Pub Date : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1160
Harsha Bhadarka, NayanaH Patel, Yuvraj D Jadeja, K. Patel, Niket Patel, M. Patel, K. Rao
Introduction: To report the first case of live birth after double trophectoderm biopsy before and after vitrification on the same cohort of blastocyst in our knowledge. Design: Case report. Patient: A 36-year-old female with a history of 13 years of active married life for treatment of infertility. Main outcome measure: Live birth after double trophectoderm biopsy. Results: Double biopsy preand postvitrification and its positive outcome. Conclusion: Preimplantation genetic screening and diagnosis (PGS/PGD), though an invasive procedure on the embryos, when done meticulously would not dampen the implantation potential of the embryo and second biopsy could be a feasible option to salvage embryos with inconclusive or suspected falsepositive PGS/PGD reports.
{"title":"First Case of Successful Implantation and Live Birth after Double Trophectoderm Biopsy before and after Vitrification on the Same Cohort of Blastocyst","authors":"Harsha Bhadarka, NayanaH Patel, Yuvraj D Jadeja, K. Patel, Niket Patel, M. Patel, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1160","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1160","url":null,"abstract":"Introduction: To report the first case of live birth after double trophectoderm biopsy before and after vitrification on the same cohort of blastocyst in our knowledge. Design: Case report. Patient: A 36-year-old female with a history of 13 years of active married life for treatment of infertility. Main outcome measure: Live birth after double trophectoderm biopsy. Results: Double biopsy preand postvitrification and its positive outcome. Conclusion: Preimplantation genetic screening and diagnosis (PGS/PGD), though an invasive procedure on the embryos, when done meticulously would not dampen the implantation potential of the embryo and second biopsy could be a feasible option to salvage embryos with inconclusive or suspected falsepositive PGS/PGD reports.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"2 1","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77900639","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1142
D. Preethi, L. Rai, M. Nambiar, Pratap Kumar, M. Pai, S. Amin
Introduction: The aim of this study was to evaluate the relevance of routinely done laboratory parameters in women with hypertensive disorders in pregnancy. Materials and methods: Hypertensive pregnant women were divided into two groups based on perinatal outcome as those with and without poor perinatal outcome. They were analyzed with various laboratory tests done at the time of diagnosis: Hematological parameters, such as hemoglobin, hematocrit, platelet count, total leukocyte count, and differential count; renal parameters, such as serum urea, creatinine, and uric acid; liver function tests; and serum lactate dehydrogenase (LDH). Coagulation parameters, such as prothrombin time, activated partial thromboplastin time, and international normalized ratio were compared between the two groups. Data were presented as mean ± standard deviation; α level of p < 0.05 was set as statistically significant. Results: Among the various hematological parameters, platelet count showed statistically significant differences between hypertensives with and without perinatal mortality or morbidity (p = 0.029, p = 0.029 respectively). All renal parameters showed statistically significant differences (p ≤ 0.005). Serum aspartate aminotransferase (p = 0.034) among the liver parameters and serum LDH (p = 0.024) showed statistically significant differences between the two groups. Coagulation parameters were abnormal among patients with thrombocytopenia. Conclusion: Blood pressure alone is not sufficient in monitoring women with hypertensive disorders in pregnancy. Laboratory parameters that are cost-effective and routinely done in most laboratories are significant in assessing the severity of maternal disease and the perinatal outcome. It can hence, be used to monitor hypertensive women in pregnancy.
