Melatonin, a pineal hormone that regulates circadian rhythms, has also been shown to exhibit unique oxygen scavenging abilities. Melatonin supplementation in IVF may lead to better pregnancy rates. Hence role for melatonin in gamete biology is under research.
Role of progestogens in obstetrics and gynecologyAhmad Saber
The
different progestogens with their overlapping effects on estrogen, androgen, glucocorticoid,
and mineralocorticoid receptors are described in order to allow the clinician to make the most appropriate choice of progestogen.
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
Role of progesterone in rpl by dr alka mukherjee dr apurva mukherjeealka mukherjee
It is well known that progesterone plays a major role in the maintenance of pregnancy, particularly during the early stages, as it is responsible for preparing the endometrium for implantation and maintenance of the gestational sac. The management of pregnant women at risk of a threatened or idiopathic recurrent miscarriage is complex and critical.
Early pregnancy loss, also known as miscarriage, generally occurs in the first trimester. For some women and their partners, miscarriages can happen several times, also known as recurrent miscarriages. While there are sometimes causes for miscarriages that are found, often no clear reasons can be found. The hormone called progesterone prepares the womb (uterus) to receive and support the newly fertilized egg during the early part of pregnancy. It has been suggested that some women who miscarry may not make enough progesterone in the early part of pregnancy. Supplementing these women with medications that act like progesterone (these are called progestogens) has been suggested as a possible way to prevent recurrent miscarriage.
Role of progestogens in obstetrics and gynecologyAhmad Saber
The
different progestogens with their overlapping effects on estrogen, androgen, glucocorticoid,
and mineralocorticoid receptors are described in order to allow the clinician to make the most appropriate choice of progestogen.
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
Role of progesterone in rpl by dr alka mukherjee dr apurva mukherjeealka mukherjee
It is well known that progesterone plays a major role in the maintenance of pregnancy, particularly during the early stages, as it is responsible for preparing the endometrium for implantation and maintenance of the gestational sac. The management of pregnant women at risk of a threatened or idiopathic recurrent miscarriage is complex and critical.
Early pregnancy loss, also known as miscarriage, generally occurs in the first trimester. For some women and their partners, miscarriages can happen several times, also known as recurrent miscarriages. While there are sometimes causes for miscarriages that are found, often no clear reasons can be found. The hormone called progesterone prepares the womb (uterus) to receive and support the newly fertilized egg during the early part of pregnancy. It has been suggested that some women who miscarry may not make enough progesterone in the early part of pregnancy. Supplementing these women with medications that act like progesterone (these are called progestogens) has been suggested as a possible way to prevent recurrent miscarriage.
Anti-Müllerian Hormone (AMH) is critical for physiologic involution of the Mullerian ducts during sexual differentiation in the male foetus.
In women,AMH is a product of the small antral follicles in the ovaries and serves to function as an autocrine and paracrine regulator of follicular maturation
Update on LETROZOLE Current Guidelines for Ovulation Induction Dr. Sharda Jain Lifecare Centre
Update on LETROZOLE Current Guidelines for Ovulation Induction
LET NOT FORGET
WHY
??
LETROZOLE was withdrawn from
Indian market (2012)
“SAFETY ISSUES”
“Could Be Teratogenic In Human”?
It describes the Progesterone physiology. It describes the latest evidence as regards progesterone formulations, use of progesterone as Luteal phase support. It scrutinizes the value of serum progesterone in monitoring luteal phase
MICROBIOME IN ART& Need of Probiotics Dr Sharda Jain Dr Jyoti Agarwal Lifecare Centre
MICROBIOME IN ART& Need of Probiotics Dr Sharda Jain Dr Jyoti Agarwal
WHAT IS MICROBIOME ?
Reproductive system comprises of number of microbes
There number is more than total cells of Genital Tract
These microbes play an important role in maintaining the homeostasis & normal functioning of the Genital Tract
system
Anti-Müllerian Hormone (AMH) is critical for physiologic involution of the Mullerian ducts during sexual differentiation in the male foetus.
In women,AMH is a product of the small antral follicles in the ovaries and serves to function as an autocrine and paracrine regulator of follicular maturation
Update on LETROZOLE Current Guidelines for Ovulation Induction Dr. Sharda Jain Lifecare Centre
Update on LETROZOLE Current Guidelines for Ovulation Induction
LET NOT FORGET
WHY
??
