1Assistant Lecturer of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Facult... more 1Assistant Lecturer of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt 2Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt 3Assistant professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt Journal of Women’s Health and Gynecology
ABSTRACT Abstract:
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic S... more ABSTRACT Abstract:
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic Sperm Injection outcome in polycystic ovarian syndrome cases treated by non-agonist chronic step up stimulation protocol.
Setting: Agial and Integrated Fertility Centers, Alexandria, Egypt.
Patients: Twenty five cases of polycystic ovarian syndrome fulfilling Rotterdam criteria.
Materials & Methods:
Patients received a protocol started with administration of urinary human menopausal gonadotropin (hMG) per day, follow up was done by ultrasound and serum estradiol level with increasing dose until the required response was achieved and if ovarian hyperstimulation syndrome (OHSS) occurred , gonadotrophin was withheld till estradiol declined. Human chorionic gonadotropin (hCG) was given intramuscularly to achieve oocyte maturation. After (34-36 hours) of hCG administration oocytes retrieval was performed. The patients received luteal phase support in the form of natural progesterone vaginally. Transvaginal ultrasound was performed two weeks after positive pregnancy test to confirm clinical pregnancy.
Main Outcome measures: number of ampoules, stimulation days, serum estradiol level and progesterone level on day of hCG, number of oocytes retrieved, grading of embryos obtained, endometrial thickness, pregnancy rate, implantation rate, abortion rate, cancellation rate, multiple pregnancy rate and cost.
Results: patients with higher number of basal antral follicles were associated with lower number of ampoules needed for stimulation (14.63 vs. 21.64 ampoules) and less stimulation days (7.07 vs. 10.73 days). Patients with higher number of mature follicles were associated with higher estrogen level (1561.53 vs. 658.14 pg/ml) and higher progesterone level on day of hCG (1.10 vs. .62 ng/ml), higher number of oocytes retrieved (7.18 vs. 4.13 oocytes) and higher number of embryos transferred (3.06 vs. 2 embryos). The number of mature follicles and the endometrial thickness were higher in pregnant group (19.78 follicles and 12.94 mm, respectively). The pregnancy rate was (36%), the chemical pregnancy rate was (33.3%), the abortion rate was (22.2%) and the ongoing pregnancy rate was (44.4%).
Conclusions: The higher the number of the basal antral follicles, the less the number of the ampoules needed for stimulation and the less the stimulation days. The higher the number of mature follicles, the higher the estrogen level on day of hCG, the greater the number of oocytes retrieved and the greater the number of embryos transferred. The stromal thickness has no effect on the pregnancy outcome but the number of mature follicles and the endometrial thickness has a positive correlation with the pregnancy outcome.
Key Words: Polycystic ovary, ultrasound parameters, non-agonist protocol, intra cytoplasmic sperm injection.
1Assistant Lecturer of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Facult... more 1Assistant Lecturer of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt 2Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt 3Assistant professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Egypt Journal of Women’s Health and Gynecology
ABSTRACT Abstract:
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic S... more ABSTRACT Abstract:
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic Sperm Injection outcome in polycystic ovarian syndrome cases treated by non-agonist chronic step up stimulation protocol.
Setting: Agial and Integrated Fertility Centers, Alexandria, Egypt.
Patients: Twenty five cases of polycystic ovarian syndrome fulfilling Rotterdam criteria.
Materials & Methods:
Patients received a protocol started with administration of urinary human menopausal gonadotropin (hMG) per day, follow up was done by ultrasound and serum estradiol level with increasing dose until the required response was achieved and if ovarian hyperstimulation syndrome (OHSS) occurred , gonadotrophin was withheld till estradiol declined. Human chorionic gonadotropin (hCG) was given intramuscularly to achieve oocyte maturation. After (34-36 hours) of hCG administration oocytes retrieval was performed. The patients received luteal phase support in the form of natural progesterone vaginally. Transvaginal ultrasound was performed two weeks after positive pregnancy test to confirm clinical pregnancy.
Main Outcome measures: number of ampoules, stimulation days, serum estradiol level and progesterone level on day of hCG, number of oocytes retrieved, grading of embryos obtained, endometrial thickness, pregnancy rate, implantation rate, abortion rate, cancellation rate, multiple pregnancy rate and cost.
Results: patients with higher number of basal antral follicles were associated with lower number of ampoules needed for stimulation (14.63 vs. 21.64 ampoules) and less stimulation days (7.07 vs. 10.73 days). Patients with higher number of mature follicles were associated with higher estrogen level (1561.53 vs. 658.14 pg/ml) and higher progesterone level on day of hCG (1.10 vs. .62 ng/ml), higher number of oocytes retrieved (7.18 vs. 4.13 oocytes) and higher number of embryos transferred (3.06 vs. 2 embryos). The number of mature follicles and the endometrial thickness were higher in pregnant group (19.78 follicles and 12.94 mm, respectively). The pregnancy rate was (36%), the chemical pregnancy rate was (33.3%), the abortion rate was (22.2%) and the ongoing pregnancy rate was (44.4%).
Conclusions: The higher the number of the basal antral follicles, the less the number of the ampoules needed for stimulation and the less the stimulation days. The higher the number of mature follicles, the higher the estrogen level on day of hCG, the greater the number of oocytes retrieved and the greater the number of embryos transferred. The stromal thickness has no effect on the pregnancy outcome but the number of mature follicles and the endometrial thickness has a positive correlation with the pregnancy outcome.
