Effects of yoga on utero-fetal-placental circulation in high-risk pregnancy: a randomized controlled trial.

Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues. Methods. 59 high-risk pregnant women were randomized into yoga (n = 27) and control (n = 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation. Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P = 0.001), head circumference (P = 0.002), femur length (P = 0.005), and estimated fetal weight (P = 0.019). The resistance index in the right uterine artery (P = 0.01), umbilical artery (P = 0.011), and fetal middle cerebral artery (P = 0.048) showed significantly lower impedance in the yoga group. Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation.

Strategies for fertility preservation in young patients with cancer: a comprehensive approach.

As a result of treatment innovations, the survival rates of young people with cancer have increased substantially. The cancers most frequently diagnosed in adults aged 25-49 years include breast, colorectal and cervical cancer and malignant melanoma (Cancer Research UK, 2009). The 5-year survival rates of over 90 % for many malignancies are now reported in young people. But the diagnosis and treatment of cancer often poses a threat to fertility. Methods of fertility preservation are evolving quickly and awareness needs to grow in the medical community regarding these methods. Studies suggest that the ability to have biological children is of great importance to many people. The possible future effects of chemotherapy or radiotherapy on fertility should be discussed with all cancer patients who have reproductive potential. Moreover, fertility preservation should be considered for all young people undergoing potentially gonadotoxic treatment. This article covers the various methods of fertility preserving options in young men and women with respect to the various treatment modalities that they may be subjected to. Sperm banking is a simple and low cost intervention. Embryo cryopreservation is the only established method of female fertility preservation. Oocyte cryopreservation offers a useful option for women without a male partner. Emergency ovarian stimulation and cryopreservation of ovarian tissue (followed by tissue transplantation or in-vitro maturation of oocytes) are experimental techniques for women who require urgent cancer treatment. Large, well-controlled studies are also required to identify any unexpected long-term sequelae of cryopreservation of oocytes and ovarian tissue.

Efficacy of yoga in pregnant women with abnormal Doppler study of umbilical and uterine arteries.

To study the efficacy of yoga on the outcome of complicated pregnancy, 121 women attending antenatal clinic at Gunasheela Surgical and Maternity Hospital (GSMH) in Bangalore, India, were enrolled between 18-20 weeks of pregnancy in a prospective, matched, observational study. Sixty-eight women were in the yoga group and 53 women in the control group. Women were matched for age, gravida and Doppler velocimetry scores of umbilical and uterine arteries. Yoga practices including physical postures, breathing and meditation were practised by the yoga group, one hour daily, from the date of entry into the study until delivery. The control group walked half an hour twice a day during the study period. Compliance in both the groups was ensured. In babies the birth-weight is significantly higher (P < 0.018) in the Yoga group (2.78 +/- 0.52 kg), compared to the control group (2.55 +/- 0.52 kg). Occurrence of complications of pregnancy (pregnancy-induced hypertension, intrauterine growth retardation, pre-term delivery) shows lower trends in yoga group.

Efficacy of yoga on pregnancy outcome.

OBJECTIVE: To study the efficacy of yoga on pregnancy outcomes. DESIGN AND SETTING: Three hundred thirty five (335) women attending the antenatal clinic at Gunasheela Surgical and Maternity Hospital in Bangalore, India, were enrolled between 18 and 20 weeks of pregnancy in a prospective, matched, observational study; 169 women in the yoga group and 166 women in the control group. METHODS: Women were matched for age, parity, body weight, and Doppler velocimetry scores of umbilical and uterine arteries. Yoga practices, including physical postures, breathing, and meditation were practiced by the yoga group one hour daily, from the date of entry into the study until delivery. The control group walked 30 minutes twice a day (standard obstetric advice) during the study period. Compliance in both groups was ensured by frequent telephone calls and strict maintenance of an activity diary. MAIN OUTCOMES: Birth weight and gestational age at delivery were primary outcomes. RESULTS: The number of babies with birth weight > or = 2500 grams was significantly higher (p < 0.01) in the yoga group. Preterm labor was significantly lower (p < 0.0006) in the yoga group. Complications such as isolated intrauterine growth retardation (IUGR) (p < 0.003) and pregnancy-induced hypertension (PIH) with associated IUGR (p < 0.025) were also significantly lower in the yoga group. There were no significant adverse effects noted in the yoga group. CONCLUSIONS: An integrated approach to yoga during pregnancy is safe. It improves birth weight, decreases preterm labor, and decreases IUGR either in isolation or associated with PIH, with no increased complications.

Critical evaluation of human blastocysts for assisted reproduction techniques and embryonic stem cell biotechnology.

Critical examination of 30 blastocysts by transmission electron microscopy (TEM) reveals cellular features not usually evident, including abnormalities of cell structure and aberrations such as multinucleation, internal fragmentation, phagocytic or degenerating cells. Invariably, such blastocysts are inactive and delay or fail to expand and hatch in vitro. Hatching seems to be a major problem in ageing blastocysts due to inactivity of the surface epithelium of trophoblast cells that do not stretch and expand. These lack surface microvilli and contractile tonofilaments that anchor on to specialized cell junctions such as desmosomes. Trophoblast expansion and consequent thinning of the zona is a prerequisite to proper hatching aided by the hydrostatic pressure in the blastocoele and by specialized cells at hatching points. Proper assessment of the inner cell mass is required if a healthy population of cells is to be harvested for embryonic stem cell culture. An inactive blastocyst is obviously not good material and could have a defective inner cell mass (ICM). Normally approximately 3-5% of cells are mitotic in blastocysts and arrested cell division is also an indicator of inactivity. An attempt has been made to evaluate blastocyst internal structure for both assisted reproduction techniques and embryonic stem cell biotechnology.

Mechanics of human blastocyst hatching in vitro.

Critical examination of 30 blastocysts by transmission electron microscopy at various stages of blastulation and hatching, has revealed the presence of specialized, plump, trophoblastic cells at the points of hatching, which seem to aid in initial breaking of the zona pellucida (ZP) and then widen its opening to permit the progressive emergence of the embryo in amoeboid fashion, when it acquires a characteristic dumb-bell shape. These cells are named 'zona-breaker' cells and their characteristics are described. Normally, trophoblast cells in expanding blastocysts are flattened (squamous), forming a continuous robust epithelium with specialized cell junctions. Bundles of tonofilaments anchor onto desmosomes, forming a terminal web. Proper expansion of blastocysts by intake of fluid into the blastocoele causes an increase in internal hydrostatic pressure that stretches the trophoblast epithelium leading to an enlargement of its volume two- to three-fold, consequently thinning the zona prior to hatching. This is an important prerequisite to normal hatching. The blastocysts usually hatch out at the pole opposite the inner cell mass (ICM), though a few hatch out at the embryonal pole or elsewhere. In all cases zona-breakers seem to play a vital role in the hatching process.