ABSTRACT
Objetivo: estudiar la influencia de la morfología del espermatozoide seleccionado para inyección intracitoplasmática de espermatozoides sobre la tasa de gestaciones tras la realización de la técnica. Material y métodos: análisis retrospectivo de 174 parejas sometidas a inyección intracitoplasmática. Estudio descriptivo de las variables del seminograma y de variables clínicas de la mujer, así como un análisis multivariante de regresión logística de las mismas para valorar su influencia en el éxito de inyección intracitoplasmática de espermatozoides. Resultados: encontramos que la morfología del espermatozoide usado para la fecundación se manifiesta como factor independiente de influencia negativa, OR de 2,94 [IC 95% (1,10-7,83)], junto con una edad mayor de 35 años, OR 1,98 [IC 95% (1,03-3,81)], para el éxito de la inyección intracitoplasmática de espermatozoides. Conclusiones: la morfología del espermatozoide inyectado influye negativamente en la tasa de embarazos bioquímicos tras inyección intracitoplasmática de espermatozoides, apoyando por lo tanto, que es una buena técnica, ya que permite seleccionar espermatozoides de morfología normal en pacientes con teratozoospermia (AU)
Objective: To study the influence of spermatozoa morphology selected for intracytoplasmic sperm injection on the rate of pregnancies after the completion of the technique. Material and Methods: Retrospective analysis of 174 couples undergoing Intracytoplasmic sperm injection. Descriptive study of seminogram variables, clinical variables of women and a multivariate logistic regression analysistoassesstheinfluenceonthesuccess of Intracytoplasmic sperm injection. Results: We found that the morphology of the spermatozoa used for fertilization is manifested as an independent factor of negative influence, OR 2.94 [95% CI (1.10 to 7.83)], together with an age over 35 years, OR 1, 98 [95% CI (1.03 to 3.81)], for the success of Intracytoplasmic sperm injection. Conclusions: Abnormal spermatozoa morphology injected influences negatively in the rate of biochemical pregnancies, supporting therefore the Intracytoplasmic sperm injection as a good technique because it allows us to select normal spermatozoa morphology in patients with teratozoospermia (AU)
Subject(s)
Humans , Male , Female , Sperm Injections, Intracytoplasmic/instrumentation , Sperm Injections, Intracytoplasmic/methods , Ovulation Induction/methods , Sperm Injections, Intracytoplasmic/statistics & numerical data , Spermatozoa/physiology , Retrospective Studies , Multivariate Analysis , Logistic Models , Semen/cytology , Semen Analysis/methods , Cohort Studies , 28599ABSTRACT
OBJECTIVE: The aim of this study is to evaluate the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx (HS)-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following IVF-ICSI treatment with those patients having had laparoscopic tubal occlusion (LTO). PATIENTS: From 2008 to 2014 a total of 50 patients were diagnosed with unilateral or bilateral hydrosalpinges: 29 patients had laparoscopic contraindications and were treated hysteroscopically and 21 patients were treated with laparoscopical salpingectomy. RESULTS: Of the 29 patients who underwent treatment with Essure(®), 21 began a cycle of in vitro fertilization (IVF), and 13 finished in embryo transfer that resulted in seven clinical pregnancies. Furthermore, in the group of women treated with salpingectomy, 17 started an IVF cycle that resulted in 12 clinical pregnancies. The clinical pregnancy rate per patient with an IVF cycle started was 33.3% and 70.6%, the live-birth rate per patient was 14.3% and 52.9%, the miscarriage rate was 57.1% and 18.2%, and the implantation rate was 16.3% and 34.1% for hysteroscopy and laparoscopy, respectively. CONCLUSION: Essure(®) placement is an alternative method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option may be considered when laparoscopy is impossible or contraindicated.
