|
 
 |
| CONFERENCE ABSTRACT |
|
| Year : 2018 | Volume
: 3
| Issue : 1 | Page : 21-28 |
|
AFRH Conference 2018 Abstracts
| Date of Web Publication | 28-Aug-2019 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
. AFRH Conference 2018 Abstracts. Afr J Infertil Assist Concept 2018;3:21-8 |
| Pregnancy and live birth rate through surrogacy in assisted reproductive technology: Experience of an in vitro fertilisation centre in Lagos | |  |
Adewusi J, Iloabachie E, Okeke C, Okonkwo C, Ashiru O
Medical Art Center, Institute of Reproductive Medicine, Ikeja, Lagos, Nigeria E-mail: biolaadewusi@gmail.com
The report aims to present the clinical success of IVF cycles in combination with surrogacy using gestational carriers in a private clinic, in a developing country.
In a 10-year period from 2008 to 2017, a total of 150 cycles of IVF with surrogate gestational pregnancy were performed for 85 couples. Although only 4 of the 85 couples used their oocytes, all 85 couples used the partner's sperm. 106 gestational carriers were used within this time period, each of whom had a history of natural conception that resulted in at least one live birth. Intra-cytoplasmic sperm injection following controlled ovarian hyper stimulation was performed, and an average of 2.3 ± 0.7 embryos transferred to each recipient. Frequencies of positive hCG, clinical pregnancy, implantation and live birth rates were recorded.
Overall pregnancy rate was 42% with a clinical pregnancy rate of 29% and implantation rate of 56%. A live-birth rate of 21% was also recorded.
Although it remains a controversial approach to the management of infertility, this study suggests that IVF surrogate gestation produces success rates which may be comparable to conventional IVF over the same time span. In Nigeria, surrogacy via IVF is now a readily accessible option for many infertile couples who dream of expanding their families.
| Sperm DNA fragmentation among sperm donors and men seeking assisted conception at an Assisted Reproductive Technology Clinic in Sub-Saharan Africa | | |
Ajay AB, Ajayi VD, Oyetunji IO, Saanu OO, Atiba A, Ehichioya J, Kalu J, Afolabi BM1
OPD, Nordica Fertility Centre,1 Department of O&G, Health, Environment and Development Foundation, Lagos, Nigeria E-mail: victor.ajayi@nordicalagos.org
This is to investigate sperm DNA fragmentation among sperm donors and men presenting with infertility and to determine its place in routine screening of infertile men.
This was a descriptive and analytic study involving 16 sperm donors and 95 male partners who presented to Nordica Fertility Centre, Lagos Nigeria between September 2017 and May 2018. DNA fragmentation test was done using the Sperm chromatin dispersion technique alongside the routine Semen Analysis. Data was analyzed using STATA 13 and significance was set at P value < 0.05.
A total of 111 apparently healthy males including 16 sperm donors and 95 partners were analyzed. The means (±sd) of age (years) and body mass index (kg/m2) for all, sperm donors and partners were 40.3 (8.8) and 27.4 (4.9), 27.9 (4.2) and 25.4 (4.2), 42.4 (7.6) and 27.7 (4.7) respectively. The mean (±sd) DFI (DNA Fragmentation Index) of all, donors and male partners were 34.5 (18,6), 30.4 (15.3) and 35.2 (19.2). Donors were 2.73 times more likely to have DFI <25 compared to partners (X = 3.42, P value = 0.06, Odds ratio 2.73 96% CI 0.91, 8.15). Compared with other BMI groups, men with normal BMI were 0.57 times as likely to present with very poor DFI (χ2= 1.33, P value = 0.25, Crude Odd Ratio=0.57, 95% CI: 0.22, 1.50); and 1.6 times as likely to have excellent/good DFI (χ2=0.82, P value = 0.37, Crude Odd Ratio=1.6, 95% CI: 0.57, 4.46). Men with DFI<25% were 3.44 times more likely to have sperm count ≥15 × 106/ml, compared with those with DFI≥25% (χ2=8.25, P value = 0.004, Odds Ratio=3.44, 95% Confidence Interval: 1.45, 8.15).
Men with normal BMI, normal sperm count and motility and sperm donors were more likely to have excellent to good DFI or DFI suggestive of good fertility potential (DFI <25).
| Maternal determinants of estimated fetal weight at mid-pregnancy | | |
Idowu AT, Kehinde TB, Ottun AM, Iketubosin F, Oloyede OA
Georges Memorial Medical Centre, Victoria-Island, Lagos, Nigeria E-mail: iketubosin@gmail.com
Assessment of fetal biometry is a vital component of prenatal care in many parts of the world.
This study assessed the correlation between some maternal variables and fetal weight estimated from mid-pregnancy ultrasound biometric data with a view to identifying significant maternal predictors of fetal weight in a sample of Nigerian women.
