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Showing 77 results for Icsi

Marzieh Mehrafza, Nadia Nobakhti, Zahra Atrkar Roushan, Havva Dashtdar, Mane Oudi, Ahmad Hosseini,
Volume 1, Issue 1 (1-2003)

Backgroud: Intrauterine insemination (IUI) is generally attempted before proceeding to more expensive and invasive assisted reproductive techniques such as invitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). This procedure is most commonly performed as a therapeutic method for couples with a wide variety of subfertility etiologies, such as low count or low motility of sperm, or an incompatibility between the sperm and the cervical mucus. The objective of this clinical trial study was to compare the correlation between the semen parameters and pregnancy rates in patients undergoing hyperstimulation and IUI. Materials and Methods: 336 infertile couples that underwent 336 cycles of IUI with washed husband�s semen were included in this study. All patients� charts were reviewed for age, etiology and duration of infertility, semen characteristics and pregnancy rates. The SPSS 9 software and Chi-square tests were applied for statistical analysis. P<0.05 was determined as statistical significance. Results: Total pregnancy rates were18.2% (61 out of 336 cycles). Postwash semen parameters including: sperm count ?10? 106 ,motility ?50% (grade III and IV >20%) had significant effect on pregnancy rates after IUI. The Outcome of this procedure was not significantly affected by female age, duration or etiology of infertility. Conclusion: Postwash semen quality was the most important factor for predication of successful pregnancy in this study.
Afsaneh Khademi, Leili Safdarian, Ashraf Alleyassin, Marzieh Agha-Hosseini, Ehsan Akbari Hamed, Hojatollah Saeidi Saeidabadi, Omid Pooyan,
Volume 2, Issue 2 (7-2004)

Background: The etiologic cause in near one third of male factor infertility is unknown. The percentage of men with idiopathic infertility who have been successfully treated by the empirical therapeutic modalities is not high. Objective: The aim of this study was to assay the effect of L-carnitine on sperm parameters in patients who needs intracytoplasmic sperm injection (ICSI) as a method for infertility treatment. Materials and Methods: The study population consisted of 65 men (mean age± SD: 34.4 ± 6.07) presenting with primary infertility due to idiopathic oligoasthenoteratozoospermia. L-carnitine was prescribed 1gram orally every 8 hours for 3 months. Before and after the ending of the L-carnitine treatment, semen analysis was performed. Results: The proportion of patients who had motile and grade C sperms rose significantly after treatment. Percentile of abnormal shaped sperms decreased significantly after treatment. In approximately 22%, complete asthenozoospermia changed to relative asthenozoospermia. Conclusion: Appearing motile sperms will potentially improve the technique of ICSI. The magnitude of the elevation in normal morphology is not clinically obvious, but it seems that it can be important in obtaining normal-shaped sperms for intracytoplasmic injection. Designing a study on selected patients with complete asthenozoospermia who have not other abnormalities in semen parameters can reveal the real effect of carnitine therapy in this category. Article
Razieh Dehghani Firouzabady, Irandokht Mehri Mahani, Mehdi Dehghani Firouzabady,
Volume 2, Issue 2 (7-2004)

Background: Embryo transfer has received little clinical attention and has been the most inefficient step in in-vitro fertilization (IVF). Recent reports have suggested that an awareness of the position and length of the uterus during embryo transfer might be helpful in improving pregnancy rate. Objectives: The main objective of the present study was to determine the relation between the length and position of the uterus during embryo transfer and pregnancy rate. Materials and Methods: Patients were randomly allocated to two groups. In case group A (n=40) length of uterus was measured at the day of oocytes collection and the position of uterus was determined. In the control group, Group B, (n=40) the length and position of uterus were not investigated. The embryo transfer catheter was advanced to 5 mm from uterine fondues based on the previously determined cavity length in group A. The embryo transfer procedures ( IVF/ICSI) at 48 hours after oocytes collection was done. The outcome of the treatment cycle in two groups was investigated. Data analysis was performed by using chi-square, fisher-exact and ANOVA tests. The statistical significant was defined (P?0.05). Results: There were no significant differences in the mean age (28.5+4.4, 27.8+6.2), and duration of infertility (7+3.4, 8.7+5.4). The pregnancy rate was not significantly different with respect to position and length of uterus. The pregnancy rate in case groups was 25% and in control group was 22.5%, the difference was not significant (P= 0.792). In both groups, there were ectopic peregnancy and in fact he incidence of ectopic pregnancy, per reported clinical pregnancy, was highest in group A (14.9%) in comparison with group B (1.8%). Conclusion: The pregnancy rate was not significantly different in the two groups. Misdirecting the embryo transfer can not be avoided by an accurate knowledge of the position or length of uterine at the time of oocytes retrieval. Further studies are required to evaluate the role of length and position of uterus related to the pregnancy rate. Article
Alireza Vahidi, Seyed Mehdi Kalantar, Mehrdad Soleimani, Mohammad Hossein Amir Arjmand, Abbas Aflatoonian, Mohammad Ali Karimzadeh, Afsaneh Kermaninejhad,
Volume 2, Issue 2 (7-2004)

