Comparison of easy and difficult embryo transfer outcomes in in vitro fertilization cycles

The aim of this study was to compare the effects of easy and difficult embryo transfers [ET] on implantation and pregnancy rates. In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs. There was a significantly higher implantation rate in the easy group [21.7%] compared to the difficult group [12.1%, p<0.05].The easy group had a higher pregnancy rate [38.1%] compared to patients who had difficult ETs [21.4%; p<0.05]. Any uterine manipulation during ET adversely affects in vitro fertilization [IVF]. Precaution should be taken to identify possibly difficult ET cases in advance

ICSI outcome in infertile couples with different causes of infertility: a cross-sectional study

Different success rate of Intracytoplasmic Sperm injection [ICSI] has been observed in various causes of infertility. In this study, we evaluated the relation between ICSI outcome and different causes of infertility. We also aimed to examine parameters that might predict the pregnancy success rate following ICSI. This cross sectional study included1492 infertile women referred to Infertility Center of Royan Institute between 2010 and 2011. We assigned two groups including pregnant [n=504] and non-pregnant [n=988], while all participants underwent ICSI cycles. All statistics were performed by SPSS program. Statistical Analysis was carried out using Chi-square and t test. Logistic regression was done to build a prediction model in ICSI cycles. The overall clinical pregnancy rate in our study was 33.9% [n=1492]. There was a statistically significant difference in mean serum concentration on day 3 after application of luteinizing hormone [LH] between the pregnant and the non-pregnant groups [p<0.05]. However, There were no significant differences between two groups in the serum concentrations on day 3 after application of the following hormones: follicle-stimulating hormone [FSH], thyroid-stimulating hormone [TSH], and metoclopramide-stimulated prolactin [PRL] . We found no association between different causes of infertility and clinical outcomes . The number of metaphase II [MII] oocytes, embryo transfer, number of good embryo [grade A, B, AB], total dose of gonadotropin, endometrial thickness, maternal age, number of previous cycle were statistically significant between two groups [p<0.05]. Our results indicate that ICSI in an effective option in couples with different causes of infertility. These variables were integrated into a statistical model to allow the prediction for the chance of pregnancy following ICSI cycles. It is required that each infertility center gather enough information about the causes of infertility in order to provide more information and better assistance to patients. Therefore, we suggest that physicians prepare adequate training and required information regarding these procedures for infertile couples in order to improve their knowledge

Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization

This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization [IVF] and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients [66.4%] showed normal uterine cavity. Abnormal cavity was found in 80 patients [33.6%]. We found polyp as the most common abnormality [19.7%] in the patients with previous history of IVF failure. The pregnancy rate was similar between IVF failure patients who treated by hysteroscopy for a detected uterine abnormality [24.6%] and similar patients with normal uterine cavity [21.2%] in hysteroscopic examinations. The intrauterine lesions diagnosed by hysteroscopy in patients with previous IVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polyp showed good outcome, similar to that achieved in patients with a normal hysteroscopy