Percutaneous epididymal sperm aspiration in combination with intracytoplasmic sperm injection as a treatment of choice in Obstructive azoospermia

Intracytoplasmic sperm injection (ICSI) has proved a boon in the field of male infertility. ICSI is unique procedure in which a small quantity of progressively motile and morphologically normal spermatozoa is required and a single best-looking motile spermatozoon is injected into the oocyte. This procedure can overcome the drawbacks of poor semen quality in terms of low count, poor motility and morphology of spermatozoa. Percutaneous epidydimal sperm aspiration (PESA) is a simple procedure of retrieving spermatozoa from epididymis in cases of obstructive azoospermia. The aim of the study was to find out the cumulative rates of sperm retrieval after 2nd PESA attempt and the feasibility of percutaneous epididymal sperm aspiration in obstructive azoospermia. A total of 100 patients were included in the study which was carried out over a period of 2 years. PESA was performed under general anaesthesia on the day of ovum pick up procedure. PESA was repeated at a different site of the same epididymis or at the contralateral site till motile spermatozoa were retrieved and processed. Sperm count motility percentage was calculated using Maklers counting chamber. In 52% of the cases (52/100), motile spermatozoa were retrieved after first PESA attempt. In cases of failure to retrieve spermatozoa after first attempt, a repeat procedure was done. In the second PESA attempt, 33%cases (16/48) reported motile spermatozoa making an overall success rate of 68%(68/100) of surgically retrieving the motile spermatozoa. The PESA remains a simple and effective technique of surgically retrieving the spermatozoa in obstructive azoospermia.&nbsp

STUDY OF ANTIMULLERIAN HORMONE (AMH) LEVEL VARIATION IN FEMALES IN ASSISTED REPRODUCTIVE TECHNOLOGY (ART) CENTRE

Study of AMH levels of patients of ART Centre and its variations has clinical relevance in the field of assisted reproductive technology. Diminished ovarian reserve has become a major cause of infertility. Anti-Mullerian hormone (AMH) seems to be a promising candidate to assess ovarian reserve and predict the response to controlled ovarian hyperstimulation (COH).  The study is a prospective, observational study carried in Department of Anatomy in collaboration with Assisted Reproductive Technology centre at a tertiary care teaching hospital. The study is carried out on eighty females who had reported to ART centre for treatment for the first time, because of involuntary childlessness with at least 1 year of unprotected intercourse without pregnancy.  In our study, eighty females were divided into four groups depending upon their AMH levels. The number of oocytes collected from each female on the day of oocyte pickup was documented. Comparison with previous studies was done. Knowledge of AMH levels will help gynaecologist to counsel the infertility patient prior to initiation of the IVF cycle. It not only allows the quantification of ovarian reserve but also predict the eventual ovarian response to ovarian stimulation and the clinical pregnancy.&#x0D; Keywords: AntiMullerian Hormone, Assisted Reproductive Technology, Ovarian Reserve</jats:p

Ovarian tissue cryopreservation as an option for fertility preservation in young unmarried girls suffering from cancer

In the present society, women in the reproductive age group delay their marriages, due to various social and economic reasons and the age of bearing their first child also gets delayed. It is well known fact that women steadily lose their oocytes from birth to menopause. Moreover, if the woman develops some kind of malignancy in due course, it leads to infertility due to unwanted gonadotoxic side effects of cytotoxic chemotherapeutic drugs and/or radiotherapy. Although survival in case of malignancy takes utmost priority, infertility also is an issue of prime concern which haunts such patients. In such patients ovarian tissue cryopreservation remains one of the methods of fertility preservation. This method has the advantage of requiring neither the sperm donor nor the ovarian stimulation as both these requirements presents ethical and social issues for an unmarried girl. In young unmarried girls suffering from malignancy, where IVF-ET (In Vitro-Fertilization-Embryo Transfer) is contraindicated, ovarian tissue cryopreservation and transplantation could become the technique of choice in the future

Sexual Dimorphism in Clavicle Using Sternal and Clavicular End Morphometry: A Cross Sectional Study

Introduction: Forensic anthropology can play an important role in identification of human remains in cases of natural or manmade calamity. The various manifestations of the morphological features in the skeleton which manifest differently according to sex and statistical differences, forms a basis for sex assessment. In cases, where the recovery of whole body or complete skeleton may not be possible, the forensic anthropologists have to give their opinion based upon the available skeletal remains. Objective: The purpose of the study was attempted to evolve a formula to enable the assessment of sex in clavicles and to know about the comparative differences between right and left clavicles of known sex, by using the various metrical parameters. Materials and Methods: A cross sectional study was conducted in Western Maharashtrian medical college. During the study, a total of 200 adult dried clavicles extracted from cadavers used during dissection. Maximum clavicular length was measured by digital caliper. Identification point were calculated from the actual range whereas Demarking point, a calculated range, was calculated by using the formulae Mean +/- 3SD because this range covered maximum sample size (99.75%) and gave more accurate results. Results: In the present study, the mean of the length of the clavicle was found to be 141.63 in males and 128.70 in females. The mean of the male subsets has been found to be greater even when the sample was categorized into right and left. The maximum length of clavicle was statistically significant when compared with the clavicle of females. Conclusion: Determination of sex the clavicle has a great medico legal importance to the forensic people. And it also helps the orthopaedic implant manufacturers and orthopaedic surgeons to decide correct size and shape of plates and intramedullary nails for clavicular fractures in open reduction method

Morphological variations in Common Facial Vein with variant venous drainage

Background: In depth anatomical knowledge of the facial vasculature is crucial not only for anatomists but also for Oto-rhino-laryngologists, reconstructive and oral and maxillofacial surgeons. The common facial vein (CFV) is a vital component of the facial venous system, which exhibits morphological variations that impact surgical and diagnostic procedures. The present study investigates the CFVs anatomical diversity, focusing on the divergent venous drainage patterns. Aim: To describe rare anatomical variations of the common facial vein. Material and Methods: The study was conducted in the Department of Anatomy, of a tertiary care establishment (Medical College) in Western Maharashtra, during the period 2023-24. Head and neck region of 20 cadavers (11 males and 9 females) i.e. 40 sides of embalmed cadavers of different age group were carefully dissected, and studied for variations in the formation and drainage pattern of Common facial vein. Results: In 34 sides (85 %), the common facial vein (CFV) terminated into the Internal jugular vein (IJV) as per standard anatomic description. On one side of the cadaver, the left common facial vein (2.5%) was found draining into the anterior jugular vein (AJV) as well as into the internal jugular vein (IJV). In three cadavers (7.5%), the CFV was found to be draining into the AJV. In two cadavers (5%), the facial vein (FV) was not receiving the anterior division of retromandibular vein and was directly draining into the IJV. Conclusion: A sound knowledge of variation in the course and termination of common facial vein is very useful for the clinicians and surgeons who perform procedures like cannulation and vein graft harvesting for endarterectomies of the head and neck region