International Journal of Reproductive BioMedicine
Volume:12 Issue: 9, Sep 2014

Frozen- thawed embryo transfer is an essential part of ART treatment and outcomes of this procedure are associated with several clinical factors. Several studies have showed an increase level of IVF outcomes in women with sufficient vitamin D.

whether treatment of vitamin D insufficiency can improve pregnancy rates in frozen-thawed embryo transfer cycles.

This is an interventional, randomized clinical trial. Serum 25-(OH) vitamin D level of 128 women who had undergone IVF/ICSI with cryopreservation of embryos was checked. One hundred fourteen infertile women with insufficient serum vitamin D (less than 30 ng/ml) were included in the study. Fifty seven women were treated with supplementary vitamin D, 50000 IU weekly, for 6-8 weeks and fifty seven women were received no supplementation. One hundred six women completed frozen thawed embryo transfer cycles and included in the final analysis. Primary and secondary outcomes were chemical and clinical pregnancy respectively.

Our study did not show any significant difference between vitamin D insufficient and treated women in term of chemical (29.40% vs. 29.10% respectively, p=1.00) or clinical (25.50% vs. 21.80% respectively, p=0.81) pregnancy rates.

Vitamin D insufficiency treatment is not associated with higher pregnancy rate in frozen-thawed embryo transfer cycles.

Mycoplasmas can cause acute and chronic diseases at multiple sites with wide-range complications and have been implicated as cofactors in diseases. The infections influenced form genital mycoplasmas specifically Mycoplasma hominis and Mycoplasma genitalium potentially affect reproductive disorders, and infertility.

Isolation and molecular identification of Mycoplasma genitalium from the genital tract of infertile male and vaginal discharge of infertile female referred to Infertility Center of Kerman in 2013.

This study was a randomized, prospective study. We included 100 infertile male and 100 infertile female that were referred to the Infertility Center of Kerman. Then for isolation and molecular identification of Mycoplasma genitalium from urethral and vaginal discharge polymerase chain reaction was performed on Mycoplasma genus and genitalium.

From a total of 100 semen samples 45 patients (45%) were mycoplasma-positive and 13 (28.8%) were genitalium species positive. Also, from a total of 100 women samples 43 women (43%) were mycoplasma-positive and 10 (23.2%) were genitalium species positive. Positive samples were sequenced and phylogenetic tree was drawn.

According to the results of this study, a high percentage of infertile male and female were infected with the Mycoplasma genitalium. For prevention of harmful and significant consequences of this infection, we suggest a screening program in symptomatic infertile couples.

Clinical reproductive centers produce large amounts of surplus poor-quality embryos annually, how to maximize the use of these embryos, and which of them have the potential to develop into blastocyst stage and influencing factors were lack of systematic research.

To investigate the fate of surplus poor-quality embryos which were cultured to obtain blastocyst, determine the factors which may influence the blastulation, and discuss their application in predicting of the pregnancy outcomes.

Day 3 (D3) after embryo transfer and freezing, surplus poor-quality embryos from IVF/ICSI cycles were cultured to blastocyst by the sequential method, then the blastulation outcomes were observed. Focusing on the blastulation rate of those embryos with different number cells and different embryonic grade; and last the relationship between the pregnancy outcomes of remained poor-quality embryos with successful blastulation or failed blastulation groups were studied.

Of 127 patients with 569 poor-quality in vitro cultured embryos, there were formation of 248 blastocysts from 91 patients (43.59%), which lead to development of 138 high-quality blastocysts (24.25%). With the increase in cells number of D 3 blastomeres, the blastulation rate gradually increased, that, 7-cell blastomeres blastulation rate was the highest (70.59%), and 8-cell blastomeres is a little below (70.37%); while the embryonic levels and blastulation rate did not show this positive relationship. The clinical pregnancy rate and implantation rate of those who had successful blastulation (67.03% and 42.39%) were higher than of those who failed to develop to blastocyst (p=0.039).

Day 3 poor-quality embryos with successful blastulation or with failed blastulation had predictive value on pregnancy outcomes. For embryo transfer 7-8 cells grade III-IV embryo is better than 4-5 cells grade I-II embryo, in case of lack good-quality embryos.

Approximately 10-14% of the clinically acknowledged pregnancies end with spontaneous abortion at Caucasian population. Possible immunologic causes of recurrent miscarriages have been extensively researched. The change in the cytokines balance synthesis in favor of those synthesized by Th2 cells with an increase of interleukin 6 (IL6) and interleukin10 (IL10) secretion is considered essential for maintaining a normal pregnancy.

The study objective was to establish an association between interleukin 6 and 10 genes polymorphisms and etiology of recurrent pregnancy loss.

The genetic polymorphism of interleukin 6 and 10 genes were studied by PCR-RFLP in the DNA of 69 women with recurrent pregnancy loss and 64 control women with at least one successful pregnancy and without known pregnancy loss. Statistical analysis was performed using Fisher test and differences were considered statistically significant with a p<0.05.

Our results demonstrated a role for -819 C/T but not for -592 C/A IL10, -1082 A/G IL10 and -174G/C IL6 polymorphisms in idiopathic recurrent spontaneous abortion (RSA) in Romanian population. Frequency of genotype -592 CC/-819 CC was higher in the control group than in experimental group (p=0.005). In contrast, genotype -592 AC/-819 CT was more frequent in the experimental group (p=0.05). In this study we have not detected genotype -174 C/C in IL6 gene in patients with spontaneous abortions, nor in the control group.

