Showing 59 results for Embryo Transfer
Razieh Dehghani Firouzabady, Irandokht Mehri Mahani, Mehdi Dehghani Firouzabady,
Volume 2, Issue 2 (7-2004)
Abstract
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
Farnoush Farzi, Marzieh Mehrafza, Ali Mirmansouri, Mona Oudi, Ahmad Hoseeini,
Volume 3, Issue 2 (7-2005)
Abstract
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
Nezhat Moossavifar, Nayereh Khadem, Alieh Torabizadeh,
Volume 4, Issue 1 (7-2006)
Abstract
Background: It has been demonstrated that performing a mock embryo transfer (ET) significantly improves the pregnancy rate in IVF cycles. The mock ET could be performed prior to the stimulation cycle or immediately before real ET. The problem of the first procedure is the possibility of variation in the uterine position and or cervico–uterine angle.
Objective: The purpose of this study was to determine the consistency of the type of ET in mock ET prior to the treatment cycle with real ET.
Materials and Methods: A prospective comparison between the technique of mock embryo transfer and real embryo transfer. One hundred and sixty treatment cycles on 141 patients between January 2003 and September 2004 ended to ET and they were analyzed prospectively. In each cycle, patients underwent a mock ET in mid luteal phase prior to treatment cycle (the date when patients referred to have consultation about down regulation regimen).
Results: Of 160 mock ET the Wallace catheter passed easily in 144 (90%) of them. In the remaining 16 cycles (10%) a tenaculum and or a rigid cannula had to be used. From 144 cases of easy mock ET, real ET was easy in 121 (84%) cases while 23 (16%) cases had difficultly during real ET. In the 16 cases of difficult mock ET, there was 8 cases (50%) of difficult real ET and 8 cases (50%) of easy real ET (p=0.001, χ2=10.67). The overall clinical pregnancy rate for both difficult and easy transfer was 35%. The pregnancy rate for easy real ET was 37.2% and for difficult real ET was 25.87%. Despite of the difference, the statistical analysis shows no significance difference (χ2=1.21). The difference between mean age for both difficult and easy real transfer was not significant.
Conclusion: Mock ET before beginning of the treatment cycle is highly consistent with real ET.
Abbas Aflatoonian, Maryam Asgharnia,
Volume 4, Issue 2 (7-2006)
Abstract
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)
Abstract
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.
Fattaneh Farifteh, Marzieh Mehrafza, Mona Oudi, Azadeh Eftekhari, Maryam Rahnavard, Khatereh Barjasteh, Ahmad Hossieni,
Volume 7, Issue 3 (7-2009)
Abstract
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)
Abstract
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.
Maryam Eftekhar, Razieh Dehghani Firouzabadi, Hesamoddin Karimi, Elham Rahmani,
Volume 10, Issue 4 (8-2012)
Abstract
Background: GnRH agonist and antagonist were developed to control the premature release of LH surge. There is some difference between two protocols.
Objective: We compared the outcome of frozen-thawed embryo transfer in infertile women who used GnRH agonist or antagonist protocol for previous COH cycle and evaluation of any adverse effect of GnRH antagonist on oocyte and embryo.
Materials and Methods: The study group included all infertile women who referred to Yazd Research and Clinical Center for Infertility. Overall 20-35 years old women who were candidate for frozen-thawed embryo transfer with regard to inclusion and exclusion criteria were participated in the study. The patients based on previous control ovarian stimulation (COH) protocol divided in to two groups: GnRH agonist long protocol (n=165) and GnRH antagonist multiple dose protocol (n=165). Frozen-thawed embryos were transferred after endometrial preparation in both groups. Main outcome measures were: implantation, chemical and clinical pregnancy rate.
Results: The implantation and clinical pregnancy rate following cryopreserved embryo transfer in GnRH agonist group and antagonist group were 16.3% vs. 15.7% (p=0.806) and 38.1% (63/165) vs. 36.9% (61/165) (p=0.915) and chemical pregnancy rate was 44.8% (74/165) vs. 43.6% (72/165) (p=0.915) respectively.
Conclusion: There was no statistically difference between two groups in terms of implantation and pregnancy rate. Although pregnancy rate in fresh embryo transfer in antagonist cycles was lower than agonist groups, Therefore decrease in these parameters might be due to detrimental effect of GnRH antagonist on the endometrium, not embryo or oocyte.
Mustafa Kara, Turgut Aydin, Nurettin Turktekin, Karacavus S ,
Volume 10, Issue 6 (4-2012)
Abstract
Background: The latest studies reported that local endometrial injury is a useful method to improve the success of IVF-ICSI outcome.