A prospective study involving 87 pregnant women scanned at 18-23 weeks of pregnancy was carried out. The fetal measurements were head circumference (HC), abdominal circumference, femur length, and biparietal diameter while the maternal variables were age, parity, height, weight and BMI.
Maternal weight and BMI were the most correlated variables (r = 0.92; P < 0.001). The significant correlation between maternal age and weight (r = 0.28; P < 0.01) and between maternal age and BMI (r = 0.30; P < 0.01), on simple correlation, vanished with partial correlation (P > 0.05). In contrast, significant correlation which was not observed between estimated fetal weight (EFW) and maternal weight (r=-0.06; P > 0.05); EFW and maternal height (r = 0.03; P > 0.05); and between EFW and BMI appeared with partial correlation (P < 0.05). Multiple regression analysis gave statistically significant models (ANOVA: F = 22.2; P < 0.01).
Maternal height, weight, parity, BMI, and estimated gestational age at scan (EGA) are significant predictors or determinants of EFW.
| First line anti-retroviral drugs affects antral follicular count in HIV positive individuals | | |
Ohihoin AG, Ohihoin EN, Ujomu I, Bakare A, Olarenwaju O, Okafor A, Aina O, Ajibaye S, Okechukwu A, Iranloye BO, Ezechi O, Taylor-Robinson SD
Division of Clinical Sciences, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria E-mail: aigbe.ohihoin@yahoo.com
Patients infected with the HIV virus are known to make remarkable improvements when managed with highly active anti-retroviral therapy (HAART). There are genuine concerns however that long-term usage of these drugs to manage HIV may be associated with compromise in reproductive functions.
The aim of the study, was to ascertain the effect of highly active anti-retroviral drugs (ARVs) on antral follicular count and reproductive potential of HIV positive human females.
A cross-sectional comparative study was done. The study population was subdivided into three groups. Group A consisted of HIV positive patients already on anti-retroviral therapy. Group B were HIV positive patients who were naïve to anti-retroviral drugs at the time of recruitment (Not on ARVs). Group C were HIV negative women within the reproductive age range not being managed for Infertility.
The mean age of the participants across the groups of HIV negative, HIV positive with drugs and HIV negative without drugs were respectively 32 years, 33.40years and 37.58 years. The average duration of use of ARVs was 81.12 months (6.7years). The commonest menstrual abnormality was oligomenorrhoea, occurring in close to 25% of respondent who are HIV positive and on ARVs. Menstrual abnormality was greater in HIV positive women receiving anti-retroviral drugs than in the other two human cohorts (P = 0.007). A reduction in the mean level of antral follicular count in the HIV positive patients on medication was observed (P = 0.009). Average FSH levels across the groups of HIV negative, HIV positive with drugs and HIV negative without drugs were respectively 4.43iu, 14.55iu and 6.69iu. When HIV negative group was compared with HIV positive on drugs, it was statistically significant (P = 0.039). Serum levels of FSH and oestradiol showed pattern consistent with disrupted follicular development in patients receiving anti-retroviral therapy when compared to other cohorts.
Chronic usage of anti-retroviral drugs is associated with disrupted menstrual cycle and reduction in follicular count.
| Overview of acupuncture as an adjunct to in vitro fertilization treatment in black African women: A preliminary study | | |
Ajayi AB, Ajayi R, Ejeliogu IS, Ajayi VD, Afolabi BM1
OPD, Nordica Fertility Centre,1 Department of O&G, Health, Environment and Development Foundation, Lagos, Nigeria Email: victor.ajayi@nordicalagos.org
This study aims to document preliminary findings on the use of acupuncture adjuvant among women undergoing in vitro Fertilization in Nigeria.
All 110 women who had adjunct acupuncture with IVF between August 2016 and July 2017 at Nordica Fertility Center Lagos Nigeria were included in the study. After all the acupuncture sessions had been done and at the completion of IVF treatment each woman had pregnancy test. The acupuncture points used were in conformity with international standards.
A total of 110 infertile women were recruited into the study. The means (±sd) of their age, Body Mass Index and years trying to conceive were 36.9 (6.4) years, 29.8 (6.3) Kg/m2 and 6.8 (5.5) years respectively. In all, 21 (19.1%) came with their spouse, 71 (64.6%) were nulliparous, 58 (52.7%) had undergone failed IVF treatment elsewhere and 19 (17.3%) had previously undergone acupuncture at Nordica fertility Center. Those who had 1-3 acupuncture sessions were 1.33 times more likely to have a positive PT than those who had >3 acupuncture sessions (χ2=0.36, P value = 0.55, OR=1.33, 95% CI:0.53, 3.36). Normal weight women who had 1-3 acupuncture sessions were 5 times likely to have positive PT than those who had >3 acupuncture sessions (χ2=1.80, P value = 0.18, OR=5.00, 95% CI:0.81, 31.00). Overweight women who had 1-3 sessions were about equally as likely to have positive PT s those who had >3 sessions (χ2=0.00, P value = 1.00, OR=1.08, 95% CI:0.21, 5.49) while obese women who had 1-3 sessions were not likely to have positive PT as those who had >3 sessions (χ2=0.08, P value = 0.77, OR=0.54, 95% CI:0.10, 3.08).
