relationship between uterine artery two-dimensional color Doppler measurement and pregnancy outcome: a prospective observational study

Background: the purpose of the study was to evaluate the role of uterine blood flow parameters measured by uterine artery two-dimensional [2D]-power color Doppler [PCD] ultrasound in predicting fertility outcomes in women undergoing IVF-ET cycles

Methods: in this prospective observational study, a total of 188 infertile women who underwent IVF-ET cycles were investigated. Uterine artery 2D-PD measurements were taken during early follicular phase and on day of trigger. Pulsatility Index [PI], Resistant Index [RI], Peak Systolic Velocity [PSV], and Systolic/Diastolic ratio [S/D] were measured. Statistical correlation was sought between the doppler parameters and fertility outcomes

Results: the pregnancy rate was 40.43% [76/188]. The women who conceived [n= 76] [Group A] were found to have mean age of 31.2+/-3.9 years whereas the nonpregnant group of women [n=112] [Group B] had mean age of 31.45+/-4.25 years. The mean PI measurements subsequently during early follicular phase and on the day of hCG trigger between group A and group B were comparable [2.09+/-1.15 versus 1.9+/-0.95; p=0.385 and 1.86+/-1.12 versus 2.03+/-1.0; p=0.192, respectively]. No significant changes in the uterine artery PSV values and S/D values and RI were noted during the cycle

Conclusion: uterine artery doppler evaluation in women undergoing IVF cycles was not predictive of the pregnancy outcomes

Correlation of the day 3 FSH/LH ratio and LH concentration in predicting IVF outcome

This study was undertaken to evaluate the role of day 3 FSH/LH ratio and day 3 LH level as predictors of IVF cycle outcomes. This prospective observational study was undertaken in the IVF and Reproductive Biology Centre and Lok Nayak Hospital, affiliated to Maulana Azad Medical College, in New Delhi, India. The study included 105 women who underwent controlled ovarian hyperstimulation for in vitro fertilization. Characteristics of IVF cycles and outcomes were studied in patient subgroups based on day 3 FSH/LH ratio [<2 and >/= 2] and day 3 LH levels [>3 and /= 2 [n=31] required higher doses of gonadotrophins [3019.34 vs. 2482.43 IU]. The outcome of IVF was poor in these patients and they had fewer number of mature follicles [>16 mm] [5.44 vs. 6.09], less E2/mature follicle ratio [4.65 vs. 6.36], fewer retrieved oocytes [6.67 vs. 9.09] and fewer pregnancy rates [11.1% vs. 33.8%]. On the other hand, patients with low basal LH levels [3 mIU/ml. Elevated day 3 FSH/LH ratio is associated with inferior outcome in IVF treatment cycles and it could be used as an additional predictor of decreased ovarian reserve

rare case of tuberculous pyometra in a young infertile female confirmed by mRNA-based RT-PCR

A 25-year-old female presented to the infertility OPD with complaints of secondary infertility and pain lower abdomen with watery discharge for the past five days. She had history of undergoing hysterosalpingography in a private hospital ten days back. The interventions included drainage of pyometra, endometrial biopsy for routine and AFB smear/ culture, confirmation of diagnosis by mRNA-based RT-PCR for detection of M. tuberculosis-specific 85B antigen gene, anti-tubercular therapy. Pyometra and tubo-ovarian masses disappeared and patient resumed her normal period post-treatment. Genital tuberculosis was confirmed by mRNA-based RT-PCR and the disease resolved after anti-tubercular therapy. We conclude that a combination of high degree of clinical suspicion and 'high-precision' gene detection methods [e.g. mRNA] in culture-negative cases may be useful in diagnosis of genital tuberculosis, particularly in infertile patients presenting with pyometra post-hysterosalpingography