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EDITORIAL |
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| Year : 2017 | Volume
: 10
| Issue : 1 | Page : 1-2 |
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From the Editor’s Desk
Madhuri Patil
Clinical Director, Dr. Patil’s Fertility and Endoscopy Clinic, Bangalore, Karnataka, India
| Date of Web Publication | 7-Apr-2017 |
Correspondence Address:
Madhuri Patil
Clinical Director, Dr. Patil’s Fertility and Endoscopy Clinic, Bangalore, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-1208.204017
How to cite this article:
Patil M. From the Editor’s Desk. J Hum Reprod Sci 2017;10:1-2 |
Clinical research today has efficiently integrated into clinical practice along with other educational methods in most clinical settings. The qualities of good research is that it should be systematic, logical, replicable and most important published. The clinical research when submitted for publication in an indexed journal should convey its message as accurately, unambiguously, and convincingly as possible. For this the research paper needs to be written clearly, should be concise, simple and easy to read and submitted to the right journal as per the instructions provided by the journal is the essence for acceptance. The review article on “Preparing and Publishing a Scientific Manuscript” provides a very good brief overview of the submission and review process of a manuscript.
We have two article on antiphospholipid syndrome (APS). One is on “Serum Protein Profile in Women With Pregnancy Morbidity Associated With Antiphospholipid Syndrome
” and the other on “Uterine CD56dim and CD16+ Cells in Refractory Antiphospholipid Antibody-Related Pregnancy Loss and Chromosomally Intact Abortuses”. APS is a systemic autoimmune disorder characterized by venous or arterial thrombosis and/or pregnancy morbidity in the presence of persistent laboratory evidence of antiphospholipid antibodies (aPL). APS occurs as a primary condition, or it can occur in the presence of systemic lupus erythematosus (SLE) or another systemic autoimmune disease. The syndrome occurs most commonly in young to middle-aged adults. Women are more frequently affected (female:male ratio of 5:1). Detectable aPL is seen 10–20 % of women with recurrent pregnancy loss. The laboratory criteria for diagnosis of APS normally include detection of either Anticardiolipin antibody (aCL) of IgG and/or IgM isotype, Lupus anticoagulant (LA) and Anti-b2-glycoprotein-I antibody of IgG and/or IgM isotype in the plasma or serum. Limitations of laboratory testing include lack of laboratory standardization for aPL and the heterogeneous nature of the antibodies, resulting in low specificity of the assays making diagnosis difficult. The original articles in this issue look at protein expression in serum and natural killer cell expression in the decidua for diagnosing APS. The first article looked at the protein expression in sera from women with pregnancy morbidity with or without aPL using time of flight mass spectrometry. They found nine proteins to be significantly higher in aPL-positive women. These authors therefore concluded that further factors beyond autoantibodies are involved in pregnancy morbidity associated with APS and might lead to the development of new biomarkers. The second research paper analyzed decidual uNK cells analysis by staining with monoclonal antibodies specific to CD56 and CD16. They found a very high expression (81.4%) of CD56dim and CD16+ in the decidua. They thus concluded that aberrant natural killer cells expression might account for refractory antiphospholipid antibody (APA)-mediated recurrent pregnancy loss.
Anti-mullerian hormone (AMH) is produced by the granulosa cells (GC) in the pre-antral and antral follicles. Because serum AMH levels reflect the ovarian follicular pool, any reduction in the number of small, growing follicles may be followed by a reduction in circulating AMH Age clearly remains the primary determinant of the probability of a live birth after assisted conception, but for any given age, women with higher ovarian reserves and therefore higher circulating AMH levels have a higher success rate than their counterparts with lower AMH. Some researchers have also looked into the co-relation of follicular fluid AMH values and ART outcome and have found no co-relation. We have two articles on AMH, one by Mohar Goswami who concluded that higher AMH level in those above 35 years had significantly higher LBR than their peers with low AMH level. In their study they found no correlation between AMH level and IVF outcome in younger women. The other study looked at the effect of Metformin and cinnamon on serum AMH levels in PCOS women. Significant decrease in the serum AMH level after administration of both metformin and cinnamon but the latter had fewer side effects.
