Carlos André Henriques

Evaluation of two incubation environments--ISO class 8 versus ISO class 5--on intracytoplasmic sperm injection cycle outcome.

OBJECTIVE To evaluate the impact of two different incubation environments-class 8 versus class 5-on embryo quality and pregnancy rate. DESIGN Retrospective comparative study. SETTING Private fertility and gynecology clinic. PATIENT(S) 123 consecutive intracytoplasmic sperm injection (ICSI) cycles were analyzed from January 2002 to February 2005. Cycles were divided into two groups: in group I (n = 60), the embryo culture was performed in class 8 air quality; in group II (n = 63), the embryo culture was performed in class 5 air quality. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Number of embryos available for transfer, number of good quality embryos transferred, implantation rate, and clinical pregnancy. RESULT(S) Age of women, duration of stimulation, total doses of gonadotropins, endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, number of oocytes metaphase II retrieved, number of embryos available, number of good quality embryos transferred, fertilization and cleavage rates, implantation rate, and clinical pregnancy were not statistically different between the groups. CONCLUSION(S) Our study demonstrated that incubation environment class 8 is as good as incubation environment class 5 when compared in relation to the parameters analyzed. We believe that there is still room for improvement in the overall outcome of ICSI embryos.

Use of antral follicle count to predict the response pattern in controlled ovarian hyperstimulation cycles with GnRH antagonist

PURPOSE to establish whether there is a predictive relationship between the antral follicle count (AFC) on the second day of the cycle and the response pattern in controlled ovarian hyperstimulation cycles for intracytoplasmic sperm injection (ICSI). METHODS a prospective study developed from May 2004 to May 2005, in which 51 patients aged <37 years old were submitted to assisted reproduction/ICSI in ovarian hyperstimulation protocol with gonadotropin recombinant and gonadotropin-releasing hormone (GnRH) antagonist. A transvaginal ultrasonography was performed on the second day of the cycle, to count the number of follicles measuring 2 to 10 mm, at the beginning of stimulus, data compared with the number of follicles with >15 mm on the day of ovulation triggering, the total number of oocytes retrieved and in metaphases II, the number of good quality embryos transferred and pregnancy rate. The statistical analysis was performed by the t-Student test and the Mann-Whitney test, with statistical significance of 5% (p<0.05). RESULTS the mean age in the study group was 32.4 years. The AFC average was 7.1, minimum of 1 and maximum of 16. Considering AFC as a main variable, a significant direct correlation was observed with the number of follicles >15 mm on the day of ovulation triggering (p=0.0001), the total number of oocytes retrieved (p=0.0001) and those in metaphases II (p=0.0001). Such correlation between AFC and pregnancy was not observed (p=0.43). There was no significant correlation between AFC and the number of good quality embryos transferred (p=0.081). CONCLUSIONS AFC on the second day of the stimulated cycle can be used to predict the quality of ovarian stimulation, the number of oocytes retrieved and the number of mature oocytes in in vitro fertilization cycles using GnRH antagonist.