Pub Date : 2021-04-01DOI: 10.5005/JP-JOURNALS-10016-1216
D. Arora, M. Dey, Sanjay Singh, Abhijeet Kumar
Introduction: After the ACOG guideline in 2007 recommending that all women, regardless of age, should be offered aneuploidy screening before 20 weeks of gestation. This protocol in the name of the fetal aneuploidy screening program was slowly introduced in various Indian hospitals. This observational study was performed to analyze population-based trends of prenatal testing (serum screening and invasive testing) for aneuploidy over 3 years (2017–2019). Materials and methods: A retrospective single-center study was carried over a period of 3 years (January 2017 to December 2019). This hospital was a tertiary care hospital with fetal medicine unit that had approximately 3,000 annual births. Analysis of data of all pregnant women undergoing prenatal testing before 20 weeks of gestation was collected in the following subheads: (1) aneuploidy screening data, (2) invasive testing data [amniocenteses and chorionic villus samplings (CVSs)], and (3) tertiary care hospital birth statistics from January 2017 to December 2019. Results: Over a period of 3 years, aneuploidy screening was accepted by the target population and at present > 85% target population undergo aneuploidy serum screening. Annual numbers of invasive prenatal tests climbed steadily from 2017 to 2019. The proportion of invasive testing performed for abnormal serum screening (ASS) increased steadily from 51% in 2017 to 72% ( p < 0.05) in 2019. While the indications abnormal ultrasound finding (AUS) showed a steady decline over the same timeline but an indication of previous baby affected with aneuploidy (PBAA) remained in the same range. By 2019, the most common indications for invasive tests were positive ASS (72%) and AUS abnormality (15%). The diagnostic yield of all invasive tests for a major chromosome abnormality over a 3-year study period was 4.7%. The rate of CVS to amniocentesis rose to 17.5% in 2019 from 4.6% in 2017. Fewer complications of invasive tests were observed as compared to previous studies. Conclusion: The study demonstrates a rise in aneuploidy serum screening and its acceptance in the pregnant population. Abnormal serum screening is the main indication of prenatal invasive testing. This study also adds to the safety profile of invasive testing.
{"title":"Prenatal Aneuploidy Screening and Diagnosis—Its Evolution and Trends: A 3-year Analysis in a Fetal Medicine Center","authors":"D. Arora, M. Dey, Sanjay Singh, Abhijeet Kumar","doi":"10.5005/JP-JOURNALS-10016-1216","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1216","url":null,"abstract":"Introduction: After the ACOG guideline in 2007 recommending that all women, regardless of age, should be offered aneuploidy screening before 20 weeks of gestation. This protocol in the name of the fetal aneuploidy screening program was slowly introduced in various Indian hospitals. This observational study was performed to analyze population-based trends of prenatal testing (serum screening and invasive testing) for aneuploidy over 3 years (2017–2019). Materials and methods: A retrospective single-center study was carried over a period of 3 years (January 2017 to December 2019). This hospital was a tertiary care hospital with fetal medicine unit that had approximately 3,000 annual births. Analysis of data of all pregnant women undergoing prenatal testing before 20 weeks of gestation was collected in the following subheads: (1) aneuploidy screening data, (2) invasive testing data [amniocenteses and chorionic villus samplings (CVSs)], and (3) tertiary care hospital birth statistics from January 2017 to December 2019. Results: Over a period of 3 years, aneuploidy screening was accepted by the target population and at present > 85% target population undergo aneuploidy serum screening. Annual numbers of invasive prenatal tests climbed steadily from 2017 to 2019. The proportion of invasive testing performed for abnormal serum screening (ASS) increased steadily from 51% in 2017 to 72% ( p < 0.05) in 2019. While the indications abnormal ultrasound finding (AUS) showed a steady decline over the same timeline but an indication of previous baby affected with aneuploidy (PBAA) remained in the same range. By 2019, the most common indications for invasive tests were positive ASS (72%) and AUS abnormality (15%). The diagnostic yield of all invasive tests for a major chromosome abnormality over a 3-year study period was 4.7%. The rate of CVS to amniocentesis rose to 17.5% in 2019 from 4.6% in 2017. Fewer complications of invasive tests were observed as compared to previous studies. Conclusion: The study demonstrates a rise in aneuploidy serum screening and its acceptance in the pregnant population. Abnormal serum screening is the main indication of prenatal invasive testing. This study also adds to the safety profile of invasive testing.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48342233","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 : 2021-04-01DOI: 10.5005/JP-JOURNALS-10016-1210
R. Dalal, A. Mishra, Sahil Gupta, D. Rani
