The Impact of Gonadotropin Type on Controlled Ovarian Stimulation and Intrauterine Insemination Cycle Outcomes.

Background: Intrauterine insemination (IUI) combined with controlled ovarian stimulation (COS) results in higher pregnancy rates. However, there is still no consensus on the optimal COS protocol. Aims: In the present study, we aimed to analyse the effects of COS protocols with different gonadotropin types on IUI outcomes. Study Setting and Design: This was a retrospective cohort study conducted at the infertility clinic of a University hospital, including 237 COS + IUI cycles. Materials and Methods: Eligible cycles were divided into three groups according to the type of gonadotropin used for COS; cycles with recombinant follicle-stimulating hormone (rFSH) (group 1, n = 36), highly purified FSH (HP-FSH) (group 2, n = 178) and highly purified menotropin (HP-hMG) (group 3, n = 23). Clinical pregnancy rate (CPR) and live birth rate (LBR) per cycle were compared between groups. Statistical Analysis Used: The Mann-Whitney U test and Kruskal-Wallis test were used to compare numerical variables. Dunn test was used for multiple comparisons. Results: The duration of stimulation and total gonadotropin dose were similar between the three groups (P > 0.05). The CPR was 16.7% in rFSH group, 9.6% in HP-FSH group and 13.0% in HP-hMG group. The LBR was 16.7% in rFSH group, 8.4% in HP-FSH group and 13.0% in HP-hMG group. Both CPR and LBR were comparable in all three groups (P > 0.05). Conclusions: Ovarian stimulation with rFSH, HP-FSH and HP-hMG show similar COS characteristics. Furthermore, these three gonadotropin protocols for COS + IUI yielded comparable CPR and LBR. These findings suggest that all three gonadotropin types (rFSH, HP-FSH, HP-hMG) are similarly effective in COS + IUI cycles.

The association of seminal oxidation reduction potential with sperm parameters in patients with unexplained and male factor infertility

ABSTRACT Purpose: Understanding the effects of high oxidation reduction potential (ORP) levels on sperm parameters will help to identify patients with unexplained and male factor infertility who may have seminal oxidative stress and determine if ORP testing is needed. This study aimed to evaluate the association between seminal ORP and conventional sperm parameters. Materials and Methods: A total of 58 patients who provided a semen sample for simultaneous evaluation of sperm parameters and ORP between January and September 2019 were enrolled in this retrospective study. To identify normal and high ORP levels, a static ORP (sORP) cut-off value of 1.36mV/106sperm/mL was used. Sperm parameters were compared between infertile men with normal sORP (control group, n=23) and high sORP values (study group, n=35). Results: Men with sORP values >1.36mV/106sperm/mL had significantly lower total sperm count (TSC) (p <0.001), sperm concentration (p <0.001) and total motile sperm count (TMSC) (p <0.001). In addition, progressive motility (p=0.04) and fast forward progressive motility (p <0.001) were significantly lower in the study group. A negative correlation was found between sORP and TSC (r=-0.820, p <0.001), sperm concentration (r=-0.822, p <0.001), TMSC (r=-0.808, p <0.001) and progressive motility (r=-0.378, p=0.004). Non-progressive motility positively correlated with sORP (r=0.344, p=0.010). Conclusions: This study has shown that TSC, sperm concentration, progressive motility and TMSC are associated with seminal oxidative stress, indicated by a sORP cut-off of 1.36mV/106sperm/mL. Presence of oligozoospermia, reduced progressive motilty or low TMSC in sperm analysis should raise the suspicion of oxidative stress and warrants seminal ROS testing.

The effect of growth hormone adjuvant therapy on assisted reproductive technologies outcomes in patients with diminished ovarian reserve or poor ovarian response.

Low response of patients with diminished ovarian reserve to exogenous gonadotropins in controlled ovarian stimulation (COS) protocols is one of the important problems of reproductive endocrinology. Various treatment protocols have been developed in patients with diminished ovarian reserve (DOR) or poor ovarian response (POR). Recently, the addition of growth hormone (GH) to treatment protocols has been brought to the agenda in these patients. In this study, we aimed to investigate the effect of GH adjuvant treatment on intracytoplasmic sperm injection (ICSI) cycle results in patients with DOR or POR. This retrospective cohort study was carried out with patients who diagnosed as DOR or POR and underwent ICSI. The patients were divided into the groups according to whether GH was used. In this study, ongoing pregnancy rates and live birth rates were observed to be significantly higher in the group receiving GH compared to the control group. In addition, there was a significant increase in embryo quality in the group receiving GH. As a result, the addition of GH to COS protocols in DOR and POR patients may increase the ongoing pregnancy rate, live birth rate, embryo quality.

The association of seminal oxidation reduction potential with sperm parameters in patients with unexplained and male factor infertility.

PURPOSE: Understanding the effects of high oxidation reduction potential (ORP) levels on sperm parameters will help to identify patients with unexplained and male factor infertility who may have seminal oxidative stress and determine if ORP testing is needed. This study aimed to evaluate the association between seminal ORP and conventional sperm parameters. MATERIALS AND METHODS: A total of 58 patients who provided a semen sample for simultaneous evaluation of sperm parameters and ORP between January and September 2019 were enrolled in this retrospective study. To identify normal and high ORP levels, a static ORP (sORP) cut-off value of 1.36mV/106sperm/mL was used. Sperm parameters were compared between infertile men with normal sORP (control group, n=23) and high sORP values (study group, n=35). RESULTS: Men with sORP values >1.36mV/106sperm/mL had significantly lower total sperm count (TSC) (p <0.001), sperm concentration (p <0.001) and total motile sperm count (TMSC) (p <0.001). In addition, progressive motility (p=0.04) and fast forward progressive motility (p <0.001) were significantly lower in the study group. A negative correlation was found between sORP and TSC (r=-0.820, p <0.001), sperm concentration (r=-0.822, p <0.001), TMSC (r=-0.808, p <0.001) and progressive motility (r=-0.378, p=0.004). Non-progressive motility positively correlated with sORP (r=0.344, p=0.010). CONCLUSIONS: This study has shown that TSC, sperm concentration, progressive motility and TMSC are associated with seminal oxidative stress, indicated by a sORP cut-off of 1.36mV/106sperm/mL. Presence of oligozoospermia, reduced progressive motilty or low TMSC in sperm analysis should raise the suspicion of oxidative stress and warrants seminal ROS testing.