Berna Seckin - Academia.edu (original) (raw)

Papers by Berna Seckin

Ginekologia polska, 2015

The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH),... more The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively and 2, 6 and 24 h after surgery. Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.00 1). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital sta...

Systems Biology in Reproductive Medicine, 2015

The aim of this study was to evaluate the reproductive outcome and assisted reproductive technolo... more The aim of this study was to evaluate the reproductive outcome and assisted reproductive technology (ART) outcomes of patients with hypogonadotropic hypogonadism (HH) and to compare the results with male factor (MF) infertility patients. The reproductive outcome of 33 HH patients was evaluated retrospectively and compared with results of 47 patients with mild male factor infertility. For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and recFSH was used in MF infertility patients. HH patients were divided into subgroups according to retrieved oocyte numbers and the groups were compared with each other. The main outcome measures were total gonadotropin dose used, duration of stimulation, human chorionic gonadotropin (hCG) day estradiol level and endometrial thickness, oocyte number retrieved, and rate of clinical pregnancy. ART outcomes and cycle characteristics of 33 HH patients were compared with 47 MF infertility patients. There was no difference in age and body mass index (BMI) between the groups, but mean follicle stimulating hormone FSH and luteinizing hormone LH levels were significantly lower in the HH group…

The Journal of reproductive medicine

To determine the impact of recombinant luteinizing hormone (rLH) combined with vaginal progestero... more To determine the impact of recombinant luteinizing hormone (rLH) combined with vaginal progesterone (P)for luteal supplementation on in vitro fertilization (IVF) pregnancy outcomes in high-responder patients undergoing long gonadotropin-releasing hormone (GnRH) agonist cycles. A total of 47 patients undergoing IVF cycles with the serum estradiol levels of > or = 2,500 pg/mL on the day of human chorionic gonadotropin administration were included in this prospective randomized study. Patients were divided into 2 treatment groups: the control group (n = 23) used luteal vaginal P, and the study group (n = 24) received a combination of vaginal P and 75 IU rLH, 4 doses every 3 days, starting on the day of embryo transfer. The main outcome measure was the clinical pregnancy rate (PR). The study group had 11 pregnancies (45.8%), while the control group had 6 (26.1%). There was no significant difference between the groups in clinical PRs (p = 0.15). No differences were found with respect ...

International journal of fertility & sterility, 2013

We aimed to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating horm... more We aimed to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (r FSH) with respect to clinical outcomes and the development of ovarian hyperstimulation syndrome (OHSS) for patients with polycystic ovary syndrome (PCOS) treated with in vitro fertilization (IVF). This prospective randomized controlled trial included a total of 80 women with PCOS. Of these, 38 were randomized to receive treatment with hMG and 42 with rFSH using a long gonadotropin releasing hormone (GnRH) analogue protocol. Outcome measures were cycle characteristics, pregnancy rates, the need for coasting, and OHSS rates. In the hMG group we observed a significantly lower peak estradiol (E2) level (p=0.02), fewer intermediate-sized follicles (p=0.001), lower number of oocytes retrieved (p=0.002) and metaphase II (MII) oocytes (p=0.003). However, there were no significant differences between the groups in the number of fertilized oocytes, fertilization rates, top quality embryo co...

Asian Pacific journal of cancer prevention : APJCP, 2013

A small but significant proportion of cases with atypical squamous cells of undetermined signific... more A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) ...

Journal of the Turkish German Gynecological Association, 2013

Female adnexal tumor of probable Wolffian origin (FATWO) is a rare neoplasm which is usually cons... more Female adnexal tumor of probable Wolffian origin (FATWO) is a rare neoplasm which is usually considered as benign, although in some cases metastasis or recurrences have been reported even after a long interval following the initial diagnosis. Preoperative diagnosis of FATWO is very difficult because of the rarity of the disease and the limited literature available. In this case report, we present a case of FATWO arising from the ovary and review the literature based on the clinical characteristics and management of this rare condition. A 51- year- old postmenopausal woman was referred to our clinic for evaluation of an adnexal mass. After diagnostic evaluation, the patient underwent explorative laparotomy. Intra-operatively, a solid- cystic mass was found in the right ovary, the rest of the abdomen and the pelvis were normal. The ovarian mass was removed and examined with frozen-section (FS). When the frozen section proved negative for malignancy, total abdominal hysterectomy and bilateral adnexectomy were performed. The anatomic study revealed a well-capsulated mass which was 3.5×1.5 cm in diameter. Based on pathological and immunohistochemical results, the final diagnosis was concluded to be FATWO. Adjuvant therapy was not administered. Te patient was followed up after discharge from the hospital. One year after surgery she was asymptomatic. No evidences of recurrence were observed throughout this period. Although FATWOs are rare tumors, they should be kept in mind in women with an abdominal mass. They can present diagnostic difficulties and the diagnosis is based on the exclusion of other neoplasms. FATWO has malignant potential, after the initial surgical treatment patients should be appropriately followed up for possible recurrence and metastasis.

