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#203 : Amazing Low-Cost IVF/ICSI Induction Protocols in Developing Countries
oleh: Sajida Shahnawaz Ahmed
Format: | Article |
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Diterbitkan: | World Scientific Publishing 2023-12-01 |
Deskripsi
Background and Aims: Basically, main cost of IVF is expensive use of gonadotrophins along with agonist or antagonist which are aimed mainly to avoid premature LH surge. Since LH surge is preceded by estrogen surge and inflammatory reaction, so all theory behind is avoiding estrogen surge by continuous aromatase inhibitors and continues use of anti-inflammatory drugs to avoid inflammatory reaction preceded by ovulation. By this expensive use of agonist and antagonist are completely avoided and at the same time dose of gonadotrophins is minimised. Method: RCT study conducted on 140 patients from 2011 to 2013. Serial follicular monitoring was done by ultrasonography till the day of LH surge. 140 patients were divided into two groups. The agonist group underwent long GnRH analogue protocol. Other groups received aromatase inhibitors with gonadotrophins & anti-inflammatory agent. Results: In group 1: In 20 patients (10-14) M2 oocytes retrieved with 4-6 embryos at blastocyst stage. 6 patients conceived. 5 ended in full term. In 40 patients (6-9) M2 oocytes retrieved with 3-5 embryos at blastocyst stage, 8 patients conceived, 6 ended in full term. In 10 patients (2-6) M2 oocytes retrieved with 0-3 embryos at blastocyst stage. 2 patients conceived & ended in full term. In group 2: In 30 patients (6-8) M2 oocytes retrieved with 2-4 embryos at blastocyst stage. 7 patients conceived. 6 ended in full term. In 40 patients (3-6) M2 oocytes retrieved with 1-4 embryos at blastocyst stage. 9 patients conceived. 7 ended in full term. Conclusion: Significant differences in gonadotrophins usage in both groups leading to marked economical saving for poor patients. According to results although mean number of oocytes retrieved were higher in group 1, but clinical pregnancy rate remained similar. Limitations are there regarding sample size & random selection of patients.