Results Of Infertility Treatment Research Articles

Evaluation of ovarian reserve and the assisted reproductive technology (ART) cycles’ outcome as well as the relapse rate within one year after ART in women with multiple sclerosis: a case-control study

ObjectiveTo compare the ovarian reserve and the results of infertility treatment, as well as to investigate the relapse rate in the first year after the assisted reproductive technology (ART) cycle in patients with multiple sclerosis (MS) referred to Royan Institute.Materials and methodsThis retrospective study was carried out to evaluate all women diagnosed with MS and referred to Royan Institute for assessment and treatment of possible infertility between 2011 and 2022. The control group consisted of randomly selected healthy women with tubal factor infertility who were referred for treatment during the same time period and matched in terms of age. A comparison was made between groups in terms of ovarian reserve and infertility treatment outcomes. Additionally, patients with MS who met the criteria were monitored via telephone to evaluate the symptoms, disability and relapse rate both pre- and post-ART.ResultsOver the course of a decade, the database documented a total of 60 cases diagnosed with MS. Upon examination of the records, it was found that in 27 patients only admission was done without any hormonal assessment or infertility treatment cycle and 5 patients proceeded with the intrauterine insemination cycle. Eventually, 28 women with MS underwent the ART cycle and all of them were treated with interferon beta, glatiramer acetate, or some oral disease modifying therapies. No statistically significant difference in terms of the basal levels of luteinizing hormone, follicle-stimulating hormone and anti-Müllerian hormone was found between the MS and control groups (P > 0.05). Two groups were comparable in terms of menstrual status. The study revealed that both groups exhibited similarities in terms of the controlled ovarian stimulation protocol and duration, the dosage of gonadotropin administered, as well as the ovarian response type, clinical pregnancy rate, and live birth rate (P > 0.05). After follow up, only 2 patients (9.5%) reported relapse of symptoms within one year after ART.ConclusionThe ovarian reserve and ovarian stimulation cycle and pregnancy outcomes following the ART cycle in MS patients were similar to the age-matched control group. The relapse rate of multiple sclerosis did not show a significant increase within a year following the ART cycle.

Hormonal profile features in patients with infertility against the background of uterine leiomyoma and chronic endometritis

The аim of research is to study the hormonal profile peculiarities of women with infertility against the background of uterine leiomyoma and chronic endometritis with unsuccessful IVF attempts in the anamnesis.Material and Methods. A retrospective analysis of the outpatient medical cards of 130 patients with infertility was carried out. Patients were divided into three clinical groups. The first group of the study consisted of 47 women with unsuccessful IVF attempts and uterine leiomyoma, the second one included 53 women with infertility against the background of uterine leiomyoma and chronic endometritis (patients in this group also had failed IVF attempts in the anamnesis). The third (control) group consisted of 30 female infertility patients due to the male factor. The concentration levels of the main gonadotropic and sex hormones in blood serum were studied and compared on different days of the menstrual cycle.Results. Certain changes in the hormonal profile, including the basal concentration of hormones of the reproductive system and their levels on different days of the menstrual cycle, were revealed among the women of the studied groups compared to the control group.Conclusions. The hormonal profile features in patients with infertility against the background of uterine leiomyoma and chronic endometritis are primarily related to the presence of one or another concomitant gynecological pathology, or their combined course. This definitely probably has an impact on the further results of infertility treatment with ART.

Ejaculate parameters and the results of <i>in vitro </i> fertilization treatment in infertile couples with overweight and obese men

