The reproductive potential of patients with Mayer-Rokitansky-Küster-Hauser syndrome using gestational surrogacy: a systematic review.

Women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome may reproduce after uterine transplantation or IVF using a gestational surrogate. As uterine transplantation is still an experimental procedure, data on their clinical outcome using assisted reproduction techniques are imperative to allow evidence-based counselling. For this purpose, a systematic non-restricted electronic literature search was conducted. The 14 studies included in this review were published between 1988 and 2011. From a cohort of 140 patients with MRKH syndrome, mostly from the the USA and Israel, only four studies contained data on more than 10 patients; the others were case reports or small series. In the studies reviewed, 125 patients underwent 369 cycles of IVF with gestational surrogacy, and delivered 71 newborns. The reporting of outcome of patients with MRKH syndrome undergoing assisted reproduction techniques in the available literature is less than optimal and is characterized by bias of publication, inconsistent reports, including few patients, treated over a long time span, and lacking systematic reports from large IVF centres. None of the national registries contain specific outcome data on patients with MRKH syndrome. The paucity of data limits the possibility to draw firm conclusions but substantiates the need for a systematic multicentre reporting system.

[CLINICAL ASPECTS OF INTRAUTERINE INSEMINATION].

INTRODUCTION: Intrauterine insemination (IUI) is an intervention performed frequently in the treatment of couples suffering from subfertility and women treated using donor sperm. The factors predicting its success include female parameters such as age and ovarian function and male parameters such as sperm quality. However, many details regarding its clinical application such as the methodology of sperm preparation, timing of IUI, the number of inseminations in the same cycle, the recommended number of cycles to be performed and the minimal threshold values of the sperm sample profile required are controversial. The conclusion to be drawn from this literature survey is that there is still lack of sufficient good quality studies performed to allow evidence based recommendations for the performance of IUI.