فهرست مطالب tahereh zare yousefi

Repeated implantation failure (RIF) refers to the condition where high quality embryos are unable tosuccessfully implant after multiple cycles of in vitro fertilization (IVF) treatment. The aim of this study is to investigatethe impact of intrauterine granulocyte colony-stimulating factor (G-CSF) and platelet-rich plasma (PRP) onpregnancy rate in patients with RIF. The present randomised clinical trial study was conducted at the IVF Centre of MehrMedical Institute in Rasht, Iran, from 2020 to 2022. The research consisted of 200 individuals who had experiencedmultiple failed cycles. These patients were randomised into two groups: intrauterine infusion of 1 ml of G-CSF andintrauterine infusion of 1 ml autologous PRP at least 48 hours before embryo transfer (ET). The groups were comparedin terms of implantation rate, and chemical, clinical, and ongoing pregnancy. The implantation rate was significantly higher in patients who received PRP (P=0.016). Chemical pregnancy inthe PRP group was significantly higher than G-CSF group (P=0.003). Both clinical pregnancy and ongoing pregnancyrates were significantly higher in the PRP group (P=0.001) compared to the G-CSF group (P=0.02). The utilisation of PRP via intrauterine infusion is considerably more successful than G-CSF in enhancingpregnancy and live birth rates among patients with RIF. (registration number: IRCT20180528039878N3).

Insufficient serum progesterone level in the implantation phase may reduce the rate of pregnancy during freeze embryo transfer (FET) cycles. The present study aimed to evaluate the impact of FET day serum progesterone level on pregnancy outcomes in patients receiving intramuscular plus vaginal progesterone administration for endometrial preparation.

Based on serum progesterone level on FET day, patients were divided into four quartiles: first ( < 25%), second (26–50%), third (51%–75%), and fourth ( > 75%). There was no significant difference among groups in basal characteristics.

No statistically significant difference was seen among groups concerning the mean number of retrieved and mature oocytes, embryos transferred, and endometrial thickness (EnT). The rate of implantation (P = 0.5), biochemical (P = 0.75), clinical (P = 0.54), and ongoing pregnancy (P = 0.5) were not associated with serum progesterone level on embryo transfer day.

We found that there is no association between serum progesterone level on ET day and pregnancy outcome during FET cycles. It seems that combination therapy using intramuscular and vaginal progesterone, keeps the serum progesterone on ET day high enough that eliminates the need for serum progesterone measurement.

Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation failure patients. The aim of the present study was to describe the impact of intrauterine platelet-rich plasma infusion on the live birth rate in patients with repeated implantation failure.

The present retrospective uncontrolled study was performed on 96 patients with more than two failed intracytoplasmic sperm injection cycles at Mehr medical institute between 2019 and 2021. Forty-eight hours before embryo transfer, patients received 1 mL lympho-platelet-rich plasma through an intrauterine insemination catheter. Patients were evaluated for pregnancy rate. Endometrial preparation for frozen-thawed embryo transfer was performed.

Participants' basal and stimulation characteristics, including gonadotropin dosage, the total number of oocytes, metaphase II oocytes and embryos, endometrial thickness, embryo transfer, quality of transferred embryos, and blastocyst transfer rate were evaluated. A total of 33 and 27 chemical (34.3%) and clinical pregnancies (28.1%) were achieved. Twenty (20.8%) and nineteen (20%) cycles resulted in ongoing pregnancies or live births, respectively.

The current study suggests that platelet-rich plasma infusion 48 hours before frozen-thawed embryo transfer may be a good option for repeated implantation failure patients and results in 20% live birth.

