International Journal of Fertility & Sterility
Year:2007 | Volume:1 | Issue:2|Papers Count:9

Background: The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate.Materials and Methods: We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 (582 patients) or on day 3 (387 patients) post-insemination over a 10 - month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed.Results: The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically& we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 (40.72%) than patients who had transferred on day 2 (38.96%), but this difference was not significant.proportion of embryos with 2-3 cells, four cells, and 5-7 cells, which selected for transfer, showed significant difference between day 2 and day 3 (p<0.05). There was also significant difference between pregnant and non-pregnant women based on embryo cell numbers on day two (p<0.011.(Conclusion: Extending the embryo culture period from 2 to 3 days had no adverse effect on pregnancy rate. Embryo transfer could be done on days 2 or 3 according to the convenience of the patient and the medical team.

Background: Levels of serum gonadotropins have direct effects on testicular functions and spermatogenesis. Assessment of levels of serum gonadotropins from fathered subjects and infertile patients indicates wide range diversity. In this study, we tried to find out whether the levels of seminal FSH and LH affect the parameters of seminal fluid analysis (SFA) and if there is any correlation between levels of serum FSH and LH in healthy men and infertile patients.Materials and Methods: Levels of FSH and LH in serum and seminal plasma were assessed randomly, in addition to examination of seminal fluid analysis from 12 normozoospermic subjects (age range: 33-56 years) and 66 infertile patients (age range: 20-62 years) with duration of infertility (15-201 months). Macroscopic and microscopic parameters of semen specimens were determined. Data were statistically analyzed using multiple correlation and regression, and MANOVA tests.Results: Result of the present study observed significant positive correlation between FSH levels in serum and seminal plasma (r=0.984; p<0.001) of normozoospermic subjects as compared to other groups of infertile patients. No correlations were noticed between LH levels in serum and seminal plasma of normozoospermic subjects and groups of infertile patients. Significant and positive correlation was assessed between sperm concentration and levels of seminal FSH (r=0.822; p<0.05 and r=0.940; p<0.01) and seminal LH (r=0.989; p<0.001 and r=0.999; p<0.001) of asthenozoospermic and OAT patients respectively. In asthenozoospermic patients, significant and positive correlations were observed between seminal FSH and percentages of sperm motility, progressive motility, sperm normal morphology and total progressive motile sperm/ejaculate.Conclusion: This study shows a strong association and effect between seminal FSH and serum FSH and parameters of SFA for normozoospermic men and different groups of infertile patients. These finding may call for large cohorts being executed with larger population of patients that is required for this analysis to be more accurate.

Background: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Evaluating the role of endometrial and sub-endometrial blood flows detected by color Doppler sonography at the day of embryo transfer, as a predictor of pregnancy rate during IVF/ICSI programs was our main goal in this study.Materials and Methods: Seventy three infertile patients aged <38 years with basal serum FSH level<12mIU/ml who had less than two failed attempts of ART cycles were prospectively evaluated. The cases with more than two failed IVF cycle and uterine disorders were excluded. All procedures were performed by one expert and two good quality embryos were transferred. Vaginal power color Doppler sonography was performed at the day of embryo transfer and endometrial characteristics including endometrial vascularization, area of vascularization distribution and pulsatility index were registered. Then pregnant and non-pregnant groups were compared for ultrasonographic parameters of endometrium.Results: Pregnancy occurred in 28 patients. Mean age, duration and etiology of infertility, baseline mean FSH and estradiol level at the day of Human chorionic gonadotropin (HCG) injection, amount of drug administered, number of retrieved oocytes and embryos, also number and quality of transferred embryos in the pregnant and non - pregnant groups showed no statistically significant difference .On the other hand, none of the sonographic parameters reported in two groups indicated a statistically significant difference.Conclusion: Doppler ultrasonographic indices at the day of embryo transfer are not considered appropriate criteria for prediction of success rate or failure of embryo implantation.

Background: With aging, the ovarian reserve is decreased and that is a major contributor to poor ovarian response to exogenous gonadotropins. The aim of the present study is to evaluate the role of Dexamethasone on ovarian response in infertile patients aged over 35 years undergoing IVF/ICSI cycles. Materials and Methods: In this triple blind placbo-control clinical trial study, a total of 72 infertile women over age 35, undergoing IVF/ICSI cycles, referred to Royan Institute from May 2000 to May 2002 were selected. Dexamethasone co-treatment (1mg/d) was started on the 21st of their preceding menstrual cycle and it was continued until oocyte aspiration. The main outcome measures were number of retrieved oocytes, number of fertilized and transferred embryos, number of used HMG, serum E2 level on HCG injection day, and pregnancy rate. Results: There was no significant statistical difference in age, duration of infertility, Body mass index, hormonal tests, number of retrieved oocytes and transferred embryos. However, the number of used HMG was significantly lower in Dexamethasone group compared to placebo group (30.6 ± 13.39 versus 41.64 ± 18.34) (p<0.05). Conclusion: The addition of dexamethasone 1mg/d to standard long protocol decreased the number of HMG used in patients over 35 years who hold known risk of low ovarian response.

