RESUMO
Background: The association between cumulative live birth rate (CLBR) and oocyte aspiration in the context of maternal age is not well understood in the Indian population. Aims: To find the relationship between CLBR and a single oocyte aspiration. Settings and Design: This is a retrospective study analysing the data of 1989 women who underwent in vitro fertilisation (IVF) between January 2015 and December 2019, at Gunasheela Surgical and Maternity Hospital, India. Materials and Methods: Participants were divided into two groups based on age: ≤35 (group I, n = 1665) and >35 (Group II, n = 324). CLBR per single oocyte aspiration in fresh and subsequent three frozen embryo transfer cycles was estimated. Statistical Analysis Used: Logistic regression analysis was used to show the likelihood of pregnancy rate, and CLBR per aspiration after treatment was represented as odd's ratios (OR) with 95% confidence intervals. Results: Maximal CLBR for Groups I and II was 81.25% with >25 oocytes and 75% with 16-20 oocytes, respectively. In the fresh ET cycle, maximal pregnancy and live birth rates were observed in 6-10 oocytes for Group I (54% and 41%) and in 16-20 oocytes for Group II (75% and 75%). The ORs for pregnancy rate (P = 0.01) and CLBR (P = 0.007) increased with an increase in the number of oocytes retrieved. The ORs for pregnancy rate and CLBR for Group II were 0.68 (P = 0.002) and 0.58 (P = 0.00002), respectively as compared to Group I. Optimal oocytes required to achieve positive IVF outcomes in fresh/frozen ET cycles were low in Group I (6-10 oocytes), but higher in Group II (16-20 oocytes). Conclusion: Robust positive relationship was observed between the number of oocytes retrieved and CLBR in women of both age groups.
RESUMO
Background: Alternative and complementary therapies have been gaining popularity as ways to reduce anxiety in patients. Aim: This study aimed to assess whether yoga and meditation could decrease the severity of anxiety in Indian women diagnosed with infertility Study. Study Setting and Design: This was a retrospective data analysis of anxiety score of 354 women undergoing treatment at a tertiary infertility hospital between January 2016 and December 2018. Materials and Method: Women participated in group yoga, meditation and counselling therapy intervention during their treatment period. A self-reported questionnaire that used the Generalised Anxiety Disorder-7 criteria measured the participants' severity of anxiety at the start of and again at the end of the intervention. Statistical Analysis: Demographic analysis and a two-tailed paired t-test were applied between groups. Results: The results indicated that there was a statistically significant mean reduction (7.3 ± 2.7) in the anxiety scores of the participants between entry (12.94 ± 2.65) and following exposure (5.39 ± 1.99) to the intervention (P < 0.0001). The mean reduction in scores remained similar between participants who received ≤6 sessions (7.50 ± 2.68) and participants who received >6 sessions (7.10 ± 2.64) (P > 0.05). Among the participants that experienced mild anxiety at baseline (n = 43), 72.1% (n = 31) reported experiencing minimal anxiety following the intervention (P < 0.0001). Among those that experienced moderate anxiety at baseline (n = 213), 32.4% (n = 69) reported experiencing minimal anxiety post-intervention (P < 0.0001). Participants who expressed severe anxiety at baseline (n = 94, 26.6%), reported experiencing minimal anxiety (13.8% [n = 13)], mild anxiety (81.9% [n = 77]) and moderate anxiety (4.3% [n = 4]) after exposure to the intervention (P < 0.0001). None of the participants reported experiencing severe anxiety post-intervention. Conclusion: The benefits of alternative anxiety-reduction therapies for women diagnosed with infertility have been demonstrated in this study. These therapies can be used to complement the routine treatment of such patients.
RESUMO
BACKGROUND: Ovarian reserve declines with age. However, there are considerable ethnic differences in the decline of ovarian reserve between individuals. AIM: This study aimed to make age-specific percentile charts of anti-Mullerian hormone (AMH) and antral follicle count (AFC) in Indian infertile women and to find the proportion of young women with low ovarian reserve. SETTING AND DESIGN: This was a retrospective data analysis of AMH and AFC of 5525 infertile women from August 2015 to December 2018. MATERIALS AND METHODS: Infertile women aged 20- 44 years, with body mass index 18-32 kg/m2 and having both ovaries were included in the study. Women with pituitary/adrenal disorders, malignancy, total AFC >40, tuberculosis, endometriosis, autoimmune disorders, smoking, chemotherapy, radiotherapy and recent ovarian surgery were excluded from the study. STATISTICAL ANALYSIS: Comparison between groups was done by Chi-square test. RESULTS: About 14.5% of women <35 years and 50.5% of women >35 years had low AMH values (<1.1 ng/ml). In addition, 5.6% of women <35 years and 23.6% of women >35 years had a low AFC of ≤5. In this study, 55.7% of women who had low AMH and 50.7% who had low AFC were <35 years of age. The median AMH values were 4.23 ng/mL in 20-25 years' age group, 3.48 ng/mL in women aged 26-30 years, 2.43 ng/mL in women aged 31-35 years, 1.28 ng/mL in women aged 36-40 years and0.52 ng/mL in 40-44 years' age group. The median AFCs were 20, 18, 14, 10 and 6 for each of the age groups, respectively. CONCLUSION: This study suggests that approximately more than half of the infertile women who were tested to have low ovarian reserve were <35 years of age.
