Background: Postmortem sperm retrieval (PMSR) is an emerging reproductive and medicolegal practice that raises complex ethical, psychological, social and legal concerns. While previous studies have largely focused on the technical feasibility of PMSR, limited data are available regarding public awareness, perceptions and psychosocial acceptance, particularly in the Indian context. Aim: To evaluate awareness, perceptions and psychological factors associated with the acceptance of PMSR. Settings and Design: A cross-sectional questionnaire-based survey was conducted among grieving relatives visiting the mortuary setting. Materials and Methods: A structured 20-item questionnaire covering four domains-Ethical and Personal Acceptance, Social and Religious Stigma, Legal and Policy Framework and Facts and Relevance-was administered to consenting adult participants. Responses were recorded using a five-point Likert scale. Content validity of the questionnaire was established using the item-level content validity index assessment by experts. Statistical Analysis Used: Data were analysed using descriptive statistics, including frequencies and percentages. Associations between categorical variables were assessed using Chi-square tests. Spearman’s rank correlation analysis was performed to evaluate inter-item relationships and visualised using a correlogram. Results: Of 600 relatives approached, 437 consented to participate. Most respondents demonstrated favourable attitudes toward PMSR, particularly in ethical and personal acceptance domains. High agreement was observed regarding ethical acceptability and personal support for PMSR. Strong positive correlations existed between ethical acceptance and personal support variables, while strong negative correlations were observed between social non-acceptance and independent approval of PMSR. Conclusion: The study demonstrates generally positive perceptions toward PMSR despite existing ethical, social and legal ambiguities. The findings highlight the need for increased public awareness and ethical guidelines for PMSR.
Background: Tubal sterilization is a common contraceptive method in resource-limited settings like India. Reversal via recanalization is often sought following child loss. Success rates vary, with pregnancy achievable in over half of the cases. Identifying prognostic factors is essential for optimal patient selection and counseling. Aim: The aim of this study was to assess pregnancy rates following tubal recanalization after sterilization and identify key prognostic factors. Setting and Design: This was a retrospective cohort study at a tertiary care teaching hospital in South India. Materials and Methods: Data from 409 women undergoing tubal recanalization between 2003 and 2017 were analyzed. Statistical Analysis Used: Descriptive statistics were used to summarize the data. Categorical variables were compared using the Chi-square test. P < 0.05 was considered statistically significant. Results: Out of 551 women, 409 whose details were available were included in the study. Most women were ≤30 years old (73.9%), sought reversal primarily due to loss of child (68.4%), and had puerperal sterilization (62.9%). The overall pregnancy rate was 57.0% (233/409). Among conceptions, live births accounted for 64.8%, miscarriages 14.6%, and ectopic pregnancies 20.6%. Over 94.8% of conceptions occurred within 4 years postrecanalization. Significantly higher pregnancy rates were observed in women ≤30 years old, with prior vaginal deliveries (60.8%; P < 0.001), interval sterilization (78.2%; P < 0.001), isthmo-isthmic anastomosis (85.7%; P < 0.001), recanalization within 4 years of sterilization, residual tubal length >6 cm (85.9%; P < 0.001), and absence of tubal adhesions (60.4%; P = 0.009). Conclusion: Tubal recanalization is a reasonable option for fertility restoration after sterilization in appropriately selected women, with key prognostic factors identified for better patient selection and counseling, though the high ectopic pregnancy rate warrants close monitoring and informed consent.
Background: Paternal methylenetetrahydrofolate reductase (MTHFR) variants may contribute to recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) by compromising sperm DNA integrity and embryonic development. Aim: To examine associations between paternal MTHFR polymorphisms and RPL and/or RIF. Settings and Design: This is a systematic review and meta-analysis. Materials and Methods: MEDLINE, Cochrane Library and Scopus were searched from 1999 to 27 June 2026. Eligible studies reported odds ratios (ORs) and 95% confidence intervals (CIs) for RPL or RIF in observational designs with a live birth control group. Quality was evaluated using the Newcastle–Ottawa Scale. Statistical Analysis Used: Meta analyses applied Mendelian inheritance models and subgroup analyses by geographical region. Results: Ten studies were included in the systematic review, and nine in the meta analysis. The dominant model of paternal MTHFR C677T (CT + TT vs. CC genotype) and A1298C (AC + CC vs. AA genotype) were associated with RPL (OR = 1.69; 95% CI: 1.08–2.63; I2 = 71% and OR = 1.72; 95% CI: 1.29–2.30, I2 = 29.4%), particularly in Asian–and Middle Eastern populations (OR = 2.07; 95% CI: 1.05–4.08; subgroup I2 = 75% and OR = 1.87; 95% CI: 1.33–2.62; subgroup I2 = 0%). No significant associations were identified in European populations or with RIF. GRADE certainty was low to very low. Conclusions: Paternal MTHFR C677T and A1298C polymorphisms may be associated with increased RPL risk in Asian and Middle Eastern populations. These exploratory findings warrant adequately powered multiethnic studies that genotype both partners and account for folate status. PROSPERO registration number: CRD42024550497.