{"title":"Role of laboratory investigations to assess maternal and perinatal outcome in hypertensive mothers","authors":"D. Preethi, L. Rai, M. Nambiar, Pratap Kumar, M. Pai, S. Amin","doi":"10.5005/JP-JOURNALS-10016-1142","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1142","url":null,"abstract":"Introduction: The aim of this study was to evaluate the relevance of routinely done laboratory parameters in women with hypertensive disorders in pregnancy. Materials and methods: Hypertensive pregnant women were divided into two groups based on perinatal outcome as those with and without poor perinatal outcome. They were analyzed with various laboratory tests done at the time of diagnosis: Hematological parameters, such as hemoglobin, hematocrit, platelet count, total leukocyte count, and differential count; renal parameters, such as serum urea, creatinine, and uric acid; liver function tests; and serum lactate dehydrogenase (LDH). Coagulation parameters, such as prothrombin time, activated partial thromboplastin time, and international normalized ratio were compared between the two groups. Data were presented as mean ± standard deviation; α level of p < 0.05 was set as statistically significant. Results: Among the various hematological parameters, platelet count showed statistically significant differences between hypertensives with and without perinatal mortality or morbidity (p = 0.029, p = 0.029 respectively). All renal parameters showed statistically significant differences (p ≤ 0.005). Serum aspartate aminotransferase (p = 0.034) among the liver parameters and serum LDH (p = 0.024) showed statistically significant differences between the two groups. Coagulation parameters were abnormal among patients with thrombocytopenia. Conclusion: Blood pressure alone is not sufficient in monitoring women with hypertensive disorders in pregnancy. Laboratory parameters that are cost-effective and routinely done in most laboratories are significant in assessing the severity of maternal disease and the perinatal outcome. It can hence, be used to monitor hypertensive women in pregnancy.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"2 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73279740","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1159
P. Sharma, M. Mittal, K. Rao
Aim: To present an overview of the current Artificial Reproductive Techniques (ART) guidelines focussing on grey zones Introduction: Infertility is a major health and social concern in modern day India. Due to the great diversity in management protocols and absence of standard operating procedures, there is a necessity to develop country-specific guidelines for assisted reproduction. Also, there is need to curb unethical practices. Guidelines in this regard have undergone several changes over the years. It is important that adequate care is taken before the bill becomes a law so that both patients and health workers mutually benefit from ART Overview: The present article gives an insight into the development of guidelines over the years with elaboration of the salient features of the current ART Bill under specific chapter headings, ten chapters in total. Also discussed is the recent Surrogacy Bill. In each context, critical analysis is provided that underscores the grey areas that need to be addressed. At the end of the article, certain recommendations have been put forward to aid the successful implementation of current guidelines Clinical significance: It is imperative that all ART practitioners be well versed with the current ART guidelines as ignorance cannot be cited as an excuse under any circumstance. Also, practitioners can give valuable inputs before the bill finally becomes a law. The law must ensure that physicians are not unnecessarily persecuted in the name of patient rights, as this will lead to fearful practice, which in turn will hamper patient management.
{"title":"Critical Analysis of the Current Assisted Reproductive Technology Guidelines","authors":"P. Sharma, M. Mittal, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1159","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1159","url":null,"abstract":"Aim: To present an overview of the current Artificial Reproductive Techniques (ART) guidelines focussing on grey zones Introduction: Infertility is a major health and social concern in modern day India. Due to the great diversity in management protocols and absence of standard operating procedures, there is a necessity to develop country-specific guidelines for assisted reproduction. Also, there is need to curb unethical practices. Guidelines in this regard have undergone several changes over the years. It is important that adequate care is taken before the bill becomes a law so that both patients and health workers mutually benefit from ART Overview: The present article gives an insight into the development of guidelines over the years with elaboration of the salient features of the current ART Bill under specific chapter headings, ten chapters in total. Also discussed is the recent Surrogacy Bill. In each context, critical analysis is provided that underscores the grey areas that need to be addressed. At the end of the article, certain recommendations have been put forward to aid the successful implementation of current guidelines Clinical significance: It is imperative that all ART practitioners be well versed with the current ART guidelines as ignorance cannot be cited as an excuse under any circumstance. Also, practitioners can give valuable inputs before the bill finally becomes a law. The law must ensure that physicians are not unnecessarily persecuted in the name of patient rights, as this will lead to fearful practice, which in turn will hamper patient management.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"78 1","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86791509","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1158