While anti-Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve, its predictive value for live births following assisted reproductive technology cycles has remained controversial. The aim of the present study was to assess the importance of AMH in predicting live birth following intrauterine insemination (IUI) in the case of low or very low ovarian reserve.
In this retrospective cohort study, 123 patients with AMH≤1 ng/ml, who underwent a total of 137 IUI cycles were enrolled and evaluated for live birth rate. Patients were divided into two groups based on serum AMH levels: group 1 with low level of AMH (0.4-1 ng/ml, n=83, cycles: 95) and group 2 with very low level of AMH (≤0.4 ng/ml, n=40, cycles: 42). The results were compared between the two groups. Main outcome was the pregnancy rate.
The rates of biochemical pregnancy, clinical pregnancy and live birth in all patients were 11%, 8% and 7.3%, respectively. The two groups showed no significant difference in the rates of biochemical pregnancy (10.4% vs. 14.3%, p=0.3), clinical pregnancy (6.3% vs. 11.9%, p=0.2) and live birth (6.3% vs. 9.8%, p=0.5). In univariate regression analysis, baseline characteristics and ovarian stimulation parameters showed no significant relationship with the rates of pregnancy and live birth.
In women with AMH≤1 ng/ml, serum levels of AMH did not appear to reflect pregnancy outcomes and live births following IUI. It can be concluded that in women with low or very low levels of AMH, there is chance of pregnancy, and live birth following IUI.

There are conflicting results regarding the benefit of gonadotropin releasing hormone (GnRH) agonist treatment on frozen embryo transfer (FET) outcome. No study was found to compare pregnancy outcome between patients undergoing short and long acting types of GnRH agonist for FET cycles. This study aimed to assess the effectiveness of short and long acting GnRH agonist on FET cycle outcomes.

The present retrospective study was conducted on 296 patients who underwent FET cycles between 2016 and 2017 at Mehr Medical Institute, Rasht, Iran. Pregnancy outcome were compared among three groups: Group A (n=103) received artificial hormone-mediated cycles without GnRH agonists, Group B (n=100) and C (n=93) received artificial hormone-mediated cycles with short and long-acting GnRH agonists, respectively. Also 16, 26, 12 polycystic ovarian syndrome (PCOS) patients (in group A, B and C respectively) were also assessed for ongoing pregnancy rate among three groups. Data were analyzed using analysis of variance, Kruskal-Wallis, Chi-square goodness of fit test and multivariate logistic regression.

No statistically significant differences were observed in terms of endometrial thickness (p=0.053), implantation (p=0.94), biochemical (p=0.67), clinical (p=0.82) and ongoing (p=0.96) pregnancy rates in three groups. Also, PCOS patients did not show significant differences in ongoing pregnancy rate among three groups (p=0.72).

The findings revealed that neither non- PCOS nor PCOS patients undergoing artificial hormone-mediated endometrial preparation benefit from the addition of short or long-acting GnRH agonist to FET cycles.

Expression of granulocyte colony stimulating factor (G-CSF) and its receptors in embryo and endometrium implicates the involvement of this glycoprotein on implantation process. In the present study, we aimed to evaluate the impact of routine use of subcutaneous administration of G-CSF on pregnancy outcomes in intracytoplasmic sperm injection (ICSI) patients.

In this retrospective study, ICSI outcomes were compared between two groups of patients: the first group (n=108) who received subcutaneous G-CSF (300 mcg) two hours before the embryo transfer and the second group (n=110) who did not receive it. Pregnancy outcome was compared between the two groups. P-value<0.05 was considered statistically significant.

There was no significant difference between G-CSF and control groups with respect to the rate of implantation (respectively, 23%vs. 23%, p=0.49), chemical (respectively, 43.5%vs. 50%, p=0.34) and clinical (respectively, 40.7% vs. 46.4%, p=0.23) pregnancy. In logistic regression analyses, subcutaneous G-CSF administration was not associated with clinical pregnancy in both crude and adjusted odds ratios (OR) with 95% confidence interval (CI) (crude OR: 0.8, CI: 0.47-1.36, p=0.4, and adjusted OR: 0.99, CI: 0.48-2.07, p=0.99).

In the present study, subcutaneous G-CSF did not improve pregnancy outcomes in patients undergoing ICSI; therefore, the routine use of this cytokine is not suggested for all patients.