Azoospermia एक चिकित्सा स्थिति है जहां पुरुषों में वीर्य में कोई शुक्राणु नहीं मिलता है ।
हम मौहक IVF सेंटर इंदौर में, सस्ती कीमतों पर उच्च सफलता दर के साथ गुणवत्ता ivf उपचार के साथ प्रदान करते हैं । हमारा लक्ष्य आपके परवरिश के सपनों को सच बनाने के लिए है ।
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अवरुद्ध फैलोपियन ट्यूब आपके और आपके मातृत्व के बीच एक कारण हो सकता है । यदि आपको गर्भवती होने में कुछ कठिनाई होती है तो हमारे विशेषज्ञ के साथ अपनी समस्या साझा करें ।
हम मौहक IVF सेंटर इंदौर में आपको सबसे अच्छी गुणवत्ता IVF उपचार प्रदान करते हैं जो सस्ती कीमत पर उच्च सफलता दर के साथ है । हमारा लक्ष्य आपके परवरिश के सपनों को सच बनाने के लिए है ।
अपॉइंटमेंट बुक करें अब कॉल करें 78980–47572 / 80852–77666 अधिक जानकारी के लिए विजिट करें www.mohakivf.com
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AbstractBackground – Women with polycystic ovarian syndrome (PCOS) may undergo laparoscopic ovarian drilling (LOD). To find out whether endometrial scratch, at time of LOD, could improve live birth rate in subfertile women with PCOS, a randomized controlled trial was conducted.
Results –There was no evidence of a significant difference in cumulative live birth rate between women who had endometrial scratch at time of LOD and those who had LOD only (38.1% and 34.3% respectively, odds ratio 1.18, 95% CI (0.67, 2.07); p = 0.57). Conclusion – Women undergoing laparoscopic ovarian drilling should not be subjected to endometrial scratch as it does not lead to improvement in live birth rate. The study was prospectively registered on 25 April 2014 in ClinicalTrials.gov with identifier number NCT02140398.
Background Polycystic ovarian syndrome is the most common cause of anovulatory subfertility [1]. Weight reduction, lifestyle modification, and ovulation induction are the recommended initial management strategies [2, 3]. Laparoscopic ovarian drilling (LOD) has been suggested to induce ovulation in these women, especially those who fail to ovulate through ovulatory medications [4,5,6]. It has been suggested that the procedure is as effective as ovarian stimulation with exogenous gonadotropins [7], yet it does not increase multiple pregnancy rates or ovarian hyperstimulation syndrome (OHSS) rates. Many women may ovulate after LOD, yet they fail to conceive [8]. Those women may need to undergo IVF treatment in their pursuit for a baby.
Endometrial scratching is a procedure where the endometrium is subjected to physical trauma that caused injury to the functional layer of the endometrium mechanically [9,10,11,12]. It has been suggested that endometrial injury could improve IVF outcome in women with recurrent implantation failure after IVF [13]. Nonetheless, endometrial scratch has been also proposed to overcome subfertility in women with unexplained infertility [14]. Randomized controlled trials have also shown improvements of intrauterine insemination (IUI) results in women subjected to controlled endometrial injury prior to insemination [9, 10]. However, there were some other studies that have shown no benefit from the procedure [15, 16].
The aim of our study was to find out whether performing endometrial scratch at time of laparoscopic drilling would improve live birth rate in subfertile women with PCOS.
Patients and methods
Study design and participants – We conducted a parallel randomized controlled trial (RCT), approved by our university ethics committee. We approached all infertile women with anovulatory infertility due to PCOS referred for laparoscopic ovarian drilling in Mansoura University Teaching Hospitals in Mansoura, Egypt. Our hospital is a tertiary care center conducting between 600 and 700 laparoscopic surgeries per year for infertile women. The study was conducted during the period from April 2014 to April 2015 (last patient enrollment). Follow-up was continued for 9 months after laparoscopy. The last pregnancy was in December 2015. Last data collection was in September 2016. An informed written consent was obtained from all women who participated in the study.
