Infertile patients with moderate/severe endometriosis, which is associated with ovulatory dysfunction, presented lower levels of IGFBP-1 in the follicular fluid when undergoing IVF.
Objetivo: Avaliar o efeito de um meio para transferência embrionária, suplementado com ácido hialurônico (AH), nas taxas de implantação e gestação, comparando parâmetros de qualidade embrionária a estas em pacientes com idade avançada submetidas à fertilização in vitro. Métodos: Ensaio clínico prospectivo não randomizado. Foram incluídas 128 pacientes, com idade ≥35 anos e embriões para transferência, de janeiro de 2004 a junho de 2005. Os 128 ciclos obtidos foram divididos em 69 ciclos com AH e 59 ciclos com albumina sérica humana ( HSA). Resultados: Foram similares, média de idade nos grupos de 38,6 ± 2,87 vs. 38,5 ± 2,6 anos, embriões transferidos (161 vs. 157) e embriões transferidos/paciente (2,33 ± 1,28 vs. 2,66 ± 1,17). As taxas de implantação e gestação foram superiores para o grupo com AH (19,3% e 36,2%) respectivamente, comparadas ao grupo com HSA (14,6% e 32,2%). Conclusão: O meio com AH apresentou uma elevação nas taxas de implantação e gestação, sem diferenças estatisticamente significativas e houve manutenção da taxa de implantação independente da qualidade embrionária, indicando possível efeito positivo no processo de implantação em pacientes com idade avançada.
Objective: Analysis and compare data between two induction protocols (long agonist and flexible antagonist) in patients submitted an assisted reproduction technique in Porto Alegre. Methods: Cross-sectional study comparing the intermediate results with the use of two different ovarian stimulation protocols with gonadotropin-releasing hormone agonist versus antagonist to assisted reproductive techniques. The statistical analysis of the retrieved data (age, body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved, total dose of FSH used and ovarian hyperstimulation syndrome) was performed by Student's t-test for parametric data and analysis of covariance for the dependent variables. Results: A total of 50 patients, 25 in each group, met the criteria for inclusion in the study between January and March in the year 2010. There was statistically significant difference only in the middle ages between the groups (P = 0.031). There was no statistical difference for the remaining data analyzed (body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved and dose of FSH utilized). There were no cases of ovarian hyperstimulation syndrome. Conclusion: Both protocols are equal in terms of results. The agonist has advantages about scheduling of the procedure, but it takes too long to start the stimulation and have possibility to start medication in a pregnant patient. Added to this, we have the possibility of getting the ovarian hyperstimulation syndrome as complication. In the antagonist group, is clear the ease-of-use of the medication and the fastest start of stimulation.
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