Background: To evaluate the effect of fragment removal and coarse granulation removal from the perivitelline space (cosmetic microsurgery) on RATES of IMPLANTATION and pregnancy in patients with a history of IMPLANTATION failure. Methods: Thirty intracytoplasmic sperm injection cycles with etiology of male factor and history of IMPLANTATION failure were included in this prospective randomized study. The patients were divided into three groups of experiment (n=10), sham (n=10) and control (n=10). Embryos with ≥ 10% and ≤ 50% were entered the study. In the experiment group, fragments and coarse granules were removed from embryos before transfer into the uterus. In the sham group, laser assisted zona hatching was performed and in the control group no intervention was done. IMPLANTATION and pregnancy RATES were compared between different groups. SPSS was used for data analysis. One-way ANOVA and Kruskal-Wallis tests were used for evaluating numerical data and categorical data were compared between the groups using chi-square test. Results: No significant differences were seen in terms of age, duration of infertility, serum estradiol, LH, FSH, ovulation induction protocol between the three groups. Also, the number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, embryo formation rate and transferred embryos were similar between groups. Fragments pattern (localized or diffused), size and degree of embryo fragmentation (14. 5± 4. 9%, 24. 6± 5. 6% and 21. 5± 4. 3%, in experiment, sham and control groups respectively) were similar between groups. However, the RATES of IMPLANTATION and clinical pregnancy in the experiment group (35% and 70%, respectively) were significantly higher compared with the sham (10% and 30. 8%, respectively) and control (0% and 0%, respectively) groups (p<0. 0001). Conclusion: The cosmetic micromanipulation of human embryos at the cleavage stage improves RATES of IMPLANTATION and pregnancy in patients with previous history of failed IMPLANTATION.

Purpose: Determining the effect of progesterone on the embryo quality (total cell number and diameter of blastocyst), survival and IMPLANTATION RATES of mouse blastocyst with or without ovarian stimulation.Materials and Methods: Female 6-10 weeks old NMRI mice were divided into four groups as follows: (a) Non-stimulated pregnant mice as control (b) Non-stimulated pregnant mice with daily injection of progesterone 1) mg/mouse subcutainly after natural mating), (c) Stimulated pregnant mice that superovulated with an intraperitoneal injection of 10IU pregnant mare's serum gonadotrophin (PMSG), followed 48h later by another intraperitoneal injection of 10IU human chorionic gonadotrophin hormone (hCG), (d) Stimulated pregnant mice with injection of progesterone (1 mg/mouse subcutainly after hCG injection). All four groups were pregnant using natural mating. To collect the blastocyst, almost 17 pregnant mice in every four groups were sacrificed by cervical dislocation on day 4 of pregnancy. The total number of normal blastocyst and degenerated embryos were recorded. Also in other part of the study the IMPLANTATION site were observed on day 7 of pregnancy in each group (near 15 pregnant mice) and compared with total number of blastocyst. Diameter of blastocyst was measured using calibrated eyepiece. After blastocyst staining with propidium iodide. The total cell numbers of blastocyst were counted.Results: The findings of this study showed that the survival and IMPLANTATION RATES of blastocyst in non-stimulated, non-stimulated with progesterone injection, hyperstimulated and hyperstimulated with progesterone injected groups were (92.25%-80.99%), (97.68%-92.06%), (85.17%-39.72%) and (87.25%-41.2%) respectively. The total cell numbers of blastocyst in studied groups were 87.37±1.4, 112±0.7, 128.62±1.3 and 126.88±1.6 respectively. There was significant differences in blastocyst survival and IMPLANTATION RATES in progesterone treated group (group 2) in comparison with the other group (p<0.05). Comparing the total cell numbers of blastocysts in studied groups, there was a statistical significatn increasing rate in both hyperstimulated grouops (p<0.001).Conclusion: The progesterone injection without ovarian induction could improve the IMPLANTATION rate and embryo survival in comparison with the hyperstimulated groups.

