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The article examines the contested aspects of neoliberalism through cinematic narratives, addressing the issue of Assisted Reproductive Technology (ART) in India, a debated subject in socio-legal spheres. Existing literature extensively discusses the biopolitical and bioethical dimensions of commercialization and commodification, particularly concerning organ, egg, sperm donations, and gestational commercial surrogacy. This research endeavors to scrutinise and appraise the ethical quandaries emanating from the technological transformation of motherhood, as portrayed in fictional representations. These narratives shed light on the difficult situations faced by surrogates and egg donors, who are often driven by familial or socio-economic pressures to provide their reproductive services. Consequently, they become commodified within the context of India's In Vitro Fertilization (IVF) industry. Ergo, through the films I Am (2010) and Mimi (2021), this article probes into the intertwining socioeconomic situations of the large percentage of infertile women and claims that the positive discourse around the 'new Indian women' is inherently diluted and undermined. Additionally, the research emphasizes that ART—and more importantly, a new agency for single women—is reiterated within the political and socio-historical contexts of the films discussed. [ABSTRACT FROM AUTHOR]

Background: Vaccination against Coronavirus-19 disease (COVID-19) was widely administered from 2021 onwards. There is little information on how this vaccine affected fertility after assisted-reproductive-technology (ART). The aim of this study therefore was to determine if COVID-19 vaccination or time-since-vaccination influenced ART outcomes. Materials and Methods: In this prospective cohort study, 502 oocyte-retrieval-cycles and 582 subsequent embryo- transfer-cycles were grouped based on COVID-19 vaccine status of the female partner into those with no-exposure, 1-dose and ≥2-dose exposure. Within the exposed cohort, time-since-last-vaccination to embryotransfer- cycle (Ttr) was calculated in days. Main outcomes were mean-total-utilizable-embryos, mean-oocyteutilization- rates and cumulative-ongoing-pregnancy-rates per oocyte-retrieval-cycle, and ongoing-pregnancy and pregnancy-loss-rates per embryo-transfer cycle. The Beta-coefficient (ß) was calculated using linear regression for mean-total-utilizable-embryos and mean-oocyte-utilization-rates and adjusted-odds-ratio (OR) was calculated for cumulative-ongoing-pregnancy-rates, ongoing-pregnancy and pregnancy-loss-rates using binomial logistic regression. Influence of T(tr) on embryo-transfer outcomes was estimated using receiver-operator-curve (ROC) analysis and cut-offs determined that influenced embryo-transfer outcomes. Results: Mean-total-utilizable-embryos and mean-oocyte-utilization-rate per oocyte-retrieval-cycle in no-exposure, 1-dose and ≥2 dose were 2.7 ± 1.8 vs. 2.5 ± 1.9 vs. 2.7 ± 2.0, P=0.78, (ß=0.42, 95% confidence-interval (CI)=0.15 to 0.69) and 21.2 ± 13.2 vs. 25.1 ± 19.0 vs. 26.7 ± 18.8, P=0.08, (ß=3.94, 95% CI=1.26 to 6.23) respectively. Ongoing-pregnancy-rates and pregnancy-loss-rates per embryo-transfer-cycle were 27.3% vs. 24.4% vs. 32.5% (aOR=1.38, 95% CI=0.3-5.6, P=0.52), and 13.6% vs. 13.4% vs. 15.2%, (aOR=0.97, 95% CI=0.18-5.2, P=0.97) respectively. Cumulative-ongoing-pregnancy-rates per oocyte-retrieval-cycle were 36.5% vs. 34.5% vs. 35.5% (aOR=1.53, 95% CI=0.57 to 4.07, P=0.35). Median T(tr) was 146 days (IQR: 80-220). T(tr) negatively affected ongoing pregnancy rates for intervals <60 days (AUC=0.59, 95% CI=0.54-0.66, P<0.01). For T(tr) >60 vs. <60 days, the aOR for ongoing-pregnancy-per-embryo-transfer-cycle was 2.85 (95% CI=1.50-5.46, P<0.01). Conclusion: Covid-19 vaccination does not negatively influence embryological-outcomes or cumulative-ongoing-pregnancies after ART-treatments. Duration since vaccination may have a weak negative effect on embryo-transfer-outcomes performed within 60 days. [ABSTRACT FROM AUTHOR]

