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Eftekhar M, Neghab N, Khani P. Effectiveness of Autologous Platelet-Rich Plasma Therapy in Women with Repeated Implantation Failure: A Randomized Clinical Trial. Int J Fertil Steril 2024; 18:162-166. [PMID: 38368520 PMCID: PMC10875303 DOI: 10.22074/ijfs.2023.553636.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 04/02/2023] [Accepted: 04/19/2023] [Indexed: 02/19/2024]
Abstract
BACKGROUND Platelet-rich plasma (PRP) therapy has been shown to enhance tissue regeneration by expressing several cytokines and growth factors (GFs). This study investigated the effect of intrauterine infusion of PRP as a noninvasive autologous GF on pregnancy outcomes in women with repeated implantation failure. MATERIALS AND METHODS This randomized clinical trial was conducted to compare the pregnancy rates between two groups of women who were candidates for the frozen-thawed embryo transfer with a history of two or more implantation failures. The PRP group (n=33) was treated with hormone replacement therapy+0.5 cc to 1 cc PRP infused into the uterine cavity two days before the embryo transfer. The control group (n=33) was only treated with hormone replacement therapy. The endometrial preparation process was done similarly in both groups. The chemical, clinical, and ongoing pregnancy, and implantation rates were compared between the two groups. RESULTS Our results showed that the chemical pregnancy rate was not statistically higher in the PRP group in comparison with the control group (36.4 vs. 24.2%). In addition, the clinical pregnancy, ongoing pregnancy, and implantation rates were higher in the PRP group than the control group; however, the difference between the two groups was not statistically significant. CONCLUSION Administration of intrauterine PRP before embryo transfer in women with repeated implantation failure (RIF) does not affect assisted reproductive technology (ART) outcomes (registration number: IRCT2016090728950N3).
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nosrat Neghab
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Parisa Khani
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Sheida A, Davar R, Tabibnejad N, Eftekhar M. The effect of adding L-Carnitine to the GnRH-antagonist protocol on assisted reproductive technology outcome in women with polycystic ovarian syndrome: a randomized clinical trial. Gynecol Endocrinol 2023; 39:1878135. [PMID: 33517804 DOI: 10.1080/09513590.2021.1878135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the effect of adding L-Carnitine to the gonadotropins on ART outcome in frozen-thawed embryo transfer cycles among PCOS women. METHODS In this randomized clinical trial, 83 patients with PCOS were randomized to either L-Carnitine supplemented (n = 42) or control (n = 41) groups. The L-Carnitine group was given 3000 mg of oral L-Carnitine daily until the final day of ovulation. The numbers of metaphase II (MII) oocytes, 2-pronuclears (2PNs), oocyte maturity rate, fertilization rate, fertilization proportion as well as implantation, chemical and clinical pregnancy rates were compared between the two groups. RESULTS Even though the duration of stimulation and endometrial thickness were comparable between groups (p > .05), serum estradiol level on the day of oocyte triggering, was significantly higher in the L-Carnitine group compared to the control group (p < .05). In contrast, the number of retrieved and MII oocytes as well as the number of 2PNs and obtained embryos were similar between groups (p > .05). Moreover, oocyte maturity rate (0.85 ± 0.38 vs. 1.02 ± 0.90), fertilization proportion (0.62 ± 0.44 vs. 0.80 ± 0.86), fertilization rate (0.70 ± 0.22 vs. 0.76 ± 0.19) along with implantation rate (18.1 vs. 13.7%), chemical (26.8 vs. 30.7%) and clinical (24.3 vs. 25.6%) pregnancy rates, were all comparable between L-Carnitine and control groups respectively (p > .05). CONCLUSIONS Our result showed that oral L-Carnitine administration during induction of ovulation among PCOS women could not improve laboratory and pregnancy outcome.
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Affiliation(s)
- Arezoo Sheida
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Robab Davar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Tabibnejad
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Bayati F, Eftekhar M, Homayoon N, Fatehi H. Comparison of Doppler ultrasound indices of uterine artery and sub endometrial blood supply in frozen embryo transfer with and without repeated implantation failure: A cross-sectional study. Int J Reprod Biomed 2023; 21:937-942. [PMID: 38292508 PMCID: PMC10823118 DOI: 10.18502/ijrm.v21i11.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 02/01/2024] Open
Abstract
Background: Uterine blood supply has been identified as a potential factor in implantation failure. Objective: This study aimed to investigate Doppler indices in the uterine artery, including vascular flow and resistance, as well as the amount of sub-endometrial blood supply in women with a history of repeated implantation failure (RIF) compared to the non-RIF group. Materials and Methods: This cross-sectional study was conducted with 139 women candidates for frozen embryo transfer in Yazd Reproductive Sciences Institute, Yazd, Iran from February to July 2023. Group A (n = 68) included women with a history of more than 2 RIF, and group B (n = 71) included women candidates for implantation for the first time without RIF. Doppler ultrasound indices of uterine artery and sub-endometrium, including sub-endometrial flow, uterine artery flow, uterine artery resistance, and peak systolic velocity, were recorded. Results: No significant differences were observed in uterine artery Doppler pulsatility index and peak systolic velocity between groups, but the uterine artery resistance index was significantly higher in the A group (p < 0.001). A significant difference was observed in the perfusion area between groups. 60/68 women in the group A had endometrial perfusion in areas 2 and 3 (p < 0.001). Conclusion: Our study revealed that women with RIF exhibited higher resistance index in sub-endometrial arteries compared to the non-RIF group.
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Affiliation(s)
- Fatemeh Bayati
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Homayoon
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Haniyeh Fatehi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Bahrami F, Eftekhar M, Zanbagh L. Uterine artery Doppler and endometrial blood flow in frozen embryo transfer: A cohort study. Int J Reprod Biomed 2023; 21:205-212. [PMID: 37122892 PMCID: PMC10133733 DOI: 10.18502/ijrm.v21i3.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/03/2023] [Accepted: 01/21/2023] [Indexed: 05/02/2023] Open
Abstract
Background The implantation rate after assisted reproductive technology depends on 2 important factors, good quality embryo and endometrial receptivity. Endometrial receptivity is mainly assessed by ultrasound measurement of endometrial thickness and morphology. Objective This study aimed to investigate the relationship between uterine artery Doppler indices/endometrial perfusion and pregnancy rate. Materials and Methods This cohort study was done on 250 women who were candidates for frozen embryo transfer from January to July 2022. For assessing endometrial receptivity, we performed a Doppler ultrasound of the uterus before embryo transfer with apparently desirable endometrium (endometrial thickness ≥ 7 mm and 3 line endometrial pattern). In addition, the women were divided into 2 groups according to assisted reproductive technology outcome (clinical pregnancy), group I positive clinical pregnancy, and group II negative clinical pregnancy, and uterine artery indices and endometrial perfusion were compared between these groups. Results Uterine artery Doppler showed that the pulsatility index was significantly different between positive and negative clinical pregnancy groups, but resistance index and peak systolic velocity (PSV) did not have statistically significant differences. Also, endometrial perfusion was significantly different between the 2 groups of clinical pregnancy. Endometrial perfusion was significantly better in positive clinical pregnancy groups. Conclusion Doppler ultrasound can help to assess endometrial receptivity.
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Affiliation(s)
- Fereshteh Bahrami
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Leila Zanbagh
- Department of Obstetrics and Gynecology, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Emami F, Eftekhar M, Jalaliani S. Corrigendum to “Correlation between clinical and laboratory parameters and early pregnancy loss in assisted reproductive technology cycles: A cross-sectional study” [Int J Reprod BioMed 2022; 20: 683-690]. Int J Reprod Biomed 2022; 20:883. [DOI: 10.18502/ijrm.v20i10.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The authors have been informed of an error that occurred on page 684 in which the number of participants should be replaced with 408 instead of 480. On behalf of the author, the publisher wishes to apologize for this error. The online version of article has been updated on 23 October 2022 and can be found at https://doi.org/10.18502/ijrm.v20i8.11757.
