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Article
Factors Affecting Pregnancy Outcome in Subfertile Couples Subjected toIntracytoplasmic Sperm Injection
بعض العوامل المؤثرة على نجاح عملية الحقن المجهري للنطف عند الازواج العقيمين

Authors: Amal M. Mubark --- AseelJassim Al- Bderi --- Basima Sh. Al-Ghazali
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 3 Pages: 36-40
Publisher: University of Kufa جامعة الكوفة

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Abstract

Purpose: Studying some Factors Affecting pregnancy outcome in subfertile couples subjected tointracytoplasmic sperm injection.Method: study performed in fertility center in Al-Sadder teaching hospital in Al-Najaf city during the period between October 2012 and April 2013 , the study include 140 subfertile couples that subjected to intracytoplasmic sperm injection(ICSI).Results: the results show some factors that affect pregnancy outcome like women age, cause and type of infertility .The results revealed that the age of women was significantly affect the pregnancy outcome, also the results show that sperm quality more important than sperm count .Recommendations: studying other hormones releated to fertility like leptinConclusions: Multiple factors affecting ICSI outcome, the most important one is female age The cause of infertility and its type also affect the outcome, also the results show that sperm quality more important than sperm count .

الهدف :دراسة لبعض العوامل المؤثرة على نجاح عملية الحقن المجهري للحيمن عند الازواج العقيمينالمنهجية: دراسة اجريت في مركز الخصوبة في النجف للفترة من ايلول 2012 والى نيسان2013 شملت140زوج عقيم اخضع للحقن ألمجهري للحيمن النتائج: .الدراسة بينت بعض العوامل المؤثرة على نتائج الحمل مثل عمر المرأة, سبب العقم ونوعه, نشاط ونوعية الحيامن المنوية. الدراسةاظهرت تاثيرا معنويا لعمر المريضة و تاثيرا معنويا لنوعية الحيمن و ليس لعدد الحيامن.الاستنتاجات:عدة عوامل تؤثر في نجاح عملية الحقن المجهري للحيمن .اكثرها اهمية هو عمر المراة و نوع العقم و لنوعية الحيمن و ليس لعدد الحيامن. التوصيات: نوصي بدراسة هرمونات اخرى مرتبطة بالعقم مثل اللبتين .


Article
Follicular Fluid Oxidative Stress Biomarkers and Intracytoplasmic Sperm Injection (ICSI) Outcome

Authors: Sami R.Al-Katib --- Basima Sh.Al-Ghazali --- Ban J. Edan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 293-300
Publisher: Babylon University جامعة بابل

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Abstract

The aim of this study was to evaluate the association between the follicular fluid (FF) malondialdehyde (MDA) levels as a free radical marker and reduced glutathione (GSH) as antioxidant and pregnancy after intracytoplasmic sperm injection (ICSI).A total seventy-five infertile women aged between 22-45 years(31.43 ± 5.38 years), referred to the fertility clinic in Al-Sadder teaching hospital, , and undergone intracytoplasmic sperm injection throughout period from March 2013 to January 2014,were included in this study. follicular fluid (FF) malondialdehyde was measured by spectrophotometer based on the calorimetric reaction with thiobarbituric acid (TBA) and follicular fluid glutathione was measured by spectrophotometer depends on the action of sulfhydryl groups.Out of the 75 included patients, 15 (20%) achieved pregnancy after ICSI. Pregnant women were associated with significantly higher MDA level (P < 0.05) and lower GSH (P < 0.05) .There was a significant positive correlation between MDA and the number of pronucleus ( r= 0.326 ). The best cutoff value of FF.MDA and FF GSH associated with pregnancy were 3.49 µM and 26.90 µM respectively. Higher FF MDA and lower FF GSH levels are associated with pregnancy after ICSI. Oxidative stress parameters may be markers of metabolic activity within the follicle.


