Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1257
M. Kamath, A. Pal
Aim and objective: To elucidate the cause of poor ovarian response to controlled ovarian hyperstimulation during in vitro fertilization in women with good ovarian reserve and the potential treatment options for them. Background: There has been a steady increase in number of in vitro fertilization (IVF) cycles being performed across the world. An important step of IVF is controlled ovarian hyperstimulation (COH), with an aim to achieve multifollicular response. Conventionally the protocol and gonadotropin dose is tailored to ensure adequate oocyte yield and minimize complications. Studies suggest that maximizing oocyte yield increases the cumulative LBR. However, in spite of high dose of gonadotropin usage during COH, many women have poor response (<4 oocytes retrieved) and/or low oocyte yield (4–9 oocytes retrieved). Patient-Oriented Strategies Encompassing Individualize D Oocyte Number (POSEIDON) criteria to classify poor responders were introduced in 2016 to achieve better stratification of poor responders and achieve an individualized treatment approach for the patients. Review results: Some of the proposed reasons include suboptimal gonadotropin dose, gonadotropin receptor resistance due to gonadotropin receptor polymorphism and issues with ovulation trigger. Two most studied single nucleotide polymorphism are those at position 307 and 680 of exon 10 of Follicle stimulating hormone receptor. Some studies have demonstrated that homozygous Asparagine at position 680 required lesser gonadotropin dose and had more oocyte yield in normoovulatory women compared with other variants at position 680. However, other studies have reported contradictory findings. Similarly contradictory results have been reported from various studies regarding ovarian response with respect to variants at locus 307. Some of the proposed treatments for patients with unexpected responders include increasing the dose of Inj. FSH, adding Inj. Luteinizing hormone receptor (LH) to ovarian stimulation, use of dual trigger, synchronizing the follicular cohort, use of adjuvants during IVF, and dual stimulation. Conclusion: The exact reason for such a response is still unclear although role of FSH/LH polymorphism has been studied extensively. However, no specific FSH/LH polymorphism has been consistently been associated with such unexpected hyporesponse. There is no high quality evidence for other proposed treatment options.
{"title":"POSEIDONE 1 and 2: Probable Causes and Proposed Treatment Strategies? An Evidence-based Update","authors":"M. Kamath, A. Pal","doi":"10.5005/jp-journals-10016-1257","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1257","url":null,"abstract":"Aim and objective: To elucidate the cause of poor ovarian response to controlled ovarian hyperstimulation during in vitro fertilization in women with good ovarian reserve and the potential treatment options for them. Background: There has been a steady increase in number of in vitro fertilization (IVF) cycles being performed across the world. An important step of IVF is controlled ovarian hyperstimulation (COH), with an aim to achieve multifollicular response. Conventionally the protocol and gonadotropin dose is tailored to ensure adequate oocyte yield and minimize complications. Studies suggest that maximizing oocyte yield increases the cumulative LBR. However, in spite of high dose of gonadotropin usage during COH, many women have poor response (<4 oocytes retrieved) and/or low oocyte yield (4–9 oocytes retrieved). Patient-Oriented Strategies Encompassing Individualize D Oocyte Number (POSEIDON) criteria to classify poor responders were introduced in 2016 to achieve better stratification of poor responders and achieve an individualized treatment approach for the patients. Review results: Some of the proposed reasons include suboptimal gonadotropin dose, gonadotropin receptor resistance due to gonadotropin receptor polymorphism and issues with ovulation trigger. Two most studied single nucleotide polymorphism are those at position 307 and 680 of exon 10 of Follicle stimulating hormone receptor. Some studies have demonstrated that homozygous Asparagine at position 680 required lesser gonadotropin dose and had more oocyte yield in normoovulatory women compared with other variants at position 680. However, other studies have reported contradictory findings. Similarly contradictory results have been reported from various studies regarding ovarian response with respect to variants at locus 307. Some of the proposed treatments for patients with unexpected responders include increasing the dose of Inj. FSH, adding Inj. Luteinizing hormone receptor (LH) to ovarian stimulation, use of dual trigger, synchronizing the follicular cohort, use of adjuvants during IVF, and dual stimulation. Conclusion: The exact reason for such a response is still unclear although role of FSH/LH polymorphism has been studied extensively. However, no specific FSH/LH polymorphism has been consistently been associated with such unexpected hyporesponse. There is no high quality evidence for other proposed treatment options.