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Clinical Outcome of Intracytoplasmic Sperm Injection using Long Protocol 长方案卵胞浆内单精子注射的临床效果
Q4 Medicine Pub Date : 2018-08-01 DOI: 10.5005/JP-JOURNALS-10016-1163
D. Arun
Primary aim: To study the outcome of intracytoplasmic sperm injection (ICSI) using long protocol. Analysis of the average number of days of stimulation, the incidence of ovarian hyperstimulation syndrome (OHSS), and the number and quality of oocyte retrieved. Secondary aim: Correlation of the outcome against the stimulation phase length Method: Retrospective study of 50 patients who underwent in vitro fertilisation (IVF) using the long protocol in our ART unit during December 2014 to December 2015. All clinical observations including the patient details, number of days of stimulation, the number of oocytes retrieved, the occurrence of OHSS were collected and tabulated. All clinical data were statistically analyzed. Result: The clinical outcome of ICSI using long protocol was satisfactory. In the study group, we achieved 72% grade 1 embryo (36) and 2 weeks after embryo transfer the biochemical testing for pregnancy showed positive pregnancy in 52% (26). The average stimulation phase length was 13.5 days, (SD 5.5). The incidence of severe OHSS needing hospitalization and treatment was 2% (1/50). 8 patients observed to have evidence of mild OHSS. OHSS was observed in patients with a shorter period of stimulation phase, mean SPL among OHSS patient was 11.38 ( SD -1.6). However, it was not statistically significant ( p–0.507). The stimulation phase length did not correlate with the quality of oocyte nor the pregnancy rate as hypothesized theoretically. Conclusion: The present study shows satisfactory clinical outcome using long protocol,the stimulation phase length did not show significant ill effects in the clinical outcome (72% grade 1 embryo, 52% pregnancy), nor increase complications like severe OHSS.
主要目的:研究采用长方案的卵胞浆内单精子注射(ICSI)的结果。分析平均刺激天数、卵巢过度刺激综合征(OHSS)发生率、取卵数量和质量。次要目的:结果与刺激期长度的相关性方法:回顾性研究2014年12月至2015年12月在我们的ART单元使用长方案进行体外受精(IVF)的50例患者。收集所有临床观察资料,包括患者详细情况、刺激天数、取卵数、OHSS发生情况。对所有临床资料进行统计学分析。结果:采用长方案进行ICSI的临床效果满意。在研究组中,我们获得了72%的1级胚胎(36例),胚胎移植2周后妊娠生化检测显示52%(26例)妊娠阳性。平均刺激阶段长度为13.5天(SD 5.5)。重度OHSS需要住院治疗的发生率为2%(1/50)。8例患者有轻度OHSS症状。OHSS患者刺激期较短,平均SPL为11.38 (SD -1.6)。但差异无统计学意义(p-0.507)。刺激期长度与卵母细胞质量和受孕率没有理论假设的相关性。结论:本研究采用长方案,临床效果满意,刺激相长度未对临床结果产生明显不良影响(1级胚胎72%,妊娠52%),未增加严重OHSS等并发症。
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引用次数: 0
Prenatal Diagnosis and Counseling in Case of Congenital Hemivertebra 先天性半椎体病的产前诊断与咨询
Q4 Medicine Pub Date : 2018-08-01 DOI: 10.5005/JP-JOURNALS-10016-1166
N. Shah, S. Gambhir
Hemivertebra is a rare congenital disorder, where only one side of the vertebral body develops and it is even rarer to find it associated with a longitudinal bar. Prenatal ultrasound diagnostic features along with postnatal radiological correlation at 20 weeks gestation are presented in this report. Also, the relevant background, incidence, and associations are discussed for the clinicians especially obstetricians and radiologists to make them familiar with this condition.
