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Showing 38 results for Pregnancy Rate

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
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
Abbas Aflatoonian, Maryam Asgharnia,
Volume 4, Issue 2 (7-2006)

The main factors affecting pregnancy and implantation rates are uterine receptivity, embryo quality, and transfer efficiency. Embryo transfer (ET) is the last step of critically important procedure of in vitro fertilization (IVF) and probably the least successful step in Assisted Reproductive Technology (ART) treatment cascade; though simple in most of the cases, it may pose to be the most difficult in some. No matter how good the IVF laboratory culture environment is, the physician can ruin everything with a carelessly performed embryo transfer. The entire IVF cycle depends on delicate placement of the embryos at the proper location near the middle of the endometrial cavity. Pregnancy rates will be significantly increased with the following procedures: 1. Trial transfer 2. Avoiding the initiation of uterine contractility by using soft catheters, gentle manipulation and by avoiding touching the fundus. 3. Removal of cervical mucus, wash and lavage of cervix with culture media. 4. Ultrasound-guided ET with full bladder. 5. Deposition of the embryo 2 cm below the uterine fundus. 6. Examination of catheter following transfer for retained embryos, blood and mucus. Slow withdrawal of the embryo transfer catheter, the use of a fibrin sealant, bed rest after embryo transfer, sexual intercourse and routine administration of antibiotics following embryo transfer remained to be studied by randomized clinical trials (RCTs).
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.
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.
Fattaneh Farifteh, Marzieh Mehrafza, Mona Oudi, Azadeh Eftekhari, Maryam Rahnavard, Khatereh Barjasteh, Ahmad Hossieni,
Volume 7, Issue 3 (7-2009)

Background: Embryo transfer (ET) has traditionally been performed two days after oocyte retrieval. Delaying transfer from day two to day three or four would allow for further development of the embryo might therefore optimize the selection of viable and best quality embryos for transfer and may be closer to the physiological time of the entry into the uterus than transfer on day two and might have a positive effect on pregnancy outcomes.
Objective: The study aimed to determine whether delayed transfer of embryos from 2 to 3 or 4 days after oocyte retrieval and the pregnancy rate in ICSI (intra cytoplasmic sperm injection) procedure.
Materials and Methods: In this deh1ive study we evaluated infertile couples who were referred to the Mehr Infertility Institute between 2006 and 2008 for ICSI according to the day of embryo transfer. We compared embryo quality pregnancy rate and implantation rate among day 2 3 or 4 of transfers. Pregnancy rate was confirmed by measurement of β-hCG in serum after 14 days. After data collection analysis was carried out with the t-test and chi squared tests by using the statistical software package SPSS.16.
Results: The overall clinical pregnancy rate (CPR) reported was 46.6%. The mean age of women and duration of infertility didn,t differ on the day of embryo transfer (p>0.05). Overall CPRs were not statistically different for day 2 (50.3%) day 3 (46.5%) and day 4 (34.8%) transfers respectively there were no significant differences in the age of transferred embryos between pregnant and nonpregnant women (p>0.05).
Conclusion: From the result of the present study there were no statistically significant differences in pregnancy rates according to the day of embryo transfer.
Farnaz Sohrabvand, Fedyeh Haghollahi, Masoomeh Maasomi, Leila Asgarpoor, Mamak Shariat, Mahtab Hamedani,
Volume 7, Issue 4 (7-2009)

Background: In spite of the great progress in assisted reproductive techniques ( ART), and although good quality embryos are transferred,  pregnancy rates have remained around 30%-35% due to low implantation rates.
Objective: The aim of this study was to assess and compare the effects of administrating indomethacin or hyoscine suppositories prior to embryo transfer on the pregnancy rate in ART cycles.
Materials and Methods: This double-blind clinical trial was performed in Vali-e-Asr Hospital as a pilot study from August 2005 through December 2006 on 66 infertile women in ART cycles. Controlled ovarian hyperstimulation  was done using recombinant FSH (Gonal-F) with a long GnRH analogue protocol. After obtaining written consent, the subjects were randomly allocated into three  equal groups (n=22). Groups A and B received  indomethacin and hyoscine rectal suppositories, respectively 30 minutes  before embryo transfer and group C was the control group. Data were analyzed by χ2 , t-test, ANOVA, and Kruskall Wallis tests.
Results: Overall pregnancy rate was 31% (n=21) with 13.6% (n=3) in  group A,  45.5% (n=10), and 36% (n=8) in groups B and C respectively, which shows that pregnancy rate is significantly higher in the group using hyoscine compared to  the other two groups (p=0.04). Uterine muscle cramps were experienced by 3 women (13.6%) in group C while none were reported by women in groups A or B, which shows a significant difference (p<0.04).
Conclusion: It seems that  compared to indomethacin, hyoscine administration 30 minutes prior to embryo transfer can significantly increase pregnancy rates  by reducing uterine and cervical muscle spasm.
Soheila Arefi, Mohammad Babashamsi, Poneh Shariat Panahi, Lima Asgharpour Saruiy, Hojjat Zeraati,
Volume 8, Issue 4 (7-2010)

Background: C-reactive protein (CRP) can be increased after hormonal stimulations. The changes of CRP might affect the success of in-vitro fertilization (IVF).