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47574510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1250
N. Shah
Jacob syndrome, also known as superman syndrome, is a sex chromosome aneuploidy characterized by an extra Y chromosome. The origin of this Y chromosome is paternal and results from nondisjunction in the second meiotic division (84% of cases) or a postfertilization mitotic error (16%). It does not result from increased parental age.1 Fetal Jacob syndrome does not have a specific phenotype although a few structural associations have been reported.1-3 Prenatal cases are usually picked up accidentally on cell free fetal DNA or karyotype/microarray offered for other indications.4 The case presented highlights an uncommon association of pulmonary atresia with ventricular septal defect with Jacob syndrome in a male fetus. The mechanism of an extra Y chromosome in causing this cardiac defect is unclear. PA-VSD is reported to be associated with 22q11.2 deletion syndrome in 25% cases.5 Association of PA-VSD with sex chromosomal abnormalities like Klinefelter syndrome (47XXY) has been reported but with Jacob syndrome (47XYY) is not yet reported.5 In this case, 22q11.2 deletion syndrome was ruled out by microarray (Fig. 2). In such cases, parents need to be counseled about the prognosis and in t r o D u c t i o n
{"title":"Fetal Jacob Syndrome (47XYY): An Uncommon Association of Fetal Pulmonary Atresia with Ventricular Septal Defect","authors":"N. Shah","doi":"10.5005/jp-journals-10016-1250","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1250","url":null,"abstract":"Jacob syndrome, also known as superman syndrome, is a sex chromosome aneuploidy characterized by an extra Y chromosome. The origin of this Y chromosome is paternal and results from nondisjunction in the second meiotic division (84% of cases) or a postfertilization mitotic error (16%). It does not result from increased parental age.1 Fetal Jacob syndrome does not have a specific phenotype although a few structural associations have been reported.1-3 Prenatal cases are usually picked up accidentally on cell free fetal DNA or karyotype/microarray offered for other indications.4 The case presented highlights an uncommon association of pulmonary atresia with ventricular septal defect with Jacob syndrome in a male fetus. The mechanism of an extra Y chromosome in causing this cardiac defect is unclear. PA-VSD is reported to be associated with 22q11.2 deletion syndrome in 25% cases.5 Association of PA-VSD with sex chromosomal abnormalities like Klinefelter syndrome (47XXY) has been reported but with Jacob syndrome (47XYY) is not yet reported.5 In this case, 22q11.2 deletion syndrome was ruled out by microarray (Fig. 2). In such cases, parents need to be counseled about the prognosis and in t r o D u c t i o n","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44963237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1254
M. A. Zucha, Muhammad Lutfi, Supak Silawani, Anastasia Feliciana, Pritania Astari
laparotomy approach to identify the previously ligated fallopian tubes. Using a loupe, we performed resection on both proximal and distal ends of the dissected tubes. Interrupted sutures were done on the mesosalpinx, followed by four stitches on muscular layers at 6, 3, 9, and 12 o’clock positions. Tubal patency test was then performed to check the patency of both tubes. An irrigated methylene blue into both fimbriae tubae indicated the patency of both tubes. During the 12-month follow-up, our patient became pregnant and delivered spontaneously. tubes after previous sterilization. This procedure involves a loupe or microscope for magnifying the tubes during reanastomosis procedure. Minimally invasive laparoscopy or robotic-assisted surgery are other alternative ways available to perform tubal reanastomosis surgery. 