Does flushing the endometrial cavity with follicular fluid after oocyte retrieval affect pregnancy rates in subfertile women undergoing intracytoplasmic sperm injection? A randomized controlled trial.

Objective: Follicular fluid of mature oocytes is rich in growth factors and cytokines that may exert paracrine and autocrine effects on implantation. The aim of this study was to investigate if flushing the endometrial cavity with follicular fluid after oocyte retrieval improved pregnancy rates in subfertile women undergoing intracytoplasmic sperm injection (ICSI).

Study Design: One hundred subfertile women undergoing ICSI between April 2012 and September 2012 at the centre for reproductive medicine, Cairo University, Egypt were enrolled in this open label, parallel randomized controlled study.

Impact of antimüllerian hormone assays on the outcomes of in vitro fertilization: a prospective controlled study.

Objective: To assess the value of routine antimüllerian hormone (AMH) assays in patients considered high risk for cancellation.

Design: Prospective controlled study.

Setting: A private IVF center, Cairo, Egypt.

International Committee for Monitoring Assisted Reproductive Technology: world report on assisted reproductive technology, 2005.

Objective: To analyze information on assisted reproductive technology (ART) performed worldwide and trends in outcomes over successive years.

Design: Cross-sectional survey on access, effectiveness, and safety of ART procedures performed in 53 countries during 2005.

Setting: A total of 2,973 clinics from national and regional ART registries.

The use of vaginal natural progesterone for prevention of preterm birth in IVF/ICSI pregnancies.

The aim of this study was to evaluate the effect of vaginal natural progesterone on the prevention of preterm birth in IVF/intracytoplasmic sperm injection (ICSI) pregnancies. A single-centre prospective placebo-controlled randomized study was performed. A total of 313 IVF/ICSI pregnant patients were randomized into two groups for either treatment with daily 400 mg vaginal natural progesterone or placebo, starting from mid-trimester up to 37 weeks or delivery.

Agonist and antagonist coast.

The use of GnRH-a in ovarian stimulation permitted stronger stimulation resulting in an increased incidence of OHSS. The first Cochrane review comparing GnRH agonist and GnRH antagonist protocols for ovarian stimulation showed no significant difference in OHSS rate between the two protocols, however, a recent Cochrane review showed a highly significant decrease in the incidence in OHSS rate in the antagonist protocol. Coasting is a commonly used procedure for preventions of OHSS.

Intrauterine injection of human chorionic gonadotropin before embryo transfer significantly improves the implantation and pregnancy rates in in vitro fertilization/intracytoplasmic sperm injection: a prospective randomized study.

Objective: To investigate the value of intrauterine injection of human chorionic gonadotropin (hCG) before embryo transfer (ET).

Design: Prospective randomized study.

Setting: The Egyptian IVF-ET Center.

A simple and relatively painless technique for hysterosalpingography, using a thin catheter and closing the cervix with the vaginal speculum: a pilot study.

Objective: To evaluate the use of a thin catheter for hysterosalpingography (HSG) for reducing the pain experienced during the procedure.

Methods: Infertile women undergoing tubal patency tests were randomised into two groups. In the study group (n=66) a thin catheter originally designed for intrauterine insemination was used to inject the dye.

Can metformin reduce the incidence of gestational diabetes mellitus in pregnant women with polycystic ovary syndrome? Prospective cohort study.

Background: Women with polycystic ovary syndrome (PCOS) are at a high risk to develop Gestational Diabetes mellitus (GDM). We hypothesized that metformin due to its metabolic, endocrine, vascular, and anti-inflammatory effects may reduce the incidence of GDM in PCOS women.

Patient And Method: We carried out a prospective cohort study to determine the beneficial effects of metformin on PCOS patients during pregnancy.

Success of frozen embryo transfer: Does the type of gonadotropin influence the outcome?

Objectives: To determine whether there is a difference in outcome between different ovulation-induced cycles after frozen-thawed embryo transfer (FET).

Methods: We searched the Cochrane Menstrual Disorders and Subfertility Group's trials register in May 2009, the Cochrane Central Register of Controlled Trials (Cochrane Library, Issue 1, 2008), ISI Web of Knowledge (1985 to August 2009), and reference lists of articles. Relevant conference proceedings were hand-searched and researchers in the field were contacted.

Effect of urinary versus recombinant FSH on clinical outcomes after frozen-thawed embryo transfers: a systematic review.

Recent randomized trials, systematic reviews and cost-effectiveness analyses have demonstrated the relative efficacy,and in some cases superiority, of urinary gonadotrophins (uFSH, human menopausal gonadotrophin) compared with recombinant FSH (rFSH). However, the effectiveness of frozen-embryo transfers (FET) following ovarian stimulation with uFSH versus rFSH in the fresh cycle has not been well investigated. The objective of this study was to determine whether there are differences in clinical outcomes in women undergoing FET according to the type of gonadotrophin used during ovarian stimulation.

The impact of vanishing fetuses on the outcome of ICSI pregnancies.

Vanishing fetal twins occurred in 9% (264 out of 2,829) intracytoplasmic sperm injection pregnancies and are associated with a lower fetal loss rate in the first trimester. The live birth rate was higher in pregnancies associated with vanishing fetuses.

