oocytes [r=0.472] and embryo transfer [r=0.291]. There was a linear and significant correlation between inhibin B and fertilization [r=0.283] Cut-off point for AMH level according to presence or absence of pregnancy was 4.8 ng/ml and it was not statistically significant [P=0.655]. Area under curve [AUC] was 0.543. Cut-off point for MIS according to picked up oocytes was 2.7 ng/ml with area under the curve [ROC curve] of 0.724 [CI=0.591-0.831] [P=0.002]. Patients with PCOS who had AMH more than 2.7 ng/ml, the number of retrieved oocytes [6 or more] was higher than MIS/AMH<2.7 ng/ml [P=0.002]. As a marker of ovarian responsiveness to controlled ovarian hyperstimulation [COH] and despite a small sample size of our study, it is revealed that pretreatment MIS/AMH is highly associated with the number of mature oocytes retrieved during COH in PCOS women

Relationship between anti-mullerian hormone and assisted reproductive technique outcome in patients with polycystic ovary syndrome

Anti-mullerian hormone [AMH] levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies. This study aimed to assess the relationship between the serum levels of AMH and results of assisted reproductive technique [ART] outcome in polycystic ovary syndrome [PCOS] patients versus control group. This cohort study was conducted on 61 [PCOS] patients and 28 patients without PCOS [controls] candidates for assisted reproductive technique. Serum levels of AMH were measured on the 3[rd] day of menstrual cycle and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between AMH serum level with retrieved oocytes, mature oocytes and pregnancy rate were assessed. There was significant correlation between the AMH level with number of total retrieved oocytes and mature oocytes in patients with PCOS and controls [p=0.001]. In PCOS and control groups AMH level in pregnant patients was higher, but it was not statically significant [p=0.65, p=0.46, respectively]. The major outcome of the study [pregnancy] did not differ significantly between two groups. This study revealed that AMH level was higher in pregnant patients undergoing ART; but AMH may not be an accurate predictor for pregnancy in PCOS patients