DOCSLIB.ORG

Intrauterine Insemination: Pregnancy Rate and Its Associated Factors in a University Hospital in Iran

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intrauterine Insemination: Pregnancy Rate and Its Associated Factors in a University Hospital in Iran Vol. 11, No. 1, 2006 Middle East Fertility Society Journal © Copyright Middle East Fertility Society Intrauterine insemination: pregnancy rate and its associated factors in a university hospital in Iran Zahra Rezaie, M.D. Ozra Azmodeh, M.D. Neda Heydari Hamadani, M.D. Mirza Koochak Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran. ABSTRACT Objective: To determine pregnancy rate and its associated factors in Intrauterine Insemination (IUI) in a University ART center in Tehran, Iran. Materials and Methods: A retrospective descriptive study was conducted on all available records of infertile patients (200 cases) who had undergone IUI treatment for their infertility problems in Mirza Koochak Khan ART center, between 1999 and 2000. The necessary data were collected and then analyzed with Chi-square test with a significant level of 0.05. Results: 200 infertile couples did 575 IUI cycles. Pregnancy rate was 19.5% per couple and 6.8% per cycle (39 cases). The pregnancy rate in couples with secondary infertility was significantly higher than those with primary infertility (47.4% vs. 8.4%, P<0.0001) and patients with more than 60% normal sperm morphology (NSM) had higher pregnancy rate than those with less than 60% NSM (24.3% vs. 7.7%, P=0.0052). Pregnancy rate tended to increase when the number of large follicles increased at the time of IUI (From 6.7% in 1-2 oocytes to 15.7% in >5 oocytes, P=0.0095). As the numbers of IUI treatment cycles increased, the success rate per cycle decreased. There was a significant difference in pregnancy rate according to kind of drug used for ovarian stimulation. Pregnancy rate was 11.5% with HMG, compared to 7.2% with clomiphene citrate and HMG (P=0.052). Pregnancy rate with twice IUI per cycle was significantly higher than those who had one IUI per cycle (24.1% versus 11.8%, P<0.05). The highest pregnancy rate was seen in 21-30 years old patients (46.5%) and the lowest in women with more than 36 years of age, while no pregnancy occurred in patients less than 20 years of age. The frequency of twin pregnancy and low birth weight infants was 25.6% (10 subjects) and 14.3% (7 subjects) respectively. Conclusion: It seems that IUI provides better results in patients with secondary infertility, with >60% NSM and with >5 large follicles at the time of treatment. Pregnancy rate does not increase with increasing the number of treatment cycles and ovarian stimulation with HMG is associated with relatively higher pregnancy rate. Key words: IUI, pregnancy rate, infertility, ovarian stimulation. Intrauterine insemination is a common Pregnancy rate per cycle of IUI ranges from 2.7% procedure used for the treatment of infertility. If it to 11.4 % (1,2). is performed based on appropriate indications and In some studies on IUI procedures, maternal accurate protocol, it will be a convenient method age, number of IUI and cause of infertility were (1, 2). IUI is easier, safer and inexpensive in related to the success rate of pregnancy (3). comparison with other ART methods. The Edward et al. reviewed 18 studies which used IUI outcome of IUI is associated with some factors. and concluded that couples with less than 3 years duration of infertility, had highest chance to Corresponding author: Zahra Rezaie: Department of conceive (4). Infertility, Mirza Koochak Khan Hospital, North Ostad Nejatollahi, Karim Khan Zand Blvd, Tehran 15978, Iran. Plosker et al. performed 381 IUI cycles for 215 Phone/Fax: #98-21-890 4172 Email: [email protected] infertile couples, and reported that the pregnancy Vol. 11, No. 1, 2006 Rezaie et al. Factors determining pregnancy rate in IUI 59 Table 1. Demographic and clinical specifications of infertile MATERIALS AND METHODS couples undergoing IUI in M.K.K. Hospital 1999-2000. This retrospective descriptive study was Number (%) performed on all infertile couples who had undergone IUI in the ART center of Mirza Age (years) Koochak Khan Hospital during the years 1999- 18-20 2 (1.0) 21-25 56 (28.0) 2000. The medical records including, duration of 26-30 66 (33.0) infertility (years), type of infertility (primary, 31-35 44 (22.0) secondary), cause of infertility (male, female, 36-40 32 (16.0) idiopathic) number of sperms, motility, Duration of infertility (years) morphology of sperms, number of IUI per cycle, <2 66 (33.0) 2-5 80 (40.0) number of follicles, the type of induction of 6-10 44 (22.0) ovulation and the number