The effect of assisted reproductive technology on ocular assessments.
OBJECTIVE
The aim was to study the various ocular assessments in women undergoing assisted reproductive techniques (ART).


METHODS
A total of 117 women with infertility were enrolled for study and the ART protocol was followed. The outcome measures were intraocular pressure (IOP), central corneal thickness, corneal endothelial cell counts, Schirmer I test done at baseline (V0), post-oral contraceptive (V1), post-GnRH agonist induction phase (V2), post-conception (V3), third trimester of pregnancy (V4) and three months post-partum (V5). Schirmer I test (without topical anaesthesia) less than 10 mm in at least one eye was considered a criterion for dry eye.


RESULTS
Out of 117 women enrolled for in vitro fertilisation (IVF), only 48 patients conceived. Sixteen women had abortions and remaining 32 women, who had childbirth were followed until three months post-partum. Baseline mean IOP showed a slight decrement and corneal pachymetry and corneal endothelial cell counts showed slight increment from phases V1 to V4 of ART but statistically they were not significant (p > 0.05). At three months post-partum (V5) mean IOP, corneal pachymetry, corneal endothelial cell counts become closer to baseline in both eyes. The number of patients with at least one eye with dryness (Schirmer I less than 10 mm) significantly increased at the third trimester (p = 0.02) and three months post-partum (p = 0.035), whereas in the rest of the phases, it was comparable to baseline (p > 0.05).


CONCLUSIONS
The ocular physiological changes (IOP, corneal pachymetry and corneal endothelial cell counts) seen in various phases of ART were non-specific. The ART appears to reduce tear secretions as measured by Schirmer I; however, further research would be required to determine the impact of ART on the tear film and whether ART is associated with symptoms and signs of dry eye.
Department of Ophthalmology, Army Hospital Research and Referral, New Delhi, India. jksparihar@gmail.com.
Jitendtra Kumar Singh
JK
Parihar
Department of Ophthalmology, Command Hospital (WC), Chandimandir Cantonment, India.
Jaya
J
Kaushik
Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences and Research, Etawah, India.
Vaibhav Kumar
VK
Jain
Department of Obstetrics & Gynecology & Assisted Reproductive Treatment Centre, Command Hospital (SC), Pune, India.
Nikita
N
Naredi
Department of Ophthalmology, Air Force Central Medical Establishment, New Delhi, India.
Sapna
S
Raina
D000328:Adult; D002452:Cell Count; D003315:Cornea / Q000033:anatomy & histology* / Q000166:cytology; D063171:Corneal Pachymetry; D015352:Dry Eye Syndromes / Q000209:etiology; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D013666:Tears / Q000378:metabolism
assisted reproductive technique (ART); dry eye; endothelial density; in vitro fertilisation (IVF); intraocular pressure (IOP); pachymetry; pregnancy