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Article
women age and embryo implantation following intracytoplasmic sperminjection and embryo transfer in infertile patients

Authors: mundhir T. AL- barzanchi منذر البرزنجي --- Saeeda M.Al-Anssari سعيدة الانصاري --- sarmad S.Khunda سرمد خوندة --- ahmed k. allow احمد خلف --- et al.
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2006 Volume: 48 Issue: 2 Pages: 155-161
Publisher: Baghdad University جامعة بغداد

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Abstract


Article
Progesterone Therapy Administered 24 hours Before Embryo Transfer in ICSI Cycle Improves Embryo Implantation and Pregnancy in Women With Luteal Phase Defect.

Authors: Saeeda A. AL-Anssari --- Mundhir T. Ridhaa --- Zuher Kanan --- Ahmed K. Allow --- et al.
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2007 Volume: 49 Issue: 1 Pages: 101-106
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ovulation induction by human menopausal gonadotrophin (HMG) results in temporal luteal phase defect. Luteal support therapies are required to support embryo implantation in stimulated cycle especially in luteal phase defect infertile women. Objective: The objective of the present study was to investigate the clinical significance of progesterone, aspirin and HCG on human embryo implantation in women with luteal phase defect following ICSI and embryo transfer (ET). Patients and Methods: The female patients were divided into six groups depending on the type of the luteal support protocols (LSP). Group 1 (No= 54), received 10 mg oral progesterone (P), group 2 (No= 35) received P plus HCG, group 3 (No= 59) received P plus HCG plus oral aspirin, group 4 (No= 47) received vaginal P administered 24 hours before embryo transfer plus oral aspirin, group 5 (No= 40) received vaginal P administered 12 hours after embryo transfer plus oral aspirin and group 6 (No= 46) received intramuscular P plus oral aspirin. The LSP were continued for at least 12 weeks, when the B-HCG test was positive, (tested two weeks after embryo transfer). Results: Statistical analysis of the clinical data showed no significant differences between the LSP in regard to patient's age, body mass index (B/M2), basal FSH/LH ratio and estradiol concentration at the day of HCG injection. The ICSI rate, percentages of embryos developed in vitro, and the numbers of the transferable quality embryos were similar in all groups (P>0.05). The pregnancy rate was significantly higher (P < 0.05), in group 4 compared to other groups (38.66% versus 24.51%(G 1), 22.53% (G 2), 28.66% (G 3), 25% (G 5), 21.60% (G 6). The percentages of viable fetal sac development per patient were 31.49 (17/54), in G 1, 42.86 (15/35), in G 2, 49.16 (29/59), in G 3, 59.58 (28/47), in G 4, 32.50 (13/40), in G 5, and 34.79 (16/46), G 6. The percent of viable gestation sac was significantly higher in group 4 compared to other groups (P < 0.05). Conclusions: The administration of 400 mg /day vaginal progesterone 24 hours before ET and 100 mg/day aspirin five days after ET results in significant improvements in pregnancy and embryo implantation rates and development of viable fetuses in luteal phase defect infertile women undergoing ICSI-ET.


Article
Embryo Implantation In Intracytoplasmic Sperm Injection-Stimulated Cycle Using Testicular And Epididymal And Ejaculated Sperm From Azoospermic, And Severely- Teratospermic Men.

Authors: Zuhair, A. Kanan, --- Saeeda, A. M. AI-Anssari, --- Mundhir T.Ridha-Barzanchi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2006 Volume: 48 Issue: 3 Pages: 313-318
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The infertility affects about 20% to 28% of Iraqi population and the primary and secondary infertility cover 80% and 20% of infertility cases respectively. It has been shown that the major male infertility factors include oligospermia, astheno-spermia, teratospermia and azoospermia.Objectives: The objective of this study was to compare the fertilizing capacity, in vitro embryonic developmental rate and embryo implantation following the use of epididymal, testicular, and ejaculated sperm in azoospermic and severely teratospermic men. Patients and Methods: The males in experiment one were divided into three groups, severely terato-spermic group (STSG, n=44), azoospermic-epididymal group (ASEG, n=35) and azoospermic-testicular group (ASTG, n=40). In experiment two the azoospermic patients were divided into two groups, obstructive (OASG, n=35) and non-obstructive (NASG, n=42). Both groups were underwent testicular extraction and intracytoplasmic sperm injection (TESE-ICSI) treatments.
Results: Concentration of FSH, LH, prolactin was significantly higher in non-obstructive group compared to obstructive group (P<0.001). The concentrations of testosterone and the volume of the testes were significantly higher in the obstructive group versus non-obstructive group (P <0.01). Percentages of the fertilizable oocytes and the number of the transferred embryos per patient in the ASTG group were significantly lower compared to STSG and ASEG groups. The pregnancy and implantation rates were not significantly different in the STSG, ASSEG, and ASTG groups. ICSI rate and embryo developmental rate and the number of the transferred embryos per patient were significantly lower in the non-obstructive group (NASG) compared to the obstructive group (OASG) Pregnancy and viable fetus percentages were similar between both groups (P>0.05).
Conclusions: Sources of sperm retrieval found to have no effect on embryo implantation and pregnancy rates when viable sperm are available for ICSI. Pregnancy and viable gestation sac percentages were not affected by the etiology of azoospermia in either obstructive, or non-obstructive with focal areas of spermatogenesis were present in testes of azoospermic men.

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