Effect of Hyaluronic Acid-Containing Transfer Media (EmbryoGlue®) on the Live Birth Rate in Frozen Thawed Embryo Transfer Cycles.

This retrospective cohort study examines the impact of EmbryoGlue® - a culture medium comprising high-concentration hyaluronan and low-concentration recombinant human albumin (rHA) - on assisted reproductive technology (ART) outcomes in 1,298 cycles across 13 centers. The study focused on live birth rates, clinical pregnancy, and miscarriage rates between a standard treatment arm and an EmbryoGlue® arm in frozen embryo transfer (FET) cycles. Propensity score matching ensured comparable baseline variables. Findings showed higher live birth rates (60.6% vs. 47.5%) and clinical pregnancies (69.5% vs. 57.6%) in the EmbryoGlue® group, correlating with factors like patient age and blastocyst transfer. Specifically, EmbryoGlue® showed a significant association with higher live birth rates (OR 1.593; CI 1.170-2.168; P = 0.003). These findings underscore the impact of personalized approaches and highlight EmbryoGlue®'s potential in improving successful embryo implantation, thus enhancing pregnancy rates in ART procedures. Univariate and multivariate analyses identified EmbryoGlue®, female age, and blastocyst transfer as predictors of live birth. EmbryoGlue® exhibited significance in improving clinical outcomes, mirroring previous studies' findings. Limitations in the study's design warrant further prospective research for validation. In conclusion, EmbryoGlue® appears promising for enhancing live birth rates in FET cycles, presenting a potential advancement in ART protocols.

Isolated Increased Nuchal Translucency With Normal Chromosomal Study: A Case Report.

Increased nuchal translucency (NT) leads to a higher risk of fetal structural abnormalities. The measurement between 11 and 14 weeks gestation is a reliable marker for associated chromosomal abnormalities. Here, we present the case of a 33-year-old female with isolated high NT in the range of 5.6 mm at 12 weeks of gestational age. She was evaluated for chromosomal and structural abnormality and followed up meticulously. None of the tests showed any chromosomal or obvious structural abnormality. Fetal echocardiography revealed no structural cardiac defect. The pregnancy was uneventful and she delivered a healthy baby at term through lower (uterine)-segment cesarean section. The baby girl is living in good health without any developmental abnormalities. Although there is a high risk of chromosomal/structural defects with increased NT, it is not mandatory to terminate the pregnancy without a thorough evaluation.

Assisted Reproductive Technology (ART): A Ray of Hope for Adolescent Idiopathic Premature Ovarian Failure.

Adolescent idiopathic premature ovarian failure (POF) is extremely rare. In such conditions, there is a defect in the process of the folliculogenesis axis leading to a hypoestrogenic state and infertility. This disorder significantly impacts a woman's prospective health, fertility, and motherhood. A case of a 24-year-old female diagnosed with adolescent idiopathic premature ovarian failure under hormone replacement therapy who visited us for fertility management is discussed here. The couple underwent in vitro fertilization (IVF) using donor oocytes resulting in a twin pregnancy. The clinical significance of premature ovarian failure and subsequent reproductive guidance is highlighted in this case report.

Successful Management of Triplet Heterotopic Pregnancy (Interstitial) With an Intrauterine Monochorionic Diamniotic Twin Pregnancy Through Laparoscopy: A Case Report.

The simultaneous occurrence of intrauterine (IU) and extrauterine pregnancies is known as heterotopic pregnancy, an uncommon clinical condition that is challenging to manage. It can be a potentially fatal illness if it remains unnoticed. This is a case report of a woman who had heterotopic triplets after transferring two embryos produced through in vitro fertilization. An ultrasound scan diagnosed live interstitial heterotopic pregnancy and an intrauterine monochorionic twin pregnancy. Laparoscopic resection of interstitial heterotopic pregnancy was done. The monochorionic twin pregnancy was closely monitored by serial ultrasound, and at 36 weeks of gestation, two healthy twins were delivered by cesarean section. The fetal growth parameters were monitored, and a dopplers study was conducted to assess fetal blood flow. Even in heterotopic pregnancy, timely diagnosis and therapeutic intervention can preserve IU pregnancy with a successful outcome. Early meticulous monitoring and early detection can lead to a favorable outcome. Even in heterotropic pregnancy, a meticulous evaluation can lead to favorable outcomes by conserving IU pregnancy, and timely intervention can prevent maternal motility.

Ovarian Filariasis: Diagnosis by detection of microfilariae in follicular fluid, a case report.

Filariasis is a common parasitic infection in India. It is rare to find neglected cases of Filariasis nowadays. We reported the presence of microfilaria species in the follicular fluid of an egg donor undergoing an ovum pick up procedure. She was a 23-year-old egg donor who underwent stimulation using the GnRH antagonist protocol. Antagonist protocol is one of the standard protocols used for controlled ovarian hyperstimulation as a part of the IVF/ICSI(in-vitro fertilization / intracytoplasmic sperm injection) procedure where GnRH antagonist (cetrorelix) is used to suppress the endogenous LH surge. Her baseline investigations were normal, with no significant history suggestive of any worm infestations. During the ovum pickup procedure, follicular fluid revealed the presence of worm-like structures suggestive of larvae of some parasites. The follicular fluid was sent to the microbiology department along with the blood sample to confirm the parasite species. The parasite was found to be the larvae of W. Bancroft. The oocytes were of poor quality and were discarded. The patient was treated with Diethylcarbamazine citrate. There are so many reports about scrotal Filariasis, but rare literature quotes ovarian Filariasis.

