A prospective randomised (comparative) study was conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in AL-Nahrain University, Baghdad – Iraq, from the 1st of October 2018 till 1st of September 2019 involving seventy women of infertile couples with the same inclusion and exclusion criteria. They were randomly allocated into two groupsreceiving minimal ovarian stimulation protocol (Clomiphene Citrate and Human Menopausal Gonadotropin) with IUI adding flexible GnRH antagonist protocol (Cetrorelix) to the study group. IUI was done 40-44 hours after ovulation trigger. There were no significant statistical variances among control and study groups in demographic characteristics concerning: age, BMI, type, duration and cause of infertility. There was no important variance in a mean day of trigger among control and study groups, 12.43 ±1.56 versus 13.11 ±1.49, at the same order (p = 0.064). The Mean number of dominant follicles was considerably greater in study groups than that of the group control, 2.40±1.03 versus 1.89±0.83, respectively (p = 0.025).Mean serum Estradiol of the study group was significantly higher than that of the control group, 478.68 ±423.61 versus 273.12 ±254.57, respectively (p = 0.016). The proportion of women with LH> 10 were significantly less frequent in the study group in comparison with the control group, 22.9 % versus 68.6 %, at the same order (p < 0.001). There was no important variance in mean serum Progesterone among control and study groups. There was no significant difference in the characteristic of the dominant follicle, ruptured versus not ruptured, (p = 0.124) on the day of IUI. The pregnancy rate was higher in the study group when compared with the control group; however, the difference in pregnancy rate doesn’t reach statistical import (p = 0.145)

Background: Pregnancy has been one of life’s great mysteries. The endometrium is where life begins, and a receptive endometriumlies at the crossroads of menstruation and pregnancy.Aim of the study: To evaluate the effects of different medical drugs used routinely to improve endometrial thickness, vascularity, andpregnancy rates and to find out the best medical protocol could be used to improve endometrial thickness, vasculature, and pregnancyrate for patient with thin and poorly vascularized endometrium regardless the cause.Materials and methods: The study was carried out on 200 infertile women who have thin , poorly vascularized endometrium, afterthey matched the inclusion and exclusion criteria , those patients were divided randomly into five groups ; 40 patient in each group,group A received esterofem oral 2mg tablet every 12 hours from day 2 of menstrual cycle till the day of ovulation trigger , group Breceived vagifem vaginal tablets 25 microgram from the fourth day of menstrual cycle for 15 days or till the day of ovulation trigger,group C received sildenafil citrate gel 3 gm which containing 37.5 mg sildenafil every 12 hours from the 2nd day of menstruation tillthe day of ovulation trigger, group D received pentoxifylline ( oral 800 mg daily) with vitamin E ( oral 400 IU daily) during the 6cycles (this study period), and group E received 4 gm of pentoxifylline vaginal gel which is containing 200 mg pentoxifylline dailywhich was timed to be 3 hours before intercourse from the 7th day of menstrual cycle till day 21 of the cycle. The endometrialthickness, vascularity zones, sub endometrial flow and both uterine arteries resistance and pulsatility indices measured at mid cycle(day11-14) on monthly basis for 6 cycles or till positive pregnancy test was achieved.Results: The study showed that the mean of endometrial thickness before starting treatment for esterofem , vagifem, vaginalsildenafil, pentoxifylline + vitamin E, and vaginal pentoxifylline gel groups were (4.770±0.842, 4.725±0.933,4.663±0.996,5.002±0.993,and 4.855±1.138) respectively, after one month of treatment the means of the mentioned groupsrespectively changed to (5.173±0.736,5.620±0.776,5.425±1.016,5.403±0.864,and5.373±1.095) which was asignificant change. Thestudy showed that the lowest mean of right uterine artery resistance index achieved after treatment was in the Pentoxifylline gelgroup which was comparable to the results achieved by pentoxifylline+vit E group, followed by sildenafil, then estrofem andvagifem groups who showed the highest resistance indeces for the right uterine artery among the study groups (unlike other drugs inthe study vagifem and esterofem has shown to increase the resistance index instead of improving it) . While for The left uterineartery, the study showed that the lowest mean of resistance index was achieved by the pentoxifylline + vit E group which wascomparable to the results achieved by the sildenafil group, pentoxifylline gel , then estrofem and vagifem groups who showed thehighest resistance indeces for the left uterine artery among the study groups. Regarding the uterine arteries pulsatility index, the studyalso showed that the lowest mean of right uterine artery pulsatility index achieved after treatment was in the pentoxifylline+ vit Egroup, followed by pentoxifylline gel group then by vaginal sildenafil , while estrofem and vagifem groups showed the highestpulsatility indeces for the right uterine artery among the study groupsConclusions: Pentoxifylline vaginal gel, pentoxifylline tablet plus vitamin E capsule, and Sildenafil vaginal gel are found to be ableto improve the vascularity indeces of endometrium and uterine arteries, improve the endometrial thickness, and enhance thepregnancy rates for patients with thin poorly vascularized endometrium with no seriuos adverse events.

Back ground: Serum chemerin levels are associated with both body fat percentage and BMI, and elevated chemerin levels are associated with metabolic problems and inflammatory shifts. Aim: The aim of this study was to evaluate the effect of BMI in serum and follicular fluid  chemerin and Leptin level on patients undergoing ICSI. Patients and methods: This study was performed by participating 44 women undergo ICSI procedure devided in to two groups based on BMI in to non-obese group, theirBMI<30 and obese group there BMI>30 . Both groups are infertile women who attend high institute of infertility diagnosis and assisted reproductive technologies at Al-NAHRAIN university In AL-KADHIMIA city in BAGHDAD. From NOVEMBER 2021 to the end of MAY 2022. Blood sample was drown from each patient at day of oocyte pick up for serum  chemerin measurements Also follicular fluid is collected for  chemerin and Leptin level. Results: The result in non obese group showed a significant positive correlation was found between Serum chmrin levels, indicating a strong effect size (p< .001). This suggests that as Serum  chemerin levels rise, so will FF  chemerin.

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Background: Pregnancy has been one of life’s great mysteries. The endometrium is where life begins, and a receptive endometrium lies at the crossroads of menstruation and pregnancy. Aim of the study: To evaluate the effects of different medical drugs used routinely to improve endometrial thickness, vascularity, and pregnancy rates and to find out the best medical protocol could be used to improve endometrial thickness, vasculature, and pregnancy rate for patient with thin and poorly vascularized endometrium regardless the cause. Materials and methods: The study was carried out on 200 infertile women who have thin , poorly vascularized endometrium, after they matched the inclusion and exclusion criteria , those patients were divided randomly into five groups ; 40 patient in each group, group A received esterofem oral 2mg tablet every 12 hours from day 2 of menstrual cycle till the day of ovulation trigger , group B received vagifem vaginal tablets 25 microgram from the fourth day of menstrual cycle for 15 days or till the day of ovulation trigger, group C received sildenafil citrate gel 3 gm which containing 37.5 mg sildenafil every 12 hours from the 2nd day of menstruation till the day of ovulation trigger.