Purpose: To determine the effects of different doses of addition of exogenous epidermal growth factor (EGF) on development of pre-IMPLANTATION mouse embryo.Materials and Methods: Mouse zygotes, two cell, 8 cell any morulae were collected from superovulated NMRI mice 24, 48, 64 and 80 hrs after hCG injection, respectively. The obtained embryos were cultured on medium alone, medium with 1, 4 and 10 ng/ml of EGF and recorded daily for 96 hrs. The blastulation and hatching RATES of every group were compared statistically using Chi-square Test.Results: The results showed that exogenous EGF could not help zygotes to overcome on developmental block. Also, the cleavage rate to two cell stage of treated zygotes were lower than non-treated zygotes. The hatching RATES of two cell embryos treated with different doses of EGF and non-treated were almost identical. The hatching RATES of eight cell and morula embryos treated with 10 ng/ml of EGF were significantly higher than other doses and control embryos.Conclusion: Exogenous EGF can improve pre-IMPLANTATION embryo development after eight cell stage but it can not affect the development of the stages before eight cell.

Introduction: Despite the improvements in assisted reproductive technologies, ART Process is with a low successing rate. There are two major determinants of IMPLANTATION: embryos and the endometrium. Although progesterone secretion is considered the major hormonal event during the luteal phase, E2 appears to play a crucial role as well.Methods: Patients who were undergoing ICSI with controlled ovarian hyperstimulation using a GnRH analog participated in the study. Patients were prospectively randomized into two groups for luteal phase supplementation. Patient's in-group I did not receive exgenouse E2 supplementation during the luteal phase. Patient's in-group 2 received 2mg of E2 polbid that starting on day 3 after E.T.serum concentrations of E2 and progesterone were measured in all patients on day HCG injection and on day 12 after E. T. pregnancy and IMPLANTATION rate were documented. Student's ttest and Fisher's exact were used for the statistical analysis of the date.Results: Higher E2 and progesterone levels found during the luteal phase and higher pregnancy rate were recorded in the patients who receive E2 supplementation and were treated with the long GnRH analog protocol.Conclusion (s): The results of this study indicate the patients who are treated with the long GnRH analong protocol for controlled ovarian hyperstimulation, the addition of E2 to the progestin support regime may have a beneficial effect on pregnancy rate.

Background: Considering the considerable influence of the vaginal microbiome on endometrial receptivity and embryo IMPLANTATION, we hypothesized that cases of recurrent IMPLANTATION failure (RIF) might benefit from the intravaginal probiotic administration. Objective: Evaluation of the effects of intravaginal probiotic administration before frozen embryo transfer (FET) on the RATES of pregnancy and the status of vaginal lactobacillary flora in cases of RIF. Materials and Methods: This was a randomized, parallel-group, clinical trial conducted at an infertility clinic in Tehran, Iran between January 2021 and September 2022. A total of 166 reproductive-aged women with a history of unexplained RIF were randomly assigned to either the probiotic group or the control group (n = 83/each group). The probiotic group received intravaginal probiotics (LactoVag®) daily for 2 wk from the second day of the menstrual cycle along with the routine treatment of FET. The control group received only the routine treatment of FET. The primary outcome was the chemical pregnancy rate, and the secondary outcomes were the clinical pregnancy rate and the status of vaginal lactobacillary flora. Results: A total of 163 participants were included in the final analysis. The probiotic group had a slightly higher chemical pregnancy rate than the control group (39.02% vs. 33.33%), but the difference was not statistically significant (risk ratio: 1.71, 95% CI: 0.77-1.76; p = 0.449). The clinical pregnancy rate was also non-significantly higher in the probiotic group than the control group (37.80% vs 33.33%; RR: 1.14, 95% CI: 0.76-1.74; p = 0.623). Conclusion: Intravaginal probiotic administration did not significantly improve the pregnancy RATES in RIF cases undergoing FET. Further studies are needed to explore the optimal dose, duration, and timing of probiotic administration, as well as the mechanisms of action and the potential adverse effects of probiotics on the vaginal microbiome and the IMPLANTATION process.