bstrAct Background: Oocyte cryopreservation has been an enigma for many years. It has not been easy to freeze the largest cell of the body owing to its large water content and low surface-to-volume ratio. The recovery of cryopreserved oocytes, for many years, remained dismal at best due to ice crystal formation and insufficient cryoprotectant permeation. In recent years, particularly after the advent of vitrification, a much more successful cryopreservation recovery has been achieved, and oocyte cryopreservation has now become a mainstream treatment procedure in artificial reproduction technology (ART). Aim and objective: Our study aims to retrospectively analyze oocyte cryopreservation data collected over a period of 5 years, between two centers, with a standardized vitrification-warming technique. The parameters taken into consideration were oocyte survival, fertilization, blastocysts formation, implantation rate, and live birth rate. Result: We have observed no significant difference in fresh vs frozen oocytes in the donor as well as patient cohorts in terms of implantation rates and live birth outcomes. Our data have been very encouraging, so that we can offer oocyte cryopreservation to the desiring women seeking this technology, and have opened up a plethora of opportunities with the successful application of oocyte vitrification. Conclusion: We are attempting a further, more elaborate study with much bigger sample size and many more individual criteria to follow-up the success of this technique more closely.
{"title":"A Retrospective Analysis of Outcome of Vitrified vs Fresh Oocytes among Donor and Patient Cohorts","authors":"R. Dalal, A. Mishra, Sahil Gupta, D. Rani","doi":"10.5005/JP-JOURNALS-10016-1210","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1210","url":null,"abstract":"bstrAct Background: Oocyte cryopreservation has been an enigma for many years. It has not been easy to freeze the largest cell of the body owing to its large water content and low surface-to-volume ratio. The recovery of cryopreserved oocytes, for many years, remained dismal at best due to ice crystal formation and insufficient cryoprotectant permeation. In recent years, particularly after the advent of vitrification, a much more successful cryopreservation recovery has been achieved, and oocyte cryopreservation has now become a mainstream treatment procedure in artificial reproduction technology (ART). Aim and objective: Our study aims to retrospectively analyze oocyte cryopreservation data collected over a period of 5 years, between two centers, with a standardized vitrification-warming technique. The parameters taken into consideration were oocyte survival, fertilization, blastocysts formation, implantation rate, and live birth rate. Result: We have observed no significant difference in fresh vs frozen oocytes in the donor as well as patient cohorts in terms of implantation rates and live birth outcomes. Our data have been very encouraging, so that we can offer oocyte cryopreservation to the desiring women seeking this technology, and have opened up a plethora of opportunities with the successful application of oocyte vitrification. Conclusion: We are attempting a further, more elaborate study with much bigger sample size and many more individual criteria to follow-up the success of this technique more closely.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42704823","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 : 2021-04-01DOI: 10.5005/JP-JOURNALS-10016-1214
G. Silva, Vítor Px Grangeiro, C. F. Oliveira
Aim and objective: To investigate the potential relationship between seminal complements (C3 and C4) and immunoglobulin (IgA and IgG) levels and seminal parameters (SPs) in chronic hemodialysis patients. Materials and methods: A cross-sectional study was conducted among patients aged between 18 years and 60 years. The sample comprises 60 males undergoing hemodialysis for > 6 months, and 15 healthy males without clinical or laboratory signs of genitourinary and eugonadic tract infections. Spermograms and leukocytopermia, serum hormonal profiles, and seminal measurements of complement fractions (C3, C4) and immunoglobulins (IgA, IgG) were performed. Results: The hemodialysis and healthy groups were similar in age (49.47 ± 05.55 and 50.53 ± 04.24 years, p = 0.06). Average levels of seminal C fractions (C3, C4) were similar between the hemodialysis and healthy groups, between normozoospermia and oligozoospermia hemodialysis subgroups, and in the oligozoospermia hemodialysis subgroup. Average seminal levels of Igs (A and G) differed significantly between the hemodialysis and healthy groups (351.60 ± 035.80 vs 247.40 ± 39.00 mg/L), and in normozoospermia and oligozoospermia hemodialysis subgroups (361.20 ± 36.30 vs 340.60 ± 32.50 mg/L). However, they were similar ( p > 0.05) between subgroups of oligozoospermia. The seminal fractions of complete (C3 and C4) and Ig (A and G) did not correlate ( p > 0.05) with SPs. All participants had hormonal profiles within the normal range. Conclusion: The complement fractions (C3 and C4) and immunoglobulins (IgA and IgG) showed no relationship with SPs in patients.