The desire for parenthood among infertile individuals is often fulfilled by resorting to the ever-evolving Assisted Reproductive Techniques (ART). Since the birth of Durga, India's first baby born using ART in 1981, the lucrative fertility industry has grown exponentially in our country. The Government of India passed the Assisted Reproductive Technology (Regulatory) Act in 2021 to provide regulatory support to these services. The legislation offers clarity on various aspects of ART, including measures to safeguard children born through these procedures. The effective implementation of the ART Act is crucial to ensure that ART services become affordable, ethical, and socially acceptable in India. This article aims to discuss the controversies with ART services and issues that could compromise the wellbeing of children, while highlighting the provisions provided under the Act to address these. [ABSTRACT FROM AUTHOR]

Background: Assisted reproductive technologies have been adopted widely in India with fewer incidences of complications. However, various increased risks including gestational diabetes, hypertension, and prematurity have been seen. Aim: The present clinical study was aimed at analyzing in-vitro fertilization (IVF) pregnancies and associated risk factors and major complications associated with IVF pregnancies. Methods: In 310 females undergoing IVF, the techniques, associated risk factors, and IVF-related complications were studied. The data gathered were analyzed statistically and results were formulated. Results: The study results showed that higher chances of twin pregnancy were associated with embryo transfer using 2 embryos. No significant association was seen in several pregnancies and gestational diabetes or gestational hypertension with p<0.05. The study results showed no significant association between gestational age gestational diabetes and gestational hypertension with p>0.05. Also, no significant correlation was seen in the gestational age and etiology of infertility with p=0.66. Among 68 preterm infants, 18 subjects reported ARDS (acute respiratory distress syndrome). Conclusion: Considering its limitations, the present study concludes that embryo numbers are correlated with multiple pregnancies. In older females, gestational hypertension is commonly seen, whereas, twin pregnancies are more common in younger females undergoing in-vitro fertilization pregnancies. A higher incidence of premature deliveries is seen in IVF pregnancies with no difference in the age of the females. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to determine if in vitro fertilization (IVF) is associated with an increase in the incidence of retinopathy of prematurity (ROP) among preterm infants. Methods: This retrospective, comparative study included all the preterm babies who were screened under an urban multicentric outreach project between April 2019 and August 2022. Infant details including gender, birth weight, mode of conception, single or multiple gestation, gestational age and post-menstrual age in weeks, age at presentation, and any presence of risk factors were recorded and analyzed. Results: Among 444 preterm babies included in the study, 373 (84%) were conceived normally and 71 (16%) were conceived by IVF. ROP was found in 99 (22.29%) babies in total. There was no significant difference in the incidence of any stage of ROP between the two groups; however, higher stages of ROP were found to be relatively more frequent in the spontaneous conception group in our study. We also found a statistically significant difference in the presence of ROP among singletons, twins, and triplets. Conclusion: IVF was found not to independently increase the risk of ROP in preterm infants. More prospective studies and randomized controlled trials are needed to establish the relationship between the mode of conception and development of severe ROP in preterm infants. [ABSTRACT FROM AUTHOR]

Controlled ovarian stimulation has been an integral part of in vitro fertilisation (IVF) treatment cycles. Availability of different gonadotropins for ovarian stimulation and gonadotropin releasing hormone (GnRH) analogues for prevention of premature rise of leutinising hormone during follicular phase offer an opportunity to utilise them for a successful outcome in women with different subsets of ovarian response. Further, use of GnRH agonist as an alternative for human chorionic gonadotropin improves safety of ovarian stimulation in hyper-responders. Mild ovarian stimulation protocols have emerged as an alternative to conventional protocols in the recent years. Individualisation plays an important role in improving safety of IVF in hyper-responders while efforts continue to improve efficacy in poor responders. Some of the follicular and peri-ovulatory phase interventions may be associated with negative impact on the luteal phase and segmentalisation of the treatment with frozen embryo transfer may be an effective strategy in such a clinical scenario. This narrative review looks at the available evidence on various aspects of ovarian stimulation strategies and their consequences. In addition, it provides a concise summary of the evidence that has emerged from India on various aspects of ovarian stimulation. [ABSTRACT FROM AUTHOR]

