Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study

Background: The aim of the study was to evaluate the efficacy of letrozole and clomiphene citrate (CC) in gonadotropin-combined for ovulation stimulation in women with polycystic ovary syndrome (PCOS). It was a prospective pilot study.Methods: This prospective trial included 124 patients of infertile women with PCOS. Letrozole dose of 5 mg/day (n = 65) or a CC dose of 100 mg/day (n = 59) was given on day 3 to day 7 of the menstrual cycle, combined with gonadotropin i.e. follicle stimulating hormone (FSH) at a dose 75 IU every day starting on day 7 and continued to day 9. Main outcome measures were occurrence of ovulation, number of mature follicles, serum estradiol (E2) and endometrial thicknesses on the day of human chorionic gonadotropin (hCG), and pregnancy rates.Results: The clinical profile including mean age, duration of infertility, BMI, baseline FSH, LH and E2 of patients belonging to both groups were comparable. The numbers of mature follicles (4.3±0.3 vs. 2.9±0.7) were significantly higher in letrozole+FSH group. Serum E2 levels on the day of hCG (301.78±85.7 vs. 464.7±72.9 pg/mL) were significantly lower in the letrozole+FSH group. Significant differences were found in endometrial thickness measured on the day of hCG in letrozole+FSH group (p=<0.0001). The rate of ovulation was higher in letrozole+FSH group and it was marginally statistically significant (p=0.040). The rate of pregnancy was slightly greater in the letrozole+FSH group (17.85% versus 13.33%), although not statistically significant.Conclusions: Letrozole in combination with FSH appears to be a suitable ovulation inducing agent versus CC with FSH in PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin

Analysis of prostaglandin-endoperoxide synthase-2 gene polymorphisms and risk of cervical cancer in an East Indian population: A case–control study

Background: The prostaglandin-endoperoxide synthase-2 (PTGS-2) gene appears to play a role in inflammation or tumor and mitogenesis. Genetic polymorphisms in PTGS-2 might contribute to differential PTGS-2 expression and subsequent interindividual variability in susceptibility to cancer. Aim: The goal of this study is to identify genetic variants of PTGS-2 gene in women of East India, which may associate with risk of cervical cancer. Materials and Methods: We enrolled 200 histopathologically confirmed patients with cervical cancer (age 18–60 years) (cases) and their corresponding sex-matched 200 normal individuals (controls). To identify genetic variants responsible for cervical cancer, we performed sequence analysis of PTGS-2 genes. Questionnaire survey was conducted to comprehend the demographic data, smoking status, and cancer stage of patients. Results: The genotype frequency of rs689466 polymorphism was significantly different between case and control groups (P C polymorphism was not associated with cancer risk although this allele was correlated with decreased risk (P = 0.701; odds ratio = 0.71; 95% CI: 0.26–1.90). CC genotype was more frequently found in controls as compared with cases and showed an inverse association with the development of cervical cancer, thus suggesting a possible protective effect. Conclusions: PTGS-2 genotype rs689466: —1195A/G gene polymorphism demonstrated strongly associated with cervical cancer disease. However, exon1-+837T > C polymorphism was not associated with cancer risk in East Indian women. Further studies evaluating the role of PTGS-2 gene polymorphisms in ethnically diverse populations and a larger cohort may help in understanding the etiopathogenesis of cervical cancer in women worldwide

At the Ragged Edges of Time: The Legend of Tilak and the Normalization of Historical Narratives

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