The Journal of reproductive medicine

To investigate the effect of luteal phase support with vaginal progesterone on pregnancy rates of... more To investigate the effect of luteal phase support with vaginal progesterone on pregnancy rates of the gonadotropin-stimulated intrauterine insemination (IUI) cycles in patients with unexplained infertility with regard tofollicular growth. A total of 149 patients with unexplained infertility who underwent 166 recombinant follicle stimulated hormone--stimulated IUI cycles were prospectively randomized into 2 groups for luteal phase support. The study group (n = 71) received vaginal progesterone gel supplementation, and the control group (n = 78) received no drug for luteal support. The clinical pregnancy rates and live birth rates per cycle and per patient were compared between the groups. The differences between the groups with regard to clinical pregnancy rates and live birth rates per patient or per cycle were not different among all patients. In cycles with > 1 dominant follicle (multifollicular response), the clinical pregnancy rate per patient was significantly higher in the ...

Journal of Pediatric and Adolescent Gynecology, 2011

To investigate the laparoscopic management of ovarian cysts in adolescents and young adults. A re... more To investigate the laparoscopic management of ovarian cysts in adolescents and young adults. A retrospective chart review study. Zekai Tahir Burak Women's Health Research and Education Hospital. A total of 282 females aged 25 years or younger underwent laparoscopic surgery for a presumed benign ovarian cyst. Patients were grouped as adolescents (ages 12-19, n = 79) or young adults (ages 20-25, n = 203). Surgical approach, operative findings and the correlation of intraoperative diagnosis with the definitive pathological reports. The mean age of the patients was 21.2 years. At laparoscopic surgery, 89 patients (31.6%) had endometriomas, 47 (16.7%) had dermoid cysts, and 37 (13.1%) had paraovarian cysts. Ninety-seven patients (34.4%) had simple ovarian cysts. Pathological reports revealed that young adults were more likely to have endometriomas (34.0% vs 7.6%, P < 0.01), but dermoid cysts and simple ovarian cysts were more frequent (20.3% vs 15.3%, P < 0.01 and 60.7% vs 40.9%, P < 0.01, respectively).in adolescents. Eleven of the cases (3.9%) were found to have mucinous cystadenomas and fourteen (5.0%) to have serous cystadenomas. Four cysts were malignant (1.4%). Cystectomy was performed in 205 cases (72.7%), fenestration of cyst wall was performed in 53 cases (18.8%), and aspiration was applied in 22 cases (7.8%). The types of operation were not significantly different among adolescents and young adults (P > 0.05). The operative diagnosis was highly correlated with the final pathological reports (kappa value= 0.901, P < 0.001). There were no operative and postoperative complications in our series. With a careful preoperative screening, the laparoscopic surgery of ovarian cyst is an efficient and safe treatment for adolescents and young adults.

Journal of Assisted Reproduction and Genetics, 2012

To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older... more To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older women. One hundred seventy-four women with normal day 3 FSH levels undergoing IVF treatment were studied. Patients were divided into two groups according to basal FSH/LH ratio: Group 1(FSH/LH ≥3, n = 43) and Group 2 (FSH/LH <3, n = 131). The effects of FSH/LH ratio on IVF outcomes were compared. Also, the impact of elevated FSH/LH levels on younger (<35 years; n = 113) and older (≥35 years; n = 61) women was evaluated. Group 1 had significantly lower mean day 3 LH levels (p = 0.001), lower number of oocytes retrieved (p = 0.004) and lower clinical pregnancy rate (p = 0.04). Older women with elevated FSH/LH ratio (n = 23) had significantly lower transferred good grade embryo counts (p = 0.04) and lower pregnancy rate (p = 0.03) versus older women with lower FSH/LH ratio. But in younger women treatment outcomes were similar in both subgroups. Elevated day 3 FSH/LH ratio is useful in predicting IVF outcome in older women, but does not seem to be an accurate predictor in younger women.