An unsung scientist of his time, Dr. Subhas Mukhopadhyay, the architect of India's first test-tube baby, is now regarded as the pioneer in the field of in vitro fertilization (IVF) and is credited with developing the cryopreservation technique of human embryos for subsequent use in the birth of a normal, healthy baby. [ABSTRACT FROM AUTHOR]

Infertility is on a rise, and so is the availability of assisted reproductive technique (ART) centres. The sole aim of these centers is to help these unfortunate couples achieve pregnancy. Hence, the concentration of the treatment is on the female partner, while the male is relegated to just being a source for sperm. In the era of intracytoplasmic sperm injection, when pregnancy is possible even with a single mature sperm, evaluation and management of male factor infertility (MFI) is often neglected. MFI and poor semen parameters are markers of male health. He could be suffering from erectile or ejaculatory issues or with correctable obstructive azoospermia. A simple timely varicocele correction may help resolve the issue. It is important to understand that MFI is not a disease but may be a symptom of major underlying clinical condition like testicular or brain tumors. Infertility treatment could be the only occasion when a male seeks health‑care evaluation. India has a large pool of qualified urologists trained in andrological care. In contrast, gynecologists may not be trained in the management of male patients, hence there is an important place for andrological services to be an integral part of ART centers. Andrologists would offer minimal andrological evaluation and condition‑specific treatment. This could avoid or reduce the need for invasive and expensive ART. Andrologists could also choose the most appropriate mode of sperm retrieval. Undoubtedly, availability of andrological services would improve the overall quality of care, reduce the costs and complications, and would also be medicolegally safe. [ABSTRACT FROM AUTHOR]

The study was conducted on a population of 203 women attending the IVF clinic, Ahmedabad, India, to explore the role of stimulation protocol and the number of oocytes retrieved on oxidative stress in follicular fluid and IVF outcome. Follicular fluid was collected during ovum pick-up to determine the oxidative stress markers: superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), total thiols (TT), l-ascorbic acid (AA), total protein, glutathione S-transferase (GST) and glutathione reductase (GRD). The average number of oocytes retrieved was significantly higher in the women receiving a long GnRH agonist protocol compared to GnRH antagonist protocol while the percentage of women with positive IVF outcome was lower in the long agonist protocol. The level of total thiols was significantly lower in the group of women administered a short agonist protocol. The proportion of ETs carried out and positive IVF outcome were higher following retrieval of an intermediate number of oocytes (6–10 oocytes) compared to a lower (0–5 oocytes) and higher (>10 oocytes) number. Mean glutathione reductase (GRD) activity in follicular fluid was significantly elevated in the intermediate (6–10) and higher (>10) oocyte retrieval groups compared to the lower oocyte retrieval group. Positive IVF outcomes were highest when oocyte retrieval was in the range of 6–10 oocytes, and the level of MDA was lower (1.76 ± 0.13 nmol/ml) as compared to 0–5 and >10 oocytes retrieved groups. [ABSTRACT FROM AUTHOR]

A 31-year-old woman, who is a known case of polycystic ovary syndrome, underwent modified radical hysterectomy and right ovarian transposition to the anterior abdominal wall for endometrioid adenocarcinoma Grade II. She then visited our facility for in vitro fertilization (IVF) and surrogacy in the year 2016. Three cycles of IVF were performed using gonadotropin-releasing hormone (GnRH) antagonist in the first two attempts and GnRH agonist in the third attempt, with percutaneous technique of oocyte retrieval from the transpositioned right ovary. In the third attempt in July 2017, we were able to retrieve five oocytes and subsequently froze three embryos and one blastocyst. The surrogate underwent sequential transfer in June 2018 which resulted in a positive clinical singleton pregnancy. The outcome of IVF following percutaneous oocyte retrieval led to a successful pregnancy and subsequent delivery by emergency cesarean by a healthy female baby on February 16, 2019. This is the first reported case of ovarian hyperstimulation and percutaneous aspiration of oocytes from a transpositioned right ovary (subcutaneous plane) in our country. Global literature survey revealed publications only of transabdominal retrieval of ovaries moved above the pelvic brim. [ABSTRACT FROM AUTHOR]

