Low dose hCG supplementation in a Gn-RH-agonist trigger protocol is associated with worse pregnancy outcomes: a retrospective cohort study.

Background: A number of studies have looked at dual triggers with hCG and GnRH agonist (GnRHa) in varying doses, but the question remains: what is the optimal dose of hCG to minimize ovarian hyperstimulation syndrome (OHSS) and still offer adequate pregnancy rates? The purpose of this study was to compare pregnancy and OHSS rates following dual trigger for oocyte maturation with GnRHa and a low-dose hCG versus hCG alone. A secondary objective was the assess pregnancy outcomes in subsequent frozen cycles for the same population.

Methods: A total of 963 women < 41 years old, with a BMI 18-40 kg/m and an AMH > 2 ng/mL who underwent fresh autologous in vitro fertilization (IVF) with GnRH antagonist protocol at a University-based fertility center were included in this retrospective cohort study.

Candidate gene analysis in a case of congenital absence of the endometrium.

Background: Primary amenorrhea usually result from a genetic or anatomic abnormality. We present the first reported patient with the absence of endometrium and lumen in a small bicornuate uterus in a patient with primary amenorrhea.

Case Presentation: A 41-year-old woman presented for evaluation of primary amenorrhea and infertility.

Optimal endometrial preparation for frozen embryo transfer cycles: window of implantation and progesterone support.

With significant improvements in cryopreservation technology (vitrification) the number of frozen ET IVF cycles is increasing and may soon surpass in numbers and success rates those of fresh stimulated IVF cycles. Increasing numbers of elective single ETs are also resulting in more frozen embryos (blastocysts) available for subsequent frozen ET cycles. Optimal endometrial preparation and identification of the receptive window for ET in frozen ET cycles thus assumes utmost importance for insuring the best frozen ET outcomes.

Luteal phase support in in vitro fertilization.

It has been well demonstrated that luteal phase physiology is disrupted in in vitro fertilization (IVF) cycles conducted with either gonadotropin-releasing hormone (GnRH) agonists or antagonists, and that supplementation of the luteal phase with either exogenous progesterone or human chorionic gonadotropin (hCG) is necessary to optimize IVF cycle outcomes. Though both progesterone and hCG supplementation resulted in comparable pregnancy rates, hCG supplementation was associated with increased risk for ovarian hyperstimulation syndrome (OHSS). For that reason progesterone has been used for luteal support by most IVF programs around the world.

Examining the evidence: progesterone supplementation during fresh and frozen embryo transfer.

ART has evolved over time and frozen-thawed embryo transfer (FET) is now a frequently performed, successful option. During the last decade, cryopreservation techniques have received considerable interest, whereas interest in the priming and preparation of the endometrium prior to and after embryo transfer was more limited. The available evidence for the rationale and timing of progesterone supplementation as well as an understanding of the differences among progesterone formulations with respect to efficacy, optimum use, and patient preference is worth examining.

Effect of body mass index on in vitro fertilization outcomes in women with polycystic ovary syndrome.

Objective: The objective of the investigation was to study the effect of body mass index (BMI) on in vitro fertilization (IVF) outcomes within a polycystic ovary syndrome (PCOS) population.

Study Design: This was a retrospective cohort study including 101 cycles from 79 women younger than 40 years old with a clinically documented diagnosis of PCOS by Rotterdam criteria undergoing IVF at a university-based infertility clinic from 2001 through 2010. All participants were stratified by BMI calculated from height and weight recorded within 3 months of cycle start: lean (18.

Patterns of luteal phase bleeding in in vitro fertilization cycles supplemented with Crinone vaginal gel and with intramuscular progesterone--impact of luteal estrogen: prospective, randomized study and post hoc analysis.

Objective: To compare patterns of luteal phase bleeding (LPB) in IVF cycles supplemented with Crinone and with intramuscular progesterone (IMP) and to evaluate the impact of luteal estrogen supplementation on LPB.

Design: Prospective, randomized trial and post hoc analysis.

Setting: University-affiliated IVF unit.

Crinone vaginal gel is equally effective and better tolerated than intramuscular progesterone for luteal phase support in in vitro fertilization-embryo transfer cycles: a prospective randomized study.

Objective: To compare the efficacy of Crinone vaginal gel and intramuscular progesterone (IMP) for luteal phase support in in vitro fertilization-embryo transfer (IVF-ET) with respect to pregnancy rates and outcomes, and to assess patient satisfaction with both products.

Design: Prospective randomized trial.

Setting: University-affiliated IVF unit.

Comparison of Crinone 8% intravaginal gel and intramuscular progesterone supplementation for in vitro fertilization/embryo transfer in women under age 40: interim analysis of a prospective randomized trial.

This study was performed to compare the efficacy of Crinone 8% intravaginal gel and intramuscular progesterone (IMP) supplementation for luteal phase support in women under age 40 undergoing IVF-ET. Results of the interim analysis of this rigorously designed prospective randomized controlled study are presented. Pregnancy rates, implantation rates, and early spontaneous abortion rates were similar for patients receiving Crinone or IMP, whereas fewer side effects and greater overall satisfaction were reported by women receiving Crinone.

Predictive usefulness of cycle day 10 follicle-stimulating hormone level in a clomiphene citrate challenge test for in vitro fertilization outcome in women younger than 40 years of age.

Objective: To determine the usefulness of the day 10 FSH level of a clomiphene citrate challenge test in predicting IVF outcome in women younger than 40 years of age.

Design: Retrospective chart review.

Setting: Academic fertility center.