coasting valuable in all patients with any cause of infertility?

Objectives: This study aimed to assess the influence of coasting duration on the number and quality of oocytes and fertilization rate in male factor infertile women and those with polycystic ovary syndrome [PCOS]

Methods: In this prospective observational follow-up study, 114 patients undergoing coasting [53 women with male factor infertility and 61 women with PCOS] were evaluated at the Royan Institute Research Center, Iran, between 2010 and 2012

Results: The results were analyzed according to the coasting periods of 1-4 days. In normal females, the number of oocytes retrieved was significantly reduced after the second day [p = 0.004]. In addition, a statistically significant drop was observed in the number of metaphase II oocytes and fertilization rate after the third day [p = 0.006 and p = 0.006, respectively]. No significant differences were observed in the number and quality of oocytes retrieved and fertilization rate with regard to coasting days in PCOS patients

Conclusion: Coasting with duration of more than three days should be performed with caution in normal females who are at risk of developing ovarian hyperstimulation syndrome

Comparing intramuscular progesterone, vaginal progesterone and 17 alpha-hydroxyprogestrone caproate in IVF and ICSI cycle

Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. The objective of this study was to compare the efficacy of three types of progesterone on biochemical, clinical and ongoing pregnancy rates and abortion and live birth rates. A prospective randomized study was performed at Royan Institute between March 2008 and March 2009 in women under 40 years old, who use GnRH analog down-regulation. One hundred eighty six patients in three groups were received progesterone in oil [100 mg, IM daily], intravaginal progesterone [400 mg, twice daily] and 17-alpha hydroxyprogestrone caproate [375mg, every three days], respectively. Final statistical analysis after withdrawal of some patients was performed in 50, 50 and 53 patients in group 1, 2 and 3 respectively. No differences between the groups were found in baseline characteristics. No statistical significance different was discovered for biochemical, clinical and ongoing pregnancies. Although the abortion rate was statistically higher in group 1 [p=0.025] the live birth rate was not statistically significant between the three groups. The effects of three types of progesterone were similar on pregnancies rate. We suggest the use of intravaginal progesterone during the luteal phase in patients undergoing an IVF-ET program because of the low numbers of abortions, and high ongoing pregnancy rates

Comparison of the effect of Garlic extract vaginal douche and clotrimazole vaginal cream in the treatment of women with vaginal candidiasis

Vaginal candidiasis is one of the most common genital infections, which has many different therapeutic methods. Some Para clinical researches suggest garlic for treatment of candidiasis.The purpose of this study was to compare the effect of garlic extract vaginal douche and clotrimazole vaginal cream in the treatment of women with vaginal candidiasis. This is a randomized, controlled, clinical trial on 100 non-pregnant women who came with the symptomatic vaginal candidiasis. Fresh garlic extract was provided by Pharmacologist, and then the patients whose mycologic culture was positive were randomly allocated into 2 groups of vaginal douche containing 1% garlic extract and vaginal cream containing 1% clotrimazole .All patients were treated daily for 7 days and assessed for clinical and mycological results 1-2 .week after the end of treatment. Data were obtained by interview and observation methods and were analyzed by SPSS software using Chi Square, Fisher exact test student, t-test and paired-samples t-test by the confidence of 95%. Successful response [according to clinical and mycologic results] were reported in 34.7% of Garlic users and 56.9% clotrimazole users. [P=0.026] There was not any significant difference between clinical results after treatment in both groups [51% against 66.7%] but there was a significant difference between mycologic results in both groups. [40.8% against 60.8%] [P=0.046] According to the results, percentage of successful response in users of vaginal garlic extract douche was less than users of vaginal clotrimazole cream but there was no significant statistical difference between these groups according to the clinical result. We suggest more studies about different methods and doses of this drug