[Optimisation of possible success in an IVF program].
The success of an IVF (in vitro fertilisation) programme is mainly dependent an the quality of the IVF laboratory. Beside this the quality of ovarian stimulation play another, but not as important role. In the 4 (th) quarter of 2003 we have changed the culture media for oocytes and embryos in the IVF laboratory of ENDOKRINOLOGIKUM Hamburg from simple to complex media (G-1 version 3). As protein source we used HSA-solution. Before embryo transfer equilibration for 1 hour in EmbryoGlue was performed, which contains hyaluran. Hyaluran is said to improve implantation rates by different ways. The media were bought from Vitrolife Schweden AB (Kungsbacka, Schweden) via a German distributor. These data were compared to those of two previous 3-month-periods (3rd quarter 2003 und 4th quarter 2002). The study design was prospective, with two historical control groups. In the three study periods 255, 343 and 503 patients were treated by either conventional IVF or ICSI (intracytoplasmic sperm injection). The cohorts were comparable regarding their anamnestic data. The number of patients treated which the GnRH antagonist cetrorelix (Cetrotide) significantly increased from 24.9 % to 49.5 % and 60.9 %. Under this protocol significantly less oocytes were retrieved (10.23 vs. 8.73 vs. 8.88), leading to slightly less embryos (1.94 vs. 1.91 vs. 1.85, not significant, n. s.). The cumulative embryo score significantly decreased from 28.58 to 24.10. It was significantly higher in the study cohort as compared to the two control cohorts (32.44). The clinical pregnancy rate significantly increased to 25.29 % in the study cohort as compared to the two historical control cohorts (15.02 % and 18.75 %). We could achieve a significant improvement in the success rates of our IVF program by switch from simple to more complex culture media in the IVF laboratory. The use of the GnRH antagonist protocol with cetrorelix (Cetrotide) lead to more comfort to the patients but did not influence the results.
Ludwig
M
M
ENDOKRINOLOGIKUM Hamburg, Zentrum für Hormon- und Stoffwechselerkrankungen, Gynäkologische Endokrinologie und Reproduktionsmedizin, Hamburg. Michael.Ludwig@Endokrinologikum.com
Nitz
B
B
D000328:Adult; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome
D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix