Mahajan N. Ovarian Hyperstimulation Syndrome. Int J Infertility Fetal Med 2013;4(3):71-78.

Uterine pathologies are the cause of infertility in 15% of infertile couples and their correction is associated with improved pregnancy rates. This prospective study was carried out to compare hysterosalpingography (HSG) with hysteroscopy (HSC) in evaluation of uterine pathology.

The research was approved by the institutional review board. A total of 100 infertile women were included in the study. HSC and HSG were performed in the follicular phase and the findings were compared. Student's t test and chi-square test were applied wherever applicable. Degree of agreement between the two procedures was calculated using kappa estimates.

Thirteen percent of the women had abnormal HSG regarding the uterine cavity while 20% had abnormal HSC findings (chi-square value 1.77, p > 0.05). Out of 10% women who had normal HSG, some abnormality was found on HSC. Similarly 3% women with abnormal HSG had normal findings on HSC. Sensitivity of HSG in detecting uterine cavity abnormality was 50% and specificity 98.1%. Positive predictive value was 76.9% and negative predictive value was 88.5%. Result of HSG was false-negative in 10% of women and false-positive in 3%.

Hysteroscopy should be considered essential while investigating infertile women., Since HSG provides valuables information about tubes, it may supplement the hysteroscopic assessment.

Chauhan MB, Lakra P, Sangwan R, Nanda S, Malhotra V. Hysterosalpingography vs Hysteroscopy: Role in Assessment of Uterine Factor during Infertility Workup. Int J Infertility Fetal Med 2013;4(3):79-82.

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 testimony to this fact. As such studies from rural setups are lacking, this study was initiated.

A study of fetal middle cerebral artery peak systolic velocity to diagnose fetal anemia in rural obstetric population.

The study was conducted in the ultrasound section of a rural medical college. Clearance from institutional ethical and research committee was obtained. Written informed consent was obtained from the pregnant mother. A prospective observational study was conducted over the last 12 months.

Fetal MCA-PSV was measured in 26 pregnant women referred for ultrasound due to clinical suspicion of fetomaternal abnormality. Middle cerebral artery peak systolic velocity was measured by a single experienced radiologist on color Doppler ultrasound machine.

The observations were entered in Microsoft Excel sheet, and statistical analysis was done by comparing with internationally accepted values at that gestational age. Karl Pearson's correlation coefficient was used to study the relation between fetal MCA-PSV and gestational age. Standard t-test was used to study the significance of difference.

There was a steady increase in MCA-PSV with rising gestational age suggestive of positive correlation between them. When compared with internationally accepted values, significantly raised fetal MCA-PSV values were seen in six patients. These patients were followed up and the cause of fetal anemia in each was identified.

Fetal MCA-PSV can be successfully used to evaluate for anemia in fetuses in a rural setup provided correct methods are followed. An attempt to measure fetal MCA-PSV in face of every fetomaternal adversity is recommended so that none of the cases of fetal anemia go undiagnosed.

Proper knowledge and routine measurement of fetal MCA-PSV value can be a life saving noninvasive practice to diagnose fetal anemia in a rural setup.

Kachewar S, Gandage SG, Pawar HJ. A Study of Fetal Middle Cerebral Artery Peak Systolic Velocity to Diagnose Fetal Anemia in Rural Obstetric Population. Int J Infertility Fetal Med 2013;4(3):83-87.

To evaluate the predictive value of estradiol levels on the day of human chorionic gonadotropin (hCG) administration on intrauterine insemination success rate.

The present study included 200 intrauterine insemination (IUI) cycles performed between June 2011 and October 2012. All IUI cycles were preceded by ovarian stimulation with gonadotropins starting on cycle day 3. A single IUI was performed 24 to 36 hours after hCG administration. Binary logistic regression analysis was performed to define the covariates of IUI success. The main outcome measure, the clinical pregnancy rate per cycle, was assessed according to the estradiol level.

With LR ± 2 and AUC=0.73, ROC analysis revealed out the estradiol level as 465 pg/ml to predict the pregnancy with 60% sensitivity and 66% specificity. Binary logistic regression analysis identified the presence of estradiol levels higher than 465 pg/ml (p < 0.01, 95% CI = 0.147 – 0.687) and stimulation duration (p < 0.01, 95% CI = 0.201 – 0.705) as the covariates approached statistical significance for IUI success.

Estradiol level >465 pg/ml on the day of hCG administration might point out advanced outcome on mild ovarian stimulation combined with insemination.

Atilgan R, Ekinci M, Sapmaz E, Ozkan ZS. Impact of Estradiol Monitoring on the Prediction of Intrauterine Insemination Outcome. Int J Infertility Fetal Med 2013;4(3):88-92.

Muralidhar L, Govindraj SK, Venkatesh S, Thimmaiah R. Acardiac Acephalus with Single Umbilical Artery in Acardiac Twin. Int J Infertility Fetal Med 2013; 4(3):93-95.

Chandana C, Venkatesh S. Triple X Syndrome Woman Presenting as Premature Ovarian Failure. Int J Infertility Fetal Med 2013;4(3):96-98.