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1.  Research Article
A Case-Control study of Body Mass Index and Infertility in Algerian Women (Sidi Bel Abbes, West of Algeria)
Hichem Abdessalem MAÏ, Abbassia Demmouche
[Year:2015] [Month:September-December] [Volume:6 ] [Number:3] [Pages:43] [Pages No:103-107] [No of Hits : 1568]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1110 | FREE


Introduction: The prevalence of obesity and female infertility in Algeria has increased in past decades, and recent study are showing a relationship between body mass index (BMI) and the risk of female infertility, suggesting that obesity is a risk factor for infertility. In order to evaluate the risk of infertility associated with BMI, we conducted a case-control study.

Materials and methods: The relationship between BMI and female infertility was investigated in a case-control study of 256 infertile cases and 326 fertile control subjects. The BMI of infertile women was compared with the BMI of the control fertile group. Odds ratios (ORs) was calculated as measures of relative risk of infertility associated with BMI.

Results: Multiple analyses showed significant association between various measures of BMI and female infertility in this population. An association between BMI and infertility was observed for the overweight (25.00-29.99 kg/m2; odds ratio = 2.23; p = 0.021; 95% confidence interval, 1.52-3.25) and obese group (> 30 kg/m2; odds ratio = 3.26; p = 0.019; 95% confidence interval, 1.62-6.58) compared to the normal weight group. However, no association was found between underweight and infertility (BMI < 20 Kg/m2, odds ratio = 0.96; p = 0.063; 95% confidence interval, 0.57-1.63).

Conclusion: The present study confirms the results that the previously reported research have shown and affirm that an negative association exist between obesity and overweight with fertility, this association might be influenced by other factors, that’s why larger and more research in the Algerian population are needed.

Keywords: Algeria, Body mass index, Female infertility, Obesity, Overweight.

How to cite this article: MAÏ HA, Demmouche A. A Case- Control study of Body Mass Index and Infertility in Algerian Women (Sidi Bel Abbes, West of Algeria). Int J Infertil Fetal Med 2015;6(3):103-107.

Source of support: Nil

Conflict of interest: None

2.  Editorial
Kamini A Rao
[Year:2015] [Month:January-April] [Volume:6 ] [Number:1] [Pages:42] [Pages No:vii] [No of Hits : 661]
Full Text PDF | Abstract | FREE


Dear Readers,
Greetings and good wishes!!
Gonadotropin-releasing hormone (GnRH) antagonists can be used to prevent luteinizing hormone surge during controlled ovarian stimulation without hypoestrogenic side effects, flare up, or long downregulation period associated with agonists. It acts through competitive binding to pituitary GnRH receptors, which allows their use at any time during the follicular phase. It is well-proven that it is associated with lower incidence of ovarian hyperstimulation syndrome and it has got comparable clinical outcomes with agonist protocols. To throw more light on this matter, we have a review article by Dr. Divya Sardana on antagonists.

3.  Research Article
Novel Design of an Intrauterine Insemination Cannula
Ritvik Vasan
[Year:2015] [Month:January-April] [Volume:6 ] [Number:1] [Pages:42] [Pages No:15-19] [No of Hits : 503]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1095 | FREE


Intrauterine insemination (IUI) is a method of assisted conception that involves transfer of fast moving sperms using an IUI cannula into the uterine cavity at the time of anticipated (or expected) ovulation, thereby increasing chance of pregnancy.
Existing cannulas are designed to be easy to use, harmless to the cervix/endometrium, capable of negotiating the cervical cavity, and to avoid the reflux of inseminate fluid. Some of the factors which influence success of pregnancy are actual number of motile sperms, number of sperms with normal morphology, volume of inseminate and sterility during procedure. This paper proposes a novel ‘completely closed loop’ design for an IUI cannula that ensures complete emptying of washed sperm during insemination, leaving no dead space while ensuring sterility during procedure.

Keywords: Intrauterine insemination, Cannula, Insemination, Catheter, Stillet.

How to cite this article: Vasan R. Novel Design of an Intrauterine Insemination Cannula. Int J Infertil Fetal Med 2015;6(1): 15-19.

Source of Support: This work was supported by Manipal Ankur, Bengaluru, India.

