RESUMO
Background: The objective of the study was to evaluate the role of subendometrial-endometrial blood flow assessment by 3D Tran-vaginal Power Doppler in predicting pregnancy outcome in IVF-ET cycles. The study was a prospective, non-randomized clinical study. Methods: A total of 107 infertile women undergoing their first IVF-ET cycle with good response were taken for study (From March 2014 to Nov 2014 at Jaipur Fertility Centre, ART unit of Mahatma Gandhi University of Medical Sciences & Technology). Women with Tubal factor, Male factor and unexplained infertility were included in the study. Those with past h/o Genital Koch’s and hypo menorrhea were excluded. Assessment of subendometrial-endometrial blood flow was done on the day of HCG with endometrial thickness ≥ 6.5mm by Tran-vaginal 3D- Power Doppler. Results: There was no significant difference in mean age, duration of infertility, BMI, cause of infertility, stimulation protocol, serological hormone levels, number of mature oocytes, number of good quality embryos and mean endometrial thickness on the day of HCG. According to Doppler study (3D-Power Doppler), women with blood flow to zones 1, 2 and 3 were categorized in to groups A (n=15), B (n=36) and C (n=56). Overall pregnancy rate was 32.71%. The clinical pregnancy rate was significantly higher in Group C in comparison of Group B and A (42.85% vs. 27.77% and 6.66%). Similarly implantation rate was also higher in group C (23.20% vs. 11.22% and 2.38%). Conclusions: The presence of good subendometrial-endometrial vascularity significantly improves pregnancy outcome in IVF-ET cycles in our study.
RESUMO
Background: The objective of this retrospective study was to compare the efficacy of slow freezing and Vitrification for the cryopreservation of supernumerary cleavage stage embryos on day 3 after IVF and its impact on clinical outcome. Methods: 485 supernumerary embryos of IVF cycles (from Oct 2011 to Dec 2012) were cryopreserved by slow freezing method while 502 embryos (from Jan 2013 to April 2014) by Vitrification method. 362/485 and 230/502 embryos were thawed for FET cycles (65 patients in each group).After warming the survival rate, post warmed embryo morphology, clinical pregnancy and implantation rates were evaluated and compared between the two groups. Results: There were 65 frozen thawed cycles in each group. The percentage of excellent and good morphology embryos before cryopreservation were same in both the groups, but after thawing the results were significantly in favour of Vitrification as compared to Slow freezing. In Vitrification group versus Slow freezing group, the different outcomes were survival rate (96.95% vs. 69.06%, p-0.000), post warmed excellent morphology embryos (94.17% vs. 60.8%, p-0.000) clinical pregnancy rate (41.53% vs. 21.53%, p-0.043) and the implantation rate (14.41% vs. 7.01%, p-0.024). Conclusions: Vitrification is a promising alternate to the conventional slow freezing method in terms of not only excellent survival and post warmed excellent morphology embryo rate but also higher clinical pregnancy and implantation rate.