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Background: Betatrophin may be associated with metabolic diseases. Objective: To investigate the betatrophin level and its association with metabolic and inflammatory parameters in infertile women with polycystic ovary syndrome (PCOS) and other infertile women during the intrauterine insemination cycle. Materials and Methods: This case-control study was conducted with 90 infertile women (45 with PCOS and 45 without) chosen by convenience sampling, in the infertility clinic of Imam Khomeini Hospital in Tehran, Iran. Participants were interviewed to obtain their age, body mass index, and reproductive history. Fasting brachial venous blood samples were obtained on the 3rd day of the menstrual cycle to measure the levels of betatrophin, fasting blood sugar, insulin, luteinizing hormone, folliclestimulating hormone, low-density lipoprotein cholesterol, estradiol, and high-sensitivity C-reactive protein. Results: The results showed that the level of betatrophin in women with PCOS was significantly higher than in the control group (p = 0.05). Based on multiple linear regression analyses, the effects of metabolic and inflammatory parameters on betatrophin were not significant (p = 0.19). The results showed no significant difference between groups in folliculogenesis (p = 0.57). Conclusion: According to the results, betatrophin levels were higher in infertile women with PCOS than in those without. The findings suggest that there may be an association between increased betatrophin and increased incidence of PCOS. Further studies with a larger sample size are needed to investigate the role of betatrophin in insulin resistance and lipid metabolism, and its effects on infertility treatment outcomes. [ABSTRACT FROM AUTHOR]

Aim: We intended to establish the threshold of Anti-Mullerian Hormone (AMH) for detection of Ovarian Hyper-Stimulation Syndrome (OHSS) and poor response to treatment in Iranian infertile women. Methods: Pre-stimulation menstrual cycle day-3 hormonal indices including basal AMH values were measured in 105 infertile women aged 32.5 ±4.3 years. Patients underwent long GnRH agonist Controlled Ovarian Hyperstimulation (COH) in a referral infertility center (Tehran, Iran). The gonadotropin dose was determined based on the age and basal serum Follicular Stimulating Hormone (FSH) level. The IVF/ICSI cycles were followed and the clinical and sonographic data were recorded. Results: Sixteen cases developed OHSS. The prevalence of PCOS was higher in subjects with OHSS [62.5 % (38.8-86.2) vs. 17 % (9.2-24.9)]. The patients with OHSS had higher ovarian follicular count [23.7 (3.2) vs. 9.1 (0.5); p < 0.05], collected oocytes [13.5 (1.9) vs. 6.9 (0.5); p < 0.05] and AMH level [7.9 (0.7) vs. 3.6 (0.3); p < 0.05]. Basal AMH level and oocyte yields (but not age, BMI, and PCOS) correlated with occurrence of OHSS; and only the AMH levels were associated with poor ovarian response (oocytes yield ≤4). The optimal cutoff value for the prediction of OHSS was 6.95 ng/ml (area under the receiver operating characteristics curve: 0.86; CI: 0.78-0.95; sensitivity: 75 %; specificity: 84 %; odds ratio for occurrence of OHSS: 9 and p < 0.001). The optimal cut point to discriminate poor response (oocytes ≤4) was 1.65 ng/ml (AUC : 0.8; CI: 0.69-0.91; sensitivity: 89 % specificity : 71 %; and OR = 23.8 and P value <0.001). Conclusions: Iranian women with basal AMH level > 6.95 ng/ml are at high risk of developing OHSS and those with AMH level < 1.65 ng/ml are poor responders. [ABSTRACT FROM AUTHOR]

Background: Advances in recombinant DNA technology led to the development of recombinant follitropin alfa. Recombinant human follicle-stimulating hormone products are used to stimulate follicular maturation. Objective: To compare the efficacy and safety of a biosimilar-candidate recombinant human follicle-stimulating hormone (Cinnal-f®; CinnaGen, Iran) with the reference product (Gonal-f®; Merck Serono, Germany) in women undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). Materials and Methods: In this randomized controlled trial, a total sample size of 200 women (age <35 yr, candidate for ICSI) was calculated. Participants began a pituitary downregulation protocol with buserelin. They received 150 IU daily of either Cinnal-f® or Gonal-f® from the second day of their cycle. The primary outcome of the study was the percentage of metaphase II (MII) oocytes. The secondary outcomes included the number and quality of oocytes retrieved, duration of stimulation, fertilization rate, embryo quality, the number of clinical and ongoing pregnancies, and the incidence of ovarian hyperstimulation syndrome (as an important safety marker). Results: A total of 208 women were enrolled, of whom, 200 completed the study period. Ovarian stimulation with Cinnal-f® resulted in a comparable percentage of MII oocytes as with Gonal-f® (78.64% vs 80.02%, respectively; p = 0.81). No statistically significant difference was seen in the secondary outcomes between the groups. Conclusion: Cinnal-f® proved non-inferior to Gonal-f®, based on the percentage of MII oocytes in women aged <35 yr undergoing ICSI. Our findings confirm that the efficacy and safety profiles of Cinnal-f® and Gonal-f® are similar. [ABSTRACT FROM AUTHOR]

Background and Objectives: To evaluate the outcomes of using in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI cycle) techniques in hypogonadotropic hypogonadism (HH) women and comparing them to women with tubal factor infertility., Design and Settings: Retrospective cohort study in Royan Institute, Iran., Patients and Methods: Data from 81 HH patients treated with IVF/ICSI in the period from early 2009 until the end of 2010 were analyzed and compared with treatment results from 89 patients with tubal factor infertility. Moreover, data from the HH patients were analyzed with respect to the age factor. P value < .05 was considered statistically significant. The main outcome measures were implantation, fertilization, pregnancy, and live birth rates., Results: Despite a higher fertilization rate and higher number of grade A/B embryos transferred in the tubal factor group, the implantation, pregnancy, and live birth rates were found to be similar between the 2 groups (P=.3, P=.1, P=.1, respectively). When the HH patients were evaluated according to the age factor, no significant difference was found regarding outcome parameters (P=.2)., Conclusions: HH women that were treated with IVF/ICSI cycles seem to have a sound potential for pregnancy, even in advanced age patients.