Fertility and Sterility, 2010

... Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health R... more ... Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara. , Turkey. Correspondence: Dr ... As ovulation is considered to be an inflammatory process, the association between CRP levels and assisted reproductive ...

Archives of Gynecology and Obstetrics, 2013

In recent years, it has become evident that ovarian stimulation, although a central component of ... more In recent years, it has become evident that ovarian stimulation, although a central component of in vitro fertilization (IVF), may itself has detrimental effects on oogenesis, embryo quality, endometrial receptivity, and perhaps also perinatal outcomes. To evaluate the effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responder ICSI cycles with long protocol. A retrospective study was planned in the Department of Reproductive Endocrinology of Zekai Tahir Burak Women's Health Education and Research Hospital. 362 normo-responders undergoing ICSI cycles with long protocol were included in the study. Group 1 (n = 260): Total gonadotrophin dose <2198 IU and Group 2 (n = 102): Total gonadotrophin dose >2198 IU. Laboratory IVF outcome, clinical pregnancy rate were evaluated. There was no statistically significant difference between peak estradiol levels, endometrial thickness, fertilization rates among the Group 1 versus Group 2 (p > 0.05). But there was a statistically significant difference in age, baseline FSH, oocyte number, 2PN, and clinical pregnancy among the Group 1 versus Group 2. Clinical pregnancy rate were significantly higher in Group 1 compared with Group 2 (p < 0.001). Lower gonadotrophin dose, 2PN was an independent positive predictor of clinical pregnancy (OR 2.65 for gonadotrophin dose, OR 1.1 for 2PN) CONCLUSION(S): Higher total gonadotrophin dose adversely affect clinical pregnancy in normo-responder patients undergoing ICSI cycles with long protocol.

Ginekologia polska, 2015

The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH),... more The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively and 2, 6 and 24 h after surgery. Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.00 1). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital sta...

Systems Biology in Reproductive Medicine, 2015

The aim of this study was to evaluate the reproductive outcome and assisted reproductive technolo... more The aim of this study was to evaluate the reproductive outcome and assisted reproductive technology (ART) outcomes of patients with hypogonadotropic hypogonadism (HH) and to compare the results with male factor (MF) infertility patients. The reproductive outcome of 33 HH patients was evaluated retrospectively and compared with results of 47 patients with mild male factor infertility. For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and recFSH was used in MF infertility patients. HH patients were divided into subgroups according to retrieved oocyte numbers and the groups were compared with each other. The main outcome measures were total gonadotropin dose used, duration of stimulation, human chorionic gonadotropin (hCG) day estradiol level and endometrial thickness, oocyte number retrieved, and rate of clinical pregnancy. ART outcomes and cycle characteristics of 33 HH patients were compared with 47 MF infertility patients. There was no difference in age and body mass index (BMI) between the groups, but mean follicle stimulating hormone FSH and luteinizing hormone LH levels were significantly lower in the HH group…

The Journal of reproductive medicine

To determine the impact of recombinant luteinizing hormone (rLH) combined with vaginal progestero... more To determine the impact of recombinant luteinizing hormone (rLH) combined with vaginal progesterone (P)for luteal supplementation on in vitro fertilization (IVF) pregnancy outcomes in high-responder patients undergoing long gonadotropin-releasing hormone (GnRH) agonist cycles. A total of 47 patients undergoing IVF cycles with the serum estradiol levels of > or = 2,500 pg/mL on the day of human chorionic gonadotropin administration were included in this prospective randomized study. Patients were divided into 2 treatment groups: the control group (n = 23) used luteal vaginal P, and the study group (n = 24) received a combination of vaginal P and 75 IU rLH, 4 doses every 3 days, starting on the day of embryo transfer. The main outcome measure was the clinical pregnancy rate (PR). The study group had 11 pregnancies (45.8%), while the control group had 6 (26.1%). There was no significant difference between the groups in clinical PRs (p = 0.15). No differences were found with respect ...

