Introduction: Infertility is an alarming issue in medical practice. This retrospective study is aimed to find out male infertility rate in this area, Belagavi, India.
Materials and methods: Case records (2010–2017) on semen examination carried out in Sristi Fertility Centre of KAHER\'s Ayurveda Hospital and Medical Research Centre were evaluated on established standard basis.
Results: The total number of case records was 627. Among them 62% were infertile. Majority of infertile men were with oligozoospermia (31.41%).
Conclusion: This retrospective study invites serious attention of health authorities on this aspect.
Aim: The aim of the study was to determine the role of inbreeding in occurrence of lethal congenital hydrocephalus (LCH) and congenital abnormalities associated with it.
Materials and methods: There was an examination of 182 fetuses born with LCH, out of which 69 were diagnosed with isolated and 113 fetuses were diagnosed with associated hydrocephalus resulting in 38% and 62% occurrences, respectively. All the fetuses were the result of spontaneous abortions, stillbirths, neonatal deaths and the pregnancy terminations due to medical reasons. The fetal autopsy was performed immediately after the fetal expulsion. The brain examination was performed after being preserved in 10% formalin solution for the period of 6 months. Measurements were taken on the ventricles in their central parts. Ventricles with the enlargements over 10 mm were determined as hydrocephalus and severe ventriculomegaly if the ventricular dimensions were over 15 mm.
Results: Lethal congenital hydrocephalus associated with were the presence of previous pregnancies with inbreeding and malformations [OR = 7.309 CI 95% (1.806–29.584)]; the maternal age over 40 and the third-degree inbreeding in fetus [OR = 18.500 CI 95% (1.410–638.150)]; agenesis of the corpus callosum in fetuses born from mothers in close relative marriages [OR = 30.000 CI 95% (1.410–638.150)]; aqueductal stenosis [OR = 9.867 CI 95% (1.328–73.296)]; skeletal dysplasia [OR = 6.727 CI 95% (1.203–37.609)]; and Dandy–Walker syndrome [OR = 6.250 CI 95% (0.803–48.671)].
Conclusion: The obtained results unambiguously prove the importance and significance of inbreeding as a risk factor of LCH appearance and its increase in association with other risk factors which should be taken into consideration when observing such pregnancies.
Clinical significance: Lethal congenital hydrocephalus is the result of a significant number of risk factors and is often associated with other malformations. Currently, prenatal ultrasound is able to visualize ventriculomegaly. It is important to gather information about the previous pregnancies and the type of marriage among close relatives. In case of ventriculomegaly it is imperative to carry out MRI and genetic testing that can provide additional information. In the case of medical abortion, stillbirth or neonatal death, a fetopathological study must be carried out which enriches our knowledge of malformations, complements and directs the ultrasound examination, modifies genetic counseling and determines the behavior to be followed when taking responsibility for a new, subsequent pregnancy.
How to cite this article:
Singh A, Leishram G. To Compare the Exogenous Human Chorionic Gonadotropin Trigger with Endogenous Leutinizing Hormone Surge in Ultrasound Monitored Cycles for Timing of Intrauterine Insemination in Women with Unexplained Infertility. Int J Infertil Fetal Med 2019; 10 (1):8-11.
Aim: To compare rates of follicular rupture after human chorionic gonadotropin (hCG) trigger with after spontaneous leutinizing hormone (LH) surge in women undergoing controlled ovarian stimulation (COS) and intrauterine insemination (IUI). To observe any findings suggestive of premature LH surge in hCG triggered cycles and compare the pregnancy rates in the two groups.
Materials and methods: A total of thirty-three women with unexplained infertility were enrolled. Women were subjected to COS with injection follicle stimulating hormone (FSH) 75IU I/M for 5 days. A total of 100 cycles were studied. The cycles were divided in to two groups. In group I, ultrasound monitoring was done from day 8 till follicle size of 18 mm followed by trigger with injection hCG 5,000 IU followed by IUI after 36–48 hours of injection hCG. Group II cycles were followed with ultrasound till follicle size 14 mm and urinary LH surge test was done till it turned positive. Ultrasound was done after 24 hours of positive test and then IUI. The two groups were compared about the proportion of cycles with documented rupture of follicle. The pregnancy rates and presence of features suggestive of premature luteinization in hCG triggered cycles were studied.
Results: The mean time of follicular rupture was 43 ± 8.32 hours in group I from hCG trigger and 27.77 ± 8.69 hours in group II from positive LH surge. The difference between number of cycles with documented follicular rupture and mean day of IUI was not significant in the two groups (95.35% vs 85.58%). The pregnancy rate was higher in group II than group I (11.6% vs 7.3%) but the difference was not significant statistically.
Conclusion: Adequately powered studies are required to support the preference of endogenous LH surge to exogenous LH surge (hCG trigger) for timing of IUI.
Clinical significance: To compare exogenous LH surge (hCG trigger) with endogenous LH surge to for timing of IUI in unexplained infertility.
Coarctation of the umbilical cord is featured as segmental or diffused absence of Wharton\'s jelly, resulting in the constriction of cord and narrowing of vessels. It can develop at any gestational age and is unrelated to parity. The stricture of the cord is usually associated with torsion and characterized by fibrosis of Wharton\'s jelly and thickening of the vessel walls, which hampers the fetoplacental circulation, resulting in hypoxia/anoxia and subsequently fetal demise. Although this event must be noticed frequently in practice, it is often not reported by the obstetricians because examination of the umbilical cord is not performed in all cases of unexplained stillbirth.