الفهرس 
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Abstract
This work was done on 50 infertile couples attending Benha
University Hospital in IVF unit . They were divided into two groups:
First group
It included 25 couples, they were stimulated by long protocol, and the
causes of infertility in this group were male factor or tubal factor.
Long protocol was used as follows:
suprfact 0.5mg twice daily from midluteal phase of the
previous cycle until the day of HCG injection
After 10-14 days from the start of treatment, down
regulation was assessed by serum E2<50 pg/ml
serum LH<5 IU/L
When downregulation was achieved, HMG was started
by 2 ampoules /d for 4 days then 3 ampoules /d for3
days.
At the 7th day, vaginal ultrasound was done to assess the
ovarian response. According to ovarian response, the
dose of HMG can be adjusted
When the leading follicles reached ≥18mm, serum E2
was assessed then HCG (10000 IU) was given.
Second group
Summary
119
This group included 25 couples; they were stimulated by soft protocol.
The causes of infertility were similar to the first group.
The soft protocol was used as follows:
Clomiphene citrate 100mg twice daily for 7days from the
second day of the cycle.
from the 7th day, cetrorelix acetate 0.25 mg/d was given s.c
until the day of HCG injection
HMG was given from the 7th day by 3ampoules/d (adjusted
according to the ovarian response) until the follicles
reached ≥18mm.
Serum E2 was assessed at the day of HCG administration
HCG (10000 IU) was given IM when the follicles reached
≥18mm
After 34 h in both groups,
Retrieval of follicles was done by voginal US. Identification of oocytes
was done by the use of stereomicroscope. Then incubated for half h.
Dissection of OCC complex was done by the use of Hyase
enzyme
After dissection of complex, the MII oocytes were injected
under inverted microscope by the use of micromanipulator.
After 16-18h,fertilization was assessed for the presence of
pronuclei
After 48 h from ICSI, embryos were identified, graded and
then transferred to the patient
Summary
120
After 14 days from retrieval, serum HCG was done to
identify the pregnancy
The results of both groups were as follows:
There were no significant differences between both protocol regarding
age, BMI, duration of infertility, cause of infertility, the percentage of MII
oocytes, fertilization rate, cleavage rate, discontinuation rate, and pregnancy
rate.
There were higher significant differences in long protocol regarding
the number of HMC ampoules, serum E2, the number of follicles before and
after retrieval. There was higher significant difference in soft protocol
regarding the cost. from these results, we concluded the use of soft protocol.