Duration of Controlled Ovarian Stimulation and Total Dose of Gonadotrophin and Its Effect on Oocyte Maturity, Embryo Grades Resulted and Clinical Pregnancy in IVF Cycle

Abstract

Background: Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercours. It affects nearly 10% of the world's population Aim of study: To evaluate correlation between total gonadotrophin dose, duration of controlled ovarian stimulation and maternal age with oocyte maturity, embryo grades, and clinical pregnancy in IVF cycle.Methods: A prospective study in Kamal Al-Samarai Hospital for infertility and IVF in Baghdad / Iraq for a period of one year from 1 st of Jun. 2019 till 1 st of Jun. 2020. It included 122 infertile females had IVF-ICSI cycles.Results: The antagonist protocol in 52.5% of patients; long agonist protocol in 47.5%. A patient of IVF was seen in 68% of study patients. The highest prevalence of pregnancy failure was significantly seen in patients aged ≥ 40 years (83.3%, P= 0.03), obese patients (80.5%, P= 0.032), in patients had primary infertility (72.6%, P= 0.041), and in patients with infertility for > 12 years' duration (90%, P= 0.036). Means of duration of stimulation, total number of oocyte pick, MII, embryo grade I were significantly higher in patients who got pregnant. Conclusion:individualization & adjustment of the dose gonadotropin according to female response, drug costs and efficacy, financial status in order not to increase or decrease duration of stimulation to be within 10 -12 days to achieve sufficient number of M II oocytes, good quality embryos selected for matching endometrium receptivity in fresh embryo transfer, the remaining embryos can be cryopreserved.