Luteal support after luteinizing hormone-releasing hormone agonist for in vitro fertilization: superiority of human chorionic gonadotropin over oral progesterone.

It has been reported that the pregnancy rate after in vitro fertilization (IVF) after pituitary desensitization with luteinizing hormone-releasing hormone agonist (LH-RH-a) is twice as low if the luteal phase is not supported. We therefore tested the respective advantages of luteal support using human chorionic gonadotropin (hCG, 1,500 IU three times) and progesterone (P, micronized, oral administration, 400 mg/d) after 171 embryo transfers (ET) in which the cycle was stimulated with the LH-RH-a triptoreline. The type of luteal phase support was randomly selected except when the estradiol level exceeded 2,700 pg/mL. The clinical pregnancy rate and the ongoing pregnancy rate were significantly higher using hCG (after the transfer of 3 embryos, 45% and 43% with hCG versus 23% and 17% with P). The same results were noted for the embryo implantation rate per ET (19% of embryos are viable after 6 months of pregnancy after hCG versus 7.5% after P). Adequate luteal support, therefore, significantly improves the results of IVF when LH-RH-a are used. The poor results obtained with P in this study might be related to its poor bioavailability after oral administration.

A randomized trial of human chorionic gonadotropin support following in vitro fertilization and embryo transfer.

This article reports on the effects of human chorionic gonadotropin (hCG) on progesterone (P) and estradiol (E2), luteal phase length, and conception in 116 cycles treated by in vitro fertilization and embryo transfer (IVF-ET). In 60 cycles, the luteal phase was supported by hCG, 1500 IU three times at 2-day intervals from the day of ET. The remaining 56 cycles served as controls. hCG significantly increased the P level (93 +/- 53 versus 62 +/- 46 ng/ml), the P/E2 ratio, and the luteal phase length (17.4 +/- 1.3 versus 12.2 +/- 1.7 days). However, the total pregnancy rate did not significantly differ between the two groups, though the pregnancy rate after transfer of two or three embryos was slightly higher in the hCG group (26.9 versus 22% in the control group), as was the rate of implanted embryo per transferred embryo after transfer of two or three embryos (25 versus 15.3%). It was concluded that, while hCG increased the magnitude and duration of the luteal P secretion, it did not clearly improve the pregnancy rate.

[Results of treating infections of the cervical mucosa with doxycycline polyphosphate in 53 infertile women]. / Résultats du traitement de l'infection de la glaire cervicale par le polyphosphate de doxycycline chez 53 femmes infertiles.

Our study was carried out on 53 women who had been infertile for more than a year and who had cervical mucus infection. In 13 cases (group A) there was no other known associated factor to cause the infertility. In 26 cases (group B) there was an obvious associated factor and in a further 14 cases there was a latent associated factor. The physical characteristics as well as the bacteriological appearances of the mucus (which included a systematic search for aerobic bacteria and for chlamydia trachomatis (CT) and for ureaplasma urealyticum (UU) were studied both before and 6-8 weeks after treatment with doxycycline polyphosphate given in doses of 100 mg twice daily. Before treatment the bacteria most often found were escherichia coli (20 cases) and enterococci (18 cases). CT was only found once and UU six times, usually in association with other bacteria. In 75.5% of cases the treatment made the affecting organism go; and cut down or removed entirely the number of leucocytes in the mucus in 73.5% of cases. But the physical characteristics of the mucus were only improved in 43% of cases, and in 18 cases a new infective organism was found in the mucus after treatment. However, it was in too low a concentration to determine its pathogenicity. There were nine pregnancies within 4 months of the start of treatment, which means that 30% in group A and 19% in group B became pregnant. Infection of the cervical mucus therefore does really seem to be a factor in lowered fertility in certain women CT and UU seem to be rarely the responsible organisms. Doxycycline phosphophate in an efficient and well tolerated treatment in these infections.

[Indirect ELISA technic for detection of human rotavirus in faeces (author's transl)]. / Technique ELISA indirecte pour la détection du rotavirus humain dans les selles.

A relatively simple indirect ELISA technic is described for detection of human Rotavirus in faeces. 329 faeces from children diarrhoea had been tested and Rotavirus were found in 30% cases.