Conflict of Interest: None

Date of Received: 08-01-15

Date of Acceptance: 10-02-15

Date of Publication: April 2015

4.  Review Article
Fibroids and Infertility
Harpreet Kaur, Kamini A Rao
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:1-7] [No of Hits : 1364]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1071 | FREE


Fibroids are the commonest benign tumors of female genital tract. Though fibroids may not be a sole cause for infertility in majority of cases, but it has been seen that there is an improvement in pregnancy rates after myomectomy. Fibroids that distort the uterine cavity and large intramural fibroids are shown to be associated with adverse effects on reproductive function. Available evidence suggests that submucosal, intramural, and subserosal ?broids interfere with fertility in decreasing order of importance. In infertile women and those with recurrent pregnancy loss, myomectomy should be considered only after a thorough evaluation has been completed. Medical management of fibroids has no role in treatment of fertility rather it might lead to delay in the final treatment for infertility. Preoperative medical treatment with a GnRH agonist should be considered for women who are anemic and those undergoing hysteroscopic myomectomy. Subserosal fibroids have least effect on fertility, so they do not need removal before infertility treatment.

Keywords: Fibroids, infertility, myomectomy, In vitro fertilization.

Keymessage: Fibroids are important cause of infertility; Removal of submucousal fibroids is warranted before IVF.

Search methodology: Data were sourced from the electronic database PubMed, MEDLINE, OVID, Cochrane Database of systematic reviews and published guidelines on fibroids and infertility. Abstracts from papers and posters presented at the international meetings, published and unpublished studies, and expert opinion was considered.

How to cite this article: Kaur H, Rao KA. Fibroids and infertility. Int J Infertil Fetal Med 2014;5(1):1-7.

Source of support: Nil

Conflict of interest: None

Date of Received: 30-03-14

Date of Acceptance: 20-04-14

Date of Publication: April 2014

5.  Editorial
Kamini A Rao
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:iv] [No of Hits : 1352]
Full Text PDF | Abstract | FREE


A few months ago, TOG, "The Obstetrician & Gynecologist", the official journal of the Royal College of Obstetrician and Gynaecology (RCOG) published an article by Jolly Joy and Neil McClure entitled "The art of reviewing a paper". As an editor, I cannot overemphasize the importance of such an article. Despite the routine publication of peer-reviewed articles in all quality journals, there is no formal training for peer reviewers. The article by Joy and McClure takes you through the basic principles and responsibilities of the review process while emphasizing the importance of ensuring quality control in a fair and appropriate way that justifies the reviewer’s responsibility to the author as well as to the editor of the journal. The point that I would like to put across here is that every editor needs a strong team of reviewers who respond promptly and ensure that the submission is reviewed and returned within the stipulated time frame. An invitation to review an article is a recognition of your standing in your area of expertise and undoubtedly an honor. However, while recognizing the invitation as an honor, many practicing clinicians also consider it an unnecessary burden on their time, leading to inordinately delayed responses. Delays in the review process due to indifference of peer reviewers remain the bane of every editor. I would like to appeal to all reviewers to devote your time and expertise selflessly in the interest of raising the quality of our publications.

6.  Original Article
Fetomaternal Outcome in Preterm Premature Rupture of Membrane
Minakeshi Rana, sharda patra, Manju Puri, Shubha Sagar Trivedi
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:18-21] [No of Hits : 1270]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1075 | FREE


This prospective observational study was carried out to study the fetomaternal outcome in women with preterm premature rupture of membrane (PPROM) between 24 and 36 weeks of gestation.

Materials and methods: A total of 150 pregnant women between 24 and 36 weeks gestation with PROM were subjected to detailed history and examination. Each patient was followed till her delivery and fetomaternal outcome was recorded gestation-wise between 24 and 28 weeks (n = 15), 28 and 32 weeks (n = 30), 32 and 34 weeks (n = 90), and 34 and 36 weeks (n = 15).

Result: The mean latency period from membrane rupture to delivery decreased from 15 days at 24 to 28 weeks, 11 days at 28 to 32 weeks to 4.4 days at 32 to 34 weeks to 2.1 days at 34 to 36 weeks. Majority of women delivered vaginally. The rate of spontaneous labor increased as the gestational age at admission increased, the difference between rate of spontaneous labor of 67% at 28 to 32 weeks and 86% at 34 to 36 weeks was statistically significant (p = 0.001). The indications for induction of labor were intrauterine fetal death, gross oligohydramnios, and clinical chorioamnionitis. The most common complication was clinical chorioamnionitis (6%) and postpartum sepsis (6%). The perinatal outcome was favorable in majority of cases and improved with the increase in gestational age at PROM. The overall perinatal mortality was 9.3%.