3 The outcome and success rate following tubal reanastomosis differ among patients, indicating several factors may affect the outcome. This study presents one report of a successful procedure of tubal reanastomosis. We also discuss the possible factors to improve the success rate of tubal reanastomosis. Systematic literature searching was done from the MEDLINE database. Our We performed a al. Rate Tubal Reanastomosis: A Case Presentation Systematic Review. Infertil Tubal reanastomosis is an option to recanalize fallopian tubes after previous sterilization. Several factors may be important in defining the success rate afterwards. This paper aimed to describe our experience performing tubal reanastomosis, and discuss the fertility outcome through a systematic literature review. We successfully performed tubal reanastomosis that resulted in pregnancy within 1 year after the procedure. Microsurgical tubal reanastomosis was performed with four-stitch technique. In addition, we conducted systematic searching to describe the efficacy of tubal reanastomosis in reversing the fertility status. MEDLINE database was searched with According to our criteria and search protocol, 16 studies were found, including 8,584 subjects. Data of pregnancy rate of those studies were collected to determine a cumulative pregnancy rate. According to our systematic review, we found tubal reanastomosis may result in successful conception of 70.27% of patients. Moreover, microsurgical tubal reanastomosis has comparable outcome in comparison to minimal invasive surgical approach. Therefore, tubal reanastomosis with microsurgery may be provided to reverse fertility status in low-resource settings. Our results mainly impact on patients who underwent tubal sterilization but need a fertility reversal. Our shared technique may be used as an important insight for the surgical approach. More importantly, pregnancy rates from the systematic review may be used as evidence-based prediction number of pregnancies.
{"title":"Pregnancy Rate after Tubal Reanastomosis: A Case Presentation and Systematic Review","authors":"M. A. Zucha, Muhammad Lutfi, Supak Silawani, Anastasia Feliciana, Pritania Astari","doi":"10.5005/jp-journals-10016-1254","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1254","url":null,"abstract":"laparotomy approach to identify the previously ligated fallopian tubes. Using a loupe, we performed resection on both proximal and distal ends of the dissected tubes. Interrupted sutures were done on the mesosalpinx, followed by four stitches on muscular layers at 6, 3, 9, and 12 o’clock positions. Tubal patency test was then performed to check the patency of both tubes. An irrigated methylene blue into both fimbriae tubae indicated the patency of both tubes. During the 12-month follow-up, our patient became pregnant and delivered spontaneously. tubes after previous sterilization. This procedure involves a loupe or microscope for magnifying the tubes during reanastomosis procedure. Minimally invasive laparoscopy or robotic-assisted surgery are other alternative ways available to perform tubal reanastomosis surgery. 3 The outcome and success rate following tubal reanastomosis differ among patients, indicating several factors may affect the outcome. This study presents one report of a successful procedure of tubal reanastomosis. We also discuss the possible factors to improve the success rate of tubal reanastomosis. Systematic literature searching was done from the MEDLINE database. Our We performed a al. Rate Tubal Reanastomosis: A Case Presentation Systematic Review. Infertil Tubal reanastomosis is an option to recanalize fallopian tubes after previous sterilization. Several factors may be important in defining the success rate afterwards. This paper aimed to describe our experience performing tubal reanastomosis, and discuss the fertility outcome through a systematic literature review. We successfully performed tubal reanastomosis that resulted in pregnancy within 1 year after the procedure. Microsurgical tubal reanastomosis was performed with four-stitch technique. In addition, we conducted systematic searching to describe the efficacy of tubal reanastomosis in reversing the fertility status. MEDLINE database was searched with According to our criteria and search protocol, 16 studies were found, including 8,584 subjects. Data of pregnancy rate of those studies were collected to determine a cumulative pregnancy rate. According to our systematic review, we found tubal reanastomosis may result in successful conception of 70.27% of patients. Moreover, microsurgical tubal reanastomosis has comparable outcome in comparison to minimal invasive surgical approach. Therefore, tubal reanastomosis with microsurgery may be provided to reverse fertility status in low-resource settings. Our results mainly impact on patients who underwent tubal sterilization but need a fertility reversal. Our shared technique may be used as an important insight for the surgical approach. More importantly, pregnancy rates from the systematic review may be used as evidence-based prediction number of pregnancies.