OBJECTIVE:To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer.STUDY DESIGN:A randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics and Gynecology, Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, Clinical pregnancy rate and Implantation rate. The results were analyzed using proportions, standard deviation and Chi-square test.RESULTS:Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0%) compared to cleavage stage embryo transfer 44 (29.33%) (P < 0.01). Implantation rate for blastocyst transfer group was also significantly higher (P < 0.001).CONCLUSION:Blastocyst transfer having higher implantation rate and clinical pregnancy rate lead to reduction in multiple pregnancies.

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INTRODUCTION:Anemia is the most common Nutritional deficiency disorder in the World. Iron-deficient anemia (IDA) is responsible for 95% of anemia during pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran. OBJECTIVE: The aim of this study was to compare the efficacy and tolerance of intravenous iron sucrose (IVIS) therapy with oral iron (OI) therapy in pregnant women with IDA with specific emphasis on body iron stores. MATERIALS AND METHODS: This prospective, randomized clinical trial included 100 pregnant women between < 32 weeks with established IDA who were treated with IVIS or OI (ferrous ascorbate). All patients were monitored for laboratory response and adverse effects. Independent sample-t test was used for statistical analysis. P < 0.05 was considered significant. RESULTS: Although hemoglobin increased in both the groups, increase in the reticulocyte count and percentage increase in hemoglobin was significantly higher in the IVIS group than in the OI group. Serum ferritin was significantly higher in the IVIS group than in the OI group (P = 0.000). The IVIS group had no major side-effects. Compliance was good with OI, although majority had gastrointestinal side-effects. CONCLUSION: IVIS is safe and effective in the treatment of IDA during pregnancy. Iron stores increased better with IVIS compared with OI.

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The purpose of our study was to compare the tubal pregnancy rates between day 3 and day 5 transfers. As theoretically blastocyst transfer is said to decrease the incidence of ectopic pregnancy following IVF-ET due to the decreased uterine contractility reported on day 5. METHODS: A prospective analysis of all clinical pregnancies conceived in our IVF program between May 2010 to April 2011 was performed. The ectopic pregnancy rates were compared for day 3 and day 5 transfers. RESULTS: There were 44 pregnancies resulting from day 3 transfers of which one was ectopic (2.27%). In day 5 transfers, there was also one ectopic pregnancies out of 66 clinical pregnancies (1.52%), difference between these rates was not statistically significant (P>0.05) CONCLUSION: This suggests that the ectopic pregnancy rate is not reduced following blastocyst transfer on day 5 compared to cleavage stage embryo on day 3. While there may be several benefits to extended culture in IVF, the decision to offer blastocyst transfer should be made independently from the issue of ectopic pregnancy risk.