Background: Controlled ovarian hyperstimulation aims to obtain mature follicles. The present study was conducted to assess the correlation of mature follicle in transvaginal ultrasound scanning (TVS) and serum estradiol levels on day of trigger injection in ovarian stimulation cycle for IVF with the oocyte yield.Methods: In this prospective study, we evaluated oocyte donor 19 to 45 years of age who underwent oocyte retrieval at our clinic. Outcome variables like number of mature follicles visualized on TVS on the last day of stimulation was noted for all patients. On the same day, serum estradiol levels and number of mature follicles seen on TVS were noted and correlated with the number of oocytes retrieved. Ultrasound guided transvaginal oocyte retrieval was performed and total number of oocytes were noted.Results: During the study period, 20 oocytes donors were included. Mean age of the patients was 27.9±4.7 years. Mean BMI was 26.8±2.3 kg/m2. Mean FSH level was 6.89±1.79 IU/L and mean antral follicle count on day 3 was 14.06±3.56. On the day of trigger, mean mature follicle count seen on TVS was 20.4±13.8, ranging from 8 to 50. On an average, 17.2 oocytes were retrieved. On the day of trigger, mean estradiol level was 4970±203, ranging from 500 to 15,665 pg/ml. It was observed that the number of retrieved oocytes correlated significantly with the serum estradiol levels, (Pearson’s coefficient 0.94, p value<0.001) and number of mature follicles seen on TVS ((Pearson’s coefficient 0.92, p value<0.001).Conclusions: Number of retrieved oocytes correlated significantly with the serum estradiol levels and number of mature follicles seen on TVS on the day of trigger.
Background: Poor Responders Patients undergoing IVF treatment were given Dual Trigger for final oocyte maturation. Poor responders are the patients in whom, less number of egg were retrieved. Typically, they were with advanced maternal age and poor ovarian reserve (AFC <5-7 follicle or AMH < 1.2ng/ml) or with a history of previous Poor ovarian reserve (<3 oocytes) with Controlled ovarian stimulation. This study aimed to examine the effectiveness of dual trigger for final oocyte maturation in poor responder patients based on Bologna criteria (2011). Methods: A total of 30 IVF cycles of poor responder patients were retrospectively analyzed. The study group (15 patients) was given dual triggers (HCG and GnRH agonist) for final oocyte maturation whereas in control group final oocyte maturation was performed with HCG only. GnRH antagonist Protocol was used in both the groups. Baseline characteristics, number of oocyte retrieved, the number of M-2 and the quality of embryo of both groups were compared. Results: Both the groups were comparable in baseline characteristics. In our study, there was not much difference in number of oocyte retrieved, but there was higher number of M2 and top quality embryo, compared to control group. Conclusion: Dual trigger might be a superior option for final oocyte maturation as compared to hCG trigger alone in terms of IVF cycles outcomes in poor responders and further large scale randomized prospective studies needed to validate our results.
Background: Progesterone (PG) is an essential hormone in the process of implantation and pregnancy maintenance. Frozen-thawed embryo transfer (FET) is being performed worldwide. This study was designed to investigate whether serum progesterone levels on the day prior to day 5 frozen-thawed embryo transfer (FET) to hormonally prepared endometrium correlates with pregnancy outcomes. Materials and Methods: A single center longitudinal observational study was conducted at an infertility center over a period of three months from October 2022 to December 2022. The study participants were the patients attending the infertility center who satisfied the inclusion and exclusion criteria. A total of 30 participants were included in this study. Serum progesterone levels were measured on the day of starting the progesterone (P0) and on day four (P4), the day prior to embryo transfer. Data analysis was conducted using SPSS version 21. Results:The mean (SD) age in those who had positive pregnancy outcome was 34.22 (1.26) years and in those who had negative pregnancy outcomes was 39.92 (2.11) years and the difference was significant (P = 0.001). The mean (SD) serum progesterone levels in those who had positive pregnancy outcome at day 0 was found to be 0.61 (1.19) ng/ml and in those who had negative pregnancy outcomes was 0.28 (0.27) ng/ml but, the difference was not significant (P = 0.347). The mean (SD) serum progesterone levels in those who had positive pregnancy outcome at day 4 was found to be 10.84 (8.13) ng/ml and in those who had negative pregnancy outcomes was 8.13 (3.81) ng/ml and the difference was significant (P = 0.039). Conclusion: Pregnancy loss increases with age and serum progesterone measurements at day 4 prior to embryo transfer could be used to assess pregnancy outcomes in frozen-thawed embryo transfer (FET) technique of infertility treatment. Monitoring of serum PG levels can be done for diagnosing potential luteal support defects before performing FET with artificial cycle (AC).
Background: The present study assessed the role of sildenafil in endometrial blood flow and successful pregnancy in IVF done in surrogate mothers.Methods: In the present study surrogate mothers were included. Thirty patients were randomized to receive sildenafil 25 mg thrice a day vaginally in addition to standard drugs and technique and another 30 were not given sildenafil.Results: Mean age, anthropometry, duration of infertility and pre-treatment endometrial thickness was similar in the two study groups. After treatment completion, it was observed that the endometrial pattern in ultrasound was similar in the two study groups (p value=0.58). Heterogenic endometrial pattern was observed in 6.7% of the Sildenafil patients and 3.3% in the control patients, while echogenic pattern was seen in 10% of the sildenafil patients and 6.7% of the control patients. Similarly, endometrial thickness was 10.2±1.7 and 9.7±1.8 mm in sildenafil and control group respectively, p value=0.62. Using doppler ultrasound, uterine artery PI was significantly lower in Sildenafil group patients as compared to control group patients. Similarly, we found uterine artery RI was also significantly lower in the Sildenafil group patients as compared to control group patients. We followed the patients and found that clinical pregnancy rate was significantly higher among Sildenafil group (60%) as compared to control group (26.6%), p value<0.05.Conclusions: Vaginal sildenafil resulted in significantly higher pregnancy rates in our study population. The uterine artery PI and RI were significantly lower in patients taking sildenafil.
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