Purvi K. Khanuja, J. Sunny, Sunita Pawar, Vandana Nimbargi, K. Rao
{"title":"Study on Infertility—Etiology, Medication Therapy Management, and Outcomes at a Tertiary Care Hospital","authors":"Purvi K. Khanuja, J. Sunny, Sunita Pawar, Vandana Nimbargi, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1158","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1158","url":null,"abstract":"","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"65 1","pages":"106-112"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89086478","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1151
Hemant Shintre, H. Pai, D. Talreja, K. R. Shah, K. Rao
Aim: To compare reproductive outcomes of day 2 and day 3 embryo transfer (ET). Materials and methods: In this retrospective records study, all couples who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and ET cycles at Lilavati Hospital & Research Centre over a period of 1 year were studied. Data were collected and analyzed by chi-square test and unpaired t-test by Statistical Package for the Social Sciences, version 16. Results: There was no statistically significant difference between the clinical and demographic parameters of group day 3 and day 2 ET. In our study, clinical pregnancy rate was 45% in day 3 ET and 36.5% in day 2 ET group [odds ratio (OR) 1.43, p-value 0.49]. The ongoing pregnancy rate was 39.2% in day 3 ET and 26.9% in day 2 ET group (OR 1.75, p-value 0.26). We observed that the miscarriage rate was 5.9% in day 3 ET and was 5.8% in day 2 ET group (p-value 0.69, OR 1.02). We observed one case each of multiple pregnancy, ectopic pregnancy, and fetal anomaly (anencephaly) in day 2 ET group, while in day 3 ET group, no such case was detected. Conclusion: There are chances that day 3 ET has better clinical and ongoing pregnancy rates than day 2 ET, but the difference is not statistically significant. Study showed similar miscarriage rates in both groups and very low incidence of complications like multiple pregnancy, ectopic pregnancy, and fetal anomaly. So, it is safe to schedule and transfer embryos either on day 2 or on day 3 for planning and programming cycles in coordination with patient and IVF team and for adjusting weekends (nonworking days). Clinical significance: Many steps of IVF procedure became standardized. However, the optimum timing of ET is still debatable. Several studies comparing ET on day 2 vs day 3 after oocyte retrieval have been performed, but the conclusions are conflicting. Despite development in culture media allowing blastocyst transfer, many centers still practice day 2/3 ET.
目的:比较第2天和第3天胚胎移植(ET)的生殖结局。材料和方法:在这项回顾性记录研究中，所有在Lilavati医院和研究中心接受体外受精/胞浆内单精子注射(IVF/ICSI)和ET周期1年的夫妇进行了研究。数据的收集和分析采用卡方检验和非配对t检验，采用Statistical Package for the Social Sciences, version 16。结果:第3天ET组与第2天ET组临床及人口学参数比较，差异无统计学意义。本研究第3天ET组临床妊娠率为45%，第2天ET组临床妊娠率为36.5%[比值比(OR) 1.43, p值0.49]。第3天妊娠率为39.2%，第2天妊娠率为26.9% (OR 1.75, p值0.26)。我们观察到第3天ET组流产率为5.9%，第2天ET组流产率为5.8% (p值0.69,OR 1.02)。第2天ET组多胎妊娠、异位妊娠、胎儿畸形(无脑畸形)各1例，第3天ET组无一例。结论:妊娠第3天的临床和持续妊娠率可能高于妊娠第2天，但差异无统计学意义。研究表明，两组的流产率相似，多胎妊娠、异位妊娠和胎儿畸形等并发症的发生率非常低。因此，在第2天或第3天安排和移植胚胎是安全的，以便与患者和试管婴儿团队协调规划和编程周期，并调整周末(非工作日)。临床意义:试管婴儿的许多步骤变得标准化。然而，ET的最佳时机仍有争议。一些研究比较了卵母细胞提取后第2天和第3天的ET，但结论相互矛盾。尽管培养基的发展允许囊胚转移，但许多中心仍然采用第2/3天的ET。
{"title":"Comparison between Day 2 and Day 3 Embryo Transfer following in vitro Fertilization/Intracytoplasmic Sperm Injection","authors":"Hemant Shintre, H. Pai, D. Talreja, K. R. Shah, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1151","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1151","url":null,"abstract":"Aim: To compare reproductive outcomes of day 2 and day 3 embryo transfer (ET). Materials and methods: In this retrospective records study, all couples who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and ET cycles at Lilavati Hospital & Research Centre over a period of 1 year were studied. Data were collected and analyzed by chi-square test and unpaired t-test by Statistical Package for the Social Sciences, version 16. Results: There was no statistically significant difference between the clinical and demographic parameters of group day 3 and day 2 ET. In our study, clinical pregnancy rate was 45% in day 3 ET and 36.5% in day 2 ET group [odds ratio (OR) 1.43, p-value 0.49]. The ongoing pregnancy rate was 39.2% in day 3 ET and 26.9% in day 2 ET group (OR 1.75, p-value 0.26). We observed that the miscarriage rate was 5.9% in day 3 ET and was 5.8% in day 2 ET group (p-value 0.69, OR 1.02). We observed one case each of multiple pregnancy, ectopic pregnancy, and fetal anomaly (anencephaly) in day 2 ET group, while in day 3 ET group, no such case was detected. Conclusion: There are chances that day 3 ET has better clinical and ongoing pregnancy rates than day 2 ET, but the difference is not statistically significant. Study showed similar miscarriage rates in both groups and very low incidence of complications like multiple pregnancy, ectopic pregnancy, and fetal anomaly. So, it is safe to schedule and transfer embryos either on day 2 or on day 3 for planning and programming cycles in coordination with patient and IVF team and for adjusting weekends (nonworking days). Clinical significance: Many steps of IVF procedure became standardized. However, the optimum timing of ET is still debatable. Several studies comparing ET on day 2 vs day 3 after oocyte retrieval have been performed, but the conclusions are conflicting. Despite development in culture media allowing blastocyst transfer, many centers still practice day 2/3 ET.