半椎体病是一种罕见的先天性疾病,其中只有一侧的椎体发育,更罕见的是发现它与纵向棒。产前超声诊断特征以及产后放射学相关性在妊娠20周提出了这个报告。此外,本文还讨论了相关背景、发病率和相关性,以便临床医生特别是产科医生和放射科医生熟悉此病。
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引用次数: 0
Sociodemographic Characteristics and Clinical Presentation of Infertile Women with Polycystic Ovary Syndrome in a Tertiary Care Hospital 某三级医院多囊卵巢综合征不孕妇女的社会人口学特征及临床表现
Q4 Medicine Pub Date : 2018-08-01 DOI: 10.5005/JP-JOURNALS-10016-1165
Vandana Nimbargi, Asha Am Mangalath, A. Alias, M. Sajith, Shivhar Kumdale
Background: Infertility has been an issue of concern especially for women for decades, and one of the identified etiological factors is polycystic ovary syndrome (PCOS) that impact on ovulation and conception. Aim: This study aims to study the sociodemographic characteristics and clinical presentationof infertile women with (POS). Materials and methods : In this prospective case-control study, out of 150 infertile patients 75 women served as PCOS group. The demographic details such as age, socioeconomic class, employment status residential area, Body mass index, menstrual patterns, clinical presentation, and infertility related lab values were noted.The collected data were statistically analyzed using the Chi-square test. Results: The prevalence of PCOS was high in the age group 24 to 27 years (37.33%), from middle socioeconomic class (45%), residing in urban areas (62.67%) and housewives (65.33%). Most of the PCOS patients were overweight (32%) and obese (21.33%) and showed statistical significance p = 0.021 and p = 0.021 respectively. Oligomenorrhea (54.67%) and amenorrhea (40%) were the commonly found clinical presentations. Weight gain (p = 0.000) and acne (p = 0.049) were found to be significant. Also, a significant relationship was seen for Luteinizing Hormone (LH) (p = 0.003) and Prolactin (p = 0.001) in both groups. Conclusion: In this study, the prevalence of PCOS was high in patients from a middle socio-economic class, residing in urban areas and obese patients. Oligomenorrhea was found to be the most common clinical presentation in PCOS patients. Furthermore, evidence of high LH and Prolactin levels were found that is known to be associated with hyperandrogenism in PCOS patients.
背景:数十年来,不孕症一直是人们关注的问题,尤其是女性,其中一个确定的病因是多囊卵巢综合征(PCOS),它影响排卵和受孕。目的:探讨不孕症(POS)妇女的社会人口学特征及临床表现。材料与方法:在本前瞻性病例对照研究中,150例不孕症患者中75例作为PCOS组。记录了年龄、社会经济阶层、就业状况、居住区域、体重指数、月经模式、临床表现和不孕相关的实验室值等人口统计学细节。收集的资料采用卡方检验进行统计学分析。结果:PCOS患病率以24 ~ 27岁年龄组(37.33%)、中等社会经济阶层(45%)、城镇居民(62.67%)和家庭主妇(65.33%)居多。PCOS患者以超重(32%)和肥胖(21.33%)居多,差异有统计学意义p = 0.021和p = 0.021。少经(54.67%)和闭经(40%)是常见的临床表现。体重增加(p = 0.000)和痤疮(p = 0.049)是显著的。在两组中,黄体生成素(LH) (p = 0.003)和催乳素(p = 0.001)也存在显著相关性。结论:本研究中,多囊卵巢综合征在中等社会经济阶层、城市居民和肥胖患者中患病率较高。月经稀少是多囊卵巢综合征患者最常见的临床表现。此外,高LH和催乳素水平的证据被发现与多囊卵巢综合征患者的高雄激素症有关。
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引用次数: 5
An Exploratory Study on Treatment Seeking Behavior and Pathways of Care Followed by Couples Attending Infertility Clinic 不孕症门诊就诊夫妇求医行为及护理途径的探索性研究
Q4 Medicine Pub Date : 2018-08-01 DOI: 10.5005/JP-JOURNALS-10016-1162
H. Kaur, Sunita Sharma, S. Ghai, Nitasha Sharma, Inderjit N. Kaur, J. Kaur
Objective: The main aim of present study was to explore the treatment seeking behavior and pathways of care followed by couples attending infertility clinic at a tertiary care center. Research design: The study adopted an exploratory research design. Using total enumeration technique a total of 40 infertile couples were interviewed using semistructured interview schedule. Results: Out of total, 82% couples visited 1–4 healthcare agencies before coming to a tertiary care center. Among all treatment settings and options, majority (62%) visited private health sector as first health agency. Based on first health agency visited a total of three care pathways were revealed with longest pathway comprised total of nine health agencies out of which four were private practitioners. Conclusion: The infertile couples try varied forms of treatments before reaching a tertiary center shuttling from one agency to another. This drains them of all hope and energy for successful treatment.