目的：探讨慢性血液透析患者精液补体（C3和C4）、免疫球蛋白（IgA和IgG）水平与精液参数（SP）之间的潜在关系。材料和方法：对年龄在18岁至60岁之间的患者进行横断面研究。样本包括60名接受血液透析超过6个月的男性，以及15名没有泌尿生殖道和性腺感染临床或实验室迹象的健康男性。进行精子图和白细胞膜、血清激素谱以及补体组分（C3、C4）和免疫球蛋白（IgA、IgG）的精液测量。结果：血液透析组和健康组的年龄相似（49.47±05.55和50.53±04.24岁，p=0.06）。血液透析组与健康组、常精子和少精血液透析亚组以及少精血透亚组的精液C组分（C3、C4）平均水平相似。血液透析组和健康组的平均精液Igs（A和G）水平存在显著差异（351.60±035.80 vs 247.40±39.00 mg/L），而正常精子和少精子血液透析组的平均精子Igs水平（361.20±36.30 vs 340.60±32.50 mg/L）。然而，少精症亚组之间的差异相似（p>0.05）。精精组分（C3和C4）和Ig（A和G）与SP无相关性（p>0.05）。所有参与者的激素水平都在正常范围内。结论：患者血清补体C3、C4及免疫球蛋白IgA、IgG与SP无相关性。
{"title":"Seminal Levels of Immunoglobulins and Complements and Their Relationship with Seminal Parameters in Chronic Hemodialytic Patients","authors":"G. Silva, Vítor Px Grangeiro, C. F. Oliveira","doi":"10.5005/JP-JOURNALS-10016-1214","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1214","url":null,"abstract":"Aim and objective: To investigate the potential relationship between seminal complements (C3 and C4) and immunoglobulin (IgA and IgG) levels and seminal parameters (SPs) in chronic hemodialysis patients. Materials and methods: A cross-sectional study was conducted among patients aged between 18 years and 60 years. The sample comprises 60 males undergoing hemodialysis for > 6 months, and 15 healthy males without clinical or laboratory signs of genitourinary and eugonadic tract infections. Spermograms and leukocytopermia, serum hormonal profiles, and seminal measurements of complement fractions (C3, C4) and immunoglobulins (IgA, IgG) were performed. Results: The hemodialysis and healthy groups were similar in age (49.47 ± 05.55 and 50.53 ± 04.24 years, p = 0.06). Average levels of seminal C fractions (C3, C4) were similar between the hemodialysis and healthy groups, between normozoospermia and oligozoospermia hemodialysis subgroups, and in the oligozoospermia hemodialysis subgroup. Average seminal levels of Igs (A and G) differed significantly between the hemodialysis and healthy groups (351.60 ± 035.80 vs 247.40 ± 39.00 mg/L), and in normozoospermia and oligozoospermia hemodialysis subgroups (361.20 ± 36.30 vs 340.60 ± 32.50 mg/L). However, they were similar ( p > 0.05) between subgroups of oligozoospermia. The seminal fractions of complete (C3 and C4) and Ig (A and G) did not correlate ( p > 0.05) with SPs. All participants had hormonal profiles within the normal range. Conclusion: The complement fractions (C3 and C4) and immunoglobulins (IgA and IgG) showed no relationship with SPs in patients.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47750511","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 : 2021-04-01DOI: 10.5005/JP-JOURNALS-10016-1215
Smita Khetarpal, A. Khetarpal
Infertility is a growing concern of society which might be due to defects in tubal, ovarian, and uterine or a combination of factors. During routine practice, we usually found anomalies of the uterus or vagina and sometimes blocked fallopian tubes in primary infertility cases but congenital anomalies related to ovaries and tubes are of rare occurrence. Nowadays, tubal factor infertility is the leading cause of female factor infertility which might result from a partial or complete absence of a fallopian tube; however, the true incidence of this condition is not reported yet, but till now very few cases of tubal anomalies (basically unilateral) have been reported in the literature. Here, we report a case of a nulliparous young aged female, who was presenting in an outpatient department with complaints of primary infertility and intraoperatively, found to have bilateral tubal anomaly (congenital) during laparoscopy.