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Jalaliani S, Davar R, Akbarzadeh F, Emami F, Eftekhar M. Addition of intramuscular to vaginal progesterone for luteal phase support in fresh embryo transfer cycles: A cross-sectional study. Int J Reprod Biomed 2022; 20:745-752. [PMID: 36340670 PMCID: PMC9619125 DOI: 10.18502/ijrm.v20i9.12064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/21/2022] [Accepted: 03/09/2022] [Indexed: 11/08/2022] Open
Abstract
Background Luteal phase deficiency is common in assisted reproductive technology and is characterized by inadequate progesterone production. Various studies have shown that administration of progesterone in fresh embryo transfer cycles increases the rate of clinical pregnancy and live birth rate. Progesterone administration has variable types: oral, vaginal, oil-based intramuscular, and subcutaneous. Objective This study aims to compare the effect of adding intramuscular progesterone to the vaginal progesterone for luteal phase support in the fresh embryo transfer cycle. Materials and Methods This study reviewed the information related to 355 women who had a fresh embryo transfer between March 2020 and February 2021 at the Yazd Reproductive Sciences Institute, Yazd, Iran. The participants population were divided into 2 groups based on the type of luteal phase support regime: group I (n = 173) received 400 mg vaginal progesterone alone twice a day from the day of ovum pick up; and group II (n = 182) received 50 mg IM of progesterone in addition to vaginal progesterone 400 mg twice a day from the day of ovum pick up. Chemical and clinical pregnancy rates were compared between groups. Results The basic characteristics of groups were statistically similar. The rates of chemical and clinical pregnancy were higher in the vaginal plus IM progesterone group than in the vaginal progesterone group. Moreover, chemical pregnancy showed a significant difference between the groups (p = 0.011). Conclusion Our findings demonstrated that the addition of IM progesterone to the vaginal progesterone improves the chemical pregnancy rate in fresh embryo transfer.
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Affiliation(s)
- Samaneh Jalaliani
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Robab Davar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farzad Akbarzadeh
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Emami
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Emami F, Eftekhar M, Jalaliani S. Correlation between clinical and laboratory parameters and early pregnancy loss in assisted reproductive technology cycles: A cross-sectional study. Int J Reprod Biomed 2022; 20:683-690. [DOI: 10.18502/ijrm.v20i8.11757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The miscarriage rate after pregnancy resulting from assisted reproductive technology (ART) is about 20%, roughly half of which is biochemical. The correlations between the number and quality of oocytes, estradiol level and early pregnancy loss have not been fully clarified.
Objective: This study aimed to examine the clinical and laboratory parameter effects on early abortion in ART cycles.
Materials and Methods: In this cross-sectional study, 408 women who were ART candidates and were referred to the Yazd Infertility and Research Center, Yazd, Iran during March 2017 to March 2020 participated. Women who had a fresh embryo transferred and who had a positive beta human chorionic gonadotropin serum test were included in the study. The Anti-Müllerian hormone (AMH) level, embryo quality, oocyte number, progesterone level, estradiol level, and maternal age were extracted from the medical records.
Results: No significant difference was observed in the age, mean estradiol and progesterone levels on trigger day, number of MII oocytes, and embryo quality between the groups (p = 0.19, 0.42, 0.07, 0.34 and 0.20, respectively). No statistically significant difference was found between the 3 groups of AMH level (p = 0.20). After evaluation using logistic regression, the rate of negative clinical pregnancies was higher in the group with AMH < 1 ng/ml. However, this was not found to be statistically significant.
Conclusion: We did not find any correlation between early abortion and AMH levels, embryo quality, oocyte number, progesterone level, estradiol level, or maternal age.
Key words: Abortion, Pregnancy, Embryo transfer, Assisted reproductive techniques, Anti-Müllerian hormone.
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Dashti S, Mirzaei M, Eftekhar M, Mangoli E. Is there any difference between the obstetric and perinatal complications of pregnancy in patients with and without repeated implantation failure in fresh and frozen-thawed embryo transfer cycles? Middle East Fertil Soc J 2022. [DOI: 10.1186/s43043-022-00097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Repeated implantation failure (RIF) is the main challenge in assisted reproduction; the present study aimed to compare the obstetric and perinatal outcomes between RIF and control patients who experienced a successful pregnancy after fresh embryo transfer (ET) or frozen-thawed embryo transfer (FET) cycles. Data were obtained from 1150 women experiencing embryo transfer(s), consisting of 720 fresh ET and 430 FET cycles, at the Research and Clinical Center for Infertility, Yazd, Iran. The 370 women, in total, reached chemical pregnancies and finally 321 cases in fresh ET (n=216) and FET (n=105) cycles with singleton deliveries divided into two groups of control and RIF according to the number of last implantation failures. Then, the rate of obstetric and prenatal complications was compared between two groups in fresh ET and FET cycles.
Results
The results showed a higher abortion rate in the RIF group compared to the control group in fresh and FET cycles. In the assessment of the data from the cases with singleton pregnancies in fresh and FET cycles, the results showed almost similar obstetric and perinatal complications in the patients of RIF and control groups. Although the rates of some complications like vaginal bleeding, PROM, preterm delivery, and NICU administration were higher in the RIF patients, these were not significant (P > 0.05).
Conclusion
There was some variation in the normal rates of obstetric and perinatal outcomes between RIF patients compared to control. But, it seems necessary to run studies on more patients to endorse this conclusion.
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Aflatoonian A, Arabjahvani F, Eftekhar M, Sayadi M. Corrigendum to “Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: A randomized clinical trial” [Iran J Reprod Med 2014; 12: 595-600]. Int J Reprod Biomed 2022; 20:68. [PMID: 35308331 PMCID: PMC8902791 DOI: 10.18502/ijrm.v20i1.10410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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10
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Eftekhar M, Hosseinisadat R, Baradaran R, Naghshineh E. Corrigendum to “Effect of granulocyte colony stimulating factor (G-CSF) on IVF outcomes in infertile women: An RCT” [Int J Reprod BioMed 2016; 14: 341-346]. Int J Reprod Biomed 2022; 20:68. [PMID: 35308324 PMCID: PMC8902798 DOI: 10.18502/ijrm.v20i1.10411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sadeghi M, Farajkhoda T, Khanabadi M, Eftekhar M. PERMA model vs. integrative-behavioral couple therapy for fertility problems: A randomized clinical trial protocol. Int J Reprod Biomed 2021; 19:1105-1116. [PMID: 35098012 PMCID: PMC8792384 DOI: 10.18502/ijrm.v19i12.10061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/23/2021] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background Psychological interventions may reduce fertility problems. Positive emotion, engagement, meaning, positive relationship and accomplishment (PERMA) is a cognitive intervention and integrative-behavioral couple therapy (IBCT) is a behavioral intervention. Appropriate mental interventions are important in infertility treatment. Objective To investigate the effect of the PERMA model vs. IBCT in reducing the fertility problems of couples. Materials and Methods The content of the interventions was developed and adjusted based on a literature review and the opinions of experts. In this three-arm parallel randomized clinical trial, 42 couples undergoing infertility treatment will be allocated randomly into three groups (n = 14 couples/each). Group 1 will receive the PERMA intervention, group 2 will receive the IBCT intervention, and group 3 as the control group will receive an infertility treatment training program intervention. The primary outcome will be the fertility problems, which will be measured by completing a fertility problem inventory at baseline, as well as in the 5th and 9th wk as a follow-up. Another primary outcome, satisfaction with the intervention, will also be assessed in the 5th and 9th wk. The secondry outcome will be a positive pregnancy test at wk 12. The interventions will be conducted through a combination of face-to-face and online via WhatsApp. Conclusion This study will assess social, sexual, and parenthood concerns. A combination of online and face-to-face interventions will be appropriate given the COVID-19 pandemic. Couple's counseling may provide better counseling outcomes for fertility problems in comparison with group counseling. This study will try to optimize resilience during infertility treatment through learning better relationship and problem-solving skills, and may have an indirect impact on pregnancy rate, burden of infertility, and costs of treatment due to increased effectiveness.
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Affiliation(s)
- Mahsa Sadeghi
- Student Research Committee, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tahmineh Farajkhoda
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdi Khanabadi
- Department of Counseling, Allameh Tabataba'i Univercity, Tehran, Iran
| | - Maryam Eftekhar
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Dashti S, Eftekhar M. Luteal-phase support in assisted reproductive technology: An ongoing challenge. Int J Reprod Biomed 2021; 19:761-772. [PMID: 34723055 PMCID: PMC8548747 DOI: 10.18502/ijrm.v19i9.9708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 01/06/2023] Open
Abstract
It has been shown that in controlled ovarian hyper stimulation cycles, defective
luteal phase is common. There are many protocols for improving pregnancy
outcomes in women undergoing fresh and frozen in vitro fertilization cycles.