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47588682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1255
R. Vembu, S. Nellepalli, M. Pandurangi, S. Nagireddy
women in the age-group of 21–42 years, identified as hyperresponders by ovarian reserve markers, anti-Mullerian Hormone [AMH ≥3.5 ng/mL and or antral follicle count (AFC) of ≥20, >14 intermediary follicles and/or a high serum estradiol (E2) level (>3500 pg/mL] on the day of trigger, receiving two doses of agonist trigger 12-hour apart were included. Women with hypothalamic amenorrhea and hypogonadotropic-hypogonadism were excluded. So 86 women fulfilling the selection criteria were analyzed. Ovarian reserve assessment (determined by AMH levels, AFC on day 2 or 3 of menstrual cycle) was done after detailed history and clinical examination. In t r o d u c t I o n
21-42岁年龄组的女性，通过卵巢储备标志物确定为高反应者，抗苗勒管激素[AMH≥3.5 ng/mL和/或窦卵泡计数（AFC）≥20，>14个中间卵泡和/或高血清雌二醇（E2）水平（>3500 pg/mL]在触发当天，包括间隔12小时接受两剂激动剂触发。患有下丘脑闭经和促性腺功能减退症的女性被排除在外。因此，对86名符合筛选标准的女性进行了分析。在详细的病史和临床检查后进行卵巢储备评估（通过AMH水平、月经周期第2或第3天的AFC确定）。在t r o d u c t I o n
{"title":"Impact of Two Doses of Agonist Trigger on Assisted Reproductive Technology Outcome","authors":"R. Vembu, S. Nellepalli, M. Pandurangi, S. Nagireddy","doi":"10.5005/jp-journals-10016-1255","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1255","url":null,"abstract":"women in the age-group of 21–42 years, identified as hyperresponders by ovarian reserve markers, anti-Mullerian Hormone [AMH ≥3.5 ng/mL and or antral follicle count (AFC) of ≥20, >14 intermediary follicles and/or a high serum estradiol (E2) level (>3500 pg/mL] on the day of trigger, receiving two doses of agonist trigger 12-hour apart were included. Women with hypothalamic amenorrhea and hypogonadotropic-hypogonadism were excluded. So 86 women fulfilling the selection criteria were analyzed. Ovarian reserve assessment (determined by AMH levels, AFC on day 2 or 3 of menstrual cycle) was done after detailed history and clinical examination. In t r o d u c t I o n","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48709240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1252
S. Pahwa, Amandeep Singh, Gauravdeep Singh, K. Gupta, R. Kaur
a detailed examination of the fetus for structural anomalies as a part of routine ultrasound scan in a two stage screening process in the general obstetric population. Detection of Fetal Structural Anomalies during First Trimester Nuchal Translucency Scan in Conjunction with Traditional 18–22 Weeks Anomaly Scan. Int Aim and objective: The purpose of this study is to assess the value of performing a detailed examination of the fetus for structural anomalies in a two stage screening process at first trimester nuchal translucency (NT) scan and mid trimester anomaly scan in general population. Materials and methods: An observational study was conducted on 400 pregnant females referred to Department of Radiodiagnosis and Imaging in our hospital for NT scan at 11–13+6 weeks of gestational age. All women enrolled in the study were again subjected to traditional 18–22 weeks anatomy scan on follow up. Results: In our study, total 400 pregnant women were enrolled. Overall congenital anomaly prevalence in study population was 6.7%. Out of which 66.6% anomalies were detected in first trimester. While 35.7% of the anomalies were detected in second trimester anomaly scan. Combined use of NT and second trimester scan detected almost all of the congenital anomalies. However, many of the total anomalies among them were detected earlier in first trimester NT scan. Conclusion: Early scan can be very helpful in early diagnosis of fetal anomalies. But as many abnormalities cannot be evident in early pregnancy due to ongoing fetal development, second trimester anomaly scan should also be performed along with early screening as two stage screening process.
