Severe early-onset ovarian hyperstimulation syndrome with liver dysfunction in an IVF segmentation cycle.

Severe early-onset ovarian hyperstimulation syndrome (OHSS) with deranged liver function tests is an entity that cannot be eliminated wholly even after gonadotropin-releasing hormone (GnRH) agonist trigger without any luteal human chorionic gonadotropin (hCG) rescue in a GnRH antagonist protocol with the freeze-all approach. We describe a case of young polycystic ovary syndrome patient with prior history of severe early-onset OHSS in her last in vitro fertilisation cycle in which she received antagonist protocol followed by blastocyst transfer. Given her history, she was planned for agonist trigger and freeze all approach during the present cycle. Despite segmentation of the cycle without any luteal rescue hCG, she developed early-onset severe OHSS with markedly deranged liver function tests for which she underwent ascitic tapping and remained hospitalised for 8 days. Her symptoms improved with conservative management, and she was discharged satisfactorily. She underwent letrozole based frozen-thawed embryo transfer cycle after 4 months. One good quality blastocyst was transferred, and she conceived in the same cycle.

Seminal reactive oxygen species and total antioxidant capacity: Correlations with sperm parameters and impact on male infertility.

OBJECTIVE: The aim of this study was to measure reactive oxygen species (ROS) production and total antioxidant capacity (TAC) in the seminal fluid of the male partners in couples undergoing intrauterine insemination and to evaluate correlations between these values and their semen parameters. METHODS: The study was conducted at Vamsam Fertility Center, Coimbatore, India and enrolled 110 male patients from whom semen samples were collected. ROS production was measured by a thiobarbituric acid reactive species assay, and TAC was measured by a 2,2-diphenyl-2-picrylhydrazyl free radical assay. The differences in the TAC and malondialdehyde (MDA) levels between the subfertile and fertile groups were analysed. Correlations between sperm parameters and TAC and MDA levels were statistically analysed, and cutoff values with respect to the controls were determined. All hypothesis tests used were two-tailed, with statistical significance assessed at the level of p<0.05. RESULTS: A total of 87 subfertile and 23 fertile men were included in the study. The mean MDA level was significantly higher in the subfertile subjects than in the fertile subjects, and the mean antioxidant level was significantly lower in the subfertile subjects than in the fertile subjects. Seminal MDA levels were negatively associated with sperm concentration, motility, and morphology, whereas the opposite was seen with TAC levels. CONCLUSION: Measurements of seminal TAC and ROS are valuable for predicting semen quality, and hence predicting the outcomes of fertility treatment.

Retrospective Study of Factors Affecting Intrauterine Insemination Pregnancy Outcome: The Impact of Male Habits and Working Environment.

AIMS: This study is aimed at determining the prognostic factors influencing successful pregnancy following intrauterine insemination (IUI). SETTINGS AND DESIGN: Retrospective analysis. MATERIALS AND METHODS: A total of 2123 cycles undergone by 871 couples during the period of 5 years (2011-2015) were retrospectively studied. STATISTICAL ANALYSIS USED: Each of the factors was compared with pregnancy outcome (PO) using statistical analysis with a confidence interval of 95% in SPSS software version 19. Chi-square test and logistic regression analysis method were used to determine the significance of each factor with the PO. RESULTS: Among the various factors included in our study population, male habits (P = 0.004), male occupational environment (P = 0.025), male age (P = 0.002), and female age (P = 0.001) were found to significantly influence the PO following IUI. CONCLUSION: Our results indicate that avoiding smoking and alcohol consuming prior and during the IUI treatment along with working in low-heat-generating environment might lead to better success following the treatment.