Asian Pacific Journal of Reproduction

147-154

Authors: Andriana K Dewi, Anggi L Wicaksana, Muhammad Lutfi, Agung Dewanto

Objective: To determine the barriers of joining in-vitro fertilization (IVF) programs among infertile couples in developing countries. Methods: This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed, ScienceDirect, EBSCO, ClinicalKey, and Cochrane Library from inception until December 31, 2021. Additional search strategies were snowballing literature search and citation tracking. Results: Eleven articles were included in the scoping review. The cost was the greatest barrier of joining IVF program. Limited access and lack of assisted reproductive technology centers, few qualified infertility trained staff, insufficient government support, low priority in government policy, along with sociocultural factors, such as religion and false beliefs or myths were also majorly considered to be associated obstacles. Conclusions: The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services. KEYWORDS: In vitro fertilization; Assisted reproductive technology; Barrier; Developing countries

162-169

Authors: Tatapudi S V Parvathi Devi, Alka Gahlot, Sangita Sharma, Manisha Choudhary, Ravikant Soni, Meeta Sharma

Objective: To determine whether a single dose of gonadotropin-releasing hormone (GnRH) agonist administered subcutaneously in addition to the regular progesterone supplementation could provide a better luteal support in antagonist protocol fresh embryo transfer cycles. Methods: This prospective, multicentric, cohort study included total 140 women, 70 in each group. Controlled ovarian stimulation was carried out as per fixed GnRH antagonist protocol. The trigger was given with hCG. In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) was performed and day-3 embryos were transferred. Patients were divided into groups 1 and 2 based on computer generated randomization sheet. Six days following oocyte retrieval, group 1 received 0.2 mg decapeptyl subcutaneously in addition to regular progesterone support while group 2 received progesterone only. Luteal support was given for 14 days to both groups; if pregnancy was confirmed luteal support was continued till 12 weeks of gestation. The clinical pregnancy rate was the primary outcome. The implantation rate, miscarriage rate, live birth delivery rate, and multiple pregnancy rates were the secondary outcomes. Results: A total of 140 patients were analysed, 70 in each group. Clinical pregnancy rates (47.1% vs. 35.7%; P=0.17), implantation rates (23.4% vs. 18.1%, P=0.24), live birth delivery rates (41.4% vs. 27.1%, P=0.08), and multiple pregnancy rates (21.2% vs. 16.0%, P=0.74) were higher in group 1 than in group 2. Group 1 had a lower miscarriage rate than group 2 (5.7% vs. 8.6%; P=0.75). However, these differences were not statistically significant between the two groups. Conclusions: Administration of a single dose of GnRH agonist in addition to regular natural micronized vaginal progesterone as luteal support in GnRH antagonist protocol cycles marginally improves implantation rates, clinical pregnancy rates, and live birth delivery rates. However, more studies with higher sample sizes are needed before any conclusive statements about GnRH agonist as luteal phase support can be made.

182-193

Authors: Wankeu-Nya Modeste, Kengne In è s T, Ateba Benjamin S, Bend Fortune E, Djeumeni Ornela N, Hatho Dominique T, Ngadjui E, Moundipa Paul F, Massoma Dieudonné L , Dongmo Alain B, Watcho Pierre

Objective: To evaluate the effects of three oxidized palm oil diets (OPD) on female rat reproductive function. Methods: Forty-four female Wistar rats presenting five consecutive and regular estrous cycles were divided into 4 groups. The rats were fed with: a standard diet, 70% of standard diet+30% oxidized palm oil diet (OPD1), OPD1+5 g of boiled yolk egg (OPD2) and OPD1+10% sucrose (OPD3) for 125 days, respectively. During the feeding period, morphometric, estrous cycle, sexual behavior, gestation, biochemical and histomorphometric parameters were evaluated. Results: All OPDs significantly increased abdominal circumference, body mass index and Lee index coupled to an irregularity and lengthening of the estrous cycle. They significantly decreased appetite and consumption behaviours, quantic pregnancy index, fertility rate, implantation sites and index, serum progesterone and high-density lipoprotein levels, increased pre-implantation losses, anti-implantation activities, serum estradiol, triglycerides, total and low-density lipoprotein-cholesterol levels, and impaired brain and ovaries oxidative status. Histomorphometric examinations revealed increases in the number of atresic and primary follicles and decreases in secondary, tertiary, Degraaf, total and corpus luteum follicles in ovaries coupled to a neurodegeneration of hypothalamic anteroventral periventricular neurons in the OPD groups compared to the standard diet group. Conclusions: The three OPDs induce obesity and impair the female reproductive function, especially OPD2 and OPD3. These findings contribute to a better understanding of the adverse effects of palm oil bleaching on the reproductive function in female rats, which could be useful in the management of women with obesity-related sexual dysfunction.