{"title":"Bilateral Tubal Anomaly (Congenital): A Rare Tubal Infertility Factor","authors":"Smita Khetarpal, A. Khetarpal","doi":"10.5005/JP-JOURNALS-10016-1215","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1215","url":null,"abstract":"Infertility is a growing concern of society which might be due to defects in tubal, ovarian, and uterine or a combination of factors. During routine practice, we usually found anomalies of the uterus or vagina and sometimes blocked fallopian tubes in primary infertility cases but congenital anomalies related to ovaries and tubes are of rare occurrence. Nowadays, tubal factor infertility is the leading cause of female factor infertility which might result from a partial or complete absence of a fallopian tube; however, the true incidence of this condition is not reported yet, but till now very few cases of tubal anomalies (basically unilateral) have been reported in the literature. Here, we report a case of a nulliparous young aged female, who was presenting in an outpatient department with complaints of primary infertility and intraoperatively, found to have bilateral tubal anomaly (congenital) during laparoscopy.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46429673","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 : 2021-03-09DOI: 10.5005/JP-JOURNALS-10016-1204
Meena Andiappan, Narghis Bushra, D. C. Mathangi, Puvithra Thanikachalam
Ab s t r Ac t Aim and objective: Obstructive sleep apnea (OSA), a prevalent and mostly underdiagnosed chronic condition, has been investigated for its cardiovascular, metabolic, and neurocognitive consequences in recent times. Intermittent hypoxia, a characteristic feature of OSA, is believed to play a key role in the pathogenesis of these consequences by inducing systemic as well as organ-specific oxidative stress. Indeed, oxidative stress has been recognized as a major causative factor of infertility. Provided that OSA provokes oxidative stress, infertility could be envisaged as a potential consequence in patients with severe OSA. The presence and severity of OSA and its associated risk with systemic comorbidities like diabetes, hypertension, and stroke were well established. Whereas the presence of OSA and its relationship with infertility remains elusive. Hence, the study was initiated to evaluate the prevalence of OSA among infertile people attending a tertiary care hospital compared with the general population of the same age group using two questionnaires—Modified Berlin and STOPBANG. Materials and methods: A sample of 120 subjects in the reproductive age group with a diagnosis of infertility was screened for the presence of OSA using two standard questionnaires—STOPBANG and Modified Berlin questionnaire. Results: The prevalence of high-risk OSA in infertile subjects was 7.5% by Modified Berlin and 15% by STOPBANG questionnaire. Overall predictive values of the employed questionnaire were fair (ROC area under curve) AUC 0.521 for Modified Berlin and 0.516 for STOPBANG. Multivariate logistic regression analysis revealed male gender, snoring, body mass index (BMI) >25 kg/m2, and neck circumference >40 cm as significant risk factors for moderate to severe sleep apnea among infertile subjects. Conclusion: There is increased OSA risk among infertile people and hence the clinical suspicion of OSA should be increased among infertile people with the polycystic ovarian syndrome (PCOS), oligozoospermia, hypertension, diabetes, and obesity. Clinical significance: Identification of OSA risk among infertile people forms a new perspective in the field of reproductive medicine, thereby helping us to achieve a high success rate in infertility treatment.
