الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
Our study was conducted from 2020 to 2021. Two hundred infertile patients treated by ICSI and given Gn-RH agonist long downregulation protocol and meeting the inclusion criteria were included. These patients were recruited from Global Nile Infertility Center.
All patients underwent pituitary down regulation by receiving a once daily subcutaneous dose of 0.1 mg (Decapeptyl) from day 21 in preceding cycle. After . bleeding occurred, the patients were randomly allocated to 2 equal groups.
group 1 (100 case) which received hp FSH (fostimon ibsa)
(150 IU per ampoule)has been started on day 2 of menstruation and then after six days, HMG (meriofert ibsa), 150 Iu, s.c) was added. Administration of HCG (chriomon), 10,000 IU i.m. was done, based on ovarian response as assessed by sequential vaginal ultra sonography until the leading follicle reach a diameter of 18 mm.
group 2 (100 case) was treated with recombinant FSH alone (Gonal-F ferring) (150 IU per ampoule) Vaginal sonoghraphic exam has been performed and in case of appropriate response, the patients underwent sonography every other day until they had at least two follicles ≥18 mm and at least two other follicles with a diameter >17 mm. Ovulation has been induced by administration of HCG (chriomon), 10,000 IU i.m. Endometrial thickness was measured on HCG injection day. Oocyte pickup was performed 34-36 hr following HCG administration. . Embryo transfer was performed on day three of ovum pickup and 2-3 embryos were transferred .. In all patients, the luteal phase was supported by cyclogest at a dose of 400 mg/Bid, which was started from the day of oocyte retrieval . chemical pregnancy was detected 2 wk following embryo transfer, clinical pregnancy was confirmed with ultrasound examination with the appearance of a gestational sac 6 wk thereafter.these were the main outcome measures
Clinical pregnancy ratios were 71% . in group 1, 54% in group 2 .. group 1 was observed to have higher clinical pregnancy ratios compared to other group, more over there was statistically significance0.01
On the basis of the results of this study we conclude that hp-HMG addition could be used as an option for the correction of results in those whose response is unexpectedly suboptimal to ovulation induction with HP-FSH during GnRH agonist protocol. Particularly, hp-HMG is recommended as it may have benifical action on implantation on the selected group.