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Showing 30 results for Luteal Phase

Mahmoud Hashemitabar, Babak Ghavamizadeh, Fatemea Javadnia, Esmaiel Sadain,
Volume 2, Issue 1 (7-2004)

Background: The luteal phase defect is a common event following the ovarian stimulation. The aim of the present study was to evaluate the use of human chorionic gonadotropine (hCG) and progesterone hormones to improve the luteal phase defect. Materials and Methods: 60 mice were superovulated routinely with human menopausal gonadotropin (hMG) (7.5U) and hCG (10U). The mice were mated and divided into 3 groups: 1- control (n=20) 2- hCG treatment (n= 20), and 3-Progesterone treatment (n=20). Each group was divided again into two subgroups. The mice (10 from each group) had no injection in group one and were injected intraperiteneal (IP) by hCG (5U/day) and progesterone (1mg/day) subcutaneously (sc) in groups 2 and 3, respectively for four days. On the day 5, the animals were killed by cervical dislocation and the uterus were flushed to count the number of blastocyst and their quality. The above treatment were carried out for 12 days in the other 10 mice in each group. Similarly group one had no injection and groups 2 and 3 were injected by hCG and progesterone for 12 days respectively by the same manner as mention above. The animals were killed on day 13 and the implanted embryos were counted. The uterus and ovary were processed on days 5 and 13 of pregnancy for histological studies. Results: The mean number of blastocysts per mouse were: 12.2%, 2.6% and 3% in group 1 to 3, respectively. The nomber of implanted embryos were 29 as: 13 living fetus in one mouse and 16 resorption fetus in the other. The morphology of uterus on day 5 was as follow: no development in the stroma and endometrial gland in control group, the stroma and endometrial gland so developed to form the saw teeth appearance which indicated on receptivity of uterus in hCG treated group similar to progesterone treated group, but without the saw teeth appearance. The continuation of hCG injection maintained the receptivity of uterus; while, the continuation in progesterone caused metaplesia of epithelium. The morphology of ovaries in all three groups showed no changes in corpus luteum size on day 5, and showed the following changes on day 13: increasing the number of primary and secondary follicles in control group; while, reducing the size of corpus luteum in hCG group. Conclusion: Progesterone did not improve the uterus and implantation rate. The prolonged usage of progesterone can change the morphology of uterus to more abnormal state in conterast to the prolonged usage of hCG.
Robabeh Taheripanah, Mohammad A Karimzadeh, Mohammad Ghafourzadeh,
Volume 2, Issue 1 (7-2004)

Background: The retrieval of good quality oocytes that is accomplished with selection of the best induction ovulation protocol on the basis of patients condition, age and cause of infertility, is one of the most important aspects of ART cycles. The objective was to evaluate the efficacy of low dose, long acting GnRH-a (Decapeptyle) for pituitary desensitization and outcome of ART compared to long protocol of short acting GnRH-a (Busereline). Materials and Methods: In this randomized clinical trial that was performed at Yazd IVF Center, 60 patients with 61 cycles of ART were included. Patients with endometriosis or age > 40 were excluded in this study. Using COH-ET, patients were randomly divided into two groups. In group one, 30 patients received a single half dose of Decapeptyle (1.87mg) in mid-luteal phase. In the other group, 31 patients received Buserelin daily (0.5mg), starting from previous mid-luteal phase. This was reduced to 0.25mg from gonadotropin administration day and was continued until the day of hCG injection. In these groups, the number of oocytes, the fertilization, cleavage, pregnancy and cancellation rates were compared. Results: In two groups, there was no case of cancellation due to premature LH surge. In group I, the mean number of gonadotropins was 27.5+4.2 ampoules while in the second group, it was 28.4±2.8 ampoules (P>0.05). 312 oocytes from group I and 294 oocytes from group II were retrieved. Oocyte quality in group II was better than group I (84.3% vs 77.2%, P<0.05). In long-acting GnRH-a group fertilization rate was 81.9% versus 71.1%in group II (P<0.01). However, embryo development in Group I (85.6% vs 94.1%, P<0.05) was lower than group II. Although, pregnancy rate was 20% in Group I which was higher than group II (12.6%) but, there was no significant difference in cancellation, pregnancy rate and gonadotropins dose in two groups. Conclusion: The low dose long acting GnRH-a is a useful method for pituitary suppression. Low dose GnRH-a combined with gonadotropins permitted the retrieval of good quality oocytes and had no effect on oocytes. The fertilization and pregnancy rates with this method are acceptable and its cost and tolerance is valuable for patients.
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.
Abbas Aflatoonian, Tahereh K Bidgoli,
Volume 3, Issue 2 (7-2005)

