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Showing 23 results for Intrauterine Insemination

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.
Robabeh Taheripanah, Maryam Sadat Hosseini, Mohamad Hashemi,
Volume 6, Issue 2 (7-2008)

Background: Ectopic pregnancy is one of the pathologic entities that it destroys the fallopian tube and impairs the future pregnancy. There are different medical and surgical therapies in order the treatment and reserve of fertility. The aim of this report is discuss a case of successful intrauterine after management of ectopic pregnancy with local injection of KCL in an infertile PCOD patient. Case: The patient was a PCOD woman with gestational age of 8.5 weeks. One gestational sac and alive fetus with normal heart beat was seen in the right adnexa. Hemodynamic situation was stable. 0.5cc KCL 10% was injected to the fetal heart and the extracted tissue sent for pathology. We evaluated the effects of this treatment by measuring serial human chorionic gonadotropin (hCG) titers. Moreover, we used hysterosalpingogrphy to diagnose and to evaluate the patency of the tubes. Induction ovulation and intrauterine insemination was done and pregnancy occurred. Patient passed the pregnancy very good and she delivered by cesarean section due to breech presentation at 39 weeks of gestational age. There was no sign of pathologic finding in the tubes or adhesion or sequel of ectopic pregnancy. Conclusion: The beneficial outcomes of this kind of treatment suggest that local injection of KCL as a low invasive treatment can be the choice treatment for alive and progressed ectopic pregnancy or heterotopic pregnancy. Because of rarity of this management and successful intrauterine we reported the usefulness of local KCL injection for the successful conservative treatment of alive ectopic pregnancy in Iran.
Sanam Moradan,
Volume 7, Issue 2 (7-2009)

Background: Pelvic inflammatory disease is one of the most serious infection and one of the important and life threatening complications of it is tubo-ovarian abscess. This infection with intrauterine insemination (IUI) is rare. We report a case of ruptured tubo- ovarian abscess after (IUI). Case: A 27 years old woman was referred to our center with acute abdominal pain and fever one week after IUI. The diagnosis was PID and after treatment with intravenous antibiotics she was still febrile after 3days and had generalized tenderness in abdominal exam. Therefore, laparatomy was performed and left fallopian tube ruptured abscess was detected. Left salpingectomy was done. The patient developed dyspnea and tachypnea in second day post operation and echocardiography with spiral CT scan was normal. So a mild ARDS was considered .The patient was discharged from hospital 5 days after operation in good condition. Conclusion: This is a case of PID, tubal abscess and ARDS after IUI and it is necessary to keep in mind this diagnosis after IUI.
Shahdokht Motazedian, Bahareh Hamedi, Jaleh Zolghadri, Khatereh Mojtahedi, Nasrin Asadi,
Volume 8, Issue 2 (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%.
Victoria Habibzadeh, Sayed Noureddin Nematolahi Mahani, Hadiss Kamyab,
Volume 9, Issue 1 (7-2011)

Background: Many studies have been carried out to understand the effect of endometrial thickness on the reproductive outcome while the factors affecting the pattern itself are still unknown. Objective: To determine the factors such as age and the number of follicles that could affect the endometrial thickness Materials and Methods: This study was conducted as a retrospective study on 680 infertile women considered for intrauterine insemination (IUI). IUI protocol was sequential regimen of clomid and gonadotropin. Endometrial thickness measurement was done on the day of HCG administration. Correlation between endometrial thickness and factors such as age, total follicle numbers, dominant follicle numbers, gonadotropine ampule numbers and pregnancy rate were assessed. Results: The mean endometrial thickness was 7.2±1.8 mm. The endometrium was thinner in older patients compared with younger ones. But in all age ranges pregnancy rate was higher in endometrial thickness 6< ET?10 mm (p<0.05). Conclusion: We did not find any correlation between age, number of follicles and gonadotropine ampoules with endometrial thickness but in all age ranges, there is a possibility of higher chance of pregnancy in endometrial thickness 6 < ET?10 mm. Article
Mahbod Ebrahimi, Firoozeh Akbari Asbagh, Azizeh Ghaseminejad,
Volume 9, Issue 1 (7-2011)