Backgrownd: Studies in regions with seasonal climatic variations have revealed a correlation between human natural conception and birth rates. Holidays and other cultural activities probably have influence on conception, but the ambient temperature and emotional influences on the female hormones related to fertility may play an important part in the seasonal variation in conception. Objectives: The aim of study was to determine the relationship between the success rate of Assisted Reproductive Technique (ART) treatment cycles and temperature in different seasons. Materials and Methods: A retrospective study on all individuals undergoing assisted ART at our institution was performed during June 2000 to June 2001. The study population represented 258 IVF-ET cycles and 821 ICSI treatment cycles. Different variables were analyzed using ?2 test. Results: In IVF treatment cycles, conception was more common from early spring (March to June). This decreased from spring, with the minimum in fall, 22% and 14%, respectably. A significant seasonal variability in the number of eggs, embryo transferred and sperm motility was not demonstrated (p>0.05), but sperm count was significantly higher in spring than any other season (72+4 x106 and 52+7x106, respectively). Conclusion: The seasonal changes should be taken into account together with other factors when evaluating infertility data. Article
Mahnaz Ashrafi, Ashraf Moini, Afsaneh Mohammadzadeh, Zahra Ezabadi, Fatemeh Zafarani, Ahmad Reza Baghestani,
Volume 3, Issue 1 (7-2005)

Background: Polycystic ovarian syndrome (PCOS) patients are prone to premature LH surge and ovarian hyperstimulation syndrome (OHSS). Long GnRH analogue protocol and GnRH antagonist protocol are two methods utilized for induction ovulation in patients undergoing IVF/ICSI. Objective: The aim of this study was to compare the effects of GnRH agonists and antagonists in PCOS patients. Materials and Methods: A total of 60 PCOS patients under 35 years old were enrolled in this study. The patients have no history of thyroid disorder and hyperprolactinemia. All patients received OCP (LD) before starting the treatment. Then patients randomly divided into two groups. The agonist group underwent standard long GnRH analogue protocol. In antagonist group, HMG (150 IU/day) was started from third day of cycle. Then GnRH antagonist (0.25mg) was administered from 6th day after HMG initiation (LH?5 IU/ml) to the day of HCG injection. Follicular development monitored by vaginal ultra sonography and serum estradiol measurement. Results: There were no significant differences in age, duration of infertility, BMI, number of HMG ampules, number of follicles?18mm, serum estradiol level on 6th day of HMG initiation and HCG injection time, fertilization and pregnancy rate between two groups. However there were significant differences regarding duration of treatment, duration of HMG usage, LH level at the initiation of HMG, OHSS rate and number of Metaphase II oocytes between two groups (p<0.05). Conclusion: Usage of the GnRH antagonist may have more advantages such as the shorter duration of treatment and less gonadotrophin requirement. Furthermore, the incidence of OHSS can be reduced in GnRH antagonist comparing to agonist. For decreasing the risk of OHSS and abortion rate, we recommend long term use of OCP before starting the treatment
Ghasem Saki, Fatemeh Ghalambor Dezfuly,
Volume 3, Issue 1 (7-2005)

