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
ABSTRACT
The infertility affects about 20% to 28% of Iraqi population and the primary and secondary infertility cover 80% and 20% of infertility cases respectively. It has been shown that the major male infertility factors include oligospermia, astheno-spermia, teratospermia and azoospermia. The objective of this study was to compare the fertilizing capacity, in vitro embryonic developmental rate and embryo implantation following the use of epididymal, testicular, and ejaculated sperm in azoospermic and severely teratospermic men. The males in experiment one were divided into three groups, severely teratospermic group [STSG, n=44], azoospermic-epididymal group [ASEG, n=35] and azoospermic-testicular group [ASTG, n=40]. In experiment two the azoospermic patients were divided into two groups, obstructive [OASG, n=35] and non-obstructive [NASG, n=42]. Both groups were underwent testicular extraction and intracytoplasmic sperm injection [TESE-ICSI] treatments. Concentration of FSH, LH, prolactin was significantly higher in non-obstructive group compared to obstructive group [P<0.001]. The concentrations of testosterone and the volume of the testes were significantly higher in the obstructive group versus non-obstructive group [P <0.01]. Percentages of the fertilizable oocytes and the number of the transferred embryos per patient in the ASTG group were significantly lower compared to STSG and ASEG groups. The pregnancy and implantation rates were not significantly different in the STSG, A[S]SEG, and ASTG groups. ICSI rate and embryo developmental rate and the number of the transferred embryos per patient were significantly lower in the non-obstructive group [NASG] compared to the obstructive group [OASG] Pregnancy and viable fetus percentages were similar between both groups [P>0.05]. Sources of sperm retrieval found to have no effect on embryo implantation and pregnancy rates when viable sperm are available for ICSI. Pregnancy and viable gestation sac percentages were not affected by the etiology of azoospermia in either obstructive, or nonobstructive with focal areas of spermatogenesis were present in testes of azoospermic men
ABSTRACT
Thirty-one patients presented with hirsutism have been studied; three patients were found to have specific endocrine disease and were treated accordingly. Nine patients found to have polycystic ovaries were treated by Clopiphene Citrate and nineteen patients found to have normal ovaries and endocrine functions were treated by Dexamethasone and Ethinyl estradiolum for 6-10 monts. From our results we conclude that; Clomiphene Citrate did not show any effect on hirsutism in patients with polycystic ovaries, and that the combined adrenal and ovarian suppression is useful for patients with moderate hirsutism and regular menstrual cycle