Article
Serum Follistatin and Its Role in Intracytoplasmic Sperm Injection Outcomes

Author: Baydaa Lateef Hameed, Mutaz Sabah Ahmeid1
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 4 Pages: 302-306
Publisher: Babylon University جامعة بابل

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Abstract

Background: progress in assisted reproductive technology (ART) has enabled the clinicians to treat many types of infertility. Objectives: Theultimate goal of all these procedures is to get a viable intrauterine pregnancy as a step to get a healthy baby. Intracytoplasmic sperminjection (ICSI) refers to the technique of assisted reproduction, including injecting a single sperm into the center (cytoplasm) of the egg.Materials and Methods: A prospective study included 45 women who were enrolled in ART programs in infertility center for in‑vitrofertilization (IVF) in International Center/Kirkuk, Iraq. All women were subjected to the basic fertility workup at the infertility center whichconsists of history taking, physical examination, ovulation detection, evaluation of tubal patency, and uterine cavity. The average age of theincluded women ranged between 20 years and 42 years of age. All women were enrolled in short protocol type of IVF/ICSI cycle, and they hadnormal menstrual cycles. Serum samples were stored for estimation of follistatin level by ELISA technique and for estimation of luteinizinghormone, follicle‑stimulating hormone, estrogen, and progesterone by VIDAS technique. Results: The present study showed that 31.1% ofwomen underwent ICSI technique became pregnant and 68.9% were nonpregnant. The highest mean of age were recorded among pregnantwomen compared with nonpregnant women (32.21 ± 6.68 vs. 31.80 ± 5.38 years) although the result was nonsignificant (P > 0.05). The highestmean of body mass index were recorded among nonpregnant women compared with pregnant women (23.92 ± 1.55 vs. 25.36 ± 1.99 kg/m2);the result was significant. The study showed highest mean level of serum follistatin present in nonpregnant compared with pregnantwomen (0.75 ± 0.32 vs. 0.62 ± 0.24 ng/ml) although the result was nonsignificant (P > 0.05). Conclusions: There was no relation of serumfollistatin with pregnancy after ICSI.


Article
Influence of Sperm Concentration, Morphology, and Motility on The Result of Intracytoplasmic Sperm Injection

Authors: Hind abdulkadim Al-Ebrahimi --- Yahya K. Al-Sultani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 144-151
Publisher: Babylon University جامعة بابل

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Abstract

Defective Sperm parameters was suggested to play an important role in determining fertility and was proven to be closely related to fertilization and pregnancy rates in the natural fertilization process as well as in ART.To evaluate the influence of defective sperm parameters including concentration, morphology and motility on intracytoplasmic sperm injection outcome represented by fertilization rate, cleavage rate, embryo quality and pregnancy rate.This a cohort study included 60 infertile couple attended the clinics of infertility treatment center Al-Sadder teaching hospital and underwent intracytoplasmic sperm injection. They are classified into three groups according to their spermiogram and ICSI outcome evaluated for each group and compared with each other.The main results of this study showed no significant difference in fertilization rate,cleavage rate ,embryo quality and pregnancy rate among studied groups i.e., no significant difference in ICSI outcome between normozoospermic group and those with defective spermiogram. Intracytoplasmic sperm injection outcomes represented by fertilization rate, cleavage rate embryo quality and pregnancy rate were identical with no significant differences between couples with defective sperm parameters and those with normal spermiogram.


Article
Embryo Grade I is The Most Important ICSI Parameters That Predict Intracytoplasmic Sperm Injection(ICSI) Outcome

Authors: Ban J. Edan --- Sami R.Al-Katib --- Basima Sh.AlGhazali
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 264-272
Publisher: Babylon University جامعة بابل

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Abstract

The aim of this study was to compare different intracytoplasmic sperm injection (ICSI) parameters with its outcome and predict the most important factor that relate with successful rate.A total seventy-five infertile women aged between 22-45 years(31.43 ± 5.38 years), referred to the fertility clinic in Al-Sadder teaching hospital, , and undergone intracytoplasmic sperm injection throughout period from March 2013 to January 2014,were included in this study. Fertilization rate (FR) and cleavage rate was calculated. The embryos grading was evaluated according to their morphology and percentage of fragmentation. The biochemical pregnancies was confirm on the fourteenth day of embryo transfer by measurement of serum human chorionic gonadotrophine ( B- HCG ). Out of the 75 included patients, 15 (20%) achieved pregnancy after ICSI. Pregnant women were associated (P < 0.05) . Total oocyte retrieved , stage metaphase II oocyte , pronucleus , cleavage rate , grade I ,total number of embryos ,and number of transferred embryo significantly higher in pregnant women when compared with non-pregnant women(P<0.05) Analysis of ROC curve revealed that area under the curve for number of grade I embryos was 0.868 for predicting pregnancy followed by followed by MII (0.815), number of total oocyte .retrieved and PN (0.773), ET( 0.767) and total number of embryos(0.758) respectively.Data show that the number of grade I embryos is the better at predicting for successful pregnancy outcome.(higher test result give more positive test).


