scholarly journals Granulocyte colony stimulating factor in COS-IUI cycles

2019 ◽  
Vol 8 (4) ◽  
pp. 1463
Author(s):  
Pradnya Devdas Shetty ◽  
Nikita Lad ◽  
Pallavi Vishwekar ◽  
Mamta Vijay Shivtare
Keyword(s):  
Pregnancy Rate ◽  
Transvaginal Ultrasound ◽  
Clomiphene Citrate ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Intrauterine Pregnancy ◽  
Minimum Thickness ◽  
Assisted Reproductive Technique ◽  
Thin Endometrium ◽  
Β Hcg

Background: An unresolved assisted reproductive technique problem is the unresponsive, thin endometrium. Approximately 0.6%-0.8% of patients do not reach the minimum thickness. Using endometrial co culture, G-CSF>130pg/mL was associated with significantly improved pregnancy rate in ART cycles. This is a retrospective study that included all unexplained infertility cycles with controlled ovulation stimulation –IUI protocols. Aim was to note the effects of G-CSF on thin endometrium and pregnancy rate in G-CSF administered COS-IUI cycles.Methods: This study was done in the IVF department of Dr D Y Patil University, Navi Mumbai, India. Thin endometrium was defined as ET<7mm on transvaginal ultrasound. Clomiphene citrate was used for ovulation induction in strengths of 100mg or 50mg on day 2 of their cycle based on the antral follicle count. Trigger used was injection 10,000µg urinary hCG. On the same day when the trigger injection was given, 300 units G-CSF was instilled into the uterus. Post 36 hours IUI was done under aseptic precautions .After 16 days β-hCG levels were done to determine whether there is a pregnancy.Results: In present study,200 COS-IUI cycles were analysed.50 cycles showed a thin endometrium and in them G-CSF was used. The chemical pregnancy rates was 32%, the intrauterine pregnancy rate was 28%, ectopic pregnancy rate was 4%.Conclusions: Present study concluded that G-CSF increases ET significantly in COS-IUI cycles in the event of thin endometrium. In view of small cohort size further larger randomized controlled trials may be required  to substantiate the above conclusions.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

Effect of resveratrol administration on ovarian morphology, determined by transvaginal ultrasound for the women with PCOS

2021 ◽  
pp. 1-18
Author(s):  
Amir Pejman Hashemi Taheri ◽  
Behnaz Moradi ◽  
Amir Reza Radmard ◽  
Milad Sanginabadi ◽  
Mostafa Qorbani ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Volume ◽  
Exact Test ◽  
Ovarian Morphology ◽  
The Mean

Abstract Background: Intake of resveratrol has been associated with improved ovarian morphology under in vitro and in the animal models; however, this finding has not been confirmed in trials. The aim of our study was, therefore, to use a placebo-controlled approach with the detailed assessment of the ovarian morphology by applying transvaginal ultrasound to examine the effectiveness of this therapeutic approach in this group of women. Methods: Forty-one women with polycystic ovary syndrome (PCOS) were randomly assigned (1:1) to 3 months of daily 1000 mg resveratrol or placebo. Random assignment was done by blocked randomisation. Our primary endpoints were the change in the ovarian volume, stromal area and antral follicle count per ovary (FNPO) from the baseline to 3 months. Secondary endpoints were improvement in the distribution of follicles and ovarian echogenicity. Differences between the resveratrol and control groups were evaluated by Chi-square, fisher’s exact test and repeated-measures of ANOVA. Results: The mean age of all participants was 28.61 ± 4.99 years, with the mean BMI of 28.26 ± 5.62 kg/m2. Resveratrol therapy, as compared with placebo, was associated with a significantly higher rate of improvement in the ovarian morphology (p= 0.02). Women who received resveratrol had a more dominant follicle than those getting placebo, with a significant reduction in the ovarian volume (p<0.05). However, the number of FNPO, stromal area, ovarian echogenicity and distribution of follicles were not significantly altered (P>0.05). Conclusions: Treatment with resveratrol significantly reduced the ovarian volume and PCOM, thus suggesting a disease-modifying effect in PCOS. Trial registration: IRCT, IRCT2017061917139N2. Registered 7 July 2017, http://irct.ir/trial/15836.

scholarly journals Evaluation of Anti-Mullerian Hormone Predictive Value and Antral Follicle Count in the Success Rate of Ovarian Drilling in Polycystic Ovary Syndrome