of IUI cycles of these >10 10 (5.0) couples were reviewed then pregnancy rate and its Type of infertility associated factors were compared. The couples Primary 143 (71.5) Secondary 57 (28.5) were considered eligible for this study if the Cause of infertility necessary information were obtained from their Male 95 (47.5) medical records. The uncertain or uncompleted Uterine tube 36 (18.0) medical records were excluded form this study. Ovarian 29 (14.5) Missing data from the medical records were Cervical 6 (3.0) Uterine 6 (3.0) completed by asking the subjects by calling their Endometriosis 6 (3.0) phone, if it was necessary. Idiopathic 22 (11.0) Every effort was made to maximize privacy of records. Statistical analysis was performed using SPSS software (version 10). The comparisons were performed using Chi-square test (a=0.05). rate decreased when the maternal age or the number of treatment cycles increased (5). Evaluation of 610 IUI cycles on 174 infertile RESULTS couples through the years of 1990-91, showed that the pregnancy rate is higher in younger women. Two hundred infertile couples underwent 575 Shorter infertility period, secondary and cycle of IUI. Women's ages ranged from 18 to 40 unexplained infertility have a higher rate of years with a median age of 27 years. The majority success. The number of motile sperms and number of subjects (73%) experienced maximum 5 years of IUI per cycle are other factors associated with duration of infertility. 71.5% had primary success rate of treatment (6). infertility and male factor was the most frequent Wang B et al. analyzed 186 patients and 216 cause of infertility (95 cases, 47.5%) (Table 1). cycles of IUI, and reported that IUI is of more The pregnancy rates were 19.7% (39 cases) and applied value for male and cervical factor 6.8% per patient and per cycle respectively. The infertility. With these factors in mind, choosing the highest pregnancy rate occurred in 21-25 years old most suitable insemination time is the key to women (26.8%) and the lowest occurred in women increasing pregnancy rate (7). Pregnancy rate was more than 36 years old (9.4%). There was no 12.8% per cycle for IUI in Mirza Koochak Khan pregnancy in women less than 20 years old. The Hospital in the year 1996. Women 21-25 years old association between age and success rate was not had highest pregnancy rate. (8) statistically significant (p=0.081) (Table 2). This study was conducted on 200 infertile Difference of pregnancy rate between primary couples who had undergone IUI procedure in (8.4%) and secondary infertility (47.4%) was Mirza Koochak Khan Hospital during 1999-2000, significant (p<0.0001) (Table 2). The pregnancy to estimate the pregnancy rate in IUI and to rate decreased as the duration of infertility increased determine the related factors for it. 60 Rezaie et al. Factors determining pregnancy rate in IUI MEFSJ Table 2. Comparison of results of treatment by studying factors in infertile couples undergoing IUI in M.K.K. Hospital 1999-2000. Infertility Pregnancy Signification Age (years) n (%) n (%) 18-20 2 (100.0) 0 (0.0) N.S. 21-25 41 (73.2) 15 (26.8) N.S. 26-30 53 (80.3) 13 (19.7) N.S. 31-35 36 (81.8) 8 (18.2) N.S. 36-40 29 (90.6) 3 (9.4) N.S. Duration of infertility (years) <2 50 (75.8) 16 (24.2) N.S. 2-5 64 (80.0) 16 (20.0) N.S. 6-10 37 (84.1) 7 (15.9) N.S. >10 10 (100.0) 0 (0.0) N.S. Type of infertility Primary 131 (91.6) 12 (8.4) P>0/0001 Secondary 30 (52.6) 27 (47.4) P>0/0001 Cause of infertility Male 79 (83.2) 16 (16.8) N.S Female 64 (77.1) 19 (22.9) N.S Idiopathic 18 (81.8) 4 (18.2) N.S Number of sperms <10×106 7 (87.5) 1 (12.5) N.S (10-20)×106 22 (78.6) 6 (21.4) N.S >20×106 132 (80.5) 32 (19.5) N.S Normal motility sperm ≤%60 147 (79.9) 37 (20.1) N.S >%60 14 (87.5) 2 (12.5) N.S Normal morphology sperm ≤%60 109 (75.7) 35 (24.3) P=0.0052 >%60 52 (92.3) 4 (7.7) P=0.0052 Number of IUI/cycle One 67 (88.2) 9 (11.8) P<0.05 Two 94 (75.9) 30 (24.1) P<0.05 (From 24.2% for less than 2 years duration to 0.0% ovulation induction (11.5%), compared to 7.2% for more than 10 years duration of infertility) with "clomiphene citrate + HMG" or to using (p=0.076) (Table 2). The relationship between "clomiphene citrate" as the sole medicine for pregnancy rate and the cause of infertility was not ovulation induction (P=0.025) (Table 3). statistically significant (p=0.076) (Table 2). The Pregnancy rate was significantly higher with highest rate of pregnancy occurred in subjects with increasing the number of IUI per cycles, being uterine factor infertility (33.3%) and the lowest 24.1% and 11.8% in two IUI per cycles and one (16.7%) occurred in patients with cervical and IUI per cycle respectively (Table 2).