Ovarian hyperstimulation syndrome (OHSS) is a unique iatrogenic complication of controlled ovarian stimulation (COH)/in vitro fertilization (IVF) in reproductive endocrinology occurring during the luteal phase or early pregnancy. It can have a serious impact on the patient�s health. With the expansion of the assisted reproductive techniques (ART) from 1978, the incidence of OHSS is increasing worldwide.OHSS is characterized by gastrointestinal symptoms, ovarian enlargement, fluid shift to the third space, and hemoconcentration. Severe cases are associated with thromboembolic phenomena, respiratory distress, liver dysfunction and renal failure. OHSS is more common among woman who are young, thin and have PCOS or multiple allergies. Vascular endothelial growth factor (VEGF) and other cytokines are pivotal in the pathogenesis of OHSS. In the prevention of any disease, it should be emphasized that the possibility of primary prevention depends on two main requirements, first, the etiology of the disease and predisposing factors; and second, it must be feasible to avoid or manipulate such factors as paint of a prevention strategy. This strategy for preventing OHSS and its severity have included prediction of women at risk; the first step in prevention is identification of patients at risk by the recognition of risk factors. As this is not always possible, there are several ways of avoiding developing of the syndrome. The stimulation phase has to be carefully monitored (regular ultrasound and estradiol measurements), and further interventions need to be implemented if signs of hyper-response are present. The aim of this systemic review of the literature is to answer this question: �can we prevent severe OHSS�. Canceling the cycle, modification of method to trigger ovulation administration of macromolecules, coasting approach, timed unilateral or bilateral aspiration of one or two ovaries performed before or after hCG administration, In vitro maturation (IVM), elective cryopreservation of all embryos, and laser or electrocautery of one or both ovaries, have been showed to be associated with a reduced risk of OHSS by some research groups. The effect of combined method should be assessed. Finally, apart from canceling, none of these approaches was totally efficient, although most of the above-mentioned methods decrease the incidence in patients at high risk of OHSS, but overall �prevention is the ideal treatment of OHSS�.
Nezhat Moossavifar, Nayereh Khadem, Alieh Torabizadeh,
Volume 4, Issue 1 (7-2006)

Background: It has been demonstrated that performing a mock embryo transfer (ET) significantly improves the pregnancy rate in IVF cycles. The mock ET could be performed prior to the stimulation cycle or immediately before real ET. The problem of the first procedure is the possibility of variation in the uterine position and or cervico–uterine angle.
Objective: The purpose of this study was to determine the consistency of the type of ET in mock ET prior to the treatment cycle with real ET.
Materials and Methods: A prospective comparison between the technique of mock embryo transfer and real embryo transfer. One hundred and sixty treatment cycles on 141 patients between January 2003 and September 2004 ended to ET and they were analyzed prospectively. In each cycle, patients underwent a mock ET in mid luteal phase prior to treatment cycle (the date when patients referred to have consultation about down regulation regimen).
Results: Of 160 mock ET the Wallace catheter passed easily in 144 (90%) of them. In the remaining 16 cycles (10%) a tenaculum and or a rigid cannula had to be used. From 144 cases of easy mock ET, real ET was easy in 121 (84%) cases while 23 (16%) cases had difficultly during real ET. In the 16 cases of difficult mock ET, there was 8 cases (50%) of difficult real ET and 8 cases (50%) of easy real ET (p=0.001, χ2=10.67). The overall clinical pregnancy rate for both difficult and easy transfer was 35%. The pregnancy rate for easy real ET was  37.2% and for difficult real ET was 25.87%. Despite of the difference, the statistical analysis shows no significance difference (χ2=1.21). The difference between mean age for both difficult and easy real transfer was not significant.
Conclusion: Mock ET before beginning of the treatment cycle is highly consistent with real ET.
Behrooz Niknafs, Fathemeh Afshari, Abdo-Rahman Dezfulian,
Volume 6, Issue 4 (7-2008)

