Sardana D. Review on Antagonists. Int J Infertil Fetal Med 2015;6(1):1-10.

Ahmad A, Rabbani TK, Kumar S. Epilepsy: Special Consideration in Women. Int J Infertil Fetal Med 2015; 6(1):11-14.

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

The aim of the present study is to evaluate the fertility outcomes of intracytoplasmic sperm injection (ICSI) as well as sperm count, motility and morphology in couples with infertile male partners exhibiting idiopathic oligoasthenozoospermia (OA) and treated with tamoxifen citrate and/or L-carnitine.

In this randomized controlled trail, couples with female cause of infertility were excluded. Only couples with male cause of infertility with idiopathic OA were admitted to this study and randomly assigned into four different groups of treatments as follow: Group A (n = 45) received an anti-estrogen compound (tamoxifen 20 mg/day), group B (n = 20) received L-carnitine (1000 mg/day), group C (n = 34) received tamoxifen 20 mg/day plus L-carnitine 1000 mg/day, whereas group D (n = 29) received placebo. Treatments were continued for 3 to 6 months.

Treatment groups of A, B, and C showed an overall improvement in the tested parameters of sperm when compared to the control group that showed an overall reduction in those parameters after termination of the treatment. In this context, sperm count increased from 7.58 ± 2.93 × 10⁶/ml before treatment to 10.81 ± 1.84 × 10⁶/ml after treatment in group A (p = 0.016). Similarly, sperm count increased from 5.32 ± 2.09 × 10⁶/ml to 8.92 ± 2.29 × 10⁶/ml in group C (p = 0.01). Patients from group C did not only have an improved total motility of sperm from 8.03 ± 1.59% to 13.78 ± 3.85% (p = 0.045) but also an improved sperm normal morphology from 0.88 ± 0.45% to 1.99 ± 0.71% (p = 0.026). Patients from group A or C exhibited an improved ICSI outcomes when compared to those in patients from group B or D (48.9 or 48.3 vs 16.6 or 20, respectively, p = 0.46).

It is concluded that administration of tamoxifen and L-carnitine can improve both sperm parameters of fertility and ICSI outcomes. Combined tamoxifen and L-carnitine treatments result in maximum therapeutic effect in men with idiopathic OA.

Haje M, Naoom K. Combined Tamoxifen and L-Carnitine Therapies for the Treatment of Idiopathic Male Infertility Attending Intracytoplasmic Sperm Injection: A Randomized Controlled Trial. Int J Infertil Fetal Med 2015;6(1):20-24.

Down syndrome (DS) is the most common chromosomal aneuploidy to result in a live birth. Absent nasal bone has been consistently observed in fetuses with ds. Multiple studies have been conducted to measure and compare the nasal bone length (NBL) in different races and ethnicity and is found to vary in size. In countries, such as India where often only the second trimester scan is performed for screening of aneuploidies, NBL could be regarded as a useful marker.

To estimate the NBL of fetuses at 18 to 22 + 6 weeks gestational age in an Indian population, establish a normogram and compare it with that of the Caucasian population.

Prospective observational study in a tertiary care hospital with 500 antenatal subjects after considering the inclusion and exclusion criteria.

The normogram was established and found to be comparable to previously established ones for Indian subjects. The 5th centiles for 18-18.6, 19-19.6, 20-20.6, 21-21.6 and 22- 22.6 weeks of gestations were 3.4, 3. 5, 4.2, 4.3 and 5.4 mm respectively. The NBL increased with gestational age (GA), and the mean NBL was 5.48 mm. No correlation was noted with maternal age, sex of fetus or religion. The NBLs were significantly shorter than those of the Caucasian population.

Mean NBL values of Indian population are less than the mean NBL of Caucasian population. This along with the GA needs to be considered in counseling patients and decisions regarding further invasive and noninvasive tests.

