Yasser Orief
Alexandria University ,Egypt, Obstetrics and Gynecology, Faculty Member
- www.yaserorief.netedit
Research Interests:
The radical strategy of vitrification results in the total elimination of ice crystal formation, both within the cells being vitrified (intracellular) and in the surrounding solution (extracellular). The protocols for vitrification are... more
The radical strategy of vitrification results in the total elimination of ice crystal formation, both within the cells being vitrified (intracellular) and in the surrounding solution (extracellular). The protocols for vitrification are very simple. They allow cells and tissue to be placed directly into the cryoprotectant and then plunged directly into liquid nitrogen. To date, however, vitrification as a cryopreservation
Research Interests:
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... 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.
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.
Research Interests:
The radical strategy of vitrification results in the total elimination of ice crystal formation, both within the cells being vitrified (intracellular) and in the surrounding solution (extracellular). The protocols for vitrification are... more
The radical strategy of vitrification results in the total elimination of ice crystal formation, both within the cells being vitrified (intracellular) and in the surrounding solution (extracellular). The protocols for vitrification are very simple. They allow cells and tissue to be placed directly into the cryoprotectant and then plunged directly into liquid nitrogen. To date, however, vitrification as a cryopreservation method has had very little practical impact on human- assisted reproduction. This may be due to the wide variety of different carriers and vessels that have been used for vitrification. Second, many different vitrification solutions have been formulated, which has not helped to focus efforts on perfecting a single approach. On the other hand, the reports of successfully completed pregnancies following vitrification at all pre-implantation stages is encouraging for further research and clinical implementation.
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Research Interests: Treatment Outcome, Cryopreservation, Pregnancy, Humans, Female, and 16 moreMale, tESTIS, Embryo Transfer, Fertility Rate, Fertilization, Adult, Retrospective Studies, Reproductive, Binary Logistic Regression, Spermatozoa, Sperm Motility, Liquid Nitrogen, Embryos, Pregnancy Rate, Logistic Models, and Cumulant
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Objective: To compare the effect of bed rest after intrauterine insemination for five, ten and twenty minutes on the pregnancy rate. Design: Randomized controlled trial. Setting: Integrated Fertility Center and Agial Fertility Center.... more
Objective: To compare the effect of bed rest after intrauterine insemination for five, ten and twenty minutes on the pregnancy rate.
Design: Randomized controlled trial.
Setting: Integrated Fertility Center and Agial Fertility Center.
Sample: Three hundred and ninety six couples with mild male factor, cervical factor, or unexplained infertility between the periods from 1/2012 to 12/2012.
Methods: Intrauterine insemination with controlled ovarian hyper-stimulation.
Main outcome measures: The chemical and clinical pregnancy rates.
Results: The couples were randomly subdivided equally into three groups: A, B& C and they allocated for bed rest for five, 10& 20 minutes respectively after insemination, the chemical and clinical pregnancy rates in group A (6.1& 4.5% respectively) were significantly lower than in group B (18.2& 15.9% respectively), and also it were significantly lower than in group C (23.5& 19.7% respectively), but there was no statistically significant difference in the pregnancy rates between group B and C.
Conclusions: Bed rest for 10 and 20 minutes after intrauterine insemination has a positive effect on the pregnancy rate, but there is no statistically significance difference between them. We recommend for at least 10 minutes after intrauterine insemination.
Key words and Abbreviations
Key words: Intrauterine insemination, infertility, bed rest.
Design: Randomized controlled trial.
Setting: Integrated Fertility Center and Agial Fertility Center.
Sample: Three hundred and ninety six couples with mild male factor, cervical factor, or unexplained infertility between the periods from 1/2012 to 12/2012.
Methods: Intrauterine insemination with controlled ovarian hyper-stimulation.
Main outcome measures: The chemical and clinical pregnancy rates.
Results: The couples were randomly subdivided equally into three groups: A, B& C and they allocated for bed rest for five, 10& 20 minutes respectively after insemination, the chemical and clinical pregnancy rates in group A (6.1& 4.5% respectively) were significantly lower than in group B (18.2& 15.9% respectively), and also it were significantly lower than in group C (23.5& 19.7% respectively), but there was no statistically significant difference in the pregnancy rates between group B and C.
Conclusions: Bed rest for 10 and 20 minutes after intrauterine insemination has a positive effect on the pregnancy rate, but there is no statistically significance difference between them. We recommend for at least 10 minutes after intrauterine insemination.
Key words and Abbreviations
Key words: Intrauterine insemination, infertility, bed rest.