PREDICTIVE FACTORS IN FRESH IN VITRO FERTILIZATION–EMBRYO TRANSFER (IVF–ET) CYCLES

Dr. Vineet  V Mishra; Dr. Urmila Sharma; Dr. Sumesh Choudhary; Dr. Rohina Aggarwal; Dr. Rajani Nawal; Dr. Ritu Agarwal

Volume : IV, Issue : VIII, August - 2015

PREDICTIVE FACTORS IN FRESH IN VITRO FERTILIZATION–EMBRYO TRANSFER (IVF–ET) CYCLES

Dr. Vineet V Mishra, Dr. Urmila Sharma, Dr. Sumesh Choudhary, Dr. Rohina Aggarwal, Dr. Rajani Nawal, Dr. Ritu Agarwal

Abstract :

Introduction Infertility affects approximately 13–14% of reproductive–aged couples. Initially, In vitro fertilization–emyo transfer (IVF–ET) was advocated for the treatment of patients with bilateral tubal block but now it has become the treatment option for patients with a variety of fertility problems including unexplained infertility, male factor infertility, endometriosis, cervical factor infertility and failed ovulation induction. Various predictive factors affecting the chances of pregnancy in a fresh IVF–ET program have been studied but there is still no consensus. Objective To identify the predictive factors affecting the outcome of a fresh IVF–ET cycle Study Design A hospital based prospective study Material and Methods A total of 135 infertile women between 20–40 years with a normal uterine cavity on office hysteroscopy and undergoing fresh IVF cycles from Januaty 2014 to December 2014 were included in the study. Patients were put on either long GnRH agonist ,short agonist or antagonist protocol for IVF followed by oocyte retrieval and emyo transfer in the same cycle .Primary outcome was clinical pregnancy defined as the presence of one or more intrauterine gestational sac at six weeks on transvaginal sonography (TVS).Various parameters were compared between the pregnant and the non pregnant group. Results Out of 135 women, 57(42.22%) became pregnant.Patients in the pregnant group were younger(29.67�2.76 years v/s 30.94�4.29years) and had low body mass index (BMI) as compared to the non pregnant group although the difference was not statistically significant. Patients in the pregnant group had comparable hormonal profile but higher antral follicle count(AFC) than the non pregnant group. The number of follicles formed, oocytes retrieved and emyos formed (14.86�2.52v/s11.42�3.16; 12.54�2.30v/s6.87�2.63; 10.02�1.92v/s4.47�1.81) were significantly higher in the pregnant group as compared to the non pregnant group. Average number of emyos transferred in the pregnant group was 2.61�0.56 while in the other group was 1.90�0.59 and the difference was significant. Endometrial thickness and vascularity indices were similar between the two groups. Conclusion Female age, duration of infertility, AFC, number of oocytes retrieved, number of emyos formed and transferred areuseful predictorsof pregnancyafter IVF. However, further large and better quality studies are necessary to identify the actual predictive factors affecting the cycle outcome.