Journal of Human Reproductive Science
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   2011| September-December  | Volume 4 | Issue 3  
    Online since January 25, 2012

 
 
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CASE REPORTS
Premature ovarian aging in primary infertility: Triple X syndrome
Sreelakshmi Kodandapani, Muralidhar V Pai, Jayaraman Nambiar, Rajshekar Moka
September-December 2011, 4(3):153-154
DOI:10.4103/0974-1208.92292  PMID:22346085
Genetic aberrations comprise one-third of women with premature ovarian aging (POA). X chromosome abnormalities are seen in these women. We report a case of a 29-year-old lady with primary infertility and POA. She was phenotypically normal and her basal follicle stimulating hormone level was above the age-specific cut-off. Karyotype was triple X syndrome.
  5,794 118 -
REVIEW ARTICLE
Ovarian reserve tests
Padma Rekha Jirge
September-December 2011, 4(3):108-113
DOI:10.4103/0974-1208.92283  PMID:22346076
Ovarian reserve plays a crucial role in achieving pregnancy following any treatment in subfertile women. The estimation of ovarian reserve is routinely performed through various ovarian reserve tests (ORTs) in an effort to predict the response and outcome in couples prior to In Vitro Fertilization and counsel them. Most widely used tests are basal follicle stimulating hormone and anti-Mullerian hormone and antral follicle count. The role of ORTs in our routine practice is discussed in this article. A MEDLINE search was done to identify suitable articles for review.
  5,248 506 5
ORIGINAL ARTICLES
A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles
Mazdak Momeni, Mohammad H Rahbar, Ertug Kovanci
September-December 2011, 4(3):130-137
DOI:10.4103/0974-1208.92287  PMID:22346080
Objective: The objective was to evaluate the relationship between endometrial thickness on the day of human chorionic gonadotropin administration and pregnancy outcome in in vitro fertilization cycles. Design: This was a systematic review and meta-analysis. Materials and Methods: We identified 484 articles using Cochrane library, PubMed, Web of Science, and Embase searches with various key words including endometrial thickness, pregnancy, assisted reproductive technology, endometrial pattern, and in vitro fertilization. A total of 14 studies with data on endometrial thickness and outcome were selected, representing 4922 cycles (2204 pregnant and 2718 nonpregnant). The meta-analysis with a random effects model was performed using comprehensive meta-analysis software. We calculated the standardized mean difference, odds ratio (OR), and 95% confidence intervals (CIs). Results: There was a significant difference in the mean endometrial thickness between pregnant and nonpregnant groups (P<0.001), with a standardized mean difference of 0.4 mm (95% CI 0.22-0.58). The OR for pregnancy was 1.40 (95% CI 1.24-1.58). Conclusions: The mean endometrial thickness was significantly higher in pregnant women compared to nonpregnant. The mean difference between two groups was <1 mm which may not be clinically meaningful. Although there may be a relationship between endometrial thickness and pregnancy, implantation potential is probably more complex than a single ultrasound measurement can determine.
  4,593 253 11
Blastocyst cryopreservation using solid surface vitrification: A preliminary study
Mohan S Kamath, Ann M Mangalaraj, K Muthukumar, Rosemary Cullinan, TK Aleyamma, Korula George
September-December 2011, 4(3):114-120
DOI:10.4103/0974-1208.92284  PMID:22346077
Objective: The objective was to evaluate the effectiveness of a blastocyst cryopreservation program using solid surface vitrification. Setting: This study took place in a university teaching hospital. Study Design: Retrospective observational study. Materials and Methods: Women undergoing frozen embryo transfer cycles over a 4-year period between 2006 and 2010 were studied. The cryopreservation policy followed was a vitrification protocol performed at the blastocyst stage, using a solid surface (nonimmersion) method. The post-thaw survival rate, implantation rate, clinical pregnancy rate, live birth rate, and neonatal outcome were recorded. Results: Eighty-one women underwent 86 frozen embryo transfer cycles. Of the 240 blastocysts warmed, 204 survived giving a cryosurvival rate of 85% (204/240). The clinical pregnancy, implantation, miscarriage, ongoing pregnancy, and live birth rates per transfer were 47%, 29%, 12%, 16%, and 23% respectively. Of the 20 live births, there were 16 singletons and 4 twins. Eleven boys and 13 girls were delivered with no major or minor abnormality detected. Conclusion(s): The blastocyst vitrification protocol using the solid surface method is effective with results comparable to fresh blastocyst transfers. While retaining the rapid cooling effect, the nonimmersion technique eliminates the risk of contamination and disease transmission. Larger studies with long-term follow-up data would further confirm the efficacy and safety of this method of vitrification.
