Objective: To determine whether failure to achieve pregnancy after repeated ET after ovum donation was due to an endometrial defect or to the embryo quality. Design: Retrospective data analysis. Setting: A private infertility center. Patient(s): Four hundred sixty-seven donors (513 cycles) undergoing IVF donating oocytes to 266 recipients (423 cycles). Intervention(s): Hormonal endometrial preparation with increasing dosages of valerate E2 (2, 4, and 6 mg) and 100 mg of P. Main Outcome Measure(s): Pregnancy rates (PRs) and abortion rates in patients undergoing one to seven ETs after ovum donation. Result(s): Pregnancy rates in recipients that had one or two ETs were significantly higher (34.8%) compared with those of recipients having three or more ETs (15.1%). Abortion rates were significantly higher (54.5%) in recipients repeating more than three ETs than in the recipients having one or two ETs (29.1%). Conclusion(s): Recipients that had failed to establish a pregnancy after two ETs had a lower PR in successive attempts, possibly because of a defect of their endometrial lining.

a-i.r Inhibin, has been recently proposed as a useful tumor marker for mucinous ovarian carcinomas (Ca), as the widely used tumor marker for ovarian malignancies, CA125 is efficient only in nonmucinous ovarian Ca, and, together with CEA, fails to detect minimal disease and show long half-life in serum after successful surgery. Moreover, conflicting evidence has been reported as to whether inhibin in ovarian malignancies is the biologically active dimer α-βA inhibin or the inactive free α-subunits and inhibin precursors. Serum α-βA i.r inhibin, CA125 and CEA were measured preoperatively and 8 days postoperatively in 39 postmenopausal patients with ovarian cancer (13 mucinous, 15 serous and 11 difference other ovarian Ca) in comparison with 20 age-matched healthy women (Controls), 18 patients with benign ovarian tumors and 10 patients with nonovarian gynecological malignancies. Serum α-βA i.r inhibin values were very low in controls (0.121 U/ml; 0.060-0.250) while they were greatly elevated in both benign (67% sensitivity) and malignant ovarian tumors (100% sensitivity in mucinous Ca, 80% in serous and 90.9% in other ovarian, 0.250 U/ml). In contrast, in non-ovarian malignancies no increased values of α-βA inhibin were found (0% sensitivity). Our results on the sensitivity of CA125 and CEA are in agreement with previous studies. After successful surgery the very high concentrations of α-βA i.r inhibin were reduced very rapidly (8 days) to normal postmenopausal values in contrast to those of CA125 and CEA, that remained elevated. Serum α-βA i.r inhibin seems to be very useful in monitoring after treatment the patients with any type of ovarian malignancy and specifically those with mucinous ovarian cancer.

Objective: To compare the pregnancy rates achieved by intrauterine insemination or timed intercourse in gonadotrophin stimulated cycles in couples whose only detectable abnormality was poor sperm quality. Design: Sixty-two couples with primary or secondary infertility due to male factor entered the study. The 62 couples were randomly equally divided into two groups. Each group began one of the two treatment modalities (controlled ovarian hyperstimulation in conjunction with timed intercourse or intrauterine insemination) for three consecutive cycles and then switched to the alternative treatment after one rest cycle, if pregnancy was not achieved. Results: Five pregnancies (3.9%) were achieved after 128 cycles with timed intercourse and 15 pregnancies (11.5%) after 130 cycles with intrauterine insemination. The difference was found to be statistically significant (P < 0.05). Conclusion: We suggest that intrauterine insemination during hMG stimulated cycles improves the pregnancy rates of couples whose only detectable abnormality is poor sperm quality.