To explore whether dual triggering for final oocyte maturation using a low dose of recombinant human chorionic gonadotropin (hCG) plus gonadotropin-releasing hormone agonist (GnRH-a) is as effective as the standard dose of recombinant hCG triggering alone in term of a total number of retrieved oocytes, fertilization and pregnancy rate in fresh autologous antagonist intracytoplasmic sperm injection (ICSI) cycles. 80 infertile women undergoing ICSI, aged ˂ 40 years, 18˂ Body mass index ˂30 Kg/m2 included in fresh autologous antagonist ICSI cycles. 40 women received a Standard dose of recombinant hCG (500 µg) alone and 40 women received GnRH-a (0.2 mg triptorelin plus 250 µg recombinant hCG) were used for final oocytes maturation. This study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Techniques, Al Nahrain University. The mean total number of retrieved oocytes, fertilization, and pregnancy rate were measured. The mean total oocyte number being statistically higher in the dual trigger group. The mean number of fertilized oocytes and clinical pregnancy rates was higher in the dual trigger group than in the control group, but the difference showed borderline statistical significance. Furthermore, fertilization rates show no statistical difference between the control group and the dual trigger group. Results of the study confirm that dual triggers show favorable improvement in fresh autologous antagonist ICSI cycles with the use of GnRH agonists plus hCG compared with hCG alone for triggering of final oocyte maturation.
Background: Fibrillin- 3 is a recently discovered hormone.However, there are no studies till now regarding the role of fibrillin-3 hormone on fertilization capacity in infertile pregnant and non-pregnant women. Objectives: The goals of this study are concentrated on the fertilization capacity parameters by examining the effect of in vivo concentration of fibrillin-3 hormone on the ovarians status at different menstrual cycle phases and to elucidate the correlation between the levels of this hormone with pregnant and non -pregnant women following Intrauterine insemination (IUI) outcome or through natural pregnancy. Methods: Sixty infertile couples were involved in this prospective study. The couples were divided according to the type of insemination and ovulation induction program into two groups Group(1): Thirty spouses were subjected to induced ovulation stimulation by using clomiphene citrate(CC) and recommended for natural coitus. Group(2): Thirty couples, the females were induced ovulation stimulation by CC, Gonal F-751U /ml and Fostimon 50IU/ml with IUI. Measurements of Fibrillin-3 with other reproductive hormones were done at different phases of menstrual cycle and for pregnant and non-pregnant women following natural coitus and IUI. Results: The mean of fibrillin-3 hormone level at day 2 of menstrual cycle was 3.7ng/ml (ranged from 3.50 to3.91) in the two groups. The mean of fibrillin-3 hormone at cycle day 13 was 6.6ng/ml( ranged from 5.83to 7.0). Whereas, The basal level of Fibrillin-3 at 14 days post insemination was 3.3ng/ml. The range is from 2.76,395 to 3.29 ng/ml. There was no significant difference in the mean of Fibrillin -3hormone between pregnant and non-pregnant women through the phases of menstrual cycle or between the two groups, but there is a significant value between fibrillin-3 post insemination and E2 day 2 and day 13 P<0.05. Conclusion: The present study concluded that Fibrillin -3 hormone has no role in pregnancy, but it may have a main relationship with estrogens reaction in folliculogenesis, oocyte maturation and follicular contents. Therefore, this hormone may be one of the new hormones that interfere with fertilization capacity.