International Journal of Infertility & Fetal Medicine

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Volume 12, Number 1, January-April 2021

EDITORIAL

Harpreet Kaur, Kamini A Rao

Editorial

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:1] [Pages No:00 - 00]

PDF  |  DOI: 10.5005/ijifm-12-1-iv  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Rutvij Jay Dalal, Akanksha P Mishra, Sahil Gupta, Divya Rani

A Retrospective Analysis of Outcome of Vitrified vs Fresh Oocytes among Donor and Patient Cohorts

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Fertility, Fertility preservation, Intracytoplasmic sperm injection, IVF ET, Oocyte cryopreservation, Reproductive health, Retrospective study, Vitrification, Vitrified oocyte

PDF  |  DOI: 10.5005/jp-journals-10016-1210  |  Open Access |  How to cite  | 

Abstract

Background: Oocyte cryopreservation has been an enigma for many years. It has not been easy to freeze the largest cell of the body owing to its large water content and low surface-to-volume ratio. The recovery of cryopreserved oocytes, for many years, remained dismal at best due to ice crystal formation and insufficient cryoprotectant permeation. In recent years, particularly after the advent of vitrification, a much more successful cryopreservation recovery has been achieved, and oocyte cryopreservation has now become a mainstream treatment procedure in artificial reproduction technology (ART). Aim and objective: Our study aims to retrospectively analyze oocyte cryopreservation data collected over a period of 5 years, between two centers, with a standardized vitrification-warming technique. The parameters taken into consideration were oocyte survival, fertilization, blastocysts formation, implantation rate, and live birth rate. Result: We have observed no significant difference in fresh vs frozen oocytes in the donor as well as patient cohorts in terms of implantation rates and live birth outcomes. Our data have been very encouraging, so that we can offer oocyte cryopreservation to the desiring women seeking this technology, and have opened up a plethora of opportunities with the successful application of oocyte vitrification. Conclusion: We are attempting a further, more elaborate study with much bigger sample size and many more individual criteria to follow-up the success of this technique more closely.

RESEARCH ARTICLE

Nandhini Balunathan, Vettriselvi Venkatesen, Jaywant Chauhan, Sanjeeva N Reddy, Venkatachalam Perumal, Solomon FD Paul

Role of MTHFR Gene Polymorphisms in Male Infertility

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:6] [Pages No:7 - 12]

Keywords: Case–control study, DNA methylation, Karyotyping, Male infertility, Nonobstructive azoospermia, Severe oligozoospermia, Single-nucleotide polymorphism

PDF  |  DOI: 10.5005/jp-journals-10016-1213  |  Open Access |  How to cite  | 

Abstract

Background: Folate metabolism plays an important role in appropriate cellular function, DNA methylation, repair, and synthesis. C677T and A1298C variants of methylenetetrahydrofolate reductase (MTHFR) play a role in reduced plasma folate and increase the susceptibility to various multifactorial disorders. Aim and objective: The present study was aimed to detect the association of C677T polymorphism and A1298C polymorphism in the MTHFR gene with male infertility. Materials and methods: In the current study, we analyzed a group of 50 infertile men with a clinical history of nonobstructive azoospermia or severe oligozoospermia. For the control group, we also analyze 50 fertile men. Cytogenetic analysis revealed a normal male karyotype in 50 cases of infertile men, which further subjected to molecular analysis. The expected genotype and allele frequencies were calculated for both infertile men and controls. These frequencies were tested when the study group followed Hardy–Weinberg equilibrium. The interaction between the MTHFR genotypes was calculated using the odds ratio for mutant genotypes as compared to the wild types. To evaluate the risk of the different genotypes, 95% confidence intervals (CI) were calculated. Results: The A1298C polymorphism of the MTHFR gene was present at a statistically increased significance in infertile men. Interpretation and conclusion: We concluded that MTHFR C677T gene polymorphism is not associated with male infertility whereas A1298C gene polymorphism showed a significant increase in male infertility. To better understanding the causes of male infertility, future studies to be conducted in a large population to obtain a better understanding of the complex gene-to-gene interactions.

RESEARCH ARTICLE

Gilmar P Silva, Vítor PX Grangeiro, Carmelita FD Oliveira

Seminal Levels of Immunoglobulins and Complements and Their Relationship with Seminal Parameters in Chronic Hemodialytic Patients

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:4] [Pages No:13 - 16]

Keywords: Chronic kidney disease, Complement, Immunity, Immunoglobulins, Male infertility

