scholarly journals Effectiveness of ovarian suspension in preventing postoperative ovarian adhesions in patients with severe pelvic endometriosis—a case-control study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Zahra Dehbashi ◽  
Shaheen Khazali ◽  
Fateme Davari Tanha ◽  
Farnaz Mottahedian ◽  
Mahsa Ghajarzadeh ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Transvaginal Ultrasound ◽  
Stage Iv ◽  
Clinical Pregnancy ◽  
Reproductive Age ◽  
Deep Infiltrating Endometriosis ◽  
Pelvic Endometriosis ◽  
Double Blind ◽  
Entire Study

Abstract Background Endometriosis can exert obvious negative effects on women’s quality of life. Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in the treatment of severe pelvic endometriosis. Given the importance and the prevalence of endometriosis and its complications, we conducted the present study to determine more effective adhesion-reducing methods with a view to improving the quality of the treatments provided. Methods The present prospective double-blind randomized clinical trial was conducted on 50 women of reproductive age (≥ 19 years) diagnosed with severe pelvic endometriosis on transvaginal ultrasound scans and vaginal examinations at Yas Hospital between 2014 and 2017. Women with severe endometriosis (stage III, stage IV, and deep infiltrating endometriosis) requiring an extensive bilateral dissection of the pelvic walls and the rectovaginal space, with preserved uterus and ovaries, were included in the study. The preoperative severity of ovarian adhesions was assessed in terms of ovarian motility, measured through a combination of gentle pressures applied with the vaginal probe and abdominal pressures applied with the examiner’s free hand. A table of random numbers was used to choose which ovary to suspend. The entire study population received standard general anesthesia. In the laparoscopic examination of the cases with severe endometriosis, both ovaries were routinely suspended to the anterior abdominal wall with PROLENE sutures. At the end of the surgery, one of the ovaries was kept suspended for 7 days, whereas the other ovarian suspension suture was cut. At 3 months postoperatively, all the patients underwent ultrasound scans for the assessment of ovarian motility and adhesions. The severity of pelvic pain was defined according to a visual analog score. After surgery, infertile women were followed for 2-4 years, and were contacted regarding the infertility treatment. Chemical and clinical pregnancy rates was compered between the two groups. Results Three months after laparoscopy, the adhesions were mild in 41 (82%) patients and moderate in 9 (18%) on the suspended side, and mild in 12 (24%) patients and moderate in 38 (76%) on the control side (P < 0.001). The mean dysmenorrhea score was 6.8 ± 1.5 before surgery and 4.5 ± 1.4 after surgery (P < 0.001). The chemical pregnancy rate and clinical pregnancy rate were not different in the suspended and control groups (P = 0. 62, P = 0.64). Conclusions The reduction in adhesions via ovarian suspension surgery promises reductions in the complications of endometriosis.

Experience of using time-lapse microscopy in IVF and ICSI programs

2020 ◽  
pp. 47-50
Author(s):  
N. V. Saraeva ◽  
N. V. Spiridonova ◽  
M. T. Tugushev ◽  
O. V. Shurygina ◽  
A. I. Sinitsyna
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Selection Procedure ◽  
Time Lapse ◽  
Single Embryo Transfer ◽  
Main Group ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Time Lapse Microscopy

In order to increase the pregnancy rate in the assisted reproductive technology, the selection of one embryo with the highest implantation potential it is very important. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the benefits of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in IVF and ICSI programs. Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 282 patients, who formed the main group; the control group consisted of 461 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and delivery. The groups did not differ in the ratio of IVF and ICSI cycles, average age, and infertility factor. The proportion of excellent quality embryos for transfer was 77.0% in the main group and 65.1% in the control group (p = 0.001). In the subgroup with receiving eight and less oocytes we noted the tendency of receiving more quality embryos in the main group (р = 0.052). In the subgroup of nine and more oocytes the quality of the transferred embryos did not differ between two groups. The clinical pregnancy rate was 60.2% in the main group and 52.9% in the control group (p = 0.057). The delivery rate was 45.0% in the main group and 39.9% in the control group (p > 0.050).

