Publications by authors named "Ms Kamath"

Background: Intracytoplasmic sperm injection (ICSI), a type of assisted reproductive technology (ART), is offered as a treatment option for male factor infertility. Over the years, the indications for ICSI have been expanded, despite uncertainty about its benefits and harms compared to the conventional method of achieving fertilisation. Artificial oocyte activation (AOA), which can be performed by chemical, electrical or mechanical intervention, has been employed during ART ICSI treatment where there has been a history of low fertilization rate or total fertilization failure, and it has been reported to improve reproductive outcomes.

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  • Endometriosis is a chronic condition that can result in infertility for women of reproductive age and affects assisted reproductive technology (ART) outcomes by impacting oocyte and embryo quality, numbers, and endometrial receptivity.
  • There has been debate on whether the main issue in pregnancy outcomes for women with endometriosis arises from the quality of oocytes or the condition of the endometrium.
  • Recent studies indicate that instead of oocyte quality, reduced oocyte yield may be a key factor diminishing ART success rates in women with endometriosis.
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Background: Polycystic ovarian syndrome (PCOS) is one of the common causes of anovulatory infertility among women in the reproductive age group. Women with PCOS and obesity often have difficulty in conceiving, and they are more prone for developing metabolic syndrome. Lifestyle modification plays a key role in women with PCOS, who are overweight or obese and is recommended as a first line management option.

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  • The study aimed to compare the effectiveness of a combination treatment of Letrozole and Clomiphene Citrate versus Letrozole alone for inducing ovulation in infertile women with PCOS.
  • Conducted as a randomized controlled trial from September 2020 to March 2023, it involved 120 women who were randomly assigned to either treatment group over three menstrual cycles.
  • Results showed no significant differences in ovulation rates, clinical pregnancy rates, or live birth rates between the two groups, indicating that the combination treatment did not provide additional benefits over Letrozole alone.
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  • - The study investigates how dietary habits affect the semen quality of South-Asian men, focusing on nutrient intake and dietary patterns through the analysis of 162 men aged 21-40 undergoing infertility evaluation.
  • - Results indicate that men with normal semen characteristics have a higher intake of the "coastal diet," which includes seafood, fish, and coconut oil, compared to those with abnormal characteristics.
  • - A significant negative correlation was found between the consumption of monounsaturated fatty acids (MUFA) and semen quality, highlighting the potential benefits of the "coastal diet" while suggesting more research is needed for conclusive results.
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Objective: Recurrent pregnancy loss (RPL) has a multifactorial etiology, with a majority of cases remaining unexplained. To account for these unexplained cases, possible male factors are being explored. Conventional semen analysis lacks a qualitative assessment of sperms and information regarding sperm DNA integrity.

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Access to quality healthcare remains a challenge in low-and middle-income countries. Vulnerable populations with unmet needs face the greatest challenge in accessing primary care for appropriate and timely healthcare. The use of digital technologies can not only strengthen health systems but also improve access to health care, particularly for the vulnerable.

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India, with a population of 1.4 billion, faces health equity challenges due to inaccessible public health systems, particularly in rural areas. Modern technologies like the internet and mobile phones are being used to bridge this gap, enhancing health equity by disseminating vital health information.

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Women from low- and middle-income countries face challenges in accessing and utilising quality healthcare. Technologies can aid in overcoming these challenges and the present scoping review is aimed at summarising the range of technologies used by women and assessing their role in enabling Indian women to learn about and access healthcare services. We conducted a comprehensive search from the date of inception of database till 2022 in PubMed and Google Scholar.

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The prevalence of women with a raised body mass index (BMI) seeking assisted conception treatment is increasing. Findings of existing studies evaluating the effect of female BMI on intrauterine insemination (IUI) treatment outcomes remain inconsistent. This systematic review and meta-analysis evaluate the effect of female BMI on IUI treatment outcomes.

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Background: While elective single-embryo transfer (eSET) has been advocated in select countries, the global acceptance of the eSET policy has been undermined due to various issues. It is imperative to understand the couples' perspectives regarding the number of embryos transferred.

Aims: We planned a study to evaluate the knowledge and attitude of infertile couples undergoing assisted reproductive technology towards eSET in self-funded treatment cycles in a low-resource setting.

