Predictive Value of Endometrial Thickness, Pattern and E2 Level on Day of hCG Administration in IVF-ET Cycles.

Objective: To evaluate the effect of endometrial thickness, pattern and E2 level on the day of human chorionic gonadotropin (hCG) administration on clinical outcome in patients undergoing in vitro fertilization and embryo transfer (IVF-ET). Method: A total number of 112 cycles of IVF-ET conducted at Jaipur Fertility Centre, an Infertility Unit of Mahatma Gandhi University of Medical Sciences and Technology, Jaipur were observed prospectively. Endometrial ultrasonographic characteristics and E2 levels were recorded on the day of hCG administration. Clinical pregnancy rates were analyzed with different endometrial thickness and E2 levels. Results: Overall 37.5% patients conceived and in these women endometrial thickness was between 6-14 mm. Only 2.38% patients conceived with an ET of <6 mm. Maximum patients (52.33%) who conceived were with an ET of 8-10 mm. It was observed that endometrial thickness pattern did not have significant effect on clinical pregnancy rate in these cases. Clinical pregnancy rate was significantly higher in patients with serum E2 levels between 1,000-2,500 pg/mL as compared to other two groups. Conclusion: When thin endometrium ≤6 mm with no triple-line coexist and serum E2 level is >2,500 pg/mL in IVF/ICSI-ET, candidate cryopreservation should be recommended.

Incidence of First Trimester Miscarriage among Women Undergoing ICSI According to Origin of Sperm for Male Factor and Non-male Factor.

Prior to the development of intracytoplasmic sperm injection (ICSI), azoospermic and severely oligospermic men had little to no chance of having a biological child. In this study, ICSI outcome in 212 transfers with ejaculated spermatozoa and 44 transfers with surgically retrieved spermatozoa were evaluated. Material and methods: The 68 singleton gestations achieved by ICSI were segregated according to underlying infertility etiology, with 54.41% having male factor and 45.59% having female factor. None of the patients had coexisting infertility factor. Results: The miscarriage rate of all ICSI singleton gestations during the first trimester was 19.12%. There were no significant differences in early pregnancy loss (EPL) rate by infertility factor. Among patients undergoing ICSI because of male factor, there were no significant differences in EPL using ejaculated or nonejaculated sperm. Regardless of etiology, women aged ≥35 years had significantly higher EPL (36.36%). Conclusion: Our preliminary results demonstrate that first trimester miscarriage rates of ICSI gestations are not affected by underlying infertility etiology but are affected by maternal age.

Implantation Rates after Two and Five Days of Embryo Culture: A Comparative Study.

The aim of our study was to compare the Implantation rates of embryos transferred after two and five days of culture. A Randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics & Gynecology,Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF)/ intra-cytoplasmic sperm injection (ICSI) cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, day 3 transfer group and blastocyst transfer group or day 5 transfer group having 150 patients each. IVF outcome in terms of Implantation rate was compared between the groups. The results were analyzed using proportions, standard deviation and chi-square test.Both the groups were similar for age, indication and number of embryos transferred. Embryo transfers on day 5 resulted in significantly higher ongoing pregnancy and implantation rates as compared with day 3 embryo transfers(44% and 35.17% versus 29.33% and 21.35%, respectively)(P< 0.001). No significant difference was found in terms of multiple gestations in both the groups. Embryo transfers on day 5 of culture give significantly higher chance of ongoing pregnancy and implantation rates per cycle and per transfer than day 3 transfers.

A Comparative Study Between Cleavage Stage Embryo Transfer at Day 3 and Blastocyst Stage Transfer at Day 5 in IVF/ICSI on Clinical Pregnancy Rates.

Objective: To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer. Study design: A randomized, prospective study was conducted in Infertility Clinic, Dept. of Obstetrics and Gynecology, Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ ICSI) cycle from May 2010 to April 2011. When three or more Grade I embryos were observed on Day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, clinical pregnancy rate and implantation rate. The results were analyzed using proportions, standard deviation and Chi-square test. Results: Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0%) compared to cleavage stage embryo transfer 44 (29.33%) (p < 0.01). Implantation rate for blastocyst transfer group was also significantly higher (p < 0.001). Conclusion: Blastocyst transfer having higher implantation rate and clinical pregnancy rate leads to reduction in multiple pregnancies.

Implantation Rates after Two and Five Days of Embryo Culture: A Comparative Study.

The aim of our study was to compare the Implantation rates of embryos transferred after two and five days of culture. A Randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics & Gynecology,Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF)/ intra-cytoplasmic sperm injection (ICSI) cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, day 3 transfer group and blastocyst transfer group or day 5 transfer group having 150 patients each. IVF outcome in terms of Implantation rate was compared between the groups. The results were analyzed using proportions, standard deviation and chi-square test.Both the groups were similar for age, indication and number of embryos transferred. Embryo transfers on day 5 resulted in significantly higher ongoing pregnancy and implantation rates as compared with day 3 embryo transfers(44% and 35.17% versus 29.33% and 21.35%, respectively)(P< 0.001). No significant difference was found in terms of multiple gestations in both the groups. Embryo transfers on day 5 of culture give significantly higher chance of ongoing pregnancy and implantation rates per cycle and per transfer than day 3 transfers.