scholarly journals Role of Low Dose Intravenous Immunoglobulin in IVF Failure - A Retrospective Analysis

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Pregnancy Rate ◽  
Retrospective Analysis ◽  
Intravenous Immunoglobulin ◽  
Embryo Transfer ◽  
Low Dose ◽  
Transvaginal Ultrasound ◽  
Clinical Pregnancy ◽  
Ivf Failure

Background: In developing countries the number of in vitro fertilization (IVF) attempts is often limited by the high costs of the procedure and relatively low success rates. In such a setup we have tried to evaluate the effect of low dose intravenous immunoglobulins (IVIg) administered to patients who have had previous failed IVF outcomes. Bearing in mind that the inherent fecundity of Indian population is higher and thus a lower dose of IVIg may suffice to give positive outcomes at an affordable price, in this manner providing them with the possibility of affording more attempts if required. Objective: To evaluate the role of low dose intravenous immunoglobulin in IVF failure. Design: Retrospective analysis Materials and methods: This is a retrospective study beginning from 1st January 2014 till 31st December 2014. During this period, 124 patients with two or more failed IVF cycles were included. The controlled ovarian stimulation was started on cycle day 2 using gonadotropins (225 - 450 iu daily) and GNRH antagonist was added on the day when follicle reached 13 -14 mm. When follicles reached 18mm, transvaginal ultrasound guided oocyte aspiration was performed within 36 hours of the hcg trigger. On the ovum pick up day, 5 grams IVIg was administered to the patient as a slow infusion. Embryo transfer was done on day 2 or 3. Serum beta hcg was done 14 days after the embryo transfer and pregnancy rate and clinical pregnancy were evaluated. Results: The total pregnancy rate was 46% (57/124) and clinical pregnancy rate was 42.7% (53/124). Conclusion: Our study concluded that low dose IVIg may play a significant role in improving pregnancy rates in women with previous failed IVF attempts.

P–318 Short (seven days) versus conventional (fourteen days) estrogen priming in an artificial frozen embryo transfer cycle: a randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Racca ◽  
S Santos-Ribeiro ◽  
D Panagiotis ◽  
L Boudry ◽  
S Mackens ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Transvaginal Ultrasound ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Study question What is the impact of seven days versus fourteen days’ estrogen (E2) priming on the clinical outcome of frozen-embryo-transfer in artificially prepared endometrium (FET-HRT) cycles? Summary answer No significant difference in clinical/ongoing pregnancy rate was observed when comparing 7 versus 14 days of estrogen priming before starting progesterone (P) supplementation. What is known already One (effective) method for endometrial preparation prior to frozen embryo transfer is hormone replacement therapy (HRT), a sequential regimen with E2 and P, which aims to mimic the endocrine exposure of the endometrium in a physiological cycle. The average duration of E2 supplementation is generally 12–14 days, however, this protocol has been arbitrarily chosen whereas, the optimal duration of E2 implementation remains unknown. Study design, size, duration This is a single-center, randomized, controlled, open-label pilot study. All FET-HRT cycles were performed in a tertiary centre between October 2018 and December 2020. Overall, 150 patients were randomized of whom 132 were included in the analysis after screening failure and drop-out. Participants/materials, setting, methods The included patients were randomized into one of 2 groups; group A (7 days of E2 prior to P supplementation) and group B (14 days of E2 prior to P supplementation). Both groups received blastocyst stage embryos for transfer on the 6th day of vaginal P administration. Pregnancy was assessed by an hCG blood test 12 days after FET and clinical pregnancy was confirmed by transvaginal ultrasound at 7 weeks of gestation. Main results and the role of chance Following the exclusion of drop-outs and screening failures, 132 patients were finally included both in group A (69 patients) or group B (63 patients). Demographic characteristics for both groups were comparable. The positive pregnancy rate was 46.4% and 53.9%, (p 0.462) for group A and group B, respectively. With regard to the clinical pregnancy rate at 7 weeks, no statistically significant difference was observed (36.2% vs 36.5% for group A and group B, respectively, p = 0.499). The secondary outcomes of the study (biochemical pregnancy, miscarriage and live birth rate) were also comparable between the two arms for both PP and ITT analysis. Multivariable logistic regression showed that the HRT scheme is not associated with pregnancy rate, however, the P value on the day of ET is significantly associated with the pregnancy outcome. Limitations, reasons for caution This study was designed as a proof of principle trial with a limited study population and therefore underpowered to determine the superiority of one intervention over another. Instead, the purpose of the present study was to explore trends in outcome differences and to allow us to safely design larger RCTs. Wider implications of the findings: The results of this study give the confidence to perform larger-scale RCTs to confirm whether a FET-HRT can be performed safely in a shorter time frame, thus, reducing the TTP, while maintaining comparable pregnancy and live birth rates. Trial registration number NCT03930706

