Search

Purpose: To evaluate the outcome of women with hypogonadotropic hypogonadism undergoing in-vitro fertilization (IVF)., Methods: We retrospectively assessed outcomes in 58 women with hypogonadotropic hypogonadism (HH) and, as matched controls, in 116 women with tubal factor (TF) infertility who underwent assisted reproduction treatment (ART). For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and a combination of hMG and gonadotropin releasing hormone (GnRH) agonist was used in TF patients. Conception and implantation rates, as well as duration of stimulation and number of oocytes retrieved, were the main outcome measures., Results: Of the 58 HH patients, 53 (91.3%) responded adequately to ovulation induction and underwent ET. A larger amount of gonadotropins and a longer duration of ovarian stimulation were needed in HH patients than in TF patients. The mean number of retrieved oocytes and implantation rates did not differ between the groups. In addition, there were no differences between the HH and TF groups in pregnancy (53.8 vs. 48.6%) and multiple pregnancy (63.4 vs. 48.4%) rates. In the HH group, the miscarriage rate was 3.4%, and none of these patients developed severe OHSS., Conclusion: IVF in HH patients, in which there was a background of previous failed ovulation induction, was as successful as in women with TF infertility.

Background: The aim of the present study was to examine the impact of the presence of endometrial fluid (seen through ultrasound) on the outcome of IVF cycles and its association with the aetiology of infertility, in tubal and polycystic ovary syndrome (PCOS) cases specifically., Methods: We retrospectively evaluated the charts of all PCOS and tubal factor infertility patients that underwent IVF between June 1, 2001 and May 31, 2002. Twenty-four PCOS and 14 tubal factor infertility patients in whom endometrial fluid was detected were compared with 94 PCOS and 160 tubal factor patients whose stimulation cycles did not show any fluid collection. The main outcome measures were implantation and pregnancy rates., Results: Implantation rates were lower in the tubal factor patients in the presence of endometrial fluid (6.12% and 21.4%, respectively) in comparison with all other tubal factor infertile patients in whom no fluid accumulation inside the cavity was detected. In PCOS cycles there was no significance in patients with presence of endometrial fluid in comparison with the all other PCOS cycles without any fluid accumulation., Conclusions: When fluid collection inside the endometrial cavity is first seen during ovarian stimulation of PCOS patients undergoing IVF, embryo transfer can be performed safely if the fluid has disappeared and not returned by the day of embryo transfer. However, in tubal factor cycles one should think of either cancellation of the cycle or cryopreservation of all embryos.

Objective: To compare the outcome of using gonadotropin-releasing hormone (GnRH) antagonists versus agonists in women with polycystic ovary disease (PCOD) who underwent controlled ovarian hyperstimulation (COH) for assisted reproductive techniques (ART)., Study Design: A total of 129 patients with PCOD were randomly allocated to undergo COH with a GnRH antagonist (59 patients) and GnRH agonist (leuprolide acetate) (70 patients) to prevent a premature luteinizing hormone (LH) surge. Assisted fertilization following oocyte retrieval and embryo transfer was performed., Results: None of the cycles were cancelled due to a premature LH surge. There was no significant difference between the antagonist and agonist arms in the number of gonadotropin ampules consumed per cycle. However, in the antagonist arm a shorter duration of ovarian stimulation was recorded as compared to the agonist arm. Although similar numbers of oocytes was retrieved from both groups of patients, the quality of the oocytes, as measured by metaphase 2/total oocyte ratio, was lower in the antagonist arm as compared to the agonist arm. Pregnancy rates were 57.6% and 58.5% in the antagonist and agonist arms, respectively (p > 0.05). Implantation rates were not different (34.0% and 34.6%, respectively). The frequency of ovarian hyperstimulation syndrome also did not differ between the treatment groups (5% and 7.1%, respectively)., Conclusion: The size of our study, on a specific subgroup of patients, does not allow a reliable conclusion regarding ART outcomefollowing the use of a GnRH antagonist versus agonist. Nevertheless, the protocol with the antagonist gave results that were as good as those of the protocol with the agonist in this PCOD patient population.

