الفهرس 
Female Causes of InfertilityOnly 14 pages are availabe for public view
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Abstract
S
ixty two Infertile women with undergoing ICSI, were recruited from Ain Shams University Maternity Hospitals (ART unit) assisted reproductive technology unit, during the period between December 2013 to October 2015.
A venous blood sample for AMH measurement was taken approximately one month before the scheduled IVF treatment, independently of the menstrual cycle phase. It measured using a second-generation ELISA, OSI was calculated by dividing the total administered HMG dose (IU) by the number of oocytes retrieved at OPU, thus obtaining the HMG-to-retrieved oocyte ratio.
In this study, no oocytes were obtained from three patients during oocyte retrieval.
Our study found that the age ranged from (20 – 39) years. The mean age was 31.4 ± 4.5years, the BMI ranged from 19.4 - 30.6.The mean BMI was 27.1 ± 3.1, the mean duration of infertility was 6 years. Most of the patients 33 patients represents (55%) had 1ry infertility while 27 patient (45%) had 2ry infertility.
Unexplained 15 (25.0%)
Male factor 29 (48.3%)
Tubal factor 10(16.7%)
Uterine factor 3 (5.0%)
Mixed (e.g tubal and male) 3 (5.0%)
In this study the antral follicular count (AFC) ranged from (8-15) follicle, the mean number was 9.86 ± 1.75 follicles.The duration of ovarian stimulation ranged from 11 – 14days, the mean duration was 12 days.The mean dose of HMG was 49 ampoules.
The mean Number of retrieved oocytes was 6, Number of transferred embryos ranged from One 6 (11.1%), Two 15 (27.8%) and Three 33 (61.1%).
Most embryos were transferred on Day 3 (70.4).
The OSI ranged from (380.4 to 1147.5) and the mean value was 562.5.
In this study the mean levels of FSH, LH, TSH hormones were (6.02 ± 2.21, 6.05 ± 4.11, 1.74 ±0.47) mIU/ml repectively, while the mean levels of prolactin and follicular AMH were (12.3 ± 5.2, 2.58 ± 1.60) ng/ml respectively, the mean level of estradiol hormone was 48.5 ±17.5 pg/ml.
We found significant correlation between serum AMH, AFC, OSI and age, but no significant and BMI (body mass index) and these varibles.
There is significant correlation between serum AMH, AFC, OSI and FSH and FSH/LH ratio
No significant correlation between other hormonal profiles and these varibles.
There is significant correlation between serum AMH, AFC, OSI and number of oocyte retrieved and number of produced embryos.
No significant correlation between serum AMH, AFC, OSI with biochemichal or clinical pregnancy.
OSI shows strong correlation more than AMH (P value < 0.0001) with number of oocyte retrieved, dose of HMG, number of produced embryos.
OSI shows strong negative correlation with AMH, AFC,, number of produced embryos (P value < 0.0001) in comparison with number of collected oocytes.
We found that the log-transformed OSI is normally distributed
Poor ovarian response was determined by the 90th percentile which correspond to 5843 IU of HMG adminstated and 10 oocyte retrieved (OSI=2070).
86.7% had good response
8.3% had bad ovarian response
5% could not be assessed (no egg was collected)
The AMH level in patients with good ovarian response ranged from (1.33 – 3.98) and the median was 2.75 compared with (0.45 – 1.10) and the median 0.70 in patients with poor ovarian response, this difference was statistically significant (p value < 0.001).
No statistically relation between the occurrence of pregnancy and AMH, total AFC, or OSI.
In conclusion, OSI shows strong correlation with AMH and the correlation between OSI and circulating AMH was stronger than those existing between AMH and the total number of oocytes, and between AMH and the total HMG dose.