The advantage of acupuncture as an IVF adjunct remains to be substantiated. Our study findings suggest that having more than 3 sessions of acupuncture have no added advantage, except in overweight-obese clients who may because of their BMI have some form of reduced response/success rates.
| Assisted reproduction technology: Comparison of anesthetic techniques for oocyte retrieval in a tertiary health facility in Ilorin, Nigeria | | |
Omokanye LO, Olatinwo AWO, Saadu LO1, Biliaminu SA2, Durowade KA3, Panti AA4, Salaudeen AG5
Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ilorin, Ilorin,1 Assisted Reproductive Technology Unit, University of Ilorin Teaching Ilorin,2 Department of Chemical Pathology and Immunology, College of Health Sciences, University of Ilorin,3 Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State,4 Department of Obst. & Gyn. College of Health Sciences, Usmanu Danfodiyo University Sokoto,5 Department of Epidemiology and Community Health, College of Health Sciences, University of Ilorin, Nigeria E-mail: omostuff1111@yahoo.com
Transvaginal ultrasound-guided oocyte retrieval (TUGOR) technique is \minimally invasive and requires shorter time compared to previous techniques. Yet, it is a potentially stressful and painful procedure and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGOR on reproductive outcomes remain controversial.
This study aimed at comparing the efficacy of paracervical block and conscious sedation for pain relief and pregnancy outcomes during TUGOR.
A cross-sectional comparative study of 137 eligible clients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for Controlled Ovarian Hyperstimulation. The choice of analgesia for TUGOR was influenced by clients' and or clinicians' preference. Paracervical block and conscious sedation were administered for TUGOR in 66 and 71 clients respectively. For Paracervical block 10ml of 1% lidnocaine was injected into each lateral fornices between 3 and 4 o'clock and 8 and 9 o'clock position while conscious sedation was achieved with 50mg of Pethidine and 2.5mg of Midazolam administered intravenously. Pain was assessed using a 10cm Visual Analogue Scale while clients' overall satisfaction was rated using Likert scoring system.
There was no statistically significant difference in the clinical pregnancy, miscarriage and live birth rates between the two groups. The mean VAS 10-point scores at 1hr, 6hrs, 24hrs post retrieval and on the day of embryo transfer were significantly higher for paracervical group. The mean Likert score for conscious sedation group was significantly higher than paracervical group.
Conscious sedation is superior to paracervical block as anesthetic/analgesic agent for pain relief and clients' satisfaction for TUGOR. However, a multimodal approach to anesthesia/analgesia for TUGOR is suggested to further improve on over all clients' satisfaction.
| The relationship between body mass index and semen quality in men seeking fertility treatment in Nigeria | | |
Olaifa OA, Ogbeche RO, Babatunde B, Ajayi A, Anya N, Idoko VB, Oraneli G, Aremu G
Department of Embryology, The Bridge Clinic, 66 Oduduwa Way, Ikeja GRA, Lagos, Nigeria Email: ogbecheogeyi@yahoo.com
The objective of the study was to establish a relationship between BMI and semen parameters. Lack of adequate available data on the impact of BMI on semen parameters in Nigeria gives credence to the need to carry out this study.
The study was a prospective multi-centre study of 51 men attending the Bridge clinic Lagos, Abuja and Port Harcourt for fertility treatment between January 2018 and June 2018 were included with the following exclusion criteria: Men >50 years, days of abstinence >5 days, Azoospermic samples, smokers, alcohol users and those on anti-hypertensive drugs or medications that will likely affect sperm production. Standard semen investigation was carried out which includes semen volume, density, motility and morphology using the WHO 2010 (5th Edition) criteria. The BMI of the men were grouped as follows: BMI <18.5 kg/m2 (group 1- underweight), BMI 18.5 – 24.9 kg/m2 (group 2 - controls), BMI 25- 29.9Kg/m2 (group 3- overweight) and BMI >30 kg/m2 (group 4 - obese). Groups 1, 3 and 4 were all compared statistically with group 2 (control group) for semen volume, sperm density, motility and morphology. Statistical analysis was done using SPSS version 17.0.
