In vitro fertilization with low-cost programmed cycles - first outcome in a teaching hospital

Nelson Antunes Júnior Georgia Haik Badra Emerson Barchi Cordts Waldemar Almeida Pereira de Carvalho Phillip Wolff Caio Parente Barbosa Sérgio Peixoto About the authors

PURPOSE: to evaluate the first in vitro fertilization results at a medical university using low-cost programmed cycles. METHODS: from May to December 2002, 66 programmed cycles of in vitro fertilization were carried out using norethisterone acetate, clomiphene citrate and human chorionic gonadotrophin (hCG). The ovarian follicle aspiration was guided by ultrasonography, 34 to 36 h after the administration of hCG, and the embryo transfer, 48 h after puncturing. The diagnosis of clinical pregnancy was defined when a pulsating heart was detected by transvaginal ultrasonography. RESULTS: the cycle cancelation rate was 21.2%. An average of 2.8 follicles and 1.7 oocytes were obtained per puncture. In 79.6% of the punctured cycles it was possible to retrieve oocytes and 69% of them were fertilized. The number of embryos per transfer was 1.5. Some level of difficulty occurred in 10.2% of the aspiration procedures and 32.4% in the embryo transfer. The obtained pregnancy rate was 10,8% per transfer; however, the drug cost per transferred embryo was only R$ 96,00. CONCLUSION: the difficulty to begin an in vitro fertilization program in a medical school, not aiming at profits and to help a population without financial possibilities, became evident. After progressive experience, the cumulative pregnancy rate tends to be similar to that of reference centers, but with significantly lower costs and incidence of complications.

In vitro fertilization; Assisted reproduction; Clomiphene; Low cost

Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Av. Brigadeiro Luís Antônio, 3421, sala 903 - Jardim Paulista, 01401-001 São Paulo SP - Brasil, Tel. (55 11) 5573-4919 - Rio de Janeiro - RJ - Brazil