scholarly journals Outcome of Intra Uterine Insemination in Sahara International Fertility Centre Pokhara, Nepal

2018 ◽  
Vol 1 (2) ◽  
pp. 105-109
Author(s):  
Gir Dhari Sharma ◽  
Rajesh Adhikari ◽  
Shyam Sundar Parajuly ◽  
Kalpana Gautam Adhikari
Keyword(s):  
Success Rate ◽  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Reproductive Age ◽  
Male Factor ◽  
Ovulatory Dysfunction ◽  
Ejaculatory Dysfunction

Introduction: The incidence of infertility is about 10 to 15 % among reproductive age group. The cause of infertility may be either due to male factor or female factor or both. The main aim of this study was to evaluate the success rate of intrauterine insemination (IUI) in a private centre of Pokhara. Materials and Methods: This was a centre based retrospective study done in private fertility centre. Sub-fertile couples who were treated from January 1st 2015 to December 31st 2016 were enrolled for the study. Couples with unexplained male factor, ovulatory dysfunction, unilateral tubal occlusion and ejaculatory dysfunction were included in this study. Three hundred and eighty IUI cases were retrospectively reviewed. Clinical pregnancy rate was the primary outcome. Result: The success rate of IUI was 15.7%. It was higher among unexplained infertility cases. Clinical pregnancy rate was directly associated with the age of the patients, indications of infertility and number of cycles. Conclusion: Success rate of IUI in infertile couples who had unexplained infertility, tubal factor, ovulatory dysfunction was higher than male factor infertility and ejaculatory dysfunction.

scholarly journals Effect of Traditional Chinese Medicine Formula Guilu Xian on in vitro Fertilization and Embryo Transfer Outcome in Older Women with Low Prognosis: Study Protocol for a Prospective, Multicenter, Randomized Double-Blind Study

2021 ◽  
Author(s):  
Zhengao Sun ◽  
Yingjie Ma ◽  
Xianling Cao ◽  
Yi Zhang ◽  
Dandan Gao ◽  
...  
Keyword(s):  
Placebo Group ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Pregnancy Rate ◽  
Older Women ◽  
Embryo Implantation ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Double Blind ◽  
Chinese Medicine Formula

Abstract IntroductionIn recent years, the prevalence of infertility has significantly increased and has become a global reproductive health problem. The female ovarian reserves have been shown to decrease progressively with an increase in age. Besides, the rate of embryo implantation and clinical pregnancy also decreases. Traditional Chinese medicine has been widely applied in assisted reproductive technology. It is reported to have a significant influence on improving the quality of oocytes, improving endometrial receptivity, increasing clinical pregnancy rate, reducing pregnancy-related complications, etc. Therefore, this study will investigate the effect of Guilu Xian, a traditional Chinese medicine formula on IVF-ET outcome in older women with low prognosis.Methods and analysisThis trial is a prospective, multicenter, randomized double-blind clinical trial. A total of 120 infertile patients with low prognosis and receiving IVF or ICSI in 3 public hospitals in China will be randomly divided into two parallel groups: Guilu Xian group (n = 60) and placebo group (n = 60). Patients in both groups will be treated with antagonist regimens to promote ovulation, and all the patients will be required to take the medication from the 2nd to 4th day of the menstrual cycle to the day of egg retrieval. A comparison of the total number of oocytes obtained, the fertilization rate, clinical pregnancy rate, embryo quality, embryo implantation rate and early spontaneous abortion rate between the experimental group and the placebo group will be performed. This study was registered in the Chinese Clinical Trials Registry Platform (ChiCTR1900028255).

