We report on 332 infertile couples who underwent 1115 cycles of intrauterine insemination (IUI) with washed husband's semen. The indication for IUI was an abnormal post-coital test due to either a male or cervical infertility factor. The mean number of IUI cycles per patient was 3.4, the overall pregnancy rate 18.7%, and the pregnancy rate per cycle 5.6%. The cumulative pregnancy rate calculated by life table analysis showed that 16.0% of pregnancies occurred in the first three treatment cycles, while the cumulative pregnancy rate was 26.9% by the sixth cycle. The outcome of the therapy was adversely affected if the woman's age was >39 years and/or total motile sperm count per insemination was <1X1O*. No pregnancy occurred in women older than 44 years or in cases with a total motile sperm count before semen preparation of <1X1O*.

A group of 140 women with a body mass index (BMI) < or = 24 kg/m(2) undergoing 291 cycles was compared with a group of 138 women with a BMI >24 kg/m(2) in 291 cycles, with respect to duration of ovarian stimulation and dose of gonadotrophin, number of oocytes collected, cleavage and implantation rate, clinical pregnancy, miscarriage and delivery rates. Patients with a BMI > 24 kg/m(2) demonstrated a significant decrease in the number of follicles after stimulation (P = 0.01), a comparative increase in the number ampoules of gonadotrophin used (P = 0.03) and a lower number of eggs collected (P = 0.05). The mean number of embryos on days 1, 2 and 3 was significantly lower in the group with BMI > 24 kg/m(2) (P < 0.001). No significant difference was found in clinical pregnancy and miscarriage rates between the two groups. In spite of the lower response in women with BMI > 24 kg/m(2), the delivery rate per retrieval was not different (24.6 versus 24.8%). These results indicate a lower stimulation response in women with elevated BMI, but no adverse effect on IVF outcome. In relation to wellbeing, however, it is recommended that patients with a high BMI reduce their weight before IVF treatment.

No abstract

No abstract

No abstract

BACKGROUND: Surmounting evidence suggests that frozen embryo transfer results in higher pregnancy and live birth rates compared to fresh transfer during in vitro fertilization (IVF) (1, 2). There is conflicting data regarding neonatal outcomes: preterm birth, pre-eclampsia and birth weight (3, 4). The effect of embryo cryopreservation on the placental morphology is not well understood. OBJECTIVE: To evaluate differences in placental morphology from infants conceived with cryothaw compared to fresh transfer in IVF. MATERIALS AND METHODS: A retrospective cohort study from 2009 through 2015 of live births resulting from IVF with autologous oocytes. The placentas were divided into two groups, those from cryothaw embryo transfers and those from fresh embryo transfers. Gross and histologic placental specimens were examined. Morphologic pathology was categorized into anatomic (e.g. cord malinsertion or circumvallate), infectious (choramnionitis), inflammatory (e.g. villitis of unknown etiology, deciduitis), and vascular/thrombotic (placental abruption, intervillous thrombus, maternal and fetal vascular malperfusion). T-tests and Chi square were used for analysis with 95% confidence intervals (CIs). Logistic regression modeling was used to control for age, race, body mass index, fertility diagnosis and gestational age gestational age at delivery. RESULT(S): A total of 838 placentas were reviewed; 13% from cryothaw transfers and 87% from fresh transfers. Gestational age was similar between the two groups, (38.5 vs. 37.7 weeks p¼ 0.2). The mean birth weight of singleton infants was higher in the cryothaw group (3241.6 grams) than in the fresh group (3099.5 grams, p¼0.001). There was no difference in the proportion of placentas submitted to pathology in frozen vs. fresh group (36% vs. 40%, p>0.05). Controlling for regression modeling, there were fewer vascular/thrombotic morphologies in the cryothaw transfers when compared to the fresh (aOR¼0.31, CI¼0.11-0.81, p<0.05). There were also fewer anatomic morphologies in the cryothaw group as compared to the fresh group (aOR¼ 0.24.

No abstract

In this study we examined various techniques of in-vitro fertilization (TVF) for treating couples in whom the male had subnormal semen parameters. We compared two sperm preparation methods (mini-Percoll and conventional swimup) for efficiency of recovery after preparation and for fertilization rates after IVF, and compared the suitability of partial zona dissection (PZD) and sub-zonal sperm insertion (SUZI) to patients with different types of male factor infertility. The mini-Percoll technique allowed the recovery of significantly more motile spermatozoa from the same semen sample compared to the swim-up method. More oocytes were fertilized after spermatozoa were prepared by the mini-Percoll technique. An increased number of spermatozoa recovered from an ejaculate led to an improvement in the quality of spermatozoa in the insemination droplet. Subsequently, when using the PZD technique, the fertilization rate increased when there was a higher number of spermatozoa in the patient's ejaculate. When comparing the two micromanipulation techniques, SUZI provided patients with oligoasthenzoospermia (i.e. < 10 x 10 6 spermatozoa/ml and 40% motility) with a higher chance of obtaining 2-pronculeate eggs.