Background: The cryopreservation of human oocyte would make a significant contribution to infertility treatment, such as using it for oocyte donation and for patients a bout to lose ovarian function due to surgery or chemotherapy. Despite of using standard freezing straws and cryovials or even open pulled straws, only a few successful pregnancies have been arisen from cryopreserved human oocytes. This situation has been primarily attributed to poor survival, fertilization and development of cryopreserved oocytes. Objective: The aim of this study was to evaluate the novel cryoloop vitrification method for cryopreservation of human oocytes. Materials and Methods: Nine infertile couples participated in this study. In all women proper regulation and desensitization was done using GnRH agonist during luteal phase. Mature oocytes allocated into two groups randomly. In group I, 34 oocytes were vitrified in conventional straws, while in group II, 33 oocytes were vitrified in cryoloop. After a store time of 1-6 months the oocytes were thawed, incubated for 2 hours and subsequently the ICSI was done on survived oocytes. To verify normal fertilization of vitrified oocytes the number of pronuclei in the cytoplasm was counted 16-18 hours after ICSI and good morphological quality embryos were transferred on day 2 or 3 after sperm injection. Pregnancy was identified by the serum � HCG level, checked 14 days after embryo transfer. Results: The present study shows that the rate of survival of vitrified human oocytes in two groups has no significant difference (52.94% in group I versus 63.63% in group II) but the fertilization rate of vitrified oocytes by cryoloop was greater than vitrified oocytes by conventional straws (73.7% versus 55.55% respectively). One of the embryo transfers achieved clinical pregnancy and resulted in the delivery of healthy baby. Conclusion: Vitrification by using cryoloop can improved the fertilization rate and developmental capacity of vitrified thawed oocyte.
Soheila Arefi, Mahmoud Jeddi Tehrani, Mohammad Mehdi Akhondi, Ali Reza Mousavi, Mahnaz Heidari, Ahmad Ali Bayat, Ali Sadeghpour Tabaei,
Volume 3, Issue 1 (7-2005)

Background: Auto antibodies to zona-pellucida (AZA) seem to be important autoantibodies implicated in reproduction, with substantial role in both endocrine and reproductive functions of the human ovary. There are some debates on the relation of AZA with infertility, repeated In Vitro Fertilization (IVF) attempts, and outcome of it. Objective: In this study, we assessed the presence of AZA in the follicular fluids (FFs) of women who underwent intra cytoplasmic sperm injection (ICSI), in relation to etiology of infertility and multiple puncture of ovaries. Materials and Methods: In this prospective study, follicular fluids were evaluated from 96 infertile women, (19-40 years old, 31.5�5.1), who were candidates for ICSI based on the etiology of infertility. From these 80 women had explained infertility whereas 16 had unexplained infertility. All FFs were evaluated for presence of AZA by ELISA test. Results: Twenty patients (20.8%) were positive for AZA in follicular fluid. In patients with unexplained infertility, AZA antibody in follicular fluid, was significantly higher than the group with proven etiology of infertility (p=0.001). In addition, 20.4 % of patients who had been punctured previously showed AZA in their FFs which is statistically similar to the patients who were punctured for the first time. Conclusions: The high incidence of AZA in infertile women, especially women with unexplained infertility has to be considered. Relation of the presence AZA and repeated puncture of ovaries is still debatable. Determinations of AZA are highly recommended in evaluation of infertile couples especially in patient with unexplained infertility
Farnoush Farzi, Marzieh Mehrafza, Ali Mirmansouri, Mona Oudi, Ahmad Hoseeini,
Volume 3, Issue 2 (7-2005)

Background: Recent studies of uterine contractility in IVF�embryo transfer led us to consider an alternative, and possibly complementary, explanation for the high implantation rates of blastocysts. It has been demonstrated that myometrial contractile activity influences embryo implantation, possibly through mechanical displacement of embryos. Objective: The aim of this study was to examine the effect of nitroglycerine (NTG) treatment for priming the uterus on the pregnancy outcome of ICSI-ET programs. Materials and Methods: This study was a prospective, randomized, double-blinded placebo-controlled clinical trial. One hundred consecutive cycles of ICSI-ET on infertile couples were randomly divided into treatment and control groups. The treatment group (50 cycles) received an oral dose of 0.4 mg of NTG, and the control group (50 cycles) received a placebo, 15 minutes before fresh ET. An informed consent from was obtained form each patients. The main outcomes were implantation rate (IR) and pregnancy rate (PR). Results: The mean age of females in the control group and in the treatment group were 30.1�5.1 and 31�5.5 years respectively. Data showed that the mean duration of infertility was not significantly different between control and treatment groups (6.6�5.8 versus 7.8�5.1 years, respectively). The mean number of oocyte retrieval (metaphase II), 2pn, embryo cleaved, embryo transferred and PR weren't different between two Groups (p>0.05). Overall PR was 36%, it was 38% in treatment group and 34% in control group but there wasn�t statistically significant difference between two groups. (p>0.05) Conclusion: NTG didn't increase PR compared to placebo group. These results suggest that NTG treatment before ET isn't effective in the priming of a uterus
Marzieh Farimani, Iraj Amiri, Sedigheh Hoseini,
Volume 4, Issue 1 (7-2006)

