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Showing 8 results for Mojtahedi

Shahdokht Motazedian, Bahareh Hamedi, Jaleh Zolghadri, Khatereh Mojtahedi, Nasrin Asadi,
Volume 8, Issue 1 (7-2010)

Background: Although intrauterine insemination (IUI) is one of the most common methods which is used for male factor and unexplained infertility the relative influence of various semen parameters on the likelihood of a successful outcome is controversial. Several semen parameters have been evaluated as predictors of a successful outcome with intrauterine insemination.
Objective: To evaluate the effects of sperm morphology on the success rate of IUI.
Materials and Methods: This was a prospective study of 200 couples who underwent IUI cycles of ovarian stimulation in Shiraz University of Medical Sciences. The patients were chosen in 2 groups group A: 100 patients with ≤20% normal sperm morphology and group B: 100 patients with >20% normal sperm morphology (unexplained infertility). The other semen parameters were normal in both groups.
Results: Total clinical pregnancies were 10.5% (pregnancy rate / cycle). There was not any difference between two groups in rate of pregnancy and also pregnancy outcome.
Conclusion: Intrauterine insemination used for treating male factor infertility has not shown excessive advantage when normal sperm morphology in semen analysis is more than 20% in comparison with ≤ 20%.
Robab Davar, Maryam Farid Mojtahedi, Sepideh Miraj,
Volume 13, Issue 8 (9-2015)

Background: There is no doubt that luteal phase support is essential to enhance the reproductive outcome in IVF cycles. In addition to progesterone and human chorionic gonadotropin, several studies have described GnRH agonists as luteal phase support to improve implantation rate, pregnancy rate and live birth rate, whereas other studies showed dissimilar conclusions. All of these studies have been done in fresh IVF cycles.
Objective: To determine whether an additional GnRH agonist administered at the time of implantation for luteal phase support in frozen-thawed embryo transfer (FET) improves the embryo developmental potential.
Materials and Methods: This is a prospective controlled trial study in 200 FET cycles, patients were randomized on the day of embryo transfer into group 1 (n=100) to whom a single dose of GnRH agonist (0.1 mg triptorelin) was administered three days after transfer and group 2 (n=100), who did not receive agonist. Both groups received daily vaginal progesterone suppositories plus estradiol valerate 6 mg daily. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were implantation rate, chemical, ongoing pregnancy rate and abortion rate.
Results: A total of 200 FET cycles were analyzed. Demographic data and embryo quality were comparable between two groups. No statistically significant difference in clinical and ongoing pregnancy rates was observed between the two groups (26% versus 21%, p=0.40 and 21% versus 17%, p=0.37, respectively).
Conclusion: Administration of a subcutaneous GnRH agonist at the time of implantation does not increase clinical or ongoing pregnancy.
Robab Davar, Sepideh Miraj, Maryam Farid Mojtahedi1,
Volume 14, Issue 1 (1-2016)

Background: Embryo implantation process is a complex phenomenon and depends on fetal and maternal factors interaction. Endometrial thickness is needed for successful implantation.
Objective: We designed this study in order to assess adding human chorionic gonadotropin (HCG) to the conventional protocol in endometrial preparation in women with thin endometrium and a history of in vitro fertilization–embryo transfer (IVF-ET) failure.
Materials and Methods: The non-randomized clinical trial study (quasi experimental design) was performed on 28 patients. Participants were women who were candidate for frozen-thawed (ET) and had two previous failed ET cycles because of thin endometrial. HCG was administrated (150 IU, intramuscular) from the 8th day of cycle and when endometrial thickness reached at least 7mm HCG was discontinued and frozen thawed ET was done.
Results: Totally 28 patients were included. The mean ± SD age of participants was 30.39±4.7. The mean of endometrium thickness before and after HCG were 5.07±0.43 and 7.85±0.52, respectively p<0.001. Also, there were five clinically and chemically pregnant women.
Conclusion: The findings of the study suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium.
Maryam Eftekhar, Sepideh Miraj, Maryam Farid Mojtahedi, Nosrat Neghab,
Volume 14, Issue 11 (11-2016)