The mean age and BMI for all men (51) included in the study was 40.31(±0.73) and 32.37(±4.67) respectively. The mean age and BMI for group 1(N = 1) was 40.00(±0.00) and 17.79(±0.0) respectively. Group 2 had 11 men with mean age and BMI of 42.45(±1.79) and 22.46 (±0.51) respectively while Group 3 (N = 24) had mean age and BMI of 39.84 (±1.54) and 27.57(±0.25) respectively. The obese group (group 4- N=15) had a mean age and BMI of 40.73(±1.11) and 32.68 (±0.78) respectively. (Values of BMI expressed as mean ± standard error of mean).
The semen volume for all groups was within normal range with significant difference in the overweight group when compared to the control group (P < 0.05). The semen density in the underweight group was significantly reduced (10 × 106mil/ml (P < 0.05)) when compared to the control group. There was no significant difference in motility for the underweight, overweight and obese group when compared to the control and WHO normal range. Semen morphology for all groups was significantly lower when compared to the accepted WHO 2010 criteria of ≥4%.
No relationship between semen parameters and BMI was noted. Further study in a larger population should be performed to investigate the relationship between BMI and sperm quality.
| Prevalence of azoospermia among men presenting with infertility at a fertility clinic in sub Saharan Africa | | |
Ajayi AB, Afolabi BM1, Ajayi VD, Oyetunji IO, Atiba A
OPD, Nordica Fertility Centre,1 Department of O&G, Health, Environment and Development Foundation, Lagos, Nigeria E-mail: victor.ajayi@nordicalagos.org
The objective of the study is to report the prevalence and characteristics of men presenting with azoospermia.
This retrospective study was carried from 2010 to 2015 and investigated the association between age, BMI, semen volume, liquefaction time and pus cells among 561 normospermic and azoospermic men. Standard semen analysis was performed and subjects were categorized by age into <30, 30 - 39.9, 40 - 49.9, 50 - 59.9 and ≥60 years and by body mass index into normal (18.5 - 24.9), overweight (25.0 - 29.9) and obese (≥30).
The 562 subjects of the study had means (±SD) age of 42.6 (±7.10) years and BMI of 27.0 (4.1) kg/m2 respectively. In all, 109 (19.4%) were azoospermic. Overweight and obese men were, respectively, more than 1½ and about 2½ times more likely to be azoospermic compared to normal weight men. Azoospermic men were significantly heavier than men with normal sperm count (t = −0.34; P value = 0.003). Among those with normal weight, liquefaction time was significantly shorter (t = 5.49, P value = 0.000001) in azoospermic (28.70 min.) than in men with normal sperm count (31.82 min.). Obese azoospermic men were about 4 times as likely to have high pus cells in semen than normal weight azoospermic men (OR =3.82; 95% CI: 0.39, 37.01). Multivariate regression analysis shows a strong but negative coefficient correlation between sperm concentration and BMI (coef. = −0.48, Std Err. =0.25, P value = 0.05, 95% CI: −0.96, 0.10).
Our findings suggest that high BMI is associated with azoospermia. Azoospermia also did not seem to negatively impact liquefaction time.
| Pyospermia in men seeking assisted reproduction technology | | |
Ajayi AB, Afolabi BM1, Ajayi VD, Oyetunji IO, Atiba A, Ehichioya J, Ayelehin I, Adeoye A, Adesida T
OPD, Nordica Fertility Centre,1 Department of O&G, Health, Environment and Development Foundation, Lagos, Nigeria E-mail: victor.ajayi@nordicalagos.org
This study assessed the relationship between pus cells and semen parameters in infertile Nigerian males.
The study was a cross-sectional descriptive study of 907 subjects carried out at Nordica Fertility Center, Lagos, Nigeria, from 2004 to 2009. Subjects ages (years) were categorized into ≤30, 30.1 - 35, 35.1 - 40, 40.1 - 45, 45.1 - 50 and >50, BMI into <18.5 (underweight), 18.5-24.5 (normal), 25.0 - 29.9 (overweight) and ≥30 (obese) and pus cells into none, 1 - 2 and ≥3/hpf.
Pus cells of ≥3/hpf occurred in 67 (7.4%) men. The overall means (±sd) of pus cells/hpf was 1.4 (0.9), 1.4 (0.7), 1.4 (0.7) and 1.6 (1.6) in all, normospermia, oligospermic and azoospermic patients respectively. Mean (±SD) pus cells in semen was 6.0 (4.0), the highest, among obese (BMI ≥30) azoospermic patients. The proportion of subjects with pyospermia of 1 - 2 was highest (323/346, 93.3%) among oligospermic patients while that with pyospermia of ≥3 was highest (10/109, 9.2%) among azoospermic patients. Obese azoospermic patients were 1.8 times as likely to have ≥3/hpf pyospermia compared to normal normospermic patients (x2 = 0.05, P value = 0.51, OR =1.82, 95% CI: 0.30, 11.02). Mean progressive motility (%) was significantly reduced (t = 1.95, P value = 0.03) among patients with ≥3/hpf pyospermia (33.75 ± 19.23) compared to those with 1 - 2/hpf (38.58 ± 21.63). Patients with sperm oval head ≤30% had significantly higher pyospermia (t = 2.22, P value = 0.013) than those with sperm oval head of >30%.