Background: The ability of the ovary to respond to exogenous gonadotrophin stimulation and development of several follicles is essential in assisted reproductive technology. Neither age and regularity of menses nor follicular phase FSH and estradiol concentrations are reliable predictors of ovarian response. Day 3 serum inhibin-B level, during induction ovulation, has been proposed as a predictor of ovarian response.
Objective: To determine day 3 serum inhibin-B as a predictor of ovarian response to induction ovulation in IVF/ ICSI cycles.
Materials and Methods: Seventy one infertile patients under 40 years old were enrolled in this study. All women have both ovaries, basal FSH level under 15 mIU/ml, and no evidence of endocrine disorders. Day 3 FSH, estradiol, inbibin-B concentrations and ovarian volume were measured before treatment. All patients underwent standard long GnRH agonist protocol. The number of oocytes retrieved, fertilization rate, clinical pregnancy rate, days of stimulation and number of HMG ampoules were determined. The patients were divided into two groups, normal responders and poor responders (number of oocytes retrived <4).
Results: The mean inhibin-B level in normal responders was 166.9 141 pg/ ml versus 115.8 87 pg/ml in poor responders, which the difference was not statistically significant (p=0.24). We could not find a cut off between normal and poor responders.
Conclusion: The use of day 3 inhibin-B level as a predictive marker of ovarian response in IVF/ICSI cycles is not reliable.
Mir Mehrdad Farsi, Ali Jorsaraei, Mahmood Hajiahmadi, Sedigheh Esmaelzadeh,
Volume 5, Issue 2 (7-2007)

Background: Multiple factors have been suggested for prediction of pregnancy in Intracytoplasmic sperm injection (ICSI) cycles such as the number of injected oocytes, fertilization rate, embryo morphology and quality of transferred embryos. Predictive value of these factors is important in ICSI outcome.
Objectives: To evaluate the role of embryo morphology for prediction of pregnancy in ICSI cycles.
Materials and Methods: This retrospective study was done on 97 patients who were treated by ICSI in Fatemeh Zahra Fertility and Infertility Centre from April 2004 to March 2005.  Number of retrieved oocytes, number of injected oocytes, fertilization rate, zygote morphology, rate of cytoplasmic fragmentation, number of four cell transferred embryos, and quality of embryo transfer, as predictors of pregnancy in ICSI cycles were evaluated. The results analysed by T-test, Mann-Whitney U test and Fisher's exact test. Logistic regression was used to estimate the significance of variables in the prediction of pregnancy probability.
Results: Out of 97 patients, 42 cases of pregnancy were detected (Pregnancy rate: 43.3%). The number of four cell transferred embryos was 112 (53.84%) in pregnant group. Pregnancy occurred in 33 (58.9%) patients with at least one good quality zygote.  The mean number of four cell transferred embryos and the quality of zygotes had significant difference between pregnant and not pregnant groups (p=0.006 and p=0.000 respectively). In logistic regression analysis, the number of four-cell transferred embryos (p=0.007) and the quality of zygotes (p=0.003) were significant predictors of the pregnancy outcome.
Conclusions: Our results suggest that the number of four-cell transferred embryos with ≤ 15% cytoplasmic fragmentation and zygotes with centralized, apposed and polarized pronuclei in women <38 years old are significant predictors for pregnancy in ICSI cycles.
Ensieh Shahrokh Tehrani Nejad, Ashraf Moini, Elham Amirchaghmaghi, Batol Hossein Rashidi, Parvin Jaberi Pour, Elham Azimi Neko,
Volume 5, Issue 3 (7-2007)

