Background:Implantation is one of the essential steps for the success of assisted reproductive techniques (ART). Their success depends on three main factors: embryo quality, endometrial receptivity (ER), and synchrony between embryo and endometrium. There are various factors that regulate the complex process of implantation. In this regard, one may refer to human chorionic gonadotropin (hCG) as the most important factor. Objective:This study aims to investigate the effect of intrauterine hCG injection before embryo transfer (ET) on pregnancy outcome in infertile couples.Materials and Methods:A total of 159 patients undergone In vitro Fertilization/ Intracytoplasmic Sperm Injection (IVF/ICSI) with an antagonist protocol were evaluated. Patients were divided into three groups (n=53). Group 1 received 500 IU of hCG, group 2 received 1000 IU of hCG intrauterine injection before ET, and the control group underwent ET without hCG preceding intrauterine injection.Results:There was no significant difference among the groups. The implantation rates were 18.86%, 13.52%, and 14.37%, chemical pregnancy rates were 34%, 32.1%, and 35.3%, and clinical pregnancy rates were 34%, 32.1%, and 31.4% respectively.Conclusion:The pregnancy outcome in IVF/ICSI /ET cycles cannot be improved through hCG intrauterine injections before ET.

Objective: To assess the correlation between the levels of BPA in the serum and follicular fluid (FF) using oocyte morphology. Materials and methods: In this cross-sectional research, oocyte, FF, and serum samples were obtained from a sample population consisting of 90 women undergone in vitro fertilization in Ganjavian Hospital in Dezful, Iran during October 2017-March 2018. The ELISA kit was utilized for the measurement of the BPA levels. In addition, oocyte morphology simultaneous with inverted optical microscopy. Results: Follicular fluid BPA levels had no significant effect on MII oocytes (p ≥ 0.05). However, the mean levels of degenerated oocytes and germinal vesicle (GV) were significantly higher in the women with high BPA levels in the FF (p ≤ 0.05). Moreover, the mean counts of MII oocytes and oocytes were significantly higher in the women with serum BPA levels of ≤ 50 ng/ml (p ≤ 0.05), while the mean count of GV oocytes was significantly higher in the women with serum BPA levels of ≥ 150 ng/ml (p ≤ 0.05). Conclusion: According to the results, higher FF BPA levels were associated with the higher counts of GVs and oocytes, while oocytes with higher maturity can be achieved in lower levels of BPA in the serum of patients.

Background: A high level of free radicals and oxidative substances in women with polycystic ovary syndrome (PCOS) can affect the ovaries through oxidative stress. Antioxidants such as selenium, a vital trace element in human health, can improve the prognosis of PCOS by reducing oxidative stress. Objective: This study was performed due to the lack of comprehensive information about selenium concentration in follicular fluid and its effect on the oocyte count and quality in infertile women with PCOS. Materials and Methods: In this cross-sectional study, 78 women with PCOS referred to Umm-al-Banin Infertility Clinic Center, Ganjavian Hospital, Dezful, Iran for in-vitro fertilization from March to November 2019 were enrolled. After ovarian stimulation with the antagonist protocol, the oocytes were retrieved under transvaginal ultrasound in in-vitro fertilization/intracytoplasmic sperm injection cycles, and selenium concentrations were measured in the follicular fluid using an atomic absorption method by spectrophotometer device. Oocyte count and morphology were evaluated using inverted optical microscopy. Results: There were no significant differences between follicular fluid selenium concentrations in terms of the total number of oocytes and immature oocytes in the metaphase I and germinal vesicle stages. However, a significantly reduced number of metaphase II oocytes was observed at selenium levels < 40 μg/dL (p = 0.001). Conclusion: Based on our results, low levels of follicular selenium concentration in infertile women with PCOS can reduce the quality and potency of oocyte maturation. Key words: Polycystic ovary syndrome, Oxidative stress, Selenium, In vitro fertilization, Oocyte quality, Follicular fluid.

Background: The purpose of the current study was to evaluate the possible effect of follicular fluid paraoxonase 3 (PON  3) on oocyte quality and sex hormones. Methods: This descriptive-analytical study was performed on totally 90 enrolled women including fifty infertile women presenting with polycystic ovaries and unilateral tubal factor and forty fertile women with male factor infertility referring to Umm-al-Banin Infertility Clinic in Dezful, Iran for in vitro fertilization during October 2018 to November 2019. Oocyte removal was carried out under transvaginal ultrasound guidance, and follicular fluid (FF) was removed and preserved to detect PON3, estrogen, and progesterone levels. In addition, oocyte number and quality were assessed and its association with PON3 activity in the FF was evaluated. One-way ANOVA and Fisher's least significant difference (LSD) were used for data analysis and p≤0.05 were considered statistically significant. Results: A significant increase was observed in the total number of the oocytes and mature metaphase II oocytes with ≥20 pg/ml of PON3 concentration in the FF (p≤0.05). Moreover, a positive relationship was shown between the increased estradiol level in follicular fluid and PON3, so that the highest estradiol level was observed in the amount of 31-40 pg/ml of PON3 (p≤0.05). Conclusion: According to the results, as the number of the mature oocytes increased, the amount of PON3 as well as estradiol levels in the FF increased. This research displays an increase in the level of PON3 with mature oocytes, thus supporting the indirect evidence for the function of PON3 in follicle development.

Background: Although there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes. Objective: To assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Materials and Methods: A total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively). Results: The subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively). Conclusion: In conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles. Key words: Embryo transfer, Endometrium, Pregnancy outcomes, IVF, ICSI.