Does the number of prior oocyte retrieval practices increase the amount of blood loss in subsequent OPU procedures?

Background: Though OPU is a safe and simple procedure, it may cause damage to pelvic structures and bleeding. It is unclear whether history of a prior OPU poses any risk of increased blood loss in the OPU. We, herein, aimed to evaluate whether mean blood loss and hematologic parameters vary between women with and without the history of an OPU, in an unexplained infertility population.Methods: A prospective case-control study was conducted through the files of patients who underwent IVF/ICSI-ET between June and December 2013. Unexplained infertility patients with a CBC result were assigned to two groups; those undergoing OPU for the first time (Group 1, n=40) and those who were previously subjected to at least 1 procedure (Group 2, n=13). Blood samples were obtained before the ET. Hemoglobin values and changes were compared between the two groups.Results: Delta hemoglobin value did not significantly differ between the groups (p=0.469) and there were no significant difference between the pre- and post-procedure hemoglobin values in the patients with no and at least one OPUs and the total patient population (p=0.792, 0.259 and 0.442, respectively).Conclusions: Our study results reveal that the amount of the blood loss in OPU does not significantly vary between women subjected to the procedure for the first time and for more than 1 time.

Progesterone vaginal capsule versus vaginal gel for luteal support in normoresponder women undergoing long agonist IVF/ICSI cycles

Objectives: The aim of the study was to investigate the effects of two different vaginal progesterone forms, administered for luteal phase support, on pregnancy outcomes in normoresponder women aged < 35, who underwent long agonist IVF/ICSI-ET cycles. Material and methods: A retrospective cohort analysis was designed. Normoresponders with primary infertility, who un­derwent IVF/ICSI-ET cycles employing GnRH analogue and who received progesterone as either capsule or gel form for LPS following a single embryo transfer, were analyzed. The cycles were categorized into two groups: micronized progesterone vaginal capsule 600 mg/day (Group 1, n = 78) and progesterone vaginal gel 180 mg/day (Group 2, n = 99). Positive β-hCG, clinical pregnancy and ongoing pregnancy rates were analyzed. Results: Both, demographic and stimulation characteristics were comparable between the groups. No difference was observed between the capsule and the gel groups regarding positive β-hCG (33.3% and 28.3%, respectively; p = 0.580), clinical pregnancy (26.9% and 22.2%, respectively; p = 0.584), and ongoing pregnancy rates (21.8% and 20.2%, respectively; p = 0.942) after treatment completion. Conclusions: In long agonist IVF/ICSI-ET cycles, positive β-hCG, clinical pregnancy and ongoing pregnancy rates do not significantly differ between normoresponder patients receiving micronized progesterone vaginal capsule and those receiv­ing progesterone vaginal gel for LPS

Does biochemical profile of follicular fluid in women undergoing assisted reproduction vary between the right and left ovaries?

Background: Follicular fluid (FF) provides a substantial micro-milieu for the development of the oocytes. Moreover, the content of FF may also reflect the circulating biochemical environment and the changes in blood serum. Despite the known embriyological and histological similarities between right and left ovaries, differences do exist between their venous drainage, anatomical relations and cyclical physiological changes. The difference between the two ovaries in the response to controlled hyperstimulatons (COH) in IVF regimens was later confirmed by recent studies. The aim of this study was to compare the biochemical differences between the FFs yielded from the right and left ovaries in patients undergoing standart IVF treatment.Methods: A prospective observational study was conducted through the unexplained infertility patients with the age between 23-39 years, body mass index (BMI) ≤28 kg/m2, FSH ≤10 mIU/mL. FFs aspirated from the right and the left ovary of the patients were assayed for estradiol, calcium, phosphorus, uric acid, urea, total protein, AST, ALT, glucose, sodium, potassium and creatinine. A total of 10 patients undergoing IVF treatments were included.Results: The investigated parameters were not significantly different between FFs yielded from the right and left ovaries.Conclusion: According to the results of our study, biochemical profile of the aspirated FFs does not significantly differ between the right and the left ovary and consequently, either right or left ovaries provide similar micro-environments to the developing oocytes.

Impact of paternal age on intracytoplasmic sperm injection cycle results

Background: The purpose of this study is to compare the impacts of the paternal age of patients included in the intracytoplasmic sperm injection-embryo transfer cycle administered with long protocol. Methods: The patients administered with long agonist protocol, who were primary infertile and had normal over reserves, were divided into two groups based on their sperm concentration. The patients with sperm concentration of over 15 million/ml were defined as group 1, while those with sperm concentration below 15 million/ml were defined as group 2.Results: 602 patients, 302 of whom were in group 1 and 300 of whom were in group 2, enrolled in this study. With regard to treatment results, the implantation rates and clinical pregnancy rates were significantly higher in group 1. In an assessment made to determine if the advanced male age had any impact on the clinical pregnancy rates, it was determined that there was a significant decrease in the clinical pregnancy rates only in group 2. When the patients in group 2 were divided and compared into two patient subgroups, i.e. those below 37 years old and over 37 years old, higher number of mature oocytes, embryos was obtained at a lower dose of recombinant follicular stimulant hormone (r-FSH) in the younger patient subgroup, which significantly increased the clinical pregnancy rates with implementation rates.Conclusions: While the pregnancy and implantation rates significantly decreased by advanced paternal age in oligospermic patients administered with ICSI, the abortus rates increased