Conclusion: Management of PPROM involves complete evaluation of risks and benefits of conservative management. Wherever possible, the treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and steroids thereby reducing fetal-maternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis.

Keywords: Preterm premature rupture of membranes, chorioamnionitis, maternal outcome, neonatal outcome.

How to cite this article: Rana M, patra s, Puri M, Trivedi SS. Fetomaternal Outcome in Preterm Premature Rupture of Membrane. Int J Infertil Fetal Med 2014;5(1):18-21.

Source of support: Nil

Conflict of interest: None

Date of Received: 10-09-13

7.  Case Report
Sandhya Krishnan
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:27-29] [No of Hits : 1111]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1077 | FREE


Globozoospermia is a severe form of terato-zoospermia characterized by round-headed acrosome-less spermatozoa. The main problem is low fertilization rate due to lack of acrosome. We report successful pregnancy outcome of intracytoplasmic sperm injection (ICSI) treatment in a case of globozoospermia.

Keywords: Globozoospermia, male infertility, round-headed sperm cells.

How to cite this article: Krishnan S. Globozoospermia. Int J Infertil Fetal Med 2014;5(1):27-29.

Source of support: Nil

Conflict of interest: None

Date of Received: 09-02-14

Date of Acceptance: 18-03-14

Date of Publication: April 2014

8.  Original Article
An Untold Story of Indian Fetal Middle Cerebral Artery Peak Systolic Velocities
Sushil Kachewar, Sidappa G Gandage, Hemant J Pawar
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:8-11] [No of Hits : 1037]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1072 | FREE


Although noninvasive diagnosis of anemia in fetus by measuring the middle cerebral artery peak systolic velocity (MCA-PSV) is practised and extensively researched in the developed world, such studies from the developing world are rare. India is the home for many hemoglobinopathies and cases of Rh alloimmunization are also reported here. Hence, it is expected that fetal anemias will be quite common. So in addition to an awareness about the correct method of measuring MCA-PSV and knowledge about changes that occur in the waveforms with advancing gestational age, it is important to know the normal values at various gestational ages in an Indian setting. Demonstrating these normal values was the primary goal of the current study.

Context: Fetal anemia can be adequately tackled only if it is diagnosed on time. Fetal MCA-PSV has the potential to reliably predict fetal anemia. Scientific studies across the globe are a testimony to this fact. As such studies from rural setups are lacking, this study was initiated.

Aims: To demonstrate the normal values of fetal MCA-PSV at various gestational ages in an Indian setting by using the standard internationally accepted protocol.

Settings and design: The ultrasound wing of radiodiagnosis department of a rural medical college was the site of this study. Permission from institutional research cell and ethical committee was obtained for study on fetal MCA-PSV. Written informed consent from every pregnant mother who participated in the study was also obtained. A cross-sectional and prospective observational study was conducted over the last 9 months.

Materials and methods: A total of 60 measurements of fetal MCA-PSV were conducted in normal 20 pregnant women referred for routine obstetric scan at 12, 24, and 36 weeks of gestation respectively, by a single radiologist on color Doppler ultrasound machine. In each fetus the proximal MCA, soon after its origin, was evaluated.

Statistical analysis: The observations were entered in Microsoft Excel sheet and statistical analysis was done by using SPSS statistical software version 12. The relation between fetal MCAPSV and gestational age was studied using the Karl Pearson?s correlation coefficient. The significance of difference was studied using the t-test.

Results: MCA-PSV increased with increasing gestational age, suggesting positive correlation between the two. Better waveforms and increasing PSV were visualized with advancing gestational age.

Conclusion: Fetal anemia can be accurately predicted only if the MCA-PSV is scientifically measured and compared with normal values in a given setting. This study demonstrates the normal values at various gestational ages in an Indian setting.

Keywords: Fetal anemia, Middle cerebral artery peak systolic velocity, Doppler.

How to cite this article: Kachewar S, Gandage SG, Pawar HJ. An Untold Story of Indian Fetal Middle Cerebral Artery Peak Systolic Velocities. Int J Infertil Fetal Med 2014;5(1):8-11.