Background: Polycystic ovary syndrome (PCOS) is associated with metabolic abnormalities and increased long-term cardiovascular risk. Endothelial dysfunction is considered an early event in atherogenesis, and soluble E-selectin has been proposed as a marker of endothelial activation. However, its role in cardiovascular risk assessment in PCOS remains uncertain. Aim: The study aimed to compare circulating soluble E-selectin levels between women with PCOS and healthy controls and evaluate their association with metabolic parameters and QRISK3-based cardiovascular risk scores. Settings and Design: Prospective hospital-based case–control study. Materials and Methods: Two hundred women with PCOS diagnosed according to the Rotterdam criteria and 50 age-matched healthy controls aged 18–40 years were enrolled. Clinical assessment, anthropometry, fasting blood glucose, HbA1c, lipid profile, C-reactive protein and soluble E-selectin levels were evaluated. Estimated 10-year cardiovascular risk was calculated using the QRISK3 algorithm. Statistical Analysis Used: Group comparisons, correlation analyses and multivariable linear regression were performed. Results: Mean soluble E-selectin levels were comparable between women with PCOS and controls (0.61 ± 0.33 vs. 0.61 ± 0.29 ng/mL, P = 0.935). Within the PCOS group, soluble E-selectin correlated positively with HbA1c (r = 0.326, P = 0.001) and fasting blood glucose (r = 0.271, P = 0.001), while no significant associations were observed with anthropometric measures, lipid parameters, blood pressure or QRISK3 scores. In multivariable analysis, fasting blood glucose remained independently associated with soluble E-selectin. Conclusion: Soluble E-selectin levels did not differ between women with PCOS and controls and showed limited associations with cardiovascular risk factors. These findings do not support a major role for soluble E-selectin in cardiovascular risk assessment among young women with PCOS.
Background: Anti-thyroid peroxidase antibodies (TPOAbs) are common among women of reproductive age, especially in assisted reproductive technologies (ART). Their impact on early embryological outcomes remains unclear. Intracytoplasmic sperm injection (ICSI) has been proposed to overcome possible adverse effects of TPOAbs in the follicular fluid. Aim: The aim of the study was to evaluate the effect of TPOAbs on fertilisation in women undergoing in vitro fertilisation (IVF) and to compare fertilisation between IVF and ICSI in TPOAb-positive women. Settings and Design: The study design was a retrospective cohort study. Materials and Methods: Data were retrieved from institutional records. 779 women undergoing their first IVF or split cycle at Herlev Hospital between December 2019 and November 2024 were included. Statistical Analysis Used: Logistic regression was used to assess fertilisation and blastocyst outcomes. All models were adjusted for age, body mass index, sperm type, sperm quality and smoking status. Results: No significant differences were observed in fertilisation or blastocyst development between TPOAb-positive and negative women undergoing IVF. In the split group, TPOAb-positive women had higher fertilisation with ICSI than IVF; however, this difference was not significant (odds ratio [OR]: 1.66, 95% confidence interval [CI]: 0.96–2.90). Among TPOAb-negative women, ICSI was associated with a significantly higher fertilisation rate (OR: 1.50, 95% CI: 1.20–1.87), whereas the increase in blastocyst formation was not significant. Conclusion: Fertilisation did not differ between TPOAb-positive and TPOAb-negative women undergoing ART. Although ICSI was associated with higher fertilisation rates, this effect was observed irrespective of TPOAb status. The benefit of ICSI likely reflects technique-related advantages rather than modulation by thyroid autoimmunity. Prospective studies are warranted.