More pus cells were seen among obese azoospermic men, men with reduced sperm progressive motility and men with fewer sperms with oval heads. Clinicians should consider pyospermia relative to BMI and mean progressive motility in their management of male infertility.
| Successful pregnancy following in vitro fertilization and embryo transfer in a patient with gonadal dysgenesis | | |
Adebayo AE, Ademulegun TE1, Akindojutimi AJ, Loto OM2
Resident Doctor,1 Embryology Unit, Paramount Specialist Hospital and Fertility Centre, Ondo State,2 Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife Osun State, Nigeria E-mail: bisiloto@yahoo.co.uk
Gonadal dysgenesis is a congenital developmental condition resulting from anomalies of sex chromosomes or mutations in the genes involved in the development of the indifferent embryonic gonads leading to amenorrhoea and infertility. We report case of a woman with pure 46, XX gonadal dysgenesis with primary infertility who was able to achieve conception and delivery following IVF with donor oocyte at our facility.
This is a case report of Mrs. AF, a 34 year old married woman with 6 years infertility. She had a history of primary amenorrhea and has had to use oral contraceptive pills to initiate and induce menses since 19 years of age. Hormonal evaluation revealed abnormally elevated gonadotropins, laparoscopy done revealed streaked gonads and cytogenetic studies revealed 46XX chromosomal compliments. Husband had normospermia on evaluation. She was evaluated for and had in vitro Fertilization and Embryo Transfer with donor oocyte. The procedure was successful at the second attempt and she was delivered of a live male baby weighing 3.5kg with APGAR score of 101 105 at 37 weeks through elective caesarean section. Post-op condition was uneventful and the mother and baby were discharged on the 3rd post-operative day.
The effective use of hormone replacement therapy and application of assisted reproductive technology (ART) techniques can help patients with gonadal dysgenesis to circumvent the monstrous challenge of infertility associated with this condition, especially in an environment like ours where marital success is a factor of the woman's ability to conceive and give birth.
| Pregnancy outcome of a novel embryo loading technique at a private fertility centre | | |
Archibong-Omon A, Ogbeche R, Babatunde B, Olaniyi M, Olaifa A, Shatta R, Uwa O, Ajayi A, Adeoshun A
Department of Embryology, The Bridge Clinic, 66 Oduduwa Way, Ikeja GRA, Lagos, Nigeria E-mail: ogbecheogeyi@yahoo.com
The study was aimed at comparing the effect of two different embryo loading techniques in Frozen Embryo Transfer (FET) cycles.
This retrospective study comprised of a total of 110 Frozen Embryo Transfer (FET) cycles from January 2017 to April 2018 {8 months each for groups A and B respectively). Groups (A and B) were identified based on the method of Embryo loading technique employed during Embryo Transfer. Egg donation and surrogacy cycles were excluded from this study.
In group A (48 FET cycles), the catheter was flushed with Global medium, followed by a column of air, embryo(s) and media to seal. In group B (62 FET cycles), loading was aided by a device known as a micrometer screw gauge. The device enabled controlled aspiration of columns of air, embryo, air and media. The volume of these columns was defined by clockwise and anticlockwise revolutions of the micrometer screw arm. The primary target outcome measured was pregnancy rate. All embryos were loaded by competently trained and experienced Embryologists with Doctors. Wallace Catheters were used for all transfers. Blind embryo transfers were carried out in both groups with the aid of prior trial embryo transfer and uterine depth measurements. Statistical analysis was done using the independent sample t-test and Chi-square test *P value < 0.05.
No significant difference was found regarding the age of patients in groups A and B (33.1 ± 0.5188 vs. 32.84 ± 0.663, P = 0.7529) respectively. The number of embryos transferred between groups A and B showed no statistically significant difference (1.889 ± 0.04738 vs. 1.934 ± 0.03196, P = 0.4106) with 37.2% and 36.4 % of higher grade embryos transferred in groups A and B respectively. Endometrial thickness in groups A and B presented no significant difference (9.487 ± 0.2574 vs. 9.364 ± 0.2349, P = 0.7258). Similarly, no significant difference was detected between groups A and B (21/48 {43.75%} vs. 27/62 {43.55%}, P = 0.9831) in pregnancy rate respectively. Ectopic pregnancy rate also revealed no significant difference between the groups with group A having 1 ectopic pregnancy (0.1%) and group B having non (0).