{"title":"Ultrasound Detection of Fetal Structural Anomalies during First Trimester Nuchal Translucency Scan in Conjunction with Traditional 18–22 Weeks Anomaly Scan","authors":"S. Pahwa, Amandeep Singh, Gauravdeep Singh, K. Gupta, R. Kaur","doi":"10.5005/jp-journals-10016-1252","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1252","url":null,"abstract":"a detailed examination of the fetus for structural anomalies as a part of routine ultrasound scan in a two stage screening process in the general obstetric population. Detection of Fetal Structural Anomalies during First Trimester Nuchal Translucency Scan in Conjunction with Traditional 18–22 Weeks Anomaly Scan. Int Aim and objective: The purpose of this study is to assess the value of performing a detailed examination of the fetus for structural anomalies in a two stage screening process at first trimester nuchal translucency (NT) scan and mid trimester anomaly scan in general population. Materials and methods: An observational study was conducted on 400 pregnant females referred to Department of Radiodiagnosis and Imaging in our hospital for NT scan at 11–13+6 weeks of gestational age. All women enrolled in the study were again subjected to traditional 18–22 weeks anatomy scan on follow up. Results: In our study, total 400 pregnant women were enrolled. Overall congenital anomaly prevalence in study population was 6.7%. Out of which 66.6% anomalies were detected in first trimester. While 35.7% of the anomalies were detected in second trimester anomaly scan. Combined use of NT and second trimester scan detected almost all of the congenital anomalies. However, many of the total anomalies among them were detected earlier in first trimester NT scan. Conclusion: Early scan can be very helpful in early diagnosis of fetal anomalies. But as many abnormalities cannot be evident in early pregnancy due to ongoing fetal development, second trimester anomaly scan should also be performed along with early screening as two stage screening process.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41386599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1256
M. Puri, Harpreet Singh, B. Goswami, A. Chitkara, J. Bhattacharjee
unexplained recurrent pregnancy loss. Insulin resistance is a condition in which cell receptors which are the target site for insulin action do not respond to the hormone insulin and resultant hyperinsulinemia.8 Insulin resistance is often associated with a hypercoagulable state (impaired fibrinolysis) and increased inflammatory cytokine levels.9 In view of this, we planned this study aiming to investigate the prevalence of IR and hyperinsulinemia in patients with RPL with unknown etiology. In t r o d u c t I o n
无法解释的复发性妊娠损失。胰岛素抵抗是指作为胰岛素作用靶位点的细胞受体对胰岛素激素没有反应，从而导致高胰岛素血症。8胰岛素抵抗通常与高凝状态（纤维蛋白溶解受损）和炎症细胞因子水平增加有关。9有鉴于此，我们计划进行这项研究，旨在调查病因不明的RPL患者中IR和高胰岛素血症的患病率。在t r o d u c t I o n
{"title":"Occurrence of Insulin Resistance with Recurrent Pregnancy Loss of Unknown Etiology in North Indian Hospital-based Women Population: A Pilot Study","authors":"M. Puri, Harpreet Singh, B. Goswami, A. Chitkara, J. Bhattacharjee","doi":"10.5005/jp-journals-10016-1256","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1256","url":null,"abstract":"unexplained recurrent pregnancy loss. Insulin resistance is a condition in which cell receptors which are the target site for insulin action do not respond to the hormone insulin and resultant hyperinsulinemia.8 Insulin resistance is often associated with a hypercoagulable state (impaired fibrinolysis) and increased inflammatory cytokine levels.9 In view of this, we planned this study aiming to investigate the prevalence of IR and hyperinsulinemia in patients with RPL with unknown etiology. In t r o d u c t I o n","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46574919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-30DOI: 10.5005/jp-journals-10016-1251
M. Jaffar, A. Rajendran, K. Rao, Sumi P. Maria, M. A. Cheruveetil, P. Shetty, M. Asif
Background: The study was undertaken to gain insight into the morphology of pronuclear oocytes developed through prematuration culture with cilostamide. The criteria such as position and orientation of pronuclei (PN), the size and distribution of nucleolar precursor bodies (NPB), alignment of polar body (PB), and the cytoplasmic halo have been included in the study. Objective: To elucidate the effect of cilostamide on zygote morphology in prematuration culture. Study design: A prospective analysis of pronuclear zygote morphology developed through IVM with prematuration culture using cilostamide conducted from April 2018 to March 2020. Materials and methods: The present study comprised of 57 zygotes, obtained from the in vitro matured oocytes of 63 patients aged between 25 and 