PDF  |  DOI: 10.5005/jp-journals-10016-1214  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To investigate the potential relationship between seminal complements (C3 and C4) and immunoglobulin (IgA and IgG) levels and seminal parameters (SPs) in chronic hemodialysis patients. Materials and methods: A cross-sectional study was conducted among patients aged between 18 years and 60 years. The sample comprises 60 males undergoing hemodialysis for >6 months, and 15 healthy males without clinical or laboratory signs of genitourinary and eugonadic tract infections. Spermograms and leukocytopermia, serum hormonal profiles, and seminal measurements of complement fractions (C3, C4) and immunoglobulins (IgA, IgG) were performed. Results: The hemodialysis and healthy groups were similar in age (49.47 ± 05.55 and 50.53 ± 04.24 years, p = 0.06). Average levels of seminal C fractions (C3, C4) were similar between the hemodialysis and healthy groups, between normozoospermia and oligozoospermia hemodialysis subgroups, and in the oligozoospermia hemodialysis subgroup. Average seminal levels of Igs (A and G) differed significantly between the hemodialysis and healthy groups (351.60 ± 035.80 vs 247.40 ± 39.00 mg/L), and in normozoospermia and oligozoospermia hemodialysis subgroups (361.20 ± 36.30 vs 340.60 ± 32.50 mg/L). However, they were similar (p > 0.05) between subgroups of oligozoospermia. The seminal fractions of complete (C3 and C4) and Ig (A and G) did not correlate (p > 0.05) with SPs. All participants had hormonal profiles within the normal range. Conclusion: The complement fractions (C3 and C4) and immunoglobulins (IgA and IgG) showed no relationship with SPs in chronic hemodialysis patients.

RESEARCH ARTICLE

Abhijeet Kumar, Madhusudan Dey, Sanjay Singh, Devendra Arora

Prenatal Aneuploidy Screening and Diagnosis—Its Evolution and Trends: A 3-year Analysis in a Fetal Medicine Center

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:5] [Pages No:17 - 21]

Keywords: Amniocentesis, Chorionic villus sampling, Down syndrome, Noninvasive prenatal test, Prenatal diagnosis, Prenatal screening

PDF  |  DOI: 10.5005/jp-journals-10016-1216  |  Open Access |  How to cite  | 

Abstract

Introduction: After the ACOG guideline in 2007 recommending that all women, regardless of age, should be offered aneuploidy screening before 20 weeks of gestation. This protocol in the name of the fetal aneuploidy screening program was slowly introduced in various Indian hospitals. This observational study was performed to analyze population-based trends of prenatal testing (serum screening and invasive testing) for aneuploidy over 3 years (2017–2019). Materials and methods: A retrospective single-center study was carried over a period of 3 years (January 2017 to December 2019). This hospital was a tertiary care hospital with fetal medicine unit that had approximately 3,000 annual births. Analysis of data of all pregnant women undergoing prenatal testing before 20 weeks of gestation was collected in the following subheads: (1) aneuploidy screening data, (2) invasive testing data [amniocenteses and chorionic villus samplings (CVSs)], and (3) tertiary care hospital birth statistics from January 2017 to December 2019. Results: Over a period of 3 years, aneuploidy screening was accepted by the target population and at present >85% target population undergo aneuploidy serum screening. Annual numbers of invasive prenatal tests climbed steadily from 2017 to 2019. The proportion of invasive testing performed for abnormal serum screening (ASS) increased steadily from 51% in 2017 to 72% (p < 0.05) in 2019. While the indications abnormal ultrasound finding (AUS) showed a steady decline over the same timeline but an indication of previous baby affected with aneuploidy (PBAA) remained in the same range. By 2019, the most common indications for invasive tests were positive ASS (72%) and AUS abnormality (15%). The diagnostic yield of all invasive tests for a major chromosome abnormality over a 3-year study period was 4.7%. The rate of CVS to amniocentesis rose to 17.5% in 2019 from 4.6% in 2017. Fewer complications of invasive tests were observed as compared to previous studies. Conclusion: The study demonstrates a rise in aneuploidy serum screening and its acceptance in the pregnant population. Abnormal serum screening is the main indication of prenatal invasive testing. This study also adds to the safety profile of invasive testing.

CASE REPORT

Smita Khetarpal, Anil Khetarpal

Bilateral Tubal Anomaly (Congenital): A Rare Tubal Infertility Factor

[Year:2021] [Month:January-April] [Volume:12] [Number:1] [Pages:2] [Pages No:22 - 23]

Keywords: Congenital anomaly, Primary infertility, Tubal factor infertility

PDF  |  DOI: 10.5005/jp-journals-10016-1215  |  Open Access |  How to cite  | 

Abstract

Infertility is a growing concern of society which might be due to defects in tubal, ovarian, and uterine or a combination of factors. During routine practice, we usually found anomalies of the uterus or vagina and sometimes blocked fallopian tubes in primary infertility cases but congenital anomalies related to ovaries and tubes are of rare occurrence. Nowadays, tubal factor infertility is the leading cause of female factor infertility which might result from a partial or complete absence of a fallopian tube; however, the true incidence of this condition is not reported yet, but till now very few cases of tubal anomalies (basically unilateral) have been reported in the literature. Here, we report a case of a nulliparous young aged female, who was presenting in an outpatient department with complaints of primary infertility and intraoperatively, found to have bilateral tubal anomaly (congenital) during laparoscopy.

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