Background: The application of luteal phase supplementation hormones to increase the implantation rate is on debate among researchers.
Objective: In this study, the morphological and morphometrical assessment of superovulated mice endometrium were investigated at window implantation period superovulated mice.
Materials and Methods: Female mice were superovualated then were mated with vasectomized mice; the mice were divided in experimental and control groups. Experimental group included five groups which in them pseudopregnant mice were given a four consecutive daily injection of 1-progesterone (P), 2-estrogen (E), 3-estrogen + progesterone, 4-antiprogesterone+estrogen and 5-sham group. The uterine of all groups were collected after 4.5 day of pseudopregnancy and were prepared for histological and morphometrical studies.
Results: Morphological studies of endometrial tissue showed that the luminal epithelium in group P appeared cuboidal shape. Endometrial folding was very high in group E+P. The luminal epithelium in groups E, E+P and RU 486 + E were seen in different morphology in comparison to control group. Morphometrical evaluation also showed height of luminal epithelium in group E (32.7±0.67) and E+P (33.6±1.3) were higher than those were seen in control (22.5±1.5) and group P (15.3±1.2).
Conclusion: Progesterone caused the lowest endometrial development compare to other groups. It is concluded that the adding of E to P may improve endometrial condition to implant at luteal phase.
Mohammad Ali Khalili,
Volume 6, Issue 4 (7-2008)

I read with interest the papers written by Peyghambari et al (2008) and Niknafs et al   nd   et al   et al   et al   et al   et al   et al   et al   (1994) did not observe any   advantage in the pregnancy rates when adding estrogen+progesterone at luteal phase in patients undergoing IVF (6). In conclusion, the mechanism of luteal phase support in assisted reproduction is complex and a controversial issue, which demands further experimented and clinical studies. (2005)   noticed that administration of estrogen + progesterone during luteal phase was involved with higher pregnancy rates in IVF cases (5). In contrast, Lewin (1990) who observed that elevated   progesterone level caused decline in endometrial receptivity following ovarian hyperstimulation in an animal model (4). In clinical setting, however, Alsian (2006)   reported that ovarian hyperstimulation with luteal support using progesterone injection altered the endometrial receptivity. This could be related to the alteration in the ratio of progesterone to estrogen after administration of exogenous gonadotropins (3). Similar results were reported by Kramer (2008) used ovarectomized mice   for their study. In their previous work, Salehnia (2008) used   superovulated mice using gonadotropins, while Payghambari (2008), on the other hand,   reported that injection of progesterone alone at luteal phase did not supply an appropriate endometrial morphology for implantation. It was shown that application of estrogen + progesterone provided an ideal endometrial state for embryo implantation. They believed that hyperstimulation of ovary may induce the morphological alterations which may decrease the endometrial receptivity during implantation. It is important to note that in their study, Niknafs day after estrogen injection. This may suggest   that endometrial proliferation in response to estrogen is a common phenomenon in the uterus of ovarectomized mice. They also found that treatment of progesterone priming with estrogen maintained the stromal proliferation, but was unsuccessful in stimulation of epithelial cells proliferation. The formation of uterine glands was found to be more prominent in progesterone treated mice than with estrogen+progesterone treated group. Niknafs (2008)   on the complex issue of luteal phase support on endometrial function in mice. I would like to comment on the data generated from their studies. Luteal supplementation with either hCG or progestrone significantly improves fertility outcomes compared with no treatment (Pritts and Atwood, 2002) (1). Also, Walter et al (2005) reported that estrogen promotes endometrial proliferation, while progesterone is necessary for stimulating endometrial proliferation (2). Peyghambari and associates (2008) found that uterine epithelial proliferation was optimized on 2
Behrooz Niknafs, Fathemeh Afshar, Abdo-Rahman Dezfulian,
Volume 8, Issue 1 (7-2010)