2020 ◽  
Vol 21 (6) ◽  
Author(s):  
Leili Hafizi ◽  
Akram Behrouznia ◽  
Maliheh Amirian ◽  
Mina Baradaran ◽  
Seyedeh Azam Pourhoseini
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Antral Follicle ◽  
Serum Levels ◽  
Antral Follicle Count ◽  
Ovary Syndrome ◽  
Antral Follicles ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling

Background: Laparoscopic ovarian drilling (LOD) is recommended for the treatment of women with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate. Objectives: This study aimed to evaluate the effect of ovarian drilling on the serum levels of anti-mullerian hormone (AMH), androgens, and the number of antral follicles. Methods: This was a pre- and post-clinical trial performed on 30 infertile women with PCOS resistant to clomiphene citrate. Patients underwent standard laparoscopic ovarian drilling. Serum levels of AMH and androgens and antral follicle count (AFC) were surveyed before LOD and three and six months after LOD. The ovarian ovulation rate in each month was also monitored for six months. Then, the association between changes in these parameters, especially the level of AMH, and postoperative ovulation was investigated. A P < 0.05 was considered statistically significant. Results: The number of antral follicles three (3.00 ± 8.00) and six months (7.73 ± 4.14) after ovarian drilling showed a significant decrease compared to preoperative values (12.40 ± 4.02) (repeated-measures ANOVA, P < 0.001). The mean AMH (6.78 ± 1.08 versus 12.25 ± 1.35; P = 0.005) and the antral follicle count (7.71 ± 0.54 versus 12.29 ± 0.67 and P < 0.001) were lower in ovulation than in non-ovulation patients. The significantly more AMH reductions were seen in pregnant women (3.63 ± 5.61) than in non-pregnant women (3.63 ± 1.24) (P = 0.01). Conclusions: It may be possible to use the changes in AMH and AFC to predict the success rate of LOD.

Relationship between anti-Müllerian hormone and antral follicle count across the menstrual cycle using the Beckman Coulter Access assay in comparison with Gen II manual assay

2017 ◽  
Vol 55 (7) ◽  
Author(s):  
Julia Schiffner ◽  
Judith Roos ◽  
David Broomhead ◽  
Joseph van Helden ◽  
Erhard Godehardt ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Transvaginal Ultrasound ◽  
Ovarian Follicle ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Cycle Number ◽  
Antral Follicles ◽  
Menstruating Women ◽  
Conversion Equation ◽  
Antral Follicle Counts

AbstractBackground:The study aim was to validate Beckman Coulter’s fully automated Access Immunoassay System (BC Access assay) for anti-Müllerian hormone (AMH) and compare it with Beckman Coulter’s Modified Manual Generation II assay (BC Mod Gen II), with regard to cycle AMH fluctuations and antral follicle counts.Methods:During one complete menstrual cycle, transvaginal ultrasound was performed on regularly menstruating women (n=39; 18–40years) every 2 days until the dominant ovarian follicle reached 16mm, then daily until observed ovulation; blood samples were collected throughout the cycle. Number and size of antral follicles was determined and AMH levels measured using both assays.Results:AMH levels measured by the BC Access assay vary over ovulatory menstrual cycles, with a statistically significant pre-ovulatory decrease from –5 to +2 days around objective ovulation. Mean luteal AMH levels were significantly lower (–7.99%) than mean follicular levels but increased again towards the end of the luteal phase. Antral follicle count can be estimated from AMH (ng/mL, BC Access assay) concentrations on any follicular phase day. BC Access assay-obtained AMH values are considerably lower compared with the BC Mod Gen II assay (–19% on average); conversion equation: AMH BC Access (ng/mL)=0.85 [AMH BC Mod Gen II (ng/mL)]Conclusions:AMH levels vary throughout the cycle, independently of assay utilised. A formula can be used to convert BC Access assay-obtained AMH levels to BC Mod Gen II values. The number of antral follicles can be consistently estimated from pre-ovulatory AMH levels using either assay.

scholarly journals Role of endometrial thickness in natural and stimulated cycles in infertility

2020 ◽  
Vol 9 (7) ◽  
pp. 2872
Author(s):  
Vandana Dhama ◽  
Kiran Kumari ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Uttar Pradesh ◽  
Sildenafil Citrate ◽  
Estradiol Valerate ◽  
Thin Endometrium ◽  
Infertile Women ◽  
Medical College