Objective: To assess whether local endometrial injury occurred by Pipelle in the spontaneous cycle could improve implantation rate, cleavage rate, and pregnancy outcome in the subsequent IVF-ICSI cycle in patients who had recurrent IVF failure.
Materials and Methods: An endometrial biopsy was performed on day 21st in 41 patients as intervention group in this retrospective cross-sectional study. The control group contained 42 women.
Results: Implantation rate was 22.5% and 10.5% in intervention and control group, respectively and this difference was found to be statistically significant (p=001). Pregnancy rate was 43.9% in the intervention group and this parameter was significantly lower in control group (21.4%) (p=0.03).
Conclusion: Local endometrial injury in the nontransfer cycle increases the implantation rate and pregnancy rate in the subsequent IVF-ICSI cycle in patients who had previous failed IVF-ICSI outcome.
Razieh Dehghani Firouzabadi, Robab Davar, Farzaneh Hojjat, Mohamad Mahdavi,
Volume 11, Issue 2 (4-2013)
Abstract
Background: Sildenafil citrate may increase endometrial thickness and affect the outcome of frozen-thawed embryo transfer cycles.
Objective: The aim of this study was to estimate the effect of sildenafil citrate on ultrasonographic endometrial thickness and pattern and to investigate the estrogen level on the day of progesterone administration, the implantation rate and chemical pregnancy rate in frozen embryo transfer cycles.
Materials and Methods: This randomized controlled trial was conducted on 80 patients who had an antecedent of poor endometrial response and frozen embryos. 40 patients were given estradiol by a step up method with menstruation to prepare the endometrium, and the other 40 were given sildenafil citrate tablets (50 mg) daily in addition to the above treatment protocol from the first day of the cycle until the day progesterone was started. This was discontinued 48-72 hours prior to the embryo transfer.
Results: The endometrial thickness was significantly higher in the sildenafil citrate group (p<0.0001), the triple line patterns of the endometrium were significantly higher in the sildenafil citrate group (p<0.0001), while the intermediate patterns of the endometrium were not significantly different in the two groups. The echogen patterns of the endometrium were significantly higher in control group (p<0.0001). Finally, implantation rate and the chemical pregnancy rates were higher in the sildenafil citrate group but not significantly.
Conclusion: As our study shows, the oral use of sildenafil citrate is a good way to improve the endometrial receptivity. We recommend the routine use of oral sildenafil citrate in patients with a previous failure of assisted reproduction technology cycles due to poor endometrial thickness.
Rehana Rehman, Zahir Hussain, Syeda Sadia Fatima,
Volume 11, Issue 9 (12-2013)
Abstract
Background: There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI). The knowledge of impact of body mass index (BMI) on reproductive outcome can help to counsel these patients.
Objective: To compare reproductive outcome in females of different BMI after ICSI.
Materials and Methods: Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, (BMI <18 kg/m2), normal weight, (BMI 18-22.9 kg/m2) overweight (BMI 23-25.9 kg/m2) and obese (BMI ≥26 kg/m2). The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA (analysis of variance). Pregnancy outcome of these was categorized as; no conception βhCG <5 m IU/ml, preclinical abortion with βhCG >5 m IU/ml, no cardiac activity on trans vaginal scan (TVS) and clinical pregnancy with βhCG >5mIU/ml and cardiac activity on trans vaginal scan.
Results: Females with BMI 23-25.99 kg/m2 had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI ≥26 kg/m2.
Conclusion: A BMI cut off value of above 26 kg/m2 in our study population is associated with a negative impact on pregnancy outcome.
