Center for Infertility Management and Assisted Reproduction

Kerala, India

Center for Infertility Management and Assisted Reproduction

Kerala, India

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Sriharibabu M.,GSL Medical College and General Hospital | Himabindu Y.,GSL Medical College and General Hospital | Gopinathan K.K.,Center for Infertility Management and Assisted Reproduction | Pandey A.K.,GSL Medical College and General Hospital | And 2 more authors.
Biomedicine | Year: 2012

Objective: The objective of the study was to find out the relevance of AMH measurements in assesing the qualitative aspects of ovarian reserve. Materials and Methods: The study included 36 patients aged between 25 and 42 years who were registered for first ART (ICSI) program. The subjects were treated with long protocol for ovarian stimulation. Pituitary down regulation was achieved by administering Luprolide acetate. Ovarian stimulation was effected with exogenous gonadotropin. Baseline hormonal profile including serum levels of Estradiol, FSH, LH and AMH were determined on day three of the previous cycle. Oocyte maturity and quality was assessed basing on morphological criteria. Embryos were graded on the basis of number of equal sized blastomeres with fragmentation less than 10% and absence of multinucleated blastomeres. Results: Statistical analysis was performed using SPSS trial version 16.0.The mean AMH levels were 0.65 ng /ml in low AMH group and 2.4ng/ml in the high AMH group .There were significant positive correlations between AMH levels and M II oocytes and fertilization rates (r=0.606, 0.589, p<0.01), followed by GR1 embryos (r=0.539, p<0.01).When both low and high AMH groups were compared for measured parameters, statistically significant differences were found for mature oocytes (p-0.003); fertilization rates (p=0.010) and Gradel Embryos (p=0.002). Conclusion: In this study Day 3 AMH levels in the range of 2.4 ng/ml are better correlated with good quality oocytes and grade 1 embryos.


Himabindu Y.,GSL Medical College and General Hospital | Sriharibabu M.,GSL Medical College and General Hospital | Gopinathan K.K.,Center for Infertility Management and Assisted Reproduction | Satish U.,Center for Infertility Management and Assisted Reproduction | And 2 more authors.
Journal of Human Reproductive Sciences | Year: 2013

Objective: The objective of this study was to test the hypothesis that AMH and antral follicle count (AFC) are good predictors of ovarian response to controlled ovarian stimulation and to compare them. Materials and Methods: This observational cross-sectional study included 56 subjects aged between 25 and 42 years who were enrolled between 1 st January and 31 st December 2010 for their first intracytoplasmic sperm injection (ICSI) program. Baseline hormone profiles including serum levels of Estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and Anti-mullerian Hormone (AMH) were determined on day 3 of the previous cycle. The antral follicle count measurements were performed on days 3-5 of the same menstrual cycle. Antral follicles within the bilateral ovaries between 2-6 mm were recorded. The subjects were treated with long protocol for ovarian stimulation. Ovulation was induced with 10,000 IU of human chorionic gonadotropin (hCG) when at least 3 follicles attained the size of more than 17 mm. Transvaginal oocyte retrieval was performed under ultrasound guidance 36 hours after hCG administration. An oocyte count less than 4 and absence of follicular growth with controlled ovarian hyper stimulation was considered as poor ovarian response. Oocyte count of 4 or more was considered as normal ovarian response. Results: Statistical analysis was performed using SPSS software trail version 16.0. Subjects were divided into 2 groups, depending on the ovarian response. The mean oocyte counts were 12.27 ± 6.06 and 2.22 ± 1.24 in normal and poor responders, respectively, ( P = 001). Multiple regression analysis revealed AMH and antral follicle count as predictors of ovarian response (β coefficient ± SE for AMH was 1.618 ± 0.602 ( P = 0.01) and for AFC, it was, 0.528 ± 0.175 ( P = 0.004). AFC was found to be a better predictor of ovarian response compared to AMH in controlled ovarian hyper stimulation. Conclusion: The observations made in this study revealed that both AMH and AFC are good predictors of ovarian response; AFC being a better predictor compared to AMH.


