Background. The best way to avoid undesirable multiple pregnancies following in vitro fertilization procedure (IVF) is to perform elective single embryo transfer, but the procedure might result in a ...reduction of the pregnancy rates. Aim of our study was to establish whether a single blastocyst transfer using a hyaluronan rich transfer medium results in higher pregnancy rates in comparison to the transfer using a conventional transfer medium. Material and methods. Our prospective randomized study included 107 patients enrolled in the 1st, 2nd and 3rd classical IVF or intracytoplasmic sperm injection (ICSI) treatment attempt. Patients included were under 37 years of age with at least one blastocyst developed in the procedure. In the study group (47 patients) blastocyst transfers using the hyaluronan rich transfer medium were performed and in the control group (60 patients) the conventional medium was used. The pregnancy rates in the study and in the control group were compared. Results. The average pregnancy rate per single blastocyst transfer was 30 %; there were no twin pregnancies. The single blastocyst transfer using hyaluronan resulted in a non-significantly higher pregnancy rate (11 %). A significantly higher pregnancy rate with the use of hyaluronan was found in the subgroup of patients with two or more blastocysts developed in their 2nd and 3rd IVF attempt (p = 0.045). Conslusions. The single blastocyst transfer results in high implantation rates. Hyaluronan significantly contributes to higher implantation rates in a selected subgroup of patients following previous implantation failure and with multiple blastocysts developed.
Background: In-vitro fertilization (IVF) is performed with oocytes collected in natural and stimulated cycles. Different approaches to ovarian stimulation have been employed worldwide. Fol- lowing ...the introduction of gonadotrophin realising hormone (GnRH) antagonists and strategies to reduce multiple birth such as single embryo transfer, there is an interest in the revival of natural and mild approaches to ovarian stimulation in IVF. Particulary mild ovarian stimulation aims to achieve cost-effective, patient-friendly regimens which optimize the balance between outcomes and risks of treatment. Methods: Pubmed was searched up to 2009 for papers on natural, modified natural, mild and con- ventional IVF cycles. Results: Data discussed in this review do not allow any conclusions to be drawn regarding the most optimal mild ovarian stimulation protocol. However, it is absolutelly clear that introduction of GnRH antagonists into clinical practice has allowed for the introduction of milder stimulation approaches for IVF treatment because of preventing premature luteinising hor- mone (LH) rise by competitive blockade of the GnRH receptors. Studies also show that mild exogenous gonadotrophins interference with the decrease in follicle-stimulating hormone ((FSH) levels in the mid-folicular phase was sufficient to override the selection of a single dominant follicle and enhance the most mature follicles to growth due to their increased sensitivity for FSH and acquired responsiveness to LH. Conclusions: The implementation of mild stimulation and modified natural cycle into standard clinical practise appears to be justified, although more prospective studies are needed to find the most appropriate mild stimulation approaches.
The aim of our study was to establish the prevalence of high-risk human papillomavirus (hr-HPV) infection in a population of women included in an in vitro fertilisation (IVF) program and to correlate ...the outcome of IVF cycles with HPV status.
A total of 195 women undergoing the IVF program were included in the study. A cervical smear for cytological analysis and hr-HPV determination was collected from every woman. RealTime High Risk HPV test (Abbott Molecular Inc., Des Plaines, IL) has been used for the detection of hr-HPV infection. All participants were invited to complete an anonymous questionnaire that included questions regarding medical and sexual history as well as risk factors for HPV infection. HPV 16 and HPV 18 positive women were invited for follow-up gynaecological examinations, including colposcopy 4 to 6 months after the inclusion.
Mean age of included infertile women was 33.7 ± 4.36 years. A total of 16/195 women (8.2%) were hr-HPV positive. Hr-HPV infection was not associated with the percentage of mature oocytes, the percentage of fertilised oocytes, with embryo quality or with pregnancy rate in our study.
The prevalence of hr-HPV genotypes in Slovenian infertile women undergoing IVF is lower than the hr-HPV prevalence in the general population. We were unable to find an association between hr-HPV cervical infection and the outcome of IVF cycles.
Namen naše raziskave je bil ugotoviti zastopanost okužbe z visokorizičnimi genotipi humanih papilomskih virusov (vr-HPV) v populaciji žensk, vključenih v postopke zunajtelesne oploditve (ZTO). Nadalje smo želeli ugotoviti, ali ima okužba s HPV vpliv na izid postopkov ZTO.
Vključili smo 195 žensk, ki so se zdravile s postopki ZTO. Vsaki ženski smo odvzeli bris materničnega vratu za citološko preiskavo in bris za določanje okužbe z vr-HPV. Za dokazovanje okužbe z vr-HPV smo uporabili test RealTime High Risk HPV (Abbott Molecular Inc., Des Plaines, IL). Vsako žensko smo prosili, da izpolni anonimni vprašalnik, ki je vključeval ginekološko anamnezo in dejavnike tveganja za okužbo s HPV. Ženske, ki so bile HPV 16 ali HPV 18 pozitivne, smo povabili na kontrolni pregled in kolposkopijo po štirih do šestih mesecih.
Povprečna starost vključenih neplodnih žensk je bila 33,7 ± 4,36 leta. V naši raziskavi je bilo 16/195 žensk (8,2 %) vr-HPV pozitivnih. Okužba z vr-HPV ni imela vpliva na število ali odstotek zrelih jajčnih celic, odstotek oplojenih jajčnih celic, kakovost zarodka ali na stopnjo zanositve.
V populaciji žensk, vključenih v postopke ZTO, je prevalenca okužbe z vr-HPV nižja kot v splošni populaciji slovenskih žensk. Okužba z vr-HPV ni bila povezana z uspehom postopkov ZTO.
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