Effect of low-dose aspirin therapy on implantation rate in women undergoing in-vitro fertilization cycles

To determine the effect of low-dose aspirin on ovarian response, implantation and pregnancy rates in patients undergoing in-vitro fertilization [IVF] cycles. We performed a randomized analysis of 145 infertile women with a mean +/- SD age of 29.6 +/- 4.47 years who underwent cyles of IVF. Patients received 100 mg of aspirin [n=72] or placebo [n=73] daily. This study was conducted in Royan Institute, Tehran, Iran from April 2002 to January 2004. Aspirin was started on the 21st of their preceding menstrual cycle and it was continued until menstruation or a negative pregnancy test. Pregnant women received the medication until 12 weeks of pregnancy. The main outcome measures were number of follicles >/= 15mm, number of oocytes retrieved, serum E2 levels, cancellation rate, Ovarian Hyperstimulation Syndrome [OHSS] occurrence, number of embryos transferred, and implantation and pregnancy rates. There were statistically significant differences between the treatment group and the control group in the number of follicles [7.4 +/- 4.1 versus 9.0 +/- 4.8] and OHSS occurrence [5.6% versus 23.3%] but not in the other measures. The addition of aspirin low dose [100 mg/daily] to the standard long protocol for oocyte retrieval did not improve implantation and pregnancy rates in unselected patients undergoing IVF cycles

role of ketoconazole in the prevention of ovarian hyperstimulation syndrome in patients with polycystic ovary syndrome during assisted reproductive technology cycles

To assess the clinical efficacy of ketoconazole [KCZ] as an inhibitory enzyme on ovarian steroidogenesis, in prevention of ovarian hyper- stimulation syndrome [OHSS] during assisted reproductive technology [ART] in patients with polycystic ovarian syndrome [PCOS]. We included 58 PCOS patients, enrolled for in-vitro fertilization or intracytoplasmic sperm injection in a randomized clinical trial between November 2000 and October 2001 in the Royan Institute, Tehran, Iran. Twenty-eight patients received KCZ during the stimulation phase and 30 patients were controls. We compared serum E2 levels, number of lead follicles, number of retrieved oocytes, fertilization rate, occurrence of OHSS and cancellation rate using student's t-test, Chi-square and Fisher exact test. We found no significant differences between the 2 groups in the peak serum estradiol level, the number of lead follicles, oocytes, and fertilization rate. One patient in the control group had clinical symptoms of severe ovarian hyperstimulation, and none from the treated group. This study reveals no significant effect of KCZ on the incidence of OHSS during ART cycles; however, also no significant negative effects of KCZ on the number and maturity of oocytes or on fertilization rate