This study demonstrated a possible association between IL-10 -819 C/T promoter polymorphism and idiopathic RSA among Romanian patients.

It has been hypothesized that blastocyst integrin expression changes can affect the spontaneous miscarriage in polycystic ovarian syndromes (PCOS).

In this study, the profile of integrin genes and proteins was investigated on blastocyst of the PCOS experimental mouse model.

30 NMRI female mice were equally divided into 3 groups: control, experimental [PCOS that was injected estradiol valerate (40 mg/kg)]. After 8 weeks, each group was hyper stimulated by PMSG and HCG. Vaginal plaque was checked, and mice were investigated 5 days after the test. Progesterone and estradiol levels were determined; α4, αv, β1 and β3 integrin genes and protein of blastocysts were examined by real time PCR method and immunohistochemistry, respectively.

Estradiol level was significantly increased (p≤0.035) in PCOS group. Based on our finding, the ratio of gene's expressions αv, β3, β1 and α4 in PCOS to control group was 0.479±0.01, 0.5±0.001, 2.7±0.4 and 1.023±0.2 respectively. Genes expression showed a great difference (p≤0.001) between β3, β1 and αv in PCOS compared to other groups. αv and β3 integrin proteins expressed in all groups but intensity of these proteins in PCOS groups, was lower than other groups.

Pattern of αv and β3 integrins expression on the mouse blastocyst surface has an important effect during the implantation window. This pattern has changed in PCOS model and might have a great influence on implantation failure. Therefore, this experimental study suggests that a great attention to this problem may be essential in patients who are involved.

Intracytoplasmic sperm injection (ICSI) is an advanced technique employed in assisted reproductive clinics for treatment of infertile couples. The reproductive endocrinologists try their level best to identify factors that enhance success rate after ICSI.

To compare estradiol progesterone ratio on ovulation induction day amongst pregnancy outcome groups following ICSI.

A cross sectional study was conducted on 323 couples of Assisted Reproductive Clinic in Islamabad from June 2010 till August 2011. Down regulation of females aged 18-40 years with gonadotrophin releasing hormone agonist was followed by calculated stimulation with gonadotrophin injections (COS). Oocytes pickup was done 36 hours after ovulation induction by 16G adapter and double lumen oocyte aspiration needle under general anesthesia. Oocytes were fertilized in vitro, graded and only blastocysts were transferred seven days after ovulation induction. Serum estradiol and progesterone were measured by enzyme linked immuno sorbent assay on ovulation induction day, ratio was compared in three groups of females; no conception with βhCG 5-25 mIU/ml, preclinical abortion with βhCG >25 mIU/ml and no cardiac activity on transvaginal scan and clinical pregnancy with βhCG >25mIU/ml and cardiac activity on transvaginal scan.

Females having high estradiol/ progesterone ratio were able to achieve clinical pregnancy shown by a positive βhCG and cardiac activity on transvaginal scan. These females also had significantly high number of oocytes, endometrial thickness and implantation rate.

A high estradiol/progesterone ratio on the day of ovulation induction predicts the success of intra cytoplasmic sperm injection.

Implantation failure of blastocyst is one of the main reasons of failure to become pregnancy following use of Assisted Reproductive Techniques. HLA-G, one of the non-classic HLA subtypes, seems to have a vital role in neutralizing of mother immune system. According to importance of ins/del polymorphism of HLA-G in regulation of HLA-G expression, it seems that this polymorphism has an important effect in immune response against embryo, and so success of embryo implantation.

In this experiment we try to evaluate association of HLA-G ins/del polymorphism with risk of occurrence of RIF in ART treated infertile women.

To evaluating insertion/deletion polymorphism association with RIF we design a case-control study. We select 40 women with history of recurrent failure to become pregnant following IVF as RIF case group. Forty women with pregnancy following IVF were selected as control. Members of both groups were assessed to rule out of anatomical, immunological and known genetical cause of infertility. Presence of 14 bp insertion/deletion alleles was assessed using PCR-PAGE technique. The data were analyzed by means of SPSS software using Chi-Square tests at the significant level of p<0.05.

Our data shows that frequency of heterozygote genotype (ins/del) was significantly higher in case group. Furthermore presence of HLA-G insertion/deletion genotype shows association with increase of implantation failure risk by 3.85 fold.

According our results, Heterozygote genotype of ins/del leads to increase of RIF risk. It seems that by genotyping of HLA-G polymorphism, we can predict risk of implantation failure in infertile women after use of ART.

Implantation is considered as the rate-limiting step in success of assisted reproduction techniques, and intrauterine insemination cycles. It might be affected by ovarian superovulation and endometrial local scratching.

This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.

In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly assigned to undergo endometrial biopsy between days 6-8 of the previous menstrual cycle before IUI (n=72, IUI cycles =126) or receive no interventions (n=72, IUI cycles=105).

The pregnancy rate per patient was 17 (23.6%) and 14 (19.4%) in endometrial biopsy and control groups, respectively (p=0.686). The pregnancy rate per cycle was 17/126 (13.5%) and 14/105 (13.3%) in endometrial biopsy and control groups, respectively (p=0.389). The abortion rate was comparable between the two groups (6.9% vs. 9.7%; p=0.764). The ongoing pregnancy rate was found to be comparable between the two study groups, as well (16.7% vs. 9.7%; p=0.325). Endometrial thickness (p=0.609) was comparable between the groups; however E2 was significantly lower in the endometrial biopsy group (p<0.001).

Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle, decreased abortion, and increased endometrial thickness.