Load more

Recommended publications
  • What's Behind the Good News: the Decline in Teen Pregnancy Rates During the 1990S. INSTITUTION National Campaign to Prevent Teen Pregnancy, Washington, DC
    DOCUMENT RESUME ED 453 907 PS 029 348 AUTHOR Flanigan, Christine TITLE What's behind the Good News: The Decline in Teen Pregnancy Rates during the 1990s. INSTITUTION National Campaign To Prevent Teen Pregnancy, Washington, DC. SPONS AGENCY Mott (C.S.) Foundation, Flint, MI.; David and Lucile Packard Foundation, Los Altos, CA.; Robert Wood Johnson Foundation, Princeton, NJ.; William and Flora Hewlett Foundation, Palo Alto, CA. ISBN ISBN-1-58671-023-0 PUB DATE 2001-02-00 NOTE 61p.; Also funded by the Summit and Turner Foundations. AVAILABLE FROM National Campaign to Prevent Teen Pregnancy, 1776 Massachusetts Avenue, NW, Suite 200, Washington, DC 20036; Tel: 202-478-8500; Fax: 202-478-8588; Web site: http://www.teenpregnancy.org. PUB TYPE Numerical/Quantitative Data (110) Reports - Research (143) EDRS PRICE MF01/PC03 Plus Postage. DESCRIPTORS Adolescents; Birth Rate; Births to Single Women; Contraception; *Early Parenthood; *Influences; Pregnancy; Pregnant Students; Sexuality; *Trend Analysis; Youth Problems ABSTRACT Noting that rates of teen pregnancies and births have declined over the past decade, this analysis examined how much of the progress is due to fewer teens having sex and how much to lower rates of pregnancy among sexually active teens. The analysis drew on data from the federal government's National Survey of Family Growth (NSFG), a large, periodic survey of women ages 15-44 on issues related to childbearing. With regard to the decline in teen pregnancy rates between 1990 and 1995, the analysis found that the proportion attributable to less sexual experience among teens ranges from approximately 40 to 60 percent, with the remaining 60 or 40 percent attributable to decreased pregnancy rates for sexually experienced teens.
    [Show full text]
  • Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009†
    Human Reproduction, Vol.24, No.11 pp. 2683–2687, 2009 Advanced Access publication on October 4, 2009 doi:10.1093/humrep/dep343 SIMULTANEOUS PUBLICATION Infertility The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009† F. Zegers-Hochschild1,9, G.D. Adamson2, J. de Mouzon3, O. Ishihara4, R. Mansour5, K. Nygren6, E. Sullivan7, and S. van der Poel8 on behalf of ICMART and WHO 1Unit of Reproductive Medicine, Clinicas las Condes, Santiago, Chile 2Fertility Physicians of Northern California, Palo Alto and San Jose, California, USA 3INSERM U822, Hoˆpital de Biceˆtre, Le Kremlin Biceˆtre Cedex, Paris, France 4Saitama Medical University Hospital, Moroyama, Saitana 350-0495, JAPAN 53 Rd 161 Maadi, Cairo 11431, Egypt 6IVF Unit, Sophiahemmet Hospital, Stockholm, Sweden 7Perinatal and Reproductive Epidemiology and Research Unit, School Women’s and Children’s Health, University of New South Wales, Sydney, Australia 8Department of Reproductive Health and Research, and the Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland 9Correspondence address: Unit of Reproductive Medicine, Clinica las Condes, Lo Fontecilla, 441, Santiago, Chile. Fax: 56-2-6108167, E-mail: [email protected] background: Many definitions used in medically assisted reproduction (MAR) vary in different settings, making it difficult to standardize and compare procedures in different countries and regions. With the expansion of infertility interventions worldwide, including lower resource settings, the importance and value of a common nomenclature is critical. The objective is to develop an internationally accepted and continually updated set of definitions, which would be utilized to standardize and harmonize international data collection, and to assist in monitoring the availability, efficacy, and safety of assisted reproductive technology (ART) being practiced worldwide.