Analysis of 2,386 consecutive cycles of in vitro fertilization or intracytoplasmic sperm injection using autologous oocytes in women aged 40 years and above.

Objective: To estimate the live-birth and miscarriage rates in 1-year age increments for women aged ≥40 years undergoing in vitro fertilization or intracytoplasmic sperm injection (ICSI-IVF) with autologous oocytes.

Design: Retrospective database and chart analysis.

Setting: Egyptian IVF and embryo transfer center.

Symposium: Update on prediction and management of OHSS. Prevention of OHSS.

Ovarian hyperstimulation syndrome (OHSS) is a major complication of ovulation induction. As the treatment of the syndrome is currently empirical, prevention is the most important aspect of its management. Identification of patients vulnerable to developing OHSS by taking a history of previous OHSS and polycystic ovarian syndrome is the first step in prevention.

Highly purified hMG achieves better pregnancy rates in IVF cycles but not ICSI cycles compared with recombinant FSH: a meta-analysis.

Objective: Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) regarding clinical outcomes. It is not clear whether this change in the evidence was due to the introduction of highly purified (HP) hMG.

Design: Systematic review of properly randomised trials comparing HP-hMG vs.

Ultrasound cervical measurement and prediction of spontaneous preterm birth in ICSI pregnancies: a prospective controlled study.

A prospective controlled study was performed in which transvaginal ultrasound measurement of cervical length was compared in 222 twin ICSI pregnancies, 122 singleton ICSI pregnancies and 51 spontaneous singleton pregnancies. Preterm birth was defined as View Article and Find Full Text PDF

Electrical activation of oocytes after intracytoplasmic sperm injection: a controlled randomized study.

Objective: To evaluate the electrical activation of oocytes in patients with previously failed or limited fertilization after intracytoplasmic sperm injection (ICSI) and in patients with possible failure of fertilization.

Design: Prospective randomized study.

Setting: A private IVF center in Egypt.

The impact of spermatozoa preincubation time and spontaneous acrosome reaction in intracytoplasmic sperm injection: a controlled randomized study.

Objective: To determine the optimum time interval between semen processing and incubation before intracytoplasmic sperm injection (ICSI) and correlate it with the acrosomal reaction rate.

Design: Controlled randomized study.

Setting: The Egyptian IVF-ET Center.

Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks.

Background: There is a consensus that administration of progesterone to women after IVF for luteal phase support (LPS) is associated with a higher ongoing pregnancy rate. However there are few studies, including only one randomized study, which have examined the optimal duration of LPS.

Methods: A questionnaire concerning details of LPS was returned from 21 leading IVF centres.

Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis.

LH activity has been proposed to influence treatment response and outcome. In order to assess its clinical profile and efficacy, human menopausal gonadotrophin (HMG) was compared with recombinant FSH (r-FSH) in IVF/intracytoplasmic sperm injection (ICSI) cycles. Computerized and hand searches were conducted for relevant citations.

A prospective randomized study comparing coasting with GnRH antagonist administration in patients at risk for severe OHSS.

This work evaluated possible advantages of gonadotrophin-releasing hormone (GnRH) antagonist administration as an alternative to coasting in prevention of severe ovarian hyperstimulation syndrome (OHSS) in women undergoing IVF/ intracytoplasmic sperm injection. A prospective randomized study comparing coasting (group A) (n = 96) and GnRH antagonist administration (group B) (n = 94) in patients at risk of OHSS was performed. The primary outcome measure was high quality embryos.

Firm versus soft embryo transfer catheters under ultrasound guidance: does catheter choice really influence the pregnancy rates?

In contrast to the previously published evidence, under ultrasound guidance, individual catheter choice does not statistically significantly affect the clinical pregnancy rate in a modern clinical IVF practice. This may be as a result of decreasing the incidence of difficult transfers and endometrial injury with ET under ultrasound guidance.

Among women undergoing embryo transfer, is the probability of pregnancy and live birth improved with ultrasound guidance over clinical touch alone? A systemic review and meta-analysis of prospective randomized trials.

Objective: To investigate the theory that ultrasound guidance during ET improves clinical outcomes.

Design: Systematic review of prospective, randomized, controlled trials comparing ultrasound with clinical touch methods of embryo catheter guidance.

Setting: Infertility centers.

Paternal age and outcome of intracytoplasmic sperm injection.

In a retrospective study, the outcome of intracytoplasmic sperm injection (ICSI) in two age groups of men was studied. Couples with male partners aged 50 years and over (group A) (n = 227) with mean age of 53 +/- 5 years were compared with couples with younger age-group male partners (group B) (n = 227) with a mean age of 38.4 +/- 5.

Sperm suspension is a highly ultrasonically visible material: a novel model to study uterine activity.

Background: The aims of this study were to find an ultrasonically echogenic material to study the uterine activity, and to test whether closing the vaginal speculum on the cervix prevents the displacement of the injected material.

Methods: A concentrated sperm suspension was used as an ultrasonically visible material. Forty-five women undergoing intrauterine insemination were randomized into: open speculum group (n=23) and closed speculum group (n=22).