Our inclusion criteria were women aged 20 and less than 39 and women with PCOS as diagnosed by Rotterdam criteria, fertile semen analysis according to WHO 2010, and bilateral tubal patency as demonstrated by hysterosalpingogram (HSG) [17, 18]. The exclusion criteria were suspected endometriosis, suspected uterine cavity anomaly or mass, associated male factor infertility, presence of endocrinopathy as thyroid dysfunction, and women subjected to endometrial curettage for any reason in the last 6 months.
Intervention
Women were admitted to our hospital 1 day before laparoscopic drilling. Women were randomized into two groups: group A (the intervention group) and group B (the control group). Randomization was through a computer-generated list of random numbers. Allocation of women to groups was through an opaque sealed envelope that had to be picked by a nurse in the operative theater. The surgeon was not blinded to the procedure while patients and data assessor were blinded to their allocation. All women underwent a three-puncture laparoscopy procedure where laparoscopic ovarian drilling (LOD) was achieved. Ovarian drilling was performed through monopolar coagulation diathermy. Four punctures were performed. Each penetrates about 4 mm depth, using 40-W power that lasts for 4 s. In the intervention group (group A), endometrial scratching was performed at the end of laparoscopy by endometrial curette. The curette was introduced gently through the cervix up to the uterine fundus then withdrawn for 1 or 2 cm. One act of scratching was performed on the posterior wall of the uterus after the end of drilling. The obtained specimens were sent for histopathology. The control group (group B) had LOD only, and no endometrial scratch was performed. Women in both groups were seen 3 months after laparoscopy and were asked whether they had a positive pregnancy test, still have oligomenorrhea, or had had regular periods. Women who had regular periods were subjected to folliculometry to confirm the establishment of ovulation while those with oligomenorrhea were subjected to ovulation induction with clomiphene citrate, tamoxifen, or letrozole. Women who did not respond to ovulatory oral medications were stimulated using exogenous gonadotropins using the low-dose step-up protocol with a 37.5 IU starting dose [19]. The primary outcome measure in this trial was live birth rate per woman randomized. Secondary outcome measures were clinical pregnancy rate, time to pregnancy, miscarriage rate, and multiple pregnancy rate. The study was registered in ClinicalTrials.gov with identifier number NCT02140398.
Definitions – Clinical pregnancy was defined as the presence of intrauterine gestational sac 1 or 2 weeks after positive pregnancy test in blood. Live birth was defined as the delivery of living fetus after 24 weeks gestation. Statistical analysis – We estimated that the pregnancy rate after laparoscopic ovarian drilling was around 50% [20]. The intervention was suggested to boost pregnancy rate up to 70%. We calculated that we will need to study 93 experimental subjects and 93 control subjects to be able to reject the null hypothesis that the failure rates for experimental and control subjects are equal with a study power (probability) of 80%. The type I error probability associated with this test of this null hypothesis is 0.05 [21]. To compensate for dropouts, we calculated that we needed to randomize 210 women. We used SPSS 15 program. We adopted the intention-to-treat analysis.
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There is no better feeling than the movement of life inside you and every mother experiences it in a different way.If you’ve had some difficulty in getting pregnant share your problem with our expert. Take a step toward parenthood with us.
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A slender tube via which eggs finds its way from an ovary to the uterus is known as a Fallopian tube. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.
Cilia are the small hair-like projections found on the cells of the lining of the Fallopian tube. For the movement of the egg through the channel (tube) into the uterus, these tubal cilia are important. In case, because of some infection, the tubal cilia are damaged, the egg might stay in the tube instead of getting ‘pushed along’ normally.
Infection can also lead to partial or complete blockage of the tube with scab tissue, actually stopping the egg from getting inside the uterus.
The chance of an ectopic pregnancy where the pregnancy develops inside the Fallopian tube or somewhere else in the abnormal location outside the uterus increases with any growth (like an infection, tumours, endometriosis, or scar tissue in the pelvic adhesions (pelvis) that lead to chinking or twisting of the tube) which rupture the Fallopian tube or shrink its diameter.
