ABSTRACT
Background: management of poor-responding patients is still major challenge in assisted reproductive techniques [ART]. Delayed-start GnRH antagonist protocol is recommended to these patients, but little is known in this regards
Objective: the goal of this study was assessment of delayed-start GnRH antagonist protocol in poor responders, and in vitro fertilization [IVF] outcomes
Materials and Methods: this randomized clinical trial included sixty infertile women with Bologna criteria for ovarian poor responders who were candidate for IVF. In case group [n=30], delayed-start GnRH antagonist protocol administered estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation with gonadotropin. Control group [n=30] treated with estrogen priming antagonist protocol. Finally, endometrial thickness, the rates of oocytes maturation,, embryo formation, and pregnancy were compared between two groups
Results: rates of implantation, chemical, clinical, and ongoing pregnancy in delayed-start cycles were higher although was not statistically significant. Endometrial thickness was significantly higher in case group. There were no statistically significant differences in the rates of oocyte maturation, embryo formation, and IVF outcomes between two groups
Conclusion: there is no significant difference between delayed-start GnRH antagonist protocols versus GnRH antagonist protocol
ABSTRACT
Background: Implantation failure is one of the most important factors limiting success in IVF treatment. The majority of trials have demonstrated favorable effect of endometrial injury on implantation success rate especially in women with recurrent implantation failure, while some studies failed to detect any benefit
Objective: The purpose of our trial was to explore whether endometrial injury in luteal phase prior to frozen-thawed embryo transfer cycles would improve pregnancy outcomes?
Materials and Methods: We conducted a prospective controlled trial of 93 consecutive subjects at a research and clinical center for infertility. All women were undergone frozen-thawed embryo transfer [FTE] cycles. Women in the experimental group underwent endometrial biopsy with a Pipelle catheter in luteal phase proceeding FET cycle. Primary outcomes were implantation and clinical pregnancy rates and secondary outcomes were chemical, ongoing and multiple pregnancy and miscarriage rates
Results: 45 subjects who underwent endometrial injury [EI] were compared with 48 control group which did not include any uterine manipulation. There were no significant differences in baseline and cycle characteristics between two groups. The difference in implantation rate was trend to statistically significance, 11.8% in EI group vs. 20.5% in control group [p=0.091]. The chemical, clinical and ongoing pregnancy rates were lower in EI group compared with control group but not statistically significant. The multiple pregnancy rate and miscarriage rate also were lower in EI group compared with control group
Conclusion: Based on results of this study, local injury to endometrium in luteal phase prior to FET cycle had a negative impact on implantation and clinical pregnancy rates
ABSTRACT
Background: Despite major advances in assisted reproductive techniques, the implantation rates remain relatively low. Some studies have demonstrated that intrauterine infusion of granulocyte colony stimulating factor [G-CSF] improves implantation in infertile women
Objective: To assess the G-CSF effects on IVF outcomes in women with normal endometrial thickness
Materials and Methods: In this randomized controlled clinical trial, 100 infertile women with normal endometrial thickness who were candidate for IVF were evaluated in two groups. Exclusion criteria were positive history of repeated implantation failure [RIF], endocrine disorders, severe endometriosis, congenital or acquired uterine anomaly and contraindication for G-CSF [renal disease, sickle cell disease, or malignancy]. In G-CSF group [n=50], 300 micro g trans cervical intrauterine of G-CSF was administered at the oocyte retrieval day. Controls [n=50] were treated with standard protocol. Chemical, clinical and ongoing pregnancy rates, implantation rate, and miscarriage rate were compared between groups
Results: Number of total and mature oocytes [MII], two pronuclei [2PN], total embryos, transferred embryos, quality of transferred embryos, and fertilization rate did not differ significantly between two groups. So there were no significant differences between groups in chemical, clinical and ongoing pregnancy rate, implantation rate, and miscarriage rate
Conclusion: our result showed in normal IVF patients with normal endometrial thickness, the intrauterine infusion of G-CSF did not improve pregnancy outcomes