Abstract:

Objective: Our aim was to compare the success of the treatment modalities used in in vitro fertilization protocols by comparing the cycles of same patients with failed and successful results to determine the factors affecting the success. Material and Method: The study was conducted in the In Vitro Fertilization - Fertility Center of the Zeynep Kamil Training and Research Hospital, between March 2007 and March 2011, where a total of 96 patients’ files were reviewed retrospectively. The data of the first cycle (Group 1), where the pregnancy was not achieved from the same couples, and the following cycle (Group 2), where pregnancy was achieved were compared. Long, antagonist or microdose protocols have been applied for ovulation induction. The primary outcome was the ‘clinical pregnancy’ achieved per cycle. Results: When the duration of gonadotropin use, gonadotropin start dose, total gonadotropin dose, antagonist start days, number of days using antagonist per cycle were compared between the patients who used the same treatment protocol in both cycles, the difference was not statistically significant (p>0.05). The effect of protocol changes on pregnancy rates between the two groups was statistically significant (p<0.05). It was found that embryo transfer day was more advanced (Group 1: 2.66±0.76 vs Group 2: 3.02±1.1 days) and the number of embryos transferred was less (Group 1: 2.52±0.64 vs Group 2: 2.32±0.7) in pregnancy cycles (p<0.05). Conclusion: The protocol change can positively affect the success rate of the IVF cycle, thus the number of developing follicles and the number of mature oocytes obtained. Beside this, it was shown that embryo transfer count and sufficient quality embryos positively affect the treatment results, and it was emphasized once again that embryo quality is the most important factor for unsuccessful IVF cycles.