This study aimed to evaluate if endometrial length (EL) affects the likelihood of a positive pregnancy test in individuals who had in vitro fertilization/intra cytoplasmic sperm injection (IVF/ICSI). Between December 2020 and June 2021, 100 women from those referred to the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, for IVF/ICSI were selected. These women were 20–40 years old with primary type sub-fertility and met the inclusion criteria. Controlled ovarian hyperstimulation (antagonist protocol), followed by transvaginal sonography (TVS), was used to measure the endometrial length (EL) from the internal ostium to the fundus on the day of ovum collection. Afterwards, the association between endometrial length and the outcome was examined. The data were analyzed using the Statistical Package for Social Sciences (SPSS). The data show an important link between EL and treatment success. Endometrial length of ≥39 mm was considered a good cut-off point for IVF/ICSI pregnancy rates with a sensitivity of 75%, a specificity of 68%, a positive predictive value of 57%, and a negative predictive value of 83, and area under the curve of 0.81. An endometrial length of 39 mm can be used as an appropriate cut-off point in IVF/ICSI to predict a greater pregnancy rate. Vaginal sonography could be used in the ART cycle to measure the endometrial length and thickness and to determine endometrial receptiveness.
Objectives: to assess the possible association between Angiopoietin-2 (ANGT-2) and the risk of recurrent implantation failure and to determine the possible role of it in the successfulness of in vitro fertilization process. Methods: A case control study was done on 80 female patients with Recurrent Implantation Failure (RIF) and 23 female patients with successful in-vitro fertilization (IVF) who were recruited from the Department of Obstetrics and Gynecology at Al Imamain Al-Kadhimain Medical City, Baghdad, Iraq between January and September 2019. The levels of ANGT-2 were measured in the serum of women with RIF and successful IVF and compared with those with a positive IVF and control group that comprise 74 age, BMI and sex-matched apparently healthy females. Results: The data revealed that there was a significant (p=0.007) decrease in ANGPT2 levels (2914.66±834.08) in women with recurrent implantation failure (RIF) in a comparison with controls (3235.83 ±444.16) whereas non-significant (p>0.05) differences were obtained between women with a successful in vitro fertilization (+ve IVF) and controls and also with RIF group. Conclusions: the possible association between ANGT-2 and the risk of RIF and the possibility of using it as a marker for a prognosis in women subjected to IVF process
Receptivity of endometrial is a series of events which enhance implantation of the embryo. It is controlled by several growth factors, cytokines and steroid hormones. The current study aims to assess the influences of vaginally managed sildenafil in ICSI patients on the thickness of endometrial, sub endometrial resistance index and pulsatility index, serum level of vascular endothelial growth factor (VEGF) and pregnancy outcome. The study was planned as a controlled randomized trial (interventional experimental study) involved a total of sixty women who attend High Institute of Infertility Diagnosis and Assisted Reproductive Technologies who undergo ICSI cycle. Enrolled patients divided into two groups: 1) Study group: thirty (30) infertile women had received sildenafil 25mg tablet intravaginally four times daily form the day of stopping blood of menstrual cycle to the day of hCG injection. 2) Control group: thirty (30) infertile women had not treated by sildenafil. In our study, we found the following results: the level of vascular endothelial growth factor was highly significant in the study group. The sub endometrial Doppler study, the mean pulsatility index was significantly lower in the study group, while no significant difference in the resistant index and mean systolic to the diastolic ratio between study and control groups. The thickness of endometrial on the same day of ova pickup was higher in the study group, although statistically not significant. The pregnancy rate of sildenafil group was higher. However, the difference was not statistically significant. We concluded the using vaginal sildenafil during fresh ICSI cycle improve endometrial receptivity by enhancing sub endometrial blood flow through reducing pulsatility index and increasing vascular endothelial growth factor.
Polycystic ovary syndrome (PCOS), is a heterogeneous disorder found in 3% - 10% of women worldwide, and it constitutes about 80 % of anovulation infertility. In cases of resistance to CC surgical option in form of ovarian drilling, for using maneuver with less invasive than laparoscopy we study the effect of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to clomiphene citrate This study was conducted o evaluate the effectiveness of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to CC. In this, A prospective, clinical trial study 42 infertile women with PCOS resistant to 3 months course of treatment with CC enrolled in this study. The preoperative assessment includes history, physical examination, the serum levels of FSH, LH, AMH, testosterone, and TVS was done for ovarian morphology. Transvaginal ovarian drilling under ultrasound guide using a needle connected to manual vacuum pressure that punctured each ovary between 3 – 6 punctures. Postoperatively Signs of spontaneous ovulation, levels of FSH, LH, AMH, testosterone, and pregnancy rate were recorded. The results revealed that There is a significant reduction in the level of LH, FSH, Testosterone, and Anti-Mullerian hormones. Signs of spontaneous ovulation was developed, and the pregnancy rate after the operation was recorded. This low cost, no recorded adverse effects, and quickly done manoeuvre has an excellent result in improving fertility rate in resistant PCOS women to CC.
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