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Editor′s view point
Address for correspondence: Dr. Kuldeep Jain, KJIVF and Laparoscopy Centre, 23-24, Gagan Vihar, Delhi - 110 051, India. E-mail: drjain@kjivf.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Can we think of a successful assisted reproductive technology (ART) program without intracytoplasmic sperm injection (ICSI)? Should we use ICSI for all? Are we missing on using the technique of ICSI in day-to-day practice? The editorial written by Abha Maheshwari, Executive Editor, looks at evidences available for ICSI use in indications other than male infertility and tries to answer some of the important questions and concludes that the studies are urgently required to support the use of ICSI for all.
Review article on uterine transplant elaborates on scope of this new technique, details the procedure as well as difficulties, ethical, social, and legal consideration and the current scenario in the Indian context. The original article on laparoscopic ovarian drilling (LOD) in polycystic ovary syndrome (PCOS) focuses on the role of the procedure in clomiphene citrate (C.C.) resistant cases; however, a study, looking at other aspect of LOD such as iatrogenic ovarian compromise, adhesions formation, and exact place of LOD in current practice is the need of the hour.
Another article highlights the role of video of Hysterolaparoscopy in unexplained infertility and concludes that the procedure is especially helpful in cases of failed intrauterine insemination (IUI) and prolonged infertility. It helps in two ways, explains the unexplained causes such as the presence of subtle pathologies like mild endometriosis, tuboperitoneal adhesions, and mild endometritis. Additionally, it helps in counseling the patients to make an informed choice to move ahead for ART at the right time.
Finding out anti-Müllerian hormone (AMH) cutoff values, especially for poor response, is a matter of clinical importance, as in practice, many times ovarian response does not correlate with AMH values. Thus, it is advised and recommended that the decision of cancellation or denial of procedure should not be based on AMH value only and other factors such as age, antral follicle count (AFC), and previous response should be taken into consideration.
Infertility is a stressful condition for both male and female partners and the stress is multiplied over the period as couples are exposed to lot of social pressure, stress of advanced and costly treatment, and most important, the stress of repeated failure in spite of all efforts. The role of counseling is very important at all stages and certainly helps in improving the outcome.
In addition this issue includes three interesting case reports - a complex uterine anomaly, role of dhea to get a successful out come and ovarian ectopic pregnancy after ivf.
Comments and feedback from readers are important and are always welcome.
