ABSTRACT
Background: Different combination of gonadotropin preparation has been introduced with no definite superiority of one over others in vitro fertilization [IVF], but individualized regimens for each patient are needed
Objective: The aim of the present study was to investigate the effect of controlled ovarian stimulation with recombinant- follicle stimulating hormone [r-FSH] plus recombinant-luteinizing hormone [rLH] versus human menopausal gonadotropin [HMG] plus r-FSH on fertility outcomes in IVF patients
Materials and Methods: This is a randomized clinical trial study that was performed from October 2014-April 2016 on 140 infertile patients with a set of inclusion criteria that referred to infertility clinics in Vali- asr and Gandhi Hospital in Tehran. The women were randomly divided into two treatment groups. The first group [n=70] received rFSH from the second day of cycle and was added HMG in 6[th] day and the 2[nd] group [n=70], received rFSH from the second day of cycle and was added recombinant-LH in 6[th] day. Then ovum Pick-Up and embryo transfer were performed. In this study, we assessed the outcomes such as; chemical and clinical pregnancy rate, live birth and abortion rate
Results: Number of follicles in ovaries, total number of oocytes or M[2] oocytes and quality of fetuses has no significant differences between two groups [p>0.05]. Total number of fetuses were significantly higher in patients who received rFSH + HMG [p=0.02]. Fertility outcomes consisted of: live birth rate, chemical pregnancy and clinical pregnancy rate were higher in rFSH + HMG group in comparison to rFSH +r-LH group [p<0.05]
Conclusion: It seems that in IVF patients, HMG + rFSH used for controlled ovarian hyperstimulation have better effects on fertility outcomes, but in order to verify the results, it is recommended to implement studies on more patients
Subject(s)
Humans , Female , Adult , Follicle Stimulating Hormone, Human , Luteinizing Hormone , Menotropins , Sperm Injections, Intracytoplasmic , Fertilization in Vitro , FertilityABSTRACT
Background: Recurrent implantation failure [RIF] is the absence of implantation after three consecutive In Vitro Fertilization [IVF] cycles with transferring at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under 40 years. The definition and management of RIF is under constant scrutiny
Objective: To investigate the effects of Granulocyte colony stimulating factor [GCSF] on RIF, pregnancy rate, abortion rate and implantation rates
Materials and Methods: A double blind placebo controlled randomized trial was conducted at two tertiary university based hospitals. One hundred patients with the history of RIF from December 2011 until January 2014 were recruited in the study. G-CSF 300 micro g/1ml was administered at the day of oocyte puncture or day of progesterone administration of FET cycle. Forty patients were recruited at G-CSF group, 40 in saline and 20 in placebo group
Results: The mean age for whole study group was 35.3 +/- 4.2 yrs [G-CSF 35.5 +/- 4.32, saline 35.3 +/- 3.98, placebo 35.4 +/- 4.01, respectively]. Seventeen patients had a positive pregnancy test after embryo transfer [10 [25%] in G-CSF; 5 [12.5%] in saline; and 2 [10%] in placebo group]. The mean of abortion rates was 17.6% [3], two of them in G-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% in saline and 4.7% in placebo group
Conclusion: G-CSF may increase chemical pregnancy and implantation rate in patients with recurrent implantation failure but clinical pregnancy rate and abortion rate was unaffected
ABSTRACT
To determine the differences in sperm quality and results of intracyto-plasmic sperm injection [ICSI] cycles between three groups of male factor infertile couples: oligozoospermic, obstructive azoospermic and non-obstructive azoospermic. In this prospective cohort study, 628 male factor infertile couples who underwent ICSI cycles from April 2004 to March 2006 were enrolled. Three hundred fourteen oligozoospermic patients [group I], 180 obstructive azoospermic patients [group II] and 134 non-obstructive azoospermic patients [group III] were included. Fertilization, cleavage, implantation and clinical pregnancy, early abortion rates were assessed. Chi-square and analysis of variances with Post Hoc [Tukey test] were used for data analysis. Fertilization rates were significantly different in the three groups [group I: 66.6%; group II: 51.8%; group III: 47.7%; p=0.004]. There were differences in the implantation rates [I: 19.5%; II: 17.6%; III: 6.4%; p=0.001]. The cleavage rates were found to be 55.1% [group I], 47.5% [group II], 45.5% [group III], respectively. The clinical pregnancy rate was the lowest in the third group [I: 37.6%; II: 28.9%; III: 13.4%; p=0.001]. There was no significant difference in early abortion rates between the three groups: [I: 10.7%; II: 9.8%; III: 8%; p=0.776]. It can be concluded that patients with oligozoospermia may benefit the most from ICSI treatment. ICSI cycles which use spermatozoa from non-obstructive azoospermic patients have a lower chance for successful outcome. The results of this study suggest, in cases of failure to achieve pregnancy after 1 or 2 cycles in non-obstructive azoospermic patients, embryo donation would be a better alternative
Subject(s)
Humans , Male , Female , Adult , Azoospermia , Oligospermia , Infertility, Male , Treatment OutcomeABSTRACT
The differential efficacy between long GnRH agonist with antagonist can partly be due to the preexisting differences in the early antral follicles before ovarian stimulation. To compare the effect of pretreatment by estradiol with GnRH antagonist on antral follicular size coordination and basal hormone levels in GNRH antagonist protocol. On cycle day 3 [control/day 3], women underwent measurements of early antral follicles by ultrasound and serum FSH and ovarian hormones then were randomized to receive oral estradiol 4mg/day [n=15] or 3mg cetrorelix acetate [n=15] in luteal phase before subsequent antagonist protocol. Participants were re-evaluated as on control/day 3. There was a significant reduction of mean follicular sizes in each group after medical intervention [7.63 +/- 2.11 Vs. 4.30 +/- 0.92 in group A and 8.73 +/- 1.96 Vs. 4.13 +/- 1.11 in group B] [p=0.0001]. The magnitude of follicular size reduction was significantly higher in group B [-4.60 +/- 2.04 Vs. -3.33 +/- 2.28] [0.027]. There was a non significant attenuation of follicular size discrepancies in two groups. FSH and inhibin B levels in the day 3 of the next cycle in both groups were significantly decreased but did not have significant difference between two groups. Both luteal E2 and premenstrual GnRH antagonist administration reduces the follicular sizes significantly and GnRH antagonist acts more potently than E2 in this way but attenuation of follicular size discrepancies in both treatment is not significant