Purpose Sperm quality plays an important role in determining embryo development and intracytoplasmic sperm injection (ICSI) outcome. Selection of competent sperm based on its ability to bind to hyaluronic acid (HA) has been suggested as one of the methods to assess sperm quality. The aim of the present study was to examine whether injection of HA bound sperm helps in improving outcome in patients undergoing ICSI with unexplained infertility having normal semen parameters. Methods Patients with unexplained infertility having normal semen parameters in accordance with WHO 2010 criterion, undergoing their first IVF-ICSI cycle were enrolled during the course of the study.156 patients were prospectively randomized after oocyte retrieval and were assigned to either the ICSI group, where sperm selection for injection was based on visual assessment, or the PICSI group, where sperm were selected based on their ability to bind to HA. Only fresh embryo transfers were included in the analysis. Results There was no difference in the fertilization rates, number of top quality embryos and clinical pregnancy rates between the ICSI and PICSI groups (65.7 % vs 64.7 %; 45.8 % vs 43.6 % and 35 % vs 35.2 % respectively). However, a higher pregnancy loss rate was observed in the ICSI group (25 % vs 12 %; P =0.227) as compared to the PICSI group, but the difference was not statistically significant. Implantation rates were 22.03 % and 18.84 % in the PICSI and ICSI groups respectively. There were 22 (31 %) live births in the PICSI group and 21(26.3 %) live births in the ICSI group. Conclusions Patients with unexplained infertility having normal semen parameters may constitute a patient group which does not benefit from this sperm selection method. A larger study may be necessary to establish a relationship between PICSI and pregnancy loss rate in patients undergoing IVF with unexplained infertility.
CONTEXT:A majority of human embryos produced in vitro are aneuploid, especially in couples undergoing in vitro fertilization (IVF) with poor prognosis. Preimplantation genetic screening (PGS) for all 24 chromosomes has the potential to select the most euploid embryos for transfer in such cases.AIM:To study the efficacy of PGS for all 24 chromosomes by microarray comparative genomic hybridization (array CGH) in Indian couples undergoing IVF cycles with poor prognosis.SETTINGS AND DESIGN:A retrospective, case–control study was undertaken in an institution-based tertiary care IVF center to compare the clinical outcomes of twenty patients, who underwent 21 PGS cycles with poor prognosis, with 128 non-PGS patients in the control group, with the same inclusion criterion as for the PGS group.MATERIALS AND METHODS:Single cells were obtained by laser-assisted embryo biopsy from day 3 embryos and subsequently analyzed by array CGH for all 24 chromosomes. Once the array CGH results were available on the morning of day 5, only chromosomally normal embryos that had progressed to blastocyst stage were transferred.RESULTS:The implantation rate and clinical pregnancy rate (PR) per transfer were found to be significantly higher in the PGS group than in the control group (63.2% vs. 26.2%, P = 0.001 and 73.3% vs. 36.7%, P = 0.006, respectively), while the multiple PRs sharply declined from 31.9% to 9.1% in the PGS group.CONCLUSIONS:In this pilot study, we have shown that PGS by array CGH can improve the clinical outcome in patients undergoing IVF with poor prognosis.
Coronavirus disease 2019 had caused a pandemic leading to over 6M positive cases worldwide out of which 3.73 lac are demised (until when the article was written). Its first outbreak was seen in Wuhan, China. In the Indian scenario, we have a total of 2 lac cases out of which 5,679 have been deceased (until when the article was written). Due to the high transmissibility of this disease, the entire country is under lockdown to prevent the spread of the virus. The main etiology of this virus is the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2). This affects the respiratory system leading to cough, shortness of breath, and fever. There have been cases with mild or no symptoms reported, but the cause of death is due to the virus. This helps us understand the diagnosis, epidemiology, symptoms, and pathophysiology about the virus, which can help in treatment modalities. An autopsy is one of the methods by which we can understand the systematic involvement other than the respiratory system. Various pathological, microbiological changes can occur in the other organs. Even though the person is deceased, the virus is highly infectious can cause the spread through body fluids. Proper care must be taken while handling the body and performing the procedure. This review article aims to focus on the autopsy findings found in various cases to study the disease pathophysiology of the SARS-CoV-2. This article also helps us understand the guidelines that have been put forward by WHO and CDC must be followed regarding the specification required in the autopsy room; PPE’s to be worn, human waste and fluid disposal, body transportation. Proper personal hygiene must be maintained while handling the COVID-19 patients; this can lead to less susceptibility of acquiring the disease.
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