Factors Affecting the Success Rate of Artificial Fertilization

Factors affecting the success rate of artificial fertilization. Aim To investigate the various factors affecting the real as well as the theoretical collective live birth rates behind artificial reproductive therapy (ART). PATIENTS AND METHODS Retrospective study of 104 couples that underwent either an IVF or ICSI cycle between 2013 and 2014, at an infertility clinic. Data collected was analyzed by SPSS. RESULTS The success rate was 18.7 %, various factors had an effect on the outcome. DISCUSSION AND CONCLUSION There are modifiable and non-modifiable factors. Modifiable factors influencing the success rate of IVF have to be optimized before the procedure to achieve higher success rates. Introduction It has been more than 30 years since the first child born after In Vitro fertilization (IVF). Since then IVF and other assisted reproductive technologies (ARTs) have advanced remarkably. Although over the past two decades there has been an increase in pregnancy rates [1]. Yet the number of live births has still not reached the desired levels [1]. The main aim of IVF treatment is to succeed a term live birth. For this reason, it is crucial to know the factors influencing the success of IVF not only for the decision of the patient to begin treatment, but also for determining the treatment protocol to be selected. There are numerous factors involved such as the age and weight of the woman undergoing the selected treatment protocol [1]. There are also other reasons for infertility such as the date of her last menstrual cycle, the womens hormone levels (FSH, LH, TSH and Prolactin), Number of follicles, whether its primary or secondary infertility and any medications she used. Material and Methods This was a retrospective study of 131 couples that underwent an artificial reproductive therapy (ART) cycle between 2013 and 2014. Out of a total of 131 cases in the mentioned period, the complete set of data was found for 104 patients. ACOG guidelines were used to define infertile patients, which are failure of conception after a year of unprotected sexual intercourse in a female below 35 years of age, or 6 months in those over 35 years. The data collection sheet used in the study included the age, weight in KG and height in CM from which the body mass index (BMI) was calculated, hormonal profile (FSH, LH, Prolactin, TSH), medication regimen, ovarian size and number of follicles from ultrasound (US) reports and a pregnancy test for each patient. The collected factors related to conception results were analyzed by SPSS. The age was between 17-49.38.4 % have normal weight (BMI= 15-24.9), and 61.6 % are overweight (BMI= greater than25). Laboratory pregnancy rates in women with different age, BMI, medication regimen, hormonal profile and different number of follicles were compared. The clinical outcomes of stimulation with gonadotropin releasing hormone (GnRH) agonist long protocol, GnRH agonist short protocol and GnH antagonist protocol were evaluated in infertile patients. Treatment regimen and Progression of pregnancy post 20 weeks were excluded from the study as well as male factors. Results As Table 1 shows the characteristics of our sample. The majority of our sample were women aged less than 50 years old (76 %), while one quarter were aged 40 years old or above. Regarding infertility, 58.7 % of the sample suffered from primary infertility while 41.3 % had secondary infertility. Duration of infertility ranged from 1 year to 24 years with a mean of 6.98 years. When measuring the number of follicles found, the majority of the sample (78.3 %) were found to have more than 5 follicles in both ovaries, while only 21.7 % had less than 5 follicles and the mean number of follicles found was 8.68 follicle. When measuring the largest follicle found in each patient, the mean size of the largest follicle was found to be 27.63mm with the majority of the sample (87.5 %) found to have a largest follicle size of more than 15mm, while only 12.5 % of the sample found to have a largest follicle size of less than 15mm. Almost two thirds of the sample (61.6 %) were found to be over the normal weight with a BMI more than 25, while 38.4 % were found to be within the normal weight with a BMI between 18.5-24.9. When measuring the success rate by doing a pregnancy test, 18.7 % of the patients had a positive pregnancy test, while 81.3 % had a negative pregnancy test. Hormone panel was done for each patient and the following hormones were measured Estradiol, Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin and Thyroid Stimulating Hormone (TSH). The mean measurements found for each hormone were as follows Estradiol had a mean of 3620.55, FSH was 8.89, LH was 9.09, Prolactin was 436.14 and TSH was 3.03. As displayed in Table 2, the relationship between the number of follicles found and factors that can affect it. When comparing the number of follicles between our two age groups, women who were