Background: Although pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET) cycles has been increased over the preceding years, but the majority of IVF-ET cycles still fail. Granulocyte colony stimulating factor (GCSF) is a glycoprotein that stimulates cytokine growth factor and induces immune system which may improve pregnancy rate in women with history of implantation failure.
Objective: The aim of this study was to evaluate GCSF ability to improve pregnancy rate in women with history of implantation failure
Materials and Methods: 0.5 ml (300 μg/ml) GCSF was infused intrauterine in intervention group. Pregnancy outcomes were assessed based on clinical pregnancy.
Results: The mean age of participants was 31.95±4.71 years old. There were no significant differences between demographic characteristics in two groups (p>0.05). The pregnancy outcome in GCSF group was improved significantly (p=0.043).
Conclusion: GCSF can improve pregnancy outcome in patients with history of implantation failure.
Abbas Aflatoonian, Robabe Hosseinisadat, Ramesh Baradaran, Maryam Farid Mojtahedi,
Volume 15, Issue 4 (6-2017)

Background: Management of poor-responding patients is still major challenge inassisted reproductive techniques (ART). Delayed-start GnRH antagonist protocol isrecommended to these patients, but little is known in this regards.
Objective: The goal of this study was assessment of delayed-start GnRH antagonistprotocol in poor responders, and in vitro fertilization (IVF) outcomes.
Materials and Methods: This randomized clinical trial included sixty infertilewomen with Bologna criteria for ovarian poor responders who were candidate forIVF. In case group (n=30), delayed-start GnRH antagonist protocol administeredestrogen priming followed by early follicular-phase GnRH antagonist treatment for7 days before ovarian stimulation with gonadotropin. Control group (n=30) treatedwith estrogen priming antagonist protocol. Finally, endometrial thickness, the ratesof oocytes maturation, , embryo formation, and pregnancy were compared betweentwo groups.
Results: Rates of implantation, chemical, clinical, and ongoing pregnancy indelayed-start cycles were higher although was not statistically significant.Endometrial thickness was significantly higher in case group. There were nostatistically significant differences in the rates of oocyte maturation, embryoformation, and IVF outcomes between two groups.
Conclusion: Delayed-start GnRH antagonist protocol can be a new hope method totreatment poor ovarian responders.
Maryam Eftekhar, Maryam Farid Mojtahedi, Sepideh Miraj, Malihe Omid,
Volume 15, Issue 7 (8-2017)

Background: Gonadotropin-releasing hormone agonists (GnRH-a) was increasingly used for triggering oocyte maturationfor the prevention of ovarian hyperstimulation syndrome. Studies suggest that GnRH-a might be used as a better trigger agent since it causes both Luteinizing hormone and follicle stimulating hormone release from a physiologic natural cycle.
Objective: The aim of this study was to evaluate the effect of dual-triggering in assisted reproductive technology outcomes.
Materials and Methods: 192 normal responder women aged ≤42 years and 18< Body Mass Index <30 kg/m2 enrolled in this single-blind randomized controlled trial. All participants received antagonist protocol. For final triggering, women randomly were divided into two groups. Group, I was triggered by 6500 IU human chorionic gonadotropin (hCG) alone, and group II by 6500 IU hCG plus 0.2 mg of triptorelin. The implantation, chemical, clinical and ongoing pregnancy, and abortion rates were measured.
Results: The mean of retrieved oocytes and obtained embryos were statistically higher in the dual-trigger group (group I), but the implantation and pregnancy rates were similar in two groups.
Conclusion: The results of our study did not confirm the favorable effect of dual-triggered oocyte maturation with a GnRH-a and a standard dosage of hCG as an effective strategy to optimize pregnancy outcome for normal responders in GnRH-antagonist cycles. We think that this new concept requires more studies before becoming a universal controlled ovarian hyperstimulation protocol in in vitro fertilization practice.
Abbas Aflatoonian, Mahnaz Mansoori-Torshizi, Maryam Farid Mojtahedi, Behrouz Aflatoonian, Mohammaad Ali Khalili, Mohammad Hossein Amir-Arjmand, Mehrdad Soleimani, Nastaran Aflatoonian, Homa Oskouian, Nasim Tabibnejad, Peter Humaidan,
Volume 16, Issue 1 (January 2018)