    [Show full text]
  • Adolescent Pregnancy in America: Causes and Responses by Desirae M
    4 Volume 30, Number 1, Fall 2007 Adolescent Pregnancy in America: Causes and Responses By Desirae M. Domenico, Ph.D. and Karen H. Jones, Ed.D. Abstract Introduction mothers did not graduate from Adolescent pregnancy has oc­ While slightly decreasing in high school. Less than one-third curred throughout America’s his­ rates in recent years, adolescent of adolescent females giving tory. Only in recent years has it pregnancy continues to be birth before age 18 ever complete been deemed an urgent crisis, as prevalent in the United States, high school, and the younger the more young adolescent mothers with nearly one million teenage pregnant adolescents are, the give birth outside of marriage. At- females becoming pregnant each less likely they are to complete risk circumstances associated year (Meade & Ickovics, 2005; high school (Brindis & Philliber, with adolescent pregnancy in­ National Campaign to Prevent 2003; Koshar, 2001). Nationally, clude medical and health compli­ Teen Pregnancy, 2003; Sarri & about 25% of adolescent moth­ cations, less schooling and higher Phillips, 2004). The country’s ers have a second baby within dropout rates, lower career aspi­ adolescent pregnancy rate re­ one year of their first baby, leav­ rations, and a life encircled by mains the highest among west­ ing the prospect of high school poverty. While legislation for ca­ ern industrialized nations, with graduation improbable. How­ reer and technical education has 4 of every 10 pregnancies occur­ ever, if a parenting female can focused attention on special ring in women younger than age delay a second pregnancy, she needs populations, the definition 20 (Dangal, 2006; Farber, 2003; becomes less at risk for dropping has been broadened to include SmithBattle, 2003; Spear, 2004).
    [Show full text]
  • Reducing Teenage Pregnancy
    REDUCING TEENAGE PREGNANCY Although the rate of teenage pregnancy in the United In 2009, recognizing that evidence-based sex States is at its lowest level in nearly 40 years, it education programs were effective in promoting remains one of the highest among the most developed sexual health among teenagers, the Obama countries in the world. Approximately 57.4 per 1,000 administration transferred funds from the women aged 15–19 — nearly 615,000 American Community-based Abstinence Education Program teenagers — become pregnant each year (Kost and and budgeted $114.5 million to support evidence- Henshaw, 2014). The majority of these pregnancies — based sex education programs across the country. 82 percent — are unintended (Finer & Zolna, 2014). The bulk of the funds — $75 million — was set aside for replicating evidence-based programs that Moreover, because the average age of menarche have been shown to reduce teen pregnancy and its has reached an all-time low of about 12 or 13 years underlying or associated risk factors. The balance old (Potts, 1990), and because six out of 10 young was set aside for developing promising strategies, women have sex as teenagers (Martinez et al., 2011), technical assistance, evaluation, outreach, and most teenage girls are at risk of becoming pregnant. program support (Boonstra, 2010). This was the The consequences of adolescent pregnancy and first time federal monies were appropriated for more childbearing are serious and numerous: comprehensive sex education programs (SIECUS, n.d.). • Pregnant teenagers are more likely than women Though off to a good start, none of these initiatives who delay childbearing to experience maternal can succeed without a general reassessment of the illness, miscarriage, stillbirth, and neonatal death attitudes and mores regarding adolescent sexuality (Luker, 1996).
