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1.
Journal of Sheikh Zayed Medical College [JSZMC]. 2016; 7 (2): 968-973
em Inglês | IMEMR | ID: emr-179224

RESUMO

Background: Semen analysis is the basic step when investigating sub fertility disorders related to male genital tract. Valuable clinical information can be obtained from Semen analysis report about the spermatogenesis and functional capabilities of spermatozoa


Objective: To determine the fertilization rate and pregnancy outcomes among intracytoplasmic sperm injection patients and its association with sperm parameters


Methodology: This retrospective analytical study was carried out at Lahore Institute of Fertility and Endocrinology, Lahore. Male partners of 272 couples were included in the study as they came for evaluation for assisted reproduction in between 1st July and 31st December 2014. Before samples were collected these males were asked to remain abstinent for 3 days. Specimens were collected by masturbation, and in cases of azoospermia it was retrieved by Percutaneous Epididymal Sperm Aspiration [PESA] or Testicular Sperm Apiration [TESA]. Semen analysis was performed according to the methods and standards outlined by the World Health Organization [WHO]. Oocytes were aspirated after 35-36 hours approximately, by ultrasound-guided transvaginal retrieval. About 4-5 hours after the aspiration of oocyte, in the IVF cycles, they were inseminated. After 18 to 20 hours all oocytes were examined for pronuclei followed by cleavage assessment within 24 hours. Embryos were examined and best embryos two or three were transferred into the uterine cavity on the 3rd day


Results: Fertilization did occurred in 182 [95.8%] patients with normal sperm count, in 30 [90.9%] with subnormal sperm count and in 43 [87.8%] with Azoospermia. Fertilization did occur in 209 [95.4%] patients with normal sperm morphology, in 12 [92.3%] with subnormal sperm morphology and in 34 [85.0%] with Azoospermia. Fertilization did occur in 160 [98.2%] patients with normal sperm motility, in 59 [88.1%] with subnormal sperm motility and in 36 [85.7%] in the Azoospermia group


Conclusion: Sperm motility and morphology abnormality affected fertilization in intracytoplasimic sperm injection. Though value of semen analysis is limited but gives direction to the investigation. Mere semen examination is not at all sufficient to make definitive diagnosis. It is not at all predictive about the functional abilities of the sperms. There is a need for adding an andrology component to the training of the gynecologists

2.
Journal of Sheikh Zayed Medical College [JSZMC]. 2014; 5 (4): 715-720
em Inglês | IMEMR | ID: emr-175976

RESUMO

Background: Infertility has social, psychological and physical effect on couples


Objective: To describe the characteristics of women attending a private clinic for assisted reproductive technology


Subjects and Methods: The infertile couples who came to Lahore Institute of Fertility and Endocrinology [LIFE] from 1[st] January to 31[st] December, 2013 for infertility work up, were included in the study. The sampling technique used in this study was non probability, convenient, and time based, as the study design was cross sectional. Sample size was 534 patients of assisted reproductive technology.[ART]. A questionnaire was used for the data collection. This questionnaire included information on woman's demographics, obstetric and infertility history, radiology and hormone investigation. SPSS version 20 was used for the data analysis


Results: Patients with age less than 35 years were 398 [74%], between 36-39 were 103 [19%] and more than 40 years were 33[6%]. Follicle stimulating hormone [FSH] was less than 9 l U/ ml in 418 [78%] between 9-11 l U/ ml in 83[15%] and greater than 11 l U/ ml in 33[6%]. Patients having regular menstrual cycle were 498 [93%]. Patients having parity were 118 [22%] who had delivered a child. Body mass index [BMI] was less than 25 in 163[30%], between 25-30 in 219[41%], greater than 30 in 152 [28%].As with the female factors, no causes were found in 254 [47%], tubal cause in 120 [22%], PCO in 68 [12%], endometriosis in 13[2%], un-explained causes were found in 79[5%]. Count of antral follicles was 6-8 per ovary in 369 [69%], 3-5 per ovary was 129 [24%], 0-2 per ovary was 36[7%]. Primary infertility was seen in 350 [65%] patients, secondary infertility in 178 [33%], unexplained infertility in 6[1%]. Regarding duration of infertility, in 113[21%] patients it was 2 or less than 2 years, 118 [22%] was 4 years, in 49 [9%] was 5 years, in 87 [16%] was 7 years, in 82 [15%] was 10 years, in 85 [16%] was greater than 10 years


Conclusion: Importance of recognition of infertility as a health issue will not only remove treatment barriers but also improve the health seeking behaviors of the infertile couple. Health education about fertility will ease the social taboos and improve the delivery of health services to infertile couples. Age, FSH, menstrual regularity, parity, BMI, female factor, antral follicles, type of infertility, duration of infertility may have a predictive value forecasting the success of the outcome of IVF. Further research is needed on these lines

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