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Hazari V, Sarvi F, Alyasin A, Agha-Hosseini M, Hosseinimousa S. Enhancing endometrial receptivity in FET cycles: exploring the influence of endometrial and subendometrial blood flow along with endometrial volume. Front Med (Lausanne) 2024; 11:1260960. [PMID: 38651066 PMCID: PMC11033323 DOI: 10.3389/fmed.2024.1260960] [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: 07/18/2023] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Fetal health and a receptive and healthy endometrium are two essential factors in achieving successful implantation. If the endometrium is unreceptive, postponing the transfer cycle to a suitable time can enhance the chances of pregnancy. This study aims to assess the impact of endometrial and sub-endometrial blood flows measured by Doppler ultrasound, as well as endometrial volume, on endometrial receptivity in frozen embryo transfer (FET) cycles. Methods 112 patients with a mean age of 33.93 ± 4.93 years underwent in vitro fertilization (IVF). Serum β-hCG level was used to confirm pregnancy, and among the participants, 50 (44.6%) achieved pregnancy after IVF. Results The study results revealed a significant difference in endometrial blood flow between the pregnant and non-pregnant groups, with a higher pregnancy rate observed in participants exhibiting multi-focal and spare endometrial blood flows (p < 0.05). Furthermore, there was a notable association between endometrial blood flow and pregnancy outcome, as indicated by higher ongoing pregnancy rates in those with multi-focal and spare endometrial blood flows (p < 0.05). However, no significant differences were observed in endometrial variables such as volume, length, width, thickness, and pattern between the pregnant and non-pregnant groups. Additionally, contextual parameters showed no significant relationship with pregnancy outcome (p > 0.05). The study also found that endometrial measurement indices did not have a significant impact on pregnancy outcomes, with no significant differences observed between the groups (p > 0.05). Conclusion In conclusion, endometrial blood flow is crucial for a successful pregnancy after IVF, while the predictive value of the endometrial volume is limited for pregnancy outcomes.
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Affiliation(s)
- Vajihe Hazari
- Department of Obstetrics and Gynecology, Rooyesh Infertility Center, Birjand University of Medical Science, Birjand, Iran
| | - Fatemeh Sarvi
- Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran
| | - Ashraf Alyasin
- Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran
| | - Marzieh Agha-Hosseini
- Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran
| | - Sedigheh Hosseinimousa
- Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran
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Alyasin A, Agha-Hosseini M, Kabirinasab M, Saeidi H, Nashtaei MS. Serum progesterone levels greater than 32.5 ng/ml on the day of embryo transfer are associated with lower live birth rate after artificial endometrial preparation: a prospective study. Reprod Biol Endocrinol 2021; 19:24. [PMID: 33602270 PMCID: PMC7890906 DOI: 10.1186/s12958-021-00703-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Previous observational studies have highlighted the negative effects of serum hormone levels at the minimum threshold during frozen embryo transfer (FET) cycles. However, still the questions regarding the maximum threshold level, and the highest allowed dosage of hormonal medications remain unresolved. The present study was conducted to determine whether there is any relationship between the serum progesterone and estradiol levels on the day of ET, and live birth rate (LBR) in patients receiving HRT in FET cycles. METHODS In this prospective cohort study, eligible women who were undergoing their first or second FET cycles with the top graded blastocyst stage embryos were included. All patients received the same HRT regimen. FET was scheduled 5 days after administration of the first dosage of progesterone. On the morning of ET, 4-6 h after the last dose of progesterone supplementation, the serum progesterone (P4, ng/ml) and estradiol (E2, pg/ml) levels were measured. RESULTS Amongst the 258 eligible women that were evaluated, the overall LBR was 34.1 % (88/258). The serum P4 and E2 values were divided into four quartiles. The means of women's age and BMI were similar between the four quartiles groups. Regarding both P4 and E2 values, it was found that the LBR was significantly lower in the highest quartile group (Q4) compared with the others, (P = 0.002 and P = 0.042, respectively). The analysis of the multivariable logistic regression showed that the serum level of P4 on ET day, was the only significant predictive variable for LBR. The ROC curve revealed a significant predictive value of serum P4 levels on the day of ET for LBR, with an AUC = 0.61 (95 % CI: 0.54-0.68, P = 0.002). The optimum level of serum P4, with 70 % sensitivity and 50 %specificity for LBR, was 32.5 ng/ml. CONCLUSIONS The present study suggests that a serum P4 value at the maximum threshold on the day of FET is associated with reduced LBR following blastocyst transfer. Therefore, measuring and monitoring of P4 levels during FET cycles might be necessary. However, the results regarding the necessity for the screening of serum E2 levels before ET, are still controversial, and further prospective studies are required.
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Affiliation(s)
- Ashraf Alyasin
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, 1411713135, Shariati Hospital, Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran
| | - Marzieh Agha-Hosseini
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, 1411713135, Shariati Hospital, Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran
| | - Motahareh Kabirinasab
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, 1411713135, Shariati Hospital, Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran.
| | - Hojatollah Saeidi
- Department of Biology and Embryology, Omid Fertility Center, Tehran, Iran
| | - Maryam Shabani Nashtaei
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Agha-Hosseini M, Hashemi L, Aleyasin A, Ghasemi M, Sarvi F, Shabani Nashtaei M, Khodarahmian M. Natural cycle versus artificial cycle in frozen-thawed embryo transfer: A randomized prospective trial. Turk J Obstet Gynecol 2018; 15:12-17. [PMID: 29662710 PMCID: PMC5894530 DOI: 10.4274/tjod.47855] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 10/11/2017] [Accepted: 02/03/2018] [Indexed: 01/20/2023] Open
Abstract
Objective: To investigate whether there was a difference in pregnancy outcomes between modified natural cycle frozen-thawed embryo transfer (NC-FET) cycles and artificial cycles (AC)-FET in women who all had regular menstrual cycles. Materials and Methods: One hundred seventy patients who met the inclusion criteria and had at least two cryopreserved embryos were included in a prospective randomized controlled trial. Eighty-five patients were randomized based on Bernoulli distribution into the following two groups: 1) Modified NC-FET using human chorionic gonadotropin for ovulation induction and 2) AC-FET, in which endometrial timing was programmed with estrogen and progesterone. The main studied outcome measure was the clinical pregnancy rate per cycle. Results: No significant differences were found between the two groups with regard to the chemical, clinical, and ongoing pregnancy rates (48.2% vs 45.9%, p>0.05; 38.9% vs 35.3%, p>0.05; and 37.6% vs 34.1%, p>0.05, respectively), as well as the live birth or miscarriage rates per cycle (35.3% vs 31.8%, p>0.05; and 1.2% vs 1.2%, p>0.05, respectively). Conclusion: These findings suggest that although both FET protocols are equally effective in terms of pregnancy outcomes in women with regular menstrual cycles, NC-FET is more favorable because it requires no medication, has no adverse events, and has a significant cost reduction.
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Affiliation(s)
- Marzieh Agha-Hosseini
- Tehran University of Medical Sciences Faculty of Medicine, Shariati Hospital, Department of Infertility, Tehran, Iran
| | - Leila Hashemi
- Tehran University of Medical Sciences Faculty of Medicine, Shariati Hospital, Department of Infertility, Tehran, Iran
| | - Ashraf Aleyasin
- Tehran University of Medical Sciences Faculty of Medicine, Shariati Hospital, Department of Infertility, Tehran, Iran
| | - Marzieh Ghasemi
- Zahedan University of Medical Sciences, Aliebneabitaleb Hospital, Pregnancy Health Research Center, Department of Obstetrics and Gynecology, Zahedan, Iran
| | - Fatemeh Sarvi
- Zahedan University of Medical Sciences, Aliebneabitaleb Hospital, Pregnancy Health Research Center, Department of Obstetrics and Gynecology, Zahedan, Iran
| | - Maryam Shabani Nashtaei
- Tehran University of Medical Sciences Faculty of Medicine, Shariati Hospital, Department of Infertility, Tehran, Iran
| | - Mahshad Khodarahmian
- Tehran University of Medical Sciences Faculty of Medicine, Department of Anatomy, Tehran, Iran
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Alleyassin A, Abiri A, Agha-Hosseini M, Sarvi F. The Value of Routine Hysteroscopy before the First Intracytoplasmic Sperm Injection Treatment Cycle. Gynecol Obstet Invest 2016; 82:125-130. [PMID: 27160848 DOI: 10.1159/000445801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/22/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS To assess uterine cavity with office hysteroscopy in order to diagnose and treat pathologies in patients who have started their first intracytoplasmic sperm injection (ICSI) cycles and evaluate its impact on pregnancy rate. METHODS A number of 220 infertile women scheduled for ICSI participated in this prospective randomized study. They were randomly divided into 2 equal groups. Group I (intervention) underwent office hysteroscopy before starting assisted reproductive techniques (ART) cycle. Group II (control) started ART cycles without office hysteroscopy. All women had normal transvaginal ultrasonography and hysterosalpingography. The detected intrauterine abnormalities were treated during hysteroscopy. Four weeks after embryo transfer, ultrasonography was done for detecting clinical pregnancy. RESULTS Abnormal findings were seen in hysteroscopy in 22.7% of the intervention group. The pregnancy rate in the intervention group (48.20%) was significantly higher than that in the control group (38.60%; p = 0.004). CONCLUSION Routine office hysteroscopy before ICSI cycles provides direct evaluation of uterine cavity. Also, pregnancy rate improves after correction of endometrial cavity abnormalities.
