Marzieh Mehrafza, Azadeh Raoufi, Parvaneh Abdollahian, Zahra Nikpouri, Mehri Nasiri, Ahmad Hosseini,
Volume 71, Issue 8 (11-2013)
Abstract
Background: Polycystic ovarian syndrome (PCOS) is the most common endocrinological disorders that affect approximately 5-7% of women in reproductive age. There is not any consensus about the efficient in vitro fertilization (IVF) protocol for patients with PCOS. The aim of the present study was to compare the half and one-third dose depot gonadotropin-releasing hormone (GnRH) agonist protocols versus the GnRH antagonist protocol in PCOS patients.
Methods: In the present study, we retrospectively evaluated 119 infertile women with PCOS. The patients entered in the study in accordance with Rotterdam criteria. According to GnRH analogue used for pituitary suppression, patients were divided into three groups: half and one-third dose depot GnRH agonist protocols and GnRH antagonist protocol. In GnRH agonist protocol, half or one-third dose depot Decapeptyl (1.875 mg, 1.25 mg) was injected on 21st day of previous cycle. In GnRH antagonist cycles, cetrotide 0.25 mg were administered daily when the leading follicles reached 14 mm. All basal and controlled ovarian hyperstimulation (COH) characteristics were analyzed.
Results: Basal characteristics including: age, FBS, prolactin, hirsutism, length of menstrual cycle were similar between 3 groups. Statically significant decreases in days of stimulation, number of gonadotrophin ampoules and metaphase II (MII) oocytes were found in GnRH antagonist protocol (P<0.001, P<0.001 and P=0.045), while the decrease in biochemical pregnancy (P=0.083) and live birth rate (P=0.169) wasn't significant. Number of embryos transferred were similar in the half and one-third dose depot GnRH agonist and GnRH antagonist cycles (P=0.881). The incidence of OHSS weren't significantly different between 3 groups (5%, 4.9% and 12.8%, P=0.308).
Conclusion: Our study suggest that one-third dose depot GnRH agonist protocol could be a suitable choice for treatment of PCOS because of lower incidence of ovarian hyperstimulation syndrome (OHSS) as compared with half dose depot GnRH agonist and higher pregnancy rate as compared with GnRH antagonist.
Elham Naghshineh, Minoo Movahedi , Hatav Tehrani , Maryam Hajhashemi , Ferdows Mehrabian, Fatemeh Jahani, Fedyeh Haghollahi,
Volume 79, Issue 12 (3-2022)
Abstract
Background: Assisted reproductive techniques have increased the chances of pregnancy for couples looking for a way to treat their infertility. To increase the effectiveness of these methods, studies are needed to identify the determinants of a successful pregnancy with these techniques.
Methods: The present study is a cross-sectional retrospective study that was performed on 253 couples who were referred for infertility treatment to the infertility clinic of Shahid Beheshti Hospital in Isfahan from April 2019 to March 2020 to evaluate the results of pregnancy in vitro fertilization. Demographic, clinical, and laboratory data from patient records were collected and entered into checklists.
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Results: Out of 253 couples, eighty-five (33.6%) became pregnant by IVF. The mean age of women with successful pregnancies was 33.96±5.2 years and in the unsuccessful pregnancies was 35.84±5.07 years. The results of this study showed that women who had a successful pregnancy after IVF were significantly younger than women who did not have a successful pregnancy (P=0.006). In the classification of patients into two groups of positive and negative pregnancies, younger age, adequate vitamin D levels, and higher sperm motility were the determinants of pregnancy in the first period of fertilization (Fresh protocol). Also, the existence of a failed history of infertility treatment in couples has been introduced as a negative factor for IVF fertility. 13(15.9%) abortions occurred and 11(12.9%) infants who were born with this method needed intensive care.
Conclusion: Lower age at the time of fertilization, higher vitamin D levels, and more active sperms were found to have important and prognostic roles in the success of pregnancy by in vitro fertilization technique.
The results of the present study showed that, Increased unsuccessful treatment has been associated with the history of failed treatment. Therefore, to respond to the relationship between previous infertility treatments and success in subsequent pregnancies in the IVF process, It is recommended to conduct studies with larger sample size and at a higher time efficiency.
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