    [Show full text]
  • Optimizing Natural Fertility: a Committee Opinion
    Optimizing natural fertility: a committee opinion Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility American Society for Reproductive Medicine, Birmingham, Alabama This Committee Opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples/ individuals attempting conception who have no evidence of infertility. This document replaces the document of the same name previously published in 2013, Fertil Steril 2013;100(3):631-7. (Fertil SterilÒ 2017;107:52–8. Ó2016 by American Society for Repro- ductive Medicine.) Earn online CME credit related to this document at www.asrm.org/elearn Discuss: You can discuss this article with its authors and with other ASRM members at https://www.fertstertdialog.com/users/ 16110-fertility-and-sterility/posts/12118-23075 linicians may be asked to pro- fecundability (the probability of preg- FREQUENCY OF vide advice about sexual and nancy per month) is greatest in the first INTERCOURSE lifestyle practices relating to 3 months (1). Relative fertility is C In some cases, clinicians may need to procreation. Currently, there are no decreased by about half among women explain the basics of the reproductive uniform counseling guidelines or in their late 30s compared with women process. Information has emerged over evidence-based recommendations in their early 20s (2, 3). the last decade that, at least in theory, available. This document will provide Fertility varies among populations may help to define an optimal fre- practitioners with recommendations, and declines with age in both men quency of intercourse. Whereas absti- based on a consensus of expert opinion, and women, but the effects of age are nence intervals greater than 5 days for counseling couples/individuals much more pronounced in women may adversely affect sperm counts, about how they might optimize the (2, 4) (Fig.
    [Show full text]
  • Evaluation of Controlled Ovarian Hyperstimulation Gonadotropin Stimulation and Clomiphene Citrate Stimulation Cycles in Infertile Women
    DOI: 10.14744/scie.2018.40085 Original Article South. Clin. Ist. Euras. 2017;28(4):249-254 Evaluation of Controlled Ovarian Hyperstimulation Gonadotropin Stimulation and Clomiphene Citrate Stimulation Cycles in Infertile Women Yasemin Odabaş,1 Bülent Kars,2 Önder Sakin,2 Engin Ersin Şimşek1 ABSTRACT Objective: The aim of this study was to evaluate the success of intrauterine insemination 1Department of Family Medicine, (IUI) treatment, the factors affecting success, and current recommendations. Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey Methods: This study was conducted by retrospectively investigating 300 cycles of IUI 2Department of Obstetrics and treatment performed in 183 patients between 2005 and 2009. The results of a single IUI Gynecology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, treatment session performed 32 to 36 hours after a dose of 10,000 units of chorionic İstanbul, Turkey gonadotropin was administered to patients with unexplained infertility were analyzed. The patients were aged between 19 and 42 years with a median follicle-stimulating hormone test Submitted: 23.01.2018 Accepted: 25.01.2018 result of 7.15 mIU/L, a total motile sperm count exceeding 5 million/mL, and a follicle size of at least 15 mm with treatment. Correspondence: Önder Sakin, Dr. Lütfi Kırdar Kartal Eğitim ve Results: The successful pregnancy rate with spontaneous coitus after clomiphene citrate Araştırma Hastanesi Kadın (CC) treatment was 12.5% (13/104) The successful pregnancy rate with IUI after CC treat- Hastalıkları ve Doğum Kliniği, Kartal, İstanbul, Turkey ment was 11.7% (16/136), and the successful pregnancy rate with IUI after gonadotropin E-mail: [email protected] treatment was 23.4% (14/60).
    [Show full text]
  • Pregnancy Rates in Beef Cattle Artifically Inseminated with Frozen-Thawed Aged Beef Semen
    Louisiana State University LSU Digital Commons LSU Master's Theses Graduate School 2010 Pregnancy Rates in Beef Cattle Artifically Inseminated with Frozen-Thawed Aged Beef Semen David Barry Carwell Louisiana State University and Agricultural and Mechanical College Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_theses Part of the Animal Sciences Commons Recommended Citation Carwell, David Barry, "Pregnancy Rates in Beef Cattle Artifically Inseminated with Frozen-Thawed Aged Beef Semen" (2010). LSU Master's Theses. 775. https://digitalcommons.lsu.edu/gradschool_theses/775 This Thesis is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Master's Theses by an authorized graduate school editor of LSU Digital Commons. For more information, please contact [email protected]. PREGNANCY RATES IN BEEF CATTLE ARTIFICALLY INSEMINATED WITH FROZEN-THAWED AGED BEEF SEMEN A Thesis Submitted to the Graduate Faculty of the Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Master of Science In The Interdepartmental Program of Animal and Dairy Sciences by David B. Carwell B.S., Arkansas State University, 2008 December 2010 ACKNOWLEDGEMENTS I would like to first thank my Co-major Professors, Dr. Glen Gentry and Dr. Robert A. Godke. Their time, energy, patience and guidance have been a blessing to me these past 2 years. The program that has been built here at Louisiana State University is unparallel to anywhere in the country, and it has been a pleasure to work and learn under these two outstanding professors.