  Background:   Objective: To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate (CPR) of the stimulated IUI cycles.   Materials and Methods: A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group (І), and two hundred couples with unexplained infertility in the group (II). The patients underwent 3 consecutive ovarian hyperstimulation (Clomiphen citrate and human menopausal gonadotropin) and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles. Results: Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group І (26.6%) and group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57 -2.28). Conclusion:   Unilateral tubal blockage (diagnosed on HSG) has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.
Soheila Akbari, Maryam Ayazi Roozbahani, Fatemeh Ayazi Roozbahani,
Volume 10, Issue 1 (7-2012)

Background: Clomiphene citrate (CC) an agonist and antagonist of estrogen, is the first line treatment in ovarian stimulation. Anti-estrogenic effect of CC in endometrial thickness and cervical mucus has negative effect on pregnancy rate. Letrozole is an Aromatase Inhibitor has been seen that has acceptable pregnancy rate compared to CC.
Objective: The aim of this study was to compare the efficacy of letrozole and clomiphene citrate (CC) with gonadotropins for ovarian stimulation in women candidate for intrauterine insemination (IUI).
Materials and Methods: One hundred sixty patients eligible to IUI therapy enrolled in this study. Patients randomized to two groups: group A (received letrozole-gonadotropin) and group B (received CC-gonadotropin). In group A (n=80) letrozole was given on days 3-7 of the menstrual cycles. In group B clomiphen citrate was given like letrozole combined with human menopausal gonadotropin (hMG) administered every day starting on day 8. Ovulation was triggered with urinary HCG when the leading follicle (s) reached 18 mm in diameter. A single IUI was performed 36-40 hours later. The ovarian stimulation response (E2 levels and number of follicles, clinical pregnancy and endometrial thickness) was primary outcome.
Results: Both groups were similar in demographic characteristics. There was a significantly lower peak serum E2 level in the letrozole group compared with CC. (236±86 Vs. 283±106 pg/mL, respectively; p<0.002). The number of mature (>18 mm) preovulatory follicles was significantly higher in CC group than letrozole group (2.2±.68 Vs. 2.02±0.63 respectively; p=0.025). Endometrial thickness measured at the time of hCG administration was significantly higher in letrozole group. (9.08±1.2 mm Vs. 8.1±1.9 mm; p=0.0001). The clinical pregnancy rate was comparable between two groups.
Conclusion: Letrozole is a good and cost-effective alternative to CC in IUI cycles.
Leili Safdarian, Zahra Khayatzadeh, Ebrahim Djavadi, Atossa Mahdavi, Marzieh Aghahosseini, Ashraf Aleyasin, Parvin Fallahi, Sima Khayatzadeh, Arash Ahmadzadeh, Mohhamad Bagher Larijani,
Volume 10, Issue 3 (7-2012)

Background: Detection of best predictor of ovarian reserve in patients with temporarily or consistently elevated early follicular phase serum levels of FSH is one of the most important goals in assisted reproductive technique (ART).
Objective: To evaluate whether high level of anti-mullerian hormone level is related to success of ART in patients with temporarily or consistently elevated early follicular phase serum levels of FSH.  
Materials and Methods: Sixty three women underwent intracytoplasmic sperm injection (ICSI) with GnRH-agonist long protocol or intrauterine insemination (IUI) in a prospective cohort study. FSH, inhibin B and anti-Mullerian hormone (AMH) levels were measured in these women whom were divided to three groups (persistently elevated FSH, variably elevated FSH and, normal FSH level). Basal characteristics, stimulation parameters, and pregnancy occurrence were evaluated.
Results: AMH was significantly higher in women with persistently elevated early follicular phase FSH achieving pregnancy. Women with normal FSH did not have significant difference in AMH level between conceived and non conceived cycles. Women with only one elevated early follicular phase FSH achieving pregnancy did not have significant difference in AMH level with non pregnant women. Response to gonadotropin stimulation, recommendation to oocyte donation significantly differed between the groups.
Conclusion: This study has demonstrated that relatively young women with persistently or intermittently elevated day 3 FSH levels have diminished ovarian reserve and lower ART success. However, in women whose FSH levels were constantly elevated, AMH (not inhibin B) concentrations were significantly higher in ART cycles resulting in pregnancy. Therefore, AMH level is a good predictor of ART outcome in patients with elevated early follicular phase serum levels of FSH.