目的:本研究的主要目的是探讨在三级保健中心不孕不育门诊就诊的夫妇的求医行为和护理途径。研究设计:本研究采用探索性研究设计。采用全枚举法,采用半结构化访谈法对40对不育夫妇进行访谈。结果:总的来说,82%的夫妇在来到三级医疗中心之前访问了1-4个医疗机构。在所有治疗环境和选择中,大多数(62%)将私营卫生部门作为第一卫生机构。根据访问的第一个卫生机构,总共发现了三条护理途径,最长的途径由总共9个卫生机构组成,其中4个是私人医生。结论:不育夫妇在到达三级中心之前尝试了各种形式的治疗,从一个机构穿梭到另一个机构。这耗尽了他们对成功治疗的所有希望和精力。
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引用次数: 2
Abnormal Uterine Bleeding in Perimenopausal Women: Relevance of Transvaginal Ultrasound, Office Endometrial Biopsy, Dilatation and Curettage—An Observational Study 围绝经期妇女异常子宫出血:经阴道超声、办公室子宫内膜活检、扩张和刮除的相关性——一项观察性研究
Q4 Medicine Pub Date : 2018-08-01 DOI: 10.5005/jp-journals-10016-1164
Ashwin Pai, S. Kodandapani
Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation due to the risk of endometrial malignancy. Symptomatic women with thick endometrium by transvaginal ultrasound (TVS) warrant endometrial sampling. D&C has been the mainstay over decades whereas pipelle has gained popularity due to good tissue yield and easy technique with no admission or anesthesia. This study aims to determine the use of office endometrial biopsy in perimenopausal women with AUB and the endometrial pathology detected by TVS. Materials and methods: In this observational study over five years, 159 women with AUB who underwent endometrial sampling were included. The patients were randomly assigned D&C or pipelle depending on symptoms and endometrial thickness after clinical examination and laboratory investigations. 79.2% of women underwent office endometrial sampling, and 20.8% underwent D&C. samples were sent for histopathology. Statistical analysis was done with respect to the type of sampling and endometrial thickness by TVS. Results: Mean age of the study group was 44 years. About 60.3% of these women had ET of 10–20 mm. It was noted that women with thinner endometrium had more benign lesions and no atypia or malignancy. Sampling was 100% adequate in D&C cases compared to 97.8% of office biopsy group, though statistically not significant. Office endometrial biopsy and D&C yielded adequate sample and a reliable histopathological report and were comparable with respect to sampling, reports and endometrial thickness. Endometrial malignancy was diagnosed in 1.3% of the study group. 56.6% of women had simple hyperplasia without atypia, and 27% had a normal endometrium. Conclusion: Office endometrial biopsy is a sensitive method to detect abnormal endometrium in women with AUB. Diagnostic Office endometrial sampling is comparable to D&C with lesser complications. TVS prior to endometrial sampling improves the sensitivity to diagnose endometrial pathology.
