In Vitro Fertilization-embryo Transfer In Recipients With And Without Premature Ovarian Failure: A Retrospective Comparative Study.

Objective: To compare the effectiveness of donor oocyte in IVF-ET in patients with premature ovarian failure (POF) and those (non-POF) with other indications for donor oocyte IVF-ET.Methods - A retrospective study was carried out in Reproductive Health Centre of 1^st affiliated hospital of Zhengzhou University, Henan, China. Study was carried out in all the patients of POF and non-POF who has undergone IVF-ET by oocyte donation for management of infertility from the year 2004 to 2007. Total 72 cycles were enrolled in the study. The long protocol with GnRH-a used to for Down regulation. Super ovulation was commenced with I.M.follicle stimulating hormone Gonal F. Human chorionic gonadotropins (HCG Profasi) was administered when the trans vaginal scan showed two or more follicles with the diameter of 18mm & serum E₂ level>400pg/ml. Oocyte retrieval was performed by trans vaginal ultrasound guided needle aspiration approximately 34 to 36 hours after HCG On the day of oocyte retrieval from the donor, the recipient started Progesterone. Oocytes were inseminated with husband's sperm or injected with the husband's spermatozoa (Intra cytoplasmic sperm injection) depending on sperm quality. The patients (Recipients) were treated with Estradiol valerate (progynova) till the endometrium thickness reaches 8mm before embryo transfer (ET) & progesterone (Gestone) 3 days before Embryo transfer (ET). ET was carried out two or three days after fertilization. Patients received fresh embryos as well as frozen embryos. For frozen thawed embryo transfer (FTET) estradiol valerate substitution was given and progesterone was started two or three days prior to embryo transfer. The embryos were thawed on the day of transfer. The Hormone Replacement Treatment (HRT) using estradiol and progesterone was continued until a pregnancy test was carried out two weeks after the transfer, if the results were positive HRT were continued until twelve weeks of pregnancy. Pregnancy was confirmed by the appearance of fetal heart motion on abdominal ultrasound. These groups were retrospectively analysed regarding types of infertility, endometrial thickness and pregnancy outcome.Results: - Our study shows the mean endometrial thickness for POF are 10mm and 11mm, clinical pregnancy rate following oocyte donation IVF-ET for POF is 50% and 34.1%. Pregnancies by fresh ET are 55% and 34%. Like wise pregnancy by frozen ET are 50%. Implantation rate is 32.8% and 11.5% for POF and non-POF respectively. Pregnancy losses are similar as POF with 14.2% and non-POF 13.3%. Birth rates are 78.5% in POF and 86.6% in non-POF. 4% of cases have ongoing pregnancy in POF.Conclusion: - It can be concluded from this study that oocyte donation is very effective treatment in managing infertility due to POF and non-POF without any other added cause of infertility in both male and female partners. However, many aspects of treatment that could optimize the rate of success remain to be defined.