ABSTRACT
Background and objective: Leptin facilitates onset of puberty by impact on hypothalamic Kisspeptin, gonadotropin releasing hormone, follicle stimulating and luteinizing hormone. The link of peripheral Leptin-Kisspeptin in regulating the ovarian and endometrial tissue in relation to adiposity is unknown. Therefore, we wanted to identify Kisspeptin-Leptin association with body mass index [BMI] and success of assisted reproductive treatments [ART] in infertile females
Methods: A cross sectional study was carried from August 2015 till May 2017 after receiving ethical approval at Australian Concept Infertility Medical Centre, and Aga Khan University. The study group comprised of females with an age range of 25-37 year who had duration of unexplained infertility for more than two years. They were grouped as; underweight [<18 kg/m2], normal weight [18-22.9 kg/m2], overweight 23-24.99 kg/m2 and obese [>25 kg/m2]. Kisspeptin and Leptin levels were measured by enzyme linked immune sorbent assay before down regulation of ovaries and initiation of treatment protocol of ART.Failure of procedure was detected by beta human chorionic gonadotropin <25mIU/ml [non-pregnant] whereas females with levels >25mIU/ml and cardiac activity on trans-vaginal scan were declared pregnant
Results: Highest Kisspeptin and Leptin levels were seen in normal weight group [374.80 +/- 185.08ng/L; 12.78 +/- 6.8 pg/ml] respectively, yet the highest number of clinical pregnancy was observed in overweight group [42%].A strong correlation of Kisspeptin with Leptin [r=0.794, p=0.001] was observed in the overweight females
Conclusion: Leptin-Kisspeptin-fertility link is expressed by maximum number of clinical pregnancies in the female group that showed strongest relationship between serum Leptin and Kisspeptin levels, irrespective of their BMI
ABSTRACT
Objective: A health risk behavior like physical inactivity, unhealthy diet, tobacco use, drug abuse, unprotected sexual practices or harmful use of alcohol is linked with serious ailments like liver cirrhosis, hypertension, abnormal lipid profile and number of cardiovascular diseases. Our study is aimed to explore perception of students about health risk behaviors; eating routines, life style and stress handling practices and compare amongst medical students of first and second year
Subjects and Methods: In this cross-sectional study, 233 female students between 1 8-25 years of age, from first two years of medical college were administered a self-structured questionnaire Response of each item was rated on five-point Likert scale. Maximum points in the scale were five and the minimum was one for each item. Mean score was obtained by adding points of all responses. Degree of health awareness was categorized into low, medium and high on the basis of mean cumulative scores. Independent sample t test was used to compare means between study groups based on academic level [Year I and II medical students]
Results: The overall results of the study revealed positive health behaviors among medical students. Year I MBBS had superior acquaintance on healthy eating routines [p-value = 0.001], lifestyle patterns [p-value = 0.002], and stress handling practices [p-value < 0.001] as compared to senior class. Tendency to have anxiety attacks was more in 1st year students [p-value=0.002] while capability to withstand stress was better in senior class [p-value=0.004]
Conclusion: Majority of medical students practiced positive health behaviors. These attitudes in terms of selection of life style choices; healthy food and physical activity with avoidance of health risk behaviors and supportive practices was better in Year I students
ABSTRACT
Background: Kisspeptin [KP] is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection [ICSI]
Materials and Methods: A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 [24%], 33 [31%] and 59 [45%] among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin [beta-hCG]<5-25 mIU/ml, preclinical abortion with beta-hCG>25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA
Results: Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility [176.69 +/- 5.03 vs. 397.6 +/- 58.2, P=0.001]. Clinical pregnancy was observed in 28 [23%] females of which 17 [71%] had a female cause of infertility. In the non-pregnant group of 66 [53%] females, common cause of infertility was unexplained 56[85%]. A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed [P=0.04 and 0.01 respectively]
Conclusion: Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI
ABSTRACT
Objective: Anti Mullerian hormone [AMH] is gaining place as ovarian marker, chiefly in infertility assistance
We explored its correlation with oocytes retrieval after long GnRH agonist protocol for stimulation, in younger and older infertile population
Methods: This retrospective analysis compiled data of 166 females, receiving ICSI treatment from June 2014 to March 2015. Serum FSH, LH, Estadiol, AMH and antral follicle count were assessed. Outcomes were measured as good [5 to 19 oocytes] and bad responders
Results: Higher discriminatory power of AMH [AUROC; 0.771; p < 0.05] was seen in comparison to FSH [0.692; p < 0.05] and AFC [0.690; p < 0.01]. AMH reported strongest association with oocyte retrieved [odds ratio of 15.06]
Subgroup analysis reported 68.6 % risk of bad response with AMH levels of less than 1.37ng/ ml. This association was observed more significant in young infertile patients <35 year of age [=0.245; p=0.012] versus older population >35 year [r=0.169; p>0.05
Conclusion: Our study reaffirms that serum AMH correlates well with oocytes retrieved, particularly in females younger than 35 years. We suggest incorporation of AMH in baseline assessment of infertile females, who are falsely advised to postpone interventions based on their age and normal FSH levels