{"title":"Assessing the Likelihood of Obstructive Sleep Apnea among Infertile Population Using STOPBANG and Modified Berlin Questionnaire: A Cross-sectional Study","authors":"Meena Andiappan, Narghis Bushra, D. C. Mathangi, Puvithra Thanikachalam","doi":"10.5005/JP-JOURNALS-10016-1204","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1204","url":null,"abstract":"Ab s t r Ac t Aim and objective: Obstructive sleep apnea (OSA), a prevalent and mostly underdiagnosed chronic condition, has been investigated for its cardiovascular, metabolic, and neurocognitive consequences in recent times. Intermittent hypoxia, a characteristic feature of OSA, is believed to play a key role in the pathogenesis of these consequences by inducing systemic as well as organ-specific oxidative stress. Indeed, oxidative stress has been recognized as a major causative factor of infertility. Provided that OSA provokes oxidative stress, infertility could be envisaged as a potential consequence in patients with severe OSA. The presence and severity of OSA and its associated risk with systemic comorbidities like diabetes, hypertension, and stroke were well established. Whereas the presence of OSA and its relationship with infertility remains elusive. Hence, the study was initiated to evaluate the prevalence of OSA among infertile people attending a tertiary care hospital compared with the general population of the same age group using two questionnaires—Modified Berlin and STOPBANG. Materials and methods: A sample of 120 subjects in the reproductive age group with a diagnosis of infertility was screened for the presence of OSA using two standard questionnaires—STOPBANG and Modified Berlin questionnaire. Results: The prevalence of high-risk OSA in infertile subjects was 7.5% by Modified Berlin and 15% by STOPBANG questionnaire. Overall predictive values of the employed questionnaire were fair (ROC area under curve) AUC 0.521 for Modified Berlin and 0.516 for STOPBANG. Multivariate logistic regression analysis revealed male gender, snoring, body mass index (BMI) >25 kg/m2, and neck circumference >40 cm as significant risk factors for moderate to severe sleep apnea among infertile subjects. Conclusion: There is increased OSA risk among infertile people and hence the clinical suspicion of OSA should be increased among infertile people with the polycystic ovarian syndrome (PCOS), oligozoospermia, hypertension, diabetes, and obesity. Clinical significance: Identification of OSA risk among infertile people forms a new perspective in the field of reproductive medicine, thereby helping us to achieve a high success rate in infertility treatment.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"87 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79037554","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 : 2021-03-09DOI: 10.5005/JP-JOURNALS-10016-1203
P. Selvaraj, Moushmi B. Parpillewar, J. Fidvi
Ab s t r Ac t Background: Infertility is a worldwide problem affecting people of all geographical location and socioeconomic status. It is estimated that globally 60–80 million couples suffer from infertility every year. The main objective of the study is to detect the diagnostic efficacy of hysterolaparoscopy in evaluating the tubal, uterine, ovarian, and pelvic pathologies causing infertility and also compare the findings of a hysterosalpingogram with diagnostic laparoscopy in evaluating the tubal factor infertility. Materials and methods: This hospital-based cross-sectional study included an evaluation of 1,456 couples presenting with complaints of infertility at the Outpatient Department of Government Medical College, Nagpur during the period of February 2016 to September 2018. After thorough gynecological examination and investigations, 130 infertile women were posted for diagnostic hysterolaparoscopy. All the data were collected on predesigned proforma and the results were tabulated and raw percentages calculated to describe the results. Results: Among the 130 infertile women, 102 women (78.46%) had primary and 28 (21.53%) had secondary infertility. The maximum number of patients belonged to the age group of 26–30 years (39.23%). About 56% of patients were in the active marriage life of 3–5 years duration. Most of them had multiple factors affecting their fertility. Out of the 130 infertile women, 32 patients (24.62%) had uterine factors, 44 patients (33.84%) had peritoneal factors, 67 patients (51.5%) had ovarian factors, and 89 patients (68.46%) had tubal factors. Only eight patients (6.15%) had normal findings in laparoscopy. Out of the 130 patients, 122 (93.84%) had more than one factor causing infertility. About 26.15% of patients had positive findings in diagnostic hysteroscopy. Conclusion: Hysterolaparoscopy provides both a panoramic view of the pelvic reproductive anatomy and also a magnified view of the pelvic organs and peritoneal surfaces. It is generally regarded as the most reliable tool in the diagnosis of tubal pathology and other intra-abdominal causes of infertility because of the correctable abnormalities like endometriosis, adnexal adhesions, and septate uterus which are usually missed, are usually identified that helps in formulating a specific plan of management.