Soghra Rabiee, Roya Kaboodmehri, Mohammad Fallah, Mahnaz Yavangi, Marzieh Sanouei Farimani,
Volume 11, Issue 10 (12-2013)
Abstract
Embryo transfer and its related factors received little clinical attention and had been, until recently, the most inefficient step in in-vitro fertilization (IVF). Factors which appear to influence implantation rates are: contamination of the catheter tip with cervical bacteria, stimulation of uterine contractions during the procedure, the type of catheter, ultrasound guidance during the transfer, the position of the embryos in the uterine cavity and perhaps cervical mucus (1-4). Easy and atraumatic transfer is essential for successful implantation and the embryos need to be placed in the middle of the cavity, away from the fundus (5). The goal of trans-cervical embryo transfer is to non-traumatic deliver the embryo to an optimal intra uterine location for implantation. Cervical canal mucus may cover the catheter tip and it can be a source of bacterial contamination of uterine cavity. Therefore, aim of this study was evaluation of effect of removal of cervical mucus on clinical pregnancy rate. This study was carried out as a randomized controlled trial. Randomization was done for stratification of age, method of treatment and cause of infertility. A total of 120 women (18-35 years) with male factor infertility, was undergoing IVF cycles with long protocol, divided to two groups: 60 infertile women as cases (group A) that cervical mucus was aspirated and 60 women as controls (group B), without aspiration. In both groups scrub was done by normal saline. Aspiration of cervical mucus was performed by Mucat catheter just before embryo transfer in case group. Embryo transfer was done after 36 hours of puncture. Bed rest for all women after embryo transfer was 1 hours. Primary outcome and pregnancy defined as: positive βhCG 12 days after embryo transfer. The mean age of group A was 29.93±5.04 years, and in the group B was 29.03±4.5 years (p>0.05). The mean duration of infertility in group A was 7.6±5.6 years and in group B the mean duration of infertility was 5.5±3.2 years (p>0.05). The frequencies of previous IVF in group A and B was 38.3%, and 28.13% respectively (p>0.05, OR=1.64 in group A, OR=2.64 in group B). There was no significant difference between two groups in terms of number of transferred embryos statistically (p=0.06). The quality of transferred embryo in group A was as following: grade a 67.7%, grade b 16.7%, grade c 6.7%, and in group B was: grade a 85% and grade b 15%, and two groups were also no significantly different (p>0.05). Contact bleeding was happened in 1.7% of group A and 3.3% of group B. The rate of pregnancy (positive βhCG) in the group A was 11.7% (n=7), however, in the group B was 16.7% (n=10) and two groups had not significant difference statistically (p>0.05, OR=0.66). This study indicates that, removal of cervical mucus during embryo transfer (ET) has no positive effect on the pregnancy rate. However, according to some reports, removal of cervical mucus during ET had been postulated to increase the pregnancy and implantation rates by not interfering with embryo implantation (6). Some researchers suggested that, this is a time- consuming procedure that may increase the incidence of difficult transfers by removing the naturally lubricant mucus. In addition, any cervical manipulation at the time of embryo transfer may cause unwarranted uterine contraction. Several studies have shown a correlation between cervical mucus aspiration and increase pregnancy rates (4, 7). According to the study of Yazd University of Medical Sciences, cervical mucus aspiration with insulin syringe before embryo transfer can increase the pregnancy rate (8). According to some reports the presence of bacterial contamination of catheter tip during embryo is evidently limited and does not significantly affect the cycle outcomes (2). Several studies have shown that cervical mucus aspiration can decrease infection rate with E. coli, Mycoplasma, Uroplasma, Streptococcus B, D, Staphilococcus and increase implantation rate (9). In addition to cleaning cervical mucus, other interventions, such as drug prescription (ritodrine for example) also has no significant effect on pregnancy rate (10). Present study showed no positive correlation between this intervention and result of pregnancy outcome; however, total pregnancy rate in both groups was not high. Because of this procedure may increase the incidence of difficult transfer by removing the naturally lubricant mucus and may cause uterine contraction. In conclusion, the data presented in this study suggest that cervical area and uterus environment manipulation before embryo transfer is not recommended.
Chunjuan Shen, Defeng Shu, Xiaojie Zhao, Ying Gao,
Volume 12, Issue 6 (8-2014)
Abstract
Background: Advances in embryo culture technology and cryopreservation have led to a shift in in vitro fertilization (IVF) from early fresh or frozen-thawed cleavage embryo transfer to fresh or frozen-thawed blastocyst stage transfer.
Objective: To compare the clinical outcomes of fresh embryo transfers and frozen-thawed embryo transfers.
Materials and Methods: In this retrospective case control study, patients undergoing IVF cycles from January 2012 to December 2012 were enrolled in Assisted Reproduction of Wuhan :union: Hospital were enrolled. A total of 1891 cycle contains 1150 fresh embryo transfers and 741 frozen-thawed embryo transfers were studied. All data were transferred directly to SPSS 18 and analyzed.
Results: Clinical pregnancy rates of fresh cleavage-stage embryo transfers compared with fresh blastocyst transfers, frozen-thawed cleavage-stage embryo transfers, post thaw cleavage-stage extended blastocyst culture transfers and frozen-thawed blastocyst transfers were 52.7%, 35.88%, 35.29%, 47.75%, 59.8% in patients under 35 years of ages and 41.24%, 26.92%, 11.32%, 46.15%, 55.8% in patients older than 35 years old, respectively. The multiple pregnancy rates, abortion rates and ectopic pregnancy rates did not differ significantly among the five groups.
