BackgroundDespite being born with a significant number of primordial cells which representing the ancestor cells of the germ-line, women experience a depletion of ovarian reserve and sub-fertility mid-way into their healthy lives. The poor ovarian response is a substantial limiting factor amplified with higher maternal age and associated with a considerably lower likelihood of pregnancy.MethodsA present analytical prospective cross-sectional study was conducted to explore whether infertile women below the age of 40 years have low ovarian reserve than fertile women of same age, assessed by Antral follicle count (AFC) and anti-Müllerian hormone (AMH), at tertiary care infertility center: Lahore Institute of Fertility and Endocrinology, Hameed Latif Hospital. The study population including 423 infertile and 388 fertile female patients from June 2013 to November 2016. Patients and controls were aged between 25 and 39 years. Serum levels of FSH, LH, AMH were assessed, and AFC was measured by transvaginal sonography on cycle days 2 or 3.ResultsA total of 35.6% of infertile women stated a menstrual cycle length shorter than 21 days, while 21% had a regular cycle length between 24 and 38 days, and 43.2%, longer than 38 days. Overall, the two cohorts did not significantly differ on cycle length. The age-specific reduction of the ovarian reserve was similar in both cohorts; serum AMH concentration decreased by 6% (95% Cl: 5–8%) and AFC decline by 4.5% (95% Cl: 5–7%) per year with increased age. Aged patients (36–39 years) had a 5.3% (95% Cl, 1.5; 7.2) higher risk ratio of having an AMH level < 0.7 ng/ml than women of younger age groups (Kruskal-Wallis test, p < 0.01).ConclusionThis study indicates that the possible common observation of low respondent in ART might not be a result of over-representation of patients with an early age-specific decline in the ovarian reserve, but rather primarily as a consequence of age-specific depletion in the stock of developing follicles at the time of recruitment and selection.

Background: The body mass index (BMI) affects reproduction and pregnancy outcomes. Infertility is defined as the inability to conceive despite having frequent, unprotected sex for at least one year. The inability to have children affects men and women across the globe.Methods: It was a retrospective study on couples coming for treatment of subfertility in Lahore Institute of Fertility and Endocrinology (LIFE). The institutional ethical review committee approved. Patients are divided into three groups, normal weight (BMI ≤25kg/m²), overweight (26-30 kg/m²), and obese (>30 kg/m²). Data were collected from July 2017 to May 2018. The number of infertile women who underwent assisted fertilization at LIFE was 222.Results: Two hundred and twenty-two sub-fertile patients were selected. Their ages were between 25-36 years. The mean age was 31 ± 3.91 years. There was a significant relationship between the number of follicles and BMI (p-value=0.03). Outcome parameters are significantly correlated with all groups of BMI. Embryo transfer is insignificantly correlated with BMI. (p-value = 0.07)Conclusion: According to this study, obesity is associated with poor embryos in obese women with more than 30 BMI. Furthermore, women who were obese might need a higher dose of FSH, and the live birth rate is higher in women with normal BMI.

Introduction: Embryo transfer into the uterus during IVF/ICSI treatment is followed by embryo implantation, which depends on the receptivity of endometrium and is a pre-requisite for the initiation of a successful pregnancy. The endometrium proliferates under the hormonal influence (estrogen and progesterone), which is reflected by its thickness which is measurable by transvaginal ultrasonic scanning (TVS). The thickness of the endometrium less than 8 mm has been linked with implantation failure.11 Endometrial thickness of 9-14 mm on the day of progesterone supplementation has been shown to have a higher implantation rate. Thus, the implantation potential of a good embryo remains low during IVF treatment despite ovarian stimulation methods of assisted fertilization and improved culture condition.Objectives: This study was planned to determine the impact of endometrial thickness on ET and pregnancy rate in Pakistani patients undergoing IVF/ ICSI.Methods: This was a prospective, cross-sectional study conducted at a private fertility clinic (Lahore institute of fertility and endocrinology, LIFE) in Lahore, Pakistan, from January 2015 to December 2015. In this study, all those cases were included that reached oocytes pickup and embryo transfer (ET). Two protocols, agonist and antagonist, were used. In all cases, human menopausal gonadotrophin (hMG) and follicle-stimulating hormone (FSH) were used for stimulation. Follicles development was monitored; at least 3 follicles were reached at the diameter of ≥16mm.Results: Thickness of endometrium on decision day was calculated at various ranges concerning both groups and find pregnancy rates. When endometrial thickness was ≤ 6mm, PR was 2.22%, 7mm pregnancy rate (PR) was 1.11%, 8 mm PR was 3.33%, 9mm PR was 17.78%, 10mm PR was 33.33%, 11mm PR was 32.22%, and more than 11 mm PR was 10%. So, PR was higher from 2.22% to 10%. The overall pregnancy rate was 45.45%.Conclusion: The study concluded that endometrial thickness has significant effects on embryo transfer and outcomes.