Due to an increase in the variability in volume of media used for embryo transfer by embryologists, this novel embryo loading technique may have provided a quality assurance system to ensure consistency in the volume used for embryo transfer without compromising pregnancy rates. There is however the need for this study to be carried out with larger population.
| Outcome assessments of preimplantation genetic testing: Nisa hospital case study | | |
Danga C, Chair M, Lawal T, Nkeiruka A, Wada I
Department of Genetics, Fertility and Genetics Centre, Nisa Hospital, Jabi- Abuja E-mail: christopherdanga6@gmail.com
The aim of the study is to assess the outcomes of fresh and frozen embryos transfers following Preimplantation Genetic Testing (PGT).
This is a retrospective study consisting data collection and analysis of all PGTs carried out at Nisa Hospital Abuja between 2013 and 2018. The PGTs included all in vitro fertilization procedures for aneuploidy testing of embryos, sex selections for family balancing and for sickle cell (HBSS) screening in which successful embryo transfers (ETs) were achieved. Primary outcome of the study was clinical pregnancy. Data analysis was performed using Analyse-it® method validation version 4.7 and statistical significance accepted at P<.05.
The results show that a total of 141 PGTs were carried in the Hospital within the period of study. Of these, there were more aneuploidy testing (119, 84%) than HBSS screening (22, 16%). Between frozen (94, 79%) and fresh (25, 21%) ETs of the aneuploidy testing, pregnancy rates were 19% (11/57) and 47% (9/19) respectively. The difference was statistically significant by Chi-squared Test, χ2 (1, N = 76) =5.71, P =.016), although there was no fresh ETs in the HBSS screening, a 7% pregnancy rate was recorded for the all the frozen ETs.
Findings from these assessments posit a safe conclusion that local IVF centres are capable of providing successful and positive outcomes from fresh ETs following PGT to clients seeking this treatment. Thus it was also indicative of the fact that fresh ETs following PGTs should be encouraged to improve on cost efficiency and pregnancy outcomes of the IVF procedures. However, further studies with large dataset are required to validate these findings in our local setting.
| The predictive value of testicular sperm extraction using serum follicular stimulating hormone level in azoospermic men | | |
Uwa JO, Ogbeche RO, Babatunde B, Adeoshun AA
Dept. of Embryology, The Bridge Clinic, 66 Oduduwa Way, Ikeja GRA, Lagos E-mail: ogbecheogeyi@yahoo.com
The aim of this study was to evaluate the predictive value of serum follicle stimulating hormone (FSH) level to successful surgical sperm retrieval outcome from azoospermic men.
Retrospective study of 144 azoospermic clients who underwent surgical sperm collection using TESE within the period 10 years from 2010 to 2018 were analysed. Men were distributed into 2 groups; Group 1 (Serum FSH ≤18IU/I) and Group 2 (Serum FSH >18IU/I). Men who had sperm cells seen in previous seminal fluid analysis were excluded from the study. Azoospermia was confirmed when no spermatozoa is detected on high-powered microscopic examination of centrifuged seminal fluid on at least two (2) occasions. A successful surgical sperm collection (SSC) procedure using TESE was indicated by the presence of sperm cells irrespective of the motility status. Statistical analysis was done using SPSS version 17.0. Simple frequencies were determined for the groups and the paired t-test was used for evaluating the significance of serum FSH level.
A total of 100 out of 144 men with serum FSH level were included in the study. A total of with 73 out of 100 men (73%) had successful TESE outcome. Group 1 and 2 (mean age of 41.9) had a total of 76 men and 24 men respectively. Sixty (60) men in Group 1 had a successful outcome giving a predictive value of 78.9% while twelve (12) men out of twenty four (24) men in Group 2 had a successful SSC outcome with a predictive value of 50%. The mean difference of Group 1 serum FSH of reference range ≤18IU/I and that of Group 2 was statistically significant (P < 0.0001). The predictive value decreased significantly to 33.3% (4 out of 12 men) when the serum FSH level was3 25IU/l.
Serum FSH level ≤18IU/I from this study correlates strongly with positive SSC outcome with a high predictive value. This study will help with counseling for clients with Azoospermia on the invasive option of TESE. A further prospective study on a larger population including testicular volume is advised.
| Outcome of fresh in vitro fertilization cycles at the Lagos University Teaching Hospital: A retrospective review of initial results | | |
Makwe CC, Olamijulo JA, Omisakin SI, Kayode B, Odunlami O, Are B, Lemomu KM, Adejumo TP, Opemuwade TI, Abdulfattah FS, Martins-Akinlose OD, Ogedengbe OK, Giwa-Osagie OF
Assisted Fertility Centre, Lagos University Teaching Hospital, Idi-Araba Surulere Lagos, Nigeria Email: makwe285@yahoo.com
In vitro fertilization (IVF) is a complex procedure for the treatment of couples with infertility, particularly tubal- and male- factor infertility. IVF was recently re-introduced at the Lagos University Teaching Hospital – a publicly owned tertiary hospital. To evaluate the outcomes of fresh IVF cycles at the new IVF centre.