Background: There are some controversial data on application of progesterone and progesterone plus estrogen at luteal phase.
Objective: To investigate the effects of different luteal support hormones on the Alkaline Phosphates (ALP) activity in the endometrial epithelium and endometrial thickness during superovulation process for obtaining the optimized endometrial receptivity in animal model.
Materials and Methods: Pseudopregnant female Balb/c mice were induced for pseudopregnany through superovulation then the mice were divided into two groups. Experimental group included five groups: the pseudopregnant mice were given four consecutive daily injections of progesterone (P group) estrogen (E group) estrogen + progesterone (E+P group) antiprogesterone + estrogen (RU 486 + E) and sham group. In the control group pseudopregnancy was induced in the natural cycle. The uterus was collected after day 4.5 of pseudopregnancy. The samples were prepared for the morphological and morphometrical evaluation of the endometrial ALP activity and endometrial thickness.
Results: ALP activity was observed in all groups except P group. ALP activity of P + E group was similar to E and RU 486 + E groups. Sham group showed high ALP activity compared to the P group. The endometrial thickness was low in the P group and high in the sham group in comparison with other groups.
Conclusion: In conclusion super ovulation decreased the ALP activity. Estrogen along with progesterone at the luteal phase increased the enzyme activity and the endometrial thickness compared with the progesterone administration and thus progesterone plus estrogen could improve embryo receptivity.
Hossein Nikzad, Maryam Kabir-Salmani, Shigetatsu Shiokawa, Yoshiro Akimoto, Mitsutoshi Iwashita,
Volume 8, Issue 4 (7-2010)

Background: Pinopodes are suggested as biological markers of uterine receptivity, but their molecular components are unknown.
Objective: Co-expression of galectin-3 and avb3 integrin at human pinopodes has been examined in this study to propose a role for them during adhesion phase of embryo implantation.
Materials and Methods: Biopsies were obtained from early and mid luteal phase endometrium of 12 fertile women with regular menstrual periods (25-35 days) and the mean age of 37 years (range 25–45). Then, they were examined under light and scanning electron microscopy for detection and dating of pinopodes. Using immunofluorescent staining and immunogold electron microscopy, the expression of galectin-3 and avb3 integrin in human endometrium and pinopodes was detected. Further, statistical analysis was performed using immunogold electron microscopy to investigate the expression and subcellular distribution of these, before and during the frame of implantation window.
Results: The results demonstrated that pinopodes of luminal epithelial cells exhibited immunoreactivity for both galectin-3 and αvβ3 integrin, which was increased statistically significant (p< 0.05) at the time of implantation window. Furthermore, area-related distribution of these proteins was found higher in pinopodes compared to the neighboring apical membrane without pinopode.
Conclusion: Temporal and spatial expression of galectin-3 and αvβ3 integrin at pinopodes proposes a role for pinopodes in the adhesion of embryo and the involvement of galectin-3 as a binding partner of integrins in the human utero-fetal complex.
Ashraf Moini, Fatemeh Zafarani, Bita Eslami, Maria Sadeghi, Zahra Kamyabi, Nadia Jahangiri,
Volume 9, Issue 2 (7-2011)

Background: Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment.
Objective: The objective of this study was to compare the efficacy of three types of progesterone on biochemical, clinical and ongoing pregnancy rates and abortion and live birth rates.
Materials and Methods: A prospective randomized study was performed at Royan Institute between March 2008 and March 2009 in women under 40 years old, who use GnRH analog down-regulation. One hundred eighty six patients in three groups were received progesterone in oil (100 mg, IM daily), intravaginal progesterone (400 mg, twice daily) and 17-a hydroxyprogestrone caproate (375mg, every three days), respectively.
Results: Final statistical analysis after withdrawal of some patients was performed in 50, 50 and 53 patients in group 1, 2 and 3 respectively. No differences between the groups were found in baseline characteristics. No statistical significance different was discovered for biochemical, clinical and ongoing pregnancies. Although the abortion rate was statistically higher in group 1 (p=0.025) the live birth rate was not statistically significant between the three groups.
Conclusion: The effects of three types of progesterone were similar on pregnancies rate. We suggest the use of intravaginal progesterone during the luteal phase in patients undergoing an IVF-ET program because of the low numbers of abortions, and high ongoing pregnancy rates.
Batool Rashidi, Roya Nasiri, Haleh Rahmanpour, Ensieh Shahrokh Tehraninejad , Maryam Deldar,
Volume 9, Issue 4 (7-2011)