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"53 1","pages":"68-74"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80404404","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 : 2017-01-01DOI: 10.5005/jp-journals-10016-1156
R. Vohra, S. Priyadarshi, Neeraj Aggarwal, N. Vyas, S. Yadav, V. Tomar, K. Rao
Introduction: Many studies have shown deleterious effects of tobacco abuse in any form on semen quality. We studied the association of tobacco chewing, smoking, and their combination on semen characteristics. Materials and methods: Our study was performed on 216 normal asymptomatic healthy males (49 controls, 54 smokers, 55 tobacco chewers, and 58 consuming both) in the age group of 24 to 35 years. The effect on semen parameters was analyzed. Results: Consuming both forms of tobacco individually and in combination had statistically significant effect on sperm morphology, progressive motility, and semen concentration. Other parameters show nonstatistically significant decline compared with controls. Conclusion: As smoking and chewing tobacco negatively affect quality of semen, strategies should be developed to direct attention of the general population toward its effect on fertility status of male.
{"title":"Study to evaluate Association of Tobacco Chewing and Smoking with Semen Parameters","authors":"R. Vohra, S. Priyadarshi, Neeraj Aggarwal, N. Vyas, S. Yadav, V. Tomar, K. Rao","doi":"10.5005/jp-journals-10016-1156","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1156","url":null,"abstract":"Introduction: Many studies have shown deleterious effects of tobacco abuse in any form on semen quality. We studied the association of tobacco chewing, smoking, and their combination on semen characteristics. Materials and methods: Our study was performed on 216 normal asymptomatic healthy males (49 controls, 54 smokers, 55 tobacco chewers, and 58 consuming both) in the age group of 24 to 35 years. The effect on semen parameters was analyzed. Results: Consuming both forms of tobacco individually and in combination had statistically significant effect on sperm morphology, progressive motility, and semen concentration. Other parameters show nonstatistically significant decline compared with controls. Conclusion: As smoking and chewing tobacco negatively affect quality of semen, strategies should be developed to direct attention of the general population toward its effect on fertility status of male.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"39 1","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84951854","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1149
Sankalp Singh, Swati Singh, A. K. Raman, S. Ramakrishnan, C. Ashraf, K. Rao
Introduction: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that arises due to assisted reproductive technologies (ARTs) during infertility treatment. Recently, the use of selective dopamine receptor agonists on D2 receptors (e.g., cabergoline) has been suggested in the prevention of OHSS. The aim of this study was to evaluate the effect of cabergoline in the prevention of OHSS in high-risk patients undergoing ART. Materials and methods: This was a randomized, double-blind, parallel group (cabergoline group and placebo) study. A total of 110 women undergoing in vitro fertilization (IVF)–intracytoplasmic sperm injection procedure using a long agonist protocol with high risk for OHSS were recruited for the study on the day of final trigger. All the patients were followed up every 48 hours for 10 days from the day of the final trigger and clinically assessed with ultrasound and blood tests. The size of ovaries and fluid collection in the pouch of Douglas (POD) was measured with ultrasound. A sample size of 92 subjects was calculated for the study to be powered at 80%. Assuming a drop-out rate of 10%, 110 subjects were enrolled for the study. Results: There was no significant difference observed in the size of right and left ovary, POD fluid volume, total leukocyte count (TLC), and serum estradiol level (E2 level) between both the groups from day 0 to day 8, except packed cell volume. No significant difference was observed in the incidence rate of moderate OHSS between both groups (p = 0.728). The differences in clinical pregnancy rate, implantation rate, and live birth rate were also insignificant. Conclusion: Cabergoline does not reduce the incidence of moderate OHSS when compared with placebo. Large, welldesigned studies are needed to evaluate the effectiveness of cabergoline when used for the prevention of OHSS.
