Clinical Pregnancy Rate (CPR) With Ovarian Stimulation Is Higher in the First Cycle Than With Subsequent Cycles in Clomiphene Citrate/IUI (CC/IUI) Cycles But Not in Gonadotropin/IUI Cycles (COH/IUI)

2005 ◽  
Vol 84 ◽  
pp. S155-S156
Author(s):  
B.R. Witt
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate

scholarly journals Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles

2021 ◽  
Vol 73 (3) ◽  
pp. 198-203
Author(s):  
Padmalaya Thakur ◽  
Sujata Pradhan
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Low Dose ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Controlled Ovarian Stimulation ◽  
Human Menopausal Gonadotropin ◽  
Group B

Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms:  subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.

scholarly journals Progestin-primed ovarian stimulation vs mild stimulation in women with advanced age above 40: a retrospective cohort study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Qian Peng ◽  
Xiang Cao ◽  
Jing Wang ◽  
Lin Wang ◽  
Jun Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Retrospective Cohort Study ◽  
Ovarian Stimulation ◽  
Retrospective Cohort ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Advanced Age ◽  
Significant Difference ◽  
Mild Stimulation

Abstract Background Previous studies have demonstrated that progestin-primed ovarian stimulation (PPOS) protocol was a feasible and efficient method in in vitro fertilization (IVF) cycle. However, its application in women with advanced age has not been determined yet. The purpose of this study was to investigate its efficacy in women aged ≥40 years old. Methods This retrospective cohort study included patients with ages of ≥40 years old at the time of ovarian stimulation. The embryonic and clinical outcome of mild stimulation and PPOS were compared. Primary outcome was top-quality embryo rate on day 3, and secondary outcome was clinical pregnancy rate. Results Baseline characteristics of patients was similar in mild stimulation (122 cycles) and PPOS (47 cycles). No significant difference was found in the number of retrieved and mature oocytes and the fertilization and cleavage rates. Of interest, the rate of top-quality embryos was significantly higher in PPOS group (50.08% vs 33.29%, p = 0.015), with an increasing trend of viable embryo rate (73.55% vs 61.16%). A greater amount of gonadotropin was observed in PPOS group (2061.17 ± 1254.63 IU vs 1518.14 ± 547.25 IU, p < 0.05) in spite of comparable duration of stimulation. After FET cycle, no significant difference was found in the clinical pregnancy rates between mild stimulation (12.5%) and PPOS group (16.7%). Conclusions Higher percentage of top-quality embryos on Day 3 and comparable clinical pregnancy rate was obtained in PPOS protocol, which could be considered as a feasible ovarian stimulation protocol in women aged above 40 years old.

scholarly journals Pregnancy outcomes of the first thawing cycle in “freeze-all” strategy of infertility patients with fever during oocyte recruitment: A matched–pair study (Preprint)

2020 ◽  
Author(s):  
Mingmei Lin ◽  
Zi-Ru Niu ◽  
Rong Li
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Ovarian Stimulation ◽  
Oocyte Retrieval ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Embryo Freezing ◽  
Group 2 ◽  
Infertility Patients ◽  
Group 1