Introduction: This study was conducted to evaluate and compare the incidence of birth defects in In-Vitro Fertilization-Intra Cytoplasmic Sperm Injection (IVF-ICSI) pregnancies with autologous and donor oocytes. As a secondary outcome, the prevalence of birth defects in IVF-ICSI pregnancies was compared with those from spontaneous conceptions in India.Material and Methods: This retrospective study included 2444 births resulting from IVF-ICSI cycles from autologous (n = 1743) and donor oocytes (n = 701) during a 3-year period in an Indian infertility center. Birth defects, if any, were noted antenatally and followed till the neonatal period, in case of live birth.Results: The overall prevalence of birth defects in IVF-ICSI pregnancies in this study was 29/2444 (118.6/10 000 births) and the most common congenital anomaly was cardiac malformation (32.7/10 000 births) followed by genitourinary (28.6/10 000 births). The risks of birth defects resulting from autologous and donor oocytes did not differ (114.7/10 000 vs 128.38/10 000; P > 0.05). However, pregnancies resulting from autologous oocytes had a higher trend of gastrointestinal birth defects (20.5/10 000 births vs 0), though not statistically significant. The risk of cardiovascular birth defects resulting from IVF-ICSI pregnancies was much higher compared with the natural conceptions in India (32.7/10 000 vs 12.7/10 000 births; P = 0.03), whereas the risk of central nervous system malformations was much lower (8.1/10 000 vs 60.18/10 000 births; P = 0.005).Conclusions: Overall, there was no significant difference in birth defects resulting from IVF-ICSI with autologous or donor oocytes. The births resulting from IVF-ICSI pregnancies did not tend to have a higher rate of birth defects a compared with natural conceptions. The differences in the prevalence of certain birth defects (cardiovascular or central nervous system) reported in IVF-ICSI pregnancies may be due to improved surveillance modalities and early detection in pregnancies following IVF-ICSI. A study with larger number of sample size will give us better understanding of the prevalence of reported incidence in this study. [ABSTRACT FROM AUTHOR]

Right to reproduction through Surrogacy arrangements has a wide prospect throughout the world despite of socio- legal and ethical controversies. Commercial surrogacy, as a form ofART, has often been a topic of debate in lack of adequate State regulatory regime. Surrogacy sets forth certain new dimensions before the society with an endeavour of redefining the age old concepts of the society that are of great concern when viewed from the human rights perspective viz family, parenthood, motherhood and child that makes the issue to be a concern in International Scenario. India, with a recent glorious history of achievements in Commercial Surrogacy is still facing the crises for an adequate regulation. Lack of adequate regulation to address the practise of surrogacy has revealed such pragmatic paradigm thatjustifies further emphasis of State authorities to stand for the vulnerable fractions engaging in the contractual pregnancy even though such agreements falls under the private laws. Thus, the contemporary practise of surrogacy arrangement must be regulated by adequate state regulatory regime. Surrogacy arrangement is notjust another fertility treatment and hence there is a need for the moderate surrogacy law that can appreciate surrogacy arrangements as a socio-legal aspect. [ABSTRACT FROM AUTHOR]