    [Show full text]
  • Pregnancy Loss in the First in Vitro Fertilization Cycle Is Not Predictive Of
    Pregnancy loss in the first in vitro fertilization cycle is not predictive of subsequent delivery in women over 40 years Rita Sneeringer, M.D.,a,b,c Sigal Klipstein, M.D.,a,b,c David A. Ryley, M.D.,a,b,c Michael M. Alper, M.D.,a,b,c and Richard H. Reindollar, M.D.a,b,c a Boston IVF, Waltham; and b Beth Israel Deaconess Medical Center, and c Harvard Medical School, Boston, Massachusetts Objective: To determine if there is an association between first IVF cycle outcome and subsequent delivery rate for women over 40 years. Design: Retrospective data analysis. Setting: Large, private academically affiliated IVF center. Intervention(s): Patients over 40 years of age undergoing IVF. Main Outcome Measure(s): Delivery rate compared between patients with a pregnancy loss versus a negative b- hCG in their first cycle. Additional factors including subsequent pregnancy losses, total number of IVF cycles, and delivery rates per cycle were also analyzed. Result(s): Among women who underwent their first IVF cycle over age 40, 8% of women had a pregnancy loss and 82% had a negative b-hCG in their initial IVF cycle. In the pregnancy loss and negative b-hCG groups, 17.9% and 21.9%, respectively, had a successful delivery in a future cycle. There were no further pregnancies leading to de- livery after the fourth treatment cycle for the pregnancy loss group and the sixth treatment cycle for the negative b-hCG group. The average number of cycles and the number of subsequent pregnancy losses were similar in both groups.
    [Show full text]
  • Menstrual Cycle Patterns and Breast Cancer Risk Factors1
    [CANCER RESEARCH 38, 4021-4024, November 1978] 0008-5472/78/0038-OOOOS02.00 Menstrual Cycle Patterns and Breast Cancer Risk Factors1 Robert B. Wallace,2 Barry M. Sherman, Judy A. Bean, James P. Leeper, and Alan E. Treloar Departments of Preventive Medicine and Environmental Health [P. B. W.,J.A. B.,J. P. L.] and Internal Medicine [B. M.S.], University of Iowa, Iowa City, Iowa 52242, and Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina 27514 [A. E. T.¡ Abstract arche and late menopause might have a longer or exagger ated phase of irregular menstrual cycles and thus a longer Using a data set of women who longitudinally recorded time of relative estrogen excess. We also theorized that the menstrual and reproductive events, we examined men association of late age at first pregnancy with increased strual cycle characteristics in relationship to early and breast cancer risk was at least in part a manifestation of late menarche, early and late menopause, and deferred involuntary infertility that might be related to abnormalities parity, three variables epidemiologically related to breast of menstrual cycle length and, by inference, inadequate cancer incidence. Women with late onset of menarche luteal-phase progesterone production. had longer and more variable cycles in the 10 years after With some evidence that relative estrogen excess in the menarche than did those with early onset. Women with face of inadequate progesterone is related to the pathogen late onset of menopause had longer and more variable esis of hormone-responsive neoplasms (3) and the pre cycles in the premenopausal interval than did those with sumption that this abnormal physiological state could be early onset.
