Corifollitropin alpha was not detrimental to follicular ovarian responsiveness measured by follicular output rate (FORT).

Corifollitropin alpha has been demonstrated to be non-inferior to other gonadotropins in reproductive outcomes. However, its impact on follicular ovarian responsiveness has never been evaluated. Follicular Output Rate (FORT) is an option for objective assessment of the follicular responsiveness. A prospective study was conducted with 306 infertile patients undergoing in vitro fertilisation. Ovarian stimulation protocol was performed with a single dose of 100 µg (<60kg) or 150 µg (≥60kg) corifollitropin alpha in group 1 (n = 147), and 150-300 IU/day human menopausal gonadotropin in group 2 (n = 150). Comparing ovarian stimulation between corifollitropin alpha and human menopausal gonadotropin, no differences regarding FORT were found (40.0% for group 1 versus 40.83% for group 2; p = 0.930). Patients treated with corifollitropin alpha had a higher number of embryos when compared with human menopausal gonadotropin group (3.0 for group 1 versus 2.0 for group 2; p = 0.04). Other secondary outcomes preset were similar between groups. Therefore, corifollitropin alpha can be an excellent option to simplify in vitro fertilisation treatment due to the "patient-friendly" protocol.

Effectiveness and Cost-effectiveness of Minimal Ovarian Stimulation in-vitro Fertilization versus Conventional Ovarian Stimulation in Poor Responders: Economic Evaluation Alongside a Propensity Score Adjusted Prospective Observational Study.

OBJECTIVE: Information on the pregnancy rate after successive in-vitro fertilization (IVF) cycles and their associated costs is relevant for couples undergoing assisted reproduction treatments (ARTs). This study, therefore, sought to investigate the effectiveness and the cost-effectiveness of two ARTs, the minimal ovarian stimulation IVF (MS-IVF) compared to the conventional ovarian stimulation IVF (C-IVF) from the payer's perspective. METHODS: A 10-months follow-up prospective observational study was conducted in a sample of couples who sought ARTs in a private clinic in Southern Brazil. Women had to satisfy the Bologna Criteria and be older than 35 years. The effect outcome was pregnancy rate per initiated cycle. Medication costs were based on medical records. Costs and effect differences were estimated using seemingly unrelated regressions adjusted for the propensity score estimated based on women's characteristics. RESULTS: All 84 eligible women who agreed to participate received a total of 92 IVF cycles (MS-IVF, n=27[35 cycles]; C-IVF n=57[57 cycles]. The effect difference between MS-IVF and C-IVF was -5.1% (95%CI, -13.2 to 5.2). Medication costs of MS-IVF were significantly lower than C-IVF by €-1260 (95%CI, -1401 to -1118). The probabilities of MS-IVF being cost-effective compared to C-IVF ranged from 1 to 0.76 for willingness-to-pay of €0 to €15,000 per established pregnancy, respectively. CONCLUSIONS: Even though there were no positive effect differences between groups, MS-IVF might be cost-effective compared to C-IVF from the payer's perspective due to its relatively large cost savings compared to C-IVF. However, further investigation is needed to confirm these findings in a larger sample.

Histeroscopia no programa de fertilizaçäo assistida do Hospital de Clínica de Porto Alegre / Histeroscopy in an assisted fertilization program of Hospital de Clínicas Porto Alegre

OBJETIVOS: estudo prospectivo, com a realizaçao de histeroscopia em pacientes que seriam submetidas a fertilizaçao in vitro (FIV). MATERIAL E MÉTODOS: foram analisadas 39 histeroscopias realizadas em 39 pacientes no período entre novembro de 1995 a fevereiro de 1996. RESULTADOS: Vinte e quatro pacientes (61,5 por cento) apresentaram alguma anormalidade à histeroscopia, sendo endometrite a lesao mais prevalente (15,4 por cento) seguida por sinéquias e pólipos (10,3 por cento cada). Onze casos (28 por cento) apresentaram alguma patologia intra-uterina, embora tivessem histerossalpingografia normal. CONCLUSOES: a histeroscopia deve ser realizada em todas as pacientes com indicaçao de Fertilizaçao Assistida a fim de que sejam excluídas patologias uterinas.

Incidência de Chlamydia trachomatis e Neisseria gonorrhoeae em mulheres assintomáticas promíscuas e nåo-promíscuas / Incidence of Chlamydia trachomatis and Neisseria gonorrhoaea in no-promiscuous asymptomatic women and in promiscuous asymptomatic women

Levando-se em conta a importância epidemiólogica da Chlamydia trachomatis e da Neisseria gonorrhoeae e das possíveis complicaçöes proveninentes destes patógenos, os autores investigaram 110 mulheres que visitaram o Serviço de Orientaçåo e Planejamento Familiar no período de fev/1987 a fev/1988. As pacientes foram dividiadas em dois grupos. O primeiro era composto por mulheres assintomáticas nåo promíscuas e o segundo por assimtomáticas promíscuas. Foi coletado do canal endocervical para cultura de gonococo e para pesquisa de Clamídia. O grupo de mulheres assintomáticas mostrou a incidência de 4 por cento para Chlamydia trachomatis e de 2 por cento para Neisseria gonorrhoeae; já que o grupo de assintomáticas promíscuas apresentou Clamídia em 11,67 por cento das amostras e gonococo em outras 8,33 por cento. Os autores concluíram que Chlamydia trachomatis e Neisseria gonorrhoae podem ser isoladas de mulheres assintomáticas (promíscuas ou nåo-promíscuas), porém nåo eståo significativamente associadas com a promiscuidade