Obesity has been become an epidemic and has negative health consequences virtually on every system of the human body. When it comes to fertility, obese women have increased risk of menstrual dysfunction, anovulation, infertility and during pregnancy, there is an increases the risk of miscarriage and various complications such as gestational diabetes and preeclampsia. Though controversial many systematic review have shown an inferior outcome in overweight and obese women undergoing in-vitro-fertilization (IVF). It is also thought that obesity may have more adverse effect in women with polycystic ovarian syndrome (PCOS) than those who do not have. But several studies have shown that in non PCOs women, BMI had independent adverse effect on the pregnancy rate of IVF/ICSI cycles. The original article by Banker et al did not any adverse effect of BMI on oocyte quality/endometrial receptivity and, subsequently, on the pregnancy outcome.
Sedentary lifestyle and diseases associated with it is on the rise, and many of the infertile population today are obese. A study recently published study by Chidiadi M. Atuegbu has shown that significant reduction in weight and therefore BMI after moderate to vigorous intensity physical exercise has resulted in increased responsiveness and sensitivity of the follicles to FSH and LH with increased ovulatory status of young females. The article in this issue has looked at the “The Effect of moderate physical activity on ovarian reserve markers in reproductive age women below and above 30 Years”. They evaluated the effect of moderate exercise on AMH, FSH and antral follicle count (AFC) and found significant differences only in the AMH values and not in the FSH values or AFC. This improvement in the AMH values was seen only in women below 30 years age.
Aim of Pre-implantation screening (PGS) is to increase clinical outcomes in IVF cycles by identifying embryos which are euploid and this is done by performing biopsy of embryo either on day three or five. The advantages of day five biopsy over day three are many and include less mosaicism and lesser incidence of absent result as more cells can be biopsied. Moreover, less embryos need to be tested and there is no impact of embryo biopsy. Researchers have shown that PGS using comprehensive chromosome screening technology on blastocyst biopsy increases the implantation rates and improves embryo selection in IVF cycles in patients with good prognosis, though it is still controversial and may not be cost effective. After publication of the article “Healthy babies after intrauterine transfer of mosaic aneuploidy blastocyst by Emanno Greco in The New England Journal of Medicine PGS has become more controversial. The article by Gaurav Majumdar in this issue has shown that the euploidy rate was found to be significantly higher for blastocysts with good morphology as compared to those with poor morphology. No significant association was found between day 3 embryo morphology and euploidy rates though the implantation rates of the good quality, euploid cleavage stage embryos was higher than that of the poor quality embryos. The implantation rates were similar for all transferred euploid blastocysts, irrespective of their morphology or the rate of development.
Premature ovarian failure (POF) is a primary ovarian defect characterized by premature depletion of ovarian follicles before the age of 40 years. It is a heterogeneous disorder affecting approximately 1% of women <40 years. The possible causes for POF are autoimmunity, toxics, drugs, as well as genetic defects. There is a strong correlation between autoimmune disease and POF. The immune-mediated diseases, such as allergy, psoriasis, atopic dermatitis, vitiligo, presence of autoimmune thyroid disease, ovarian and adrenal autoimmunity, celiac disease, rheumatis arthritis, systemic lupus erythematosus, sjogren’s syndrome and chronic active hepatitis can cause of POF. Here we have a case reoprt of a young patient with secondary infertility with high FSH levels and was diagnosed with a auto immune cause for POF. Her Antinuclear antibodies (ANA) and anti-Scl 70 were positive thus confirming the diagnosis of systemic sclerosis (SSc).
We have two more case reports one on “Ureteric injury during transvaginal oocyte retrieval” and the other on clinic-radiological diagnosis of Swyer Syndrome with gonadoblastoma.
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