Interventional study to find out effect of human chorionic gonadotropin and antioxidants on idiopathic male infertility

Background: Male contributes about 50% for cases with combined male and female infertility. When the cause is not known, it is term as idiopathic infertility. It affects 25% of men. Many advances have been made in reproductive medicine which provides great opportunities, couples which were considered untreatable now have got chance to have their own babies. Various ART procedures like ICSI have been proven as an efficient therapy in severe male factor infertility. However, the cost per cycle and complications such as multiple gestations cannot be ignored. Medical management of infertility can be specific or empirical depending on etiology. Specific medical management is use when certain etiology is identified. However, in absence of specific etiology use of empirical medical treatment can be attempted in order to improve treatment results. In this study our aim is to evaluate the effect of human chorionic gonadotropin (hCG) and antioxidants on semen parameters in men with idiopathic male infertility.Methods: Thirty men with abnormal semen parameters were included in study. Patients were treated with injection hCG-2000 IU three times a week for three months along with the antioxidants. After 3 months of treatment repeat semen analysis were performed and results were compared with pre-treated seminal parameters.Results: Results showed significant increase in sperm count (p value ≤ 0.001), total motility (p value=<0.001), and progressive forward motility (p value = <0.001), while no significant difference is seen in rest of the parameters.Conclusions: Use of hCG and antioxidants in idiopathic male infertility can significantly improve seminal parameters in idiopathic male infertility

Knowing a cross-talk between embryo and endometrium can help to achieve successful pregnancy outcome in recurrent implantation failure

Recurrent implantation failure is most distressing condition to both couple as well as doctor in the field of reproductive medicine. Patients have already undergone various ART treatments with no favourable outcome and are drained emotionally as well as economically. To overcome this obstacle a comprehensive approach is needed. In this case report, we are addressing a couple who came to us with primary infertility of 15 yrs, with recurrent IVF failures (four cycles of IUI, seven cycles of ICSI both fresh and frozen and with ovum donation in last two cycle), with poor ovarian reserve and male factor infertility for surrogacy as a last option. After complete evaluation of couple, recurrent Implantation failure is thought to be due to poor endometrium and bad embryo quality, and we counselled couple to go for ovum donation and ICSI before considering surrogacy. To improve endometrial receptivity we performed local endometrial injury, oral estradiol therapy, intrauterine G-CSF instillation and IVIG etc. Simultaneously for better quality of embryo we decided to choose ovum donation due to poor ovarian reserve and advance age of the patient and ICSI was done with husband sperm after treatment of male factor infertility and ET was performed. Patient conceived in first cycle with single live intrauterine pregnancy, her antenatal course was uneventful and delivered a healthy baby at term without any complication

Prolactin level in umbilical cord blood of newborn and its relation to respiratory distress syndrome

Background: Production of lower concentrations of prolactin in fetus is considered as one of the major contributor for the development of respiratory distress syndrome (RDS) in newborns considerably in pregnants with maternal complications. Hence the present study was conducted with the objective to measure the serum level of cord blood prolactin in normal pregnancy and in pregnancy with maternal complications and its association with development of RDS in newborn.Methods: In this prospective study of 100 women, 28 with normal pregnancy (Group A) and 72 with abnormal pregnancies (Group B) were included in the study. Umbilical cord blood was collected and serum prolactin level was estimated using radio-immuno assay. The obtained values were correlated with prevalence of RDS in neonates and maternal complications.Results: The average age of pregnant women participated in Group A was 26 years and Group B was 27 years. In Group A 2 babies with birth weight of 2001-3000 gm had a cord serum prolactin level of 216±137.8 ng/mL developed RDS. In Group B the level of prolactin was 285±276 and 326±132 ng/mL in 4 RDS babies with birth weight of <1000 gm and 1000-2000 gm respectively. It was observed that cord serum prolactin levels had no correlation with the mode of delivery, sex of newborn, steroid therapy. In Group A, 2 neonates developed RDS which were of gestational age between 32-35 weeks with mean prolactin level of 216 ng/ml, while in Group B, 1 neonate with gestational age less than 32 weeks and mean prolactin level of 480 and 4 neonates of 32-35 weeks with mean prolactin level of 266 ng/mL developed RDS. Out of 27 mothers with complications of PIH, 3 developed RDS. 1 case each from IUGR and twins developed RDS respectively.Conclusions: The risk of RDS is less in newborn with high prolactin level than in newborns with low prolactin levels. So prolactin might have a role in fetal lung maturation