Article
Relation of Follicular Fluid C-Reactive Protein Level to Intracytoplasmic Sperm Injection Outcome at Al-Najaf Fertility Centre

Authors: Ban Dhahir Thabbah --- Sami Raheem Al-Katib --- Basima Shamki Al-Ghazali
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 4 Pages: 948 -955
Publisher: Babylon University جامعة بابل

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Abstract

C-reactive protein is a protein that act as a sensitive marker in inflammatory processes, rises following hormonal stimulation it may affect fertility and intracytoplasmic sperm injection (ICSI) outcome. this study aimed to measure follicular fluid proinflammatory mediator as C-reactive protein and their relation controlled ovarian hyperstimulation protocols and to interpret these findings according to the cause of subfertility and subfertility treatment outcome. This study was carried out on 110 subfertile women aged between 18-45year (30.01±6.02), referred to fertility clinic in Al-Sadder teaching hospital at AL-Najaf city who classified into four group according to the cause of subfertility, estradiol(E2) also measured on day of HCG and CRP were measured in follicular fluid collected on day of pickup using special ELISA kit then correlate the result to ICSI outcome. The Result of this study reported that the pregnancy rate was 34.55% for embryo transferred after 48-72 hours, there was non-significant increment in pregnant than non-pregnant women regarding FF-CRP (P>0.05), also non-significant difference in FF- CRP in subfertile women according to cause of subfertility(p=0.303), higher FF-CRP value were in ovulatory factor female. Regarding ICSI parameters, there was positive non-significant correlation between FF- CRP and embryo number, Grade I, Grade II, embryo transferred, fertilization rate. so conclusion of this study minimal increment in these inflammatory markers would aid and share in success ICSI outcome.


Article
The aptness of antagonistic protocol in intracytoplasmic sperm injection: Embryologic study

Author: Tuqa Yousif Sharef
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2019 Volume: 23 Issue: 1 Pages: 28-34
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Infertility and poor ovarian response are serious problems in our society; fortunately the in vitro fertilization and intracytoplasmic sperm injection technique dissolve many of these problems. This study aimed to assess the effect of an individualized GnRH antagonist regimen on intracytoplasmic sperm injection process especially the aptness of it in given mature reiterative oocytes, normal fertilization, and acceptably zygote cleavage which enhance pregnancy. Methods: The population of the study consisted of 877 couples attending the in vitro fertilization-infertility center in the maternity teaching hospital and chose to undergo intracytoplasmic sperm injection after using of antagonist protocol for stimulation of women ovaries. The women ages ranged between 24 and 44 years. The collected data included a number of reiterative oocytes; fertilization, embryo grades and lastly estimates the pregnancy results Results: A significant association (P <0.001) was found in the numbers of reiterative oocytes between the age groups of the study. A significant association (P = 0.005) was also found concerning to quality of fertilization process. The study of the zygote cleavage and blastomeres formation followed the fertilization show variable grade of embryos and analyzed data of embryo grades in this study indicate presence of significant association (P = 0.003). The rate of pregnancy showed significant association between the groups of the study with the <30 years age group have chance of pregnancy higher than other groups.Conclusion: The antagonist protocol of ovary stimulation according to the results of this study is a qualified protocol; besides it is rapid and can be reversed. This protocol can give effective results in the intracytoplasmic sperm injection process especially for young women, and enhance the pregnancy.


Article
RELATION OF ANTIMÜLLERIAN, FOLLICULAR STIMULATING HORMONE AND ANTRAL FOLLICLE COUNT ON INTRACYTOPLASMIC SPERM INJECTION OUTCOME IN INFERTILE PATIENTS

Authors: Menal F. Farhood منال فاضل فرهود --- Farqad B. Hamdan فرقد بدر حمدان --- Anam R. Al-Salihi انعم رشيد الصالحي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 3 Pages: 261-266
Publisher: Al-Nahrain University جامعة النهرين

