فتانه فریفته

Family of colony-stimulating factors (CSF) have an essential role on early cross talk between embryo and uterine endometrium.

The aim of this study was to evaluate the effects of the single dose of Granulocyte-CSF (G-CSF) injection on clinical outcome of assisted reproductive technology cycle in patients with repeated implantation failures.

This randomized control trial study was performed on 52 infertile women who referred to the clinic with the history of more than three previous In vitro fertilization/Intracytoplasmic sperm injection-embryo transfer failures. All patients were stimulated with standard long protocol. All embryos were transferred on day five in blastocyst stage in both groups. The treated group received 300 μg (0.5 ml) recombinant human G-CSF subcutaneously which was injected 30 min before blastocyst embryo transfer.

There was not statistically significant differences in abortion rate in G-CSF and control group (p=0.09). G-CSF treated group showed higher clinical pregnancy rate in comparison with control group (56.2% vs. 40.0%) but it was not statistically significant (p=0.09). Although live birth rate in G-CSF group was higher than control group (53.1% vs. 35.0%) but there wasn’t statistically significant difference in the overall live birth rate between the two groups (p=0.10). G-CSF group had a twin pregnancies while in control group there was no twin pregnancy.

Our result demonstrates the possibility that pregnancy outcome is better in women with repeated unexplained In vitro fertilization failure who are treated with G-CSF.

Natural endometrium in Frozen-thawed Embryo Transfer (FET) may have some benefits upon implantation in patients with Repeated Implantation Failure (RIF). It might be due to possible differences between natural and stimulated endometrial growth factors and cytokins secretions.

The objective of this study was to compare the pregnancy rate of FET on modified natural cycle versus hormone replacement therapy (HRT) cycle endometrium in patients with RIF.

In this observational study the pregnancy rate of patients with RIF undergoing day 3 FET in natural cycle endometrium (group 1, n=56), were compared with another group of patients with RIF in whom frozen-thawed day 3 embryos were transferred on HRT cycle (group 2, n=52).

The pregnancy rate in group 1 was 41.07%, compared with the pregnancy rate of group 2; 36.5% (p=0.63). The abortion rate was not significantly different among the groups.

It can be concluded that FET in a modified natural cycle is comparable with HRT cycle in patients with RIF.

Infertility is considered as one of the oldest human dilemmas that have caused difficult periods of life with various nervous breakdowns and psychological pressures for the people involved in and finally such conditions led to some efforts to be made in order to achieve proper solutions for the case. One form of infertility which was thought incurable heretofore was "nonexistence of sexual cells" in which using the third person's gamete for fertilizing an infertile person has opened new horizons in treating the mentioned disorder. Along with the success of the great efforts were made in fertilizing the infertile person using the third person gamete, several ethical and juridical questions and challenges aroused that required specific regulations to be issued, especially for the state of donating gamete and embryo to the infertile couple, more necessary than ever. In order to solve these problems, different committees were formed within different countries and some rules were ratified in many countries upon which special conditions were determined for gamete and embryo donation or reception. One of these conditions is anonymity or "confidentiality" that is of the most discussable issues among all juridical and ethical schools. To conceal a parent-child genetic relationship is one of the important subjects which are ethically, jurisprudentially, legally, sociologically and psychologically discussable. A new article of law was ratified in Britain in 2005 that has terminated the anonymity of the gamete or embryo donor. Other countries like Austria, Sweden, Norway, Netherland and New Zealand issued similar regulations subsequently and put them into the action. The current study tries to challenge the principle of anonymity or confidentiality through analyzing different (ethical, jurisprudential, sociological and psychological) areas.