scholarly journals Ovarian and Uterine Blood Flow Indices in Patients with Unexplained Infertility Undergoing ICSI and their Relation to Clinical Pregnancy Rate

2020 ◽  
Vol 10 (3) ◽  
pp. 188-200
Author(s):  
Ahmed Ibrahim ◽  
Mohamed El-Mandooh ◽  
Haitham Mohammed Gad ◽  
Heba Al Hariri
2021 ◽  
Vol 14 (3) ◽  
pp. 1297-1304
Author(s):  
Shruti Chopra ◽  
Ajit Varma ◽  
Seema Jain ◽  
Sangeeta Jain ◽  
Devendra Choudhary

Objective: To study the effect of sperm chromatin condensation (DNA fragmentation index (DFI)) using aniline blue-eosin (AB-E) staining on pregnancy outcomes in patients facing unexplained infertility undergoing intra- uterine insemination (IUI). Our initial hypothesis states that if DNA fragmentation is high then chances of pregnancy are low/NIL hence these patients should be recommended with advanced ART procedures like IVF and ICSI. Design: Prospective study Setting: Tertiary care infertility centre Method: A total of 185 patients with age less than 40 years, non-smokers and without history of any pathogenic infection in the past 2months facing unexplained infertility i.e., males with normal semen analysis reports and females with normal ovulation and hysterosalpingography (HSG) reports were selected for the study. Patients were undergoing their first or second IUI treatment cycle between the period of June 2016 to December 2016. DNA fragmentation index (DFI) using aniline blue- eosin staining method was studied in semen samples provided on the day of IUI procedure. The patients were separated into 3 groups: low DFI (DFI<= 10%), medium DFI (DFI=11 % - 20%), and high DFI (DFI >= 21%) and clinical pregnancy outcomes of IUI were recorded. Statistical analysis was performed using Pearson correlation co-efficient, ANOVA and Shapiro Wilk Test on the above groups. Main Outcome Measures: DNA fragmentation index (DFI) (%), Clinical pregnancy rate (%) Result: The overall clinical pregnancy rate for the selected patient pool was 21.08% with an average DFI of 8.84% in the pregnant female group and 14.65% in the non-pregnant female group. Sperm DFI % and clinical outcomes in IUI treated patients were statistically significant and negatively correlated with correlation coefficient (r) of -0.1, -0.3 and -0.3 in low DFI%, medium DFI and high DFI% groups respectively. Conclusion: Our study demonstrated that DFI (%) and clinical pregnancy rate (%) are significantly and negatively correlated in patients with normal semen parameters undergoing IUI. The higher the DFI% the chances of clinical pregnancy become very low, therefore, these patients should not be recommended IUI but with advanced ART procedures like IVF and ICSI.


2020 ◽  
Author(s):  
Shahintaj Aramesh ◽  
Maryam Azizi Kutenaee ◽  
Fataneh Najafi ◽  
Parvin Ghafari ◽  
seyed abdolvahab taghavi

Abstract Background The cause of infertility has not been found in unexplained infertile patients,, and perhaps one of the possible reasons is impairment of fetal implantation, as well as the multiple role of GCSF in improving implantation and quality of blastocyst. Therefore, the aim of this study was to investigate the role of GCSF in the pregnancy rate of patients undergoing IUI.Methods The patients with unexplained infertility were divided into two groups: one group was received GCSF in their IUI cycle and the other group had the routine IUI. Both groups were stimulated by letrozole, metformin, and monotropin during the cycle. When at least one follicle was greater than 18 mm, 5000 IU hCG intramuscularly was administered for ovulation induction and IUI was performed 34–36 hours later. In intervention group, 300 ug GCSF subcutaneously administrated in two days after IUI. Biochemical pregnancy rate was evaluated two weeks after IUI and clinical pregnancy rate was identified by the presence of a gestational sac on ultrasonography 8 weeks after IUI.Results There was no significant difference in demographic and clinical characteristics between the two groups. The chemical pregnancy rate(16.3% vs 12.2%) and the clinical pregnancy rates (16.3% vs 8.3%) were improved in patients receiving GCSF compared to controls, but these differences was not significant (P = 0.56) and (P = 0.21).Conclusion Systemic administration of a single dose of 300 µg GCSF subcutaneously two days after IUI may slightly improve clinical pregnancy rate in patients with unexplained infertility. Nevertheless, our findings do not support routine use of G-CSF in unexplained infertility women with normal endometrial thickness.


2018 ◽  
Vol 1 (2) ◽  
pp. 105-109
Author(s):  
Gir Dhari Sharma ◽  
Rajesh Adhikari ◽  
Shyam Sundar Parajuly ◽  
Kalpana Gautam Adhikari

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.


Author(s):  
Mervat A. Elsersy

Background: Unexplained infertility is diagnosed when the basic infertility workup is found to be normal. The objective was to compare between the results of IUI performance at 24 hours or 36 hours after hCG injection in couples with unexplained infertility.Methods: A prospective comparative study was conducted on 250 patients diagnosed with unexplained infertility who were randomly allocated in two equal groups. Each patient received ovulation induction. Follicular growth scanning was performed, patients received 10.000 hCG injection when there was mature follicle equaled to or more than 18mm. Then they randomly allocated to either group 1 who underwent IUI 24 hours after hCG injection or group 2 who underwent IUI 36 hours after hCG injection.Results: The positive qualitative serum β -hCG test was higher in group 1 who received IUI  24 hours after hGC injection, 24%, while in group 2 who received IUI  36 hours after hGC injection, it was 16.8% but no statistical differences between the two studied groups  could be observed. The most important finding in this study is that the clinical pregnancy rate in group 1 was significantly higher than in group 2.Conclusions: Earlier IUI procedures increased the clinical pregnancy rate in patients with unexplained infertility during ovulation induction with gonadotropins. Correct timing of insemination is essential.


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