scholarly journals Stress, anxiety, and depression in infertile couples are not associated with a first IVF or ICSI treatment outcome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meijuan Peng ◽  
Mingyang Wen ◽  
Tao Jiang ◽  
Yangqian Jiang ◽  
Hong Lv ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Psychological Distress ◽  
Pregnancy Rate ◽  
Conditional Logistic Regression ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Reproductive Age ◽  
Categorical Variables ◽  
Birth Cohort Study ◽  
Fresh Embryo Transfer

Abstract Background Psychological distress may exert a negative influence on reproductive function of couples at reproductive age. Couples seeking assisted reproductive technology (ART) treatment may have a higher prevalence of psychological distress than fertile couples. However, whether psychological distress is associated with the outcome of ART treatment remains unknown. We aimed to investigate the association of pre-treatment psychological distress and clinical pregnancy rate among infertility couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Methods This nested case-control study was conducted based on women who underwent their first fresh IVF or ICSI cycle in the Jiangsu Birth Cohort Study (JBC) between November 2015 and January 2019. A total of 150 women who did not obtain clinical pregnancy after first IVF or ICSI fresh embryo transfer were identified as cases, and a total of 300 age matched women who obtained clinical pregnancy were identified as controls. Conditional logistic regression analyses were used to investigate the association between psychological distress and the outcome of first IVF or ICSI treatment, adjusting for multiple potential confounders. Results No statistically significant association was observed between score of maternal symptoms of psychological distress and clinical pregnancy. Adjusted ORs of logistic regression were 1.00 (95% CI 0.97-1.03) for anxiety, 0.98 (95% CI 0.95-1.02) for depression, and 0.98 (95% CI 0.95-1.01) for perceived stress, respectively. When treat depression and anxiety as categorical variables, 62 (13.8%) were classified as clinical depression, 11 (2.4%) were classified as clinical anxiety, among 450 women in the present study. Psychological distress symptoms were also not associated with clinical pregnancy rate. Adjusted ORs of logistic regression were 0.27 (95% CI 0.03-2.33) for anxiety, 0.88 (95% CI 0.46-1.68) for depression, respectively. Conclusions Our findings firstly indicated that psychological distress experienced prior to IVF/ICSI treatment was not associated with clinical pregnancy.

scholarly journals DYSMORPHISMS OF OOCYTES IN ART PROCEDURES: A LITERATURE REVIEW

2021 ◽  
pp. 44-53
Author(s):  
G.M. Karibayeva ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Literature Review ◽  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Morphological Changes ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Human Oocytes

Relevance: Assisted reproductive technologies (ART) are rapidly developing and in recent decades have become increasingly important due to the growing number of infertile couples around the world. Human oocytes are the main objects used in ART procedures. Consequently, the quality of oocytes can determine the key parameters of ART. The purpose of this review was to analyze the literature and the results of studies in the field of ART devoted to extracytoplasmic dysmorphisms of human oocytes – morphological changes outside the cytoplasmic structure of oocytes, their effect on fertilization, cleavage, implantation frequency, clinical pregnancy rate, as well as the possibility of their use as biomarkers for predicting the quality of embryos, blastocysts, and their further implantation potential. Materials and Methods: This literature review was based on a search conducted among domestic and foreign publications for 2000-2020 available in Russian and international search systems (PubMed, eLibrary) using the keywords «infertility,” “IVF,” «oocyte,” “morphological assessment of oocytes,” “dysmorphisms of oocytes ,” and “ assisted reproductive technologies.” Results: This literature review contains literature data and the analysis of research results in the field of ART devoted to the morphological qualities and abnormalities (dysmorphisms) of human oocytes. It describes the types of extracytoplasmic abnormalities encountered in the clinical practice of in-vitro fertilization, their effect on fertilization, cleavage, implantation rate, and clinical pregnancy rate, as well as the possibility of their use as biomarkers to predict the quality of embryos and blastocysts and their further implantation potential.

