ABSTRACT
Background: despite advances in clinical and laboratory techniques, including stimulating ovulation and transferring embryo, success rate of pregnancy remains is about 30%. The aim of this study was to assess the effect of intra uterine G-CSF on implantation and clinical pregnancy rate in patients with implantation failure in IVF
Methods: this study was a randomized clinical trial on patients undergoing in vitro fertilization within an age range of 45-18 years and a history of failure in implantation for two or more times. A total of 34 patients receiving G-CSF in the intervention group and 38 patients in the control group were enrolled
Results: mean age of the participants was 34.1 years with a standard deviation of 6.4 years. The average number of years of fertility was 10 years with a standard deviation of 5.2 years. The average number of embryos implanted in the intervention group was 2.88 with a standard deviation of 0.33. The figures for the control group were 2.97 and 0.37, respectively. The two groups did not differ significantly. With respect to the potential clinical and laboratory fertility outcomes, including existing gestational sac with observed heart rate and positive serum betaHCG, no statistically significant difference was observed between the two groups
Conclusion: it seems that the effect of G-CSF on improving fertility outcomes inpatients with implantation failure does not exist and more related studies are recommended in this regard
ABSTRACT
Meconium-stained amniotic fluid [MSAF] occurs in 7-22% of term pregnancies. It is less common before 38 weeks and more common after 40 weeks of pregnancy and associates with increased perinatal mortality and morbidity. The aim of this study was to determine if the perinatal outcome is affected by mode of delivery in meconium-stained amniotic fluid. Five hundred meconium stained neonates born at Alzahra Hospital were studied from 2008 to 2010. All pregnancies were at 36-42 weeks, single fetus, cephalic presentation and normal fetal heart rate pattern. Umbilical cord arterial blood gasses were analyzed immediately after delivery. Perinatal outcome was compared in normal vaginal delivery [NVD] and cesarean section [CS] groups. From 500 meconium-stained neonates 73 were born through [NVD] and 427 by CS. Two groups were not significantly different for the maternal age, gestational age and meconium concentration. Although the mean PH was in normal range [PH>7.2] and mean 1st min and 5th min Apgar scores were higher than 8 in two groups, mask ventilation, intubation and suctioning, respiratory distress and admition in NICU were significantly higher in NVD group. Serious complications like MAS and asphyxia were not statistically different between groups. According to the results of this study it is advisable that cesarean section be limited in MSAF to abnormal fetal heart rate pattern and PH<7.2
ABSTRACT
Intrauterine insemination [IUI] is a less expensive and less invasive treatment in comparison with other assisted reproductive techniques, and it has been widely used for a variety of indications as well as in the treatment of couples with infertility. The outcome of IUI may be affected by numerous factors but in this study, we evaluated the effects of cervical mucus removal undertaken before IUI on clinical pregnancy rates. In this randomized clinical trial study, all infertile women who were candidates for IUI and attended Shahid Akbar Abadi Hospital during 2009 and 2010 were recruited. The participants were randomly assigned into two groups. Cervical mucus was removed prior to IUI in patients in group A but in group B, a classic IUI was done without removing the cervical mucus. Pregnancy rates were assessed in the two groups by serum levels of beta-HCG and detection of fetus in the uterus. 291 women including 143 in the classic IUI group and 148 in cervical mucus removal group completed the study. The pregnancy rates were 14.2% [21 pregnancies upon 148 cycles] in the cervical mucus removal group and 7% [10 pregnancies upon 143 cycles] in the control group [P=0.04, OR: 2.199; CI 95%: 0.997-4.85]. The findings showed that cervical mucus removal could result in a twofold increase in pregnancy rate in comparison with classic IUI. Thus, we suggest this practical and noninvasive method to improve pregnancy rate in these patients