Caspian Journal of Reproductive Medicine
Volume:9 Issue: 2, Summer-Autumn 2023

Frozen embryo transfer (FET) has become a widely used technique in assisted reproductive technology (ART) cycles. Various protocols have been developed to optimize outcomes, including hormone replacement therapy followed by frozen embryo transfer (HRT FET) cycles and non-stimulated FET (NC-FET) protocols. Additionally, the use of gonadotropin-releasing hormone analogues (GnRH-a) in combination with FET has been explored. However, comparative studies evaluating the effectiveness of these protocols on clinical pregnancy and live birth rates are limited. This study aimed to assess the efficacy of addition of GnRH-a during luteal support in FET different on clinical pregnancy and live birth.

A retrospective cohort analysis was conducted on 3,515 data from patients undergoing FET cycles at the reproductive center of the Hospital of Zhengzhou University between February 2018 and December 2,021. Patients were divided into two groups based on the FET protocol utilized: GnRH-a (Triptorelin +existing treatment) group (1,033 patients) and non-GnRH-a group (existing treatment without Triptorelin) (2,458 patients) group. Clinical pregnancy rates and live birth rates were compared between these groups using appropriate statistical analyses.

The study revealed significantly enhanced clinical pregnancy rates (58.0% vs. 48.4%; p=0.003) and live birth rates (52.7% vs. 45.6%; p=0.001) specifically for HRT-FET cycles compared to controls. However, no significant differences were observed between NC-FET groups. Similarly, no statistical difference emerged when comparing GnRH-a plus HRT-FET or stimulation-FET cycles to their respective controls regarding both clinical pregnancy rates and live birth rates. Notably, within the GnRH-a group, a 47% increase in clinical pregnancy rates and a 33% rise in live birth rates were noted.

Our findings suggest that HRT-FET cycles may be associated with improved clinical pregnancy and live birth rates compared to standard FET protocols. However, further studies are warranted to validate these results and explore the mechanisms underlying the observed differences in outcomes among different FET protocols. Additionally, the potential benefits of GnRH-a use in FET cycles warrant further investigation.

Despite the advancement in thanatological research, stillbirth remains one of the most proscribed and misunderstood types of losses. Aim of our study was to compare the efficacy and safety of the combination of mifepristone and Misoprostol vs. Misoprostol alone for the induction of labor in antepartum stillbirth.

This study recruited fifty-two pregnant individuals at a gestational age beyond 28 weeks who had been diagnosed with antepartum stillbirth. Participants allocated to group I received an oral dose of 200 mg of Mifepristone. Subsequently, after a 24-hour interval, patients were administered 50 mcg of Misoprostol orally every 4 hours, up to a maximum of four doses. In contrast, participants in group II were provided with a placebo of Tablet Calcium (500mg). Following the same 24-hour interval, they received a dose of 50 mcg of Misoprostol orally every 4 hours, for a maximum of four doses.

The mean (standard deviation) induction-to-delivery interval (IDI) in group I and group II were 8.6 (1.9) and 11.9 (3.7) hours, respectively (p <0.001). In group I, the mean (SD) total dosage of Misoprostol was 65.4 (30.9) milligrams, whereas in group II, it was 126.9 (45.2) milligrams. A significant difference was observed between the two groups in terms of the total dosage of Misoprostol (p <0.001).

These results underscore the potential benefits of Mifepristone and Misoprostol in improving outcomes for individuals experiencing antepartum stillbirth. Further research is warranted to validate and expand upon these findings, with the ultimate goal of enhancing care and support for those affected by stillbirth.

Male factor infertility, often characterized by deficiencies in sperm count, motility, and morphology, is a significant concern in the context of infertility. Azoospermia, the absence of spermatozoa in the ejaculate, represents a particularly challenging condition. This study aimed to investigate the prevalence of azoospermia among male partners of couples undergoing infertility treatment at a fertility center in Ghana.

A six-year retrospective descriptive investigation was conducted, focusing on male partners of couples seeking infertility treatment at the Emena Diagnostic and Fertility Centre. Semen analysis results indicative of azoospermia were systematically retrieved and analyzed. All samples were collected through masturbation and adhered to the stringent criteria outlined by the World Health Organization (WHO).

Among 1,224 semen analyses conducted between 2015 and 2020, 67 cases of azoospermia were identified, accounting for approximately 5.5% of the total cases. Participants' ages ranged from 28 to 69 years, with a mean age of 41.0 (SD = 9.2) years. The majority of azoospermic individuals belonged to the 30–39 age group (44.8%), followed closely by the 40–49 age group (31.3%). Notably, 90% of the cases fell within the age range of 30–59 years. Analysis of semen characteristics revealed variations in viscosity and volume, with hypospermia most prevalent in the 40–49 age group.

This study provides valuable insights into the prevalence and characteristics of azoospermia among male partners seeking infertility treatment in Ghana. These findings contribute to a better understanding of male infertility and can inform strategies for its management and treatment in clinical settings.