These approaches include progesterone supplements, human chorionic gonadotropin,
estradiol, gonadotropin-releasing hormone agonist, and recombinant luteinizing
hormone. The main challenge is luteal-phase support (LPS) in cycles with
gonadotropin-releasing hormone agonist triggering. There is still controversy
about the optimal component and time for starting LPS in assisted reproductive
technology cycles. This review aims to summarize the various protocols suggested
for LPS in in vitro fertilization cycles.
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Affiliation(s)
- Saeideh Dashti
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Hoseini M, Tabibnejad N. Is there a relationship between luteinizing hormone levels and ART outcome in GnRH antagonist protocols? A retrospective cross-sectional study. Indian J Endocrinol Metab 2021; 25:563-568. [PMID: 35355918 PMCID: PMC8959195 DOI: 10.4103/ijem.ijem_331_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the potential link between serum LH concentrations on the day of oocyte triggering and pregnancy outcome during controlled ovarian hyperstimulation. MATERIALS AND METHODS In this retrospective cross-sectional study, data of women ≤42 years undergoing fresh embryo transfer cycles and who had downregulated with GnRH antagonist protocol in a 12-month period was reviewed. Patients with incomplete hospital records were excluded. Women were divided into four groups based on the percentiles of the serum LH level on the day of oocyte triggering: <1.49 (<25th percentile), 1.49-2.59 (25-50th percentile), 2.60-4.60 (50-75th percentile), and >4.60 IU/L (>75th percentile). Clinical pregnancy was considered the primary outcome, while chemical pregnancy and implantation rate were the most important secondary outcomes which were compared between the four groups. RESULTS Four hundred and nighty-three women of 1003 infertile women, who were initially assessed for eligibility, met the inclusion criteria. Finally, 426 women were analyzed. Levels of progesterone were significantly correlated with the level of LH on the day of trigger in the >4.60 IU/L group (r = 0.20, P = 0.034). Furthermore, the levels of estradiol were significantly correlated with the level of LH on the day of trigger in the <1.49 IU/L (r = 0.21, P = 0.026). The number of retrieved oocytes, 2PNs (two pronucleis), number, and quality of total embryos were similar between groups (P > 0.05). With regard to oocyte maturity rate, fertilization proportion, fertilization rate, chemical pregnancy rate, and clinical pregnancy rate, there was no difference between varied LH levels in the four groups (P > 0.05). The only observed difference was the implantation rate that was significantly higher in the 2.60-4.60 IU/L group than the <1.49 IU/L group (P < 0.05). CONCLUSIONS Our result could not show the potential link between LH concentrations during GnRH antagonist cycles and pregnancy outcomes. However, very low LH levels during ovarian stimulation period may negatively affect the implantation rate.
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Affiliation(s)
- Maryam Eftekhar
- Department of Obstetrics, Gynecology and Infertility, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masrooreh Hoseini
- Department of Obstetrics, Gynecology and Infertility, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Tabibnejad
- Department of Obstetrics, Gynecology and Infertility, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Neghab N, Naghshineh E, Khani P. Corrigendum to "Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial" [Taiwan J Obstet Gynecol 57 (2018) 810-813]. Taiwan J Obstet Gynecol 2021; 60:973. [PMID: 34507697 DOI: 10.1016/j.tjog.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nosrat Neghab
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Elham Naghshineh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Khani
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Mirzaei M, Mangoli E, Mehrolhasani Y. Effects of multiple doses of gonadotropin-releasing hormone agonist on the luteal-phase support in assisted reproductive cycles: A clinical trial study. Int J Reprod Biomed 2021; 19:645-652. [PMID: 34458673 PMCID: PMC8387711 DOI: 10.18502/ijrm.v19i7.9475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/22/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background The effect of adding gonadotropin-releasing hormone (GnRH) agonist on the luteal phase support in assisted reproductive technique (ART) cycles is controversial. Objective To determine the effects of adding multiple doses of GnRH agonist to the routine luteal phase support on ART cycle outcomes. Materials and Methods This clinical trial study included 200 participants who underwent the antagonist protocol at the Research and Clinical Center for Infertility, Yazd, Iran, between January and March 2020. Of the 200, 168 cases who met the inclusion criteria were equally divided into two groups - the case and the control groups. Both groups received progesterone in the luteal phase, following which the case group received GnRH agonist subcutaneously (0/1 mg triptorelin) zero, three, and six days after the fresh embryo transfer, while the control group did not receive anything. Finally, chemical and clinical pregnancy rates, number of mature oocytes, fertilization rate, total dose of gonadotropin, and the estradiol level were determined. Results The baseline characteristics were similar in both groups. No significant difference was observed between embryo transfer cycles. Clinical results showed that differences between the fertilization rate, chemical and clinical pregnancies were not significant. Conclusion The results showed that receiving multiple doses of GnRH agonist in the luteal phase of ART cycles neither improves embryo implantation nor the pregnancy rates; therefore, further studies are required.
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Affiliation(s)
- Maryam Eftekhar
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Mirzaei
- Department of Obstetrics and Gynecology, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran
| | - Esmat Mangoli
- Department of Reproductive Biology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yasamin Mehrolhasani
- Department of Obstetrics and Gynecology, Bam University of Medical Sciences, Bam, Kerman, Iran
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Javaheri A, Ashkezar SK, Eftekhar M, Tafti SZG. Ovarian reserve in women with endometriosis under total cystectomy compared to partial cystectomy: A randomized clinical trial. Int J Reprod Biomed 2021; 19:619-624. [PMID: 34458670 PMCID: PMC8387706 DOI: 10.18502/ijrm.v19i7.9472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/02/2020] [Accepted: 09/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background The standard procedure for ovarian endometriosis is laparoscopic excision of ovarian cysts and complete removal of the cyst capsule using the striping technique. Owing to the possibility of reducing ovarian reserve, and in some cases, the premature ovarian failure, the safety remains to be known. Objective To compare the ovarian reserve in women with endometriosis who underwent total cystectomy with partial cystectomy. Materials and Methods In this randomized clinical trial, 56 women with endometriosis who were referred to the Research and Clinical Center for Infertility and Shahid Sadoughi Hospital, Yazd, Iran between January and February 2020 were randomly assigned into two groups (n = 25/each); group I (total cystectomy) and group II (partial cystectomy). To assess the ovarian reserves, the anti-Müllerian hormone (AMH) level before and three months after surgery was measured and compared between the two groups. Results No significant difference was observed in the AMH levels before and after surgery (p = 0.52, p = 0.32, respectively). However, the mean reduction of AMH in total cystectomy group was significantly higher than the partial cystectomy (p = 0.001). Conclusion Cystectomy in women with endometriosis reduces ovarian reserve and can help maintain some ovarian reserve by performing partial instead of total cystectomy.
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Affiliation(s)
- Atiye Javaheri
- Obstetrics and Gynecology Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Samane Kabirpour Ashkezar
- Obstetrics and Gynecology Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Obstetrics and Gynecology Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seiede Zahra Ghanadzade Tafti
- Obstetrics and Gynecology Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Hoseini M, Saeed L. Erratum to "Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT" [Int J Reprod BioMed 2019; 17: 671-676. Int J Reprod Biomed 2021; 19:579. [PMID: 34401654 PMCID: PMC8350850 DOI: 10.18502/ijrm.v19i6.9380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
[This corrects the article DOI: 10.18502/ijrm.v17i9.5103.].