35 years, who underwent controlled ovarian stimulation for IVF/ICSI. Results: In pronuclear morphology, the central juxtaposed position was higher in the experimental group (77.1%) than in the control group (54.5%). The Group 1 NPB distribution was statistically significant in the experimental group (51.4%) as compared to the control group (22.7%) ( p = 0.03). Besides, Group 3 NPBs were lower in the experimental group (11.4%) when compared to the control group (36.4%) ( p = 0.02). The α-type polar body distribution was significantly higher in the experimental group (65.7%) ( p = 0.03). Cytoplasmic halo was noted in the experimental (60%) and control (45.5%) groups ( p > 0.05). Conclusion: The results indicate that prematuration culture using cilostamide for synchronizing nuclear and cytoplasmic maturation yielded a better pronuclear zygote morphology.
{"title":"Impact of Prematuration Culture on Zygote Morphology In Vitro Maturation: An Early Clue to Embryo Competence","authors":"M. Jaffar, A. Rajendran, K. Rao, Sumi P. Maria, M. A. Cheruveetil, P. Shetty, M. Asif","doi":"10.5005/jp-journals-10016-1251","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1251","url":null,"abstract":"Background: The study was undertaken to gain insight into the morphology of pronuclear oocytes developed through prematuration culture with cilostamide. The criteria such as position and orientation of pronuclei (PN), the size and distribution of nucleolar precursor bodies (NPB), alignment of polar body (PB), and the cytoplasmic halo have been included in the study. Objective: To elucidate the effect of cilostamide on zygote morphology in prematuration culture. Study design: A prospective analysis of pronuclear zygote morphology developed through IVM with prematuration culture using cilostamide conducted from April 2018 to March 2020. Materials and methods: The present study comprised of 57 zygotes, obtained from the in vitro matured oocytes of 63 patients aged between 25 and 35 years, who underwent controlled ovarian stimulation for IVF/ICSI. Results: In pronuclear morphology, the central juxtaposed position was higher in the experimental group (77.1%) than in the control group (54.5%). The Group 1 NPB distribution was statistically significant in the experimental group (51.4%) as compared to the control group (22.7%) ( p = 0.03). Besides, Group 3 NPBs were lower in the experimental group (11.4%) when compared to the control group (36.4%) ( p = 0.02). The α-type polar body distribution was significantly higher in the experimental group (65.7%) ( p = 0.03). Cytoplasmic halo was noted in the experimental (60%) and control (45.5%) groups ( p > 0.05). Conclusion: The results indicate that prematuration culture using cilostamide for synchronizing nuclear and cytoplasmic maturation yielded a better pronuclear zygote morphology.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42783921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.5005/jp-journals-10016-1227
Prasanna L Kakarla, A. Bilolikar, S. Reddy, Vyjayanthi Sreenivasan
Ab s t r Ac t Aim and objective: Congenital rubella syndrome (CRS), a consequence of rubella virus infection in the first trimester of pregnancy is a silent crippling disease endemic in India. This study sought to find out and vaccinate rubella susceptible women attending a fertility clinic in an urban setup. Materials and methods: As an institutional policy, all females attending fertility clinic were screened for anti-rubella IgG antibodies. A total 2272 non-duplicate serum samples received between January 2011 and December 2017 were processed using enzyme-linked fluorescent assay using mini VIDAS system following standard recommendations. Any value <10 IU/mL was regarded negative, between 10 and 15 as equivocal and >15 as positive. Results: An average of 10.95% women was susceptible to rubella whereas 86.75% were immune to it. Samples from 52 women gave equivocal results and they were considered to be susceptible. All susceptible females were vaccinated with R-vac and treated for infertility one month after vaccination. Age-specific immune status was not significant. A trend analysis revealed steady increase in immunity from 2011 to 2017 with a slight drop in 2016. Conclusion: The proportion of susceptible females of reproductive age who need to be vaccinated is significant. This study emphasizes the need for preconception screening as we would have an opportunity to vaccinate susceptible women. Clinical significance: There is a need for preconception screening of rubella not only in infertile women but also normal reproductive age females. With successful eradication of polio, elimination of rubella and measles being the next targets, combined vaccination strategy is the key to rubella elimination.