LETROZOLE was withdrawn from
Indian market (2012)
“SAFETY ISSUES”
“Could Be Teratogenic In Human”?
It describes the Progesterone physiology. It describes the latest evidence as regards progesterone formulations, use of progesterone as Luteal phase support. It scrutinizes the value of serum progesterone in monitoring luteal phase
MICROBIOME IN ART& Need of Probiotics Dr Sharda Jain Dr Jyoti Agarwal Lifecare Centre
MICROBIOME IN ART& Need of Probiotics Dr Sharda Jain Dr Jyoti Agarwal
WHAT IS MICROBIOME ?
Reproductive system comprises of number of microbes
There number is more than total cells of Genital Tract
These microbes play an important role in maintaining the homeostasis & normal functioning of the Genital Tract
system
The two main sex hormones — estrogen and testosterone — have wide-ranging effects in the body. Produced primarily by the ovaries (estrogen) and testes (testosterone), these hormones affect not just your sexual function but also your bones, brain, and blood vessels.
Buy Melatonin 10mg tablet if you desire a stress-free existence and a good night's sleep. Melatonin, a hormone, is produced by your body to maintain a normal circadian cycle. To alleviate the symptoms of jet lag, it is commonly used The blind can be used to treat shift-work sleep disorders in persons with shift work patterns. In a 24-hour period, the average person sleeps eight hours at night and sixteen during the day. Melatonin is the name of a hormone produced naturally by the body. It's not even close to being a vitamin. Mild sorrow, moderate tremors, mild anxiety, cramping in the stomach, impatience, poor attentiveness, confusion or disorientation, and unusually low blood pressure are all minor side effects of melatonin use.
Management of poor ovarian reserve- Dr Parul KatiyarDr Parul Katiyar
Premature ovarian aging or ovarian failure is a major cause of female factor infertility. Dr Parul explains the mechanism of premature ovarian failure and discusses some simple measures to preserve/ regain fertility among women.
Endometriosis is a painful disorder and can reduce fertility if not treated early. Endometriosis most commonly involves ovaries, fallopian tubes and the tissue lining pelvis.Endometriosis can be a challenging condition to manage.
Fertility enhancing surgeries are usually advised to young women with suspected minimal to moderate disease of tubes, ovaries or uterus.
https://www.femelife.com/ivf-fertility-care/fertility-enhancing-surgeries/
PCOS- An insight into polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is extremely prevalent and probably constitutes the most frequently encountered endocrine (hormone) disorder in women of reproductive age
PGD combines advances in Molecular genetics and in assisted reproductive technology and is conducted before the embryo is placed inside the womb of the woman.Pre implantation genetic diagnosis was introduced to prevent the inheritance of sex linked diseases
A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility
Significant increase in live birth rate is found when IUI is done with stimulation compared with IUI in natural cycle in women with Unexplained Infertility .
Embryogenesis is the process by which the embryo forms and develops. In mammals, the term refers chiefly to early stages of prenatal development from conception to 8 weeks of pregnancy .Later it is referred to as fetogenesis
Sperm is the male reproductive cell and its main sperm function is to reach the ovum and fuse with it to deliver two sub-cellular structures called embryoOn average, each time a man ejaculates he releases nearly 100 million sperm but it takes only one to make a baby .To meet the waiting egg, semen must travel from the vagina to the fallopian tubes, a tough journey that few sperm survive.
An oocyte is a female gametocyte or germ cell involved in reproduction.It is an immature ovum or an egg
An oocyte is produced in the ovary during female gametogenesis.The female germ cells produce a primordial germ cell pgc which undergoes mitosis to form an oogonium
During oogenesis the oogonium becomes a primary oocyte
Oogenesis consists of several sub processes – oocytogenesis, ootidogenesis and the maturation to form an ovum
Folliculogenesis is a separate sub process and supports all three oogenetic sub process
Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilisation. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilisation.
The cause for infertility could be in the male or the female or both or neither-as in ‘Unexplained Infertility.’
Male infertility is usually caused by problems that affect either sperm production or sperm transport.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
ALKAMAGIC PLAN 1350.pdf plan based of door to door delivery of alkaline water...rowala30
Alka magic plan 1350 -we deliver alkaline water at your door step and you can make handsome money by referral programme
we also help and provide systematic guideline to setup 1000 lph alkaline water plant
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
2. Melatonin Melatonin, a pineal hormone that
regulates circadian rhythms, has also
been shown to exhibit unique oxygen
scavenging abilities.