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Eftekhar M, Mohammadi B, Tabibnejad N, Razi MH. Early oocyte triggering followed by in vitro maturation is a good approach in women with resistance ovary syndrome: A case-series. Int J Reprod Biomed 2021; 19:569-574. [PMID: 34401651 PMCID: PMC8350847 DOI: 10.18502/ijrm.v19i6.9378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/09/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022] Open
Abstract
Background Some women represent the inability to respond to endogenous and exogenous gonadotropins during in vitro fertilization/intracytoplasmic sperm injection cycles leading to the follicular developmental arrest. The women with resistant ovaries could benefit from in vitro maturation. Case This case-series presents pregnancies resulting from initially scheduled conventional in vitro fertilization which led to arrested cycles because of resistant ovary syndrome. The protocol was changed to early oocyte triggering for 15 women due to the small follicles ≤ 12 mm in diameter on day 15 after stimulation with high doses of exogenous gonadotrophins instead of cycle cancellation. Germinal vesicle and metaphase I oocytes that were retrieved from follicles were matured in vitro and inseminated by intracytoplasmic sperm injection. Twenty formed embryos were transferred on day 3 after oocyte retrieval. This resulted in a 30.76% chemical pregnancy out of which no abortion occurred. Therefore, we reported a 30.76% singleton ongoing pregnancy. Conclusion It seems that early oocyte triggering followed by in vitro maturation may be considered as a good modality in women experiencing follicular resistance to gonadotropins. These cycles can be rescued from cancellation with satisfactory clinical outcomes.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Banafsheh Mohammadi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Tabibnejad
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hossein Razi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Mohammadian F, Yousefnejad F, Molaei B, Aflatoonian A. Corrigendum to "Comparison of conventional IVF versus ICSI in non-male factor, normoresponder patients" [Iran J Reprod Med 2012; 10: 131-136]. Int J Reprod Biomed 2021; 19:391. [PMID: 34095745 PMCID: PMC8106817 DOI: 10.18502/ijrm.v19i4.9067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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20
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Javaheri A, Kianfar K, Pourmasumi S, Eftekhar M. Correction to "Platelet-rich plasma in the management of Asherman's syndrome: An RCT" [Int J Reprod BioMed 2020; 18: 113-12]. Int J Reprod Biomed 2021; 19:392. [PMID: 34056513 PMCID: PMC8106820 DOI: 10.18502/ijrm.v19i4.9068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
[This corrects the article DOI: 10.18502/ijrm.v18i2.6423.].
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Eftekhar M, Rahmani E, Eftekhar T. Effect of Adding Human Chorionic Gonadotropin to The Endometrial Preparation Protocol in Frozen Embryo Transfer Cycles. Int J Fertil Steril 2021; 15:305-306. [PMID: 34913302 PMCID: PMC8530222 DOI: 10.22074/ijfs.2021.244054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 06/21/2021] [Indexed: 12/03/2022]
Abstract
In this article which was published in Int J Fertil Steril , Vol 6, No 3, Oct-Dec 2012, on Pages: 175-178, the authors found that Four sam ples from the control group were incorrectly included in the study. 4 cases were removed from the data and the data were re-analyzed. The results in Tables 1-3 are corrected. The authors would like to apologies for any inconvenience caused.
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Affiliation(s)
- Maryam Eftekhar
- Department of Obstetrics and Gynecology, Yazd Research and
Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd,
Iran
| | - Elham Rahmani
- Department of Obstetrics and Gynecology, Bushehr University of
Medical Sciences, Bushehr, Iran,P.O. Box: 3631Department of Obstetrics and GynecologyBushehr University of Medical SciencesBushehrIran
| | - Tahereh Eftekhar
- Department of Obstetrics and Gynecology, Tehran University of
Medical Sciences, Tehran, Iran
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22
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Eftekhar M, Mohammadi B, Mangoli E, Mortazavi M. Is there any correlation between Estradiol supplementation, as luteal phase support, and clinical pregnancy in ART cycles? A cross-sectional study. Int J Reprod Biomed 2020; 18:969-974. [PMID: 33349805 PMCID: PMC7749977 DOI: 10.18502/ijrm.v13i11.7964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/24/2020] [Accepted: 06/06/2020] [Indexed: 11/24/2022] Open
Abstract
Background Endometrial receptivity is one of the important factors in assisted reproductive technology (ART) success. In the luteal phase of an ART cycle, serum estradiol (E2) and progesterone are often placed in low levels. Supporting the luteal phase with progesterone is a usual method. Objective To evaluate the effects of E2 supplementation plus progesterone on the luteal phase support in the antagonist protocol who have undergone intracytoplasmic sperm injection-embryo transfer cycles. Materials and Methods In this cross-sectional study, 200 patients with antagonist stimulation protocol, who had undergone intracytoplasmic sperm injection treatment, were divided into two groups based on the use of E2 supplementation. In both groups, 400 mg progesterone suppositories (CyclogestⓇ), twice a day/vaginally, was administered starting from the day of oocyte collection until the fetal heart activity. However, in the E2 group, in addition to progesterone, 4 mg tablet of E2 was received daily. Beta hCG was checked 14 days after the embryo transfer, and the clinical pregnancy rate was the main endpoint. Results The patients' characteristics were matched, and insignificant differences were observed, except for endometrial thickness. The clinical outcomes showed the rate of pregnancy was higher in the E2 group compared to the control group; nonetheless, statistically, there was no noticeable difference. Conclusion E2 supplementation had no beneficial effect in the luteal phase support of IVF cycles. Nevertheless, more studies are required to confirm the supportive role of E2 supplementation for embryo implantation and to improve the outcomes in ART cycles.
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Affiliation(s)
- Maryam Eftekhar
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Banafsheh Mohammadi
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Esmat Mangoli
- Department of Reproductive Biology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Mortazavi
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Gynecology and Obstetrics, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Razi Y, Eftekhar M, Fesahat F, Dehghani Firouzabadi R, Razi N, Sabour M, Razi MH. Concentrations of homocysteine in follicular fluid and embryo quality and oocyte maturity in infertile women: a prospective cohort. J OBSTET GYNAECOL 2020; 41:588-593. [PMID: 32749170 DOI: 10.1080/01443615.2020.1785409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Homocysteine is one of the components of follicular fluid (FF), so that any disruptions in its concentration may affect oocyte development. The aim of this study was to determine the relationship between FF homocysteine concentration and embryo quality, oocyte maturity, and pregnancy rate. Oocytes and embryos of 44 infertile women were categorised into different groups based on their maturity and quality, respectively. FF homocysteine levels, oocyte maturity, embryo quality, and pregnancy status were measured. A significant association was observed between the levels of FF homocysteine and oocyte maturation rate (p = .00). The concentration of FF homocysteine was higher than 9.8 µm/L in women with oocyte maturation < 80%. Most of the good quality embryos belonged to homocysteine levels < 9.8 µm/L. Decreased FF homocysteine concentrations can significantly improve the oocyte maturation rate and embryo quality. Aging may be an indirect factor contributing to decreased embryo quality and oocyte maturation through increasing FF homocysteine levels.IMPACT STATEMENTWhat is already known on this subject? It has been demonstrated that homocysteine is one of the components of follicular fluid (FF), but no information is available about the link between its concentration in FF and oocyte development.What do the results of this study add? The data indicated that decreased FF homocysteine concentrations at a younger age may remarkably improve the oocyte maturity and embryo quality of infertile patients undergoing assisted reproductive treatment (ART).What are the implications of these findings for clinical practice and/or further research? Based on the findings and considering the ease of measuring serum homocysteine and its direct correlation with FF homocysteine, homocysteine level measurement is recommended in patients who are candidates for infertility treatment in order to estimate oocyte maturation rate, embryo quality, and ART outcomes. Future studies are suggested to investigate patients with PCOS, endometriosis, and male factor infertility.
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Affiliation(s)
- Y Razi
- Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - M Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - F Fesahat
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - R Dehghani Firouzabadi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - N Razi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - M Sabour
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran
| | - M H Razi
- Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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24
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Dehghani Firoozabadi A, Dehghani Firouzabadi R, Eftekhar M, Sadat Tabatabaei Bafghi A, Shamsi F. Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study. Int J Reprod Biomed 2020; 18:339-346. [PMID: 32637862 PMCID: PMC7306059 DOI: 10.18502/ijrm.v13i5.7154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/24/2019] [Accepted: 10/26/2019] [Indexed: 11/24/2022] Open
Abstract
Background Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care.
