Background: Endometriosis is defined as the existence of endometrial glands and stroma outside the uterine cavity. This disease is responsible for about 15% of the indications for assisted reproductive technologies (ART). Materials and Methods: This study is a retrospective cross-sectional study on 1382 women aged 18-42 who underwent ART in Yazd Reproductive Sciences Institute during 2018-2022. Women were divided into two groups: women with endometriosis (N = 173) and women with a tubal factor or unexplained infertility as the control group (N = 1209). Chemical and clinical pregnancy rates and live birth rates were compared. Results: Women with endometriosis had significantly (P < 0. 001) lower retrieved oocytes (7. 73 ± 5. 52 vs 11. 53 ± 7. 46), metaphase II oocytes (6. 27 ± 4. 72 vs 9. 37 ± 6. 62), and the total number of obtained embryos (3. 95 ± 3. 52 vs 6. 13 ± 5. 02). Chemical (P = 0. 001) and clinical (P = 0. 028) pregnancy rates were lower in women with endometriosis, while live birth rates showed no difference between the two groups (P = 0. 069). Conclusion: The findings of this study showed that endometriosis can disturb reproductive outcomes after ART.

When treating infertile couples by assisted reproductive technologies (ART), all aspects of their care in individual clinics should be evaluated frequently. Results should then be compared with other clinics offering similar treatment. Evaluation of possible adverse long-term outcomes can be achieved by pooling results from individual clinics in national, regional and international registers and other data systems.As large numbers of infertile women have been treated by ART, it is not surprising that diseases such as cancer and other chronic diseases will be reported in some of these women and in their children. Relatively few studies have systematically evaluated any possible risk of cancer of the female reproductive tract, breast cancer and other diseases among women treated by ART.In a Swedish study based on national IVF data linked to the Swedish Cancer Register, women treated by IVF had a slightly higher risk of cancer before being treated, especially a higher risk of ovarian cancer. The risk of cancer after IVF was slightly reduced, mainly due to a lower risk of breast and cervical cancer.In another similar Swedish study, cancer in children and young adults was slightly more common among those conceived by IVF. The risk of one rare type of cancer, histiocytosis, was found be higher after IVF. However, the overall incidence of cancer in this younger age group is much less than in their mothers so other studies are needed to determine whether these results are replicated.The increased risk of cerebral palsy and other neurological impairment after ART seems to be due to the higher risk of preterm birth and multiple births in these pregnancies. Some of these adverse outcomes can be avoided by reducing the incidence of multiple births.Evaluating whether ART causes any increased risk of other diseases requires further careful analysis of data from many sources, sometimes combining data from national health registers in several countries. Such studies are needed to ensure that the safety of new modes of treatment is adequately monitored.

Worldwide more than 70 million couples suffer from infertility. Human fertility rates have declined all over the world, including both developed and developing countries. Infertility is a distressing issue for the couples and their families and even impacts on the local community. According to the World Health Organization (WHO), infertility is a global health problem and its negative psychological consequences of childlessness are common and often severe. Thus, the decreasing trends in fertility rates in many countries are now remarkable that necessitate for more scientific attention. Several factors influence fertility decline that some of these factors are unknown. It is generally assumed that these declining trends are due to social and economic factors such as woman’s working careers, their education and better contraception. One of these factors is age and an age-related decline in fertility is observed in natural fertility and also artificial insemination. The decreasing usually starts at 32 years and a marked decline in fecundity and fertility rates occurs in women older than 35 years.It seems one of factors that may be contribute to this trend is a general lack of knowledge about the decline in fertility with age. Recently, it has been shown a 13% increase in the use of assisted reproduction technology (ART) services. Increasing female age decreases the chance of live birth rates achieved using ART and ageing has negative impact on ART outcome, especially after 40 years of age. Even some IVF centers refuse women over the age of 40 years because of the natural decline in fertility with age and the higher incidence of genetic anomalies in infants of these women. Age is perhaps the single most important factor in assessing an ovarian reserve. Moreover, several indirect biomarkers have been recognized to assess ovarian reserve. Some of these factors include: Follicle Stimulating Hormone (FSH): In women with a decreased ovarian reserve, through the feedback mechanism, low levels of inhibin B cause high levels of serum FSH in the early follicular phase. FSH levels higher than 20 mIU/ml are related to poor pregnancy outcomes. Although elevated levels of basal FSH predict a lower oocytes number and poor IVF success, it is better to be used from elevated basal FSH in counseling couples prior to ART but should not be used to cancellation of ART procedures.Anti-Mullerian Hormone (AMH): AMH is produced by granulose cells from pre-antral and antral follicles. Serum AMH levels essentially reflect the ovarian follicular pool. AMH levels do not significantly change throughout the menstrual cycle and allow measurement any time of the cycle. Reduction in the number of small growing follicles, especially in the late reproductive period, may be followed by a reduction in serum AMH levels. Recently, clinical application of AMH levels measurement are proposed for the prediction of quantitative and qualitative ovarian response in assisted reproductive technologies (ART), although its role still has not been established. Thus, before proposing AMH measurement as ovarian reserve testing, it should be defined what is the aim of ovarian reserve testing.In conclusion age is the most important prognostic factors regarding fertility, in naturally and even with all of ART procedures. We recommend avoidance of delay in child bearing among high-educated females and increased knowledge about age-related decline fertility and it seems ovarian reserve tests are useful as prognostic tools but poor predictors of ART outcomes.

Introduction: Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years.Objective: This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy.Materials and Methods: In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire.Results: Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score<7, NICU hospitalization, mortality, respiratory distress, and icterus).Conclusion: With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.