Objective: The aim of this study was to determine the possible relationship between the serum CRP level and outcome of controlled ovarian stimulation, and pregnancy rate in patients undergoing IVF or intra cytoplasmic sperm injection (ICSI).
Materials and Methods: This prospective cross sectional study was performed in Avicenna Infertility Clinic on 70 consecutive infertile patients (Jan 2008-Aug 2009) who were candidate for IVF/ICSI, using standard long GnRH agonist protocol. Blood was drawn 4 times during the cycle, on first day of stimulation, the day of HCG injection, the day of ovum pick up, and the day of embryo transfer.
Results: In 82.2% of cases, the serum CRP level was higher in day of HCG injection than first day of stimulation and also the day of ovum pick up than the day of HCG injection. The ratio of CRP level in the day of transfer to the day of ovum pick up, was significantly higher (ratio1.23) in patients who became pregnant after ICSI (p =0001). All patients with less than this Ratio have not been pregnant.
Conclusion: Controlled ovarian hyper stimulation and puncture of ovaries can potentiate systemic stimulation. Increasing serum CRP level in day of embryo transfer rather than ovum pick up can predict the success in patients undergoing IVF/ICSI.
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. 
Abbas Aflatoonian, Maryam Eftekhar, Farnaz Mohammadian, Fariba Yousefnejad,
Volume 9, Issue 4 (7-2011)

Background: Human fertility has been declined all over the world. Advanced women’s age is one of the most important factors in determining the success of reproduction and ageing has negative impact on ART outcome and advanced female age decreases the chance of live birth rates achieved using ART, especially after 40 years of age.
Objective: To evaluate  ART outcomes regarding to pregnancy, abortion, cycle cancellation and live birth rates in women 40 years and older.
Materials and Methods: A retrospective study was performed on three hundred-thirteen women undergoing ART cycles in the Madar Hospital in Yazd. Women with age ≥ 40 years who indicated for ART enrolled the study regardless of the infertility type or etiology. In this study, we used data from IVF or ICSI cycles using fresh embryo transfer. Follow up was performed in regard to pregnancy, abortion, cycle cancellation and live birth rates.
Results: The mean age of women was 41.87±1.97 years. Chemical pregnancy rate was 8.6% (27/313) per cycle. Clinical pregnancy rate was 3.8% (12/313) per cycle. Spontaneous abortion was observed in 63% (17/27) of patients with positive pregnancy test. The overall cancellation rate was 23.3% per oocytes retrieval. The overall live birth rate per cycle for all women who initiated an ART cycle at age ≥40 years was 3.2% (10/313) that eight of those women were under 42 years old.
Conclusion: Based on our results, we suggest that women with age 42 years and above should be advised to use other options, including oocyte donation or adoption.
Mehdi Sahmani, Reza Najafipour, Laya Farzadi, Ebrahim Sakhinia, Masoud Darabi, Vahideh Shahnazi, Amir Mehdizadeh, Maghsod Shaaker, Mohammad Noori,
Volume 10, Issue 2 (7-2012)

Background: Peroxisome proliferative-activated receptors (PPARs) are nuclear receptors that involved in cellular lipid metabolism and differentiation. The subtype γ of the PPAR family (PPAR?) plays important roles in physiologic functions of ovaries.
Objective: To determine correlation between PPARγ protein level in granulosa cells and pregnancy rate in women undergoing in-vitro fertilization (IVF) treatment.
Materials and Methods: In this cross-sectional study, twenty-five samples of granulosa cells were collected from women referred to an IVF treatment center. PPARγ protein expression level in granulosa cells was determined in comparison with β-actin level as control gene with Western blot test. Laboratory pregnancy was determined by a rise in blood ?-hCG level fourteen days after embryo transfer. Correlation analyses were used to test for associations between the oocytes and pregnancy occurrence as outcome variables and PPARγ protein expression level.
Results: Correlation analysis indicated that there was no significant relationship between granulosa cells PPARγ protein level with IVF parameters including number of matured oocytes and the ratio of fertilized to matured oocytes. Comparison of granulosa cells PPARγprotein level with positive and negative laboratory pregnancy revealed also no significant relationship.
Conclusion: According to the results of this study, PPARγ protein level in granulosa cells could not be directly correlated to the success rate of IVF.
Maryam Eftekhar, Farnaz Mohammadian, Fariba Yousefnejad, Behnaz Molaei, Abbas Aflatoonian,
Volume 10, Issue 2 (7-2012)