Background: Although the uterine fibroids are common, their influence on fertility remains controversial. The association of submucosal fibroid with subfertility is well recognized, but debate persists as to whether intramural fibroids can cause infertility and the evidence for its effect on pregnancy in cycles of assisted conception remains unclear.
Objective: The purpose of present study was to determine the effect of intramural fibroids less than 6 cm not compressing uterine cavity on the outcome of ART cycles in patients undergoing IVF/ICSI cycles.
Materials and Methods: In this prospective cohort study, 94 women with uterine intramural fibroids and 184 controls referred to Royan Institute between 2001 and 2002 were enrolled. The intramural fibroids and their location were detected by transvaginal ultrasound performed just before the ART cycle. All patients underwent long standard GnRH agonist protocol. Student t-test and Chi-square test were used for the statistical analysis.
Results: The mean age of patients was 33.9 ±3.37 years in myoma group (n=94) and 33.28 ±3.59 years in control group (n=184). The total dose of gonadotropin used, estradiol level on day of hCG administration, the number of metaphase II oocytes retrieved, fertilization rate, number and quality of embryos developed and transferred, the clinical pregnancy and abortion rates were similar in two groups.
Conclusion: The presence of intramural fibroids less than 6 cm not compressing endometrial cavity does not adversely affect clinical pregnancy rate in patients undergoing IVF or ICSI.
Marefat Ghaffari Novin, Mahnaz Heidari, Mahdi A Akhondi, Mahmood Jeddi Tehrani,
Volume 5, Issue 4 (7-2007)

Background: Matrigel (extracellular matrix) can improve the growth of many cell types in vitro.
Objective: The aim of the present study was to determine the effect of Matrigel on the development of 2-4 cells human embryos in culture.
Material and Methods: Surplus 2-4 cells human embryos, resulting from ICSI, were divided into two groups (control and test). Quality of embryos in both groups was morphologically similar. The test group (n=140) was cultured in Hams’ F10 supplemented with 10% human serum albumin and 150 µl liquid Matrigel. The control group (n=140) was cultured in the same medium devoid of Matrigel. Embryos were cultured for an additional 4 days and their morphology was assessed every 24 hours. Both groups were then statistically compared.
Results: The percentage of the human embryos that reached the morula stage in the control and test groups were 79.2% and 80%, respectively (p>0.05).  However, 36.4% of embryos reached the blastocyst stage in the test group as compared to 5.7% in the control group after 144 hours in culture. This difference was statically significant (p <0.01). In addition, culture of embryos on Matrigel and medium versus medium alone significantly improved in vitro hatching (25.7% versus 3.5%; p <0.01).
Conclusion: Matrigel at low concentration enhances human blastocyst formation and hatching in vitro.


Robab Davar, Sedighe Ghandi, Naeimeh Tayebi,
Volume 5, Issue 4 (7-2007)

Background: Recent reports have suggested that ultrasound-guided embryo transfer (UG-ET) might improve pregnancy rates.
Objective: To determine whether transabdominal UG-ET is a useful tool for increasing pregnancy and implantation rates in patients undergoing IVF or ICSI.
Materials and Methods: A prospective randomized clinical trial was conducted in 180 patients in order to compare embryo transfer under abdominal ultrasound-guidance (n=90) with embryo transfer by clinical touch method (n=90).
Results: The Clinical pregnancy rate was 21.1 % in the ultrasound-guided group and 15.5 % in the clinical touch group (p =0.3). The implantation rate in the ultrasound guided group was 11.1% while this was 7.2% in the clinical touch group (p =0.12). The percentage of difficult transfer was not significantly different in both groups, this was 8.9% in the ultrasound-guided group and 13.3% in the clinical touch group (p =0.47).
Conclusions: Although the clinical pregnancy and implantation rate are higher in UG-ET group than the clinical touch group, but this difference was not statistically significant.
Monir Owj, Moid Mohseni, Elham Amirchaghmaghi, Maria Sadeghi, Babak Eshrati, Fatemeh Shabani,
Volume 5, Issue 5 (7-2007)

Background: Smoking has negative effects on reproductive process. Exposing to cigarette smoking (passive smoking) may exert some effects as the direct smoking.
Objective: The aim of this study was to evaluate the correlation between ovarian response and passive smoking in women who underwent ART cycles.
Materials and Methods: One hundred-sixty patients who underwent ICSI between 2000 and 2001 were studied in a prospective cohort study. The case group included women whose husbands smoked at least 5 cigarettes daily for 1 year or more. The control group included women with nonsmoking husbands. Women with high FSH level (>12 IU/ml) were excluded. Long standard protocol with GnRH agonist and HMG were used in all patients. In vitro fertilization and embryo transfer was carried out in a standard fashion.
Results: Eighty one women were in case group and 82 in control group. Ovarian response variables were not significantly different between two groups but there was a significant relation between passive smoking and fertilization (RR= 1.18, 95% CI: 1.07-1.31). However pregnancy rate was not significantly different between two groups. Moreover there were no significant differences between heavy and light smokers in ovarian response outcomes.
Conclusion: This study showed no correlation between ovarian response parameters and passive smoking in women underwent ART cycles, whereas fertilization rate is significantly lower in this group compared to control group. It may be related to sperm quality than oocytes. Assessment of nicotin in follicular fluid and cytogenetic evaluation of embryo before transfer are recommended for more information and confirmation.
Soheila Arefi, Haleh Soltanghoraee, Amir Hassan Zarnani, Ali Sadeghpour Tabaei , Marefat Ghaffari Novin , Hojat Zeraati, Pegah Ebadi,
Volume 6, Issue 2 (7-2008)