Background: The differential efficacy between long GnRH agonist with antagonist can partly be due to the preexisting differences in the early antral follicles before ovarian stimulation.
Objective: To compare the effect of pretreatment by estradiol with GnRH antagonist on antral follicular size coordination and basal hormone levels in GNRH antagonist protocol.
Materials and Methods: On cycle day 3 (control/day 3), women underwent measurements of early antral follicles by ultrasound and serum FSH and ovarian hormones then were randomized to receive oral estradiol 4mg/day (n=15) or 3mg cetrorelix acetate (n=15) in luteal phase before subsequent antagonist protocol. Participants were re-evaluated as on control/day 3.
Results: There was a significant reduction of mean follicular sizes in each group after medical intervention (7.63±2.11 Vs. 4.30±0.92 in group A and 8.73±1.96 Vs. 4.13±1.11 in group B) (p=0.0001). The magnitude of follicular size reduction was significantly higher in group B (-4.60±2.04 Vs. -3.33±2.28) (0.027). There was a non significant attenuation of follicular size discrepancies in two groups. FSH and inhibin B levels in the day 3 of the next cycle in both groups were significantly decreased but did not have significant difference between two groups.
Conclusion: Both luteal E2 and premenstrual GnRH antagonist administration reduces the follicular sizes significantly and GnRH antagonist acts more potently than E2 in this way but attenuation of follicular size discrepancies in both treatment is not significant
Hossein Nikzad, Hamed Haddad Kashani, Maryam Kabir-Salmani, Yoshihiro Akimoto, Mitsutoshi Iwashita,
Volume 11, Issue 1 (4-2013)

Background: The up-regulation of galectin-3, galectin-9, and galectin-15 expression in the luminal and glandular epithelium was reported in preparation of the endometrium for embryo implantation at the midlutheal phase. However, no data was available regarding the expression and the distribution pattern of galectin-8 in the human endometrium during a regular menstrual cycle.
Objective: The current study designed to investigate the expression and the distribution pattern of galectin-8, a beta-galactoside-binding lectin in the human endometrium during both proliferative and luteal phases of a regular menstrual cycle.
Materials and Methods: Endometrial biopsies were obtained from the anterior wall of the uterine cavity of 16 women (proliferative phase: n=4, lutheal phase: n=12). All female patients with mean age of 37.5 years were fertile (range 25-45) . Each biopsy was divided into three pieces; one piece was fixed in formaldehyde for light microscopy and immunohistochemistry. The second portion fixed in glutaraldehyde for scanning electron microscopy and the third portion was prepared for western blot analysis.
Results: Data of immunoblotting revealed a molecular weight of 34 kD band with high intensity in the lutheal phase samples. The immunohistochemistry staining demonstrated that galectin-8 expressed at a very low concentration during the proliferative phase, but showed a high expression throughout the lutheal phase. The expression of galectin-8 observed in luminal surface epithelium, glandular epithelium and stroma.
Conclusion: The up-regulation of the expression of galectin-8 during lutheal phase may suggest galectin-8 as one of the potential molecular marker of the endometrial receptivity. These data propose that galectin-8 may play an important role during the initial events of human embryo implantation.
Maryam Eftekhar, Elham Rahmani, Farnaz Mohammadian,
Volume 11, Issue 2 (4-2013)

