الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 171 |  |  |
| | | from | 171 | | |
Abstract
Since the birth of the first IVF baby in 1978, IVF results have much improved reaching an average of 30% pregnancy rate and 25% live birth rate per cycle. Central to this improvement in IVF performance was the shift in paradigm from natural unifollicular IVF cycles to multifollicular IVF cycles as data showed higher pregnancy rates with controlled ovarian hyperstimulation (Van Der vorst et al., 1997) However, the patients are exposed to the possibility of a low or excessive ovarian response. Furthermore, the possibility of a negative impact of supraphysiological levels of estrogen resulting from the large numbers of follicles and oocytes on the embryo quality and/or the endometrium has been repeatedly questioned (Martinez 2007- Rubio,2010).
For this reason, knowledge of the patient’s potential ovarian response can help clinicians individualize the medication dosage, which may reduce the adverse effects of an excessive ovarian response, decrease the rate of cancelled cycles and ultimately, increase the pregnancy rate.
This prospective study included a total of 119 women undergoing ICSI at Minia infertility research unit(MIRU),Minia University Hospital during the period from October, 2013 to April, 2015 according to study protocol All patients fulfilled the following Age less than 39 years ,Regular menstrual cycle .Both ovaries present ,No history of ovarian surgery ,No evidence of endocrine disorder. To correlate different factors ( age , antral follicle count (AFC) and anti-Mullerian hormone (AMH)) that anticipated ovarian response which help maximizing the success rate of controlled ovarian stimulation (COH). and to offer every single woman her individual stimulation protocol prior to IVF/ICSI cycle. Aiming at maximizing the success rate with the least risks of ovarian stimulation.
During the period of the study a 119 patients who agreed to participate, one withdrew before starting stimulation and two patients were canceled during stimulation for the following reasons: wrong timing of hCG (one) and significant vaginal bleeding during stimulation (one). The remaining 116 women underwent to ovarian stimulation four of them were cancelled and did not proceed to oocyte collection (three)due to poor response ,(one) due to an excessive response to gonadotrophins and therefore had their cycle canceled before hCG because of risk of OHSS.
Out of 112 who had oocyte retrieval, 3 women did not proceed to embryo transfer. One patient failed to have any oocytes collected and one women had complete failure of fertilization. and one women had elective cryopreservation of all embryos because of risk of OHSS
The patients were subjected to 2 schemes of controlled ovarian stimulation, as follows: a long gonadotropin releasing hormone (GnRH) agonist (GnRH-a; n=70) protocol or a multi-dose GnRH antagonist (GnRH-ant/n=48) protocol. The selection of the stimulation protocol was at at the discretion of the clinician.