Effect of progesterone supplementation on natural frozen-thawed embryo transfer cycles: a randomized controlled trial

The transfer of cryopreserved embryos can be timed with ovulation in a natural cycle or after artificially preparing the endometrium with exogenous hormones. Progesterone is essential for the secretory transformation of the endometrium that permits implantation as well as maintenance of early pregnancy. The purpose of this study is to assess the effect of luteal phase supplementation on pregnancy rates in natural frozen-thawed cycles. The study was designed as a prospective randomized clinical trial of 102 women who underwent embryo transfers in natural cycles. The women in the interventional group [n=51] received intra muscular [IM] progesterone 50 mg twice a day starting from 36 hours after hCG administration. The control group [n=51] did not receive any progesterone support. There were no significant differences in demographic characteristics between the groups and no statistically significant differences were observed between study and control groups in clinical pregnancy rate [33.3% vs. 27.5%, p=0.66]. There were no differences in implantation rate or spontaneous abortion rate. Our results suggest that luteal phase support does not affect clinical pregnancy rates in natural frozen-thawed embryo transfer cycles [Registration Number: IRCT201108044339N6]

Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: a randomized clinical trial

Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence. Laparotomy or laparoscopy is the standard surgery for the large endometrioma. Also, sclerotherapy is basically used to treat different diseases one of which is endometrioma. The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma. In a randomized clinical trial, an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma. The patients were followed up first after one and two weeks and then after one, two, and three months. If the patients had no endometrioma, they were treated with in vitro fertilization [IVF] [standard long protocol]. A control group of 20 patients with endometrioma were enrolled for an IVF protocol. They had no treatment by ethanol sclerotherapy. IVF parameters, pregnancy rates, and implantation rates were compared in both groups. The demographic data showed no difference between the two groups. The initial mean endometria size was 41.45 +/- 15.9 cm, the recurrence rate after 6 months was 4 [20%], FSH before and after sclerotherapy was 6.97 +/- 2.25 IU/L and 6.78 +/- 1.88 IU/L [p=0.343]. The clinical pregnancy rate was 6 [33.3%] vs. 3 [15%], [p=0.616]. The fertilization rate emerged 63.06% in study group vs. 60.38%, [p=0.57]. The implantation rate turned out 12.9% in study group vs. 7.5%, [p=0.52]. None of these results were significant. However, the data pointed to a better trend toward the ethanol sclerotherapy group. Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF

Effect of oocyte activation with calcium ionophore on ICSI outcomes in teratospermia: a randomized clinical trial

Chemical activation is the most frequently used method for artificial oocyte activation [AOA], results in high fertilization rate. This prospective, randomized, unblinded, clinical study aimed to evaluate the efficiency of oocyte activation with calcium ionophore on fertilization and pregnancy rate after intracytoplasmic sperm injection [ICSI] in infertile men suffer from teratoospermia. Thirty eight women with teratoospermic partner underwent ICSI with antagonist protocol. A total of 313 metaphase 2 [M2] oocytes were randomly divided into two groups: In the oocytes of the control group [n=145], routine ICSI was applied. Oocytes in the AOA group [n=168] immediately after ICSI, were entered in culture medium supplemented with 5 Micro calcium ionophore [A23187] for 5 minutes and then washed at least five times with MOPS solution. In both groups, the fertilization was evaluated 16-18 hours after ICSI. The number of fertilized oocytes and embryos obtained were significantly different between two groups [p=0.04]. There was no significant difference between the two studied groups regarding the fertilization and cleavage rate [95.33% vs. 84.4%, p=0.11; and 89.56% vs. 87.74%, p=0.76, respectively]. Implantation rate was higher in AOA group than in control group, but the difference was not significant [17.64% vs. 7.4%, p=0.14]. No significant differences were observed in chemical and clinical pregnancy rate between groups [47.1% vs. 16.7%, p=0.07; and 41.2% vs. 16.7%; p=0.14, respectively]. We didn't find significant difference in the implantation, fertilization, cleavage and pregnancy rates between the two groups but could significantly increase the number of fertilized oocytes and embryos obtained. Finally oocyte activation with calcium ionophore may improve ICSI outcomes in infertile men suffer from teratoospermia. Further study with more cases can provide greater value