The Journal of Obstetrics and Gynaecology of India
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ORIGINAL ARTICLES

ORIGINAL ARTICLES

Hysterolaparoscopy in the Evaluation and Management of Female Infertility

Kabadi YM, Harsha B

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Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature

Said TH

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Unmet Needs of Family Planning Among Women: A Cross-Sectional Study in a Rural Area of Kanchipuram District, Tamil Nadu, South India

Vishnu Prasad R, Venkatachalam J, Singh Z

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Efficacy of Use of Long-Term, Low-Dose Mifepristone for the Treatment of Fibroids

Kapur A, Angomchanu R, Dey M

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Non-decent Vaginal Hysterectomy in Rural Setup of MP: A Poor Acceptance

Jain SB, Chandrakar KD

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The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding

Eralil GJ

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Factors Leading to Pregnancies in Stimulated Intrauterine Insemination Cycles and the Use of Consecutive Ejaculations Within a Small Clinic Environment

Bahadur G, Almossawi O, IIlahibuccus A, Al-Habib A, Okolo S

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Endometrial and Subendometrial Vascularity by Three-Dimensional (3D) Power Doppler and Its Correlation with Pregnancy Outcome in Frozen Embryo Transfer (FET) Cycles

Mishra VV, Agarwal R, Sharma U, Aggarwal R, Choudhary S, Bandwal P

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Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Elnaggar EA, Elwan YA, Ibrahim SA, Abdalla MM

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Study to Evaluate Targeted Management and Syndromic Management in Women Presenting with Abnormal Vaginal Discharge

Meena V, Bansal CL

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Litigations in Obstetric and Gynecological Practice: Can it be prevented? A Probability to Possibility

Gowda SL, Bhandiwad A, Anupama NK

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Impact of Structured Counseling with Trained Counselors in Choosing a Modern Contraceptive Method in India

Kumar S, Nabh D, Arora R, Garg P

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Endocrine and Metabolic Profi le of Diff erent Phenotypes of Polycystic Ovarian Syndrome

Pikee S, Shivani S, Jayshree B

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To Assess the Safety of Morcellation for Removing Uterine Specimen During Laparoscopic and Vaginal Hysterectomies for Leiomyomas

Agrawal P, Agrawal R, Chandrakar J

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“The Jelly Belly”: Diagnostic Dilemmas and Current Concepts

Kedia PP, Ravikumar G, Mohanty S, Crasta J, Vallikad E

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Lower Genitourinary Tract Trauma Caused by Cow Horn Injury

Priyadarshi V, Gupta D, Pal DK

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GYNECOLOGY

Impact of Ovarian Factor Mediums on the Apoptotic Gene Expression and Embryo Quality Derived From Vitrified Immature Human Oocytes

Hakimeh Akbari1 · Hossein Foruozandeh1 · Masoud Mohammadi1

Background Condition mediums have a potential role in oocyte development. In this study, we evaluated the effects of different mediums on the developmental potential of vitrified immature human oocyte after IVM and parthenogenesis by ionomycin.

Methods Immature oocytes were collected from 184 women after vitrification/thawing and maturation, in three types of IVM mediums separately. Finally, 151 IVM MΙΙ oocytes were obtained and randomly divided into six groups and underwent the following intervention. Fresh and vitrified-thawing MΙΙ oocytes were activated after IVM in three conditioned mediums by ionomycin. Mediums included 1) Minimum Essential Medium Alpha (α-MEM) (as control medium), 2) α-MEM supplemented with supernatants of Mesenchyme bone marrow (B.M), 3) α-MEM with ovarian growth factors (O.F). Then, scoring of parthenote embryos was undertaken in accordance with pertinent morphological properties. Moreover, the expression of Bax and Bcl2 were determined in the parthenote embryos.

Result Percentage of the degenerated oocyte, 2–4 cells, 4–8 cells, and 16 cells, was different in the experimental groups. Also, cytoplasmic maturation and blastocyst formation rates were significantly different (p < 0.05) between the control and the other mediums. The highest mRNA expression levels of Bcl2 and Bax genes in parthenotes were observed in the fIVM O.F and vIVM α-MEM mediums, respectively. vIVM, α-MEM and fIVM O.F showed the lowest expression of Bcl2 and Bax genes, respectively.

Conclusion Our findings indicate that the O.F. medium had more potent effects on oocyte growth and cytoplasmic maturation up to the blastocyst stage with the highest expression level of the BCL2 gene and the lowest relative amount of the BAX gene in this medium. The results of the present study have been verified only for parthenogenetically activated embryos, and any positive effect of the environment on the egg/embryo fertilized with sperm requires more extensive studies.

IVM · Conditioned medium · Parthenogenesis · Developmental potential · Oocyte activation
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GYNECOLOGY

The effect of zinc supplementation on improving sperm parameters in infertile diabetic men

Hakimeh Akbari1 · Leila Elyasi2 · Ali Asghar Khaleghi1 · Masoud Mohammadi1

Background and aims Diabetes mellitus (DM) may have different adverse effects on the male reproductive system. Zinc (Zn) is one of the necessary elements in the human and mammalian diet that plays an important role in scavenging reactive oxygen species (ROS) by providing antioxidant and anti-apoptotic properties. The aim of this study was to determine the protective effects of zinc supplements on sperm chromatin and the evaluation of sperm deoxyribonucleic acid (DNA) integrity in diabetic men.