{"title":"Rubella Immune Status among Infertile Women: A Priority Vaccination Cohort","authors":"Prasanna L Kakarla, A. Bilolikar, S. Reddy, Vyjayanthi Sreenivasan","doi":"10.5005/jp-journals-10016-1227","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1227","url":null,"abstract":"Ab s t r Ac t Aim and objective: Congenital rubella syndrome (CRS), a consequence of rubella virus infection in the first trimester of pregnancy is a silent crippling disease endemic in India. This study sought to find out and vaccinate rubella susceptible women attending a fertility clinic in an urban setup. Materials and methods: As an institutional policy, all females attending fertility clinic were screened for anti-rubella IgG antibodies. A total 2272 non-duplicate serum samples received between January 2011 and December 2017 were processed using enzyme-linked fluorescent assay using mini VIDAS system following standard recommendations. Any value <10 IU/mL was regarded negative, between 10 and 15 as equivocal and >15 as positive. Results: An average of 10.95% women was susceptible to rubella whereas 86.75% were immune to it. Samples from 52 women gave equivocal results and they were considered to be susceptible. All susceptible females were vaccinated with R-vac and treated for infertility one month after vaccination. Age-specific immune status was not significant. A trend analysis revealed steady increase in immunity from 2011 to 2017 with a slight drop in 2016. Conclusion: The proportion of susceptible females of reproductive age who need to be vaccinated is significant. This study emphasizes the need for preconception screening as we would have an opportunity to vaccinate susceptible women. Clinical significance: There is a need for preconception screening of rubella not only in infertile women but also normal reproductive age females. With successful eradication of polio, elimination of rubella and measles being the next targets, combined vaccination strategy is the key to rubella elimination.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47741499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.5005/jp-journals-10016-1225
Zh. Kozhabek, Qiongzhen Zhao, Pang Min
Klinefelter syndrome (KS) is a genetic condition that results from male with one or more extra copy of the X chromosome. The primary features are infertility and small, poorly functioning testicles. Symptoms also include greater height, less body hair, weaker muscles, poor coordination, enlarged breast tissue, and less interest in sex. We present the case of a 36-year-old man who is KS with normal clinical and laboratory phenotype, which is a very rare finding in this syndrome. Most men with KS are infertility, they produce little or no sperm. Assisted reproductive procedures may help some men with KS to father a child. But the necessity of PGD during assisted reproductive treatment has always been a controversial topic. In this case, we examined five blastocysts of patient, two of them with abnormal karyotype and other three were normal. Therefore, it is necessary to carry out preimplantation genetic diagnosis for KS patients before implantation, even though their phenotypes are normal.
