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Purpose: Controlled ovarian hyperstimulation has been shown to advance endometrial maturation and adversely affects implantation in ART. It has been reported that there is a better embryo-endometrium synchrony in frozen-thawed embryo transfer cycles than fresh embryo transfer cycles. The objective of this study was to compare ongoing pregnancy rates between fresh ET and FET cycles., Methods: In an open prospective, controlled study, the patients who were classified as high responders, were randomized to either fresh ET or FET. The embryos in FET group were cryopreserved with vitrification by Cryotop method., Results: A total of 374 patients were included, 187 of which were randomized to FET and 187 to fresh ET. There were 39% (n = 73) ongoing pregnancy in FET group compared with 27.8% (n = 52) in fresh ET group[odds ratio = 1.66;95% confidence interval = 1.07-2.56; p = 0.02]., Conclusions: FETs can be performed instead of fresh ETs to improve the outcome of ART in highly selected patients.

Purpose: To evaluate the effect of local injury to the endometrium on the day of oocyte retrieval on implantation and pregnancy rates in assisted reproductive cycles., Methods: In a prospective controlled trial, a total of 156 patients, <38 years old, in their first in vitro fertilization (IVF) cycle were randomized. In 77 patients, two small endometrial samples from anterior and posterior walls of uterus were obtained with a Novak curette on the day of oocyte retrieval and in 79 patients no intervention was performed., Results: The experimental and control patients were matched regarding women's age, body mass index, basal FSH, duration and etiology of infertility, treatment protocol, number of retrieved oocyte, endometrial thickness, percentage of intracytoplasmic sperm injection performance, fertilization rate, the percentage of patients with good and top quality embryos, and the number of embryos transferred. The implantation rate (7.9 vs. 22.9%), clinical (12.3 vs. 32.9%; odds ratio = 0.25; 95% confidence interval = 0.12-0.66; p < 0.05) and ongoing pregnancy (9.6 vs. 29.1%; odds ratio = 0.25; 95% confidence interval = 0.10-0.64; p < 0.05) rates were significantly lower in experimental group, compared with 79 controls., Conclusion: According to the results of this study, local injury to the endometrium on the day of oocyte retrieval disrupts the receptive endometrium and has a negative impact on implantation and IVF outcomes.

Purpose: To evaluate the predictive value of basal serum anti-müllerian hormone level and small antral follicle count for high ovarian response to controlled ovarian hyperstimulation., Methods: A total of 159 patients were prospectively included. Basal serum anti-müllerian hormone and small antral follicle count (2-6 mm) were measured., Results: Small antral follicle count and anti-müllerian hormone have similar predictive accuracy for high ovarian response with area under curve of 0.961 and 0.922, respectively. The sensitivity and specificity for prediction of high ovarian response were 89% and 92% for small antral follicle count and 93% and 78% for anti-müllerian hormone at the cutoff values of > or = 16 and > or = 34.5 pmol/l, respectively., Conclusions: Small antral follicle count and anti-müllerian hormone are equally accurate predictors of high ovarian response and facilitate determination of the optimal strategy for controlled ovarian hyperstimulation.