Background: Conventional IVF and ICSI are two common techniques to achieve fertilization. IVF has long been used for treatment of infertility, although it is not an effective treatment in severe male infertility. The use of ICSI has been expanded in severe male factor and fertilization failure after IVF cycle. In spite of the widespread use of ICSI in patients with non-male factor infertility, there is still little evidence to confirm its effectiveness in this population. Objective: To evaluate assisted reproductive technology outcomes between IVF and ICSI cycles in non-male factor, normoresponder patients.
Materials and Methods: A total of 220 non-male factors, normoresponder patients who were indicated for ART were enrolled in this study. The patients received standard long GnRH agonist or GnRH antagonist protocols for ovarian stimulation and after oocytes retrieval, the patients were divided into two groups (IVF and ICSI groups). In IVF group (n=112), all of retrieved oocytes were treated by conventional IVF and in ICSI group (n=88), microinjection (ICSI) was done on all of retrieved oocytes.
Results: In IVF group, fertilization and implantation rates were significantly higher than ICSI group (66.22% and 16.67% in IVF group versus 57.46% and 11.17% in ICSI group, respectively). Chemical and clinical pregnancy rates were statistically higher in IVF group as compared with the ICSI group (42.9% vs. 27.3% and 35.7% vs. 21.5%, respectively).
Conclusion: According to our study, the routine use of ICSI is not improved fertilization, implantation and chemical pregnancy rates and is not recommended in non-male factor, normozoospermic patients.
Farnaz Sohrabvand, Shahrzad Sheikhhassani, Maryam Bagheri, Fedyeh Haghollahi, Maryam Shabihkhani, Mamak Shariat, Manijeh Nasr Esfahani,
Volume 10, Issue 3 (7-2012)

Background: Polycystic ovary syndrome (PCOS) is a common cause of ovulatory disorders and infertility with high LH to FSH ratio. In order to prevent further increase of LH and follicle atresia, different regimens for ovulation induction have been recommended using FSH alone.  
Objective: This study was performed in PCOS patients to compare ART outcomes in cycles induced by FSH alone, using either recombinant or urinary products.  
Materials and Methods: In a randomized trial, from 623 patients who underwent down regulation with GnRH analogue in a long protocol, 160 PCOS patients were randomly divided into two groups of 80. Group A received 150 IU/d recombinant FSH (Gonal-F) and group B 150 IU/d urinary FSH (Fostimon).
Results: 33 cases (41.2%) in group A and 36 (45%) in group B achieved clinical pregnancy, which was not significantly different (p=0.67). Total number of oocytes retrieved (13.03±5.56 vs. 14.17±4.89, p=0.17), quality and number of embryos (7.42±3.35 vs. 7.63±3.28, p=0.68) and OHSS rate were similar in group A compared to group B. Endometrial thickness which was 9.66±1.67 mm in group A and 10.36±1.35 mm in group B, showed a significant difference (p=0.004).
Conclusion: It seems that in PCOS patients, both pure FSH products used for controlled ovarian hyperstimulation have similar effects on ART outcome and can be used according to availability and patient acceptance without significant difference.
Nastaran Aflatoonian, Maryam Eftekhar, Behrooz Aflatoonian, Elham Rahmani, Abass Aflatoonian,
Volume 11, Issue 1 (4-2013)

Background: Repeated implantation failure (RIF) is defined as pregnancy failure after two to six times with at least ten high grade embryo transfer to uterus. A variety of causes have been anticipated for RIF, including anatomical, autoimmune, genetics, endocrine and thrombotic anomalies. Factors responsible for RIF have important implication regarding treatment however in many couples a perfect cause cannot be found.
Cases: In these case series, we reported nine couples with RIF that after investigation no definitive etiology was found for RIF and empirical therapy by heparin, aspirin and or immunotherapy was not effective. In these cases we recommended transfer of embryos to surrogate uterus. Nine patients were studied and six of them developed a normal pregnancy (pregnancy rate=66.66%).
Conclusion: This study showed that surrogacy is a good option for treatment of RIF.
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.
Afsoon Zarei, Mohammad Ebrahim Parsanezhad, Masoumeh Younesi, Saeed Alborzi, Jaleh Zolghadri, Alamtaj Samsami, Sedigheh Amooee, Shahintaj Aramesh,
Volume 12, Issue 1 (2-2014)

