Oncofertility awareness among primary care physicians in India [version 1; peer review: 2 approved, 1 not approved]

Background: Primary care physicians not only coordinate referrals to oncology services but can play a crucial role in successful fertility preservation referrals in cancer-diagnosed patients. Hence, it is important to assess their knowledge and attitudes towards fertility preservation. Methods: An eighteen-item oncofertility survey was administered to primary care physicians between May 2019 to September 2020.  Results: A total of forty-six responses were received and analysed. About 60% of primary care physicians did not have adequate knowledge about available fertility preservation options and only 26-32% were aware of international guidelines recommending fertility preservation in cancer patients.  Conclusions: Imparting awareness and knowledge of fertility preservation and its options to primary care physicians could enable an integrated cancer care model while also facilitating successful oncofertility referrals in countries like India

Oncofertility awareness among primary care physicians in India [version 2; peer review: 2 approved, 1 not approved]

Background: Primary care physicians not only coordinate referrals to oncology services but can play a crucial role in successful fertility preservation referrals in cancer-diagnosed patients. Hence, it is important to assess their knowledge and attitudes towards fertility preservation. Methods: An eighteen-item oncofertility survey was administered to primary care physicians between May 2019 to September 2020.  Results: A total of forty-six responses were received and analysed. About 60% of primary care physicians did not have adequate knowledge about available fertility preservation options and only 26-32% were aware of international guidelines recommending fertility preservation in cancer patients.  Conclusions: Imparting awareness and knowledge of fertility preservation and its options to primary care physicians could enable an integrated cancer care model while also facilitating successful oncofertility referrals in countries like India

Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe

Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

Survey of third-party parenting options associated with fertility preservation available to patients with cancer around the globe

bstract PURPOSE In the accompanying article, “Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. METHODS We provide data on the legalities of third-party assisted reproductive technologies and other familybuilding options in the 28 oncofertility-practicing countries surveyed. RESULTS We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. CONCLUSION Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

Advancing or postponing the day of human chorionic gonadotropin does not matter for the outcome in assisted reproductive technology

Context : The primary outcome is to remove the worry of getting immature oocytes with early administration of human chorionic gonadotropin (hCG). Aim : The aim was to find out the association between the day of hCG administration and follicular response in relation to the number and maturity of oocytes, and fertilization rate in assisted reproduction to avoid weekend oocyte recovery (OR). Settings and Design : Retrospective study was carried out in the university infertility clinic. Materials and Method : Controlled ovarian hyperstimulation (COH) in 94 patients undergoing assisted reproductive technology (2010-2011) with recombinant follicle stimulating hormone and timely gonadotropin-releasing hormone antagonist were analyzed regarding day of hCG from day 8-11. Oocyte maturity and fertilization was analyzed and correlated with the day of hCG administration. STATISTICAL ANALYSIS: Kruskal-Wallis test. Results : The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different. However, the OR rate (54.2%), number of mature oocytes (92.5%), and fertilization rate (78.5%) was maximum in the patients where hCG was administered on day 8 of COH. Conclusions : The day of hCG administration between 8 and 11 does not affect the OR rate significantly although the number of oocytes recovered on day 8 are marginally higher compared with day 9-11. Hence, it is possible to safely avoid weekend oocyte retrieval, by delaying or advancing hCG administration without compromising the outcome

A randomized controlled study to evaluate the cost-effectiveness in sperm extraction using carbon dioxide and carbon dioxide free system in relation to intrauterine insemination pregnancy

Objectives: To evaluate the effectiveness of two different systems i.e. circulating water bath and carbon dioxide (CO 2 ) incubator in extracting motile sperm for IUI programme and their effect on pregnancy outcome.Methods: The study was performed on sixty-two patients recruited for ovulation induction followed by intrauterine insemination (IUI) in University fertility clinic. The patients were randomly divided into two groups and sperm preparation was performed with either water bath or CO 2 incubator system. The efficiency of the two systems was analyzed in relation to pregnancy outcome. Results: There was no significant difference in the efficacy of water bath and CO 2 system with respect to the quality of sperm extracted and pregnancy outcome. Although pregnancy rate was marginally higher in water bath group, it was not statistically significant. Conclusion: CO 2 -free system can be a cost-effective approach in IUI programme which does not compromise with pregnancy rate

Controlled cooling versus rapid freezing of teratozoospermic semen samples: Impact on sperm chromatin integrity

Aim: The present study evaluates the impact of controlled slow cooling and rapid freezing techniques on the sperm chromatin integrity in teratozoospermic and normozoospermic samples. Setting: The study was done in a university infertility clinic, which is a tertiary healthcare center serving the general population. Design: It was a prospective study designed in vitro. Materials and Methods: Semen samples from normozoospermic (N=16) and teratozoospermic (N=13) infertile men were cryopreserved using controlled cooling and rapid freezing techniques. The sperm chromatin integrity was analyzed in fresh and frozen-thawed samples. Statistical Analysis Used: Data were reported as mean and standard error (mean ± SEM) of mean. The difference between two techniques was determined by a paired t-test. Results: The freeze-thaw induced chromatin denaturation was significantly (P<0.01) elevated in the post-thaw samples of normozoospermic and teratozoospermic groups. Compared to rapid freezing, there was no difference in the number of red sperms (with DNA damage) by the controlled slow cooling method in both normozoospermic and teratozoospermic groups. Freeze-thaw induced sperm chromatin denaturation in teratozoospermic samples did not vary between controlled slow cooling and rapid freezing techniques. Conclusions: Since the controlled slow cooling technique involves the use of expensive instrument and is a time consuming protocol, rapid freezing can be a good alternative technique for teratozoospermic and normozoospermic samples when sperm DNA damage is a concern

Plasma protein thiols, ceruloplasmin, C-reactive protein and red blood cell acetylcholinesterase in patients undergoing intrauterine insemination

Objective: To estimate acetylcholinesterase (AChE), protein thiols (PT), ceruloplasmin (CP) and C-reactive proteins (CRPs) to assess any change in their levels following intrauterine insemination (IUI). Materials and Methods: Forty-two patients aged 31 ± 4.65 years (mean ± SD) with primary infertility selected for IUI. All of them had induced ovulation with clomiphene citrate 50 mg from day 2 to day 6. After taking the consent, 2 ml of blood was withdrawn before and after 24 h of IUI for biochemical estimations. Results: We observed a significant decrease in plasma CP, PT and RBC AChE ( P < 0.001) following IUI compared with the respective pre-procedure levels. Highly sensitive CRP showed a marginal increase after IUI. Conclusion: Fluctuations in levels of the above parameters point to their role in the female reproductive system and in the outcome of the IUI