Antagonist Protokol ile Uyarılmış İntrasitoplazmik Sperm Enjeksiyonu (İcsi) Sikluslarında Elde Edilen Oosit Başına Düşen Estradiol Seviyesinin Embriyo Kalitesi ve Canlı Doğum Oranı Üzerine Etkisi

Abstract

The material of our study was composed of 1315 patients who underwent intracytoplasmic microinjection (ICSI) between 2010 and 2016 at Hacettepe University Faculty of Medicine Department of Obstetrics and Gynecology. Patients in our study who have had at least 20 -35 years of age, who have had at least one year of unprotected sexual intercourse and who have had any of the causes of infertility as an indication for assisted reproductive technique (ART), have previously tried or have not tested ARC cycles. Patients were divided into 5 groups according to the ratio of estradiol levels on hCG date to the number of collectable oocytes. E2 / Oocyte ratio <100 Group 1, group 100-200, group 2, group 200-300, group 3, group 300-400, group 4, and group 400 were classified as group 5. As a result of our work; The mean age of the patients was lowest in group 1 and highest in group 5. The number of antral follicles counted on the 3rd day of the study as the basal USG were found in Groups 2 and 4 at most. On the day of Hcg, ultrasonography revealed that the follicle number of 17 mm and over was detected in Group 3 at most. There was a significant difference between the groups in terms of number of oocytes in M2 phase collected from the patients. Up to M2 oocytes were collected in Group 2. The number of immature oocytes collected from patients was found to be statistically significant compared to other groups. From the obtained embryo, on the second day, average number of cells containing 4 and over,on the third day average number of cells containing 7 and over found to be the highest in Group 2 and a significant difference was found compared to the other groups. The rate of transfer of diseased embryos is highest in group 2 (90%) and lowest in group 5 (74%). The clinical pregnancy outcomes of the patients were at least in Group 5 (38.9%). These pregnancies were 73.1% in Group 1, 76.5% in Group 2, 81.4% in Group 3, 75% in Group 4 and 77% in Group 5, 1 resulted in live birth. The rates of hospitalization for OHSS during and after treatment monitoring were highest in Group 5 (6.4%) and at least in Group 4 (1.3%).