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Affiliation(s)
- Ashraf Alleyassin
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Agha-Hosseini M, Rahmani M, Alleyassin A, Safdarian L, Sarvi F. The effect of progesterone supplementation on pregnancy rates in controlled ovarian stimulation and intrauterine insemination cycles: a randomized prospective trial. Eur J Obstet Gynecol Reprod Biol 2012; 165:249-53. [PMID: 22940119 DOI: 10.1016/j.ejogrb.2012.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 07/13/2012] [Accepted: 08/05/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate the effect of vaginal progesterone as luteal phase support on pregnancy rates in controlled ovarian stimulation and intrauterine insemination cycles in couples with unexplained or mild male factor infertility. STUDY DESIGN 290 Patients who met the inclusion criteria were included in a prospective randomized controlled trial. All patients underwent controlled ovarian stimulation and intrauterine insemination: 148 patients were randomized to start with a supported cycle and 142 patients with an unsupported cycle. In supported cycles, patients received vaginal progesterone once daily from the day after insemination until 12 weeks of pregnancy or, in non-pregnant women, for 14 days. No progesterone was given during unsupported cycles. The main outcome measures were clinical pregnancy rates per cycle. RESULTS In total, 148 cycles with luteal phase support and 142 cycles without luteal phase support were performed. The clinical pregnancy rates per cycle were higher for cycles with luteal phase support than for the unsupported cycles (24.3% vs. 14.1% respectively, p=0.027). CONCLUSION The use of vaginal suppositories as luteal phase support significantly improved clinical pregnancy rates in controlled ovarian stimulation and intrauterine insemination in patients with unexplained or mild male factor infertility.
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Affiliation(s)
- Marzieh Agha-Hosseini
- Infertility Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Agha-Hosseini M, Aleyaseen A, Peyvandi S, Kasha L. Comparison of pregnancy and implantation rates in zygote intrafallopian transfer and uterine embryo transfer for nontubal infertility. East Mediterr Health J 2010; 16:29-33. [PMID: 20214154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We carried out a prospective randomized trial on 220 couples with nontubal factor infertility to compare pregnancy rates and implantation rates after zygote intrafallopian transfer (ZIFT) and uterine embryo transfer (UET). The zygote was transferred by laparoscopy into the fallopian tube 24 hours after oocyst retrieval. UET was performed 72 hours after retrieval with abdominal sonography guide. Transfer was performed in 102 cycles in the ZIFT and 100 cycles in the U ET group. The pregnancy and implantation rates were significantly higher in the ZIFT group (42.1% and 11.7%) than in the UET group (21.0% and 7.8%) (P < 0.05). ZiFT could be considered for couples who have limited time and adequate financial support.
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Affiliation(s)
- M Agha-Hosseini
- Infertility Centre, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Agha-Hosseini M, Aleyaseen A, Safdarian L, Kashani L. Secondary Amenorrhea with Low Serum Luteinizing Hormone and Follicle-stimulating Hormone Caused by an Inhibin A- and Inhibin B-producing Granulosa Cell Tumor. Taiwan J Obstet Gynecol 2009; 48:72-5. [DOI: 10.1016/s1028-4559(09)60040-1] [Citation(s) in RCA: 6] [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] [Indexed: 11/28/2022] Open
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Agha-Hosseini M, Kashani L, Aleyaseen A, Ghoreishi A, Rahmanpour H, Zarrinara AR, Akhondzadeh S. Crocus sativus L. (saffron) in the treatment of premenstrual syndrome: a double-blind, randomised and placebo-controlled trial. BJOG 2008; 115:515-9. [DOI: 10.1111/j.1471-0528.2007.01652.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Khademi A, Alleyassin A, Agha-Hosseini M, Safdarian L, Saeidi Saeidabadi H, Pooyan O. The Effect of L-Carnitine on Sperm Parameters in Patients Candidated for Intracytoplasmic Sperm Injection. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.539] [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: 11/26/2022]
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