引言:由于子宫内膜恶性肿瘤的风险,围绝经期妇女子宫异常出血(AUB)需要仔细评估。经阴道超声(TVS)检查有症状的子宫内膜厚的妇女需要子宫内膜取样。约几十年来一直是支柱而pipelle已经得到普及,因为没有配好的组织产量和简单的技术或麻醉。本研究旨在确定办公室子宫内膜活检在围绝经期AUB妇女中的应用以及TVS检测的子宫内膜病理。材料和方法:在这项为期5年的观察性研究中,纳入了159名接受子宫内膜取样的AUB妇女。经临床检查和实验室检查后,根据患者症状和子宫内膜厚度随机分为D&C或管道组。79.2%的女性接受了办公室子宫内膜取样,20.8%的女性接受了D&C。样本送去做组织病理学检查。对TVS取样类型和子宫内膜厚度进行统计分析。结果:研究组平均年龄44岁。这些妇女中约有60.3%的ET为10-20毫米。我们注意到,子宫内膜较薄的女性有更多的良性病变,没有异型或恶性病变。D&C病例的采样率为100%,而办公室活检组的采样率为97.8%,但统计学上不显著。办公室子宫内膜活检和D&C产生足够的样本和可靠的组织病理学报告,并在采样,报告和子宫内膜厚度方面具有可比性。子宫内膜恶性肿瘤在研究组中诊断为1.3%。56.6%的女性有单纯增生无异型,27%的女性子宫内膜正常。结论:子宫内膜活检是一种检测AUB患者子宫内膜异常的灵敏方法。诊断办公室子宫内膜取样与D&C相当,并发症较少。子宫内膜取样前TVS可提高子宫内膜病理诊断的敏感性。
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引用次数: 0
Duchenne Muscular Dystrophy: Carrier Discretion to Prenatal Care—Report of a Case 杜氏肌萎缩症:携带者对产前护理的判断——1例报告
Q4 Medicine Pub Date : 2018-01-01 DOI: 10.5005/jp-journals-10016-1168
K. Rao, S. Agarwal, A. Rajendran, Sushma Madhuprakash
Duchenne muscular dystrophy (DMD) is the most common hereditary cause of neuromuscular weakness and the most common of X-linked recessive diseases. It is caused by a mutation in the DMD gene located on chromosome X, 21.2 locus that encodes the dystrophin protein. Nucleic acid analytical techniques have advanced so much that the identification of potential carriers is possible by assessment of the causative mutations. The following case report describes the identification of a denovo dystrophin gene mutation in a carrier female and the subsequent antenatal workup of her present pregnancy
杜氏肌营养不良症(DMD)是神经肌肉无力最常见的遗传原因,也是最常见的x连锁隐性疾病。它是由位于X染色体上的DMD基因突变引起的,21.2个位点编码肌营养不良蛋白。核酸分析技术的进步使得通过评估致病突变来识别潜在的携带者成为可能。以下病例报告描述了一种先天性肌营养不良蛋白基因突变的鉴定,并在随后的产前检查,她目前的怀孕
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引用次数: 0
Bilateral Ovarian Torsion: A Rare Complication of Ovarian Stimulation in In Vitro Fertilization 双侧卵巢扭转:体外受精中卵巢刺激的一种罕见并发症
Q4 Medicine Pub Date : 2018-01-01 DOI: 10.5005/jp-journals-10016-1167
A. Rajendran, K. Rao, S. Agarwal, Haritha Mannem
Aim: To enlighten about one of the rare complications of ovarian stimulation during in vitro Fertilization (IVF) and how to manage it with early diagnosis and intervention. Background: Torsion of ovary, tube or both are estimated to be responsible for a minimal number of overall gynecological emergencies with an incidence of 2.7–7.4%. It is considered a common diagnostic challenge in any emergency setting. Torsion should be referred and managed at a tertiary health center with all emergency facilities. The trending availability of assisted reproductive technology and its increasing success day by day has resulted in an increase in ovulation induction and its complications including OHSS and ovarian torsion in the present scenario. Case report: At our center, one case of bilateral ovarian torsion as a consequence of controlled ovarian stimulation in a woman with PCOS was reported. This can be considered as a potentially fatal complication of pharmacological stimulation of ovary in assisted reproduction. Life–saving emergency laparoscopic surgery was undertaken. Timely diagnosis and intervention prevented oophorectomy and fertility was preserved. Conclusion: An Early and prompt intervention to preserve ovarian function and conduct a fertility-conserving surgery should be laparoscopic whenever and wherever possible. Detorsion should be the treatment of choice in reproductive age women whose families are incomplete, regardless of the fact of the color of the ovary. Oophoropexy may be considered to prevent recurrence. In older women whose family are complete and in postmenopausal women, oophorectomy is the treatment of choice to remove the risk of retorsion. Clinical significance: If on laparoscopy, a cyst whether nonfunctional or not is found in the ovary or paraovarian structure, cystectomy or interval cystectomy should be performed in younger women. Ovarian mutilating surgery is not considered to be a viable option in the management of torsion in a patient who is undergoing fertility preserving management except in cases with complete tissue necrosis.