Vikraman SK, Chandra V, Balakrishanan B, Gudi A, Batra M, Kannoli G. Nasal Bone Length Normogram of Mid-second Trimester Euploid Fetuses of an Indian Population. Int J Infertil Fetal Med 2015;6(1):25-29.

To determine the diagnostic effectiveness of symphysis fundus height (SFH) measures plotted on customized growth charts for the identification of fetal growth patterns in a tertiary care perinatal center in south India.

Serial SFH of pregnant women with singleton babies booked for antenatal care up to 22 weeks was measured from 24 weeks of gestation and plotted on customized growth charts that were developed using the gestation related optimal weight (GROW) software downloaded from www.gestation.net to identify fetal growth patterns. Fetal growth patterns were also ascertainedusing ultrasound in the antenatal period and confirmed at birth using a neonatal growth classification. The diagnostic effectiveness of SFH was compared with ultrasound and neonatal classifications using sensitivity, specificity, area under the ROC curve and likelihood ratio tests

The study included 666 pregnant women who presented at the antenatal clinics from January 2010 to October 2010. On ultrasound examination, 564 (84.6%) fetuses were AGA, 78 (11.7%) fetuses were LGA and 19 (2.9%) were SGA and 5 (0.8%) showed crossing centile from higher to lower pattern. On serial SFH measures, 426 (64.0%) of the fetuses were normal growth, 180 (27.0%) were excessive growth and 40 (6.0%) were slow growth. Serial SFH measures had a positive likelihood ratio of 4.7 (8.5 for USG) for the identification of SGA and a negative likelihood ratio of 0.06 for the detection of LGA.

The SFH measures plotted on a customized GROW curve have the potential to develop into a low cost screening tool to identify fetuses with altered growth. The diagnostic effectiveness of SFH plotted on customized growth charts has to be improved further through the development of appropriate customized growth charts for India before application on a larger scale.

Radhika B, Suseela V, Nirmalan PK. Identification of Fetal Growth Patterns with Customized Growth Charts: A prospective study in South India. Int J Infertil Fetal Med 2015;6(1):30-34.

To investigate the correlation of blood flow detected by 2-Dimensional Power Doppler (2D-PD) sonography in the subendometrial-endometrial unit with the pregnancy outcome in frozen-thawed embryo transfer (FET) cycles.

Prospective non-randomized observational study.

A total of 127 patients undergoing their first FET cycle were recruited and prepared using hormone replacement therapy. All patients were evaluated for subendometrial-endometrial blood flow by 2D-PD once the endometrium was ≥7 mm thick. Progesterone supplement was added and transfer of 2 to 3 cleavage stage good quality embryos was done after 3 days.

The difference in the BMI, FSH, LH and endometrial thickness of women in the three zones was not statistically significant (p > 0.05). However, women with blood flow in zone 1 were of older age as compared to women in zone 3 with a statistically significant difference (p = 0.0001). In the present study, the overall pregnancy rate was 35.43% (45/127). Women having blood flow in zone 3 or 4 showed a rising trend of pregnancy rate as compared to those in zone 1 and 2 although it was not statistically significant (p = 0.15). But, clinical pregnancy and implantation rates were significantly higher in women with zone 3 or 4 penetration compared with zone 1 or 2 penetration (p = 0.03 and 0.01, respectively).

The subendometrial-endometrial vascularity has a useful predictive value for pregnancy outcome in FET cycles. However, larger studies are needed to reach definite conclusion.

Sardana D. Assessment of Uterine Receptivity by the Subendometrial-Endometrial Blood Flow Distribution Pattern in Frozen-Thawed Embryo Transfer Cycles. Int J Infertil Fetal Med 2015;6(1):35-39.

Rajdeo RN, Taori K, Rathod J, Sejpal NN. Cor Triloculare Biventriculare with Ventricular Septal Defect: Prenatal Diagnosis. Int J Infertil Fetal Med 2015;6(1):40-42.