Success of frozen embryo transfer: Does the type of gonadotropin influence the outcome?

Hesham Al-Inany1, Pieter van Gelder21Egyptian IVF-ET Center, Maadi, Egypt; 2PSCT BV, Den Haag, The NetherlandsObjectives: To determine whether there is a difference in outcome between different ovulationinduced cycles after frozen-thawed embryo transfer (FET).Methods: We searched the Cochrane Menstrual Disorders and Subfertility Group’s trials register in May 2009, the Cochrane Central Register of Controlled Trials (Cochrane Library, Issue 1, 2008), ISI Web of Knowledge (1985 to August 2009), and reference lists of articles. Relevant conference proceedings were hand-searched and researchers in the field were contacted. Randomized controlled trials and retrospective studies were included, comparing the various cycle regimens and different methods during FET in assisted reproductive technology, ie, in vitro fertilization and intracytoplasmic sperm injection.Results: Using the agonist long protocol for downregulation, five trials provided extractable data for live-birth rates, ongoing pregnancy, and clinical pregnancy rates following FET. One trial provided extractable data for clinical pregnancy rate. There was no evidence of a significant difference in any outcome between the users of urinary gonadotropins versus recombinant follicle-stimulating hormone. Data on implantation and miscarriage rates following FET were not available for analysis.Conclusions: It seems that clinical pregnancy rate after FET is not influenced by the type of gonadotropins used. Research should be directed towards improving freezing and thawing techniques.Keywords: infertility, assisted reproductive technology, frozen embryo transfer, gonadotropin

OPINION - Current state of intrauterine contraceptive devices

Background: Intrauterine contraceptive device (IUCD) is the most commonly used method of contraception in many countries. Despite the availability of many generations of IUDs with variable shapes and configurations, side effects and complications are frequent. We hypothesize that a modified IUD design with a fundal seeking effect will nullify the side effects and the complications of the currently available IUDs. Such a design will be at least as effective as the traditional copper devices without their well-known disadvantages. This simple modification of the IUD shape will add to the acceptability of this method even in communities with known preferences to other alternatives