Background: Despite numerous developments in the field of assisted reproduction, the implantation rate remains low. Among the various reasons of implantation failure, endometrial regularity has an important role. Hysteroscopy is an accurate method for evaluating the endometrial characteristics, with the ability to treat uterine pathology.
Objective: The aim of the present study was to evaluate the findings on hysteroscopy and thereafter the result of subsequent IVF/ICSI in infertile women with the history of frequent unexplained and unsuccessful IVF/ICSI attempts.
Materials and Methods: In this observational study, the hysteroscopy findings and the outcomes of subsequent IVF/ICSI were evaluated in 89 infertile women admitted in Avicenna Infertility Clinic, with previous repeated (more than two) failed IVF/ICSI-ETs, including the patients with normal Hysterosalpinography (HSG) and excluding severe male factor infertility and also thrombophilia, genetic and immunologic problems. The data were analyzed with SPSS software and Fisher exact, chi-square, and MC-Nemar tests.
Results: In 53 (59.5%) cases, hysteroscopy revealed abnormal intrauterine findings including adhesions 7 (13.7%), single polyp 11 (20.7%), endometrial polyposis 10 (18.8%), endometrial hyperplasia 10 (18.8%), uterine cavity hypoplasia 4 (7.8%) and myoma 5 (9.8%). These abnormalities were significantly higher in women with more than 8 years of infertility (chi-square=4.7, p-value=0.03). After hysteroscopy and subsequent IVF/ICSI-ET attempt using standard long protocol, pregnancy rate were significantly higher compared with the previous repeated IVF/ICSI attempts (35.8% versus 0%). Conclusion: According to this study, we strongly suggest evaluation of endometrial integrity by hysteroscopy in patients with repeated IVF/ICSI-ETs failure, before entering any other fertilization procedures.
Farnaz Sohrabvand, Nasrin Abedinia, Reyhaneh Pirjani, Mina Jafarabadi,
Volume 6, Issue 3 (7-2008)

Background: There is increasing evidence that psychological factors like anxiety and depression can affect IVF/ICSI treatment results.
Objective: This study aimed to clarify the role of women’s anxiety and depression on the outcome of ART cycles using Intra Cytoplasmic Sperm Injection (ICSI).
Materials and Methods: This was a prospective pilot study. One hundred six (106) consecutive women undergoing ICSI cycles were enrolled between January 2006 and 2007. Age, duration and cause of infertility, number and score of transferred embryos were recorded for each patient. Data regarding the state of anxiety and depression of each volunteer were collected using the translated and validated Iranian Cattle Anxiety and Beck Depression Inventories.
Results: Among 106 women enrolled in the study, 25 cases (23.5%) of clinical pregnancies occurred. In univariate analysis, there was no significant difference regarding age and cause and duration of infertility between groups. Number of transferred embryos was significantly associated with higher pregnancy rates (3.4± 1.15 vs. 2.5±1.38 in pregnant and nonpregnant group respectively). Among the 106 participants, 73.58% had anxiety and 30.18% showed various degrees of depression. Out of 28 patients with no anxiety, 21(75%) and out of 74 patients with no depression, 24(32%) became pregnant. There was significant association between depression/anxiety and pregnancy rate (p=0.034 and p=0.00 respectively). Logistic regression model showed that anxiety/depression affect the outcome of ART significantly.
Conclusion: It is crucial to identify infertile patients at greater demand for psychological support before starting ART cycles.
Abbas Aflatoonian, Sedigheh Ghandi, Nasim Tabibnejad,
Volume 6, Issue 3 (7-2008)