{"title":"A Rare of Klinefelter Syndrome with Normal Phenotype: A Case Report","authors":"Zh. Kozhabek, Qiongzhen Zhao, Pang Min","doi":"10.5005/jp-journals-10016-1225","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1225","url":null,"abstract":"Klinefelter syndrome (KS) is a genetic condition that results from male with one or more extra copy of the X chromosome. The primary features are infertility and small, poorly functioning testicles. Symptoms also include greater height, less body hair, weaker muscles, poor coordination, enlarged breast tissue, and less interest in sex. We present the case of a 36-year-old man who is KS with normal clinical and laboratory phenotype, which is a very rare finding in this syndrome. Most men with KS are infertility, they produce little or no sperm. Assisted reproductive procedures may help some men with KS to father a child. But the necessity of PGD during assisted reproductive treatment has always been a controversial topic. In this case, we examined five blastocysts of patient, two of them with abnormal karyotype and other three were normal. Therefore, it is necessary to carry out preimplantation genetic diagnosis for KS patients before implantation, even though their phenotypes are normal.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45198396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.5005/jp-journals-10016-1224
Rupali Gupta, Shweta S. Mishra, A. Parihar, R. Kumari
Ab s t r Ac t Background and aims and objectives: There is a substantial lacuna in the awareness of menstruation and menstrual hygiene practice among young girls and women of reproductive age. Menstruation is a normal hormonal process and the leading indicator of women’s reproductive age groups’ reproductive health. Inadequate knowledge about menstrual hygiene influences education practice, social activity, environment, and women’s daily activities. This study evaluates women’s hygiene practices in the Sitapur district among women aged 13–45 years, evaluates their knowledge of menstrual hygiene, and promotes their knowledge about menstrual hygiene. Materials and methods: This was hospital-based cross-sectional research conducted in the woman age group of 13–45 years attending Gynecology’s outpatient department. A predesigned, pretested, semi-structured questionnaire has been used as a questionnaire survey. The interview process has been used for data collection and obtaining informed consent from the participants. The SPSS 20v software analyzed data. Results: The mean age of participants was 29.00 ± 9.60 years; 76.8% of participants were not aware of menstruation before attaining menarche, around 23.78% were not known about the cause of menstruation, and 75.20% source of the blood of menstruation cycle in a rural area. In the rural area, only 4.72% used only sanitary pads, and the majority of participants, 79.39%, used old clothes, whereas 75% used sanitary pads in the urban. Only water used for cleaning the external genitalia was practiced by 52.36% of rural area subjects. Meaningfully deplorable menstrual hygiene practices associated with rural participates. Conclusion: The educational and communication program for public health care focusing on menstrual hygiene must be strengthened. Educational awareness and very well programs will play a key role in implementing health education in women.
{"title":"Knowledge, Attitude, and Practice of Menstrual Hygiene in Women Aged 13–45 Years Attending Hind Institute of Medical Sciences, Sitapur: A Cross-sectional Study","authors":"Rupali Gupta, Shweta S. Mishra, A. Parihar, R. Kumari","doi":"10.5005/jp-journals-10016-1224","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1224","url":null,"abstract":"Ab s t r Ac t Background and aims and objectives: There is a substantial lacuna in the awareness of menstruation and menstrual hygiene practice among young girls and women of reproductive age. Menstruation is a normal hormonal process and the leading indicator of women’s reproductive age groups’ reproductive health. Inadequate knowledge about menstrual hygiene influences education practice, social activity, environment, and women’s daily activities. This study evaluates women’s hygiene practices in the Sitapur district among women aged 13–45 years, evaluates their knowledge of menstrual hygiene, and promotes their knowledge about menstrual hygiene. Materials and methods: This was hospital-based cross-sectional research conducted in the woman age group of 13–45 years attending Gynecology’s outpatient department. A predesigned, pretested, semi-structured questionnaire has been used as a questionnaire survey. The interview process has been used for data collection and obtaining informed consent from the participants. The SPSS 20v software analyzed data. Results: The mean age of participants was 29.00 ± 9.60 years; 76.8% of participants were not aware of menstruation before attaining menarche, around 23.78% were not known about the cause of menstruation, and 75.20% source of the blood of menstruation cycle in a rural area. In the rural area, only 4.72% used only sanitary pads, and the majority of participants, 79.39%, used old clothes, whereas 75% used sanitary pads in the urban. Only water used for cleaning the external genitalia was practiced by 52.36% of rural area subjects. Meaningfully deplorable menstrual hygiene practices associated with rural participates. Conclusion: The educational and communication program for public health care focusing on menstrual hygiene must be strengthened. Educational awareness and very well programs will play a key role in implementing health education in women.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43904877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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