  4,660 184 -
CASE REPORTS
Umbilical laparoscopic scar endometriosis
Sreelakshmi Kodandapani, Muralidhar V Pai, Mary Mathew
September-December 2011, 4(3):150-152
DOI:10.4103/0974-1208.92291  PMID:22346084
Umbilical endometriosis is rare and challenging in both diagnosis and treatment. We report a case of an umbilical scar endometriotic nodule in a 39-year-old lady following laparoscopy-assisted vaginal hysterectomy. The wide local excision of the nodule and histopathological examination confirmed the diagnosis. We discuss the pathogenesis, diagnosis, differential diagnosis, and treatment options for the patient.
  4,142 124 -
ORIGINAL ARTICLES
Laparoscopic tubal sterilization reversal and fertility outcomes
K Jayakrishnan, Sumeet N Baheti
September-December 2011, 4(3):125-129
DOI:10.4103/0974-1208.92286  PMID:22346079
Purpose: The purpose of the study was two-fold. Firstly it was to assess the suitability for tubal recanalization and factors predicting successful laparoscopic recanalization. Secondly, it was to analyze the fertility outcomes and factors affecting the pregnancy rate following laparoscopic tubal recanalization. Materials and Methods: A retrospective chart review of prospectively followed-up 29 women at a tertiary care center seeking tubal sterilization reversal between May 2005 and February 2010 were included. Results: In 14 (48.3%) women unilateral tubes were suitable and in only 3 women (10.3%) bilateral tubes were suitable. All cases with laparoscopic tubal sterilization were suitable, whereas all cases with fimbriectomy were unsuitable for recanalization. In 6 (20.7%) cases salphingostomy was performed as an alternative procedure to tubal reanastomosis. The overall pregnancy rate was 58.8%. In cases with sterilization by Pomeroy's method, 4 out of 10 (40%) conceived, whereas for laparoscopic tubal ligation cases 6 out of 7 (85.7%) conceived (P=0.32). None of the patients with final tubal length <5 cm conceived (P=0.03). Comparing the age at recanalization, in women ≤30 years, 71.4% conceived, as compared with 50% when age of women was more than 30 years (P=0.37). Conclusions: The important factors determining the success of recanalization are technique of sterilization and the remaining length of the tube after recanalization. The gynecologist must use an effective technique of sterilization to minimize the failure rates, but at the same time, which causes minimal trauma, and aim at preserving the length of the tube so that reversal is more likely to be successful, should the patient's circumstances change.
  3,896 187 4
CASE REPORTS
Recurrent genuine empty follicle syndrome
MP Smisha, Kundavi Sankar, Betty Thomas, Thangam R Varma
September-December 2011, 4(3):147-149
DOI:10.4103/0974-1208.92290  PMID:22346083
Failure to aspirate oocytes after ovarian stimulation for an in vitro fertilization cycle, after confirming normal folliculogenesis and steroidogenesis occurs in about 0.2-7% of the cycles. This condition is known as empty follicle syndrome. Most of the time, it may be due to human or pharmacological error, but rarely there is an entity called genuine empty follicle syndrome where no known cause can be identified.
  3,694 162 2
ORIGINAL ARTICLES
Gestational surrogacy: Viewpoint of Iranian infertile women
Azad Rahmani, Nilofar Sattarzadeh, Leila Gholizadeh, Zahra Sheikhalipour, Atefeh Allahbakhshian, Hadi Hassankhani
September-December 2011, 4(3):138-142
DOI:10.4103/0974-1208.92288  PMID:22346081
Background: Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women's viewpoint regarding gestational surrogacy. Aim: To assess the viewpoint of Iranian infertile women toward gestational surrogacy. Setting and Design: This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. Materials and Methods: The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. 0 Statistical Analysis: Data analysis was conducted by SPSS statistical software using descriptive statistics. 0 Results: Viewpoint of 214 women (89.9%) was positive. 36 (15.1%) women considered gestational surrogacy against their religious beliefs; 170 women (71.4%) did not assume the commissioning couple as owners of the baby; 160 women (67.2%) said that children who were born through surrogacy would better not know about it; and 174 women (73.1%) believed that children born through surrogacy will face mental problems. Conclusion: Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed.
