ABSTRACT
Our objective was to evaluate the effectiveness of clomiphene citrate [CC] vs. letrozole [L] plus human menopausal gonadotropin [hMG] in gonadotropin releasing hormone [GnRH] antagonist protocol in poor prognosis women with previous failed ovarian stimulation undergoing intracytoplasmic sperm injection [ICSI]. This retrospective cohort study included cycles with CC and L plus hMG/GnRH antagonist protocols of 32 poor responders who had failed to have ideal follicles to be retrieved during oocyte pick-up [OPU] or embryo transfer [ET] at least for 2 previous in vitro fertilization [IVF] cycles with microdose flare protocol or GnRH antagonist protocol from January 2006 to December 2009. Main outcome measures were implantation, clinical pregnancy and live birth rates per cycle. Duration of stimulation, mean gonadotropin dose used, endometrial thickness, number of mature follicles, serum estradiol [E[2]] and progesterone [P] levels on the day of human chorionic gonadotropin [hCG] administration, number of retrieved oocytes and fertilization rates were also evaluated. A total number of 42 cycles of 32 severe poor responders were evaluated. Total gonadotropin consumption was significantly lower [1491 +/- 873 vs. 2808 +/- 1581 IU, P=0.005] and mean E2 level on the day of hCG injection were significantly higher in CC group than L group [443.3 +/- 255.2 vs. 255.4 +/- 285.2 pg/mL, P=0.03]. ET, overall pregnancy and live birth rates per cycle were significantly higher in CC than L protocol [27.2 vs. 15%, 13.6 vs. 0% and 4.5 vs. 0%, respectively, P=0.05. Severe poor responders who had previously failed to respond to microdose or GnRH antagonist protocols may benefit from CC plus hMG/GnRH antagonist protocol despite high cancellation rate
ABSTRACT
The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. In this prospective randomized study, a total of 180 patients were included in the study. Amongst these, pertubation of the uterine cavity was carried out in 79 patients prior to insemination. One patient in the pertubation group was later excluded because insemination could not be performed due to cycle cancellation. There were no significant differences in demographic characteristics between the study and control groups. When the pregnancy rates of both groups were evaluated, 14[17.8%] patients in the study group achieved pregancy. Three [3.8%] had a biochemical pregnancy, 1[1.3%] miscarried and 10[12.7%] had live births. In the control group, a total of 24[23.8%] pregnancies were achieved, amongst which one [1%] had a biochemical pregnancy, 3[3%] miscarried and 20[19.8%] resulted in live births. There was no significant difference between groups in terms of total pregnancy and live birth rates [p>0.05]. There was a 21% total pregnancy loss rate. There was no significant difference between the control and study groups in terms of pregnancy loss rates [p>0.05]. This study on a homogenous group of unexplained infertile patients determined that the addition of pertubation to a controlled ovarian hyperstimulation plus intrauterine insemination [COH+IUI] treatment protocol did not affect pregnancy rates