The role of in vitro fertilization and intracytoplasmic sperm injection in couples with unexplained infertility after failed intrauterine insemination

1997 ◽  
Vol 68 (1) ◽  
pp. 171-173 ◽  
Author(s):  
Amparo Ruiz ◽  
José Remohí ◽  
Yolanda Minguez ◽  
Pedro P. Guanes ◽  
Carlos Simón ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Intracytoplasmic Sperm Injection ◽  
Intrauterine Insemination ◽  
Unexplained Infertility ◽  
Vitro Fertilization

scholarly journals The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

2019 ◽  
Vol 8 (4) ◽  
pp. 548 ◽  
Author(s):  
Agni Pantou ◽  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Polina Giannelou ◽  
Anna Rapani ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
In Vitro Fertilization ◽  
Primary Outcome ◽  
Unexplained Infertility ◽  
Vitro Fertilization ◽  
Natural Conception ◽  
Infertility Patients ◽  
Infertile Patients

The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts.

scholarly journals The Role of Interleukin-18 in Serum and Follicular Fluid during In Vitro Fertilization and Intracytoplasmic Sperm Injection

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Corinna Fuhs ◽  
Ali Salmassi ◽  
Liselotte Mettler ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Follicular Fluid ◽  
Intracytoplasmic Sperm Injection ◽  
Ovarian Stimulation ◽  
The Body ◽  
Interleukin 18 ◽  
Vitro Fertilization ◽  
Median Level

Cytokines are key modulators of the immune system and play an important role in the ovarian cycle. IL-18 levels in serum and follicular fluid were analyzed in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. The cohort study group consisted of 90 women, who were undergoing IVF or ICSI. The body mass index (BMI) was determined in all patients; IL-18 levels were measured in follicular fluid and serum. IL-18 levels in serum were significantly higher than those in follicular fluid. The median level in serum was 162.75 (80.21) pg/mL and that in follicular fluid, 138.24 (91.78) pg/mL. Women undergoing IVF treatment had lower IL-18 levels in serum (median, 151.19 (90.73) pg/mL) than those treated with ICSI (median, 163.57 (89.97) pg/mL). The correlation between IL-18 levels in serum and BMI was statistically significant, as well as the correlation between IL-18 levels in follicular fluid and ovarian stimulation response (p=0.003). IL-18 was correlated with the response to ovarian stimulation and was the reason for successful pregnancy after IVF or ICSI treatment. Among other cytokines, IL-18 appears to be a promising prognostic marker of success in reproductive treatment and should be evaluated as such in further prospective studies.

Clinical biochemistry of assisted conception

2009 ◽  
Vol 46 (3) ◽  
pp. 197-204
Author(s):  
Rajeev Srivastava ◽  
Vanessa Kay
Keyword(s):  
In Vitro Fertilization ◽  
Clinical Biochemistry ◽  
Intrauterine Insemination ◽  
Test Tube ◽  
Fertility Treatment ◽  
Assisted Conception ◽  
Eligibility Criteria ◽  
Vitro Fertilization

Assisted reproductive technology has shown rapid advancement since the birth of the first ‘test-tube’ baby in Oldham, UK, in 1978. Since April 2005, women between the ages of 23 and 39, who meet the described eligibility criteria, are able to get one free in vitro fertilization cycle funded by the National Health Service. Private treatment costs anything from £4000 to £8000 for a single cycle of treatment. Almost 15% of the couples in UK are affected by fertility problems and undergo detailed investigations before being offered assisted conception. Assisted reproduction is the collective name for treatments designed to lead to conception by means other than sexual intercourse. These include intrauterine insemination, in vitro fertilization, intracytoplasmic sperm injection and gamete donation. This review is intended to summarize the principles of assisted conception and examine the role of the biochemistry laboratory in: (A) the diagnosis and subsequent management of ovulatory disorders; (B) assessing ovarian reserve before initiating fertility treatment and (C) monitoring fertility treatment. It touches on the screening of potential gamete donors and follow-up of children born after assisted conception. This article was prepared at the invitation of the Clinical Sciences Reviews Committee of the Association of Clinical Biochemistry.

The role of diagnostic hysteroscopy before the first in vitro fertilization/intracytoplasmic sperm injection cycle

2012 ◽  
Vol 286 (5) ◽  
pp. 1323-1328 ◽  
Author(s):  
Hsing-Tse Yu ◽  
Chin-Jung Wang ◽  
Chyi-Long Lee ◽  
Hong-Yuan Huang ◽  
Chun-Kai Chen ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Intracytoplasmic Sperm Injection ◽  
Vitro Fertilization ◽  
Diagnostic Hysteroscopy ◽  
Injection Cycle

The Role of the Urologist in the Era of In Vitro Fertilization-Intracytoplasmic Sperm Injection

Urology ◽  
2017 ◽  
Vol 103 ◽  
pp. 19-26 ◽  
Author(s):  
Alexander W. Pastuszak ◽  
John T. Sigalos ◽  
Larry I. Lipshultz
Keyword(s):  
In Vitro Fertilization ◽  
Intracytoplasmic Sperm Injection ◽  
Vitro Fertilization

scholarly journals Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?

2020 ◽  
Vol 38 (01) ◽  
pp. 029-035
Author(s):  
Mohan S. Kamath ◽  
Judith F.W. Rikken ◽  
Jan Bosteels
Keyword(s):  
Intrauterine Insemination ◽  
Semen Analysis ◽  
Unexplained Infertility ◽  
Fertility Treatment ◽  
Future Research ◽  
Vitro Fertilization ◽  
Tubal Patency ◽  
The Impact

AbstractThe standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevalence of pelvic infection, setting, and availability of expertise. Moreover, whenever a laparoscopy is planned as a part of the fertility workup, the preparation should include ability to carry out simultaneous therapeutic intervention to maximize the benefit. Similarly, the routine use of hysteroscopy in women with unexplained infertility cannot be recommended. There is a need to investigate the impact of choice of tubal test on chances of spontaneous conception and treatment outcomes in women with unexplained infertility. Our future research agenda should also include high-quality multicenter randomized trials assessing the cost-effectiveness of screening and operative hysteroscopy prior to intrauterine insemination or in vitro fertilization.

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