Comparison of short and long ovulation induction protocols used in ART applications according to the ovarian response and outcome of pregnancy

PubMed ID: 11998967This retrospective study was designed to determine whether there is any difference between short and long protocol ovulation induction with Gonadotropin Releasing Hormone agonist (GnRHa) and gonadotropins used in Assisted Reproductive Technology (ART) applications according to the number of retrieved oocytes, oocyte maturity, fertilization rates, embryo quality and the outcome of pregnancies. 240 cycles consisting of in vitro fertilization (IVF) cycles without andrologic factor and intracytoplasmic sperm injection (ICSI) cycles were evaluated. 112 cycles which were induced by short protocol GnRHa and Follicle Stimulating Hormone (FSH) + Human Menopausal Gonadotropin (HMG) combinations and 128 cycles which were induced by long protocol GnRHa and FSH + HMG combinations were compared according to the number of retrieved oocytes, cancellation rate of cycles, oocyte maturity, fertilization rates, embryo quality and pregnancy rates. The cancellation rate for short protocol cycles were found to be significantly higher than those with long protocol. The number of retrieved oocytes, mature oocytes and fertilized oocytes were also found significantly lower. The quality of embryos did not show any significant difference between these groups. The clinical pregnancy rates were evidently found to be high in the long protocol cycles. As a conclusion we have found that while the number of retrieved oocytes, mature oocytes, fertilized oocytes and clinical pregnancy rates were increasing, the cancellation rate of cycles were decreasing significantly in ART cycles induced by long protocol

Gluteal artery pseudoaneurysm, a rare cause of sciatic pain: Case report and literature review

PubMed ID: 12177552This article describes a very unusual case of sciatic pain and motor dysfunction resulting from gluteal artery pseudoaneurysm, A 36-year-old woman with primary infertility sustained an iatrogenic injury to her left gluteal artery during transvaginal ultrasound-guided follicle aspiration. Twenty-five days after the procedure she developed severe left sciatic pain and motor dysfunction. Pelvic computed tomography and magnetic resonance imaging revealed a huge pelvic hematoma. Angiography demonstrated a gluteal artery pseudoaneurysm. Because endovascular occlusion of the aneurysm did not relieve the pain, the patient underwent surgery for evacuation of the hematoma and release of the lumbosacral plexus, This eliminated all her sciatic pain and restored her motor dysfunction completely, The English literature details only five other cases of sciatic pain resulting from gluteal artery aneurysm, and these reports are also discussed

Relationship of follicle number, serum estradiol level, and other factors to clinical pregnancy rate in gonadotropin-induced intrauterine insemination cycles

PubMed ID: 11998958Objective: To determine the characteristics associated with clinical pregnancy rate after gonadotropin-induced intrauterine insemination cycles in patients without male or tubal factor infertility. Materials and methods: One hundred and eighty patients undergoing controlled ovarian hyperstimulation followed by intrauterine insemination were included in the study retrospectively. The patients' files were retrospectively evaluated with respect to age, number of follicles, endometrial thickness and serum hormone levels at baseline and at the day of human chorionic gonadotropin (hCG) administration. The patients with male or unilateral tubal factor infertility were excluded from the study. Results: The serum estradiol level at the day of hCG administration was not correlated with the clinical pregnancy rate (r=-0.05, p=0.481). The number of follicles was not correlated with the clinical pregnancy rate (r=-0.09, p=0.209). There was no significant difference between the clinically pregnants (n=32) and not pregnants (n=148) regarding the mean age, baseline serum levels of luteinizing hormone (LH) and estradiol, serum estradiol and LH levels at the day of hCG administration and endometrial thickness (p>0.05). Although not statistically significant, a pregnancy rate of 14.2% with less than 3 follicles ?18 mm is present compared to a pregnancy rate of 27.5% with at least 3 follicles ?18 mm and 24% with ?4 follicles ?18 mm. Conclusion: The clinical pregnancy rate does not seem to be affected with the number of follicles present at the time of intrauterine insemination or the serum estradiol level at the day of hCG administration in a controlled ovarian hyperstimulation cycle in non-andrologic and non-peritubal factor infertility; however, there is a clear trend towards higher pregnancy rates with higher number of follicles