Study Objectives: To investigate the effect of N312S polymorphism in the LHCGR gene as a predictive pharmacogenetic marker on clinical and embryological parameters and determining the need of r-hLH supplementation combine with r-hFSH in patients undergoing ART treatment.Study Design: In a cross-sectional study, a retrospective analysis of women (n = 553), who underwent controlled ovarian stimulation treatment protocol was conducted during the years 2012-2014. R-hFSH (Gonal-F, Merck Serono) was administered to all patients undergoing ART cycle after initiating long luteal gonadotrophin-releasing hormone (GnRH) agonist down-regulation. R-hLH was supplemented based on P.C. Wong criteria. N312S genotype was determined using sequencing methodology. The mean r-hFSH, r-hLH doses, total number of oocytes, cleavage rates of embryos and clinical pregnancy were recorded. The association between the r-hLH supplementation and LHCGR N312S polymorphism and clinical pregnancy rates was determined using regression analysis by SPSS.Results: 19.7% of women were homozygous for A allele encoding asparagine (N/N), 45.7% were heterozygous (N/S) and 34.6% were homozygous (S/S) for G allele encoding serine. Women heterozygous (N/S) or homozygous (S/S) for serine showed a higher requirement for r-hLH (OR, 95% p-trend = <0.0001) compared to those homozygous for asparagine (N/N). Homozygous G allele was also associated with higher daily and total r-hLH dose per treatment cycle p-trend = <0.0001. Though, the total no of oocytes (14.87 ± 4.95 vs 12.98 ± 5.39 and 13.58 ± 5.45), Gr-I quality embryos (2.61 ± 1.81 vs 2.18 ± 1.96 and 1.98 ± 2.05) were significantly higher in women homozygous for A allele compared to women with heterozygous and homozygous for G allele, clinical pregnancy rates were significantly more in women with for G allele after excluding patients with PCOS and endometriosis conditions (P < 0.04).Conclusion: The present findings reveal that women heterozygous and homozygous for G allele required higher doses of r-hLH supplementation and these women were shown to have higher clinical pregnancy rates. [ABSTRACT FROM AUTHOR]

Objective: To compare the predictive value of manual two-dimensional follicular monitoring with that of sonography-based automated volume calculation (SonoAVC) in routine follicular tracking in in vitro fertilization (IVF).Methods: A prospective study was undertaken of women undergoing IVF with controlled ovarian hyperstimulation at a center in New Delhi, India, between October and November 2013. Follicular monitoring was performed both manually and in three dimensions with SonoAVC. On the day of oocyte retrieval, the follicular count and dimensions were calculated with both techniques and correlated with the number of oocytes retrieved.Results: Overall, 46 patients and 91 ovaries were studied. The mean times taken to perform manual and SonoAVC measurements were 209.2 ± 47.4 s and 156.6 ± 38.6 s, respectively (P < 0.001). The mean follicular count was significantly lower when measured manually than with SonoAVC (8.46 ± 3.35 vs 9.91 ± 4.60; P = 0.016). However, the mean leading follicle diameter measured manually (19.45 ± 2.46 mm) was similar to both the mean diameter (21.12 ± 2.65 mm) and the volume-based diameter (19.56 ± 2.16 mm) measured with SonoAVC.Conclusion: Three-dimensional SonoAVC could be a useful adjunct for follicular monitoring, with a significant reduction in time and a good correlation with manual counts. However, further studies with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess ovarian reserve in infertile women with genital tuberculosis planning to undergo in vitro fertilization and in women of proven fertility, and compare the findings. Methods: A cross-sectional study was conducted at an outpatient gynecology unit with 104 women with genital tuberculosis and 104 healthy controls. In each group, ovarian reserve tests consisted in estimating serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and inhibin B on day 3 of a natural menstrual cycle. On the same day ovarian volume, number of antral follicles, and ovarian stromal blood flow were also estimated. Results: The mean FSH and LH levels were significantly higher, and the mean inhibin B levels were significantly lower, among the participants with genital tuberculosis than among the controls. Conversely, the mean ovarian volume and the mean number of antral follicles were significantly lower among the participants with genital tuberculosis, as were the mean peak systolic velocity and pulsatility index for each ovary. Conclusion: There is no single absolute predictor of ovarian reserve, but combining the current assessment methods provides a close estimation of a woman''s reproductive capability. Values for the studied markers showed that ovarian reserve was compromised in women with genital tuberculosis. [Copyright &y& Elsevier]