Conclusion: The clinical pregnancy rates were not different significantly between fresh cleavage-stage embryo transfers and fresh blastocyst transfers. But the clinical pregnancy rate of frozen-thawed blastocyst transfer was the highest among fresh/frozen-thawed embryo transfers.
Maryam Eftekhar, Elham Rahmani, Soheila Pourmasumi,
Volume 12, Issue 7 (8-2014)
Abstract
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.
Abbas Aflatoonian, Farideh Arabjahvani, Maryam Eftekhar, Mozhgan Sayadi,
Volume 12, Issue 9 (10-2014)
Abstract
Background: Frozen- thawed embryo transfer is an essential part of ART treatment and outcomes of this procedure are associated with several clinical factors. Several studies have showed an increase level of IVF outcomes in women with sufficient vitamin D.
Objective: whether treatment of vitamin D insufficiency can improve pregnancy rates in frozen-thawed embryo transfer cycles.
Materials and Methods: This is an interventional, randomized clinical trial. Serum 25-(OH) vitamin D level of 128 women who had undergone IVF/ICSI with cryopreservation of embryos was checked. One hundred fourteen infertile women with insufficient serum vitamin D (less than 30 ng/ml) were included in the study. Fifty seven women were treated with supplementary vitamin D, 50000 IU weekly, for 6-8 weeks and fifty seven women were received no supplementation. One hundred six women completed frozen thawed embryo transfer cycles and included in the final analysis. Primary and secondary outcomes were chemical and clinical pregnancy respectively.
Results: Our study did not show any significant difference between vitamin D insufficient and treated women in term of chemical (29.40% vs. 29.10% respectively, p=1.00) or clinical (25.50% vs. 21.80% respectively, p=0.81) pregnancy rates.
Conclusion: Vitamin D insufficiency treatment is not associated with higher pregnancy rate in frozen-thawed embryo transfer cycles.
Maryam Eftekhar, Mozhgan Sayadi, Farideh Arabjahvani,
Volume 12, Issue 10 (11-2014)
Abstract
Background: We often see patients with a thin endometrium in ART cycles, in spite of standard and adjuvant treatments. Improving endometrial growth in patients with a thin endometrium is very difficult. Without adequate endometrial thickness these patients, likely, would not have reached embryo transfer.
Objective: We planned this study to investigate the efficacy of intrauterine granulocyte colony-stimulating factor (G-CSF) perfusion in improving endometrium, and possibly pregnancy rates in frozen-thawed embryo transfer cycles.
Materials and Methods: This is a non-randomized intervention clinical trial. Among 68 infertile patients with thin endometrium (-7 mm) at the 12th-13th cycle day, 34 patients received G-CSF. G-CSF (300 microgram/1mL) to improve endometrial thickness was direct administered by slow intrauterine infusion using IUI catheter. If the endometrium had not reached at least a 7-mm within 48-72 h, a second infusion was given. Endometrial thickness was assessed by serial vaginal ultrasound at the most expanded area of the endometrial stripe.
Results: The cycle was cancelled in the patients with thin endometrium (endometrial thickness below 7mm) until 19th cycle day ultimately The cycle cancelation rate owing to thin endometrium was similar in G-CSF group (15.20%), followed by (15.20%) in the control group (p=1.00). The endometrial growth was not different within 2 groups, an improvement was shown between controlled and G-CSF cotreated groups, with chemical (39.30% vs. 14.30%) and clinical pregnancy rates (32.10% vs. 12.00%) although were not significant.
Conclusion: Our study fails to demonstrate that G-CSF has the potential to improve endometrial thickness but has the potential to improve chemical and clinical pregnancy rate of the infertile women with thin endometrium in frozen-thawed embryo transfer cycle.
Robab Davar, Maryam Farid Mojtahedi, Sepideh Miraj,
Volume 13, Issue 8 (9-2015)
Abstract
Background: There is no doubt that luteal phase support is essential to enhance the reproductive outcome in IVF cycles. In addition to progesterone and human chorionic gonadotropin, several studies have described GnRH agonists as luteal phase support to improve implantation rate, pregnancy rate and live birth rate, whereas other studies showed dissimilar conclusions. All of these studies have been done in fresh IVF cycles.
Objective: To determine whether an additional GnRH agonist administered at the time of implantation for luteal phase support in frozen-thawed embryo transfer (FET) improves the embryo developmental potential.