To compare pregnancy results of patients with or without pcosWho are included gnrh agonist long protocol treatment

Kadın infertilitesinin en sık nedeni ovulasyon bozukluklarıdır. Anovulatuar infertilitenin en temel nedeni Polikistik Over Sendromudur. Polikistik Over Sendromu fertil çağdaki kadınlarda görülen en sık endokrin bozukluktur. Polikistik Over Sendromlu infertil kişide ilk tercih ovulasyon indüksiyon ajanı Klomifen Sitrat’tır. Klomifen Sitrat’a yanıtsız olgularda eksojen gonadotropinler kullanılmaktadır. Çalışmamızda, GnRH Agonist Uzun Protokol uygulanan PKOS olan ve olmayan hastalarda gebelik sonuçları ve yanısıra kullanılan gonadotropin dozları, bazal FSH, E2, prolaktin değerleri, elde edilen matur oosit sayıları gibi parametreleri retrospektif olarak karşılaştırmayı hedefledik.Ovulation defects are the most common cause of womaninfertility. Polycystic Ovary Syndrome is main cause of anovulatory infertility and most commonly seen endocrine pathologyin fertile period of women. In infertile patients with PCOS, firstchoice of induction agent is Klomifen Citrate. Patients who donot response to Klomifen Citrate, exogen gonadotropines areused for induction. In our study we aimed to evaluate gonadotrophine doses, basaline FSH, E2, prolactine levels, matureoocyte number and pregnancy rates in GnRH Agonist LongProtocol treatment in patients who have PCOS or not

Normal over rezervi olan ve long protokol uygulanan İVF hastalarında rekombinant fsh ve yüksek derecede saflaştırılmış hmg kullanımının gebelik sonuçlarına etkisinin karşılaştırılması]

Objective: Gonadotropins used in controlled ovarian stimulation have been increasing in number. Beside the recombinant preparations such as rec-FSH, rec-LH and h-hMG human-derived preparations have entered the market. We decided to compare the effects of rec-FSH and HP-hMG with GnRHa on embryo quality and pregnancy outcome in women undergoing an IVF cycle. Material and Methods: In this study, data of 87 patients who had applied to our center from 2007 to 2008 and who had met all inclusion criteria, were analyzed. The patients underwent controlled ovarian hyperstimulation with HP-hMG, rec-FSH following down-regulation with a GnRHa in a long protocol, selected according to determined criteria and acquired embryo via IVF transfer. Results: Of the 87 patients, 44 were stimulated with rec-FSH and 43 with HP-hMG. Distribution of infertility causes was similar between the groups. Duration of gonadotropin administration (p=0.677, Student's t-test) and the total dose of gonadotropin received (p=0.392, Student's t-test) were similar between the two groups. The fertilization rate of the rec- FSH group was significantly higher than the HP-hMG group (p=0.001, Mann-Whitney U test). No significant differences were observed between the study groups in biochemical, clinical and ongoing pregnancy parameters. Conclusion: The higher oocyte yield with rec- FSH does not result in higher quality embryos. LH activity in combination with FSH activity positively affected the oocyte and embryo maturation. Therefore, when we consider the clinical and ongoing pregnancy rates there is no inferiority of HP-hMG in controlled ovarian stimulation

GnRH Agonist Uzun Protokol tedavi uygulanan Polikistik Over Sendromu olan ve olmayan hastaların gebelik sonuçlarının karşılaştırılması

Kadın infertilitesinin en sık nedeni ovulasyon bozukluklarıdır. Anovulatuar infertilitenin en temel nedeni Polikistik Over Sendromudur. Polikistik Over Sendromu fertil çağdaki kadınlarda görülen en sık endokrin bozukluktur. Polikistik Over Sendromlu infertil kişide ilk tercih ovulasyon indüksiyon ajanı Klomifen Sitrat’tır. Klomifen Sitrat’a yanıtsız olgularda eksojen gonadotropinler kullanılmaktadır. Çalışmamızda, GnRH Agonist Uzun Protokol uygulanan PKOS olan ve olmayan hastalarda gebelik sonuçları ve yanısıra kullanılan gonadotropin dozları, bazal FSH, E2, prolaktin değerleri, elde edilen matur oosit sayıları gibi parametreleri retrospektif olarak karşılaştırmayı hedefledik.Ovulation defects are the most common cause of womaninfertility. Polycystic Ovary Syndrome is main cause of anovulatory infertility and most commonly seen endocrine pathologyin fertile period of women. In infertile patients with PCOS, firstchoice of induction agent is Klomifen Citrate. Patients who donot response to Klomifen Citrate, exogen gonadotropines areused for induction. In our study we aimed to evaluate gonadotrophine doses, basaline FSH, E2, prolactine levels, matureoocyte number and pregnancy rates in GnRH Agonist LongProtocol treatment in patients who have PCOS or not