First trimester obstetric outcome of frozen thawed embryo transfer: does the stage of embryo make any difference?

BACKGROUND: The direction of management and outcome of frozen thawed embryo transfer (FET) is becoming different day by day with the invention of newer technologies and application of it as a treatment modality in modern medicine. It also contributes to around 25% of births because of Assisted Reproductive Technology (ART) procedures worldwide today. METHODS: A prospective longitudinal study was conducted at ART Center of tertiary care hospital. Couples with infertility planned to undergo FET were included in the study. Following FET, all positive cases were followed up till 14 weeks period of gestation. Data were collected and analyzed with appropriate statistical test using Epitable, 6.04 version, and SPSS, version 18, software. RESULTS: During the study period, a total of 470 FET cycles were carried out, and 1108 cryopreserved embryos were subjected to thawing procedure. Overall survival rate of 93.86% was noted. Among various stages of embryos thawed, the lowest survival rate (64.62%) was found in blastocyst group. Biochemical pregnancy rate, clinical pregnancy rate, and ongoing pregnancy rate were also analyzed in different subgroup of transferred embryos. The blastocyst group showed best implantation and clinical pregnancy rate but lowest survival rate among all subgroup of embryos. CONCLUSION: The blastocyst transfer during FET cycle showed best clinical and ongoing pregnancy rate. So if clinical situations were favorable for blastocyst stage transfer, the same should be preferred for FET cycle.

Doppler indices of the umbilical and fetal middle cerebral artery at 18-40 weeks of normal gestation: A pilot study.

BACKGROUND: Doppler indices form an integral component of noninvasive evaluation of fetal well-being. There is paucity of information about normal obstetric Doppler indices, particularly from the Indian subcontinent. The aim of the study was to find the values of pulsatility index (PI), resistive index (RI) of umbilical artery (UA), and fetal middle cerebral artery (MCA) and calculate cerebro-placental ratio (CP ratio) for 18-40 weeks of normal gestation so that a reference range of these Doppler values can be postulated. METHODS: 200 patients were enrolled in the study for color Doppler study of UA and MCA and were serially followed up at 4-6 weeks interval for Doppler indices. Angle-independent Doppler indices like PI and RI for MCA and UA were obtained during each examination. CP ratio was calculated in each case. All the cases were followed up till delivery and the perinatal outcome was recorded. RESULTS & CONCLUSION: The fetal MCA PI and RI showed a parabolic curve with plateau at 28-30 weeks of gestation. A significant correlation was noted between MCA PI and RI with gestational age. UA PI and RI showed a gradual fall over the gestational age with a strong negative correlation. There was a significant correlation between MCA PI and UA PI with their respective RI values. CP ratio has also shown a parabolic curve with turning point at 31-32 weeks of gestation. A significant correlation was noted between CP ratio and gestational age. CP ratio also showed a minimal positive correlation with MCA PI and a strong negative correlation with UA PI.