Materials and Methods: This is a prospective controlled trial study in 200 FET cycles, patients were randomized on the day of embryo transfer into group 1 (n=100) to whom a single dose of GnRH agonist (0.1 mg triptorelin) was administered three days after transfer and group 2 (n=100), who did not receive agonist. Both groups received daily vaginal progesterone suppositories plus estradiol valerate 6 mg daily. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were implantation rate, chemical, ongoing pregnancy rate and abortion rate.
Results: A total of 200 FET cycles were analyzed. Demographic data and embryo quality were comparable between two groups. No statistically significant difference in clinical and ongoing pregnancy rates was observed between the two groups (26% versus 21%, p=0.40 and 21% versus 17%, p=0.37, respectively).
Conclusion: Administration of a subcutaneous GnRH agonist at the time of implantation does not increase clinical or ongoing pregnancy.
Robab Davar, Sepideh Miraj, Maryam Farid Mojtahedi1,
Volume 14, Issue 1 (1-2016)
Abstract
Background: Embryo implantation process is a complex phenomenon and depends on fetal and maternal factors interaction. Endometrial thickness is needed for successful implantation.
Objective: We designed this study in order to assess adding human chorionic gonadotropin (HCG) to the conventional protocol in endometrial preparation in women with thin endometrium and a history of in vitro fertilization–embryo transfer (IVF-ET) failure.
Materials and Methods: The non-randomized clinical trial study (quasi experimental design) was performed on 28 patients. Participants were women who were candidate for frozen-thawed (ET) and had two previous failed ET cycles because of thin endometrial. HCG was administrated (150 IU, intramuscular) from the 8th day of cycle and when endometrial thickness reached at least 7mm HCG was discontinued and frozen thawed ET was done.
Results: Totally 28 patients were included. The mean ± SD age of participants was 30.39±4.7. The mean of endometrium thickness before and after HCG were 5.07±0.43 and 7.85±0.52, respectively p<0.001. Also, there were five clinically and chemically pregnant women.
Conclusion: The findings of the study suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium.
Zahra Basirat, Hajar Adib Rad, Sedigheh Esmailzadeh, Seyed Gholam Ali Jorsaraei, Karimollah Hajian- Tilaki, Hajar Pasha, Faeze Ghofrani,
Volume 14, Issue 1 (1-2016)
Abstract
Background: The use of assisted reproductive technology (ART) is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection (ICSI), single fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET).
Objective: The objective of this study was to compare pregnancy rate in fresh ET and FET.
Materials and Methods: In this retrospective cross-sectional study 1014 ICSI-ET cycles (426 fresh ET and 588 FET) from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed.
Results: There were no significant differences between biochemical pregnancy rate (23% versus 18.8%, OR 1.301; 95% CI .95-1.774), gestational sac (95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67), and fetal heart activity (87.2% versus 93.6% OR .46; 95% CI .16-1.32) in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures.
Conclusion: Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET.
Ali Aflatoonian, Mohammad Ali Karimzadeh Maybodi, Nastaran Aflatoonian, Nasim Tabibnejad, Mohammad Hossein Amir-Arjmand, Mehrdad Soleimani, Behrouz Aflatoonian, Abbas Aflatoonian,
Volume 14, Issue 3 (3-2016)
Abstract
Background: Despite of higher pregnancy rate after frozen embryo transfer (FET) which is accepted by the majority of researches, the safety of this method and its effect on neonatal outcome is still under debate.
Objective: The aim of this study was to evaluate pregnancy and neonatal outcome of FET compare to fresh cycles.
Materials and Methods: In this study,1134 patients using fresh ET and 285 women underwent FET were investigated regarding live birth as primary outcome and gestational age, birth weight, gender, multiple status, ectopic pregnancy, still birth and pregnancy loss as secondary outcomes.
Results: Our results showed that there is no difference between FET and fresh cycles regarding live birth (65.6% vs. 70.4% respectively). Ectopic pregnancy, still birth and abortion were similar in both groups. The mean gestational age was significantly lower among singletons in FET group compared to fresh cycles (p=0.047). Prematurity was significantly elevated among singleton infants in FET group (19.6%) in comparison to neonates born after fresh ET (12.8%) (p=0.037).
Conclusion: It seems that there is no major difference regarding perinatal outcome between fresh and frozen embryo transfer. Although, live birth is slightly increased in fresh cycles and prematurity was significantly increased among singleton infants in FET group.
