overall objective of the best luteal phase support upon pregnancy outcome in frozen –thawed embryo transfer cycle
dedicated objectives :
1-survey effect of didrogesteron in comparison by cyclogest upon clinical pregnancy rate in frozen thawed embryo transfer cycle
2- survey effect of didrogesteron in comparison by cyclogest upon ongoing pregnancy rate in frozen thawed embryo transfer cycle
3- survey effect of didrogesteron in comparison by cyclogest upon abortion rate in frozen –thawed embryo transfer cycle
4- survey effect of didrogesteron with GnRH-a in comparison by cyclogest upon clinical pregnancy rate in frozen –thawed embryo transfer cycle
5- survey effect of didrogesteron with GnRH-a in comparison by cyclogest upon ongoing pregnancy rate in frozen –thawed embryo transfer cycle
6-survey effect of didrogesteron with GnRH-a in comparison by cyclogest upon abortion rate in frozen –thawed embryo transfer cycle
7- survey effect of didrogesteron with HCG in comparison by cyclogest upon clinical pregnancy rate in frozen –thawed embryo transfer cycle
8-survey effect of didrogesteron with HCG in comparison by cyclogest upon ongoing pregnancy rate in frozen –thawed embryo transfer cycle
9- survey effect of didrogesteron with HCG in comparison by cyclogest upon abortion rate in frozen thawed embryo transfer cycle
inclusion criteria:
1-unexplained infertility
2- tubal factor
3-mild male factor
4-POF
5-sub fertility in pco field
6-average age between 20-40
7-normal uterine cavity
exclusion criteria:
1-women over 40 year
2-endometriosis stage III ،IV
3-Hydro salpinx
4- severe male factor
5-ab normal uterine cavity
6-failed embryo transfer cycle ≥3
methods:
According to previous studies and consult with statistics 400 patients were entered to our study.patients who were scheduled for IVF in infertility clinic of mother and child hospital,and Dena hospital of Shiraz city were assessed for having inclusion criteria,patients that were 20-40 y with normal uterine cavity and special infertility cause were included and patients that had more than 40 y with abnormal uterine cavity and more or equal 3 unsuccessful embryo transfer cycle were excluded .
After entrance to stimulation cycles ,in third day of past ovum pick up,embryos were assessed for quality and counts of blastomers.If number of blastomers were more than or equal 8 with fragmentation rate less than 20%,embryo was freezes as Top quality embryo with vitrification method in cleavage stage.The patients who had Top quality freeze embryo were admitted in next cycle for preparation endometrium. Estradiol was started from second day of menstrual cycle , progesterone ampule 100 mg/d for three days was prescribed after getting adequate endometrial thickness. Number of embryo for transfer was determined according to mother age. after taking testimonial form study,patients randomized and divided to four groups for receiving luteal phase support.
- First group:patients who received cyclogest vaginal suppository 400 mg twice a day.
- Second group: patients who received didrogesteron oral tablet 10 mg twice a day.
- Third group: patients who received didrogesteron oral tablet 10mg twice a day in combination with 3 dose of Amp Dipherelin 0.1mg in days of embryo transfer,3 day,6 day .
- Fourth group: patients who received didrogesteron oral tablet 10mg twice a day in combination with 3 dose of Amp HCG 1500u in days of embryo transfer,3 day,6 day
- HCG Test was done 16 days after embryo transfer.if the test was positive ,trans vaginal ultra sound was done 6 week and 12 week later for determining clinical pregnancy rate and ongoing pregnancy rate.Meanwhile luteal phase support was continued till 12 week gestation.
- Main outcome were consist of clinical pregnancy rate ,ongoing pregnancy rate, abortion rate that was recorded for 4 groups and after statistical analysis were compared for assessing best luteal phase support in frozen-thaw embryo transfer cycle.