目的:探讨体外受精(IVF)过程中卵巢刺激的一种罕见并发症及如何及早诊断和干预。背景:据估计,卵巢、输卵管或两者的扭转是导致总体妇科急诊数量最少的原因,发生率为2.7-7.4%。它被认为是任何紧急情况下常见的诊断难题。应在具有所有急救设施的三级保健中心转诊并进行治疗。辅助生殖技术的发展趋势及其日益提高的成功率导致了排卵诱导及其并发症的增加,包括OHSS和卵巢扭转。病例报告:我们报告了一例多囊卵巢综合征(PCOS)患者在控制卵巢刺激后出现双侧卵巢扭转的病例。这可以被认为是辅助生殖中卵巢药物刺激的潜在致命并发症。进行了挽救生命的紧急腹腔镜手术。及时的诊断和干预预防了卵巢切除术,保留了生育能力。结论:无论何时何地,只要有可能,腹腔镜下手术应及早、及时干预,以保持卵巢功能并进行保生育手术。对于家庭不完整的育龄妇女,无论卵巢的颜色如何,卵巢扭曲都应该是治疗的选择。可考虑卵巢切除术以防止复发。在家庭完整的老年妇女和绝经后妇女中,卵巢切除术是消除复发风险的治疗选择。临床意义:如果在腹腔镜下发现卵巢或卵巢旁结构内的囊肿,不论有无功能,年轻女性均应行膀胱切除术或间歇膀胱切除术。卵巢残割手术不被认为是一个可行的选择,在扭转的病人谁正在进行生育保留管理,除非是完全组织坏死的情况下。
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引用次数: 0
Restoring Fertility in Cancer Survivors: Ovarian Tissue Cryopreservation or Assisted Reproduction Technique 恢复癌症幸存者的生育能力:卵巢组织冷冻保存或辅助生殖技术
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.5005/JP-JOURNALS-10016-1143
K. Priya, P. Divyashree, K. Rao
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引用次数: 0
A Retrospective Study of Recipient-related Predictors of Success in an Oocyte Donation Program 卵母细胞捐赠计划中受者相关成功预测因素的回顾性研究
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.5005/JP-JOURNALS-10016-1152
R. Punhani, S. Balasubramanyam, K. Shankar, Thankam R. Varma, K. Rao
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引用次数: 1
Laparoscopic Ovarian Drilling in Clomiphene-resistant Polycystic Ovarian Syndrome Women: A Retrospective Analysis 克罗米芬耐药多囊卵巢综合征妇女腹腔镜卵巢钻孔:回顾性分析
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.5005/jp-journals-10016-1155
Sumi V Thomas, Vivek P Vithayathil, A. Chandy, T. K. Aleyamma, M. Kamath, K. Rao
{"title":"Laparoscopic Ovarian Drilling in Clomiphene-resistant Polycystic Ovarian Syndrome Women: A Retrospective Analysis","authors":"Sumi V Thomas, Vivek P Vithayathil, A. Chandy, T. K. Aleyamma, M. Kamath, K. Rao","doi":"10.5005/jp-journals-10016-1155","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1155","url":null,"abstract":"","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"4 1","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90092868","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}
引用次数: 0
期刊
International Journal of Infertility and Fetal Medicine
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