Background: Gonadotrophin-releasing hormone (GnRH) agonist is used for controlling ovarian stimulation in assisted reproductive technology (ART) cycles which has some benefits.
Objective: To compare the efficacy of two different formulations of GnRH agonist: short-acting and long-acting, for ART protocols.
Materials and Methods: In a prospective randomized study, one hundred women who underwent ART cycles were randomly divided into two groups. In group I, the patients received one single injection of 1.87 mg Triptorelin in previous mid-luteal phase. In group II, Decapeptyl 0.1 mg per day started from previous mid-luteal phase. Pregnancy outcome in in vitro fertilization (IVF) cycle was compared between two groups.
Results: There were no statistically significant differences in the number of retrieved oocyte (p=0.545), fertilization (p=0.876), implantation (p=0.716) and pregnancy rate (p=0.727) between the two groups.
Conclusion: There were not any advantages in IVF outcome between half-dose long-acting and short-acting GnRH agonist groups in ART cycle.
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.
Aalie Torabizadeh, Fatemeh Vahidroodsari, Zakieh Ghorbanpour,
Volume 11, Issue 10 (12-2013)

Background: Ovarian hyperstimulation syndrome (OHSS) is the most serious and potentially life-threatening iatrogenic complication associated with ovarian stimulation during Assisted Reproductive Technology (ART) protocols. OHSS typically is a result of ovarian expression of vascular endothelial growth factor (VEGF) which increases vascular permeability.
Objective: Comparison of albumin and cabergoline in the prevention of OHSS.
Materials and Methods: 95 high risk infertile women for OHSS (more than 20 follicles in both ovaries at day of Human Chorionic Gonadotropin (HCG) injection) were randomly divided into two groups. First group including 48 women received 10 unit intravenous albumin at starting oocyte retrieval, and second group including 47 women received 0.5 mg/day dopamine agonist (Cabergolin) at day of HCG injection till 8 days. The dosage of human Menopausal Gonadotropin (HMG) used, total number of follicles developed, number of oocytes retrieved, serum E2 concentrations during the luteal phase, development of ascites, number of embryos generated, clinical pregnancy rate, results of the in vitro fertilization-embryo transfer (IVF-ET) cycles and incidence and severity of any OHSS were evaluated.
Results: There was evidence of a statistically significant reduction in the incidence of OHSS in the cabergolin group (53.7%) versus albumin group (46.3%) (p=0.04). But there was no significant difference of a reduction in severe OHSS (p=0.62). There was no difference in clinical pregnancy rate too.
Conclusion: Administration of cabergolin can prevent incidence of OHSS and does not appear to effect on its severity. 
Saghar Salehpour, Maryam Tamimi, Nasrin Saharkhiz,
Volume 11, Issue 11 (12-2013)

Background: Luteal phase support is mandatory in ART (Assisted Reproductive Technologies) for optimizing outcome, so the luteal phase is supported with either progesterone, addition of estradiol to progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment.
Objective: To compare oral dydrogestrone with vaginal progesterone for luteal-phase support in IVF.
Materials and Methods: We performed this prospective, randomized trial in a tertiary infertility care unit in Taleghani hospital, Tehran, Iran. 80 Women with a history of male factor infertility undergoing controlled ovarian stimulation for IVF treatment (fresh cycle) randomly were divided in two groups (group A or oral dydrogesterone group and group B or vaginal progesterone group). The inclusion criteria were the use of GnRH analogue down-regulation and less than 40 years old with regular menstrual cycles. All women were euthyroid and normoprolactinemic. Group A (n=40) received 10 mg dydrogesterone QID (40mg daily) and group B (n=40) received 400 mg suppository vaginal Progesterone (cyclogest) twice per day (800 mg daily).
Results: Clinical pregnancy rate in cyclogest group was higher than dydrogesterone group but the difference was not significant (p=0.52), furthermore the miscarriage rate in two group was the same .The difference between two groups regarding antral follicle, embryo number, luteal-phase duration, endometrial thickness ,oocyte number and metaphase-II was not significant (p>0.05).
Conclusion: The results showed that oral dydrogesterone is as effective as vaginal progesterone for luteal-phase support in women undergoing IVF.
Zohreh Alizadeh, Shamila Faramarzi, Massoud Saidijam, Tahereh Alizamir, Farzaneh Esna-Ashari , Nooshin Shabab, Marzieh Farimani Sanoee,
Volume 11, Issue 12 (1-2013)