{"title":"Efficacy of Cabergoline in the Prevention of Ovarian Hyperstimulation Syndrome: A Randomized, Double-blind and Placebo-controlled Trial","authors":"Sankalp Singh, Swati Singh, A. K. Raman, S. Ramakrishnan, C. Ashraf, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1149","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1149","url":null,"abstract":"Introduction: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that arises due to assisted reproductive technologies (ARTs) during infertility treatment. Recently, the use of selective dopamine receptor agonists on D2 receptors (e.g., cabergoline) has been suggested in the prevention of OHSS. The aim of this study was to evaluate the effect of cabergoline in the prevention of OHSS in high-risk patients undergoing ART. Materials and methods: This was a randomized, double-blind, parallel group (cabergoline group and placebo) study. A total of 110 women undergoing in vitro fertilization (IVF)–intracytoplasmic sperm injection procedure using a long agonist protocol with high risk for OHSS were recruited for the study on the day of final trigger. All the patients were followed up every 48 hours for 10 days from the day of the final trigger and clinically assessed with ultrasound and blood tests. The size of ovaries and fluid collection in the pouch of Douglas (POD) was measured with ultrasound. A sample size of 92 subjects was calculated for the study to be powered at 80%. Assuming a drop-out rate of 10%, 110 subjects were enrolled for the study. Results: There was no significant difference observed in the size of right and left ovary, POD fluid volume, total leukocyte count (TLC), and serum estradiol level (E2 level) between both the groups from day 0 to day 8, except packed cell volume. No significant difference was observed in the incidence rate of moderate OHSS between both groups (p = 0.728). The differences in clinical pregnancy rate, implantation rate, and live birth rate were also insignificant. Conclusion: Cabergoline does not reduce the incidence of moderate OHSS when compared with placebo. Large, welldesigned studies are needed to evaluate the effectiveness of cabergoline when used for the prevention of OHSS.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"56 1","pages":"54-60"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72887971","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1161
Aradhana Kalra, A. Nadkarni, P. Nadkarni, Pooja Singh, K. Rao
Background: To review and analyze the incidence of heterotypic pregnancies after intracytoplasmic sperm injection (ICSI) and embryo transfer and to report pregnancy outcome after successful management of heterotypic pregnancies. Setting: Nadkarni’s 21st Century Hospitals and Test Tube Baby Center, Surat, Gujarat, India. Design: Retrospective study. Materials and methods: Retrospective data were taken from hospital records from January 2013 to December 2015. A total of 2,771 patients underwent in vitro fertilization IVF/ICSI, out of which 1,455 patients were pregnant (52.5%). Out of the pregnant patients, the incidence of ectopic (EP) and heterotypic pregnancies was calculated. The etiological factors, management of heterotypic pregnancies, and their pregnancy outcome were reported. Conclusion: Out of the 1,455 pregnant patients, there were 29 EPs (EPs: 1.99%) and 5 were heterotypic (0.34%). Laparoscopic intervention was done for all five of them and successful pregnancy outcome was reported in terms of live birth. Clinical significance: Heterotypic pregnancy is rare and poses a diagnostic dilemma in assisted reproductive technology (ART) cycles. Serial beta-human chorionic gonadotropin (hCG) measurement is not reliable and ultrasonography may not confirm due to the presence of ovarian hyperstimulation syndrome (OHSS) or multiple cysts. Early diagnosis is ideal and good perinatal outcome can be achieved by prompt and excellent laparoscopic management of the heterotypic pregnancies.