Imbalance of reactive oxygen species,
or ‘ oxidative stress’, can have a
negative impact on the success of
infertility treatments.
Studies also suggest that melatonin
supplementation in IVF may lead to
better pregnancy rates. Hence role for
melatonin in gamete biology is under
research.
3. Melatonin: synthesis and degradation
Its production is dependent on ambient
illumination, with release being suppressed
by light
A neuro-hormone
mainly synthesized
and secreted from
the pineal gland.
It has been found in the
gastrointestinal tract , brain ,
eye , lungs , skin , kidney, liver
, thyroid, thymus, pancreas ,
immune system and
reproductive system in less
quantity.
Melatonin is an
indoleamine, which is
synthesized from the
essential amino acid,
tryptophan
4. Metabolism Of Melatonin
Melatonin is metabolized in the
liver and excreted by the kidneys.
It has a short half-life and both
melatonin and its metabolites
can be measured in serum, urine
and saliva .
A key factor in the regulation of
circadian rhythms and the sleep-
wake cycle. Long exposure to
artificial lighting leads to a reduction
in endogenous melatonin exposure.
It has several qualities distinguishing
and rendering it superior to classical
anti-oxidative agents.
5. Antioxidant actions
Melatonin is a suicidal terminal anti-
oxidant, does not promote oxidation
under any circumstances and its
metabolites are also capable of acting as
anti-oxidants in a ‘ scavenging cascade
reaction’ without themselves becoming
oxidative
Melatonin also enhances the activity of other
endogenous antioxidants including glutathione
peroxidase and superoxide dismutase
6. Antioxidant Actions
Melatonin can be useful in Medical conditions in
which oxidative stress has been implicated,
including diabetes, glaucoma, irritable bowel
syndrome and even in curtailing the side effects of
chemo- and radiotherapy.
Melatonin has been shown to suppress
tumor growth
Anti-inflammatory and DNA stabilizing
actions can be useful in reducing chronic
pelvic pain in women with endometriosis
7. Importance of melatonin in reproduction
Levels of melatonin reach a nadir in the preovulatory phase and peak in the luteal
phase
8. Effects of melatonin on menstrual cycle,
fertility and pregnancy
Shift-workers are more likely than
daytime workers to experience circadian
disruption and longer menstrual cycles,
more menorrhagia and dysmenorrhea
Melatonin levels varied
significantly between night and
dayshift workers, while LH and
FSH levels did not In very high doses, when combined with
progesterone, melatonin has the ability to
suppress ovulation in humans, possibly
by interfering with LH release
9. Effects Of Melatonin On Oocyte
Preovulatory follicles had
higher concentrations of
follicular fluid melatonin than
smaller immature follicles.
Follicular fluid from mature
follicles have higher antioxidant
capacity than smaller follicles,
implying a role for melatonin in
oocyte maturation
10. Melatonin In Pregnancy
Melatonin requirements appear to
increase during pregnancy
After oral melatonin
supplementation there is increase
in fetal blood flow
Activation of melatonin receptors
may be the mechanism behind the
apparent increase in fetal blood
flow
Reduce the neurological effects of
oxidative stress-induced fetal brain
injury in rats and sheep
11. Aging And Melatonin
Melatonin levels naturally decrease with age
Melatonin also appears to have a role in the prevention of
postmenopausal bone loss, with effects being exerted via
inhibition of oxidative stress, induction of osteoblastogenesis
and inhibition of osteoclastogenesis
12. Safety Profile Of Melatonin
Melatonin has a remarkably
benign safety profile in both
animal and human
studies, with no teratogenic
effects
Does not have significant sedative
effects and is
not associated with hepato-
nephrotoxicity
13. Immuno-Stimulatory Actions
Melatonin can adversely affect
autoimmune
conditions, particularly
rheumatoid arthritis
Melatonin being
associated with
autoimmune
hepatitis
May be implicated in
multiple sclerosis through T-
cell activation
It is recommended to avoid
the use of melatonin
in those with autoimmune
conditions.