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Affiliation(s)
| | - Razieh Dehghani Firouzabadi
- Research and Clinical Centre for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadougui University of Medical Sciences and Health Services, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Centre for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadougui University of Medical Sciences and Health Services, Yazd, Iran.,Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Farimah Shamsi
- Shahid Sadougui Hospital, Shahid Sadougui University of Medical Sciences, and Health Services, Yazd, Iran
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Eftekhar M, Saeed L. Effect of adding letrozole to gonadotropin on in vitro fertilization outcomes: An RCT. Int J Reprod Biomed 2020; 18:287-294. [PMID: 32494767 PMCID: PMC7218674 DOI: 10.18502/ijrm.v13i4.6891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 10/23/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022] Open
Abstract
Background Aromatase inhibitors prevent the aromatization of androgens into estrogens, which reduces the negative feedback of estrogen on the hypothalamic-pituitary axis. It is clear that increasing the secretion of follicle-stimulating hormones results in an increased follicular growth. Objective This study aimed to evaluate the effect of adding letrozole to gonadotropin on in vitro fertilization outcomes in normal responders. Materials and Methods In this randomized clinical trial, 100 normal responder women candidate for controlled ovarian stimulation were randomly enrolled in two groups (n = 50/each). In the case group letrozole was added to gonadotropin in the antagonist protocol. The control group received the conventional antagonist protocol. The main outcome was clinical and chemical pregnancy; and the second outcomes were the number of mature oocytes, the fertilization rate, estradiol level, and the total dose of gonadotropins. Results Basic clinical and demographic features were comparable between the groups. Estradiol level on the day of human-chorionic-gonadotropin administration and the total gonadotropin consumption were significantly higher in the control group than the case group (p = 0.045). In addition, the number of MII oocytes was higher (but not significantl) in the case group than the control group (p = 0.09). Moreover, the endometrial thickness was significantly lower in the case group. There were no significant differences in fertilization rate and chemical and clinical pregnancy rates between the two groups. Conclusion Although adding letrozole to gonadotropin in normal responders reduces the total dose of gonadotropin, it does not improve the pregnancy outcomes.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Lida Saeed
- Afzalipour Hospital, Kerman University of Medical Science, Kerman, Iran
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Eftekhar M, Mohammadi B, Khani P, Lahijani MM. Dual stimulation in unexpected poor responder POSEIDON classification group 1, sub-group 2a: A cross-sectional study. Int J Reprod Biomed 2020; 18:465-470. [PMID: 32754681 PMCID: PMC7340986 DOI: 10.18502/ijrm.v13i6.7287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/11/2019] [Accepted: 01/01/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Poor ovarian response management is a complex and controversial issue in the field of reproductive medicine. OBJECTIVE The aim of this study was to apply double stimulation in the same cycle in unexpected poor responders in POSEIDON classification group 1, sub group 2a and compare assisted reproductive technology outcomes between luteal phase and follicular phase ovarian stimulation. MATERIALS AND METHODS In this cross-sectional study, 10 women with age < 35 yr, antral follicle count > 5, and anti-müllerian hormone > 1.2 ng/mL were enrolled. All participants received conventional antagonist protocol in the follicular phase and only the cycles with retrieved oocytes < 4 in this phase included. The luteal phase ovarian stimulation was initiated from the day of first oocytes retrieval by 300 IU of human menopausal gonadotropin / day. When dominant follicles amounted to 14 mm in mean diameter, 0.25 mg/day of gonadotropin-releasing hormone antagonist was initiated and 10,000 IU human chorionic gonadotropin was injected when at least two follicles with a mean diameter of 17 mm were observed. Oocyte retrieval was carried out 34-36 hr following human chorionic gonadotropin injection. Finally, a comparison was made between the two phase in terms of the number of retrieved oocytes as well as the number of obtained embryos and fertilization rates. RESULTS Numbers of retrieved oocytes (p = 0.004), mature oocytes (p = 0.016), and embryos (p = 0.013) was significantly higher in luteal phase in compared with follicular phase. Quality of embryos was similar in two phases. CONCLUSION Double stimulation protocol can increase number of retrieved oocytes in unexpected PORs.
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Affiliation(s)
- Maryam Eftekhar
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Banafsheh Mohammadi
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Parisa Khani
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Maryam Mortazavi Lahijani
- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Obstetrics and Gynecology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Hossein Razi M, Eftekhar M, Ghasemi N, Hasan Sheikhha M, Dehghani Firoozabadi A. Expression levels of circulatory mir-185-5p, vascular endothelial growth factor, and platelet-derived growth factor target genes in endometriosis. Int J Reprod Biomed 2020; 18:347-358. [PMID: 32637863 PMCID: PMC7306060 DOI: 10.18502/ijrm.v13i5.7155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/17/2019] [Accepted: 09/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Using blood-based biomarkers such as microRNAs (miRNAs) may allow particularly effective and minimally invasive diagnosis and treatment of endometriosis. Objective: We evaluated the differential expression of circulating miRNA-185-5p (miR-185-5p), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF) target genes between endometriosis and healthy women. MATERIALS AND METHODS 25 women with a history of endometriosis (grad III-IV) diagnosed by laparoscopy as the case group and 25 women without endometriosis underwent laparoscopy for ovarian cysts or pelvic pain as the control group were enrolled in this case-control study. Blood samples were obtained, and total RNA was used for high-throughput small RNA sequencing, and this was confirmed by means of quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS miRNA expression profiling using non-coding RNA sequencing revealed that one miRNA including miR-185-5p was significantly down-regulated in the case group compared with the controls. The qRT-PCR results showed significant downregulation of the expression level of miR-185-5p (p < 0.01) in the plasma of the case group. Receiver operating characteristic (ROC) curve analysis showed the area of miR-185-5p under the ROC curve for endometriosis diagnosis was 0.919 (p < 0.001). The RT-PCR results demonstrated that there was no significant difference in the expression of VEGF and PDGF mRNA of blood samples in the cases compared to the control group (PDGF, p = 0.09 and VEGF, p = 0.36). CONCLUSION The low expression of miR-185-5p in the plasma of women with endometriosis could be employed as an important non-invasive biomarker for early detection and screening of endometriosis by blood samples.
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Affiliation(s)
- Mohammad Hossein Razi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Ghasemi
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Sheikhha
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Javaheri A, Kianfar K, Pourmasumi S, Eftekhar M. Platelet-rich plasma in the management of Asherman's syndrome: An RCT. Int J Reprod Biomed 2020; 18:113-120. [PMID: 32259005 PMCID: PMC7097166 DOI: 10.18502/ijrm.v18i2.6423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/01/2019] [Accepted: 08/24/2019] [Indexed: 01/16/2023] Open
Abstract
Background Asherman's syndrome (AS) is a rare reproductive abnormality, resulting in endometrial collapse due to aggressive or recurrent endometritis and/or curettage. Objective We aimed to assess the effectiveness of using platelet-rich plasma (PRP) to lower the recurrence rate of intrauterine adhesions (IUAs) following hysteroscopy. Materials and Methods In this non-randomized clinical trial, women aged 20-45 years with AS diagnosed by sonohysterography, 3D sonography, hysteroscopy, or uterosalpingography between May 2018 and September 2018 were included. Participants (n = 30) were divided into case and control groups. Following hysteroscopic adhesiolysis, a Foley catheter was placed into the uterine cavity in all women. After two days, the catheter was removed, and 1-mL PRP was injected into the uterine cavity of women in the PRP (case) group, while the control received no PRP. All controls and subjects underwent diagnostic hysteroscopy 8-10 weeks following the intervention to assess the IUAs according to the American Society for Reproductive Medicine scoring system. Results Our results did not reveal any significant difference in the menstrual pattern of either the control or test groups before or after treatment (p = 0.2). Moreover, the IUA stage in both studied groups before and after treatment was similar (p = 0.2). The duration of menstrual bleeding in both studied groups before and after treatment was also similar. Conclusion PRP cannot change the menstrual pattern or development of postsurgical AS, as evaluated by follow-up hysteroscopy.
