AIM: To compare clomiphene citrate (CC), metformin or the combination of CC and metformin as the first line ovulation induction drug in Asian Indian women with polycystic ovary syndrome (PCOS). METHODS: One hundred and five newly diagnosed, treatment naive PCOS women were recruited. They were randomized into any of the three groups: Group I (CC 50–150 mg/day), Group II (metformin 1700 mg/day), and Group III (CC + metformin in similar dosage to Groups I and II). Patients underwent follicular monitoring and advice on timed intercourse. The study period was 6 months, or till pregnant, or till CC resistant. Primary outcome studied was live birth rate (LBR). Secondary outcomes were ovulation rate, pregnancy rate, and early pregnancy loss rate. RESULTS: There was no significant difference among the groups in baseline characteristics and biochemical parameters. LBR was 41.6%, 37.5%, and 28.1%, respectively in Groups III, II, and I. Group III (CC + metformin) had the highest ovulation (83.3%), pregnancy (50%), and LBRs (41.6%). Group II (metformin) was as good as Group I (CC) in all the outcomes. CC + metformin (Group III) had statistically significantly higher ovulation rate as compared to CC alone (Group I) (P = 0.03; odds ratio: 95% confidence interval: 3.888 [1.08–13.997]). CONCLUSION: Thus, our study shows that metformin was as good as CC in terms of “LBR” and the combination of CC and metformin gave the highest ovulation and LBR.

Purpose To identify the paternal factors responsible for aberrant embryo development leading to loss of foetus in recurrent pregnancy loss (RPL) through proteomic analysis of ejaculated spermatozoa. Materials and Methods: This prospective study consisted of male partners of RPL patients (n=16) experienced with two or more consecutive unexplained miscarriages and with no female factor abnormality as revealed by gynaecologic investigation including karyotyping and age matched fertile healthy volunteers (n-20). All samples were collected during 2013 to 2015 after getting institutional ethical approval and written consent from the participants. Seminal ejaculates were collected by masturbation after 2 to 3 days of sexual abstinence and analyzed according to World Health Organization 5th criteria 2010. Two-dimensional difference gel electrophoresis followed by mass spectrophotometric analysis was used to identify differentially expressed proteins (DEPs). Western blotting was used for validation of the key proteins. Results: The data identified 36 protein spots to be differentially expressed by more than 2-fold change with p<0.05 considered as significant. Matrix-assisted laser desorption/ionization time of flight/mass spectrometry identified GPx4, JIP4, ZN248 to be overexpressed while HSPA2, GSTM5, TF3C1, CC74A was underexpressed in RPL group. Western blot analysis confirmed the differential expression of key redox associated proteins GPx4 and HSPA2 in the RPL group. Functional analysis revealed the involvement of key biological processes that includes spermatogenesis, response to oxidative stress, protein folding and metabolic process. Conclusions: The present study provides a snapshot of the altered protein expression levels consistent with the potential involvement of the sperm chromatin landscape in early embryonic development.

Context: Polycystic ovary syndrome (PCOS), one of the most common endocrine disorders encountered in women of reproductive age, is associated with an increased prevalence of metabolic syndrome (MetS). Development of PCOS and its phenotypic expressions is influenced by genetic, ethnic and environmental factors. Due to the vast cultural diversity in our country, differences in the prevalence of MetS may exist across different regions. Aims and Objectives: To study the distribution of anthropometric, clinical, and metabolic profiles of women with PCOS across the four regions of India. Materials and Methods: A multicentric prospective study using data collected from four tertiary Assisted Reproductive Centres across four different regions of India was carried out between January 2017 and December 2017. A total of 651 women were diagnosed with PCOS, with 178 belonging to North, 209 to East, 115 to West and 149 to South India. A comparison of the metabolic and anthropometric profiles of women with PCOS was made across the four different ethnic regions of India. Statistical Analysis: Quantitative variables were compared using the Mann–Whitney test and qualitative variables using the Chi-square test.P < 0.05 was considered statistically significant. Results: North Indian women had the highest mean body mass index (BMI) – 27.53 ± 4.55 kg/m² and a higher waist circumference (89.93 ± 14.53 cm) compared to women from South and West India (P = 0.0001). The prevalence of MetS (41.98%) and impaired glucose tolerance (IGT) (37.04%) was also highest in North India followed by East India. PCOS women from East India were lean but had the highest waist-to-hip ratio (WHR) 0.9 ± 0.05 (P = 0.0001) and dyslipidemia. Using multivariate logistical regression analysis, age >25 years, BMI >25 kg/m², and WHR >0.8 had a strong association with MetS. Conclusion: Prevalence of MetS is high among Indian PCOS women, with women from the North and East India having the worst metabolic profiles. IGT is the main driver for MetS.

A BSTRACT: Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women, with a global prevalence of 5%–10%, and up to 25% in certain populations. Developing countries like India have witnessed a surge in obesity and related metabolic comorbidities due to rapid urbanisation and lifestyle transitions. This study examines temporal changes in the clinical and metabolic profile of women with PCOS from Odisha, India, over the past 15 years Aim: This study aims to analyse how PCOS women have changed in their clinical, phenotypic, biochemical and metabolic parameters over the last two decades Settings and Design: Private hospital and retrospective analysis Materials and Methods: This retrospective chart review included 1530 women diagnosed with PCOS (Rotterdam criteria) at a tertiary care centre in Odisha. Patients were grouped into three periods: Period 1 (2009–2013), Period 2 (2014–2018) and Period 3 (2019–2024), with approximately equal numbers. Anthropometric, biochemical and ultrasonographic features were compared across time periods Statistical Analysis Used: The data were analysed using Chi-square and Kruskal–Wallis tests and the R v4.1.1 (R Core Team, 2021) software Results: Mean body mass index increased from 26.40 ± 4.61 kg/m ² (Period 1) to 28.42 ± 5.31 kg/m ² (Period 3), P < 0.001. Waist circumference rose from 86.83 ± 11.18 cm to 90.78 ± 12.12 cm, P < 0.001. Abnormal glucose tolerance (glucose challenge test 75 g 2 h) (mg/dl) 129.95 ± 66.54 to 136.99 ± 44.37, P < 0.001 and fasting blood glucose (mgs/dl) 94.71 ± 17.36 to 94.91 ± 14.38, P < 0.001 also increased significantly. Family history of PCOS, diabetes mellitus, hypertension, obesity and dyslipidaemias significantly increased, indicating a rising prevalence of these conditions over time. Menstrual dysfunction remained consistently prevalent, with cycles of 60–90 days most frequent in Period 2 (59.1%). Metabolic syndrome prevalence increased from 36.5% to 45.6% Conclusion: Over the last 15 years, the metabolic and phenotypic profile of Indian women with PCOS has worsened significantly. These findings highlight the need for early lifestyle interventions and public health strategies targeting metabolic risk factors in this population.