effect of coasting on intracytoplasmic sperm injection outcome in antagonist and agonist cycle

Background: Coasting can reduce the ovarian hyperstimulation syndrome [OHSS] risk in ovulation induction cycles before intracytoplasmic sperm injection [ICSI]. This study aimed to investigate the effect of gonadotropin-releasing hormone [GnRH] agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation [COH] cycles with coasting on the parameters of ICSI cycles and the outcome

Materials and Methods: In a retrospective cohort study, 117 ICSI cycles were performed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group [n=91] and the GnRH antagonist group [n=26]

Results: The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol [E[2]] levels on human chorionic gonadotropin [hCG] day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 [G1] embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant [32.8% for agonist group vs. 39.1% for antagonist group, P>0.05]

Conclusion: The present study showed that applying GnRH-agonist and GnRH-antagonist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates

Can hyaluronan binding assay predict the outcome of intrauterine insemination in couples with unexplained or mild male factor infertility?

The purpose of this study was to evaluate the prognostic effect of Hyaluronan Binding Assay [HBA] which has been used as a method of sperm selection for intracytoplasmic sperm injection procedure, on the outcome of intrauterine insemination [IUI] in couples with unexplained or mild male factor infertility. 77 infertile couples were enrolled in our study. On the day of IUI procedure, HBA test was performed by using fresh semen samples, and the rates of sperm binding to HBA were calculated. HBA values and semen parameters were compared. Fisher exact test was used to evaluate the relationship between HBA ratio and pregnancy status. Mann-Whitney U test was used to compare quantitative variables between pregnant and non-pregnant groups. The p<0.05 was considered statistically significant. In this study, HBA ratio was 69[29.25%] and pregnancy rate was 14.29%. A significant positive correlation between HBA and total motile sperm count, inseminating sperm count, progressive motility, morphology, and sperm concentration [p<0.001, p<0.001, p:0.007, p<0.003, p:0.003 respectively] was observed. Although HBA values in pregnant group were higher than those in non-pregnant group, this result did not reach the statistically significant level [HBA: 67[20%] for non-pregnant group, 80.5[21.3%] for pregnant group]. Also, no relationship between HBA values and pregnancy status was found. Moreover, there was no significant correlation between pregnancy status and HBA ratios based on the suggested cut-off value of 60 in literature [p=0.425]. HBA does not predict the IUI outcome in couples with unexplained infertility or mild male factor infertility, but it can be used together with semen parameters to verify sperm quality

Idiopathic Retroperitoneal Fibrosis Mimicking a Pelvic Tumor: a Case of Pericystitis Plastica

Retroperitoneal fibrosis was first described in 1905 by Albarran, a French urologist, who performed ureterolysis for ureteral compression produced by the disease. However, this disease became an established clinical entity by Ormond's account in the English literature in 1948. Pericystitis plastica has been used the define an extremely rare type of Idiopathic retroperitoneal fibrosis (IRF) constricting the bladder. In this study, we discussed the recovery of 29-year-old woman with pericystitis plastica who was misdiagnosed as pelvic malignancy or a chronic/subacut pelvic inflammation at the first evaluation.