Since the 1990s, scientific studies have explored possible correlations of "race/ethnicity" with ovarian aging and, by extension, the outcome of In Vitro Fertilization (IVF) procedures. Relying on a close reading of English-language scientific publications about "Asian" or "South Asian" women, corroborated by interviews with selected authors in 2018 and 2021 as well as ethnographic research in India conducted between 2010 and 2017, I analyze processes and practices of racializing infertility over time and across space. In a first step, I explore the socio-political configurations through which South/Asian race/ethnicity became a relevant variable in infertility research between the 1990s and 2010s. Further, I interrogate how South/Asian race/ethnicity has been scientifically mobilized and problematized by examining publications from the US, the UK, and India/Spain. I argue that South/Asian race/ethnicity has been constituted as an independent risk factor for ovarian aging and/or IVF outcome by invisibilizing possible alternative explanations for inequalities with regard to infertility and by establishing comparability and continuity between contexts. Inquiring why researchers actively try to make a seemingly universal notion of South/Asian race/ethnicity present in their work, I point to global scientific hierarchies and postcolonial power dynamics that characterize this body of literature. Finally, I explore the implications that the notion of South/Asian-ness as risk has in medical practice in India and illustrate how it contributes to bringing the (in)fertility of bodies racialized as "South Asian" into new realms of capital accumulation., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

In vitro fertilization (IVF) is a hallmark of reproductive medicine. However, the inconclusive outcome leads to marital disharmonies; thus, the choices of gamete donation and surrogacy (GD/S) are often offered. In restricted countries, the child-rearing choice through foster/adoption care is promising, but the uptake remains low. We explore the current reproductive services and adoption scenarios in Asian countries to delineate this issue. The web and literature search using PubMed and Ichushi was conducted in Japanese and English using the keywords "adoption", "foster care", "reproductive medicine", including the interview with the respective Asian clinicians. We found that an established adoption system was seen in China, Malaysia, and the Philippines, mainly due to the restriction of GD/S. Although GD/S were allowed in Thailand, Singapore, and India, the different local affordability of IVF cost led to various adoption system scenarios. Nevertheless, the country's economic aspect does influence the establishment of adoption care, mainly due to financial support from local government. Otherwise, the significant barrier was the cultural/religious background leading to low adoption rates. We concluded that the adoption option should always be highlighted as an alternative strategy as it synergistically contributes to children's and infertile couples' welfare.

Infertility has always been considered as a social stigma and has often been treated as socially, mentally and physically damaging experience for the childless women rather than man. Fatherhood was more a social rather than biological concept, thereby making childlessness a legitimate ground for divorce and a matter of disgrace for women. Every country has its own set of customs and traditional beliefs for the relief of childlessness. While introducing a second wife was one way to overcome the predicament of childlessness, divorce was also an available choice. There were several myths that contemplated the human concerns and their needs during ancient times. It is evident that types of the infertility and their treatment in the modern era have some historical background and different representations in the ancient civilizations. The present review discusses the historical and modern perspectives of infertility and assisted reproduction and their importance in different cultures., Competing Interests: None

Aim: To determine the role of ethnicity on IVF/ICSI outcomes between Indian and white Caucasian women., Settings and Design: Retrospective cohort study., Materials and Methods: White Caucasian and Indian women undergoing IVF/ICSI treatment cycles. Total 5549 self, non-donor, fresh IVF cycles conducted from January 2014 to March 2015, out of which, 4227 were white Caucasian and 1322 were Indian. Data were collected on baseline characteristics, IVF cycle parameters and outcomes. Ongoing pregnancy rate (OPR) was measured as main outcome., Results: Indian women differed significantly from white Caucasian women in baseline characteristics like age (30.6 ± 0.2 versus 37.6 ± 0.1 years; p < 0.001), BMI (22.3 ± 0.2 versus 26.6 ± 1.0 kg/m 2 ; p < 0.05), duration of infertility (6.9 ± 3.0 versus 2.5 ± 0.1 years; p < 0.001) and antral follicle count (AFC) (8.9 ± 0.4 versus 7.5 ± 0.2; p < 0.001). Indian women had lower implantation rate (30.1% versus 39.6%: p < 0.001) and OPR (35.1% versus 41.7%: p < 0.001) compared with white Caucasian women. Regression analysis proved independent effect of ethnicity on OPR (OR 0.944; 95% CI 0.928-0.961: p < 0.001) Conclusions: OPR was significantly lower among Indian ethnic group following IVF/ICSI suggest that ethnicity, like age, is a major and an independent predictor of IVF outcome.