A retrospective review of 54 consecutive IVF cycles initiated from January 2016 to June 2018. All the cycles were stimulated IVF cycle using a long-agonist protocol. Following fertilization and embryo culture based on standard IVF techniques, fresh viable embryos were transferred on the 3rd or 5th day after oocyte retrieval. Clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR) were the main outcome measures.
Of the 54 IVF cycles initiated, 47 (87.0%) had oocyte retrieval and 7 (13.0%) had cycle cancellation due to poor ovarian response. The mean age of the women was 39.7 ± 6.7 years (age range: 24 – 56 years). Forty-four embryo transfer (ET) cycles were performed, with a median number of 3 embryos transferred per cycle. The ET rate per initiated cycle and per oocyte retrieval cycle was 81.5% (44/54) and 93.6% (44/47), respectively. Of the 44 fresh ET cycles, nineteen had clinical pregnancy. The CPR was 43.2% (19/44) per ET cycle and 35.2% (19/54) per initiated cycle. Three women had miscarriage before 12 weeks' gestation. The OPR was 36.4% (16/44) per ET cycle and 29.6% (16/54) per initiated cycle.
Our CPR and OPR are comparable to results from other established IVF centres.
| Is there a difference in culture outcomes and clinical pregnancy rate when two single step media on sibling embryos are compared? | | |
Uwa JO, Ogbeche RO, Olaifa A, Shatta S, Agioh M, Achibong-Omon AA, Ajayi A, Adeoshun AA
Department of Embryology, The Bridge Clinic, 66 Oduduwa Way, Ikeja GRA, Lagos, Nigeria E-mail: ogbecheogeyi@yahoo.com
The study was aimed at evaluating the effects of two (2) single step media system; the Global culture medium (LGGG-100) and Irvine culture medium (CSCM 90164) on fertilization rate, blastocyst formation rate and pregnancy rate in sibling embryo culture.
A prospective study carried out from December 2017 to June 2018. Two (2) Single-step media supplemented with human serum albumin (HSA) was used. A total of 70 clients were treated using various inclusion and exclusion criteria. Patients were randomized based on the number of oocytes treated. Only patients with ≥10 oocytes were included in this study. Mature oocytes (MII) were injected 3-4hrs after oocyte pick up. Treated oocytes were randomly distributed into 2 groups, Group A (LGGG-100 plus HSA) and group B (CSCM 90164 plus HSA) after Intracytoplasmic Morphological Sperm Injection (IMSI). Fertilization check was performed 16-18 hours after IMSI and resulting zygotes were cultured till blastocysts stage with refresh of the media on Day 3. The main outcome measures were fertilization, blastocyst formation, high grade embryos (according to Gardner's classification) and clinical pregnancy rate.
A total of 1347 mature oocytes out of 1707 were injected 3-4hrs after oocyte pick up. Treated oocytes were randomly distributed into 674 and 585 oocytes in Group A and B respectively after Intracytoplasmic Morphological Sperm Injection (IMSI). In group A, 456 oocytes fertilized out of 674 treated (67.7%) with 265 (58.1%) blastocysts generated. Higher grade of Embryos and clinical pregnancy rate of 11.2% and 33.7% respectively was recorded for this group. Group B had 402 oocytes fertilized out 585 (68.7%) with 235 blastocysts generated (58.5%), higher grade of embryos (14.7%) and clinical pregnancy rate of 34.9%.
Although there is no significant difference between the Embryo cultures outcomes of the two (2) single step culture media. This study will provide a platform for effective scientific assessment of clinic's on-going embryo culture practices. In addition it will add to the body of scientific knowledge that will help in bolstering Assisted Reproduction.
| The oil and gas industry and the impact on reproductive health: Case reports on management of fertility related hazards | | |
Adeyi T, Iloabachie E, Soyoye A, Bello B, Ashiru O
Medical Art Center, Institute of Reproductive Medicine, Ikeja, Lagos, Nigeria E-mail: dapo.ashiru@medicalartcenter.com
This study aimed to review the case reports of the clinical success of IVF cycles in combination with Modern Mayr Medicine type of detoxification in our clinic in Lagos, Nigeria.
