Aims and objectives To compare the efficacy of urinary human chorionic gonadotropin (uhCG) vs recombinant human chorionic gonadotropin (rhCG) for triggering ovulation in gonadotropinreleasing hormone (GnRH) antagonist in vitro fertilization (IVF) cycle. Materials and methods Two hundred patients who underwent GnRH antagonist IVF/ICSI cycles were analyzed, 100 of them received recombinant hCG 250 μg (injection overtrelle) and another group of 100 received urinary hCG (injection ovutrig) either 5000 IU or 10,000 IU for final oocyte maturation and ovulation trigger. The primary outcome measured was total oocytes retrieved and the secondary outcome measured 09 was the maturity rate fertilization rate, cleavage rate and clinical pregnancy rates were also compared. Results Age, day 2 follicle stimulating hormone (FSH) and total dose of rFSH were comparable between the groups. There were no significant differences between the groups in terms of the mean number of oocytes retrieved per follicle (uhCG; 12.5, rhCG; 12.09, p-value-0.6698). Similarly, there was statistically no difference in any of the other parameters studied between the two groups. That is number of mature oocytes, number of fertilized oocytes and number of cleaved oocytes, as the p-value was not significant. The clinical pregnancy rate was somewhat higher in the uhCG group but was not statistically significant. Both treatments were well tolerated and there was no significant side effects for either drug. Conclusion There is no difference in clinical outcomes between urinary and recombinant hCG for induction of final oocyte maturation. Additional factors, including the cost, drug availability and ease of administration, should be considered, when choosing gonadotropin type. How to cite this article Sidhmalswamy GA, Srinivas MS, Dipika K, Anu K, Rao KA, Mekhala D. Comparing the Efficacy of Urinary hCG vs Recombinant hCG for Final Maturation of Oocyte in GnRH Antagonist IVF/ICSI Cycle. Int J Infertility Fetal Med 2012;3(3):92-96.

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of fertile age. The prevalence, time of onset and severity of clinical presentation vary among different ethnic and racial groups. Though there is significant reproductive, endocrine and metabolic morbidity of PCOS, very little is known about its different modes of presentation in Indian population. A cross sectional observational study. The objective To study the correlation between the clinical, ultrasonographical and hormonal features in women diagnosed as PCOS based on the revised diagnostic criteria, 2003.Methods: A cross-sectional study of 74 PCOS women who had oligo ovulatory cycles and polycystic ovarian morphology on ultrasound was done. Data about menstrual history and anthropometric measurements were collected. Clinical observations of acne and hirsutism were made.  Transvaginal ultrasonography and biochemical analysis for free testosterone was done.Results: In all, 74 PCOS women were studied and analyzed. The mean age was 24.884.03, mean BMI was 25.48 ±3.75 and mean free testosterone was 3.81±4.05. Among the PCOS women 39.8% were hirsute, 10.1% were obese, 2.3% had acne and 38% were hyperandrogenemic. Of the hyperandrogenemic women 61.2% were hirsute, 53.22% were obese and 36.54% had acne.  The association between BMI and free testosterone level was statistically significant (p=0.0023). BMI was moderately correlated with hyperandrogenemia (r=0.446). The mean left ovarian volume was higher in obese than in non-obese women, which was statistically significant (p=0.003). The mean left ovarian volume was high in hyperandrogenemic women which was statistically significant (p=0.00034).Conclusions: In the present study it was found that there is association between obesity and free testosterone level which was significant. There was statistically significant association between ovarian volume and obesity. Similarly, there was association between ovarian volume and hyperandrogenemia which was significant. Hirsutism and acne had no association with hyperandrogenemia.

Background: Laparoscopy has become an accepted method of management of ovarian cysts. Objective of present study was to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.Methods: Ten patients from May 2014 to April 2015, with large ovarian cysts, with diameter >10 cm, were managed laparoscopically. All the masses were cystic and were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA 125 levels were within the normal range (0-35 U/mL). Preoperative evaluation included history, clinical examination, sonographic images and serum markers. The management of these ovarian cysts included aspiration, cystectomy or salphingo-oophorectomy, depending on the patient's age, obstetric history and desire of future fertility.Results: Seven patients presented with pain abdomen, 3 patients with abdominal distension and discomfort. The average maximum diameter of the ovarian cysts was 14.75 cm (range, 10-22 cm). The mean duration of the operation was 80 minutes (60 -120 min). The postoperative hospital stay was 2 days. No intraoperative complications occurred, and the hospital course of all patients was uncomplicated. The patients did not report any complaints during follow-up and the clinical examination findings were normal in all, up to 9 months after discharge.Conclusions: With proper patient selection, the size of an ovarian cyst is not necessarily a contraindication for laparoscopic surgery.