ABSTRACT
Background: There are different methods in endometrial preparation for frozen-thawed embryo transfer [FET]
Objective: The purpose of this study was to compare the live birth rate in the artificial FET protocol [estradiol/ progesterone with GnRH-agonist] with stimulated cycle FET protocol [letrozole plus HMG]
Materials and Methods: This randomized clinical trial included 100 women [18-42 years] randomly assigned to two groups based on Bernoulli distribution. Group I received GnRH agonist [Bucerelin, 500 micro g subcutaneously] from the previous midlutea lcycle, Then estradiol valerat [2 mg/ daily orally] was started on the second day and was increased until the observation of 8mm endometrial thickness. Finally progesterone [Cyclogest, 800 mg, vaginally] was started. Group II received letrozole on the second day of the cycle for five days, then HMG 75 IU was injected on the7P[th] day. After observing [18 mm folliclhCG10000 IU was injected for ovulation induction. Trans cervical embryo transfer was performed in two groups. The main outcome was the live birth rate. The rate of live birth, implantation, chemical, and clinical pregnancy, abortion, cancellation and endometrial thickness were compared between two groups
Results: Implantation rate was significantly higher in group I. Live birth rate was slightly increased in group I without significant difference [30% vs. 26%]. The rate of chemical and clinical pregnancy was similar in two groups. The abortion rate was lower in letrozole protocol but the difference was not statistically significant. The mean endometrial thickness was not different between two groups
Conclusion: Letrozole plus HMG method cannot improve pregnancy outcomes in frozen-thawed embryo transfer but it has only one injection compare to daily injections in artificial method
ABSTRACT
Irradiation is one of the major causes of induced sperm DNA damage. Various studies suggested a relation between sperm DNA damage and fertilization rate after intra-cytoplasmic sperm injection [ICSI]. In this study, fertilization rate and premature chromosome condensation [PCC] formation after ICSI of hamster oocytes with irradiated sperms from normal and oligosperm individuals was investigated. Human sperms were classified according to counts to normal and oligosperm. Ten samples were used for each group. Golden hamster oocytes were retrieved after super ovulation by PMSG and HCG injection. From retrieved oocytes, 468 were in metaphase II. Control and 4 Gy gamma irradiated sperms were then injected into oocytes. After pronuclei formation in injected oocytes and formation of 8 cells embryos, slides were prepared using Tarkowskie's standard air-drying technique. The frequency of embryos and PCC were analyzed using 1000x microscope after staining in 5% Giemsa. The extent of embryo development in oocytes injected by irradiated sperms was lower than those injected by non-irradiated sperms [p=0.0001]. The frequency of PCC in failed fertilized oocytes was significantly higher in oligosperms [46%] compared with normal ones [0%], but there was no significant difference between irradiated and non-irradiated samples in each group [p=0.12]. The results showed that irradiation of sperms might influence the fertilization outcome possibly due to sperm DNA damage. One possible cause of precluding oocytes from fertilization in oligosperm individuals might be the formation of PCC.