Background Estradiol is an important marker of ovarian response to ovarian stimulation in ART cycles. The study tries to find the correlation of serum estradiol on the day of HCG trigger to the number of follicles, the number of oocytes retrieved, and the number of mature oocytes, and also, to correlate estradiol per follicle and estradiol per oocyte on the day of HCG, to the number of oocytes retrieved, and to the number of mature oocytes. It is a cross sectional study using retrospective data. Results The data of 232 patients were analyzed. Our study showed a positive correlation between estradiol levels and the number of follicles (NF) (r = 0.592, p < 0.001), number of retrieved oocytes (NRO) (r = 0.576, p < 0.001), and number of mature oocytes (NMO) (r = 0.554, p < 0.001). E/follicle ratio did not have a significant correlation with NRO and NMO. E/Oocyte ratio had a strong negative correlation with NMO (r = −0.280, p < 0.001) Conclusions Serum estradiol had a positive correlation with NF, NRO, and NMO. But E/O had a strong negative correlation with NMO. These results indicate that estradiol levels can be used as an important clinical tool in the prediction of oocyte and mature oocyte yield in ART cycles. Reproductive outcome in ART cycles is largely dependent on the number of oocytes and mature oocyte yield. Estradiol levels on the day of HCG appear to strongly correlate with the outcome of ART cycles.
Background: Chlamydial infection is considered to be one of the important causes of tubal factor infertility. This study will help to explore the relationship between positive Chlamydial infection and tubal damage in infertile women assessed by diagnostic laparoscopy. The results will help to determine whether a policy of routine screening for Chlamydia antibody is justifiable in infertile women to suspect tubal factor so that they can be taken up for laparoscopy earlier.Methods: A prospective study was performed on 158 consecutive patients who underwent laparoscopy as part of infertility evaluation. About 5 mL of venous blood was drawn preoperatively to detect Chlamydia IgG antibody in all the patients by ELISA. The laparoscopic findings were documented and the relationship to Chlamydial antibody evaluated.Results: Of the 158 patients who underwent laparoscopy, 95 patients had evidence of tubal disease as evidenced by unilateral or bilateral tubal block, peritubal adhesions, hydrosalpinx, beading of the tube and unhealthy shaggy appearance. Of the 95 patients with documented tubal disease at laparoscopy, 14 (14.7%) had antibodies to Chlamydia. Of the 63 patients with normal tubes, 12 (19%) had Chlamydial positivity. The difference is not statistically significant. However of the 26 patients who were positive for Chlamydia antibodies 14 patients (53.8%) had abnormal tubes. Out of the 158 patients who underwent laparoscopy 26 patients were positive for Chlamydia. Hence the prevalence in our study is 16.4% (26/158). The sensitivity is 14.7% and the specificity is 81%.Conclusions: This study showed no difference in Chlamydial positivity between infertile women with abnormal tubes and those with normal looking tubes in our population. The absence of Chlamydial antibodies cannot be taken as a marker for normal tubes. Hence screening for chlamydial antibody can neither be used as a screening test for tubal factor infertility nor to decide on the need for laparoscopy in the present population.
A BSTRACT Background: Seasonal variations in semen parameters have been detected in many previous studies, mostly conducted in the West and Mediterranean countries. Located in a tropical region, we have only three seasons – summer, winter and rainy season. Literature search did not reveal studies from Indian subcontinent. Aims: Our objective was to find if our climate produced seasonal variations in semen parameters such as sperm concentration (SC), total motile SC, morphology and vitality, which may have implications in fertility management. Settings and Design: This is a descriptive study, conducted at a tertiary level hospital. Semen analysis reports of male partners of all infertile couples during the 4-year period from 2019 to 2022 were analysed. Materials Methods: The data were collected from records of all infertile couples registered for the treatment in the department during the study period. Semen analysis reports of male partners of all infertile couples attending outpatient department of the Reproductive Medicine Department during the 4-year period from January 2019 to December 2022 were collected. The data of azoospermic and severe oligospermic (<5 million/mL) men and those receiving hormone treatment were excluded. Statistical Analysis Used: Data were analysed using SPSS 23 and variables expressed as mean and standard deviation. Changes in mean values over years and over seasons were evaluated using F -test. Post hoc analysis was done using Sidak method. P < 5% was considered statistically significant. Results: The data of 2326 patients were analysed. SC was lowest during summer but was not statistically significant. Sluggishly motile sperm per cent was maximum in rainy season ( P = 0.002). Post hoc analysis showed significant variations in summer samples compared to both rainy and winter seasons. Head defect (HD) and tail defects showed a significant seasonal variation ( P = 0.011 and P = 0.024, respectively), lowest HD seen in rainy season. Conclusion: Semen parameters showed seasonal variations, with favourable features in colder climates, and may need to be considered in infertility management, especially if the male is oligospermic.
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