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BACKGROUND: Although there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes. OBJECTIVE: To assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. MATERIALS AND METHODS: A total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively). RESULTS: The subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively). CONCLUSION: In conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles.
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BACKGROUND: The purpose of this study was to determine the optimal endometrial preparation protocol by comparing the clinical outcome of two methods of endometrial preparation in frozen-thawed embryo transfer (FET) cycles, including that is, oral estradiol and 17ß-estradiol transdermal patch. METHODS: In this randomized controlled trial, women underwent either conventional IVF or intracytoplasmic sperm injection (ICSI) who had at least two top-quality embryos appropriate for cryopreservation and frozen embryos from previous cycles. In the study group (n=45), 17-B estradiol transdermal patches 100 µg were applied from the second day of the cycle and continued every other day. Then, each patch was removed after four days. In the control group (n=45), oral estradiol valerate 6 mg was started at the same time and continued daily. RESULTS: There was a significant difference in estradiol level on the day of progesterone administration and the day of embryo transfer between the two groups (p= 0.001 in both), but no significant difference was observed between them in biochemical and clinical pregnancy rates (32.6% vs. 33.3%, p=1.000 and 30.2% vs. 33.3%, p=0.810, respectively). CONCLUSION: It is suggested that estradiol transdermal patches be used instead of oral estradiol in FET cycles. Due to the reduced costs, drug dose, and emotional stress as well as the simplicity of the protocol for patients.
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BACKGROUND: Based on classical two-cell, two-gonadotropin theory, in the follicle, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) put on their main effects on the granulosa and theca cells. LH is essential for androgens production. Androgens are used for estradiol production by granulosa cells. Profound suppression of LH concentrations in some normogonadotropic patients can cause several adverse effects. OBJECTIVE: The main clinical purpose of this study was that normoresponder women treated with controlled ovarian super ovulation for IVF or ICSI may benefit from co-administration of rLH. MATERIALS AND METHODS: 40 patients who were candidates for assisted reproductive technology (ART) were randomly selected. In all patients long luteal protocol was used for ovulation induction. Patients were randomly divided into two groups: Group 1 (n=20) with standard long protocol (GnRH agonist) and r-FSH alone, Group 2 (n=20) with standard long protocol (GnRH agonist) and r-FSH with r-LH. RESULTS were statistically analyzed and compared in two groups. RESULTS: The number of retrieved oocytes, mature oocytes, cleaved embryos, transferred embryos, estradiol levels in Human chorionic gonadotropin (hCG) administration day, implantation rate and clinical pregnancy rate in group 2 were higher but not significantly different. CONCLUSION: Administration of rLH in late follicular phase had no beneficial effect on outcomes in young women with mean age of 31 years. Maybe a greater sample size should be used to see the effects more accurately; also it is possible that rLH will be useful in older patients. Registration ID in IRCT: IRCT201304302575N4.
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BACKGROUND: Although cervical cancer is a preventable disease, its prevalence is increasing in many developing countries. The aim of this study was to evaluate risk factors. MATERIALS AND METHODS: This cross-sectional study was conducted on 100 cervical cancer cases according to their pathology reports in Yazd city. The patients were referred to 4 gynecological centers. Demographic data (age, age at marriage, number of marriages and spouses, age at first pregnancy, frequency of pregnancies and term labors, positive history of smoking and Pap smear findings were documented by interview, questionnaire and reviewing patients documents. The data were analyzed with SPSS software. RESULTS: Mean age of the patients was 53.6 years. Mean age of marriage and first pregnancy was 15.2 and 16.6; respectively. Twenty percent (20%) of the cases married more than once and husbands of 38 patients (38%) had another wife too. Frequency of pregnancies and term labors was 7.4 and 6.4 in our patients. Some 17% of the patients had history of smoking; while 53% of them were passive smokers. Also only 2% of our patients have done Pap smear before diagnosis. DISCUSSION: The important risk factors of patients with cervical cancer were as follows: Marriage at young age (15.2%), high mean parity (7.4), low mean age at first pregnancy (16.2 year), smoking, and not doing Pap smear. CONCLUSION: There is important association between mass screening program with Pap smear and decreasing cervical cancer. Thus we should increase our women knowledge about all of risk-factors of cervical cancer and get them clues about regular pap smears.