Arzu Yavuz, Oya Demirci, Hamdullah Sözen, Mehmet Uludoğan,
Volume 11, Issue 3 (5-2013)

Background: So far, many studies investigated factors that affect pregnancy rates after intrauterine insemination (IUI). Various investigators have not agreed on the nature and ranking of these criteria.
Objective: The aim of this study was to assess the predictive factors for pregnancy rate after controlled ovarian hyperstimulation (COH)/ IUI.
Materials and Methods: Retrospective study of all patients undergoing IUI at Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital from January 2006 to December 2009. In total 980 IUI cycles in 569 couples were analyzed. All women in the study underwent ovarian stimulation using gonadotropin and IUI was performed 36 h after triggering ovulation. The primary outcome measure was clinical pregnancy rates. Predictive factors evaluated were female age, body mass index (BMI), duration of infertility, type of infertility, follicle stimulating hormone (FSH) level and estradiol (E2) on third day of the cycle, number of preovulatory follicles, endometrial thichness, total motil sperm (TMS) count, and ratio of progressive motile sperm.
Results: The overall clinical pregnancy rate was 4.7%. Among the predictive factors after multivariate logistic regression analysis level of BMI (<25 kg/m²), number of preovulatory follicles (≥2), level of FSH (<9.4 IU/L), level of E2 (<80 pg/ml) and the ratio of progressive motile sperm (>50%) significantly influenced the clinical pregnancy rate.
Conclusion: Level of BMI, FSH, estradiol, number of preovulatory follicles and the ratio of progressive motile sperm may determine IUI procedure as optimum treatment model.
Bibi Shahnaz Aali, Sakineh Ebrahimipour, Siavash Medhdizadeh,
Volume 11, Issue 4 (6-2013)

Background: Controlled ovarian stimulation combined with intra uterine insemination (IUI) is a convenient treatment of infertility with a success rate of 11%. The clinical observation and pattern of progesterone secretion in this method is suggestive of luteal phase defect and postulated as an implicating factor of treatment failure.
Objective: To investigate the efficacy of luteal phase support with intravaginal cyclogest in women undergoing controlled ovarian stimulation combined with intrauterine insemination.
Materials and Methods: In this single-blinded clinical trial, 196 consecutively seen women eligible for the study protocol, were randomized to receive either intravaginal progesterone (cyclogest pessary, Actavis) or no medication in luteal phase. Blood samples were collected and serum progesterone level in 7th and 11th day of the cycle, biochemical and clinical pregnancy and luteal phase duration were compared in case and control groups.
Results: The mean age in case and control group was 28 and 27.9 years, respectively and the most frequent cause of infertility was unexplained. Additionally, ovulatory dysfunction was the most common cause of female infertility in both groups. Based on these variables, there was no statistically significant difference between the two groups. Mean serum progesterone level in the case group were 48.34 and 34.24nmol/day on day 7 and 11 after insemination, respectively and both values were significantly higher than the control group. There was no difference between the two groups in terms of biochemical and clinical pregnancy. Luteal phase duration in the case group was significantly longer than the control group.
Conclusion: Luteal phase support by Cyclogest pessary increases progesterone level and prolongs the luteal phase, but does not affect success rate of IUI cycles in terms of achieving pregnancy.
Ahmed M. Isa, Basim Abu-Rafea, Sahel Al-Asiri, Johara Al-Motawa,
Volume 12, Issue 7 (8-2014)

Background: Intrauterine Insemination (IUI) remains the first thought of infertility treatment.
Objective: To compare the stimulation effects and Pregnancy rate (PR) outcomes of two ovulation induction (OI) medications, human-derived menopausal gonadotrophins (hMGH), Merional (MER), and recombinant follicular stimulating hormone (rFSH), Puregon (PUR), in a cohort of Saudi infertile patients, for better predictability of treatment results.
Materials and Methods: During a 24-month period, 296 women underwent IUI single treatments. PR’s were correlated with the type of stimulation medication that were prospectively and randomly assigned to each patient, and with the number and size of maturing follicles detected on the hCG injection day.
Results: MER and PUR needed comparable number of days (9.26±4.74 and 9.73±6.27 respectively) before follicles were ready for IUI, although the average amount used from MER, 1199.90 IU, was about double that was used from PUR, 621.08 IU. The overall PR in case of PUR however was nearly double that of MER, 13.28% and 7.14% respectively. The best PR, 16.22%, occurred when the follicles matured within 12-13 days. Three follicles of at least 15-mm diameter on the hCG day had better PR’s than one or two, however when the follicles’ diameters were at least 18-mm, PR was significantly higher, (p=0.013).
Conclusion: MER and PUR had comparable stimulation effects; however PUR had noticeably higher PR. The best PR occurred when the follicles matured within 12-13 days. PR in case of three maturing follicles on the hCG day was better than only one or two, and significantly better when their diameters were at least 18 mm.
Afsoon Zarei, Saeed Alborzi, Nasrin Dadras, Ghazal Azadi,
Volume 12, Issue 9 (10-2014)

