Abstract Background To evaluate the effect of adding letrozole to the antagonist ovarian stimulation protocol (COS) on in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcome in endometriosis patients. Methods This randomized clinical trial was carried out in the department of infertility treatment at Arash Women’s Hospital from May 2019 to May 2021. The eligible women with normal ovarian reserve tests who had endometriosis diagnosis and underwent IVF/ICSI cycles were evaluated. A flexible regimen of GnRH-antagonist protocol was used for COS. In the experimental ( n = 34), the patients received 5 mg letrozole daily for the first 5 days in combination with 150 IU of recombinant follicle-stimulating hormone (rFSH). In the control group ( n = 30), the patients received only the same dose of rFSH. The treatment cycle was compared between groups. Results Analysis of demographic characteristics, severity of endometriosis, and baseline hormonal tests of patients showed that the two groups were similar and comparable. The means of total used gonadotropins ampoules and serum E 2 level on oocyte trigger day in the letrozole group were significantly lower than those of in the control group ( P = 0.03 and P = 0.004, respectively). No statistically significant difference in terms of the total number of retrieved and MII oocytes as well as the total numbers of obtained and top-quality embryos, and cryopreserved embryos was found. Conclusion The co-treatment of letrozole with gonadotropins during the antagonist protocol was associated with a reduction in the total dose of gonadotropins, although it had no effect on the oocyte or embryo yield in patients with endometriosis. Trial registration The study was registered in the Iranian Registry of Clinical Trials on 2018 -07-13 (IRCT20150310021420N4 at www.irct.ir , registered while recruiting).
{"title":"The effect of letrozole as an adjunct in GnRH-antagonist protocol on IVF/ICSI outcome in women with endometriosis: a randomized clinical trial","authors":"Maryam Farid Mojtahedi, Ashraf Moini, Ladan Kashani, Tiba Mirzarahimi","doi":"10.1186/s43043-023-00153-7","DOIUrl":"https://doi.org/10.1186/s43043-023-00153-7","url":null,"abstract":"Abstract Background To evaluate the effect of adding letrozole to the antagonist ovarian stimulation protocol (COS) on in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcome in endometriosis patients. Methods This randomized clinical trial was carried out in the department of infertility treatment at Arash Women’s Hospital from May 2019 to May 2021. The eligible women with normal ovarian reserve tests who had endometriosis diagnosis and underwent IVF/ICSI cycles were evaluated. A flexible regimen of GnRH-antagonist protocol was used for COS. In the experimental ( n = 34), the patients received 5 mg letrozole daily for the first 5 days in combination with 150 IU of recombinant follicle-stimulating hormone (rFSH). In the control group ( n = 30), the patients received only the same dose of rFSH. The treatment cycle was compared between groups. Results Analysis of demographic characteristics, severity of endometriosis, and baseline hormonal tests of patients showed that the two groups were similar and comparable. The means of total used gonadotropins ampoules and serum E 2 level on oocyte trigger day in the letrozole group were significantly lower than those of in the control group ( P = 0.03 and P = 0.004, respectively). No statistically significant difference in terms of the total number of retrieved and MII oocytes as well as the total numbers of obtained and top-quality embryos, and cryopreserved embryos was found. Conclusion The co-treatment of letrozole with gonadotropins during the antagonist protocol was associated with a reduction in the total dose of gonadotropins, although it had no effect on the oocyte or embryo yield in patients with endometriosis. Trial registration The study was registered in the Iranian Registry of Clinical Trials on 2018 -07-13 (IRCT20150310021420N4 at www.irct.ir , registered while recruiting).","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"29 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135935825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Progesterone (P4) plays a critical role in a natural menstrual cycle. It is an essential hormone to have successful embryo implantation into the endometrium. Objective In the current study, we compared the clinical outcomes of patients with different levels of P4 on embryo transfer day and aimed to determine the optimum threshold for P4 in the luteal phase. Material and methods We performed a prospective cohort study on 100 patients who were referred to the Taleqani Infertility Treatment Institute to undergo frozen embryo transfer (FET). Endometrial preparation was programmed using an estrogen (E2) and progesterone supplement. FET was carried out 3 days after administration of the first dosage of progesterone. We measured serum progesterone levels on embryo transfer day. Clinical pregnancy was the main investigated outcome. We used a parametric receiver operating characteristic curve (ROC) to determine the best-cut points of P4 on embryo transfer day. Results Overall, the average endometrial thickness was 7.9 ± 0.2 mm. We observed no association between endometrial thickness and clinical pregnancy ( P value = 0.719). The mean number of the transferred embryos in all investigated cycles was 1.5 ± 0.5, and 80.0% of the transferred embryos were high quality (high and medium level). The average progesterone level in cycles with clinical pregnancy was 17.2 ± 3.3 ng/mL. It was only 13.4 ± 9.4 in patients without clinical pregnancy. The observed difference was statistically significant ( P value = 0.032). The estimated AUC for the drawn ROC curve was 0.71 indicating a high predictive value. Conclusion The current study demonstrated that high and low serum progesterone (P4) levels on embryo transfer day were associated with reduced clinical outcomes following blastocyst transfer during IVF/ICSI. However, more studies with large sizes are required in this regard.
