this presentation to explain in a simple form the contents of IVF protocol targeted to the beginners.

1. AN INTRODUCTION TO
IVF/ICSI
Osama M Warda MD
Professor of OB/GYN
Mansoura University-EGYPT

8. Fresh
IVF
Cycle
Pregnancy
Rates
(CDC
report
2014)
Age
(years)
Pregnancy
rates
(%)
<
30
50.0
30-­‐35
41.9
36-­‐37
21.1
38-­‐39
33.3
40
30.4
41
16.0
42
10.7
43
-­‐
44+
9.5
https://www.centerforhumanreprod.com/

9. IVF
success
in
terms
of
live
births
per
100
embryo
transfers.
The
vertical
axis
shows
embryo
transfers;
the
horizontal
axis
shows
age
of
woman
(based
on
all
52,996
embryo
transfers
using
the
woman's
own
eggs
undertaken
in
the
UK
between
1
October
2007
and
30
June
2009)
[HFEA,
personal
communication]
(note:
small
numbers
of
women
aged
under
24
years
in
the
HFEA
database).
HEFA=
human
fertilization
&
Embryology
authority

10. CYCLE
TYPE
CLINICL
PREGNANCY
RATE
(%)
Frozen-­‐thawed
embryo
transfer
(FET)
cycles
22.4
Donor-­‐Recipient
cycles
64.4
PGD
cycles
(all
ages)
35.7
Clinical
pregnancy
rates
for
FET,
egg
donation
&
PGD
cycles
(2014-­‐
CDC):
Source
:
Center
of
disease
control
&
prevention
(CDC),
and
society
for
assisted
reproductive
technology
(SART)’s
annual
reports
(2014)

11. Clinical
pregnancy
rate
=
#
of
clinical
pregnancies
(
positive
hCG
test)
#
procedures
performed
(start
cycle,
egg
retrieval,
embryo
transfer)
Live
birth
rate
=
#
of
live
birth
#
procedures
performed
(start
cycle,
egg
retrieval,
embryo
transfer)

18. ITEM
(NICE
2013)
LOW
RESPONSE
HIGH
RESPONSE
Total
AFC
(follicles
<
8mm
at
day
2-­‐6)
(Normally
AFC=4-­‐8
per
ovary)
≤ 4 ≥ 16
AMH
ng/ml
≤ 0.8
≥ 3.5
Day
2-­‐3
FSH
U/L
≥ 8.9
≤ 4
Do
not
use
any
of
the
following
tests
individually
to
predict
any
outcome
of
fertility
treatment:
ovarian
volume,
ovarian
blood
flow,
inhibin
B,
estradiol
(E2).
[NICE
2013]

23. Both
partners
Female
only
1-­‐
ANTIBIOTIC:
Zithrokan
500mg
(1x1x5)
or
Vibramycin
100mg
(1x3x7)
2-­‐
ANTIFUNGAL
:
Flucoral
150
mg
1x2x1
or
Diflucan
150
mg
1x1x1
+/-­‐
antianerobe
eg
cipazole
1x2x1
or
flagentyl
2x2x1
1-­‐
Folic
acid
5mg
1x1
2-­‐
Cobal
500
mg
1x1
3-­‐
vitamin
E
400
mg
caps
1x1
4-­‐
Vitamin
C
1gm
eff
tabs
1x1
5-­‐
Aspirin
81
mg
t
1x1

28. THANK
YOU
FOR
YOUR
ATTENSION
&
PATIENCE