International journal of fertility & sterility, 2013

We aimed to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating horm... more We aimed to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (r FSH) with respect to clinical outcomes and the development of ovarian hyperstimulation syndrome (OHSS) for patients with polycystic ovary syndrome (PCOS) treated with in vitro fertilization (IVF). This prospective randomized controlled trial included a total of 80 women with PCOS. Of these, 38 were randomized to receive treatment with hMG and 42 with rFSH using a long gonadotropin releasing hormone (GnRH) analogue protocol. Outcome measures were cycle characteristics, pregnancy rates, the need for coasting, and OHSS rates. In the hMG group we observed a significantly lower peak estradiol (E2) level (p=0.02), fewer intermediate-sized follicles (p=0.001), lower number of oocytes retrieved (p=0.002) and metaphase II (MII) oocytes (p=0.003). However, there were no significant differences between the groups in the number of fertilized oocytes, fertilization rates, top quality embryo co...

Asian Pacific journal of cancer prevention : APJCP, 2013

A small but significant proportion of cases with atypical squamous cells of undetermined signific... more A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) ...

Journal of the Turkish German Gynecological Association, 2013

Female adnexal tumor of probable Wolffian origin (FATWO) is a rare neoplasm which is usually cons... more Female adnexal tumor of probable Wolffian origin (FATWO) is a rare neoplasm which is usually considered as benign, although in some cases metastasis or recurrences have been reported even after a long interval following the initial diagnosis. Preoperative diagnosis of FATWO is very difficult because of the rarity of the disease and the limited literature available. In this case report, we present a case of FATWO arising from the ovary and review the literature based on the clinical characteristics and management of this rare condition. A 51- year- old postmenopausal woman was referred to our clinic for evaluation of an adnexal mass. After diagnostic evaluation, the patient underwent explorative laparotomy. Intra-operatively, a solid- cystic mass was found in the right ovary, the rest of the abdomen and the pelvis were normal. The ovarian mass was removed and examined with frozen-section (FS). When the frozen section proved negative for malignancy, total abdominal hysterectomy and bilateral adnexectomy were performed. The anatomic study revealed a well-capsulated mass which was 3.5×1.5 cm in diameter. Based on pathological and immunohistochemical results, the final diagnosis was concluded to be FATWO. Adjuvant therapy was not administered. Te patient was followed up after discharge from the hospital. One year after surgery she was asymptomatic. No evidences of recurrence were observed throughout this period. Although FATWOs are rare tumors, they should be kept in mind in women with an abdominal mass. They can present diagnostic difficulties and the diagnosis is based on the exclusion of other neoplasms. FATWO has malignant potential, after the initial surgical treatment patients should be appropriately followed up for possible recurrence and metastasis.

The Journal of reproductive medicine

To investigate the effect of luteal phase support with vaginal progesterone on pregnancy rates of... more To investigate the effect of luteal phase support with vaginal progesterone on pregnancy rates of the gonadotropin-stimulated intrauterine insemination (IUI) cycles in patients with unexplained infertility with regard tofollicular growth. A total of 149 patients with unexplained infertility who underwent 166 recombinant follicle stimulated hormone--stimulated IUI cycles were prospectively randomized into 2 groups for luteal phase support. The study group (n = 71) received vaginal progesterone gel supplementation, and the control group (n = 78) received no drug for luteal support. The clinical pregnancy rates and live birth rates per cycle and per patient were compared between the groups. The differences between the groups with regard to clinical pregnancy rates and live birth rates per patient or per cycle were not different among all patients. In cycles with > 1 dominant follicle (multifollicular response), the clinical pregnancy rate per patient was significantly higher in the ...