Background: One of the major and life-threatening side effects of Assisted Reproductive Technique (ART) is ovarian hyperstimulation syndrome (OHSS). The available data however, have been showed that both Cabergoline (anti VEGF) and coasting reduce the severity of OHSS.
Objective: We aimed to compare coasting and Cabergoline administration in prevention of severe OHSS.
Materials and Methods: A total of 60 IVF/ICSI cycles were selected. Patients at risk of developing OHSS were divided into two groups as patient's convenience. For 30 patients in coasting group, exogenous gonadotropins were withheld to allow E2 to decrease while GnRH-a was maintained. Then 10,000 unit hCG was administrated and oocyte retrieval was performed 36 hours later. In Cabergoline group, 30 patients were administered with 0.5mg Cabergoline tablet on day of hCG injection, continued for 8 days.
Results: The mean number of retrieved, good quality, mature oocytes and the mean number of embryos were significantly different in two groups (p<0.05). The clinical pregnancy rate was 13.3% in coasting and 26.7% in Cabergoline group that was not significantly different (p>0.05). The incidence of severe OHSS was similar in two groups.
Conclusion: The Cabergoline was as effective as coasting in the prevention of early severe OHSS in high risk patients, but yielded more retrieved oocytes.
Elke Heytens, Reza Soleimani, Petra de Sutter,
Volume 6, Issue 5 (7-2008)

Fertilization is triggered by changes in intracellular calcium concentration. In mammals, these transients in ooplasmic calcium concentration take the form of repetitive spikes, so called calcium oscillations (Ca2+-oscillations). These oscillations are important for relieve of meiotic arrest and to induce all the other events of oocyte activation. Although a surface mediated way of oocyte activation has been proposed, there is now substantial evidence to suggest that the sperm cell induces these Ca2+-oscillations by introducing a sperm specific phospholipase C, PLCζ, in the ooplasm. Ca2+-oscillations are also observed after intracytoplasmic sperm injection (ICSI), a successful technique in human assisted reproduction. In the rare cases that no fertilization is observed following ICSI, this may be due to a deficiency in PLCζ. However, artificial activating the oocytes after ICSI by increasing the calcium concentration can restore fertilization rates in these cases and support further development, as evidenced by successful pregnancies. Further evaluation of the current protocols for assisted oocyte activation is appropriate and investigation of the future application of PLCζ is warranted.
Mohammad Ali Karimzadeh, Sedigheh Ghandi,
Volume 7, Issue 2 (7-2009)

Background: Female age and basal FSH level are independently associated with IVF outcome. They are both related to the same phenomenon, namely ovarian reserve.
Objective: To evaluate the effective role of serum FSH concentration at the start of treatment cycle on ART outcome.
Materials and Methods: A total of 207 women undergoing IVF and ICSI cycles were included in this study. Basal FSH concentrations were measured and the women's ages were calculated before they were undergoing pituitary desensitization and its correlation with ART outcome was evaluated.
Results: Increasing FSH was associated significantly with reduced number of follicles > 15mm, oocytes retrieved, and embryos obtained.
Conclusion: Age is the most important prognostic factor but basal serum FSH can be used to identify women who are very likely to perform poorly in ART, probably because of diminished ovarian reserve.
Ensieh Shahrokh Tehrani Nejad, Batool Hosein Rashidi, Atefeh Larti, Zahra Ezabadi, Nadia Jahangiri, Elham Azimi Nekoo,
Volume 7, Issue 2 (7-2009)

Background: Endometriosis is one of the most challenging diseases that constitute 20% - 40% of women searching for their infertility diagnosis. Objective: This study was undertaken in order to compare the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in women with endometriosis, and tubal factor infertility as controls.
Materials and Methods: From 2005 to 2006 a retrospective study was carried out in patients with endometriosis (n=80) and tubal infertility (n=57) after treatment with IVF/ICSI. The main outcome measures were ovarian responsiveness, quality of oocytes, implantation, pregnancy and ongoing pregnancy rates. Appropriate statistical analysis was performed using χ2 and student t-tests.
Results: No differences were found in mean number of ampoules of hMG, duration of hMG injection, number of MΙΙ oocytes, number of embryo transferred, and rates of implantation, pregnancy, ongoing pregnancy and twin birth between women with endometriosis and tubal infertility and also between women with stages I/II or those with stages III/IV disease with women with tubal factor infertility.
Conclusion: Our results suggest that endometriosis does not seem to have adverse effect on outcome of IVF/ ICSI as compared with tubal infertility.

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