Dehydroepiandrosterone ( DHEA) role in enhancement and maintenance of implantation (DREAM) - Randomized Double Blind Placebo Controlled Trial - DREAM TRIAL

Start Date29 Jun 2020

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Craft Hospital & Research Centre

100 Clinical Results associated with Craft Hospital & Research Centre

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Literatures (Medical) associated with Craft Hospital & Research Centre

20 Mar 2025·Cureus

Expert Opinion on the Use of Probiotics in General Gynecological Conditions

Review

Author: Ashraf, Noushin ; Patki, Ameet ; Makhwana, Sanjay ; Ghosh Dastidar, Bishwanath ; Pandit, Suchitra

Various gynecological conditions, including bacterial vaginosis, urinary tract infection, genitourinary syndrome of menopause, polycystic ovarian syndrome, and vulvovaginal candidiasis, impose a significant global burden, including among the Indian population. This expert opinion emphasizes the importance of oral probiotic supplementation in managing these conditions. A physical meeting with 14 experts was conducted on June 29-30, 2024, during which they highlighted that probiotics, particularly Lactobacillus species, have beneficial effects on restoring and maintaining healthy vaginal microbiota. Probiotics also promote vaginal health and aid in treating conditions such as bacterial vaginosis, vulvovaginal candidiasis, polycystic ovarian syndrome, and genitourinary syndrome of menopause. Probiotics are proven effective in managing bacterial vaginosis by enhancing beneficial bacteria and reducing harmful ones. They help prevent and treat recurrent urinary tract infections by increasing lactobacilli levels, inhibiting Candida growth, and maintaining vaginal pH to prevent vulvovaginal candidiasis. Symptoms of genitourinary syndrome of menopause, such as vaginal dryness, itching, and recurrent urinary tract infections, can be alleviated through a combination of Lactobacillus-based probiotics and estrogen therapy. Experts also recommended probiotic supplementation for women with polycystic ovarian syndrome to improve both chemical and clinical pregnancy rates. Probiotics help modulate gut microbiota; improve blood glucose levels, insulin resistance, cholesterol, and androgen levels; restore the LH/FSH ratio; and enhance reproductive health. This expert opinion underscores the key role of Lactobacillus species in treating and preventing various gynecological disorders such as bacterial vaginosis, vulvovaginal candidiasis, genitourinary syndrome of menopause, urinary tract infection, and polycystic ovarian syndrome by restoring and maintaining vaginal microbiota, thus supporting overall feminine health.

01 Nov 2023·Medical Journal of Dr. D.Y. Patil Vidyapeeth

Does the Human Embryo Culture Media Has Any Impact on Implantation and Live Birth Rate in ART Cycles? A Comparative Study

Author: Ramakrishnan, Sujatha ; Ashraf, C. Mohammed ; Varghese, Alex C. ; Viswam, Sreesha ; Ravindran, A. David

ABSTRACTIntroduction:Culture media plays a pivotal role in the embryo culture system apart from the other crucial components as air quality, temperature, humidity etc., so that the selection of embryo culture media is a crucial step for the embryology team for the optimal blastocyst development and for achieving a viable pregnancy. There are two opposing views for the selection of embryo culture medium. One is embryo free choice’-“Let the embryo choose” (single-step media) and the other one is “back to nature” (sequential media) approach. Present study analyses the efficacy of these media in terms of embryo developments in vitro and pregnancy rates.Materials and Methods:Patients were randomly recruited for single step or sequential media culture post intracytoplasmic sperm injection. Inclusion criteria were patients with no severe male or female factors. To minimize the confounding variables, patients with surgically retrieved sperm samples were excluded from the study. Biochemical pregnancy, clinical pregnancy, implantation rate, live birth rate and miscarriage rate were analyzed.Results:Biochemical pregnancy, clinical pregnancy and live birth rate were favorable for group 2 (sequential media) but not statistically significant. None of the analyzed parameters differed significantly among the two media.Conclusion:There is a lack of solid scientific data to support the sequential media culture. However, moving embryos from one medium to another in a sequential media system probably adds significant stress to the preimplantation developing embryos in-culture apart from the unintentional humane errors. Moreover, this approach is quite labor-intensive and expensive.

01 Jan 2022·Journal of Human Reproductive Sciences

Mitochondrial DNA Levels in Trophectodermal Cells Show No Association with Blastocyst Development and Pregnancy Outcomes

Article

Author: Ashraf, Mohammed C ; Veerasigamani, Geetha ; Modi, Deepak ; Singh, Sankalp ; Laheri, Saniya ; Colaco, Stacy ; Ritu, G

ABSTRACTBackground:In patients undergoing assisted reproduction, levels of mitochondrial DNA (mtDNA) in the trophectodermal cells of the developing blastocyst are suggested to be associated with its ability to implant. However, discrepancies exist regarding the use of mtDNA levels as a reliable biomarker to predict outcomes of assisted reproduction.Aims:The aim of the study is to explore the association of trophectodermal mtDNA levels to determine blastocyst quality, implantation potential of blastocyst and clinical outcomes in couples who have undergone pre-implantation genetic testing for aneuploidy (PGT-A).Study Setting:Private fertility centre.Study Design:Retrospective analysis.Materials and Methods:We analysed mtDNA levels in the trophectodermal cells of 287 blastocysts from 61 couples undergoing PGT-A. The levels of mtDNA were estimated by next-generation sequencing method. mtDNA levels were correlated with maternal age, blastocyst morphology, ploidy status, implantation rates, miscarriage rate and live birth rate.Statistical Analysis Used:Linear regression and one-way ANOVA with Tukey's all column comparison test.Results:The trophectodermal mtDNA levels did not correlate with maternal age. There were no significant differences in their levels in grade 1 and grade 2 blastocysts. No significant differences were seen between mtDNA levels of implanted and non-implanted blastocysts or those blastocysts that resulted in miscarriage or live birth. However, significantly lower amounts of mtDNA were seen in euploid blastocysts as compared to that in aneuploid blastocysts.Conclusion:mtDNA levels in the trophectodermal cells of the blastocyst do not associate with blastocyst quality (grade 1 and grade 2), implantation potential and clinical outcomes but can differentiate between aneuploid and euploid blastocysts. Our study does not support the use of trophectodermal mtDNA levels as a biomarker for blastocyst quality and predictor of clinical outcomes.

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