Key Words: Polycystic ovary, ultrasound parameters, non-agonist protocol, intra cytoplasmic sperm injection.
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Papers by Ashraf Hany
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic Sperm Injection outcome in polycystic ovarian syndrome cases treated by non-agonist chronic step up stimulation protocol.
Setting: Agial and Integrated Fertility Centers, Alexandria, Egypt.
Patients: Twenty five cases of polycystic ovarian syndrome fulfilling Rotterdam criteria.
Materials & Methods:
Patients received a protocol started with administration of urinary human menopausal gonadotropin (hMG) per day, follow up was done by ultrasound and serum estradiol level with increasing dose until the required response was achieved and if ovarian hyperstimulation syndrome (OHSS) occurred , gonadotrophin was withheld till estradiol declined. Human chorionic gonadotropin (hCG) was given intramuscularly to achieve oocyte maturation. After (34-36 hours) of hCG administration oocytes retrieval was performed. The patients received luteal phase support in the form of natural progesterone vaginally. Transvaginal ultrasound was performed two weeks after positive pregnancy test to confirm clinical pregnancy.
Main Outcome measures: number of ampoules, stimulation days, serum estradiol level and progesterone level on day of hCG, number of oocytes retrieved, grading of embryos obtained, endometrial thickness, pregnancy rate, implantation rate, abortion rate, cancellation rate, multiple pregnancy rate and cost.
Results: patients with higher number of basal antral follicles were associated with lower number of ampoules needed for stimulation (14.63 vs. 21.64 ampoules) and less stimulation days (7.07 vs. 10.73 days). Patients with higher number of mature follicles were associated with higher estrogen level (1561.53 vs. 658.14 pg/ml) and higher progesterone level on day of hCG (1.10 vs. .62 ng/ml), higher number of oocytes retrieved (7.18 vs. 4.13 oocytes) and higher number of embryos transferred (3.06 vs. 2 embryos). The number of mature follicles and the endometrial thickness were higher in pregnant group (19.78 follicles and 12.94 mm, respectively). The pregnancy rate was (36%), the chemical pregnancy rate was (33.3%), the abortion rate was (22.2%) and the ongoing pregnancy rate was (44.4%).
Conclusions: The higher the number of the basal antral follicles, the less the number of the ampoules needed for stimulation and the less the stimulation days. The higher the number of mature follicles, the higher the estrogen level on day of hCG, the greater the number of oocytes retrieved and the greater the number of embryos transferred. The stromal thickness has no effect on the pregnancy outcome but the number of mature follicles and the endometrial thickness has a positive correlation with the pregnancy outcome.
Key Words: Polycystic ovary, ultrasound parameters, non-agonist protocol, intra cytoplasmic sperm injection.
Objective: to correlate the ultrasound parameters to the Intra-cytoplasmic Sperm Injection outcome in polycystic ovarian syndrome cases treated by non-agonist chronic step up stimulation protocol.
Setting: Agial and Integrated Fertility Centers, Alexandria, Egypt.
Patients: Twenty five cases of polycystic ovarian syndrome fulfilling Rotterdam criteria.
Materials & Methods:
Patients received a protocol started with administration of urinary human menopausal gonadotropin (hMG) per day, follow up was done by ultrasound and serum estradiol level with increasing dose until the required response was achieved and if ovarian hyperstimulation syndrome (OHSS) occurred , gonadotrophin was withheld till estradiol declined. Human chorionic gonadotropin (hCG) was given intramuscularly to achieve oocyte maturation. After (34-36 hours) of hCG administration oocytes retrieval was performed. The patients received luteal phase support in the form of natural progesterone vaginally. Transvaginal ultrasound was performed two weeks after positive pregnancy test to confirm clinical pregnancy.
Main Outcome measures: number of ampoules, stimulation days, serum estradiol level and progesterone level on day of hCG, number of oocytes retrieved, grading of embryos obtained, endometrial thickness, pregnancy rate, implantation rate, abortion rate, cancellation rate, multiple pregnancy rate and cost.
Results: patients with higher number of basal antral follicles were associated with lower number of ampoules needed for stimulation (14.63 vs. 21.64 ampoules) and less stimulation days (7.07 vs. 10.73 days). Patients with higher number of mature follicles were associated with higher estrogen level (1561.53 vs. 658.14 pg/ml) and higher progesterone level on day of hCG (1.10 vs. .62 ng/ml), higher number of oocytes retrieved (7.18 vs. 4.13 oocytes) and higher number of embryos transferred (3.06 vs. 2 embryos). The number of mature follicles and the endometrial thickness were higher in pregnant group (19.78 follicles and 12.94 mm, respectively). The pregnancy rate was (36%), the chemical pregnancy rate was (33.3%), the abortion rate was (22.2%) and the ongoing pregnancy rate was (44.4%).
Conclusions: The higher the number of the basal antral follicles, the less the number of the ampoules needed for stimulation and the less the stimulation days. The higher the number of mature follicles, the higher the estrogen level on day of hCG, the greater the number of oocytes retrieved and the greater the number of embryos transferred. The stromal thickness has no effect on the pregnancy outcome but the number of mature follicles and the endometrial thickness has a positive correlation with the pregnancy outcome.
Key Words: Polycystic ovary, ultrasound parameters, non-agonist protocol, intra cytoplasmic sperm injection.