Background: The direct effect of hCG on the human endometrium was studied several times.
Objective: The objectives of this study were to evaluate the effectiveness of intrauterine injection of recombinant human chorionic gonadotropin (rhCG) before embryo transfer (ET).
Materials and Methods: In this randomized placebo-controlled clinical trial, a total number of 182 infertile patients undergoing their first in vitro fertilization/ intracytoplasmic sperm injection (IVF-ICSI) cycles were randomly assigned to receive 250μg intrauterine rhCG (n=84) or placebo (n=98) before ET. The implantation and pregnancy rates were compared between groups.
Results: Patients who received intrauterine rhCG before ET had significantly higher implantation (36.9% vs. 22.4%; p=0.035), clinical pregnancy rates (34.5% vs. 20.4%; p=0.044) and ongoing pregnancy rate (32.1% vs. 18.4%; p=0.032) when compared to those who received placebo. The abortion (2.4% vs. 2.0%; p=0.929) and ectopic pregnancy rates (1.2% vs. 1.0%; p=0.976) were comparable between groups of rhCG and placebo, respectively. Conclusion: Intrauterine injection of 250μg of rhCG before ET significantly improves the implantation and pregnancy rates in IVF/ICSI cycles
Maryam Eftekhar, Elham Rahmani, Soheila Pourmasumi,
Volume 12, Issue 7 (8-2014)

Background: Frozen embryo transfer (FET) is one of the most important supplementary procedures in the treatment of infertile couples. While general information concerning the outcome of fresh embryo transfer has been documented, paucity of investigations has addressed the clinical factors influenced on pregnancy rates in FET.
Objective: In this study, we performed a retrospective analysis of clinical factors that potentially influence the outcome of FET.
Materials and Methods: We reviewed the data from 372 women who were subjected to FET registered from April 2009-2011 at the Research and clinical center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Baseline data and pregnancy rate were collected. The data were analyzed statistically using the Kolmogorov-Smirnov, and Mann-Whitney tests.
Results: The clinical pregnancy rate was 57.7 and 29.2% in women <35 years old, and women >35 years old, respectively (p<0.0001). Clinical pregnancy rates in women with FSH <10 IU/ml, and FSH >10 IU/ml were 56.3% and 17.5 %, respectively (p<0.0001). Whereas the other clinical parameters consist of reason of fetus freezing, primary IVF protocol, IVF procedure, endometrial thickness, treatment duration to fetal transfer found to be unrelated to FET outcomes (p>0.05).
Conclusion: Female age and basal FSH level are the most important factors influencing the clinical pregnancy rate following FET. 
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.
Hai Bo Zhu, Zhi Hong Zhang, Elfateh Fadlalla, Rui Xue Wang, Dong Feng Geng, Rui Zhi Liu,
Volume 12, Issue 9 (10-2014)

Background: Clinical reproductive centers produce large amounts of surplus poor-quality embryos annually, how to maximize the use of these embryos, and which of them have the potential to develop into blastocyst stage and influencing factors were lack of systematic research.
Objective: To investigate the fate of surplus poor-quality embryos which were cultured to obtain blastocyst, determine the factors which may influence the blastulation, and discuss their application in predicting of the pregnancy outcomes.
Materials and Methods: Day 3 (D3) after embryo transfer and freezing, surplus poor-quality embryos from IVF/ICSI cycles were cultured to blastocyst by the sequential method, then the blastulation outcomes were observed. Focusing on the blastulation rate of those embryos with different number cells and different embryonic grade; and last the relationship between the pregnancy outcomes of remained poor-quality embryos with successful blastulation or failed blastulation groups were studied.
Results: Of 127 patients with 569 poor-quality in vitro cultured embryos, there were formation of 248 blastocysts from 91 patients (43.59%), which lead to development of 138 high-quality blastocysts (24.25%). With the increase in cells number of D 3 blastomeres, the blastulation rate gradually increased, that, 7-cell blastomeres blastulation rate was the highest (70.59%), and 8-cell blastomeres is a little below (70.37%); while the embryonic levels and blastulation rate did not show this positive relationship. The clinical pregnancy rate and implantation rate of those who had successful blastulation (67.03% and 42.39%) were higher than of those who failed to develop to blastocyst (p=0.039).
Conclusion: Day 3 poor-quality embryos with successful blastulation or with failed blastulation had predictive value on pregnancy outcomes. For embryo transfer 7-8 cells grade III-IV embryo is better than 4-5 cells grade I-II embryo, in case of lack good-quality embryos.

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