Methods In this interventional study, 43 infertile Iranian men in diabetic and non-diabetic groups were included. They were then randomly divided into two subgroups: normal saline intake and zinc sulfate intake (25 mg orally for 64 days each). Different indices of sperm analysis (number, morphology and motility) and testosterone levels were evaluated in four groups. Protamine deficiency and DNA fragmentation were assessed using chromomycin A3 (CMA3) and sperm chromatin dispersion (SCD) methods, respectively.

Results Zinc supplementation reduced the deformity of neck and head of sperms (p < 0.05), as well as deformity of sperm tail in infertile diabetic men. Zinc administration ameliorated sperm motility types A, B and C (p < 0.05). Moreover, zinc administration reduced abnormal morphology and DNA fragmentation of sperms, which increased the SCD1 and SCD2 and reduced the SCD3 and SCD4 in both treated groups.

Conclusion Zinc supplementation, as a powerful complement, is able to balance the effect of diabetes on sperm parameters, sperm chromatin and DNA integrity. Consequently, zinc supplementation can probably be considered a supportive compound in the diet of diabetic infertile men.

Sperm · Infertile · Male · Semen · Zinc
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GYNECOLOGY

Effects of Non‑Cavity‑Distorting Intramural Fibroids on IVF Outcomes in Patients with Recurrent IVF Failure: Does Myomectomy Change IVF Outcomes ?

Ugur Deger1 · Ekin Altinbas2 · Melis Karabay2 · Yagmur Karatas2 · Zeynep Deniz2 · Ceyda Buyuker2 · Sule Yildirim Kopuk3 · Bulent Tiras2,3 · Yigit Cakiroglu2,3

Background Uterine fibroids are the most common benign smooth muscle tumors of the uterus. However, there is no consensus on whether myomectomy improves IVF success in women with non-cavity-distorting intramural fibroids. The aim of this study was to compare the IVF and pregnancy outcomes of women who had non-cavity-distorting intramural fibroids and underwent myomectomy vs women who had intramural fibroids, but did not undergo myomectomy.

Methods A retrospective cohort study at Acibadem Maslak Hospital, IVF Center, between 2019 and 2020. Data of 128 women aged between 25 and 43 years who have at least 2 intramural non-cavity-distorting fibroids of 2–6 cm in size were used. All patients had at least two IVF failure. The intervention group comprised women who decided to proceed to myomectomy before IVF (Group 1, n = 56). The control group was established women with intramural fibroids who reject myomectomy (Group 2, n = 71).

Results In regard to IVF result parameters and perinatal outcomes, there was no statistically significant difference between the two groups. Between study groups, there were no statistically significant differences in the perinatal outcomes. Myomectomy surgery did not increase miscarriage and biochemical pregnancy rate (odds ratio (OR) 0.9; 95% confidence interval (CI) 2.8–3.7). Conclusion Myomectomy does not impact on pregnancy or live birth rates substantially, according to the results of this study.

Intramural fibroids · Non-cavity-distorting · In vitro fertilization · Myomectomy · Perinatal outcome
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GYNECOLOGY

Elective Single Cleavage‑Stage Embryo Transfer in IVF Patients with Suboptimal Ovarian Response is Not Detrimental to Cumulative Pregnancy and Reduces Multiple Pregnancy Rates.

Alessio Paffoni1 · Sabrina Cesana1 · Laura Corti1 · Hilda Wyssling1 · Alessandro Kunderfranco1 · Marco Claudio Bianchi1

Purpose To evaluate whether elective single embryo transfer in patients with suboptimal response to ovarian stimulation is
detrimental to pregnancy rates compared to double embryo transfer.
Methods A case–control retrospective study was performed in a cohort of couples undergoing IVF at the Infertility Unit of
the ASST Lariana with ≤ 9 oocytes and at least 2 viable embryos. A total of 424 women were analyzed in the “double embryo
transfer” group (n = 212) and elective “single embryo transfer” group (n = 212); they were matched 1:1 for female age, ovarian
reserve and number of previous cycles. Cumulative clinical pregnancy rate per oocyte retrieval was the main outcome.
Results The cumulative pregnancy rate per cycle, including the fresh embryo and subsequent frozen embryo transfers, was
26% and 26%, respectively. Considering the main confounding factors, a binomial logistic model indicated that the cumulative
clinical pregnancy rate was not significantly affected when a single embryo transfer was performed in women recovering
up to nine oocytes.
Conclusion Live birth rate was similar between the two groups, while twin pregnancies were significantly reduced in women
receiving single embryo transfer suggesting that elective single embryo transfer in patients with a limited number of embryos
is not detrimental to pregnancy rates.

Poor ovarian response · Single embryo transfer · In vitro fertilization · Twin pregnancy
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