Subject(s)
Fallopian Tube Diseases/therapy , Fertilization in Vitro/methods , Hysteroscopy/instrumentation , Infertility, Female/therapy , Outcome Assessment, Health Care , Prostheses and Implants , Adult , Female , Humans , SalpingectomyABSTRACT
OBJECTIVE: To determine the effect of vaginal progesterone as luteal support on pregnancy outcomes in infertile patients who undergo ovulation induction with gonadotropins and intrauterine insemination (IUI). DESIGN: Prospective randomized trial. SETTING: Tertiary referral center. PATIENT(S): About 398 patients with primary infertility were treated during 893 ovarian stimulation and IUI cycles from February 2010 to September 2012. METHODS: All patients underwent ovarian stimulation with gonadotropins combined with IUI. Patients in the supported group received vaginal micronized progesterone capsules 200 mg once daily from the day after insemination until next menstruation or continuing for up to 8 weeks of pregnancy. Women allocated in the control group did not receive luteal phase support. MAIN OUTCOME MEASURE(S): Livebirth rate, clinical pregnancy rate and early miscarriage rate per cycle. RESULT(S): Of the 893 cycles, a total of 111 clinical pregnancies occurred. There were no significant differences between supported with progesterone and unsupported cycle in terms of livebirth rate (10.2% versus 8.3%, respectively, with a p value = 0.874) and clinical pregnancy rate (13.8% compared with 11.0% in unsupported cycle with a p value = 0.248). An early miscarriage rate of 3.6% was observed in the supported cycles and 2.7% in the unsupported cycles, with no significant differences between the groups (p value = 0.874). CONCLUSION(S): In infertile patients treated with mildly ovarian stimulation with recombinant gonadotropins and IUI, luteal phase support with vaginal progesterone is not associated with higher livebirth rate or clinical pregnancy rate compared with patients who did not receive any luteal phase support.
Subject(s)
Corpus Luteum Maintenance/drug effects , Infertility, Female/therapy , Infertility, Male/therapy , Insemination, Artificial, Heterologous , Ovulation Induction , Progesterone/pharmacology , Progestins/pharmacology , Administration, Intravaginal , Adult , Birth Rate , Capsules , Drug Compounding , Female , Gonadotropins, Pituitary/administration & dosage , Gonadotropins, Pituitary/genetics , Gonadotropins, Pituitary/pharmacology , Humans , Luteal Phase/drug effects , Male , Pregnancy , Pregnancy Rate , Progesterone/administration & dosage , Progesterone/chemistry , Progestins/administration & dosage , Progestins/chemistry , Recombinant Proteins/administration & dosage , Recombinant Proteins/pharmacology , Spain/epidemiologyABSTRACT
Objetivo: Valorar nuestro protocolo de actuación en los embarazos prolongados, determinando si la inducción del parto a las 42 semanas de gestación conlleva más beneficios maternofetales que la finalización posterior a éste. Métodos: Un total de 64 mujeres con gestaciones prolongadas no complicadas, que decidieron terminar su embarazo a las 42 semanas, se compararon con 173 mujeres que decidieron continuar su embarazo después de dicho período de gestación. Resultados: Hubo una mayor tasa de cesáreas y de malos resultados perinatales en el grupo de mujeres que decidió no inducir el parto en la semana 42 de gestación. La mayor parte de estas mujeres acaba induciéndose el parto algo más adelante. Conclusiones: En las gestaciones prolongadas no complicadas, la inducción del parto a las 42 semanas conlleva mejores resultados maternofetales y resulta más eficiente que continuar con los controles durante más tiempo
Objective: To assess our protocol of performance at the post-term pregnancies, determining if the induction of labour at 42 weeks' gestation entails more mother-foetal benefits than the later ending of it. Methods: 64 uncomplicated post-term pregnancies that decided to finish her pregnancy at 42 weeks were compared with 173 women who decided to continue her pregnancy beyond the above mentioned date of gestation. Results: There was a greater rate of caesarean section and poor perinatals results in the group of women that decided not to induce the labour at 42 weeks' gestation. Most of these women finishes her gestation inducing it slightly later on. Conclusions: In uncomplicated post-term pregnancies, the induction of the labour at 42 weeks' gestation entails better mother-foetal results and is more efficient than to continue with mother-foetal controls during more time