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Background: In vitro fertilisation (IVF) is a treatment for unexplained subfertility but is invasive, expensive, and associated with risks.

Objectives: To evaluate the effectiveness and safety of IVF versus expectant management, unstimulated intrauterine insemination (IUI), and IUI with ovarian stimulation using gonadotropins, clomiphene citrate (CC), or letrozole in improving pregnancy outcomes.

Search Methods: We searched following databases from inception to November 2021, with no language restriction: Cochrane Gynaecology and Fertility Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL.

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Article Synopsis
  • Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women, particularly affecting South Asian women who have a higher risk of insulin resistance and metabolic issues.
  • The study outlines a randomized controlled trial focusing on South Asian women with PCOS aged 19 to 37, assessing the effectiveness of personalized lifestyle interventions (diet and exercise) versus standard advice.
  • The primary goal is to evaluate the live birth rates following the intervention, while secondary outcomes include pregnancy rates, miscarriage rates, and other related factors.
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Background: In IVF/ICSI treatment, the process of embryo implantation is the success rate-limiting step. Endometrial scratching has been suggested to improve this process, but it is unclear if this procedure increases the chance of implantation and live birth (LB) and, if so, for whom, and how the scratch should be performed.

Objective And Rationale: This individual participant data meta-analysis (IPD-MA) aims to answer the question of whether endometrial scratching in women undergoing IVF/ICSI influences the chance of a LB, and whether this effect is different in specific subgroups of women.

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Objective: We planned a study to evaluate the impact of selecting hysterosalpingography (HSG) over diagnostic laparoscopy during initial fertility evaluation on IUI treatment outcomes in couples diagnosed with unexplained infertility.

Methods: The study comprised a retrospective cohort and included couples evaluated for infertility at our tertiary level hospital between January 2008 and December 2019. Couples diagnosed with unexplained infertility based on tubal patency tests (either HSG or diagnostic laparoscopy) were included.

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The aim of this study is to compare the ART (assisted reproductive technology) outcomes and cancellation rates between GnRH antagonist protocol and GnRH agonist short protocol in POSEIDON (Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number) groups 3 and 4. It is a retrospective cohort study conducted in the Department of Reproductive Medicine and Surgery of a tertiary-level hospital. Women who underwent ART treatment with either GnRH antagonist or GnRH agonist short protocol with fresh embryo transfer, between January 2012 and December 2019 belonging to POSEIDON 3 and 4 groups, were included.

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In the decade since non-invasive prenatal testing (NIPT) was first implemented as a prenatal screening tool, it has gained recognition for its sensitivity and specificity in the detection of common aneuploidies. This review mainly focuses on the emerging role of NIPT in pregnancies following assisted reproductive technology (ART) in the light of current evidence and recommendations. It also deals with the challenges, shortcomings and interpretational difficulties related to NIPT in ART pregnancies, with particular emphasis on twin and vanishing twin pregnancies, which are widely regarded as the Achilles' heel of most pre-natal screening platforms.

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Article Synopsis
  • Infertility is a significant global health issue, and previous studies show that the prevalence of unexplained infertility can vary based on the type of investigation conducted, creating a need to understand how minimal and mild endometriosis affects treatment outcomes after intrauterine insemination (IUI).
  • This study aimed to compare the success rates of ovarian stimulation and IUI in women with minimal and mild endometriosis against those with unexplained infertility, using data from women treated at Christian Medical College, Vellore, from 2014 to 2020.
  • The results indicated that there were no significant differences in key outcomes, such as clinical pregnancy rate and live birth rate, between the two groups, suggesting that minimal and mild end
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The process of implantation is characterized by a complex cross-talk between the endometrium and the blastocyst, with the endometrium only being receptive to implantation during a transient window of implantation of approximately 2-3 days during the midsecretory phase. The timing of embryo transfer, including frozen embryo transfer, is therefore critical to the success of implantation. In this article, we discuss various elements that may guide the timing of frozen embryo transfer, including the role of endometrial characteristics such as thickness, days postovulation or length of progesterone administration, stage of the embryo, and the application of endometrial receptivity tests to guide personalized embryo transfer.

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