Himabindu Y.,GSL Medical College and General Hospital | Gopinathan K.K.,Center for Infertility Management and Assisted Reproduction | Pandey A.K.,BPS Government Medical College for Women | Sriharibabu M.,GSL Medical College and General Hospital
Indian Journal of Physiology and Pharmacology | Year: 2013

Increasing female literacy and employment have resulted in a clear rise in the age at which women conceive. As fertility starts to decline with advancing age more and more number of women are facing the problem of infertility and are seeking medical attention to over come this problem. This resulted in more number of women seeking medical help to over come the problem of Infertility. This age related decline in ovarian reserve is not uniform in all women of reproductive age. A number of ovarian reserve tests were developed to overcome this problem. But to date there is no ideal marker for predicting ovarian reserve and pregnancy outcome in assisted reproductive technology program (ART). Recent studies indicate that anti mullein hormone is a promising marker for predicting ovarian reserve and pregnancy out come. The aim of this study was to assess the influence of age on Anti-Mullerian Hormone (AMH) in ART program outcomes. Ninety-three subjects in the age group of 25 to 42 years were recruited to the study. All these subjects underwent controlled ovarian stimulation (COS) and later intracytoplasmic sperm injection (ICSI). Subjects were divided into four groups. AMH levels in positive and negative pregnancy subjects in the above and below 35years age groups were compared. AMH levels were correlated with other ovarian reserve parameters and clinical pregnancy out come in both the age groups. Statistically significant differences were found in AMH levels between positive and negative pregnancy subjects in the age group of 35 and above, but not in the age group below 35 years. There were positive correlations between AMH and other ovarian reserve markers and clinical pregnancy outcome in this age group. AMH and the number of retrieved oocytes (r=0.784, P<0.01), Antral Follicle count (AFC) (r=0.749, P<0.01) and Mature Oocytes (MII) (r=0.407, P<0.01) followed by Grade-I Embryos (r=0.433, P<0.01). The current study revealed that AMH levels are better correlated with ovarian reserve and clinical pregnancy out come in subjects aged 35 years and above.


Francis A.,Center for Infertility Management and Assisted Reproduction | Meleyil S.M.,Center for Infertility Management and Assisted Reproduction | Pullely J.P.,Center for Infertility Management and Assisted Reproduction | Koshy T.,Sri Ramachandra University | And 3 more authors.
Laboratory Medicine | Year: 2015

Objective: To assess the postnatal clinical manifestation of an antenatally detected unbalanced rearrangement involving chromosome 13 in an ethnic South Indian couple. Methods: We used conventional cytogenetics on fetal cells obtained from prenatal specimens and on peripheral blood lymphocytes from consanguineous family members to ascertain the chromosomal abnormalities. Results: We report the reproductive outcomes of a maternally inherited chromosome translocation involving chromosome 9 and 13 and the informed decisions of the couple, after genetic counseling in India, regarding their 4 pregnancies. Conclusion: This case report highlights the current practice in India of offering prenatal diagnosis and preimplantation genetic diagnosis to individuals who are carriers of balanced translocations, to reduce the risk of conceiving chromosomally abnormal offspring.


PubMed | Center for Infertility Management and Assisted Reproduction and Sri Ramachandra University
Type: Case Reports | Journal: Laboratory medicine | Year: 2015

To assess the postnatal clinical manifestation of an antenatally detected unbalanced rearrangement involving chromosome 13 in an ethnic South Indian couple.We used conventional cytogenetics on fetal cells obtained from prenatal specimens and on peripheral blood lymphocytes from consanguineous family members to ascertain the chromosomal abnormalities.We report the reproductive outcomes of a maternally inherited chromosome translocation involving chromosome 9 and 13 and the informed decisions of the couple, after genetic counseling in India, regarding their 4 pregnancies.This case report highlights the current practice in India of offering prenatal diagnosis and preimplantation genetic diagnosis to individuals who are carriers of balanced translocations, to reduce the risk of conceiving chromosomally abnormal offspring.

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