Year : 2012 | Volume
: 5 | Issue : 3 | Page : 231--232
From the Editor's desk
Editor-in-Chief, Journal of Human Reproductive Sciences, India
Editor-in-Chief, Journal of Human Reproductive Sciences
|How to cite this article:|
Rao K. From the Editor's desk.J Hum Reprod Sci 2012;5:231-232
|How to cite this URL:|
Rao K. From the Editor's desk. J Hum Reprod Sci [serial online] 2012 [cited 2020 Jul 3 ];5:231-232
Available from: http://www.jhrsonline.org/text.asp?2012/5/3/231/106332
We start this issue with a review article by Sandro C. Esteves and Alex C. Varghese on the importance of sperm-processing techniques and the caution to be used to avoid jeopardizing the sperm-fertilizing potential in treatment cycles. They have described the current methods for processing surgically retrieved specimens, either fresh or frozen-thawed, and provide tips and discuss pitfalls in facilitating the handling of such specimens. In addition, they have also given us the available laboratory tools to aid in the identification of viable immotile spermatozoa to be used in conjunction with assisted reproductive techniques.
In vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) pregnancies are associated with a higher risk for multiple gestation, preterm labor, and low birth weight. Since the birth of the first IVF baby, Louise Brown, it has been an area of great conflict and interest to know whether assisted reproductive technology (ART) is associated with increased congenital malformations. Factors that may increase the risk of birth defects include the relatively advanced age of infertile couples, the underlying cause of their infertility, the medications used to induce ovulation or to maintain the pregnancy in the early stages, and factors associated with the procedures themselves, such as the freezing and thawing of embryos, and so on. The authors of this review article, Sunita Tandulwadkar, Pooja Lodha, and Vineeta Kharb postulate that although the risk of congenital malformations is slightly but significantly increased following ART, the risks of other complications associated with pregnancy, in particular multiple pregnancy and its consequences and preterm delivery, remain far more common obstetric complications in this patient group. This should be the guiding factor in counseling an ART couple. The role and importance of prenatal diagnosis in ensuring an extracautious and vigilant surveillance for malformations needs to be emphasized to all ART specialists.
Munawar Hussain, Samawal El-Hakim, and David J. Cahill did a nine-year cohort study of women with unexplained recurrent miscarriages who attended a recurrent miscarriage clinic in a tertiary care university hospital. Before 20 weeks of gestation, 1 to 1.5% of the pregnant population suffers from recurrent miscarriages, that is, the loss of three or more consecutive intrauterine pregnancies with the same partner. The study adds emphasis to the existing literature on this subject which claims that supplementation with progesterone may improve the outcome of pregnancy in selected groups of unexplained recurrent miscarriages.
Declining endometrial receptivity above the age of 45 is one of the leading causes of lower rates of implantation and pregnancy. Pooja Gupta, Manish Banker, Pravin Patel, and Bharat Joshi in their original article have shown that an endometrial thickness of >8 mm is considered ideal before transfer and that transfer of two selected embryos on day 3 yields a favorable outcome of pregnancy with reduced rates of multiple pregnancies.
Recent years have seen a significant rise in women presenting with polycystic ovary syndrome (PCOS) and a concomitant spurt in scientific interest to understand the syndrome. The competitive benefits of letrozole versus clomiphene citrate has been the subject of discussion for over a decade. Sujata Kar in her study joins a long list of researchers who emphasize that letrozole has excellent rates of pregnancy compared to clomiphene citrate and should be considered at par with clomiphene citrate as a first-line drug for the induction of ovulation in infertile PCOS women.
Sonal Panchal and Chaitanya Nagori have published an article on the comparison of anti-Mullerian hormone (AMH) and antral follicle count (AFC) for the assessment of ovarian reserve. AFC and AMH both correlate with each other but have independent significance for estimating follicles larger than 12 mm on the day of human chorionic gonadotropin (hCG). In their opinion, AFC alone may suffice as a test for the estimation of ovarian reserve as the ultimate end result is eggs retrieved on ovum pick up (OPU), and the difference of correlation coefficient between AFC and AMH is minimally significant in the non-PCO group and not significant in the PCO group.
A study by Abha Majumdar and D.B. Inamdar on the evaluation of the impact of gonadotropin-releasing hormone agonist as an adjuvant in luteal phase support on the outcome of IVF concluded that the administration of three 1 mg doses of lupride six days after oocyte retrieval in the long protocol cycles does not result in an increase in ongoing rates of pregnancy.
We close this issue with a few interesting case reports, and I take this opportunity to wish all our readers a very happy and prosperous 2013.