BACKGROUND It is well known that assisted reproduction technology (ART) is currently an effective method for treating infertility. But it is currently unknown whether the patients with fever after control ovulation during egg retrieval could increase risk of pelvic infection or not, and fever itself may be affect oocyte or embryo quantity and quality, thus with poor pregnancy outcomes? But if the oocyte retrieval was cancelled cause of fever, the risk of severe ovulation complications might increase, such as ovarian hyper-stimulation syndrome, thrombus and ovarian pedicle torsion. OBJECTIVE The goal of this study was to analysis the outcomes of the patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer cycle. METHODS This is a 1:3 retrospective paired study matched for age. In this study, 58 infertility patients (Group 1) had fever during the control ovulation and the time of the oocyte retrieval within 72 hours, they undertook ovum pick up and whole embryo freezing (“freeze-all” strategy). The control controls (Group 2) are174 patients matched for age with whole embryo freezing for other reasons. The baseline characteristic, clinical data of ovarian stimulation and the outcomes, such as the clinical pregnancy rate, early miscarriage rate, ectopic pregnancy rate and ongoing clinical pregnancy rate were compared between the two groups. RESULTS There were 58 patients were enrolled in the Group 1, and matched with 174 patients for the Group 2. All the patients had no pelvic inflammatory disease after oocyte retrieval. The basic characteristics of patients refers to age, BMI, nulliparity, basal FSH, basal LH, basal E2 and infertility type (primary or secondary) were with no significantly difference. But the AMH lever (4.2 versus 2.2, P<0.001) were higher and the infertility time (3 versus 2, P=0.035) was longer in the control group. The number of oocytes retrieved and fertilization rate were lower in the group (P< 0.001), but the ovarian stimulation protocol, the usage of Gn both time and dose, the ICSI rate, the 2PN rate, the number of available embryos (D3 and D5), the endometrial thickness, the number of embryo transfer and the type of luteal support supplementation were similar between the two groups. Regarding pregnancy outcomes，the implantation rate, clinical pregnancy rate, early spontaneous rate, ectopic pregnancy rate and ongoing pregnancy rate all were with no significantly difference. CONCLUSIONS The patients with fever during control ovulation and the oocyte retrieval got similar outcomes compared with those with no fever patients when taken the whole embryos freezing. Fever had almost no effect on the quality of embryo and endometrium. Moreover, the oocyte retrieved is relatively safe and reliable under strict disinfection and taken oral antibiotics for prevention infection.

scholarly journals Progesterone- primed ovarian stimulation in polycystic ovarian syndrome: An RCT

2019 ◽  
Author(s):  
Maryam Eftekhar ◽  
Masrooreh Hoseini ◽  
Lida Saeed
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Polycystic Ovarian Syndrome ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Miscarriage Rate ◽  
Antagonist Group ◽  
Ovarian Syndrome ◽  
Antagonist Protocol

Background: In vitro fertilization is an important therapy for women with polycystic ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet required. Objective: This study was aimed to investigate the efficacy of progesterone primed ovarian stimulation (PPOS) and compare with conventional antagonist protocol in PCOS. Materials and Methods: A total of 120 PCOS women who were candidates for assisted reproductive technology treatment from August to January 2019 were enrolled in this RCT and were placed into two groups, randomly (n = 60/each). The PPOS group received 20 mg/day Dydrogesterone orally since the second day of the cycle and the control group received antagonist protocol. The pregnancy outcomes including the chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational sacs/transferred embryos was compared in two groups. Results: Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p = 0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS group was higher than antagonist group (p = 0.005). Although there wasn’t sever ovarian hyper simulation syndrome in any participants, mild and moderate ovarian hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical and clinical pregnancy rate were higher in the antagonist group, althoughit was not statistically significant (p = 0.136, p = 0.093 respectively). Conclusion: Our study demonstrate that PPOS does not improve chemical and clinical pregnancy rate of the infertile women with PCOS. Key words: Progesterone, Polycystic ovarian syndrome, Controlled ovarian stimulation, Frozen-thawed embryo transfer, Pregnancy rate.

scholarly journals What is the optimal protocol for Intrauterine Insemination (IUI)? A Mini Review and A Retrospective Study to Evaluate Effective Factors Influencing Pregnancy after IUI

2019 ◽  
Author(s):  
Qing Li ◽  
Belén Herrero ◽  
Mao-Ling Zhu ◽  
Josée Lefebvre ◽  
William Buckett
Keyword(s):  
Logistic Regression ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Effective Factors ◽  
Optimal Protocol