Background: Implantation is considered as the rate-limiting step in success of assisted reproduction techniques, and intrauterine insemination cycles. It might be affected by ovarian superovulation and endometrial local scratching.
Objective: This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.
Materials and Methods: In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly assigned to undergo endometrial biopsy between days 6-8 of the previous menstrual cycle before IUI (n=72, IUI cycles =126) or receive no interventions (n=72, IUI cycles=105).
Results: The pregnancy rate per patient was 17 (23.6%) and 14 (19.4%) in endometrial biopsy and control groups, respectively (p=0.686). The pregnancy rate per cycle was 17/126 (13.5%) and 14/105 (13.3%) in endometrial biopsy and control groups, respectively (p=0.389). The abortion rate was comparable between the two groups (6.9% vs. 9.7%; p=0.764). The ongoing pregnancy rate was found to be comparable between the two study groups, as well (16.7% vs. 9.7%; p=0.325). Endometrial thickness (p=0.609) was comparable between the groups; however ER2R was significantly lower in the endometrial biopsy group (p<0.001).
Conclusion: Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle, decreased abortion, and increased endometrial thickness.
Ziba Zahiri Sorouri, Maryan Asgharnia, Ameneh Gholampoor,
Volume 13, Issue 1 (1-2015)

Background: Intrauterine insemination (IUI) is one of the most appropriate and cost-effective methods in infertility treatment.
Objective: We aimed to investigate effect of vaginal misoprostol on pregnancy rate after IUI.
Materials and Methods: Two hundred and ten infertile women who were referred to Infertility Clinic of Alzahra Hospital by an indication of IUI during 2012-2013 were randomly assigned to receive 200 μg vaginal misoprostol (n=105) or vaginal placebo (n=105) after IUI. For detecting pregnancy, past 2 weeks, beta human chorionic gonadotropin evaluation was made and if positive, transvaginal sonography was done for evaluation of pregnancy 2-3 weeks later and clinical pregnancy was recorded.
Results: Pregnancy had been noted in 24 patients in misoprotol (22.9%) and 27 patients in placebo (25.7%) groups that this difference was not significant (p=0.748). In misoprostol group, 3 case of nausea and vomiting (2.9%) had been observed.
Conclusion: According to the results, administering 200 μg vaginal misoprostol after IUI doesn’t have significant effect on the success rate of IUI.
Donya Khosravi, Robabeh Taheripanah, Anahita Taheripanah, Vahid Tarighat Monfared, Seyed-Mostafa Hosseini Zijoud,
Volume 13, Issue 7 (9-2015)

Background: The aim of this study, we have compared the advantages of oral dydrogestrone with vaginal progesterone (cyclogest) for luteal support in intrauterine insemination (IUI) cycles. Progesterone supplementation is the first line treatment when luteal phase deficiency (LPD) can reasonably be assumed.
Objective: This study was conduct to compare the effect of oral dydrogestrone with vaginal Cyclogest on luteal phase support in the IUI cycles.
Materials and Methods: This prospective, randomized, double blind study was performed in a local infertility center from May 2013 to May 2014. It consisted of 150 infertile women younger than35years old undergoing ovarian stimulation for IUI cycles. They underwent ovarian stimulation with oral dydrogesterone (20 mg) as group A and vaginal cyclogest (400 mg) as group B in preparation for the IUI cycles. Clinical pregnancy and abortion rates, mid luteal progesterone (7daysafter IUI) and patient satisfaction were compared between two groups.
Results: The mean serum progesterone levels was significantly higher in group A in comparison with group B (p=0.001). Pregnancy rates in group A was not statistically different in comparison with group B (p =0.58). Abortion rate in two groups was not statistically different (p =0.056) although rate of abortion was higher in group B in comparison with A group. Satisfaction rates were significantly higher in group A compared to group B (p<0.001).
Conclusion: We concluded that oral dydrogestrone is effective as vaginal progesterone for luteal-phase support in woman undergoing IUI cycles.
Moreover, the mean serum progesterone levels and satisfaction rates in dydrogestrone group were higher than cyclogest group.
Saghar Salehpour, Marzieh Zamaniyan, Nasrin Saharkhiz, Shahrzad Zadeh Modares, Sedighe Hosieni, Samira Seif, Narges Malih, Parinaz Rezapoor, Mohammad-Reza Sohrabi,
Volume 14, Issue 9 (9-2016)

