A prospective randomized controlled trial showing efficacy of luteal phase low molecular weight heparin in fresh non-donor IVF/ICSI cycles in women with previous implantation failures

Background: Implantation failure is a major challenge in in-vitro fertilization (IVF) cycles. The present study was undertaken to determine the immunomodulatory effects of heparin in patients with previous implantation failures undergoing assisted reproductive techniques (ART).Methods: This was a prospective randomized controlled trial with sample size of 100 patients who had history of at least one previously failed IVF/ICSI. Study group of 50 patients received heparin and 50 patients in control group received routine luteal phase support.Results: Primary outcome of the study was implantation rate (IR) which was 11.03% in the study group was and 5.48% in the control group (p=0.08). Biochemical pregnancy rate and clinical pregnancy rate in the study group was 18% and 12% in the control group (p=0.401). Calculated live birth was 5.15% and 3.42% in the study and control groups respectively (p=0.562). 11 babies were taken home from the study group and 6 from the control group (p=0.18).Conclusions: The result of this pilot study showed relative increase in implantation rates (IR) suggesting beneficial effects of heparin in patients with repeated implantation failures. Although these changes are not statistically significant, the presence of an increasing trend in all the outcome parameters signify the possible benefits of heparin proving for the present study hypothesis

Mutations in the mitochondrial DNA D-loop region are frequent in cervical cancer

BACKGROUND: Mitochondrial DNA (mtDNA) is known for high mutation rates caused by lack of protective histones, inefficient DNA repair systems, and continuous exposure to mutagenic effects of oxygen radicals. Alterations in the non-coding displacement (D) loop of mitochondrial DNA are present in many cancers. It has been suggested that the extent of mitochondrial DNA mutations might be useful in the prognosis of cancer outcome and/or the response to certain therapies. In order to investigate whether a high incidence of mutations exist in mitochondrial DNA of cervical cancer patients, we examined the frequency of mutations in the D-loop region in 19 patients of cervical cancer. RESULTS: Mutations, often multiple, were detected in 18 of 19 (95%) patients. The presence of mutations correlated with Human Papilloma Virus (HPV) infection in these patients. Mutations were also detected in normal samples and lymphocytes obtained from cervical cancer patients, but their frequency of occurrence was much lower as compared to the cervical cancer tissues. CONCLUSION: Our findings indicate that D-loop alterations are frequent in cervical cancers and are possibly caused by HPV infection. There was no association of mtDNA D-loop mutations with the histopathological grade and tumor staging

Randomized comparative study of conventional minilaparoscopy (5mm) versus modern minilaparoscopy (2.9mm) in patients of infertility

Background: To compare diagnostic conventional minilaparoscopy (5mm) with diagnostic modern minilaparoscopy (2.9mm) in patients of infertility in terms of operating time, post-operative pain, hospital stay.Methods: A prospective randomized comparative study was done in a tertiary care centre involving eighty patients of infertility undergoing diagnostic laparoscopy. Diagnostic laparoscopy was done using 5mm laparoscope (Conventional minilaparoscope-Group I) in 40 patients and using 2.9mm laparoscope (Modern minilaparoscope-Group II) in 40 patients. Operating time was measured from the point of skin incision to closure, post op pain was assessed with VAS scoring system, total hours of hospital stay from shifting to day care recovery ward till discharge was noted.Results: Both conventional minilaroscope and modern minilaparoscopes were comparable to each other. Operating time in both groups was similar (7.7min in Group I vs 8.7min in Group II). In both groups, there was no statistically significant difference in post-operative pain as assessed by VAS scoring System (39 in Group I vs 38 in Group II had mild post-op pain and 1 in Group I vs 2 in Group II had moderate pain). The difference in duration of post-op hospital stay in both Group I and group II was not statistically significant (3.5 hours vs 3.3 hours).Conclusions: Both conventional minilaparoscopy (5mm laparoscope) and modern miniaparoscopy (2.9mm laparoscope) are comparable with respect operating time, post-op pain, hospital stay. Modern minilaparoscope is no better than conventional minilaparoscope