Pregnancy outcome in long- versus short-acting gonadotropin-releasing hormone agonist cycles in participants with normal ovarian reserve: An RCT.

Background: There is no agreement on which of the 2 gonadotropin-releasing hormone (GnRH) agonist protocols are the most efficient, neither there is any consensus on which one yields a better clinical pregnancy percentage. Objective: The present study aims to compare the effectiveness of reduced dosages of long- and short-acting GnRH agonists on pregnancy outcomes. Materials and Methods: In this randomized controlled clinical trial, 400 women were randomly assigned to 2 groups (n = 200/group): the reduced dosage of long-acting GnRH agonist group (group 1, 1.25 mg Decapeptyl) and the short-acting GnRH agonist group (group 2, 0.5 mg/day Buserelin Acetate). The study was conducted at Mehr Medical Institute, Rasht, Iran between July 2019 and July 2020. Biochemical and clinical pregnancy were compared between groups. Results: No significant differences were observed in the endometrial lining, the total number of retrieved and metaphase-II oocytes, progesterone, and serum estradiol levels on human chorionic gonadotropin day, fertilization rate, and top-quality embryos between the groups. The duration of induction (10.8 ± 1.7 vs. 10 ± 2.1, p < 0.001) and the total dosage of gonadotropins (2939.4 ± 945.9 vs. 2441 ± 1247.1, p < 0.001) were significantly greater in group 2 than in group 1. No significant differences were observed between the 2 groups in terms of implantation rate, chemical pregnancy rate, and clinical pregnancy rate. A higher percentage of ovarian hyperstimulation syndrome was observed in group 2 (p = 0.005). Conclusion: Due to a lower percentage of ovarian hyperstimulation syndrome in group 1 and similar assisted reproductive technology outcomes in both groups, the long protocol was found to be superior to the short protocol.

The efficiency of low-dose letrozole plus clomiphene citrate for ovulation induction in intrauterine insemination cycles: A randomized clinical trial.

OBJECTIVE: To investigate if combination therapy with clomiphene citrate (CC) plus letrozole (L) was associated with a higher efficacy than L and CC alone in patients undergoing ovarian induction plus intrauterine insemination. METHODS: The present multicenter randomized controlled clinical trial was performed between 2018 and 2020. Participants were randomized into three groups: L (n = 167; 5 mg/day), CC (n = 167; 100 mg/day), and L + CC (n = 167) (2.5 mg/day + 50 mg/day) from day 3. Ovarian stimulation was continued with the appropriate dose of gonadotropins daily starting from day 8 and continued until follicular size was 20 mm or more followed by administration of human chorionic gonadotropin (10 000 IU). Semen samples were prepared by direct swim-up technique. RESULTS: In the CC group, gonadotropin dose was significantly higher but endometrial thickness was significantly lower compared with other groups. Number of follicles of 18 mm or more was significantly lower in the L group compared with the other two groups. Number of follicles less than 15 mm was meaningfully higher in the CC group compared with the other groups. In the L + CC group, total and largest follicular size, and the rates of chemical, clinical, and ongoing pregnancy, and live birth were significantly higher compared with other groups. CONCLUSION: Combination therapy with L + CC was superior to either L or CC for achieving pregnancy in women undergoing ovarian induction plus intrauterine insemination.

The effect of seasonality on reproductive outcome of patients undergoing intracytoplasmic sperm injection: A descriptive cross-sectional study.

BACKGROUND: There is conflicting evidence regarding the impact of season on the assisted reproductive technology outcome. OBJECTIVE: To retrospectively compare three year outcome of women undergoing their first intracytoplasmic sperm injection cycle, across seasons. MATERIALS AND METHODS: In this descriptive cross-sectional study, 3,670 women who underwent their first intracytoplasmic sperm injection cycle in Mehr Medical Institute, Rasht, Iran between April 2010 and May 2014 were studied. Women were divided into four groups according to the day of oocyte retrival as: spring (n = 808), summer (n = 994), autumn (n = 1066), and winter (n = 802). Basal and stimulation charecteristics were compared among groups. RESULTS: While sperm concentration and motility were significantly lower during summer, the total number of retrieved and metaphase II oocytes were significantly higher (p = 0.0001, p = 0.0001, p = 0.004, p = 0.02, respectively). Fertilization rate were significantly higher during autumn (p = 0.0001). Also, the number of high- quality transferred embryos were significantly higher during summer and winter (p = 0.03). A similar pattern was observed in implantation rate and pregnancy over the four seasons. CONCLUSION: Despite the fact that intracytoplasmic sperm injection minimize the seasonal effect on pregnancy outcome, changes in pregnancy rate still occur among different seasons without particular pattern. It seems that performing assisted reproductive technology procedures in a particular season should be considered as an effective factor.

Antioxidant properties of coenzyme Q10-pretreated mouse pre-antral follicles derived from vitrified ovaries.

AIM: This study evaluated the antioxidant status of pre-antral follicles derived from vitrified ovaries pretreated with coenzyme Q10 (CoQ10). METHODS: Mouse pre-antral follicles derived from fresh and vitrified warmed ovarian tissue were cultured with or without CoQ10 (50 µmol/L). Follicular growth, total antioxidant capacity (TAC), malondialdehyde (MDA) level, and superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) activity during cultivation were assessed. RESULTS: The growth rate of the fresh pre-antral follicles was higher compared with the vitrified groups, especially in the CoQ10-treated than non-treated groups. MDA increased while TAC decreased at 96 h of the cultivation period. TAC was higher while MDA was lower in the fresh pre-antral follicles than in the vitrified groups. These rates were higher in the CoQ10-treated than non-treated groups. The vitrified and fresh CoQ10-pretreated groups had significantly higher SOD, GPX, and CAT activity compared with the CoQ10 non-treated groups. CONCLUSION: CoQ10-supplemented maturation medium can increase antioxidant enzyme activity and decrease lipid peroxidation in cultured pre-antral follicles derived from fresh and vitrified mouse ovaries.