{"title":"Diagnostic Hysterolaparoscopy in the Evaluation of Female Factor Infertility: A Cross-sectional Study at a Tertiary Care Hospital in Central India","authors":"P. Selvaraj, Moushmi B. Parpillewar, J. Fidvi","doi":"10.5005/JP-JOURNALS-10016-1203","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1203","url":null,"abstract":"Ab s t r Ac t Background: Infertility is a worldwide problem affecting people of all geographical location and socioeconomic status. It is estimated that globally 60–80 million couples suffer from infertility every year. The main objective of the study is to detect the diagnostic efficacy of hysterolaparoscopy in evaluating the tubal, uterine, ovarian, and pelvic pathologies causing infertility and also compare the findings of a hysterosalpingogram with diagnostic laparoscopy in evaluating the tubal factor infertility. Materials and methods: This hospital-based cross-sectional study included an evaluation of 1,456 couples presenting with complaints of infertility at the Outpatient Department of Government Medical College, Nagpur during the period of February 2016 to September 2018. After thorough gynecological examination and investigations, 130 infertile women were posted for diagnostic hysterolaparoscopy. All the data were collected on predesigned proforma and the results were tabulated and raw percentages calculated to describe the results. Results: Among the 130 infertile women, 102 women (78.46%) had primary and 28 (21.53%) had secondary infertility. The maximum number of patients belonged to the age group of 26–30 years (39.23%). About 56% of patients were in the active marriage life of 3–5 years duration. Most of them had multiple factors affecting their fertility. Out of the 130 infertile women, 32 patients (24.62%) had uterine factors, 44 patients (33.84%) had peritoneal factors, 67 patients (51.5%) had ovarian factors, and 89 patients (68.46%) had tubal factors. Only eight patients (6.15%) had normal findings in laparoscopy. Out of the 130 patients, 122 (93.84%) had more than one factor causing infertility. About 26.15% of patients had positive findings in diagnostic hysteroscopy. Conclusion: Hysterolaparoscopy provides both a panoramic view of the pelvic reproductive anatomy and also a magnified view of the pelvic organs and peritoneal surfaces. It is generally regarded as the most reliable tool in the diagnosis of tubal pathology and other intra-abdominal causes of infertility because of the correctable abnormalities like endometriosis, adnexal adhesions, and septate uterus which are usually missed, are usually identified that helps in formulating a specific plan of management.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"1 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82866257","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 : 2021-03-09DOI: 10.5005/JP-JOURNALS-10016-1202
H. Hannachi, H. Elloumi, S. B. Khlifa, M. Hamdoun, K. Kacem, O. Bahri
Ab s t r Ac t Background: Leukocytospermia (LCS) is implicated in male infertility since it was found in 30% of the infertile male. However, its influence on semen parameters remains controversial. Aims and objectives: This study aimed to determine the impact of LCS on semen parameters and intracytoplasmic sperm injection (ICSI) results in infertile couples. Materials and methods: A retrospective clinical study was conducted at Aziza Othmana Hospital of Tunis. Sperm parameters from infertile men were studied for volume, motility, vitality, and morphology according to seminal leukocytes. Intracytoplasmic sperm injection results were also compared to those observed in a control group matched by age, ICSI indication, hormonal profile, and endometrium thickness. Results: No statistical difference was observed for all semen characteristics except the volume which was higher for the non-leukospermic group (p = 0.035). Conclusion: Intracytoplasmic sperm injection outcomes were lower in the leukospermic group than the controls but the difference was not statistically significant.