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Affiliation(s)
- Atiyeh Javaheri
- Department of Obstetrics and Gynecology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Katayoon Kianfar
- Department of Obstetrics and Gynecology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Soheila Pourmasumi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Mirhashemi ES, Molaei B, Pourmasumi S. Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes? Arch Endocrinol Metab 2020; 64:11-16. [PMID: 31576965 PMCID: PMC10522278 DOI: 10.20945/2359-3997000000177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 08/14/2019] [Indexed: 11/23/2022]
Abstract
Objective The aim of this study was to assess the serum vitamin D level in a retrospective study in women with polycystic ovary syndrome (PCOS), according to the different phenotypes of the disease. Subjects and methods In this retrospective study, the records of 351 infertile women who were diagnosed with PCOS were examined, and 200 of them were enrolled in the study randomly in 4 PCOS phenotypes. Fifty normal ovulatory women with the history of male factor were selected as the control group. Parameters, including age, infertility duration, body mass index (BMI), hormone profile, as well as the serum vitamin D level were compared among the 4 phenotypes, with the P-value ≤ 0.05 considered statistically significant. Results The findings showed a higher serum vitamin D level in the control group than in PCOS patients, which was statistically significant (P < 0.001). In addition, there was no significant difference in the serum vitamin D level among the four phenotypes of PCOS. Conclusions No significant difference was found in the serum vitamin D level of the different phenotypes of PCOS. Further studies with larger sample sizes are recommended to be done to establish the role of the serum vitamin D level in PCOS patients.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for InfertilityYazd Reproductive Sciences InstituteShahid Sadoughi University of Medical SciencesYazdIranResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Abortion Research CenterYazd Reproductive Sciences InstituteShahid Sadoughi University of Medical SciencesYazdIranAbortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Sadat Mirhashemi
- Research and Clinical Center for InfertilityYazd Reproductive Sciences InstituteShahid Sadoughi University of Medical SciencesYazdIranResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behnaz Molaei
- Department of Obstetrics and Gynecology, Fellowship of PerinatologyZanjan University of Medical SciencesZanjanIranDepartment of Obstetrics and Gynecology, Fellowship of Perinatology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soheila Pourmasumi
- Non-Communicable Diseases Research CenterRafsanjan University of Medical SciencesRafsanjanIranNon-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit (CRDU)Moradi HospitalRafsanjan University of Medical SciencesRafsanjanIranClinical Research Development Unit (CRDU), Moradi Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Eftekhar M, Mehrjardi SZ, Molaei B, Taheri F, Mangoli E. The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: a retrospective study. Middle East Fertil Soc J 2019. [DOI: 10.1186/s43043-019-0013-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In assisted reproductive technology (ART) cycles in addition to embryo quality, the receptivity of the endometrium plays the main role in clinical outcomes. Endometrial receptivity is necessary to implantation of an embryo, and ultrasound has been established as an appreciated, simple, and non-invasive technique in the evaluation of the endometrial preparation before embryo transfer in fresh in vitro fertilization (IVF) cycles. Debate on the predictive value measuring endometrial thickness before administering human chorionic gonadotropin (HCG) for ovulation triggering in ART is ongoing. In order to explore the impact of endometrial thickness on triggering day on ongoing pregnancy rate (OPR) in ART cycles, we retrospectively analyzed data from 1000 patients undergoing IVF/ICSI cycles.
Results
The data showed pregnancy rate was increased in the endometrial thickness of 8 mm to 11 mm then decreased, and in endometrial thickness (Ent) > 14 mm, pregnancy rate was zero. There were significant differences in endometrial thickness and pregnancy outcomes between different age groups. The pregnancy rate was higher (32%) in 23–30 years old women, and the range of Ent in this group was 6–12 mm. Also, the data showed a positive correlation between Ent with AMH and estradiol levels and the number of COC and MII oocytes and a negative correlation between female age with Ent.
Conclusion
The result showed that Ent on hCG administration day is associated with pregnancy outcomes in fresh IVF/ICSI cycles with different age groups, although some of the clinical parameters may have an effect on Ent. Large studies are needed to make a definitive conclusion.
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Mangoli E, Khalili MA, Eftekhar M, Macchiarelli G, Palmerini MG. First successful live birth following the use of MSOME and time lapse for sperm and embryo selections in a patient with severe male factor infertility: A case report. J Gynecol Obstet Hum Reprod 2019; 48:883-885. [DOI: 10.1016/j.jogoh.2019.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 02/20/2019] [Accepted: 03/15/2019] [Indexed: 11/30/2022]
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Eftekhar M, Hoseini M, Saeed L. Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT. Int J Reprod Biomed 2019; 17:671-676. [PMID: 31646262 PMCID: PMC6804324 DOI: 10.18502/ijrm.v17i9.5103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background In vitro fertilization is an important therapy for women with polycystic ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet required. Objective This study was aimed to investigate the efficacy of progesterone primed ovarian stimulation (PPOS) and compare with conventional antagonist protocol in PCOS. Materials and Methods A total of 120 PCOS women who were candidates for assisted reproductive technology treatment from August to January 2019 were enrolled in this RCT and were placed into two groups, randomly (n= 60/each). The PPOS group received 20 mg /day Dydrogesterone orally since the second day of the cycle and the control group received antagonist protocol. The pregnancy outcomes including the chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational sacs/ transferred embryos was compared in two groups. Results Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p = 0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS group was higher than antagonist group (p = 0.005). Although there wasn't sever ovarian hyper simulation syndrome in any participants, mild and moderate ovarian hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical and clinical pregnancy rate were higher in the antagonist group, althoughit was not statistically significant (p = 0.136, p = 0.093 respectively). Conclusion Our study demonstrate that PPOS does not improve chemical and clinical pregnancy rate of the infertile women with PCOS.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences Yazd Iran.,Abortion Research Center, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science Yazd Iran
| | - Masrooreh Hoseini
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Lida Saeed
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences Yazd Iran.,Afzalipour Hospital Kerman University of Medical Sciences Kerman Iran
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Ghiasi Hafezi S, Ahmadi Zand M, Molaei M, Eftekhar M. Dynamic model with factors of polycystic ovarian syndrome in infertile women. Int J Reprod Biomed 2019; 17. [PMID: 31435609 PMCID: PMC6686656 DOI: 10.18502/ijrm.v17i4.4548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 10/01/2018] [Accepted: 12/12/2018] [Indexed: 12/01/2022] Open
Abstract
Background Previous studies present various methods for prediction disease based on statistics or neural networks.These models use statistics and results from past procedures to provide prediction through probability analysis. Objective In this article, the authors present a dynamic model aiming at predicting the treatment result of infertile women with the factor of polycystic ovary syndrome. Materials and Methods For this purpose, the authors have divided the study population into five groups: women prone to infertility, PCOS women, infertile women undergoing the treatment with Clomiphene Citrate and Gonadotropin, infertile women under IVF treatment, and improved infertile women. Therefore, the authors modeled the disease in infertile women mathematically and indicated that the free equilibrium point was asymptotically stable. Also the possibility of other equilibrium point of the system has been studied. Results The authors showed that this equilibrium point was marginally stable. Using Stoke's Theorem, the authors proved that the recurrence of the disease cycle with the factor of polycystic ovary syndrome was not intermittent in infertile women. They solved this model numerically using Rung-Kutta method and sketched the figures of the resulted solutions. Conclusion It shows that with increasing age, the ovarian reserve is decreased and the treatment Clomiphene Citrate and Gonadotropin are not responsive, so IVF treatment is recommended in this group of patients considering the graphs of the model.
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Affiliation(s)
| | | | - Mohammadreza Molaei
- Mahani Mathematical Research Center and Department of Pure Mathematics, Faculty of Mathematics and Computer, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences,Yazd, Iran
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Eftekhar M, Saeed L, Hoseini M. The effect of catheter rotation during its withdrawal on frozen thawed embryo-transfer cycles outcomes: A Case-control study. Int J Reprod Biomed 2019; 17:481-486. [PMID: 31508573 PMCID: PMC6718884 DOI: 10.18502/ijrm.v17i7.4859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/13/2019] [Accepted: 03/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Embryo transfer (ET) is the last and the most clinical process in assisted reproductive technology cycle. It has been suggested that cervical mucus interacts with an adequate embryo transfer in different ways. A few studies showed that catheter rotation could discharge mucus entrapped in the embryo to neutralize embryo displacement. Objective The aim of this present study was to compare the outcome of frozen embryo transfer (FET) based on catheter rotation during withdrawal. Materials and Methods In this case-control study, the clinical documents of 240 women who experienced frozen embryo transfer cycles were reviewd. The subjects were divided into two groups (n = 120/each), including A) the rotation treatment group (360°) that underwent ET using catheter rotation and B) the control group including the subjects who experienced ET with no catheter rotation. Clinical and chemical pregnancies and implantation rates were compared between two groups. Results Results showed that there is no significant difference between the basic clinical and demographic features of both groups (p > 0.05). A significant difference was observed in terms of the rate of chemical pregnancy between groups (21.7% vs 43.3%, p = 0.001 respectively). In addition, the rate of clinical pregnancy was significantly higher in study group than the control (33.35% vs 14.2%, p = 0.002 respectively).