Journal of Pediatric and Adolescent Gynecology, 2011

To investigate the laparoscopic management of ovarian cysts in adolescents and young adults. A re... more To investigate the laparoscopic management of ovarian cysts in adolescents and young adults. A retrospective chart review study. Zekai Tahir Burak Women's Health Research and Education Hospital. A total of 282 females aged 25 years or younger underwent laparoscopic surgery for a presumed benign ovarian cyst. Patients were grouped as adolescents (ages 12-19, n = 79) or young adults (ages 20-25, n = 203). Surgical approach, operative findings and the correlation of intraoperative diagnosis with the definitive pathological reports. The mean age of the patients was 21.2 years. At laparoscopic surgery, 89 patients (31.6%) had endometriomas, 47 (16.7%) had dermoid cysts, and 37 (13.1%) had paraovarian cysts. Ninety-seven patients (34.4%) had simple ovarian cysts. Pathological reports revealed that young adults were more likely to have endometriomas (34.0% vs 7.6%, P < 0.01), but dermoid cysts and simple ovarian cysts were more frequent (20.3% vs 15.3%, P < 0.01 and 60.7% vs 40.9%, P < 0.01, respectively).in adolescents. Eleven of the cases (3.9%) were found to have mucinous cystadenomas and fourteen (5.0%) to have serous cystadenomas. Four cysts were malignant (1.4%). Cystectomy was performed in 205 cases (72.7%), fenestration of cyst wall was performed in 53 cases (18.8%), and aspiration was applied in 22 cases (7.8%). The types of operation were not significantly different among adolescents and young adults (P > 0.05). The operative diagnosis was highly correlated with the final pathological reports (kappa value= 0.901, P < 0.001). There were no operative and postoperative complications in our series. With a careful preoperative screening, the laparoscopic surgery of ovarian cyst is an efficient and safe treatment for adolescents and young adults.

Journal of Assisted Reproduction and Genetics, 2012

To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older... more To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older women. One hundred seventy-four women with normal day 3 FSH levels undergoing IVF treatment were studied. Patients were divided into two groups according to basal FSH/LH ratio: Group 1(FSH/LH ≥3, n = 43) and Group 2 (FSH/LH <3, n = 131). The effects of FSH/LH ratio on IVF outcomes were compared. Also, the impact of elevated FSH/LH levels on younger (<35 years; n = 113) and older (≥35 years; n = 61) women was evaluated. Group 1 had significantly lower mean day 3 LH levels (p = 0.001), lower number of oocytes retrieved (p = 0.004) and lower clinical pregnancy rate (p = 0.04). Older women with elevated FSH/LH ratio (n = 23) had significantly lower transferred good grade embryo counts (p = 0.04) and lower pregnancy rate (p = 0.03) versus older women with lower FSH/LH ratio. But in younger women treatment outcomes were similar in both subgroups. Elevated day 3 FSH/LH ratio is useful in predicting IVF outcome in older women, but does not seem to be an accurate predictor in younger women.

Fertility and Sterility, 2010

... Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health R... more ... Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara. , Turkey. Correspondence: Dr ... As ovulation is considered to be an inflammatory process, the association between CRP levels and assisted reproductive ...

Archives of Gynecology and Obstetrics, 2013

In recent years, it has become evident that ovarian stimulation, although a central component of ... more In recent years, it has become evident that ovarian stimulation, although a central component of in vitro fertilization (IVF), may itself has detrimental effects on oogenesis, embryo quality, endometrial receptivity, and perhaps also perinatal outcomes. To evaluate the effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responder ICSI cycles with long protocol. A retrospective study was planned in the Department of Reproductive Endocrinology of Zekai Tahir Burak Women's Health Education and Research Hospital. 362 normo-responders undergoing ICSI cycles with long protocol were included in the study. Group 1 (n = 260): Total gonadotrophin dose <2198 IU and Group 2 (n = 102): Total gonadotrophin dose >2198 IU. Laboratory IVF outcome, clinical pregnancy rate were evaluated. There was no statistically significant difference between peak estradiol levels, endometrial thickness, fertilization rates among the Group 1 versus Group 2 (p > 0.05). But there was a statistically significant difference in age, baseline FSH, oocyte number, 2PN, and clinical pregnancy among the Group 1 versus Group 2. Clinical pregnancy rate were significantly higher in Group 1 compared with Group 2 (p < 0.001). Lower gonadotrophin dose, 2PN was an independent positive predictor of clinical pregnancy (OR 2.65 for gonadotrophin dose, OR 1.1 for 2PN) CONCLUSION(S): Higher total gonadotrophin dose adversely affect clinical pregnancy in normo-responder patients undergoing ICSI cycles with long protocol.