{"title":"Influence of Leukocytospermia on Semen Parameters and the Outcome of Intracytoplasmic Sperm Injection","authors":"H. Hannachi, H. Elloumi, S. B. Khlifa, M. Hamdoun, K. Kacem, O. Bahri","doi":"10.5005/JP-JOURNALS-10016-1202","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1202","url":null,"abstract":"Ab s t r Ac t Background: Leukocytospermia (LCS) is implicated in male infertility since it was found in 30% of the infertile male. However, its influence on semen parameters remains controversial. Aims and objectives: This study aimed to determine the impact of LCS on semen parameters and intracytoplasmic sperm injection (ICSI) results in infertile couples. Materials and methods: A retrospective clinical study was conducted at Aziza Othmana Hospital of Tunis. Sperm parameters from infertile men were studied for volume, motility, vitality, and morphology according to seminal leukocytes. Intracytoplasmic sperm injection results were also compared to those observed in a control group matched by age, ICSI indication, hormonal profile, and endometrium thickness. Results: No statistical difference was observed for all semen characteristics except the volume which was higher for the non-leukospermic group (p = 0.035). Conclusion: Intracytoplasmic sperm injection outcomes were lower in the leukospermic group than the controls but the difference was not statistically significant.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"101 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77345387","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 : 2021-03-09DOI: 10.5005/JP-JOURNALS-10016-1206
Shruti Gupta
Ab s t r Ac t Purpose: Poor responder is a quasi-cluster of patients whose management has confounded clinicians. Luteal phase stimulation as a solution is proposed on a new principle of follicular development. Case description: Mrs. X, a 34-year-old woman with an anti-Mullerian hormone (AMH) of 0.86 ng/mL and a history of failed in vitro fertilization (IVF) with the recovery of one egg was stimulated in the luteal phase. The patient’s ovarian stimulation was done with menopur 375 IU, cetrotide 0.25 mg was added after 8 days. The stimulation lasted for 15 days. Results: There were seven oocytes recovered, two blastocysts were formed and transferred in a freeze–thaw cycle. This resulted in a live-born preterm fetus at 27 weeks in view of bleeding placenta previa. Conclusion: Luteal phase stimulation can be another reasonable solution in the long list of stimulation regimens for patients who are poor responders.
{"title":"Luteal Start of Stimulation in a Case of Expected Poor Response with the Successful Outcome: A Case Report","authors":"Shruti Gupta","doi":"10.5005/JP-JOURNALS-10016-1206","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1206","url":null,"abstract":"Ab s t r Ac t Purpose: Poor responder is a quasi-cluster of patients whose management has confounded clinicians. Luteal phase stimulation as a solution is proposed on a new principle of follicular development. Case description: Mrs. X, a 34-year-old woman with an anti-Mullerian hormone (AMH) of 0.86 ng/mL and a history of failed in vitro fertilization (IVF) with the recovery of one egg was stimulated in the luteal phase. The patient’s ovarian stimulation was done with menopur 375 IU, cetrotide 0.25 mg was added after 8 days. The stimulation lasted for 15 days. Results: There were seven oocytes recovered, two blastocysts were formed and transferred in a freeze–thaw cycle. This resulted in a live-born preterm fetus at 27 weeks in view of bleeding placenta previa. Conclusion: Luteal phase stimulation can be another reasonable solution in the long list of stimulation regimens for patients who are poor responders.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"247 1","pages":"54-56"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86707210","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 : 2021-03-09DOI: 10.5005/JP-JOURNALS-10016-1205
S. Mangal
Androgens are converted to estrogens by the enzyme called aromatase. This process called aromatization is inhibited by a group of drugs called aromatase inhibitors (AIs). Letrozole is a nonsteroidal inhibitor that reversibly binds aromatase. Decrease in circulating estradiol level leads to release of negative feedback at hypothalamus pituitary level, thereby increasing follicle stimulating hormone (FSH) secretion resulting in stimulation of growth of ovarian follicles. Letrozole is well tolerated and is used in different protocols of ovarian stimulation. The extended spectrum of uses includes addition with gonadotrophins in poor responders, ovarian hyperstimulation syndrome (OHSS) prevention, fertility preservation in cancer patients. Due to its wide range of use, easy availability, affordability and good tolerability, Letrozole has emerged as a first line drug for ovulation induction.