scholarly journals Step-up protocol gonadotrophin versus laparoscopic ovarian drilling in clomiphene citrate resistant PCOS infertile women in two Iraqi hospitals

2019 ◽  
Vol 15 (1) ◽  
pp. 103-109
Author(s):  
Thikra N Abdull
Keyword(s):  
Pregnancy Rate ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Reproductive Age ◽  
Infertile Women ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome is a common endocrine disorder affecting 6-10% of women of reproductive age and the most common cause of anovulatory infertility. Objective: The aim of the study was to compare the effectiveness, side effects and outcomes of step-up gonadotrophin protocol versus laparoscopic ovarian diathermy (LOD) in infertile patients with clomiphene citrate resistant polycystic ovary syndrome. Methods:  The sample included women who attended our infertility clinic at Al-Elwiya Maternity Teaching Hospital and Kamal Al-Samarraee for Infertility and IVF Hospital in Baghdad/ Iraq from November 2013 to November 2014.    Eighty cases of infertile women with polycystic ovarian syndrome who failed to ovulate with clomiphene citrate for six months where collected, forty women treated with step-up protocol with low dose recombinant FSH gonadotrophin which increased gradually according to ovulation response, another forty women treated with LOD. Ovulation monitoring in each group was done with transvaginal ultrasound to exclude monofollicullar, bifollicular ovulation, ovarian hyperstimulation syndrome, multiple pregnancy and pregnancy rate in each cycle for 6 cycles. Results: Higher unifollicular ovulation and pregnancy rate in LOD than step-up protocol (91.4% & 25% versus 75% & 10%) respectively, while multifollicular and hyperstimulation rate were higher in gonadotrophin group (24.3% & 0.1% versus 8.50% & nil) respectively. Conclusion: Ovulation induction and pregnancy rate per cycle was higher with LOD group, not time consuming, also there was no risk of hyperstimulation of the ovary or twin pregnancy as compared to the step-up protocol with gonadotrophin

scholarly journals Effect of traditional Chinese medicine formula Guilu Xian on in vitro fertilization and embryo transfer outcome in older women with low prognosis: study protocol for a prospective, multicenter, randomized double-blind study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yingjie Ma ◽  
Xianling Cao ◽  
Jingyan Song ◽  
Dandan Gao ◽  
Xinlei Wang ◽  
...  
Keyword(s):  
Placebo Group ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Pregnancy Rate ◽  
Older Women ◽  
Embryo Implantation ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Double Blind ◽  
Chinese Medicine Formula

Abstract Introduction In recent years, the prevalence of infertility has significantly increased and has become a global reproductive health problem. The female ovarian reserves have been shown to decrease progressively with an increase in age. Besides, the rate of embryo implantation and clinical pregnancy also decreases. Traditional Chinese medicine has been widely applied in assisted reproductive technology. It is reported to have a significant influence on improving the quality of oocytes, improving endometrial receptivity, increasing clinical pregnancy rate, reducing pregnancy-related complications, etc. Therefore, this study will investigate the effect of Guilu Xian, a traditional Chinese medicine formula on IVF-ET outcome in older women with low prognosis. Methods and analysis This trial is a prospective, multicenter, randomized double-blind clinical trial. A total of 120 infertile patients with low prognosis and receiving IVF or ICSI in 3 public hospitals in China will be randomly divided into two parallel groups: Guilu Xian group (n = 60) and placebo group (n = 60). Patients in both groups will be treated with antagonist regimens to promote ovulation, and all the patients will be required to take the medication from the 2nd to 4th day of the menstrual cycle to the day of egg retrieval. A comparison of the total number of oocytes obtained, the fertilization rate, clinical pregnancy rate, embryo quality, embryo implantation rate, and early spontaneous abortion rate between the experimental group and the placebo group will be performed. Trial registration Chinese Clinical Trials Registry ChiCTR1900028255. Registered on 16 December 2019.

Sign in / Sign up

Export Citation Format

Share Document