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Background: Poor ovarian response and diminished ovarian reserves (DOR) significantly contribute to female infertility. Previous attempts have been made to enhance follicular growth and improve pregnancy outcomes in these participants. Objective: This study aimed to assess the efficacy of the in vitro drug-free activation technique of the ovarian reservation and in vitro fertilization stimulation cycle outcomes in DOR participants. Materials and Methods: This pilot phase study investigated the impact of in vitro activation (IVA) on ovarian reservation and in vitro fertilization outcome in 10 infertile women with DOR from May to December 2023 at Taleghani Infertility Center, Tehran, Iran. Participants underwent general surgery and laparoscopy, involving the removal of a portion of one ovary, immediate transfer to the laboratory, dissection into small cubes, and subsequent re-implantation into the cases's ovary. The primary outcomes, include the count of retrieved oocytes, the number of oocytes reaching metaphase, and the secondary outcomes were the quantity and the number of embryos transferred, implantation rate, and occurrence of clinical pregnancy. Results: The study revealed a significant increase in the antral follicle count before and after IVA (p = 0.033). Before IVA, the median estradiol level was 93.5 (57.0), which reduced to 79.0 (35.0) after IVA, indicating a statistically significant difference. On average, 2.3 (0.8) oocytes were retrieved, among which 1.5 (0.7) were metaphase II oocytes. The observed pregnancy rate among the 2 cases was 22.2%. Conclusion: The current study suggests that IVA may positively impact follicular growth and pregnancy outcomes among women with DOR. [ABSTRACT FROM AUTHOR]

Background: Repeated implantation failure (RIF) is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on the most effective one. Objective: This study was conducted to evaluate the effectiveness of platelet-rich plasma in improvement of pregnancy rate in RIF patients. Materials and Methods: Twenty women with a history of RIF who were candidates for frozen-thawed embryo transfer were recruited in this study. Intrauterine infusion of 0.5 ml of platelet-rich plasma that contained platelet 4-5 times more than peripheral blood sample was performed 48 hrs before blastocyst transfer. Results: Eighteen participants were pregnant with one early miscarriage and one molar pregnancy. Sixteen clinical pregnancies were recorded and their pregnancies are ongoing. Conclusion: According to this study, it seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients. [ABSTRACT FROM AUTHOR]

Background: Recurrent implantation failure is one of the most issues in IVF cycles. Some researchers found that beneficial effects of endometrial Scratching in women with recurrent implantation failure, while some authors demonstrated contrary results. Objective: The present study aimed to investigate the effect of intrauterine. Saline infusion as a form of endometrial injury, during fresh in vitro fertilization-embryo transfer cycle, among patients with recurrent implantation failure. Materials and Methods: In this clinical trial study 63 women undergoing assisted reproductive technology were divided into two groups either local endometrial injury by intrauterine saline infusion during day 3-5 of the ongoing controlled ovarian stimulation cycle, or IVF protocol performed without any other intervention in Taleghani Hospital, Tehran, Iran. The main outcome measure was clinical pregnancy rates. Results: Patients who received intra uterine saline infusion (n=20), had significantly lower clinical pregnancy numbers (1 vs. 9, p<0.05) and implantation rates (4.7% vs. 41.6%, p<0.05), compared to controls (n=39). However, there was no significant difference in miscarriage rates (9.4% vs. 8.7%, p>0.05) and multiple pregnancy numbers (1 vs. 3, p>0.05) between groups. Conclusion: When intrauterine saline infusion as a form of endometrial injury is performed during the ongoing IVF cycles it has negative effect on reproductive outcomes among patients with recurrent implantation failure. [ABSTRACT FROM AUTHOR]