  3,283 149 1
Role of 14-bp deletion/insertion polymorphism in exon 8 of the HLA-G gene in recurrent spontaneous abortion patients
U Shankarkumar, A Shankarkumar, Z Chedda, K Ghosh
September-December 2011, 4(3):143-146
DOI:10.4103/0974-1208.92289  PMID:22346082
Background: Human leukocyte antigen (HLA)-G belongs to the nonclassical Class I major histocompatibility complex, and is predominantly and specifically found on the extravillous cytotrophoblast cells of the placenta. HLA-G has been postulated as an important immunotolerant molecule in maintaining successful pregnancy and maternal tolerance of the semiallogenic fetus. Recent reports indicate that the 14-bp deletion/insertion polymorphism in exon 8 of the 3′UTR region of the HLA-G gene influences the HLA-G mRNA stability and isoform splicing patterns, thus modulating the levels of HLA-G expression. Aim: The aim was to study the 14-bp deletion/insertion polymorphism in exon 8 of the 3′UTR region of the HLA-G gene. Materials and Methods: A total of 50 women with unexplained three or more recurrent spontaneous abortions (RSAs) and 41 normal healthy control women who have had normal pregnancies and were genotyped for the 14-bp deletion/insertion polymorphism were genotyped for the 14-bp deletion/insertion polymorphism by polymerase chain reaction for exon 8-specific primers Results: It was found that the 14-bp allele deletion frequency was lower in patients (67%) versus controls (73%), while 14-bp allele insertion was higher among patients (33%) versus controls (9%). Similarly, the homozygous deletion halotype was higher among the controls (80.48%); the heterozygous insertion deletion haplotype (34%) and homozygous insertion haplotype (16%) were higher in RSA patients. The HLA haplotype HLA A*02:11_B*40:06:01:01 was increased among RSA women compared to controls. Conclusion: Our results suggest that 14-bp deletion/insertion polymorphisms might have importance in the outcome of pregnancy and the 14-bp deletion polymorphism in exon 8 of the HLA-G gene may be important from an evolutionary perspective of successful pregnancy.
  2,844 177 10
LETTERS TO EDITOR
Discrepancy in the results of Y chromosome microdeletions in an Iranian population
Kioomars Saliminejad, Hamid Reza Khorram Khorshid
September-December 2011, 4(3):157-157
DOI:10.4103/0974-1208.92295  PMID:22346088
  2,631 104 3
ORIGINAL ARTICLES
Controlled cooling versus rapid freezing of teratozoospermic semen samples: Impact on sperm chromatin integrity
Shivananda N Kalludi, Guruprasad Kalthur, Susan Benjamin, Pratap Kumar, Satish Kumar Adiga
September-December 2011, 4(3):121-124
DOI:10.4103/0974-1208.92285  PMID:22346078
Aim: The present study evaluates the impact of controlled slow cooling and rapid freezing techniques on the sperm chromatin integrity in teratozoospermic and normozoospermic samples. Setting: The study was done in a university infertility clinic, which is a tertiary healthcare center serving the general population. Design: It was a prospective study designed in vitro. Materials and Methods: Semen samples from normozoospermic (N=16) and teratozoospermic (N=13) infertile men were cryopreserved using controlled cooling and rapid freezing techniques. The sperm chromatin integrity was analyzed in fresh and frozen-thawed samples. Statistical Analysis Used: Data were reported as mean and standard error (mean ± SEM) of mean. The difference between two techniques was determined by a paired t-test. Results: The freeze-thaw induced chromatin denaturation was significantly (P<0.01) elevated in the post-thaw samples of normozoospermic and teratozoospermic groups. Compared to rapid freezing, there was no difference in the number of red sperms (with DNA damage) by the controlled slow cooling method in both normozoospermic and teratozoospermic groups. Freeze-thaw induced sperm chromatin denaturation in teratozoospermic samples did not vary between controlled slow cooling and rapid freezing techniques. Conclusions: Since the controlled slow cooling technique involves the use of expensive instrument and is a time consuming protocol, rapid freezing can be a good alternative technique for teratozoospermic and normozoospermic samples when sperm DNA damage is a concern.
  2,341 132 -
LETTERS TO EDITOR
Combination of aspirin and heparin in unexplained recurrent miscarriages - "Empirical or evidence based"
Prakriti Jain, Sneha Badwe Dhodapkar, Mary Daniel
September-December 2011, 4(3):155-156
DOI:10.4103/0974-1208.92293  PMID:22346086
  2,052 111 -
EDITORIAL
From the Editor's desk
Kamini Rao
September-December 2011, 4(3):107-107
DOI:10.4103/0974-1208.92282  PMID:22346075
  1,924 148 -
LETTERS TO EDITOR
Glycodelin - Newer perceptions
Dilip Gude
September-December 2011, 4(3):156-157
DOI:10.4103/0974-1208.92294  PMID:22346087
  1,682 80 -
Post-glucose insulin level in polycystic ovarian syndrome
Somsri Wiwanitkit, Viroj Wiwanitkit
September-December 2011, 4(3):158-158
DOI:10.4103/0974-1208.92297  PMID:22346090
  1,434 84 1
Authors' reply
Pikee Saxena, Anupam Prakash, Aruna Nigam
September-December 2011, 4(3):158-159
PMID:22346091
  1,383 67 -
Authors' reply
Ali Mohammad Malekasgar, Hayat Mombaini
September-December 2011, 4(3):157-158
PMID:22346089
  1,212 72 -
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