A subset of three patients from a total of 131 patients undergoing in vitro fertilization (IVF) from Jan 2014-December 2017 at the Medical ART Center, Lagos, Nigeria work at a petrochemical industry. They were referred to Mart-Life Detox Clinic for supervised modern Mayr detoxification therapy before further assisted reproductive treatment. All couples underwent the necessary fertility work-up at Medical Art Center. Mayr detoxification therapy was thereafter carried out with relevant Mayr protocols. Frozen embryo transfer (FET) cycles commenced for two patients following Mayr therapy. The third patient deferred her IVF treatment.
All three patients achieved significant weight reduction and improvement in BMI. Two of the patients tested positive for beta HCG following detoxification and FET. The third patient confirmed natural conception after Mayr therapy.
Results obtained suggest that supervised modern Mayr therapy detoxification may positively impact fertility indices in infertile couples (particularly those linked to the oil and gas sector) who undergo ART. However, there is need for further studies on larger populations to establish a pattern of response, if any, and increase knowledge on the potential role of modern Mayr detoxification in assisted conception.
| Relationship between blood and seminal fluid zinc levels and semen parameters among Nigerian men in a fertility clinic in Nigeria | | |
Adewunmi AA, Ottun TA, Omisakin S1, Ogah K2
Department of Obstetrics and Gynaecology, Lagos State University College of Medicine,2 Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja,1 Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria E-mail: niyi_55@yahoo.com
This study sets out to determine the correlation of blood and seminal fluid zinc levels and semen parameters in Nigerian men with normal and abnormal semen parameters who were seen for infertility.
A prospective case-control study of eighty five men with abnormal semen parameters (cases) and equal number with normozoospermia (controls) enrolled from the Institute of Fertility Medicine was carried out. The cases were further sub-grouped as oligozoospermic (n = 64), asthenozoospermic (n = 13) and azoospermic (n = 8). Blood and seminal fluid concentrations of zinc were determined by microwave plasma-atomic emission spectrophotometer.
The median zinc concentrations in blood and seminal seminal fluid were significanty lower in the cases compared with the controls; 1.7 μmol/L(IQR 0.6,2.7) versus 3.2 μmol/L (IQR 1.6,5.2), P < 0.001 and 9.0 μmol/L (IQR 6.1,11.0) versus 19.4 μmol/L (IQR 14.0,25.5), P < 0.001 respectively. Blood zinc levels showed a significant positive correlation with sperm count (r = 0.311 P = 0.012), progressive motility (r = 0.252 P = 0.045) and total motility (r = 0.285 P = 0.022) in the oligozoospermic men. Seminal fluid zinc level however was significantly correlated only with progressive sperm motility (r = 0.251 P = 0.045) in the oligozoospermic men.
This study revealed that blood and seminal plasma zinc levels were significantly lower in men with abnormal semen parameters compared with normal controls. In oligozoospermic men, blood zinc levels were significantly positively correlated with semen parameters while the seminal fluid zinc levels showed significant positive correlation only with progressive motility.
| Awareness of pelvic inflammatory disease amongst women of reproductive age in Rivers state | | |
Eli S1,2, Kalio KGB3, Abam DS2, Nwosu CC2, Allagoa DO4, Green K2, Pepple DKO2, Ikimalo J2
1 Mother and Baby Care Global Foundation,2 Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital,3 Braithwaite Memorial Specialist Hospital, Port Harcourt, Rivers State,4 Department of Obstetrics and Gynaecology, Federal Medical Centre Yenagoa, State, Nigeria E-mail: elisukarime@gmail.com
Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract. Unprotected sexual intercourse is a common means of transmission PID and has devastating consequences on women reproduction due to its relationship with infertility, ectopic pregnancy and chronic pelvic pain. Globally, there are estimated 90 million cases of Chlamydia trachomatis  which are major causative agents of PID.
The aim of the study was to determine the awareness of PID amongst women of reproductive age and prevent adverse effect on reproduction.
It was a cross sectional study of women of reproductive age who attended enlightenment campaign by the Mother and Baby Care Global Foundation. Information were coded and analysed using SPSS version 20.
Two hundred ten questionnaires were distributed and 200 retrieved. The mean age was 24 years ±4. Ninety two (46%) were between ages 20 – 29 years, 30 – 39 years represented 68(34%) of the subjects, 40(20%) were between ages 40 – 49years. PID awareness was 30% in the said subjects. Thirty (15%) between ages 40 -49 years, 20(10%) between ages 30 -39 years, 10 (5%) between ages 20 – 29 years. The relationship between PID and unprotected intercourse was 20%, while for infertility was 10%, 5% for ectopic pregnancy and 2% for chronic pelvic pain.
PID is a public health concern worldwide; because of its adverse effects on human reproduction. Awareness is still poor amongst women of reproductive age group. Enlightenment programme is highly recommended to prevent its negative consequences on fertility.
|