    [Show full text]
  • Comparison of Implantation and Pregnancy Rate Using Two Methods of Embryo Selection: “Pronuclear Morphology and Embryo Quality” and “Embryo Morphology Alone”
    Vol. 12, No. 3, 2007 Middle East Fertility Society Journal © Copyright Middle East Fertility Society Comparison of implantation and pregnancy rate using two methods of embryo selection: “Pronuclear morphology and embryo quality” and “embryo morphology alone” Robab Davar, M.D. Mehrdad Soleimani, Bs.C. Shamsi Beigi, M.D. Research and clinical center for infertility, Shahid Sadoughi University of medical sciences and health services, Yazd, Iran ABSTRACT Objective: Despite many advances in the field of reproductive medicine, with <30% of embryos that are transferred ever resulting in clinical pregnancies. This study compared implantation and pregnancy rate in two methods of embryo selection. Design: randomized double blind clinical trial Materials and Methods: Research and clinical center for infertility, Yazd, Iran Subject: In this randomized double blind clinical trial, 95 patients referring to the Yazd Research and Clinical Center for Infertility for IVF or ICSI treatment were included from March to December 2004. These patients randomly allocated in two groups. (A & B) In group A (Case), embryo selection was done by pronuclear morphology and embryo quality while in group B (Control), this process was done by embryo morphology methods alone. Oocytes were classified according to their quality. According to cause of infertility ICSI or IVF was done. Finally ≤ 4 embryos with best quality were selected and transferred to uterus. Main outcome measures: Implantation rate, Pregnancy Rate Results: In case group, 419 and in control group, 444 oocytes were collected. In case group 129 embryos and in control group 151 embryos were transferred. Number and percent of clinical pregnancies was 14 (31.11%) and 9 (18%) and implantation rate was 18 (13.95%) and 12 (7.94%) in case and control groups.
    [Show full text]
  • Changes with Age in the Level and Duration of Fertility in the Menstrual Cycle
    Human Reproduction Vol.17, No.5 pp. 1399–1403, 2002 Changes with age in the level and duration of fertility in the menstrual cycle David B.Dunson1,4, Bernardo Colombo3 and Donna D.Baird2 1Biostatistics Branch, MD A3-03 and 2Epidemiology Branch, National Institute of Environmental Health Sciences, P.O.Box 12233, Research Triangle Park, NC 27709, USA and 3Dipartimento di Scienze Statistiche, University of Padua, Padua, Italy 4To whom correspondence should be addressed. E-mail: [email protected] BACKGROUND: Most analyses of age-related changes in fertility cannot separate effects due to reduced frequency of sexual intercourse from effects directly related to ageing. Information on intercourse collected daily through each menstrual cycle provides the data for estimating day-specific probabilities of pregnancy for specific days relative to ovulation, and these estimates allow unconfounded analysis of ageing effects. METHODS: A total of 782 healthy couples using natural family planning methods contributed prospective data on 5860 menstrual cycles. Day of ovulation was based on basal body temperature measurements. Estimates of day-specific probabilities of pregnancy and the length of the fertile window were compared across age groups. RESULTS: Nearly all pregnancies occurred within a 6 day fertile window. There was no evidence for a shorter fertile window in older men or women. On average, the day-specific probabilities of pregnancy declined with age for women from the late 20s onward, with probabilities of pregnancy twice as high for women aged 19–26 years compared with women aged 35–39 years. Controlling for age of the woman, fertility was significantly reduced for men aged >35 years.
    [Show full text]
  • Live-Birth Rates and Multiple-Birth Risk Using in Vitro Fertilization
    ORIGINAL CONTRIBUTION Live-Birth Rates and Multiple-Birth Risk Using In Vitro Fertilization Laura A. Schieve, PhD Context To maximize birth rates, physicians who perform in vitro fertilization (IVF) Herbert B. Peterson, MD often transfer multiple embryos, but this increases the multiple-birth risk. Live-birth and multiple-birth rates may vary by patient age and embryo quality. One marker for Susan F. Meikle, MD embryo quality is cryopreservation of extra embryos (if embryos are set aside for cryo- Gary Jeng, PhD preservation, higher quality embryos may have been available for transfer). Isabella Danel, MD Objective To examine associations between the number of embryos transferred dur- ing IVF and live-birth and multiple-birth rates stratified by maternal age and whether Nancy M. Burnett, BS extra embryos were available (ie, extra embryos cryopreserved). Lynne S. Wilcox, MD Design and Setting Retrospective cohort of 300 US clinics reporting IVF transfer procedures to the Centers for Disease Control and Prevention in 1996. INCE THE GOAL OF IN VITRO FER- tilization (IVF) is pregnancy and, Subjects A total of 35 554 IVF transfer procedures. ultimately, live birth, clinical de- Main Outcome Measures Live-birth and multiple-birth rates (percentage of live cision making about IVF prac- births that were multiple). ticesS is heavily focused on maximizing Results A total number of 9873 live births were reported (multiple births from 1 preg- a woman’s chances of becoming preg- nancy were counted as 1 live birth). The number of embryos needed to achieve maximum nant. One common practice that aims live-birth rates varied by age and whether extra embryos were cryopreserved.
    [Show full text]