Source of support: Nil

Conflict of interest: None

Date of Received: 07-06-13

Date of Acceptance: 03-04-14

Date of Publication: April 2014

9.  Original Article
Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study
Sailaja Devi Kallur, Nuzhat Aziz
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:22-26] [No of Hits : 920]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1076 | FREE


Aim: To determine the ability of fetal monitoring tests to predict adverse perinatal outcomes in absent end diastolic flow (AEDF) babies.

Materials and methods: A retrospective cohort study of pregnant women with AEDF during the period 2001 to 2009. Fetal monitoring tests of interest included amniotic fluid index (AFI), nonstress tests (NST), and Doppler flow studies. Adverse perinatal outcomes included perinatal/neonatal mortality, necrotizing enterocolitis, respiratory distress syndrome, and grades III/IV intraventricular hemorrhage. Sensitivity, specificity, likelihood ratios, adjusted odds ratios, area under the receiver operator characteristic curves (AUROC) and the 95% confidence intervals were determined.
Study included 142 women with AEDF who delivered before 34 weeks. Indications for delivery included abnormal AFI in 6 (4.23%), worsening Doppler in 31 (21.83%), and abnormal NST in 48 (33.80%). An adverse fetal event was noted in 107 [75.35%, 95% confidence interial (CI) 68.18%, 82.53%]. Birth weight adjusted odds for an adverse perinatal outcome decreased (Odds ratio: 0.79, 95% CI: 0.56, 1.10, p = 0.16) with an increase in each week of gestation. Fetal monitoring tests did not have clinically meaningful positive/negative likelihood ratio or significant AUROC.

Conclusion: Current fetal monitoring tests are more useful to identify noncompromised fetuses than to identify fetal distress. Delaying delivery till 34 weeks might improve outcomes.

Keywords: Absent end diastolic flow, Fetal monitoring, Diagnostic tests, Perinatal outcomes, Neonatal death.

How to cite this article: Kallur SD, Aziz N. Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study. Int J Infertil Fetal Med 2014;5(1):22-26.

Source of support: Nil

Conflict of interest: None

Date of Received: 31-09-2013

Date of Acceptance: 04-04-14

Date of Publication: April 2014

10.  Original Article
Pattern of Prolactin Secretion after Normal Vaginal Delivery and in Cesarean Delivery
Asokan Keloth Manapatt, Latha Anoop, Deepna Tharammal, Aiswarya Sathyapal, Yasmeen Muneer
[Year:2014] [Month:January-April] [Volume:5 ] [Number:1] [Pages:31] [Pages No:15-17] [No of Hits : 910]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10016-1074 | FREE


Prolactin (PRL) is hormone of multiple biological actions and is best known for its role in milk production. This hospital-based study was undertaken to review the impact of PRL hormone in vaginal delivery and cesarean delivery. Our study is meant to create awareness in the society to promote breast feeding and the importance of promoting normal vaginal delivery whenever possible. In this study, we investigated the serum PRL values using enzyme-linked immunoflow assay method in 101 women who underwent normal (56) and cesarean delivery (45) in obstetrics and gynecology department of Kannur Medical College, Anjarakandy. Serum PRL at 24 and 48 hours blood sample was estimated among the two groups, mean PRL in vaginal delivery 24 hours 359.46 ± 119.70 ng/ml, 48 hours 386.67 ± 135.66 ng/ ml and in cesarean delivery 24 hours 245.49 ± 115.49 ng/ml, 48 hours 282.92 ± 69.59 ng/ml. The values of serum PRL are found to be significantly higher in the vaginal delivery group (p < 0.001) as compared with the cesarean section group. Through this study, we concluded that the mothers who delivered by cesarean section had decreased PRL levels than the women who delivered vaginally which may have a significant role in establishment of breastfeeding.

Keywords: PRL, glycoprotein, lactogenesis, hypoprolactinemia, Enzyme-linked immunoflow assay, vaginal delivery, cesarean section.

How to cite this article: Manapatt AK, Anoop L, Tharammal D, Sathyapal A, Muneer Y. Pattern of Prolactin Secretion after Normal Vaginal Delivery and in Cesarean Delivery. Int J Infertility Fetal Med 2014;5(1):15-17.

Source of support: Nil

Conflict of interest: None

Date of Received: 25-03-14

Date of Acceptance: 01-04-14

Date of Publication: April 2014

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