Background: Recurrent implantation failure is one of the most issues in IVF cycles.Some researchers found that beneficial effects of endometrial Scratching in womenwith recurrent implantation failure, while some authors demonstrated contrary results
Objective: The present study aimed to investigate the effect of intrauterine. Salineinfusion as a form of endometrial injury, during fresh in vitro fertilization-embryotransfer cycle, among patients with recurrent implantation failure.
Materials and Methods: In this clinical trial study 63 women undergoing assistedreproductive technology were divided into two groups either local endometrialinjury by intrauterine saline infusion during day 3-5 of the ongoing controlledovarian stimulation cycle, or IVF protocol performed without any other interventionin Taleghani Hospital, Tehran, Iran. The main outcome measure was clinicalpregnancy rates.
Results: Patients who received intra uterine saline infusion (n=20), had significantlylower clinical pregnancy numbers (1 vs. 9, p<0.05) and implantation rates (4.7% vs.41.6%, p<0.05), compared to controls (n=39). However, there was no significantdifference in miscarriage rates (9.4% vs. 8.7%, p>0.05) and multiple pregnancynumbers (1 vs. 3, p>0.05) between groups.
Conclusion: When intrauterine saline infusion as a form of endometrial injury isperformed during the ongoing IVF cycles it has negative effect on reproductiveoutcomes among patients with recurrent implantation failure.
Leila Pourali, Sedigheh Ayati, Shirin Tavakolizadeh, Hourieh Soleimani, Fatemeh Teimouri Sani,
Volume 15, Issue 1 (1-2017)

Background: Clomiphene citrate is one of the effective drugs for infertilitytreatment due to oligo-ovulation or anovulation. Intrauterine insemination (IUI) isone of more adherent methods for treatment of infertile cases which is followed bycontrolled ovarian hyperstimulation (COH).
Objective: the aim of this study was to evaluate Clomiphene citrate versus letrozolewith gonadotropins in IUI cycles.
Materials and Methods: In this prospective randomized trial, 180 infertile patientswho were referred to Milad Hospital were selected. The first group received 5mg/day letrozole on day 3-7 of menstrual cycle. The second group received 100mg/day Clomiphene in the same way as letrozole. In both groups, humanmenopausal gonadotropin was administered every day starting on day between 6-8of cycle. Ovulation was triggered with urinary Human Chorionic Gonadotropin(5000 IU) when have two follicles of ≥16 mm. IUI was performed 36 hr later.
Results: The number of matured follicles, cycle cancellation, and abortion were thesame in both groups. Endometrial thickness was higher at the time of humanmenopausal gonadotropin administration in letrozole group. Chemical and clinicalpregnancy rates were much higher in letrozole group. Ovarian hyperstimulation wassignificantly higher in clomiphene group.
Conclusion: Letrozole appears to be a good alternative to clomiphene citrate withfewer side effects.
Tahereh Behrouzi Lak, Masoomeh Hajshafiha, Fariba Nanbakhsh, Sima Oshnouei,
Volume 15, Issue 4 (6-2017)