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Background:Studying some of fertility-related hormones is of major benefit to identify the causative factors and to search for an appropriate treatment. Anti-müllerian hormone regarded as quantitative markers for ovarian reserve. Basal follicular stimulating hormone provides a picture of how well the hypothalamic-pituitary-gonadal axis is functioning and is the most commonly used tests for predicting success in intracytoplasmic sperm injection (ICSI) treatment.Objective:To evaluate the level of serum and follicular fluid antimüllerian hormone, serum follicular stimulating hormone and antral follicle count and its relation to ICSI outcome in infertile patients.Methods:Seventy four infertile women were selected randomly from those attending the Fertility Centre, Al-Sader Teaching Hospital, Al-Najaf /Iraq. Ultrasound was performed for antral follicle count and their measurement at cycle day 2. Hormonal analysis is done for serum follicular stimulating hormone at cycle day 2 and for serum and follicle fluid antimüllerian hormone at day of ovum pickup.Result:The fertilization rate was positively correlated with follicular fluid antimüllerian hormone (r = 0.303; P = 0.048) but not with serum follicular stimulating hormone, serum antimüllerian hormone and antral follicle count.Conclusion:Follicular fluid antimüllerian hormone level was positively correlated with fertilization rate, while serum antimüllerian hormone level does not affect the fertilization rate in ICSI cycle. The basal follicular stimulating hormone level do not relate to fertilization rate, and the same thing regarding antral follicle count.Keywords:Anti-müllerian hormone, follicular stimulating hormone, antral follicle count, intracytoplasmic sperm injection.


Article
Hormonal Profile in Intracytoplasmic Sperm Injection Cycles may Predict Poor Responders: A Comparative Study

Authors: Hanan Abdul Jabbar Altaee --- Zainab Hassan Alkhafaji --- Zaid Abdul Majeed Almadfai
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2012 Volume: 9 Issue: 3 Pages: 604-612
Publisher: Babylon University جامعة بابل

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Abstract

Abstract Background: Ovarian response varies considerably among individuals and depends on various fators. Poor response in In Vitro Fertilization (IVF) yields lesser oocytes and is associated with poorer pregnancy perspective. Cycle cancellation due to poor response is frustrating for both clinicians and the patient. Objective: This paper studies some ovarian reserve hormonal profiles which may be a contributing factor for poor ovarian response in Intra Cytoplasmic Injection (ICSI) cycles. Design: A prospective controlled trial. Setting: Fertility unit in Al- Sadar medical city, Najaf province. Subjects and Methods: Eighteen poor responders to controlled ovarian hyperstimulation with gonadotropin have been withdrawn from 67 initially selected participants intended to undergo intracytoplasmic sperm injection as a treatment option for their infertility. Basal cycle day 2 hormonal levels for follicular stimulating hormone( FSH) ,Anti mullerian hormone ( AMH) and estradiol(E2) as well as antral follicular count( AFC) were measured and compared for both groups . Results: The poor responder group found to be of higher age and basal serum FSH and lower basal serum AMH. Conclusions: some markers of ovarian reserve may be used as a predictor of poor responders in assistedreproduction programme.

الخلاصةتختلف أستجابة المبيض للمحرضات الخارجية أختلافا كبيرا بين النساء و تعتمد على عوامل مختلفة . ان ضعف أستجابة المبيض عند اجراء التقنيات المساعدة على الأنجاب يؤدي الى قلة عدد البيوض المستحصلة وضعف منظور الحمل.ان الغاء الدورة العلاجية بسبب ضعف استجابة البيض امر يثير الأحباط لدى الأطباء والمريض. الهدف من هذه الد راسة : تحديد ملامح احتياطي المبيض الهرموني والتي يمكن ان تكون عاملا مساهما في هذا الضعف عند اجراء عمليات الحقن المجهري للحيوانات المنوية داخل البويضة . تمت هذه الدراسة في وحدة الخصوبة في مدينة الصدرالطبية في مدينة النجف الأشرف . تم أستحصال ثمانية عشر ضعيفة استجابة من اصل سبعة و ستون يخضعون لعلاجات تحريض الأباضة في برنامج الحقن المجهري كخيار علاجي لحالة عدم الأنجاب التي يعانون منها. تم قياس مستويات مصل الدم المستحصل ثاني يوم الدورة الشهرية لكل من هرمون المحرض للجريبات ,انتي موليرين هرمون وهرمون الأسترادايول و تم ايضا قياس عدد الجريبات الغارية , وتم مقارنة نسب هذه الهرمونات لكلا الفريقين. تم استنتاج ان عمر فريق ضعيفي الاستجابة وهرمون المحرض للجريب أعلى من الفريق الأخرولكن الأنتي موليرين هرمون اوطأ في فريق الضعيفي الأستجابة . من هذه النتائج يمكن توقع الضعيفي الأستجابة في برامج المساعدة على الأنجاب من خلال اجراء فحوصات احتياطي المبيض.