Impact of antepartum diagnostic amnioinfusion on targeted ultrasound imaging of pregnancies presenting with severe oligo- and anhydramnios: An analysis of 61 cases.

OBJECTIVES: The primary objective our study was to assess the role of diagnostic antepartum amnioinfusion on the yield from targeted ultrasounds performed in pregnancies with severe oligo- and anhydramnios. STUDY DESIGN: This was a retrospective and descriptive study, conducted in the fetal medicine units of two private tertiary care referral centers in south India. The details of all the cases of diagnostic amnioinfusion performed at these two centers from January 2009 to June 2016 were collected and analyzed. Inclusion criteria were pregnancies between 17 and 26 weeks of gestational age with severe oligo- or anhydramnios. Pregnancies with obvious preterm premature rupture of membranes (PPROM) were excluded. The primary outcome measure was the improvement in diagnostic information pertaining to cause of severe oligo- and anhydramnios, and the nature of such anomalies. RESULTS: A total of 61 cases of were identified. The median gestational age at performance of the procedure was 22 weeks [IQR, 19.5-23]. The mean volume of normal saline infused was 314±54ml. A significant increase in the single vertical pocket (SVP) was observed following the procedure (pre-procedure SVP=0.6±0.9cm, post procedure SVP=3.4±1.7; paired t test, p<0.001). In 37 cases (37/61, 60.7%), there were no pre-procedure ultrasound findings. There was significant overall detection of abnormalities post procedure (mean pre-procedure findings=0.39±0.49, mean post procedure findings=1.59±1.24; paired t test, p<0.001). The most frequent group of anomalies/abnormalities were renal (36/61, 59%), followed by PPROM (13/61, 21.3%) and finally fetal growth restriction (11/61, 18%). CONCLUSION(S): Antepartum amnioinfusion is a valuable ancillary technique in prenatal diagnosis as it increases the diagnostic yield from pregnancies presenting with severe oligo- and anhydramnios.

Unguarded tricuspid orifice---a rare cause of fetal right atrial dilatation with characteristic color doppler sign: Case report with review of literature.

The anatomic causes for fetal right atrial dilatation with tricuspid regurgitation include Ebstein anomaly, tricuspid dysplasia, unguarded tricuspid orifice, and Uhl anomaly. Unguarded tricuspid orifice is characterized by complete or partial agenesis of the tricuspid valvular and subvalvular structures. It is commonly associated with pulmonary atresia. Its prenatal diagnosis is usually associated with unfavorable prognosis. We present a prenatally diagnosed case of fetal unguarded tricuspid orifice with description of its diagnostic workup, along with a review of literature, to enhance the understanding of this rarely reported entity. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:370-374, 2017.

A retrospective single centre review of the incidence and prognostic significance of persistent foetal right umbilical vein.

The objective of our study was to appraise the incidence and significance of persistent right umbilical vein (PRUV), the most common foetal venous aberration. Based on a south Indian antenatal cohort, we identified 23 cases of PRUV amongst 20,452 foetuses of consecutive pregnancies, from 2009 to 2014, yielding an incidence of 1 in 889 total births (0.11%). The median maternal age was 24 (IQR, 22-26) years, and median gestational age at diagnosis was 23 (IQR, 22-24) weeks. Intrahepatic drainage of PRUV was seen in 91.3% cases. In three cases (13%), ductus venosus was absent. In 52.2% of the cases, additional major abnormalities were observed - predominantly cardiovascular (39.1%). The common minor marker was single umbilical artery (13%). The karyotype was found to be normal in six cases (26%) which underwent invasive testing. When associated anomalies were inconsequential or absent, the postnatal outcome was good, which reflected in 60.9% of our cases.

Ewing's Sarcoma of the Adrenal Gland.

Ewing's sarcoma (ES) or primitive neuro-ectodermal tumor (PNET) typically occurs in long or flat bones, the chest wall, extra-skeletal soft tissue, and rarely in solid organs. Incidence of adrenal Ewing's sarcoma is very rare. Here we report a case of Ewing's sarcoma of the right adrenal gland in an 8-year-old girl who presented with an abdominal mass. The huge tumor was managed by preoperative neo-adjuvant chemotherapy followed by surgical resection. She died due to metastasis after five months of surgery.

Electric wire in the urinary bladder in an adolescent boy.

Self-inserted foreign bodies in the bladder is an uncommon entity in males due to the lengthy urethra. Here we present a case of insulated electric wire present in the urinary bladder of a 15-year-old male inserted for sexual arousal. Diagnosis was made by history and radiological investigation and it was removed by cystoscope with an uneventful recovery.

Renal Agenesis with Full Length Ipsilateral Refluxing Ureter.

Unilateral renal agenesis with vesicoureteral reflux in the ipsilateral full length ureter is a rare phenomenon. Herein we report a case of 10-year old boy who presented with recurrent urinary tract infections. No renal tissue was identified on left side in various imaging studies. Micturating cystourethrogram (MCUG) showed left sided refluxing and blind ending ureter. Left ureterectomy was done because of recurrent UTI in the refluxing system.