Background: The endometrium plays an important role in infertility. The growth of endometrium depends on serum oestradiol level and blood flow to the uterus. A thin endometrium is defined as a lining of less than 7 mm which is associated with infertility. The endometrium is best seen on Transvaginal scan (TVS). The purpose of this study was to evaluate the role of endometrial thickness and its outcome in natural and stimulated cycles in infertile women.Methods: This prospective cohort study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut, Uttar Pradesh, India. Total 150 infertile women of age less than 35 years presented with either primary or secondary infertility were enrolled. Each patient was undergoing transvaginal scan (TVS) to measure endometrial thickness follicular monitoring.Results: The endometrial thickness and pregnancy rate was higher in letrozole induced group as compared to clomiphene with estradiol valerate and clomiphene with sildenafil citrate induced group.Conclusions: Letrozole had better effect on endometrial thickness and pregnancy rate as compared to clomiphene citrate with estradiol valerate and clomiphene citrate with sildenafil citrate.

scholarly journals Unruptured unilateral twin ectopic pregnancy: a rare case report

2020 ◽  
Vol 9 (5) ◽  
pp. 2151
Author(s):  
Nayanika Gaur ◽  
Piyush K. Goyal ◽  
Manish Jha
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Complete Recovery ◽  
Intrauterine Pregnancy ◽  
Serum Progesterone ◽  
Post Surgery ◽  
Β Hcg ◽  
The Right

Unilateral twin ectopic pregnancy is a rare entity with an incidence of 1 in 125,000 pregnancies. This is a case of a 26-year-old primigravida with a spontaneous unilateral twin ectopic gestation, diagnosed on transvaginal ultrasound, treated laparoscopically by doing unilateral salpingectomy and confirmed with histopathology. The doubt for ectopic pregnancy was raised when the serum β-HCG level was constantly >1500 mIU/ml and serum progesterone level was <5 pg/ml and no intrauterine pregnancy was seen. On a follow-up scan, twin gestational sac was noted in right adnexa along with a large haemorrhagic cyst in the right ovary. On post-surgery follow-up, patient was found to have had complete recovery. This case report discusses the incidence and rarity, yet possibility of twin ectopic gestations, the need for early diagnosis and its management.

scholarly journals Supplementation of cows with linseed: effects on antral follicle count, oocyte quality, and nutritional and plasma metabolite parameters

2019 ◽  
Vol 40 (6) ◽  
pp. 2637
Author(s):  
Christopher Junior Tavares Cardoso ◽  
Ana Caroline Bini de Lima ◽  
Wilian Aparecido Leite da Silva ◽  
Mirela Brochado Souza-Cáceres ◽  
Daniela Moraes Pereira ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Antral Follicle ◽  
Oocyte Quality ◽  
Antral Follicle Count ◽  
Neutral Detergent Fiber ◽  
Significant Difference ◽  
Lipid Supplementation ◽  
The Mean ◽  
Plasma Metabolite

Linseed is distinguished by its composition of fatty acids, which are rich in unsaturated acids, and by the slow release of oil in the rumen, consequently providing a greater amount of lipids of interest for intestinal absorption. The aim of this study was to evaluate the effect of linseed supplementation on the antral follicle count (AFC) and oocyte quality of Girolando cows, as well as their digestive parameters and plasma metabolite. Twelve Girolando cows were used in the study and were randomly distributed in two experimental groups: control (CTL, n = 6) and linseed (LINS, n = 6). During the 126 days of supplementation, seven transvaginal ultrasound-guided ovum pick-up (OPU) sessions were performed at intervals of 21 days. AFC was performed in each OPU session. The cows fed with linseed showed no significant difference in the dry matter coefficient of digestibility (63.11 and 62.88), crude protein (62.7 and 55.26), neutral detergent fiber (NDF; 75.36 and 77.15), or acid detergent fiber (ADF; 72.45 and 74.77) for LINS and CTL, respectively. On the contrary, a higher level of ethereal extract was observed for LINS (69.31 vs. 40.7). There was no effect (p > 0.05) of lipid supplementation on plasma metabolite between groups and OPU sessions. There was no difference (p > 0.05) in the mean number of antral follicles (CTL: 31.14 ± 1.97; LINS: 25.52 ± 2.68), cumulus oocyte complexes recovered (CTL: 6.45 ± 1.66; LINS: 5.28 ± 1.18), or oocyte quality (CTL: 60.48% ± 8.46; LINS: 64.54% ± 7.77). The supplementation of 800g of linseed in the diet of Girolando cows did not alter the apparent digestibility of nutrients, AFC, or quality of oocytes obtained by OPU.

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