Article
Level of follicular fluid vitamin D and embryo quality in a sample of Iraqi women undergoing IVF
مستوى فيتامين د في السائل الجريبي وجودة الجنين في عينة من النساء العراقيات اللواتي يخضعن لعمليات التخصيب المختبري

Author: Zainab M. Alawad د.زينب مثنى جياد العواد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2018 Volume: 60 Issue: 4 Pages: 215-221
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Vitamin D has been linked to fertility since its receptors were found in reproductive organs. Nevertheless, its exact role in fertility is yet to be cleared.Objectives: To analyze follicular fluid (FF) vitamin D in females doing Intracytoplasmic Sperm Injection (ICSI), to compare its level between Polycystic Ovary Syndrome (PCOS) and non-PCOS females, and to explore whether vitamin D correlates with oocytes number, percentage of oocyte maturity, fertilization rate and percentage of high quality embryos.Patients and methods: This comparative observational study was done, from January to October 2018, at Al Amal IVF Center, Jenin hospital, Baghdad. The study was conducted on 40 women; 18 had PCOS, 15 had blocked fallopian tubes and 7 had idiopathic infertility. FF vitamin D was analyzed by Ichroma kit, Boditech. Deficient, insufficient, and sufficient vitamin D levels were as: <10, 10-29, and 30-100 ng/ml, respectively.Results: Most participants were deficient (12 women) or insufficient (18 women) of vitamin D, only 10 women had adequate vitamin D levels. FF vitamin D was higher in non-PCOS than PCOS women (P= 0.011). The correlation between vitamin D and oocytes number was not significant. However, it was significant with percentage of oocyte maturity (rho= 0.459, P= 0.003), fertilization rate (rho= 0.471, P= 0.002) and percentage of high quality embryos (rho= 0.316, P= 0.047).Conclusions: PCOS patients, when compared to non-PCOS, have lower vitamin D levels. FF vitamin D might correlate with percentage of oocyte maturity, fertilization rate and percentage of high quality embryos in patients undergoing ICSI.

ةخلفية البحث: فيتامين د يرتبط بالخصوبة حيث توجد مستقبلاته في الأعضاء التناسلية لكن دوره الدقيق في الخصوبة لم يتم فهمه بعد.الاهداف: تحليل فيتامين د في السائل الجريبي في النساء اللواتي يخضعن لحقن الحيوانات المنوية في السايتوبلازم، مقارنة مستواه بين المريضات المصابات وغير المصابات بمتلازمة تكيس المبايض، واستكشاف ما إذا كان فيتامين د يرتبط مع عدد البويضات، نسبة نضج البويضة ، معدل الإخصاب ونسبة الأجنة ذات الجودة العالية.المرضى وطرق العمل: قد أجريت هذه الدراسة الرصدية المقارنة، من كانون الثاني الى تشرين الاول سنة 2018، في مركز الأمل لاطفال الانابيب في مستشفى جنين في بغداد، على 40 امرأة، كان لدى 18 منهن متلازمة تكيس المبايض ، و 15 كان لديهن انسداد قناتي فالوب و 7 كان لديهن عقم مجهول السبب. تم تحليل فيتامين د في السائل الجريبي بواسطة عدة Ichroma ، Boditech. كان تقسيم مستويات فيتامين د: نقص ، غير كافي و كافي كالتالي: اقل من 10 و 10-29 و 30-100 نانوغرام/ مل على التوالي.النتائج : كانت معظم المشاركات اما لديهن نقص في فيتامين د (12 امرأة) أو مستوى غير كاف (18 امرأة) ، ولم يكن لدى سوى 10 نساء مستويات كافية من فيتامين د. كان فيتامين د في السائل الجريبي أعلى في النساء غير المصابات بمتلازمة تكيس المبايض من النساء المصابات (P = 0.011). العلاقة بين فيتامين د وعدد البويضات لم تكن ملحوظة. ومع ذلك ، فقد كانت ملحوظة مع نسبة نضج البويضة (rho = 0.459 ، P = 0.003) ، ومعدل الإخصاب (rho = 0.471 ، P = 0.002) ونسبة الأجنة عالية الجودة (rho = 0.316 ، P = 0.047).الاستنتاجات: المرضى اللواتي يعانين من متلازمة تكيس المبايض ، بالمقارنة مع غيرالمصابات بمتلازمة تكيس المبايض ، لديهن فيتامين د أقل. فيتامين د في السائل الجريبي قد يرتبط بنسبة نضج البويضة ، ومعدل الاخصاب ونسبة الأجنة عالية الجودة في المريضات اللواتي يخضعن لحقن الحيوانات المنوية في السايتوبلازم.

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