Background: HOXA11 and HOXA10 are expressed in endometrium throughout the menstrual cycle and show a dramatic increase during the mid-luteal phase at the time of implantation. The expression of these genes is decreased in women with myomas.
Objective: To determine whether myomectomy would reverse HOXA11 and HOXA10 expression, we evaluated the transcript levels of these genes in the endometria of patients before and after myomectomy.
Materials and Methods: Expression of HOXA11 and HOXA10 were examined prospectively during the midluteal phase in endometrium obtained from infertile women (n=12) with myoma before and three months after myomectomy. Endometrial HOXA11 and HOXA10 expression were evaluated using quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR).
Results: Endometrial HOXA11 and HOXA10 mRNAs expression levels (normalized to 18SrRNA) were increased insignificantly in endometrium of patients after myomectomy (p=0.7 and p=0.15 respectively).
Conclusion: The results suggest that the alteration in expression pattern of these genes could not account for some aspects of fertility after myomectomy.
Leyla Fath Bayati, Marefat Ghaffari Novin, Fatemeh Fadaei Fathabadi, Abbas Piryaei, Mohammad Hasan Heidari, Mozhgan Bandehpour, Mohsen Norouzian, Mahdi Alizadeh Parhizgar, Mahmood Shakooriyan Fard,
Volume 12, Issue 1 (2-2014)

Background: Tubal ectopic pregnancy (tEP) is the most common type of extra-uterine pregnancy and the most common cause of maternal mortality. Nitric oxide (NO) is a molecule that incorporates in many physiological processes of female reproductive system. Recent studies have demonstrated the possible role of endothelial isoform of nitric oxide synthase (eNOS) enzyme in the regulation of many reproductive events that occur in the fallopian tube (FT).
Objective: The aim of this study was to evaluate the expression of eNOS in the FTs of women with tEP.
Materials and Methods: In this case-control study, a total number of 30FTs samples were obtained from three groups including: 10 FTs of women that bearing an EP, 10 FTs from the non-pregnant women at luteal phase of the menstrual cycle, and 10 FTs of healthy pregnant women (n=10). Samples were fixed in 10% buffered formalin and then were evaluated by immunohistochemistry.
Results: Localization of eNOS was seen in secretory and ciliated luminal epithelium and vascular endothelium of all groups. However, we did not observed the expression of eNOS in smooth muscle cells of all groups. Expression of eNOS in luminal epithelium of women with EP compared to non-pregnant women at luteal phase of menstrual cycle and healthy pregnant group showed statistically significant increase (p=0.00). Significant difference in expression of eNOS was not observed in luminal epithelium of FTs of women at luteal phase compared to healthy pregnant groups (p=0.78).
Conclusion: This study indicates that changes in expression of eNOS in luminal epithelium of FT may lead to development of EP.

Mesut Yıldız, Mehmet Vural, Mehmet Emin Erdal, Özlem Izci Ay, Şenay Görücü Yılmaz, Ibrahim Fatih Karababa, Salih Selek,
Volume 13, Issue 4 (5-2015)

Background: Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized with physical and affective symptoms during the luteal phase of susceptible women.
Objective: The aim of this study was to investigate the association of Dopamine D3 receptor ( DRD3 ) polymorphism, and Cannabinoid receptor Type 1 ( CNR1 ) polymorphism with PMDD.
Materials and Methods: Fifty one participants with documented PMDD according to the DSM IV criteria and 51 healthy controls were included in this cross sectional study. Symptom severity was measured with daily self-rating, monthly premenstrual assessment forms and psychiatric interviews. The genotyping of DRD3 receptor and Cannabinoid type 1 receptors were performed using Taqmanfluorogenic assay method.
Results: Distribution of DRD3 and CNR1 polymorphism was not different between patients and controls.
Conclusion: These findings do not support a major role of DRD3 , and CNR1 polymorphisms in contributing to susceptibility to premenstrual dysphoric disorder.
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.

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