Invitro Fertilizaion Clinical Trial
Official title:
Prediction of Metaphase II Oocytes According to Different Levels of Serum AMH in Poor Responders Using the Antagonist Protocol
A multicentric study looked into 179 poor responders who underwent antagonist protocol in
ICSI cycles Gonadotrophines is started on day 2 with HMG until the day of HCG administration
with starting dose 300IU to 450IU,with no pretreatment with OCPs or progestogens or estrogen.
GNRH antagonist (cetrorelix 0,25mg s.c, cetrotide, serono laboratories, Aubonne Switzerland)
is given using flexible protocol, it is given when at least one follicle reaches size 14 mm
to prevent premature lutenization ,until the day of hCG administration Ovarian ultrasound
scans were performed using a 5.0-9.0 MHZ multi frequency trans vaginal probe to assess the
ovarian response till the mature follicles reach18-20mm when hCG administration 10000 IU is
given to induce final oocytes maturation , serum E2 is done on day of HCG trigger.
Trans vaginal ultrasound-guided oocyte retrieval is performed 34-36 hours after hCG
injection.
Ultrasound -guided fresh embryo transfer is performed on day 3 or 5 after fertilization.
Progesterone support of luteal phase was commenced on the day of ovum pick up using
prontogest 400 mg twice daily.
A multicentric study looked into 179 poor responders who underwent antagonist protocol in
ICSI cycles
Induction of ovulation cycle:
1. Gonadotrophines is started on day 2with HMG(merional, IBSA) ,until the day of HCG
administration(choriomon,IBSA10000IU)with starting dose 300IU to 450IU,with no
pretreatment with OCPs or progestogens or estrogen.
2. GNRH antagonist (cetrorelix 0,25mg s.c, cetrotide, serono laboratories, Aubonne
Switzerland) is given using flexible protocol, it is given when at least one follicle
reaches size 14 mm to prevent premature lutenization ,until the day of hCG
administration
3. Ovarian ultrasound scans were performed using a 5.0-9.0 MHZ multi frequency trans
vaginal probe (mindrayDP-5) to assess the ovarian response till the mature follicles
reach18-20mm when hCG administration 10000 IU is given to induce final oocytes
maturation , serum E2 is done on day of HCG trigger.
4. Trans vaginal ultrasound-guided oocyte retrieval is performed 34-36 hours after hCG
injection.
5. Ultrasound -guided fresh embryo transfer is performed on day 3 or 5 after fertilization.
. Embryo transfer was performed under abdominal ultrasound guide for proper embryo
placement to the mid-uterine cavity. 0ne to three grade 1 or 2 embryos were transferred
on day 3 after oocyte retrieval. The quality of the embryos were graded as 1,2,3 (1
being the best and 3 being the worst) based on the number of cells, degree of
fragmentation and regularity. Embryo transfer was performed with a Wallace catheter
(Smith Medical International Ltd, Hythe, Kent, UK). Progesterone support of luteal phase
was commenced on the day of ovum pick up using prontogest 400 mg twice daily (IBSA,
institut Biochemique,Switzerland).
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