Browsing by Author "Shubhra Agarwal"

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Antral follicle count in normal (fertility-proven) and infertile Indian women
(Georg Thieme Verlag, 2014) Arjit Agarwal; Ashish Verma; Shubhra Agarwal; Ram Chandra Shukla; Madhu Jain; Arvind Srivastava
Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup). Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women. Settings and Design: Prospective observational case-control study. Materials and Methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient. Statistical Analysis Used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient. Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume. Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.
Microdeletion of Y chromosome as a cause of recurrent pregnancy loss
(Wolters Kluwer Medknow Publications, 2015) Shubhra Agarwal; Arjit Agarwal; Anuradha Khanna; Kiran Singh
CONTEXT: In majority of couples experiencing recurrent pregnancy loss (RPL), etiology is still unknown. Two genetic factors have been suggested to underlie miscarriage in a subset of patients, namely skewed X chromosome inactivation in females and Y chromosome microdeletions in their partners. In males, microdeletions of the Y chromosome are known to cause spermatogenetic failure and male infertility. AIMS: The aim of the study was to find out the role of Y chromosome microdeletion in male partners of couples experiencing RPL. SETTINGS AND DESIGN: University hospital and genetic laboratory. Prospective case-control study. SUBJECTS AND METHODS: 59 couples with a history of RPL and 20 fertile controls (FC) with no miscarriage were included in the study. The study subjects were divided into male partners of RPL couples with abnormal semen parameters (AS) (n = 8), and couples with normal semen parameters (NS) (n = 51). Fertile controls with normal semen parameters were (FC) (n = 20). Y chromosome microdeletion was performed on 40 male partners of RPL and 20 FC. STATISTICAL ANALYSIS USED: Chi-square test. P <0.05 were considered statistically significant. RESULTS: 13 of the 40 RPL cases showed deletion in three azoospermia factor loci on the long arm of Y chromosome. The P value was significant with Y chromosome microdeletion in RPL cases as compared to 20 FC where no Y chromosome microdeletion was present. CONCLUSIONS: Y chromosome microdeletion may be an important hidden cause of recurrent pregnancy miscarriage and can be offered to couples with the undiagnosed cause of miscarriage. © 2015 Journal of Human Reproductive Sciences | Published by Wolters Kluwer - Medknow.
Total basal ovarian volume as a marker of ovarian reserve: Myth or reality
(Journal of Clinical and Diagnostic Research, 2018) Arjit Agarwal; Shubhra Agarwal; Ashish Verma; Ram Chandra Shukla
Introduction: Total Basal Ovarian Volume (BOV) is a marker of ovarian follicular pool assessment known as ovarian reserve. Assisted Reproductive Techniques (ART) centres rely on Antral Follicular Count (AFC) for the planning of stimulation protocols. BOV is presently considered a subordinate marker and trailing behind the AFC and Anti-Mullerian Hormone (AMH) in their relative importance. Aim: The aim of the present study was to evaluate the role of BOV as a marker of ovarian reserve and its correlation with the age and AFC. Materials and Methods: In this prospective, case-control study, A total of 30 patients were included and compared to the equal number of controls (with proven fertility). The BOV was measured and then compared with clinical and other sonographic parameters, recorded for the same patient in both the groups. SPSS platform was used to perform the Student’s t-test and Mann-Whitney U test for intergroup comparisons. Correlations were determined by Pearson’s ranked correlation coefficient. Results: Regression analysis revealed the best correlation of BOV with AFC in both the groups in the present study. The correlation of BOV with age was nonlinear and insignificant in the group of subfertile patients; however, BOV strongly correlated with AFC in both the groups. Conclusion: Ovarian volume is a routine parameter to be measured in pelvic sonography; however, its role in prediction of ovarian reserve is confounded by many factors and hence, should be treated as a surrogate marker with no remarkable impression over treatment planning. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.