{"title":"Current Knowledge on the Use of Letrozole in Ovarian Stimulation","authors":"S. Mangal","doi":"10.5005/JP-JOURNALS-10016-1205","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1205","url":null,"abstract":"Androgens are converted to estrogens by the enzyme called aromatase. This process called aromatization is inhibited by a group of drugs called aromatase inhibitors (AIs). Letrozole is a nonsteroidal inhibitor that reversibly binds aromatase. Decrease in circulating estradiol level leads to release of negative feedback at hypothalamus pituitary level, thereby increasing follicle stimulating hormone (FSH) secretion resulting in stimulation of growth of ovarian follicles. Letrozole is well tolerated and is used in different protocols of ovarian stimulation. The extended spectrum of uses includes addition with gonadotrophins in poor responders, ovarian hyperstimulation syndrome (OHSS) prevention, fertility preservation in cancer patients. Due to its wide range of use, easy availability, affordability and good tolerability, Letrozole has emerged as a first line drug for ovulation induction.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"117 1","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85299027","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1197
Harpreet Kaur, Sushmita Sharma, Minni Verma
Vitamin D deficiency is a common endocrinological problem. Maternal vitamin D insufficiency during pregnancy has been associated with many pregnancy-related complications like preeclampsia, gestational diabetes (GDM), preterm labor, and low birth weight (LBW). Maternal vitamin D deficiency can lead to poor skeletal growth and reduced bone mineral density in children. To study the prevalence of vitamin D deficiency in antenatal women and to study an association between vitamin D deficiency and maternal and neonatal complications. A prospective study of 100 antenatal women presenting to obstetrics and gynaecology OPD at GSMCH, Banur. Out of these, data from 94 women were finally analyzed. For the rest of the women, follow-up and intrapartum and neonatal details were not available, so they were excluded from the study. The prevalence of vitamin D deficiency in the present study was 79.8%. The rate of small for gestational age babies (SGA) and oligohydramnios was significantly higher in the study group. There was no significant difference in the incidence of GDM, preterm labor, and preterm premature rupture of membranes (PTPROM). Antenatal vitamin D deficiency is associated with hypertensive disorders of pregnancy (HDP), SGA, oligohydramnios, and LBW. So, routine vitamin D supplementation should be recommended in the antenatal period. Kaur H, Sharma S, Verma M. Vitamin D Deficiency in Pregnancy and Its Effect on Maternal and Perinatal Outcome. Int J Infertil Fetal Med 2020;11(1):11–15.
{"title":"Vitamin D Deficiency in Pregnancy and Its Effect on Maternal and Perinatal Outcome","authors":"Harpreet Kaur, Sushmita Sharma, Minni Verma","doi":"10.5005/JP-JOURNALS-10016-1197","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1197","url":null,"abstract":"\u0000\u0000\u0000Vitamin D deficiency is a common endocrinological problem. Maternal vitamin D insufficiency during pregnancy has been associated with many pregnancy-related complications like preeclampsia, gestational diabetes (GDM), preterm labor, and low birth weight (LBW). Maternal vitamin D deficiency can lead to poor skeletal growth and reduced bone mineral density in children.\u0000\u0000\u0000\u0000To study the prevalence of vitamin D deficiency in antenatal women and to study an association between vitamin D deficiency and maternal and neonatal complications.\u0000\u0000\u0000\u0000A prospective study of 100 antenatal women presenting to obstetrics and gynaecology OPD at GSMCH, Banur. Out of these, data from 94 women were finally analyzed. For the rest of the women, follow-up and intrapartum and neonatal details were not available, so they were excluded from the study.\u0000\u0000\u0000\u0000The prevalence of vitamin D deficiency in the present study was 79.8%. The rate of small for gestational age babies (SGA) and oligohydramnios was significantly higher in the study group. There was no significant difference in the incidence of GDM, preterm labor, and preterm premature rupture of membranes (PTPROM).\u0000\u0000\u0000\u0000Antenatal vitamin D deficiency is associated with hypertensive disorders of pregnancy (HDP), SGA, oligohydramnios, and LBW. So, routine vitamin D supplementation should be recommended in the antenatal period.\u0000\u0000Kaur H, Sharma S, Verma M. Vitamin D Deficiency in Pregnancy and Its Effect on Maternal and Perinatal Outcome. Int J Infertil Fetal Med 2020;11(1):11–15.\u0000","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46164164","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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