BACKGROUND: Infertility and obesity are actual and at the same time occurring problems of many couples. Conflicting data have been obtained on ejaculate parameters and the results of infertility treatment using in vitro fertilization treatment (IVF) in overweight and obese men.
 AIM: To evaluate the results of examination and treatment using ART, depending on the body mass index (BMI) of men in infertile couples.
 MATERIALS AND METHODS: A retrospective analysis of the results of treatment at the International Center for Reproductive Medicine in 368 infertile couples was carried out. The mean age of men and women was 36.4 6.2 and 33.9 5 years, respectively. Previous treatment for varicocele, sexually transmitted infections, prostatitis and cryptorchidism was performed in 58 (15.7%), 43 (11.7%), 42 (11.4%) and 11 (2.9%) men, respectively. Height and weight were measured for all patients, and BMI was calculated. The ejaculate was processed using a gradient medium (SupraSperm, Origio), IVF or ICSI were used in 110 (29.9%) and 258 (70.1%) couples, respectively, signs of good embryo quality were determined according to recommendations of professional societies for reproductive medicine. The onset of pregnancy was confirmed by the results of ultrasound sonography of the uterus. The results were subjected to statistical analysis.
 RESULTS: The BMI mean was 27.4 4.4 kg/m2, overweight and obesity of the 1st and 2nd degrees were observed in 161 (43%), 58 (15.8%) and 23 (7%) men respectively. Higher BMI values of men corresponded to higher BMI values of women (p 0.001), BMI values did not depend on ejaculate volume, concentration, total number and number of motile spermatozoa, proportion of high-quality embryos, and pregnancy rate. The highest pregnancy rate was noted after treatment of couples with younger women and higher values of the total number, concentration and number of progressively motile spermatozoa and ejaculate volume (p = 0.037, p = 0.028, p 0.001, p = 0.003, p 0.0001, respectively).
 CONCLUSIONS: Overweight and obese men prevail in infertile couples seeking IVF treatment. IVF treatment can overcome infertility in couples with overweight and obese men.

Results of infertility treatment using ART methods in patients who underwent myomectomy: risk factors for repeated unsuccessful ART programs

Aim. To evaluate the results of treatment of patients with uterine fibroids and infertility with ineffective art programs in the anamnesis and to identify possible risk factors for repeated art failures.
 Materials and methods. 510 patients with uterine fibroids and infertility were examined and surgically treated prior to the ART program. Myomectomy was performed using various approaches: laparoscopic access in 250 patients, laparotomic access in 70 patients, hysteroscopic myomectomy in 100 patients, and combined access (laparoscopic and hysteroscopic) in 90 women.
 Results. Primary infertility was observed in 38.0%, secondary in 62.0% of patients. The average duration of infertility was 4.41.9 years. ART had in history 54.5% of patients. During the follow-up period up to 2 years, 24.3% of women had recurrent uterine fibroids. After carrying out of surgical treatment and the following ART pregnancy was achieved in 44.3% of patients. Pregnancies ended in childbirth in 58.8% of cases, which exceeded the total share (41.6%) of adverse pregnancy outcomes (ectopic pregnancy, abortions, spontaneous miscarriages at various times) by 1.4 times.
 Conclusion. Risk factors for repeated ART failures in patients who have undergone myomectomy are: age over 40 years; duration of infertility for more than 5 years and the presence of 3 or more ineffective IVF attempts in the history; the presence of previous surgical interventions such as uterine artery embolization and FUS-ablation; the presence of submucous fibroids, a dominant node located close to the uterine cavity and myoma with signs of blood supply disorders; the combination of uterine fibroids with external genital endometriosis and chronic endometritis.

When a couple wants a baby: What are the consequences on their sexuality?

Summary Objectives To review the knowledge we have on changes that take place in a couple's sex-life when the desired pregnancy does not take place immediately, and fertility treatment is prescribed. Method A review of recent literature was conducted, and compared to observations usually made on the subject, in addition to those of the author, a gynaecologist and sexologist, in charge of a medically-assisted reproduction (MAR) centre for 15 years. Results and discussion Having a baby is still one of the most effective ways of feeling completely fulfilled from a human point of view, and few couples decide to forgo this experience. Once the decision has been taken, the desire to conceive can become extremely strong, and the consequences if it does not happen straight away can lead to a serious emotional crisis. The stronger the desire, the greater the frustration, materially, professionally and in the couple's relationship. It is clear that, in the middle of such turmoil, it cannot be easy to avoid sexual consequences, and manage to preserve an arousing and erotic environment, and avoid focusing one's sexuality on frantic activity in the middle of the ovulation cycle. And after all the efforts, if the couple does prove to be infertile, how easy is it to recover a mutually appealing sexual balance? Conclusion Better cooperation between practitioners specializing in reproduction and the other parties involved in sexology and sexual health would certainly help these couples preserve a better quality of sexual life and quality of life in general, and probably also improve the quality and the results of infertility treatment.