14. USES IN INFERTILITY
IVF can result in exposure of
oocytes
and embryos to high levels of
superoxide free radicals,
which begins prior to oocyte
retrieval
In-vitro, these oocytes are no longer
protected by
antioxidant-rich follicular fluid,
leaving them more susceptible
to oxidative damage
They may also
be exposed to high oxygen
concentrations in incubators
15. Oxidative stress modifies the quality
of oocytes
and embryos, decreasing the
fertilization rate and
the success of the infertility
treatment
Inverse relationship between
follicular fluid levels of ROS and
success of ART,
16. EFFECT ON SPERM QUALITY
Increased susceptibility of
sperm to
oxidative stress is the
abundance of oxidative
targets
such as polyunsaturated
fatty acids in the plasma
membrane
of sperm required for
fusion with the oocyte and
fertilization
Reactive oxygen species are
required for sperm
capacitation events
Imbalance of ROS has been implicated as a
factor in reducing the quality and
function of sperm
17. DNA damage has been
shown to have a negative
impact on fertilization,
blastocyst development , and
miscarriage rates and
pregnancy outcome
18. The role of melatonin in assisted
reproductive technology
Oral supplementation of
melatonin during the
ovarian stimulation phase
of the
IVF cycle and its effects
on gamete and embryo
quality.
19. Effects of melatonin on oocyte quality
Oocyte quality begins to deteriorate
immediately following
ovulation, a process thought to be
inflammatory
and through its production of
cytokines and proteases
is associated with an increase in ROS
which can inhibit
oocyte maturation
The follicular environment is naturally
protective
against oxidative damage to the
oocyte
20. Effects of melatonin on oocyte quality
Melatonin is an effective
mitigator of mitochondrial DNA
damage
Studies have found significantly
lower level of ROS and a greater
proportion of MII (mature)
oocytes in the melatonin
Group
Melatonin supplementation in-
vitro is associated with a
reduction in
oxidative stress and improved
oocyte maturation.
21. However lower concentrations of
melatonin in culture media improved nuclear
maturation
rate of immature MI oocytes , implantation
rate and an insignificant increase in clinical
pregnancy rate
Oral administration of
melatonin reduces intrafollicular oxidative
damage and
increases fertilization rates
22. Myo-Inositol Vs Melatonin
Myo-inositol may also be a
useful treatment for infertility in
polycystic ovarian syndrome
(PCOS), with improvements observed in
the
quantity of mature oocytes, the number
of top quality
embryos and the clinical pregnancy
rates
Trial comparing myo-inositol (an
insulin sensitizing agent) and folate
supplementation to myo-inositol, folate
and melatonin
found that those in the melatonin
group achieved a
greater number of mature oocytes,
fewer immature oocytes
and a greater number of top-quality
embryos
23. Effects of melatonin on sperm quality
Reproductive effects of melatonin
do
not extend only to the female
counterpart, with melatonin
receptors being demonstrated on
spermatozoa
Melatonin also appears to inhibit
apoptosis in spermatozoa, with a reduction in early
apoptotic events being demonstrated in human sperm
thus prolonging sperm survival
24. Effects On Cryopreserved SPERM
Melatonin has a positive
effect on sperm that
have been subjected to
oxidative stress, improving
sperm number, viability and
motility
Addition of melatonin to semen in
cryopreserved seminal samples from Holstein
bulls resulted in amelioration of the oxidative
effects of
the freeze-thaw process
25. Effects of melatonin on embryo culture media
Higher cleavage rate, increased
8-cell embryo yield and an increased
number of
blastocysts and blastocyst hatching in
embryos cultured
with melatonin concentrations
Higher concentrations of melatonin in
embryo culture media can be harmful
Melatonin has a significant
impact on the development
and quality of embryos, with
lower concentrations being
more beneficial (and less
harmful) than higher ones.
26. Effects of melatonin on luteal function
A certain level of ROS are required
for normal ovulation (follicular
rupture) and corpus luteal function
An imbalance of ROS results in
oxidative stress and this has been
identified as
a potential cause of luteal phase
defect
Melatonin supplementation
significantly increase progesterone
Levels, melatonin can increase serum
progesterone levels in women with a
luteal phase defect
27. Conclusion
Infertility treatments are associated with significant
levels of reactive oxygen species which have the potential
to negatively affect the quality of oocytes and embryos.
Melatonin shows promise as an adjunctive therapy in
the treatment of infertility. Its unique anti-oxidative
characteristics and safety profile make it an ideal potential
adjuvant therapy