Conclusion Our results demonstrated that catheter rotation during withdrawal increased the implantation rate and clinical pregnancy.
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Affiliation(s)
- Maryam Eftekhar
- Yazd Reasearch and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University, Yazd, Iran.
| | - Lida Saeed
- Yazd Reasearch and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University, Yazd, Iran.
- Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
| | - Masrooreh Hoseini
- Yazd Reasearch and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University, Yazd, Iran.
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Eftekhar M, Mirhashemi ES, Tabibnejad N. Outcome of assisted reproductive technology in different subgroups of poor ovarian responders fulfilling the POSEIDON criteria. Middle East Fertility Society Journal 2018. [DOI: 10.1016/j.mefs.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Eftekhar M, Mirhashemi ES, Tabibnejad N. Assisted reproductive outcomes in women with different polycystic ovary syndrome phenotypes. Int J Gynaecol Obstet 2018; 144:147-152. [DOI: 10.1002/ijgo.12707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/22/2018] [Accepted: 11/07/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility; Yazd Reproductive Sciences Institute; Shahid Sadoughi University of Medical Sciences; Yazd Iran
- Research Abortion Center; Yazd Reproductive Sciences Institute; Shahid Sadoughi University of Medical Sciences; Yazd Iran
| | - Elham S. Mirhashemi
- Research and Clinical Center for Infertility; Yazd Reproductive Sciences Institute; Shahid Sadoughi University of Medical Sciences; Yazd Iran
| | - Nasim Tabibnejad
- Research and Clinical Center for Infertility; Yazd Reproductive Sciences Institute; Shahid Sadoughi University of Medical Sciences; Yazd Iran
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Eftekhar M, Tavakkoli H, Khosravi I, Ghaemi A. Synthesis and crystallographic characterization of new heterotrinuclear oxo-centered complex. B CHEM SOC ETHIOPIA 2018. [DOI: 10.4314/bcse.v32i3.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Karami N, Mirabutalebi SH, Montazeri F, Kalantar SM, Sheikhha MH, Eftekhar M. Aberrant expression of microRNAs 16 and 21 and gene targets in women with unexplained recurrent miscarriage: A case-control study. Int J Reprod Biomed 2018. [DOI: 10.29252/ijrm.16.10.617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Karami N, Mirabutalebi SH, Montazeri F, Kalantar SM, Sheikhha MH, Eftekhar M. Aberrant expression of microRNAs 16 and 21 and gene targets in women with unexplained recurrent miscarriage: A case-control study. Int J Reprod Biomed 2018; 16:617-622. [PMID: 30643853 PMCID: PMC6314642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Noorodin Karami
- Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | | | - Fatemeh Montazeri
- Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Science, Yazd, Iran.
| | - Seyed Mehdi Kalantar
- Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Science, Yazd, Iran.
| | - Mohammad Hasan Sheikhha
- Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Science, Yazd, Iran.
| | - Maryam Eftekhar
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Eftekhar M, Bagheri RB, Neghab N, Hosseinisadat R. Evaluation of pretreatment with Cetrotide in an antagonist protocol for patients with PCOS undergoing IVF/ICSI cycles: a randomized clinical trial. JBRA Assist Reprod 2018; 22:238-243. [PMID: 29969209 PMCID: PMC6106631 DOI: 10.5935/1518-0557.20180039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 06/11/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of three days of GnRH antagonist pretreatment on the pregnancy outcomes of women with polycystic ovarian syndrome (PCOS) on GnRH antagonist protocols for IVF/ICSI. METHODS Fifty women with PCOS in the control group received conventional antagonist protocols, starting on day 2 of the cycle. In the pretreatment group (n=38), a GnRH antagonist was administered from day 2 of the menstrual cycle for three days. RESULTS Controlled ovarian stimulation (COS) duration and gonadotropin dosages were similar in both groups. The number of metaphase II (MII) oocytes, 2PN oocytes, embryos, along with implantation and clinical pregnancy rates, were higher in the pretreatment group when compared with controls, although the increment was not significant (P value ≥0.05). The chemical pregnancy rate was significantly higher in the pretreatment group. The rate of OHSS was significantly lower in the pretreatment than in the control group. CONCLUSION Women with PCOS offered early follicular phase GnRH antagonist pretreatment for three consecutive days had significantly fewer cases of OHSS and higher chemical pregnancy rates. There were trends toward greater numbers of MII oocytes, 2PN oocytes, and embryos, and higher clinical pregnancy rates in the pretreatment group.
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Affiliation(s)
- Maryam Eftekhar
- Reasearch and Clinical Center for Infertility, Yazd
Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran
- Recurrent Abortion Research Center, Yazd Reproductive
Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd,
Iran
| | - Ramesh Baradaran Bagheri
- Reasearch and Clinical Center for Infertility, Yazd
Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran
- Recurrent Abortion Research Center, Yazd Reproductive
Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd,
Iran
| | - Nosrat Neghab
- Reasearch and Clinical Center for Infertility, Yazd
Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran
- Recurrent Abortion Research Center, Yazd Reproductive
Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd,
Iran
| | - Robabe Hosseinisadat
- Department of Obstetrics and Gynecology, School of
Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Davar R, Nokhostin F, Eftekhar M, Sekhavat L, Bashiri Zadeh M, Shamsi F. Comparing the Recurrence of Vulvovaginal Candidiasis in Patients Undergoing Prophylactic Treatment with Probiotic and Placebo During the 6 Months. Probiotics Antimicrob Proteins 2018; 8:130-3. [PMID: 27206514 DOI: 10.1007/s12602-016-9218-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This is a randomized, double-blind, clinical/comparative trial study, involving the recurrence of vaginal candidiasis (VVC) after initial treatment with oral fluconazole in patients undergoing prophylactic management with a probiotic and placebo for 6 months. Fifty-nine VVC patients who were diagnosed based on their history, physical examination, and culture of vaginal discharge were initially treated by a single dose of 150 mg fluconazole. According to the table of random numbers, the sample was divided into two groups. The patients from one group took probiotics, while those from the other group took a placebo, with all of them being continuously monitored for 6 months. The patients complaining of vaginal candidiasis symptoms, such as burning, pruritus, and a vaginal (curd-like) discharge, were examined and the discharge was cultured for candida. The positive cultures were considered to be recurring for the patients in each group. Thirty-one cases from the placebo group and 28 cases from the probiotic group were carefully observed. In total, the 6-month recurrence in the control group was eleven (35.5 %) and in the research group was two (7.2 %). The results from Fisher's exact test for the value p = 0.01 and OR 0.14 95 % CI (0.028-0.7) showed significant recurrence in the placebo group. The findings demonstrated that taking probiotics withazole antifungal drugs could be highly effective in treating VVC, resulting in a lower recurrence rate as well.
