OBJECTIVES: To identify the clinical factors associated with intrauterine insemination (IUI) success among Filipino couples and incorporate the significant clinical factors in a formula for a prognostic scoring index for the success of IUI.

METHODS: This is a review of cases who consulted for infertility and underwent IUI at a tertiary hospital between January 2007 and December 2014. The variables considered for analysis were female age, duration of infertility, etiology of infertility, method of sperm processing, number of preovulatory follicles, total motile insemination count (TMSC), and sperm motility. The outcome measure was determined either by a positive urine or serum beta HCG or a gestational sac on transvaginal ultrasound. Results from the logistic regression analysis were used to develop prognostic scoring index for IUI success. Computed scores were plotted in a Receiver Operating Characteristic Curve and cut off values were determined.

RESULTS: The overall pregnancy rate in this study was 10.7%. Duration of infertility (OR 10.33, 95% CI 3.488-30.602) and sperm motility (OR 5.30, 95% CI 1.830-15.331) showed the strongest significant association with the occurrence of pregnancy. Odds of pregnancy after IUI are likewise increased in female age of < 32.5 years (OR 2.52, 95% CI 1.704-3.734), swim-up method (OR 2.17, 95% CI 1.383-3.415) and TMSC of ?19.5 million (OR 1.78, 95% CI 1.076-2.954). The odds of successful pregnancy among patients whose duration of infertility is ? 2.5 years and who have a sperm motility count of ? 67.5 are more than thrice (OR 3.13, 95% CI 0.095-0.990), compared to those with duration of infertility of > 2.5 years. The formulated prognostic scoring index for IUI success was 18.6, with specificity of 91.1%, sensitivity of 39.4%.

CONCLUSION: Duration of infertility, female age, sperm motility, TMSC and sperm processing method significantly affect the success of IUI success among Filipino couples studied. Using the formula derived, with a sensitivity of 91% and a sensitivity of 39, couples with a score of ?18.6 are more likely to get pregnant 4 times more than those with a score of less than 18.6.

Human ; Female ; Adult ; Pregnancy ; Sperm Motility ; Pregnancy Rate ; Gestational Sac ; Prognosis ; Infertility, Female ; Spermatozoa ; Fertilization In Vitro ; Insemination

Conjoined oocytes are characterized by a follicle containing two oocytes surrounded by a single zona pellucida or their fusion in a zonal region. Gonadotropin stimulation, coupled with PCOS, predisposes to the occurrence of conjoined oocytes. Although a result of developmental accident, conjoined oocytes have the potential to develop into genetically normal embryos and babies. In this paper, the authors describe the aspiration of multiple conjoined oocytes in a single IVF cycle, leading to normal fertilization after selective intracytoplasmic sperm injection (ICSI). Development to blastocyst stage allowed trophectoderm biopsy resulting to a euploid embryo that was eventually transferred, and resulted to a live term birth.

Key words: conjoined oocytes, in vitro fertilization (IVF), intracytoplasmic sperm injection(ICSI)

Fertilization in Vitro ; Sperm Injections, Intracytoplasmic

This commentary is focused primarily on the relationship between menopausal hormone therapy (MHT) and breast cancer risk, the primary adverse outcome measure of the Women’s Health Initiative (WHI) hormone trials. The WHI hormone trials are to date the largest randomized, placebo-controlled studies that evaluated the risks and benefits of hormone therapy in postmenopausal women. There are two arms: the estrogen-progestin (conjugated equine estrogen/medroxyprogesterone acetate) arm for women with intact uterus and the estrogen-alone (conjugated equine estrogen) arm for women who had a hysterectomy1. Both arms, planned to continue for 8.5 years, were stopped prematurely, the CEE/MPA arm after a mean of 5.2 years of follow-up and the CEE-alone arm after a mean of 7.2 years follow-up.
Female ; Estrogens, Conjugated (USP) ; Medroxyprogesterone Acetate

Objective: This study aimed to evaluate the effect of oocyte incubation after retrieval in TFF among IVF-ICSI and identify factors affecting total fertilization failure (TFF).

Methods: This is a retrospective cohort study, involving 995 IVF cycles using the antagonist protocol that were clustered into three timings of oocyte denudation from retrieval : Group 1: <1 hour, Group 2: ?1 hour to <2hours and Group 3: ?2hours. Other variables considered were etiology of infertility, female age, days of stimulation and total number of oocytes retrieved.

Results: Overall TFF was 4.5%. TFF among groups were 4.8%, 5.8% and 3.2%, respectively. Multiple logistic regression analysis showed that oocyte incubation prior to denudation for ? 2 hours tend to decrease TFF incidence. Among factors studied, male factor infertility and a low number of oocytes adversely affect TFF.

Conclusion: Timing of incubation of oocyte did not significantly affect the occurrence of TFF. Among factors studied, male factor infertility and a low number of oocytes adversely affect TFF.