Objective: To report the birth of a healthy female infant from a father with nonmosaic Klinefelter syndrome (KS) and document the experience of men with KS undergoing assisted conception., Design: Retrospective., Setting: Private IVF center., Patient(s): Twelve couples with male factor infertility due to Klinefelter syndrome undergoing assisted reproduction treatment., Intervention(s): Controlled ovarian hyperstimulation, testicular sperm extraction, intracytoplasmic sperm injection (ICSI), round spermatid injection (ROSI), and preimplantation genetic diagnosis., Main Outcome Measure(s): Testicular sperm retrieval rate, fertilization rate, and pregnancy outcome., Result(s): There was a sufficient amount of motile sperm for injection into mature oocytes in 6 of the 11 testicular biopsies (54.5%). Fertilization rates for ICSI and ROSI cases were 54.2% and 41.6%, respectively. The pregnancy rate per ET was 27.2%. None of the ROSI cases resulted in pregnancy. Two patients had spontaneous abortions at 8 and 18 weeks of gestation, respectively. Only one patient delivered a healthy female baby after 36 weeks of an uneventful pregnancy., Conclusion(s): Men with KS can benefit from assisted reproductive technologies, and the testicular sperm retrieval rate among them is promising. Although sex chromosome aberrations among the embryos from men with KS are not common, couples can be offered preimplantation genetic diagnosis before ET.

Objective: In this retrospective study, we analyzed the in vitro fertilization (IVF) clinical and laboratory outcome of cryptozoospermia cases compared to the extremely severe oligospermia cases in a single IVF center. Materials and Methods: All the IVF laboratory and clinical outcomes of cryptozoospermia and extremely severe oligospermia cases were analyzed and compared between January 2014 and December 2019 in Istanbul Florence Nightingale IVF Center. The same reproductive group treated all couples. Virtual azoospermia or cryptozoospermia were diagnosed once the mature sperm cells could be recognized after centrifugation (group 1). Patients without motile sperm were excluded. Extremely severe oligospermia was defined as a sperm count was less than <1 mil/mL (group 2). The study consisted of 33 virtual azoospermic patients with 40 cycles, whereas there were 40 severely oligospermic patients with 45 cycles. All patients underwent the intracytoplasmic sperm injection (ICSI) procedure and all the embryos were let to grow until the blastocyst stage on day 5. Groups were compared for clinical and laboratory reproductive outcome. Results: Both the median maternal and paternal ages were similar. All outcomes including fertilization rates, blastulation rates, clinical pregnancy and delivery rates were comparable. The miscarriage rates did not also show any statistical difference. Conclusion: Reproductive outcomes in cryptozoospermic IVF patients are comparable to those of extremely severe oligospermic patients provided that the ICSI is performed using motile spermatozoa. Our results favor using sperm from fresh ejaculate rather than surgical sperm retrieval when motile sperm is available in cryptozoospermic IVF patients. [ABSTRACT FROM AUTHOR]

The management of poor responders in IVF has always been a big problem. The ideal approach has yet to be formulated. In this study we aim to compare two alternative stimulation protocols. A total of 48 poor responder patients described from previous cycles were included and grouped into two: group I consisted of 24 patients in 24 cycles in which leuprolide acetate (40 microg s.c. per day) was initiated on cycle day 2 followed by exogenous gonadotrophins on cycle day 3; group II consisted of 24 patients in 24 cycles in which ovarian stimulation included gonadotrophin-releasing hormone (GnRH) antagonist (cetrorelix, 0.25 mg daily during late follicular phase) administration. While only the oestradiol concentrations on the day of HCG were lower in group II compared with group I, the clinical pregnancy and implantation rates among groups did not show any significance. The impact of these two regimens in ovarian stimulation of poor responders seem to be same and to establish these results further randomized studies with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

: ObjectiveTo report a case of cervical heterotopic pregnancy after IVF-ET treatment.: DesignCase report.: SettingPrivate IVF center.: Patient(s)A woman who had undergone controlled ovarian hyperstimulation and intracytoplasmic sperm injection–ET for primary male factor infertility.: Intervention(s)Resection of cervical heterotopic pregnancy by hysteroscopy.: Main outcome measure(s)Successful treatment of heterotopic cervical pregnancy.: Result(s)A successful pregnancy resulting in a term baby.: Conclusion(s)Hysteroscopic resection can be used to treat a cervical heterotopic pregnancy. [Copyright &y& Elsevier]

Presents a study that analyzed the outcome of assisted reproduction treatment in poor responder patients who elect to undergo oocyte retrieval. Problem concerning poor response to ovarian stimulation for assisted reproduction treatment; Factors that affect poor ovarian response; Materials and methods used in the study; Results and discussion.