{"title":"Successful Live Births after Laparoscopic Management of Heterotypic Pregnancies in Assisted Reproductive Technology Cycles: A Tertiary Fertility Center Experience","authors":"Aradhana Kalra, A. Nadkarni, P. Nadkarni, Pooja Singh, K. Rao","doi":"10.5005/JP-JOURNALS-10016-1161","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1161","url":null,"abstract":"Background: To review and analyze the incidence of heterotypic pregnancies after intracytoplasmic sperm injection (ICSI) and embryo transfer and to report pregnancy outcome after successful management of heterotypic pregnancies. Setting: Nadkarni’s 21st Century Hospitals and Test Tube Baby Center, Surat, Gujarat, India. Design: Retrospective study. Materials and methods: Retrospective data were taken from hospital records from January 2013 to December 2015. A total of 2,771 patients underwent in vitro fertilization IVF/ICSI, out of which 1,455 patients were pregnant (52.5%). Out of the pregnant patients, the incidence of ectopic (EP) and heterotypic pregnancies was calculated. The etiological factors, management of heterotypic pregnancies, and their pregnancy outcome were reported. Conclusion: Out of the 1,455 pregnant patients, there were 29 EPs (EPs: 1.99%) and 5 were heterotypic (0.34%). Laparoscopic intervention was done for all five of them and successful pregnancy outcome was reported in terms of live birth. Clinical significance: Heterotypic pregnancy is rare and poses a diagnostic dilemma in assisted reproductive technology (ART) cycles. Serial beta-human chorionic gonadotropin (hCG) measurement is not reliable and ultrasonography may not confirm due to the presence of ovarian hyperstimulation syndrome (OHSS) or multiple cysts. Early diagnosis is ideal and good perinatal outcome can be achieved by prompt and excellent laparoscopic management of the heterotypic pregnancies.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"90 1","pages":"125-127"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84110516","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 : 2017-01-01DOI: 10.5005/JP-JOURNALS-10016-1147
A. Alahmar, K. Rao
Introduction: Accumulating evidence suggests that oxidative stress plays an important role in the development of male infertil ity and recently antioxidants have been tried to treat men with idiopathic infertility. Objective: To assess the effect of treatment with vitamin C, vitamin E, zinc, selenium, and coenzyme Q10 on seminal fluid parameters in infertile men with idiopathic oligoasthenozoo spermia. Materials and methods: A prospective randomized trial was conducted on 32 infertile men with idiopathic oligoasthenozoo spmia who received a daily supplement of one caplet contain ing vitamin C (90 mg/day), vitamin E (15 mg/day), coenzyme Q10 (4 mg/day), selenium (30 μg/day), and zinc (5 mg/day) for 3 months. Semen analysis was performed at baseline and 3 months after treatment using World Health Organization (WHO) 2010 guidelines. Results: Significant improvement in sperm concentration was observed after combination therapy (9.13 ± 4.29 vs 11.3 ± 6.05 × 106/mL, p < 0.05). Sperm progressive motility (18.1 ± 8.68 vs 24.6 ± 10.2%, p < 0.01) and total motility (28.4 ± 8.71 vs 34.4 ± 11.7%, p < 0.01) also increased significantly following treatment. No change, however, was observed in semen volume or the proportion of sperms with normal morphology. Conclusion: The combination of vitamin C, vitamin E, zinc, selenium, and coenzyme Q10 can significantly improve sperm concentration and motility in infertile men with idiopathic oligo asthenozoospermia, which could be attributed to their synergistic antioxidant action.
越来越多的证据表明，氧化应激在男性不育症的发展中起着重要作用，最近抗氧化剂已被尝试用于治疗男性特发性不育症。目的:探讨维生素C、维生素E、锌、硒和辅酶Q10治疗对特发性少弱精子症男性不育患者精液参数的影响。材料与方法:对32例特发性少弱性贫血的不育男性进行前瞻性随机试验，每天补充1片含维生素C (90 mg/d)、维生素E (15 mg/d)、辅酶Q10 (4 mg/d)、硒(30 μg/d)、锌(5 mg/d)，持续3个月。根据世界卫生组织(世卫组织)2010年指南，在基线和治疗后3个月进行精液分析。结果:联合治疗后精子浓度显著提高(9.13±4.29 vs 11.3±6.05 × 106/mL, p < 0.05)。精子进行性活动力(18.1±8.68 vs 24.6±10.2%，p < 0.01)和总活动力(28.4±8.71 vs 34.4±11.7%，p < 0.01)均显著升高。然而，精液量和正常形态精子的比例没有变化。结论:维生素C、维生素E、锌、硒和辅酶Q10联合应用可显著提高特发性少弱精子症男性不育患者的精子浓度和活力，可能与其协同抗氧化作用有关。
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Pub Date : 2017-01-01DOI: 10.5005/jp-journals-10016-1140
M. Tzafetas, K. Lathouras, T. Tantanasis, S. Fidani, K. Tziomalos, K. Kalinderi, A. Loufopoulos, V. Zournatzi, K. Rao
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