الفهرس | Only 14 pages are availabe for public view |
Abstract In an attempt to determine the possible relation between the serum CRP level and outcome of controlled ovarian stimulation and pregnancy rate in patients undergoing IVF or ICSI. This prospective cohort study was conducted at outpatient clinic in Private Infertility Unit, Menoufia, Egypt. In the period from August 2018 to August 2019. An informed consent was obtained from all study participants after explanation the nature and scope of the study. The study was done on 100 infertile patients who were candidate for IVF/ICSI, the selected cases were fulfilled the following Inclusion criteria: Age from 20 to 35 years who were candidate for IVF/ICSI due to 1ry infertility or 2ndy infertility Normal uterus and fallopian tubes on HSG and/or hysteroscopy. Exclusion criteria: Those with positive CRP level at the day of beginning of induction protocol, had endometriosis or myoma at the beginning of induction protocol and those who had any medical problems were excluded from this study, all participants were subjected to Full medical and surgical history, general clinical examination and routine Laboratory investigations. patients were under went Serum sampling of C-reactive protein in three different times as follows: The day of ovarian stimulation start (Day-S), ovum pick-up (Day-OPU) and day of transfer (Day-Transfer). The gathered samples were evaluated by comparative enzymelinked immunosorbent assay (ELISA) method. Pregnancy test were done 14 days after embryo transfer two groups were identified: those who get pregnant and those who did not get pregnant. Mean age of studied participants was 26.42 ± 4.03 years, mean of duration of infertility was 4.41 ± 2.38 years, among those sixty-three women had 1ry infertility and thirty-seven women has 2ry infertility. Two groups were identified: those who get pregnant (N = 66) and those who did not get pregnant (N = 34). There was no significant statistical difference between two groups according to the level of CRP at the beginning of ovarian stimulation (1.53±1.67 vs 1.71±1.54 respectively) and at day of embryo transfer (22.21±23.61 vs 19.82±23.28 respectively), but there was significant statistical difference as regarding CRP at ova pickup (11.18±12.49 vs 6.47±5.83 respectively) p- value = 0.04. According to number of oocyte retrieved and number of embryo transferred there was no significant statistical difference between women who get pregnant or not (p value 0.05). Patients whose CRP level decreased on transfer day (19 cases) fourteen get pregnant, whereas only five failed to get pregnant. Patients whose CRP level increased on transfer day (81 cases) fifty-two get pregnant, whereas twenty-nine failed to get pregnant. ROC curve showed ratio of CRP level at embryo transfer to CRP level at ovum pickup at a cutoff ≥1.399 mg/dl might predict for success (being pregnant) with sensitivity 60.9%, specificity 33.3%, negative predictive value 30.6% and positive predictive value 63.9 %. |