Vaginal micronized progesterone capsule versus vaginal progesterone gel for luteal support in normoresponder IVF/ICSI-ET cycles

To compare the outcomes of luteal phase support by micronized progesteron vaginal capsule 600mg/day and progesterone vaginal gel 180 mg/day in the normoresponder IVF/ICSI-ET cycles of the patients down-regulated via GnRH agonist long protocol or fixed antagonist protocol below 40 years of age. A total of 463 normoresponder cycles between January 2013 and December 2013 were retrospectively analyzed. Those with a BMI>28 kg/m[2], any kind of uterine, ovarian or adnexial pathology, any significant systemic, endocrine or metabolic disease or who were reported as azoospermia, were excluded from the study. The patients were grouped according to the usage of micronized progesterone vaginal capsule 600 mg/day [Group 1] or progesterone vaginal gel 180 mg/day [Group 2] as luteal phase Treatment cycle characteristics and pregnancy outcomes were compared between groups. Group-I included 220 cycles and group 2 included 243 cycles. Although the MII oocyte percentage among the total number of MII oocytes was significantly higher in Group-II [77.5% and 80.2%; p=0.034], positive beta-hCG [32.3% and 21.8%; p=0.015] and clinical pregnancy [27.3% and 17.7%; p=0.018] rates were significantly higher in Group-I. No difference was observed between groups regarding the ongoing pregnancy rates [23.2% and 17.3%; p=0.143]. Micronized progesterone vaginal capsule 600 mg daily used for luteal support in the IVF/ICSIET cycles was observed to significantly increase the biochemical and clinical pregnancy rates compared to progesterone vaginal gel 180 mg daily. However, no difference was observed between two groups regarding ongoing pregnancy rates

Body composition: A predictive factor of cycle fecundity / 대한생식의학회지

OBJECTIVE: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. METHODS: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. RESULTS: Body fat mass was significantly lower in pregnant women than in non-pregnant women (15.61+/-3.65 vs.18.78+/-5.97, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient> or =0.277, t-value> or =2.537; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. CONCLUSION: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.