{"title":"Effect of different levels of serum progesterone on day of frozen ET on clinical outcome","authors":"Sedigheh Hosseini, Saghar Salehpour, Parisa Taherzadeh Borujeni, Nazanin Hajizadeh","doi":"10.1186/s43043-023-00151-9","DOIUrl":"https://doi.org/10.1186/s43043-023-00151-9","url":null,"abstract":"Abstract Background Progesterone (P4) plays a critical role in a natural menstrual cycle. It is an essential hormone to have successful embryo implantation into the endometrium. Objective In the current study, we compared the clinical outcomes of patients with different levels of P4 on embryo transfer day and aimed to determine the optimum threshold for P4 in the luteal phase. Material and methods We performed a prospective cohort study on 100 patients who were referred to the Taleqani Infertility Treatment Institute to undergo frozen embryo transfer (FET). Endometrial preparation was programmed using an estrogen (E2) and progesterone supplement. FET was carried out 3 days after administration of the first dosage of progesterone. We measured serum progesterone levels on embryo transfer day. Clinical pregnancy was the main investigated outcome. We used a parametric receiver operating characteristic curve (ROC) to determine the best-cut points of P4 on embryo transfer day. Results Overall, the average endometrial thickness was 7.9 ± 0.2 mm. We observed no association between endometrial thickness and clinical pregnancy ( P value = 0.719). The mean number of the transferred embryos in all investigated cycles was 1.5 ± 0.5, and 80.0% of the transferred embryos were high quality (high and medium level). The average progesterone level in cycles with clinical pregnancy was 17.2 ± 3.3 ng/mL. It was only 13.4 ± 9.4 in patients without clinical pregnancy. The observed difference was statistically significant ( P value = 0.032). The estimated AUC for the drawn ROC curve was 0.71 indicating a high predictive value. Conclusion The current study demonstrated that high and low serum progesterone (P4) levels on embryo transfer day were associated with reduced clinical outcomes following blastocyst transfer during IVF/ICSI. However, more studies with large sizes are required in this regard.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136114564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-23DOI: 10.1186/s43043-023-00147-5
Ali Hosseini, Zohreh Lavasani
Abstract Background Thyroid cancer is one of the common cancers that, depending on the need for treatment, patients are treated with radioactive iodine after thyroidectomy surgery. The purpose of this study is to investigate the effect of iodine therapy on the ovarian reserve of women at reproductive ages. Methods In this prospective study, 60 patients with thyroid cancer aged 18 to 35 who were undergoing iodine therapy for the first time in 2018–2019 were included in the study. Patients with underlying diseases and any ovarian disorders and patients who needed repeated iodine treatment were excluded from the study. Anti-Müllerian hormone (AMH) level of patients was evaluated 4 times before, 3, 6, and 12 months after iodine therapy. The significance level of the P -value study was considered less than 0.05. Results The average age of the patients was 29.53 ± 4.53 years. With aging, AMH level decreases significantly. No significant correlation was observed between smoking, menarche age, and abnormal uterine bleeding with AMH level. The average AMH before, 3, 6, and 12 months after iodine therapy was 2.25 ± 0.55 ng/ml, 1.15 ± 0.35 ng/ml, 1.58 ± 0.47 ng/ml, and 1.94 ± 0.58 ng/ml, which has a significant decrease respectively 49.05%, 29.55%, and 13.58% compared to the amount before iodine therapy ( P -value < 0.001). Conclusion Considering the effect of iodine therapy on the reduction of AMH levels, it is recommended that women of reproductive age group should be evaluated prior to iodine therapy to determine their ovarian reserve level so that if their AMH level is not suitable, they may need to consult with a fertility preservation specialist.