Abstract Background: Although it is well documented on the study of intrauterine insemination (IUI), the effectiveness of various factors on IUI treatment is inconsistent. The aim of this study is to investigate the various factors that influence IUI outcome and attempt to set up optimal protocol for IUI patients. Methods: This was a retrospective cohort study including1948 cycles (843 couples) that performed IUI between January 2012 and December 2013 in a single centre. Various factors that may affect IUI outcome were analyzed using chi-square. Moreover, we conducted multiple logistic regression to evaluate the main factors on the effects of IUI outcome. In addition, follicle growth and endometrial development relevant to conception were also assessed among protocols. Results: The clinical pregnancy rate (CPR) per cycle was 12.5% in the present study. Seven factors were identified to be associated significantly with CPR by multivariate logistic regression analysis: female age, type of infertility, ovarian stimulation protocol, preovulatory follicles, endometrial thickness, growing length of preovulatory follicle, post-washed total motile spermatozoa count (TMSC). Comparing with 11 days or less, more than 15 days for ovarian response and endometrial development before insemination induced a better success rate. Although ovarian stimulation with gonadotrophin or letrozole induced higher CPR when comparing to stimulation with clomiphene citrate or without stimulation, ovarian stimulation with letrozole was superior to gonadotrophin by its similar CPR to gonadotrophin but lower follicle number, without the risk of multiple pregnancy. Women younger than 41 years with elevated endometrial thickness inseminated with TMSC ≥ 4.0 million had better chance to obtain pregnancy. Number of treatment cycle was not a factor to affect CPR, with a stable CPR in the first four cycles. Conclusions: We conclude that women no more than 41 years old are suitable to perform at least 4 cycles of IUI before proceeding to IVF. The optimized IUI treatment requires ovarian stimulation with letrozole to induce one/two follicles and fertilize with four or more million motile spermatozoa and an elevated endometrium on day 15 or after in the cycle. Key words: infertility, intrauterine insemination, effective factors, clinical pregnancy rate.

Suboptimal response to controlled ovarian stimulation in IVF / ICSI cycles

2021 ◽  
Vol 69 (6) ◽  
pp. 61-70
Author(s):  
Cong Tuan Nguyen ◽  
Dariko A. Niauri ◽  
Lyailya Kh. Dzhemlikhanova ◽  
Igor Yu. Kogan ◽  
Inna O. Krikheli ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Uterine Fibroids ◽  
Negative Influence ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Controlled Ovarian Stimulation ◽  
Male Factor ◽  
Art Programs

Hypothesis/Aims of study. Currently, the frequency of suboptimal response (4-9 retrieved oocytes) to controlled ovarian stimulation (COS) in woman is quite high; however, its efficacy is poorly studied. The aim of this study was to evaluate the main characteristics of IVF / ICSI programs in patients with a suboptimal response to COS. Study design, materials and methods. We performed a retrospective study of 412 IVF / ICSI cycles in women with a suboptimal response to COS, including a comparative analysis of clinical and embryological parameters, ovarian reserve and the efficacy of IVF / ICSI protocols. Results. Clinical pregnancy rate in ovarian stimulation cycles with a suboptimal response to COS was 27.9%. The efficacy of assisted reproductive technology (ART) programs in women with uterine fibroids was significantly lower than in patients without fibroids (19.1% vs. 30.5%, p = 0.03; OR = 0.54; 95% CI: 0.31-0.95). Clinical pregnancy rate in patients with male factor infertility was significantly higher than in women with anovulation (37.1% vs. 20.9%, р = 0.005; OR = 2.24; 95% CI: 1.27-3.94) or tubal factor infertility (37.1% vs. 24.8%, р = 0.02; OR = 1.79; 95% CI: 1.09-2.94). There were significant correlations between the number of retrieved oocytes with serum anti-Mllerian hormone (AMH) concentration (r = 0.32, p 0.001) and antral follicle count (AFC) (r = 0.38, p 0.001). In addition, the need for follicle-stimulating hormone (FSH) preparations during COS correlated significantly with ovarian reserve parameters (AMH and AFC) (r = 0.45 and 0.44, both p 0.001, respectively) and the age of patients (r = 0.47; p 0.001). Conclusion. The clinical pregnancy rate in women with a suboptimal response to COS was low. Concomitant uterine fibroids represented an additional factor of negative influence on IVF / ICSI outcomes in women with a suboptimal response to COS. The male factor of infertility in patients with a suboptimal response did not reduce the efficacy of ART programs. Ovarian reserve parameters in women with a suboptimal response correlated with the need for FSH preparations during COS and the number of retrieved oocytes.

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