Background: The use of embryo cryopreservation excludes the possible detrimental effects of ovarian stimulation on the endometrium, and higher reproductive outcomes following this policy have been reported. Moreover, gonadotropin-releasing hormone agonist trigger in gonadotropin-releasing hormone (GnRH) antagonist cycles as a substitute for standard human chorionic gonadotropin trigger, minimizes the risk of ovarian hyperstimulation syndrome (OHSS) in fresh as well as frozen embryo transfer cycles (FET).
Objective: To compare the reproductive outcomes and risk of OHSS in fresh vs frozen embryo transfer in high responder patients, undergoing in vitro fertilization triggered with a bolus of GnRH agonist.
Materials and Methods: In this randomized, multi-centre study, 121 women undergoing FET and 119 women undergoing fresh ET were investigated as regards clinical pregnancy as the primary outcome and the chemical pregnancy, live birth, OHSS development, and perinatal data as secondary outcomes.
Results: There were no significant differences between FET and fresh groups regarding chemical (46.4% vs. 40.2%, p=0.352), clinical (35.8% vs. 38.3%, p=0.699), and ongoing (30.3% vs. 32.7%, p=0.700) pregnancy rates, also live birth (30.3% vs. 29.9%, p=0.953), perinatal outcomes, and OHSS development (35.6% vs. 42.9%, p=0.337). No woman developed severe OHSS and no one required admission to hospital.
Conclusion: Our findings suggest that GnRHa trigger followed by fresh transfer with modified luteal phase support in terms of a small human chorionic gonadotropin bolus is a good strategy to secure good live birth rates and a low risk of clinically relevant OHSS development in in vitro fertilization patients at risk of OHSS.
Ashraf Moini, Zohreh Lavasani, Ladan Kashani, Maryam Farid Mojtahedi, Nazila Yamini,
Volume 17, Issue 9 (September 2019)

Background: Ovarian stimulation (OS) for poor ovarian response (POR) patients is still a major challenge in assisted reproductive techniques. Aromatase inhibitors as co-treatment in antagonist protocol are suggested to these patients, but there are controversial reports.
Objective: To evaluate the effectiveness Letrozole (LZ) as adjuvant treatment in gonadotropin-releasing hormone (GnRH)-antagonist protocol in POR patients undergoing in vitro fertilization/ intracytoplasmic sperm injection cycles.
Materials and Methods: This double-blind randomized clinical trial was conducted in Arash womenchr('39')s hospital. One hundred sixty infertile women with POR based on Bologna criteria were allocated into two groups randomly: LZ + GnRH-antagonist (LA) and placebo + GnRH-antagonist (PA) groups. In the experimental group, the patients received 5 mg LZ on the first five days of OS with 150 IU of recombinant human follicle-stimulating hormone (rFSH) and 150 IU of human menopausal gonadotropin (HMG). The cycle outcomes were compared between groups.
Result: The total number of retrieved oocytes and the metaphase II oocytes in LA-treated group were significantly higher than those in the control group (p = 0.008, p = 0.002). The dosage of hMG used and the duration of OS and antagonist administration in LZ-treated group were significantly lower than those of the control group. The number of patients with no oocyte, in the control group, was higher than the LZ-treated group, and the clinical pregnancy rate in LA-treated group (25%) was higher than the control group (18%); however, the differences were not significant statistically.
Conclusion: Adding 5 mg of LZ to rFSH/hMG antagonist protocol may improve the in vitro fertilization/intracytoplasmic sperm injection cycle outcome in POR patients.

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