Variations in ambient temperature can lead to incorrect prediction of the luteinizing hormone surge using urinary dipsticks (OvuStick)

To prevent laparoscopy from being timed after ovulation has occurred, the detection of luteinizing hormone (LH) surge in women being superovulated for in vitro fertilization is a key factor. Urinary dipsticks provide patients with a simple means of monitoring their LH levels at home; however, many patients experience difficulties interpreting the blue color of these sticks and variations in color intensity. To investigate the temperature dependence of these LH urinary dipsticks, the OvuStick test kit (Medimar Laboratories) was used. The reactive ends of the dipsticks were immersed for 45 minutes in test tubes containing 0.5 ml of the enzyme-conjugated-antibody solution and 0.5 ml of either the 20 IU or the 40 IU calibrator solutions of LH supplied with the kit. There was no variation found between the color scores of the 2 sticks used at each temperature point in the 2 experiments. The color for the 40 IU LH calibration solution varied between a definite blue at 24 C and almost white at 12.6 C, whereas the color for the 20 IU LH standard varied between a very pale blue at 20 C-24 C and white below 16 C. It seems clear that the variation in response of these dipsticks to normal daily fluctuations in the ambient temperature may lead to serious errors in the prediction of the time of inset of the LH surge for in vitro fertilization or artificial insemination where home testing of urinary LH is used.     

An evaluation of semen analysis and in-vitro tests of sperm function in the prediction of the outcome of intrauterine AIH

Twenty-nine couples with an average of 5 years of infertilitywere selected for treatment by intrauterine insemination ofwashed semen (AIH). The criteria for selection were (i) thefemale partner showed no detectable fertility disorders by routinescreening; (ii) the male partner showed subnormal semen qualityon conventional semen analysis. Ovulation was stimulated uniformlywith clomiphene citrate and precipitated with human chorionicgonadotrophin (HCG). Inseminations were performed 31–32h post-HCG, with the day of HCG determined by ultrasound monitoringof follicular development. The fertilizing capacity of the malepartners‘ spermatozoa was tested in vitro using donatedhuman oocytes and/or the zona-free hamster oocyte penetrationassay. Up to eight cycles of AIH were alternated with cyclesof natural intercourse. While no pregnancies occurred in thegroup during normal coital cycles, the AIH pregnancy rate was17% per couple, but only 3% per insemination cycle. Four furtherpregnancies were achieved spontaneously in couples from thestudy group within 3 years of completion of the AIH therapyand four patients became pregnant following subsequent GIFTor IVF treatments. Neither of the in-vitro tests was helpfulin predicting the outcome of AIH, spontaneous pregnancy norof subsequent assisted conception procedures.     

Female and male partner age and menotrophin requirements influence pregnancy rates with human menopausal gonadotrophin therapy in combination with intrauterine insemination

This study analyses the influence of female and male patient age and human menopausal gonadotrophin (HMG) requirements on clinical pregnancy rates and live birth rates with ovulation stimulation using HMG in combination with intrauterine insemination (IUI). In this study, 363 consecutive HMG/IUI treatment cycles in 184 patients carried out at a university fertility centre were analysed in a retrospective fashion. The main outcomes measured were clinical pregnancy rates and live birth rates. Increased female partner age (> or = 35) and male partner age (> or = 40) were found to negatively influence pregnancy rates with HMG/ IUI therapy. In addition, this study demonstrated a critical threshold of HMG requirements beyond which pregnancy did not occur. No pregnancies occurred in treatment cycles requiring > 25 ampoules (1875 IU) of menotrophins to achieve follicular maturity, irrespective of patient age. In conclusion, female partner age, male partner age, and HMG requirements all significantly influence pregnancy rates with HMG/IUI therapy.