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Affiliation(s)
- Robab Davar
- Yazd Research and Clinical Center for OB\GYN, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fahimeh Nokhostin
- Yazd Research and Clinical Center for OB\GYN, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Maryam Eftekhar
- Yazd Research and Clinical Center for OB\GYN, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Leili Sekhavat
- Yazd Research and Clinical Center for OB\GYN, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Farimah Shamsi
- Yazd Research and Clinical Center for OB\GYN, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Naghshineh E, Khani P. Role of granulocyte colony-stimulating factor in human reproduction. J Res Med Sci 2018; 23:7. [PMID: 29456564 PMCID: PMC5813296 DOI: 10.4103/jrms.jrms_628_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/18/2017] [Accepted: 11/15/2017] [Indexed: 12/26/2022]
Abstract
As new research reveals, granulocyte colony-stimulating factor (G-CSF) plays an effective role in pregnancy success, considering that it not only affects the embryo implantation and ovarian function but also it promotes endometrial thickening and improves the pathophysiology of endometriosis, which all fundamentally lead to reducing pregnancy loss. In this review, we focus on the role of G-CSF in human reproduction. We summarized its role in ovulation, luteinized unruptured follicle syndrome, poor responders, improving repeated in vitro fertilization failure, endometrial receptivity and treatment of thin endometrium, and recurrent spontaneous abortion.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Naghshineh
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Khani
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Omidi M, Eftekhar M, Agha-Rahimi A, Khalili M. Missed estradiol determination resulting in oocyte retrieval and embryo development following controlled ovarian hyperstimulation at early pregnancy: Case report. Asian Pac J Reprod 2018. [DOI: 10.4103/2305-0500.233577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Enjezab B, Eftekhar M, Ghadiri-Anari A. Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome. Electron Physician 2017; 9:5820-5825. [PMID: 29403625 PMCID: PMC5783134 DOI: 10.19082/5820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS), as the most common endocrine disorder among reproductive-aged women may lead to psychological morbidity. Objectives The present study set out to evaluate the severity of depression in PCOS and non-PCOS women and to evaluate correlation between depression score with body mass index, HOMA-IR, and testosterone level in every group (PCOS and non-PCOS women) in Yazd province. Methods In this cross-sectional study, 62 women with PCOS and 61 non- PCOS subjects (20 to 40 years) who were attending Imam-Ali Clinic in Yazd, Iran from September 2014 through March 2015 participated. These persons completed the Beck Depression Short Inventory (BDI-S) Questionnaire. Frequency of depression in PCOD and healthy persons and correlation between depression severity with body mass index, HOMA-IR, testosterone level in PCOS and non- PCOS women were evaluated by ANOVA test and independent-samples t-test and Pearson correlation. P-value of less than 0.05 was considered as statistically significant. Data analyses were performed using SPSS version 16. Results Of 62 PCOS subjects, 40 (64.5%) were verified positive for depression, determined by the BDI-S Questionnaire. In the control group, 60.7% had depression. Mean±SE score of depression for PCOS and non-PCOS women were 7.47±5.54 and 7.57±5.77 respectively. There was no statistically significant correlation between body mass index, HOMA-IR, testosterone level with depression score in either group separately or together. Conclusions We found considerable amounts of depression in our population. There is no correlation between body mass index, HOMA-IR, and testosterone level with depression score in our study.
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Affiliation(s)
- Behnaz Enjezab
- Ph.D. in Reproductive Health, Associate Professor, Research Center for Nursing and Midwifery Care, Department of Midwifery, Faculty of Nursing & Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Eftekhar
- M.D., Gynecologist, Associate Professor, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Akram Ghadiri-Anari
- M.D., Endocrinologist, Associate Professor, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Eftekhar M, Farid Mojtahedi M, Miraj S, Omid M. Final follicular maturation by administration of GnRH agonist plus HCG versus HCG in normal responders in ART cycles: An RCT. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.7.429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Eftekhar M, Mojtahedi MF, Miraj S, Omid M. Final follicular maturation by administration of GnRH agonist plus HCG versus HCG in normal responders in ART cycles: An RCT. Int J Reprod Biomed 2017; 15:429-434. [PMID: 29177244 PMCID: PMC5601934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Gonadotropin-releasing hormone agonists (GnRH-a) was increasingly used for triggering oocyte maturationfor the prevention of ovarian hyperstimulation syndrome. Studies suggest that GnRH-a might be used as a better trigger agent since it causes both Luteinizing hormone and follicle stimulating hormone release from a physiologic natural cycle. OBJECTIVE The aim of this study was to evaluate the effect of dual-triggering in assisted reproductive technology outcomes. MATERIALS AND METHODS 192 normal responder women aged ≤42 years and 18< Body Mass Index <30 kg/m2 enrolled in this single-blind randomized controlled trial. All participants received antagonist protocol. For final triggering, women randomly were divided into two groups. Group, I was triggered by 6500 IU human chorionic gonadotropin (hCG) alone, and group II by 6500 IU hCG plus 0.2 mg of triptorelin. The implantation, chemical, clinical and ongoing pregnancy, and abortion rates were measured. RESULTS The mean of retrieved oocytes and obtained embryos were statistically higher in the dual-trigger group (group I), but the implantation and pregnancy rates were similar in two groups. CONCLUSION The results of our study did not confirm the favorable effect of dual-triggered oocyte maturation with a GnRH-a and a standard dosage of hCG as an effective strategy to optimize pregnancy outcome for normal responders in GnRH-antagonist cycles. We think that this new concept requires more studies before becoming a universal controlled ovarian hyperstimulation protocol in in vitro fertilization practice.
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Affiliation(s)
- Maryam Eftekhar
- Reasearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Recurrent Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Maryam Farid Mojtahedi
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Roointan Arash Women’s Health Research and Educational Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sepideh Miraj
- Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Malihe Omid
- Reasearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Molaei B, Mohmmadian F, Eftekhar M, Hatami R, Tirkan A, Kiani M. The frequency of gonorrheal and chlamydial infections in Zanjanian women in 2013-2014. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Molaei B, Mohmmadian F, Eftekhar M, Hatami R, Tirkan A, Kiani M. The frequency of gonorrheal and chlamydial infections in Zanjanian women in 2013-2014. Int J Reprod Biomed 2017; 15:75-82. [PMID: 28462398 PMCID: PMC5405219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis and Neisseria gonorrhoeae are the most prevalent bacterial sexually transmitted diseases in women. OBJECTIVE The purpose of this study was to investigate the prevalence of gonorrheal and chlamydial infections and determination of related risk factors in married women with vaginal discharge attending gynecological outpatient department (OPD) in Zanjan in 2013-2014. MATERIALS AND METHODS In this cross sectional study, 100 married women aged 18-49 years with vaginal discharge were evaluated for signs and symptoms of gonococcal and chlamydial infections. Then cervical discharge samples and blood samples were collected from each subject for the detection of Nisseria gonorrhea and Chlamydia trachomatis by bacterial culture and serological tests, respectively. RESULTS The overall prevalence of Chlamydia trachomatis and Nisseriagonorrhoeae were 16% and 4%, respectively. There was no significant relationship between the contraception methods, previous history of vaginal infections, previous history of urinary tract infections, number of coitus per week and self-reported symptoms (itching, burning, abdominal pain) with prevalence of Nisseriagonorrhoeae and Chlamydia trachomatis. CONCLUSION According to our results, the prevalence of gonococci infection in Zanjan was remarkable and relatively was higher than other parts of Iran, therefore it is necessary to put emphasis on education and further preventive and therapeutic programs.
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Affiliation(s)
- Behnaz Molaei
- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Farnaz Mohmmadian
- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Maryam Eftekhar
- Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Robabeh Hatami
- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Atefe Tirkan
- Zanjan University of Medical Sciences, Znjan, Iran.
| | - Mahsa Kiani
- Zanjan University of Medical Sciences, Znjan, Iran.
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Eftekhar M, Miraj S, Farid Mojtahedi M, Neghab N. Efficacy of Intrauterine infusion of granulocyte colony stimulating factor on patients with history of implantation failure: A randomized control trial. Int J Reprod Biomed 2016. [DOI: 10.29252/ijrm.14.11.687] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Eftekhar M, Miraj S, Farid Mojtahedi M, Neghab N. Efficacy of Intrauterine infusion of granulocyte colony stimulating factor on patients with history of implantation failure: A randomized control trial. Int J Reprod Biomed 2016; 14:687-690. [PMID: 27981253 PMCID: PMC5153573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Although pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET) cycles has been increased over the preceding years, but the majority of IVF-ET cycles still fail. Granulocyte colony stimulating factor (GCSF) is a glycoprotein that stimulates cytokine growth factor and induces immune system which may improve pregnancy rate in women with history of implantation failure. OBJECTIVE The aim of this study was to evaluate GCSF ability to improve pregnancy rate in women with history of implantation failure. MATERIALS AND METHODS 0.5 ml (300 µg/ml) GCSF was infused intrauterine in intervention group. Pregnancy outcomes were assessed based on clinical pregnancy. RESULTS The mean age of participants was 31.95±4.71 years old. There were no significant differences between demographic characteristics in two groups (p>0.05). The pregnancy outcome in GCSF group was improved significantly (p=0.043). CONCLUSION GCSF can improve pregnancy outcome in patients with history of implantation failure.
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Affiliation(s)
- Maryam Eftekhar
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Sepideh Miraj
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Maryam Farid Mojtahedi
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Roointan Arash Women’s Health Research and Educational Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nosrat Neghab
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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