The Fallopian tube, also known as the uterine tube is meant to carry an egg to uterus from the ovary. Normally a woman has two uterine tubes in her body, unless a surgery, biological abnormality or ectopic pregnancy lead to the loss of one tube.
The ampulla is a part of Fallopian tube usually where an egg gets fertilized by male sperm. Then the derived fertilized egg develops into blastocyst and gets into the uterus where it remains developing until birth.
It is seen in some women who suffer from an ectopic or tubal pregnancy that keeps their Fallopian tube and their lives as well in trouble. When a fertilized egg stays in the tube instead of moving to the uterus, it results in Ectopic pregnancy. A surgery that terminates the pregnancy is performed in order to treat it.
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Obesity, which is an important health issue, is a common problem among women of reproductive age. Overweight and obese women are at high risk for reproductive health. The risk of subfecundity and infertility, conception rates, miscarriage rates, and pregnancy complications are increased in these women. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Book an Appointment Now Call 78980–47572 / 80852–77666 For more detail visit www.mohakivf.com
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“Should we be using new tool of Flageliar Analysis and Sperm Tracking ( FAST)?”
INTRODUCTION: Can flagellar analyses be scaled up to provide automated tracking of motile sperm and does knowledge of the flagellar waveform provide new insight not provided by routine head tracking? The clinical gold standard for sperm motility analysis comprises a manual analysis by a trained professional, with existing automated sperm diagnostics.
computer-aided sperm analysis (CASA)] relying on tracking the sperm head and extrapolating measures. It is not currently possible with either of these approaches to track the sperm flagellar waveform for large numbers of cells in order to unlock the potential wealth of information enclosed within.
SUMMARY: Using the software tool IFlagellar Analysis and Sperm Tracking (FAST)! Gallagher et al’ analysed 176 experimental microscopy videos and have tracked the head and flagellum of 205 progressive cells in diluted semen (DSM), 119 progressive cells in a high-viscosity medium (HVM) and 42 stuck cells in a low-viscosity medium. The software tool in this manuscript has been developed to enable high-throughput, repeatable, accurate and verifiable analysis of the sperm &Filar beat. Unsc reened donors were recruited after giving informed consent. They described fully automated tracking and analysis of flagellar movement for large cell numbers. The analysis is demonstrated on freely motile cells in low- and high•-viscosity fluids and validated on published data of tethered cells undergoing pharmacological hyperactivation. Direct analysis of the flagella,- beat reveals that the CASA measure ‘beat cross frequency’ does not measure beat frequency; attempting to fit a straight line between the two measures gives R2R2 values of 0.042 and 0_00054 for cells in DSM and I-IVM, respectively. A new measurement, track centroid speed, is validated as an accurate differentiator or progressive motility. Coupled with fluid mechanics codes, waveform data enable extraction of experimentally intractable quantities such as energy dissipation, disturbance of the surrounding medium and viscous stresses. They provide a powerful and accessible research tool, enabling connection of the mechanical activity of the sperm to its motility and effect on its environment. The FAST software package has only been tested for use with negative phase contrast microscopy. Other imaging modalities, with bright cells on a dark background, have not been tested but may work. FAST is not designed to analyse raw semen; it is specifically for precise analysis of flagellar kinematics, as that is the promising area for computer use. flagellar capture will always require that cells are at a dilution where their paths do not frequently cross.
CONCLUSION: High-throughput flagellar waveform tracking and analysis enable measurement of experimentally intractable quantities such as energy dissipation, disturbance of the surrounding medium and viscous stresses, which are not possible by tracking the sperm head alone. Combining tracked flagella with mathematical modelling has the potential to reveal new mechanistic insight. By providing the capability as a free-to-use software package, ability to accurately quantify the flagellar waveform in large populations of motile cells will enable an abundant array of diagnostic, toxicological and therapeutic possibilities, as well as creating new opportunities for assessing and treating male subfertility.
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