{"title":"The effect of radioactive iodine therapy on anti-Müllerian hormone changes in women with thyroid cancer at reproductive age: a prospective study","authors":"Ali Hosseini, Zohreh Lavasani","doi":"10.1186/s43043-023-00147-5","DOIUrl":"https://doi.org/10.1186/s43043-023-00147-5","url":null,"abstract":"Abstract Background Thyroid cancer is one of the common cancers that, depending on the need for treatment, patients are treated with radioactive iodine after thyroidectomy surgery. The purpose of this study is to investigate the effect of iodine therapy on the ovarian reserve of women at reproductive ages. Methods In this prospective study, 60 patients with thyroid cancer aged 18 to 35 who were undergoing iodine therapy for the first time in 2018–2019 were included in the study. Patients with underlying diseases and any ovarian disorders and patients who needed repeated iodine treatment were excluded from the study. Anti-Müllerian hormone (AMH) level of patients was evaluated 4 times before, 3, 6, and 12 months after iodine therapy. The significance level of the P -value study was considered less than 0.05. Results The average age of the patients was 29.53 ± 4.53 years. With aging, AMH level decreases significantly. No significant correlation was observed between smoking, menarche age, and abnormal uterine bleeding with AMH level. The average AMH before, 3, 6, and 12 months after iodine therapy was 2.25 ± 0.55 ng/ml, 1.15 ± 0.35 ng/ml, 1.58 ± 0.47 ng/ml, and 1.94 ± 0.58 ng/ml, which has a significant decrease respectively 49.05%, 29.55%, and 13.58% compared to the amount before iodine therapy ( P -value < 0.001). Conclusion Considering the effect of iodine therapy on the reduction of AMH levels, it is recommended that women of reproductive age group should be evaluated prior to iodine therapy to determine their ovarian reserve level so that if their AMH level is not suitable, they may need to consult with a fertility preservation specialist.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135958933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-06DOI: 10.1186/s43043-023-00149-3
Li-fan Peng
{"title":"Sperm genetic abnormality testing in recurrent pregnancy loss cases: a narrative review","authors":"Li-fan Peng","doi":"10.1186/s43043-023-00149-3","DOIUrl":"https://doi.org/10.1186/s43043-023-00149-3","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45494693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-02DOI: 10.1186/s43043-023-00148-4
Velu Krishnan, Shivani S. Patel, Priyanka Shenoy, J. Cottrell
{"title":"Bioinformatic network analysis on the molecular interactions between Parkinson’s disease, alpha-synuclein, and infertility condition","authors":"Velu Krishnan, Shivani S. Patel, Priyanka Shenoy, J. Cottrell","doi":"10.1186/s43043-023-00148-4","DOIUrl":"https://doi.org/10.1186/s43043-023-00148-4","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49069571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-14DOI: 10.1186/s43043-023-00146-6
K. Atwa, Z. Ibrahim, Eman M. El Bassuony, O. Taha
{"title":"Factors associated with recurrent endometriomas after surgical excision","authors":"K. Atwa, Z. Ibrahim, Eman M. El Bassuony, O. Taha","doi":"10.1186/s43043-023-00146-6","DOIUrl":"https://doi.org/10.1186/s43043-023-00146-6","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48065460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-04DOI: 10.1186/s43043-023-00145-7
O. Taha, Mohammed M. Abd-Elgelil, E. Kishk, Mohammed M. Shaaban, Rasha E. Khamees
{"title":"Metformin versus levonorgestrel-releasing intrauterine system in the management of endometrial hyperplasia: a randomized clinical trial","authors":"O. Taha, Mohammed M. Abd-Elgelil, E. Kishk, Mohammed M. Shaaban, Rasha E. Khamees","doi":"10.1186/s43043-023-00145-7","DOIUrl":"https://doi.org/10.1186/s43043-023-00145-7","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42617730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-20DOI: 10.1186/s43043-023-00143-9
A. Youssef, O. Shaaban, Mariam Kamal, A. Shaltout, A. Abbas, A. Mohamed
{"title":"Internal vaginal douching increases the incidence of vaginal infection among IUD users: a cross-sectional study","authors":"A. Youssef, O. Shaaban, Mariam Kamal, A. Shaltout, A. Abbas, A. Mohamed","doi":"10.1186/s43043-023-00143-9","DOIUrl":"https://doi.org/10.1186/s43043-023-00143-9","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44025186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-17DOI: 10.1186/s43043-023-00144-8
R. Elnahas, Amal K. Behery, S. Kholeif, Y. Orief, G. Elhady
{"title":"Sperm chromosomal abnormalities in infertile men with failed intracytoplasmic sperm injection (ICSI)","authors":"R. Elnahas, Amal K. Behery, S. Kholeif, Y. Orief, G. Elhady","doi":"10.1186/s43043-023-00144-8","DOIUrl":"https://doi.org/10.1186/s43043-023-00144-8","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48298574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.1186/s43043-023-00141-x
M. A. Al Shukri, Al Shimaa Abdullah Al Riyami, Wadha Mohammed Al Ghafri, V. Gowri
{"title":"Reproductive outcome and gynecologic comorbidities in women with endometriosis in a non-IVF setting: a retrospective study","authors":"M. A. Al Shukri, Al Shimaa Abdullah Al Riyami, Wadha Mohammed Al Ghafri, V. Gowri","doi":"10.1186/s43043-023-00141-x","DOIUrl":"https://doi.org/10.1186/s43043-023-00141-x","url":null,"abstract":"","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41756019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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