Background: The present study offers our contribution on the topic by a retrospective analysis of the prevalence of chromosomal abnormalities in a population of Iranian infertile men attending assisted reproduction programs.Materials and Methods: Cytogenetic analysis was performed according to standard methods on cultured cells obtained from the patient peripheral blood. In all, 874 files belonging to male partner of each couple were classified as follows: azoospermic, oligozoospermic and patients with low sperm quality in respect of morphology and motility.Results: Chromosomal abnormalities were observed in 136 (15.5%) individuals of the whole population studied including 12.0 %, 1.2 % and 2.0% of azoospermic, oligozoospermic and patients with low sperm quality, respectively. Of those, 116 (13.2%) had sex chromosome abnormalities and 20 (2.3%) had autosomal chromosome abnormalities.Conclusion: We observed high frequency of aneuploidy and sex chromosomal mosaicism in azoospermic men and high structural aberrations in males with low sperm quality. We suggested that type of chromosomal abnormalities had an inverse relation to sperm count. So that, high chromosomal aneuploidy was detected in males with lower sperm count and high structural aberration was detected in males with low sperm quality. Chromosomal abnormalities are a major cause of male infertility. Consequently, Genetic testing and counseling is indicated for infertile men with abnormal semen parameters with either abnormal karyotype or normal karyotype before applying assisted reproductive techniques.

Background: The prevalence of infertility is about 10-15% among the couples overally. Several factors can affect fertility ability of men and women. Chlamydia is a non-motile gram negative obligatory interacellular pathogenic organism. It can cause infections in females as cervicitis, urethritis, endometritis, pelvic inflammatory disease also prostatitis and epidydidimitis in male as well. The aim of this survey is to mention the frequency of infection with Chlamydia in infertile female who were treated in Yazd Research & Clinical Center for Infertility.Materials and Methods: A questionnaire containing some demographic information and clinical features related to the infection was completed for each infertile woman. Specimen of vaginal discharge was collected by well trained nurses using sterile cotton swap from 91 women. Elisa test was done on blood serum. DNA extraction for Chlamydia was carried out using low salt method and PCR was done using MOMP and plasmid primers. DNA sequencing was performed on two PCR products using Chromas LITE ver.2.01 and analyzed by BLAST.Results: Of 91 blood samples collected in this survey, none of them was positive by ELISA. Also there was no positive PCR result. Four PCR products showed a questionable band which was not in the range of Chlamydia. The products underwent DNA sequencing and there were not any finding related to any other micro-organism.Conclusion: However, it is well known that Chlamydia as an infection plays a role in infertility. Nevertheless, there was not evidence of this organism in these infertile patients. It is necessary to design such a survey in larger populations of infertile patients especially on infertile women with tubal infertility and their husbands as well.

The aim of this report has been evaluating protamine content and DNA integrity of two patients with globozoospermia undergoing Intra Cytoplasmic Sperm Injection (ICSI).Semen analysis was carried out according to WHO criteria. Protamine deficiency and DNA fragmentation was assessed using Chromomycin A3 and sperm chromatin dispersion assay respectively. ICSI and chemical activation were carried out on inseminated oocyte.Both cases demonstrated high degrees of protamine deficiency, while one of the cases indicated high level of DNA fragmentation, too. High fertilization rates were achieved in both cases. However, embryo transfer did not lead to implantation or pregnancy.Artificial oocyte activation overcomes low fertilization rate reported in cases with high level of protamine deficiency. In the present study, failed implantation in one of the cases may be caused by high DNA fragmentation.

There is an increased risk of thromboembolism, anticoagulant-related hemorrhage, fetal-wastage and congestive cardiac failure in pregnant women with mechanical heart valves. In order to have a good outcome, the care of such patients must necessarily be multidisciplinary and in a well- equipped centre with adequate support services. One such patient who had mechanical mitral and aortic valves replacement in 2000 receiving warfarin anticoagulant therapy, presented with a first trimester pregnancy by ICSI method in 2006. She remained in stable homodynamic state and went through pregnancy without event. Delivery was done by caesarian section at 37 weeks gestation age.With considering use of warfarin during pregnancy, use of stimulation protocol during ICSI and delivering normal neonate ultimately, this interesting case is presented herein.

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