Administration of NTG before embryo transfer does not increase pregnancy rate

Farnoush Farzi, 1 M.D., Marzieh Mehrafza, 2 M.D., Ali Mirmansouri,1 M.D., Mona Oudi,3B.Sc., Ahmad Hoseeini, 4 Ph.D.  
1 Department of Anesthesiology, Guilan University of Medical Sciences, Rasht, Iran. & Mehr Infertility Institute, Rasht, Iran. 2 Department of Gynecology & Obstetrics ,Guilan University of Medical Sciences,Rasht,Iran- Mehr Infertility Institute, Rasht, Iran. 3  Member of Mehr Infertility Institute, Rasht, Iran. 4 Cellular and Molecular Biology Research Center, Shaheed Beheshti University of Medical Sciences. Tehran .Iran & Mehr Infertility Institute, Rasht, Iran.  
Abstract Background: Recent studies of uterine contractility in IVF–embryo transfer led us to consider an alternative, and possibly complementary, explanation for the high implantation rates of blastocysts. It has been demonstrated that myometrial contractile activity influences embryo implantation, possibly through mechanical displacement of embryos. Objective: The aim of this study was to examine the effect of nitroglycerine (NTG) treatment for priming the uterus on the pregnancy outcome of ICSI-ET programs.  Materials and Methods: This study was a prospective, randomized, double-blinded placebocontrolled clinical trial. One hundred consecutive cycles of ICSI-ET on infertile couples were randomly divided into treatment and control groups. The treatment group (50 cycles) received an oral dose of 0.4 mg of NTG, and the control group (50 cycles) received a placebo, 15 minutes before fresh ET. An informed consent from was obtained form each patients. The main outcomes were implantation rate (IR) and pregnancy rate (PR).  Results: The mean age of females in the control group and in the treatment group were 30.1±5.1 and 31±5.5 years respectively. Data showed that the mean duration of infertility was not significantly different between control and treatment groups (6.6±5.8 versus 7.8±5.1 years, respectively). The mean number of oocyte retrieval (metaphase II), 2pn, embryo cleaved, embryo transferred and PR weren't different between two Groups (p>0.05).  Overall PR was 36%, it was 38% in treatment group and 34% in control group but there wasn’t statistically significant difference between two groups. (p>0.05)  Conclusion: NTG didn't increase PR compared to placebo group. These results suggest that NTG treatment before ET isn't effective in the priming of a uterus.  
Keywords: Nitroglycerine(NTG), Embryo transfer(ET), Intracytoplasmic sperm injection (ICSI), Pregnancy rate (PR) 

Delayed transfer of embryos from 2 to 3 or 4 days after oocyte retrieval and the pregnancy rate in ICSI

Fattaneh Farifteh1,2 Ph.D., Marzieh Mehrafza1,3 M.D., Mona Oudi1 B.Sc., Azadeh Eftekhari1 B.Sc., Maryam Rahnavard1 B.Sc., Khatereh Barjasteh1 B.Sc., Ahmad Hossieni1,2 Ph.D.  
1 Mehr Infertility Institute, Rasht, Iran. 2 Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3 Guilan University of Medical Sciences, Rasht, Iran.  
Received: 3 February 2009; accepted: 23 August 2009   
Abstract Background: Embryo transfer (ET) has traditionally been performed two days after oocyte retrieval. Delaying transfer from day two to day three or four would allow for further development of the embryo, might therefore optimize the selection of viable and best quality embryos for transfer and may be closer to the physiological time of the entry into the uterus than transfer on day two, and might have a positive effect on pregnancy outcomes. Objective: The study aimed to determine whether delayed transfer of embryos from 2 to 3 or 4 days after oocyte retrieval and the pregnancy rate in ICSI (intra cytoplasmic sperm injection) procedure. Materials and Methods: In this descriptive study we evaluated infertile couples who were referred to the Mehr Infertility Institute between 2006 and 2008 for ICSI, according to the day of embryo transfer. We compared embryo quality, pregnancy rate and implantation rate among day 2, 3 or 4 of transfers.  Pregnancy rate was confirmed by measurement of β-hCG in serum after 14 days. After data collection, analysis was carried out with the t-test and chi squared tests by using the statistical software package, SPSS.16. Results: The overall clinical pregnancy rate (CPR) reported was 46.6%. The mean age of women and duration of infertility didn't differ on the day of embryo transfer (p>0.05). Overall CPRs were not statistically different for day 2 (50.3%), day 3 (46.5%) and day 4 (34.8%) transfers respectively, there were no significant differences in the age of transferred embryos between pregnant and nonpregnant women (p>0.05). Conclusion: From the result of the present study there were no statistically significant differences in pregnancy rates according to the day of embryo transfer.   
Key words: Embryo transfer, Transfer day, Pregnancy rate, ICSI.

Outcome of Intracytoplasmic Injection of Epididymal and Testicular Sperm Obtained from Patients with Obstructive and Nonobstructive Azoospermia

Authors: M.Mehrafza*, R.Tavakolnia*, H.Dashtdar*, F.Farzi*, M.Oudi*, A.Hosseini ** 

  •  *Mehr Infertility Clinic, Rasht, Iran.  
  •  ** Sh.B.Uni. Med. Sciences, Tehran, Iran. 


Purpose: Fertilization and pregnancy rates in patients with obstructive and nonobstructive azoospermia whom underwent ICSI were assessed.  
Method: From Sep. 2001 to Jun.2003, 50 ICSI procedures with precutaneouse epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) were carried out in obstructive azoospermia and nonobstructive azoospermia patients.  
Results: 172 and 116 MII oocytes were injected in obstructive azoospermia and nonobstructive azoospermia which 69.2% and 64.6% were fertilized respectively. The clinical pregnancy rates were 23.3 and 25% and ongoing pregnancy were similar in the both groups. (20%)  
Conclusion: The azoospemric patients are potentially fertile and using new technique of sperm retrieval in combination with ICSI, they can achieve fertilization and pregnancy. Moreover, the etiology (obstructive versus nonobstructive) didn’t influence the outcome of treatment significantly in the present study. 
Key words: Azoospermia; Obstructive; nonobstructive; ICSI  

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مولف : دکتر مرضیه مهرافزا، دکتر احمد حسینی و حوا دشتدار
تعداد صفحات : 180
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