International Journal of Infertility & Fetal Medicine

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VOLUME 9 , ISSUE 1 ( January-August [1-2 Combined], 2018 ) > List of Articles


Clinical Outcome of Intracytoplasmic Sperm Injection using Long Protocol

Diviya Arun

Keywords : Infertility, In vitro fertilisation (IVF)/Intracytoplasmic sperm injection, Long protocol

Citation Information : Arun D. Clinical Outcome of Intracytoplasmic Sperm Injection using Long Protocol. Int J Infertil Fetal Med 2018; 9 (1):6-9.

DOI: 10.5005/jp-journals-10016-1163

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Primary aim: To study the outcome of intracytoplasmic sperm injection (ICSI) using long protocol. Analysis of the average number of days of stimulation, the incidence of ovarian hyperstimulation syndrome (OHSS), and the number and quality of oocyte retrieved. Secondary aim: Correlation of the outcome against the stimulation phase length Method: Retrospective study of 50 patients who underwent in vitro fertilisation (IVF) using the long protocol in our ART unit during December 2014 to December 2015. All clinical observations including the patient details, number of days of stimulation, the number of oocytes retrieved, the occurrence of OHSS were collected and tabulated. All clinical data were statistically analyzed. Result: The clinical outcome of ICSI using long protocol was satisfactory. In the study group, we achieved 72% grade 1 embryo (36) and 2 weeks after embryo transfer the biochemical testing for pregnancy showed positive pregnancy in 52% (26). The average stimulation phase length was 13.5 days, (SD 5.5). The incidence of severe OHSS needing hospitalization and treatment was 2% (1/50). 8 patients observed to have evidence of mild OHSS. OHSS was observed in patients with a shorter period of stimulation phase, mean SPL among OHSS patient was 11.38 ( SD -1.6). However, it was not statistically significant ( p–0.507). The stimulation phase length did not correlate with the quality of oocyte nor the pregnancy rate as hypothesized theoretically. Conclusion: The present study shows satisfactory clinical outcome using long protocol,the stimulation phase length did not show significant ill effects in the clinical outcome (72% grade 1 embryo, 52% pregnancy), nor increase complications like severe OHSS.

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  1. Al-Inany HG, Abou-Setta AM, Aboulghar M. Gonadotrophinreleasing hormone antagonists for assisted conception: a Cochrane review. Reproductive BioMedicine Online. 2007 Jan 1;14(5):640-649.
  2. Griesinger G, Felberbaum R, Diedrich K. GnRH antagonists in ovarian stimulation: a treatment regimen of clinicians’ second choice? Data from the German national IVF registry. Human Reproduction. 2005 Jun 2;20(9):2373-2375.
  3. Fauser BC, Devroey P. Precycle Estradiol in Synchronization and Scheduling of Antagonist Cycles Fertil Steril . 2005;83:1607-1611.
  4. Ludwig M, Katalinic A, Diedrich K. Arch. The Effect of GnRH Agonist versus GnRH Antagonist on Pregnancy Rate. Gynecol Obstet 2001;265:175-182.
  5. Orvieto R, Rabinson J, Meltzer S, Homburg R, Anteby E. GnRH antagonist versus agonist in normoresponders undergoing ICSI: a randomized clinical trial in Iran Clin Exp Obstet Gynecol. 2006;33:197-199.
  6. Engel JB, Griesinger G, Schultze-Mosgau A, Felberbaum R, Diedrich K. GnRH agonists and antagonists in assisted reproduction: pregnancy rate. Reproductive biomedicine online. 2006 Jan 1;13(1):84-87.
  7. Tarlatzis BC, Kolibianakis EM. Agonist Vs antagonist ,Best Pract Res Clin Obstet Gynaecol. 2007;21:57–65.
  8. Al-Inany H, Aboulghar M. GnRH antagonist in assisted reproduction: a Cochrane review. Human Reproduction. 2002 Apr 1;17(4):874-885.
  9. Brie Alport, Allison Case, Hyun Lim, Angela Baerwald. Does the Ovarian Stimulation Phase Length Predict in Vitro Fertilization Outcomes. Int J Fertil Steril. 2011 Oct-Dec;5(3): 134-141.
  10. Franco Jr JG, Baruffi RL, Mauri AL, Petersen CG, Felipe V, Cornicelli J, et al. GnRH agonist versus GnRH antagonist in poor ovarian responders: a meta-analysis. Reproductive biomedicine online. 2006 Jan 1;13(5):618-627.
  11. Huirne JA, van Loenen AC, Donnez J, Pirard C, Homburg R, Schats R, et al. Effect of an oral contraceptive pill on follicular development in IVF/ICSI patients receiving a GnRH antagonist: a randomized study. Reproductive biomedicine online. 2006 Jan 1;13(2):235-245.
  12. Kolibianakis EM, Collins J, Tarlatzis BC, Devroey P, Died rich K, Griesinger G . A systematic review and metaanalysis. Hum Reprod Update. 2006;12: 651-671.
  13. HYPERLINK “ pubmed/?term=Bar-Hava%20I%5BAuthor% 5D andcauthor=true&cauthor_uid=16316846” Bar-Hava I1, HYPERLINK “ pubmed/?term=Yoeli%20R%5BAuthor%5 D and cauthor=true and cauthor_uid=16316846” Yoeli R, HYPERLINK “https:// 0V% 5BAuthor% 5D and cauthor=true and cauthor_uid =16316846” Yulzari-Roll V, HYPERLINK “https://www.ncbi.nlm.nih. gov/pubmed/?term=Ashkenazi%20J%5BAuthor%5D&cauthor=true&cauthor_uid=16316846” Ashkenazi J, HYPERLINK “ J%5BAuthor%5D&cauthor=true&cauthor_uid=16316846” Shalev J, HYPERLINK “ pubmed/?term=Orvieto%20R%5BAuthor%5D&cauthor=true&cauthor_uid=16316846” Orvieto R. Controlled ovarian hyperstimulation: does prolonged stimulation justify cancellation of in vitro fertilization cycles? HYPERLINK “https://www.ncbi.”Gynecol Endocrinol. 2005 Oct;21(4):232-234.
  14. Oehninger S. Poor responders in in vitro fertilization (IVF) therapy: the -challenge continues. Facts Views Vis Obgyn 2011;3:101-108.
  15. Davis OK. IVF stimulation:protocols for poor responders. Methods Mol Biol 2014;115:329-341.
  16. Xiuhua Liao. Optimal usage of the GnRH antagonist protocol Peter Humaidan The Fertility Clinic, Skive Hospital and Aarhus University,Denmark.Int J Clin Exp Pathol 2016;9(11):11965-11971.
  17. Roberto M, Donatella C, Vincenza D, Carla T, Antonio P, Massimo M. GnRH antagonist in IVF poor-responder patients: results of a randomized trial. Reproductive biomedicine online. 2005 Jan 1;11(2):189-193.
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