Naslov
In vitro fertilization in treatment of infertility - Own experiences

Autori
Kurjak, Asim ; Kupešić, Sanja ; Vujisić, Sanja ; Stilinović, Krešimir ; Babić Marija Maja

Izvornik
Gynaecologia et perinatologia : journal for gynaecology, perinatology, reproductive medicine and ultrasonic diagnostics (1330-0091) 5 (1996), 2; 57-63

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, stručni

Ključne riječi
in vitro fertilization

Sažetak
Procedure parameters were studied in 289 couples treated for infertility between May 1993 and December 1995. 193 (66.8%) of these couples were previously included in two or more IVF/ET procedures in other clinics. The age in female patients ranged from 23 to 47 years, while 60% being above 35. Combined male and female factor was the indication for the IVF procedure in more than 50%. 73.4% of 324 ovulation induction cycles were stimulated with HMG/FSH. Combined GnRH/HMG or GnRH/FSH protocols were applied in 26.6% of patients with confirmed poor endometrial receptivity and inadequate response to. HMG stimulation. Number of the aspirated oocytes per stimulated cycle with HMG/FSH stimulation was 6.2 ± 4.2 versus 9.3 ± 6.0 with GnRH/HMG or FSH induction. Patients with inadequate response to HMG stimulation (less then 3 oocytes per stimulated cycle) were subsequently treated with GnRH/HMG protocol, which resulted in 4-9 oocytes per stimulated cycle. Their quality was better with microdosis (0.1 mg of Decapeptyl) than with the long-term protocol. The overall fertilization rate of the oocytes was 80%. 97.3% of the cycles resulted with successful oocyte retrieval, while 93.8% of the cycles ended with embryo transfer. Pregnancy rate was 22%, while the percentage of healthy newborns was 19.4%. There were 0.6% of ectopic pregnancies and 6 (2%) patients with spontaneous abortions. Singleton pregnancy rate was 91.5%, white 8.5% were twin gestation. There were no multiple pregnancies. In 70% of the patients with unsuccessful embryo transfer, RI in spiral arteries was above 0.55. Furthermore, 70% of the spiral arteries showed absent diastolic flow (RI = 1.0). Endometrial texture was triple-lined in 45%. Hyperechogenic lines were present in 40%, while homogenic and hyperechogenic texture appeared in 15%. In patients with successful IVF/ET procedure, RI in spiral arteries ranged from 0.42 to 0.54 in 86.4%. Endometrium showed homogenous and hyperechogenic appearance in 78%, while in other 22% lateral hyperechogenic echoes were missing. Long-term GnRH therapy resulted in appropriate endometrial secretory transformation in patients with poor endometrial receptivity. Endometrial thickness varied from 10 to 17 mm, and RI in spiral arteries was less than 0.55. In this particular group, embryo transfer was successful in 75% of patients.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

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