Background: N-acetyl cysteine (NAC) was proposed as an adjuvant to clomiphenecitratefor ovulation induction in patients with polycystic ovary syndrome (PCOS)without clomiphene citrate resistance.
Objective: To evaluate the effect of NAC on pregnancy rate in PCOS patients whowere candidates for intrauterine insemination.
Materials and Methods: In this randomized clinical trial 97 PCOS women aged 18-38 years were enrolled in two groups, randomly. For the case group (n=49), NAC(1.2 gr) + clomiphene citrate (100 mg) + letrozole (5mg) were prescribed dailyfromthe third day of menstruation cycle for five days. The control group (n=48) had thesame drug regimen without NAC. In order to follicular development, GONAL-Fwas injected on days of 7-11 menstrual cycles in all participants. When the folliclesize was 18mm or more, HCG (10000 IU) was injected intramuscular and theintrauterine insemination was performed after 34-36 hr.
Results: There was no significant difference between study groups regarding BMI(p=0.28), FSH level (p=0.66), LH level (p=0.67), mean endometrial thickness(p=0.14), mean number of mature follicles (p=0.20) and the pregnancy occurrence(p=0.09).
Conclusion: NAC is ineffective in inducing or augmenting ovulation in PCOSpatients who were candidates for intrauterine insemination and cannot berecommended as an adjuvant to CC in such patients.
Robabeh Taheripanah, Marzieh Zamaniyan, Atefeh Moridi, Anahita Taheripanah, Narges Malih,
Volume 15, Issue 6 (7-2017)

Background: The purpose of triggering in ovulation induction is to induce the final maturation of oocytes and their release from the ovary for fertilization.
Objective: The aim of the present study was to compare the effectiveness of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (HCG) on the final maturation of oocytes and pregnancy rates in intrauterine insemination (IUI) cycles.
Materials and Methods: In this randomized clinical trial, 110 infertile women who were selected for IUI entered the study. Ovulation induction was performed. Group I received 0.1 mg GnRH agonist as triggering and group II received 10,000 IU of HCG. The serum Estradiol (E2), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH) levels were measured at 12 and 36 hr after injection.
Results: LH surge was detected in all patients. LH levels at 12 and 36 hr after triggering was higher in Group I and it washed out earlier than group II (p=0.00). The pregnancy rate was higher in Group I, but the difference was not statistically significant (26.9% vs. 20.8%, respectively p=0.46). Also, the incidence of ovarian hyperstimulation syndrome was not different between the two groups (p=0.11). There was a significant difference regarding the estradiol levels at 36 hours after triggering (p=0.00).
Conclusion: Effects of GnRH on endogenous LH surge is sufficient for oocyte releasing and final follicular maturation. Pregnancy rates and ovarian hyperstimulation syndrome incidence were not different between the groups. We suggest that GnRH agonists might be used as an alternative option instead of HCG in IUI cycles.
Marzieh Ghasemi, Masoumeh Kordi, Negar Asgharipour, Habibollah Esmaeili, Maliheh Amirian,
Volume 15, Issue 11 (11-2017)

Background: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment.
Objective: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad.
Materials and Methods: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period.
Results: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047).
Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.
Ahmad Mahran, Ahmed R Abdelraheim, Abdelrahman Eissa, Mohamed Gadelrab,
Volume 15, Issue 12 (12-2017)

Background: More than 3 decades after the introduction of in vitro fertilization (IVF) and despite the improved success rates of assisted reproductive technologies, the argument for performing laparoscopy as a part of the infertility workup still stands.
Objective: To evaluate the role of laparoscopy±hysteroscopy in diagnosis and management of infertility in our setting in view of modern fertility practice.
Materials and Methods: This case control study was carried out on 600 infertile women subjected to laparoscopy or combined laparoscopy and hysteroscopy at endoscopy unit in Minia University Hospital, Egypt during the period from January 2012 to December 2014.
Results: The causes of infertility as identified by laparoscopy±hysteroscopy were polycystic ovary syndrome (25.1%), tubal factor (30%), uterine cause (4%), and endometriosis (2.7%). No cause was identified in 38.2% of cases. Based on operative findings, women were treated with different options. Expectant management was used in 92 cases (15.3%). Ovulation induction with anti-estrogens or gonadotropins was used in 372 cases (62%). Sixty cases (10%) had intrauterine insemination and sixty four cases (10.7%) underwent in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) treatment. Within 1 yr after laparoscopy, 180 cases achieved pregnancy (30%). The most favorable outcome was recorded in women with unexplained infertility (36.7% of cases got pregnant) followed by women with polycystic ovary syndrome (27.8%). Participants with uterine and tubal infertility factor achieved pregnancy in 25% and 22.8% of cases, respectively. The worst outcome was recorded in women with endometriosis.
Conclusion: Laparoscopy still has an important role in the diagnosis and treatment of infertility.

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