Background: Refractive surgery is the most rapidly evolving issue in ophthalmology. In this study, we compared the effect of two phakic intraocular lenses, Artisan and Artiflex, in refractive surgery.Methods: In a prospective clinical trial studyd 58 eyes of 29 patients with high myopia were treated by phakic intraocular lenses. Artiflex lens was used in 24 eyes and Artisan lens in 34 eyes. Patients were followed up for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and refraction were assessed in both groups.Findings: Artiflex lens had better visual outcomes, but the difference with Artisan lens was only significant in first two months of follow-up. After 6 months, both groups had similar visual outcomes.Although astigmatism was greater in Artisan group in first three months, refraction in both groups was stable after 6 months and the results were not significantly different between the groups. Adverse reaction was not noticed.Conclusion: Artisan and Artiflex had similar long-term outcomes but refraction and vision establishment occur in a shorter period in Artiflex lenses.

Vascularization of the follicle may play a role in its maturation and aspirin seems to increase this Vascularization. In this investigation we have studied the effects of low-dose aspirin on ovarian and uterine response, IMPLANTATION and pregnancy RATES in patients undergoing intracytoplasmic sperm injection (ICSI). This prospective semirandomized, double-blind, placebo-controlled study was undertaken in Mirza Kochek khan IVF center. forty four infertile patients who were undergoing ICSI cycle were studied and they were divided in two groups. The mean age of patients and distribution of the cause of infertility in two groups were similar. In the treatment group, 22 patients underwent controlled ovarian hyperstimulation and received a daily dose of 100 mg aspirin. In the control group 22 patients underwent controlled ovarian hyperstimulation in association with placebo. Number of follicles > 15 mm in diameter, number of oocytes retrieved, endometrial thickness, cancellation rate, number of transferred embryos and IMPLANTATION and pregnancy RATES were analyzed in two groups. There was no statistically significant difference between the treatment and control groups for each of the above variables (p>0.05). The study showed that low dose aspirin therapy has no added effect to ovarian and uterine response, IMPLANTATION and pregnancy RATES in ICSI patients. further studies are recommended for confirmation of our results.

Background: Granulocyte colony stimulating factor (GCSF) has been introduced as an immunomodulatory agent by increasing IMPLANTATION rate in vitro fertilization (IVF) patients but it has not been studied in intrauterine insemination (IUI) patients. The aim of this study is to answer the role of GCSF in IMPLANTATION rate of IUI. Materials and Methods: In this prospective double-blind randomized control trial, 320 eligible patients were enrolled, who were referred to the referral infertility clinic of Shiraz University of Medical Sciences from February 2018 till the end of 2019. They were divided into two groups randomly. After collecting the demographic data, all patients received clomiphene citrate from the 5th day of the menstruation cycle for 5 days. 50-150 units of recombinant purified follicle-stimulating factor (FSH) were started from the 8th day of the cycle. Follicle monitoring was done by transvaginal sonography till a mature follicle of 18 mm or more was developed. Human chorionic gonadotropin (HCG) injection was done in both groups with intrauterine administration of 300 μ, g GCSF in the case group and normal saline in the control group simultaneously. After 36 hours, IUI was performed. The clinical pregnancy, miscarriage, and ongoing pregnancy RATES of both groups were calculated by SPSS software. Results: The results showed improvement of clinical pregnancy rate [15. 38% vs. 13. 81% OR=1. 17 (0. 62-2. 21)], miscarriage rate [3. 84% vs. 5. 26% OR=0. 74 (0. 25-2. 20)] and ongoing pregnancy rate [11. 53% vs. 8. 55% OR=1. 37 (0. 65-2. 92)] in the GCSF group compared to the control. However, the results revealed no statistically significance (P>0. 05). Conclusion: Although it was not statistically significant, 300 μ, g Intrauterine GCSF administration simultaneously with hCG injection in standard IUI procedure might increase the pregnancy outcomes. Further studies are warranted (registration number: IRCT201212079281N2).