Background: Insulin plays a key role in producing hyperandronism and suppression of insulin secretion in women with PCOS is associated with decreased cytochrome P450c17α. cytochrome P450c17α is a bifunctional enzyme present in ovary is a key enzyme for androgen synthesis. Various studies have been conducted regarding association of insulin resistance with PCOS in infertile patients but there is no study is available about this in our area. So we have designed this study to evaluate insulin resistance in infertile patients with PCOS in rural Andhra Pradesh.Methods: The study population include 180 untreated patients who attended the infertility clinic in outpatient department of obstetrics with infertility due to different cause that include polycystic ovarian disorder also. They have been selected for this study randomly based on inclusion and exclusion criteria.Results: The mean value of glucose insulin ratio was 5.146+2.611 in group A and 8.62 + 5.55 in group B the P value was 0.004909. The mean of LH/FSH ratio was 1.78+0.423 in group A and 1.02 +0.042 in group B. The P value was <0.00001. The mean of HOMA IR was 8.375+ 2.68 in group A and 3.03+ 1.09 in group B, with P value <0.00001. The mean value of QUICKI was 0.2815+ 0.0002875 in group A and 0.347+0.10 in group B with P value <0.00001. Mean serum DHEAS level was 275.59 + 53.48 in infertile patient with PCOS and 208.48 + 36.11 in infertile patients without PCOS. The p value was 0.00012.Conclusions: Based on present study we would like to conclude that the body mass index was high among infertile women with PCOS and a greater number of women presented with acanthosis. There was decrease insulin sensitivity and increase insulin resistance among infertile women with poly cystic ovarian disease, in rural area of Andhra Pradesh and that is not different from the study of other part of world.

BACKGROUND: A non-stress test (NST) is an essential diagnostic test performed during pregnancy to assess fetal well-being. It is a recording of fetal movements besides fetal heart rate, indicating fetal biophysiological well-being. As maternal physiology is altered in various positions, apt positioning during the NST is essential for accurate results while ensuring maternal comfort. This study aims to evaluate the effect of different maternal positions, left lateral and semi-fowler's, on NST reactivity, maternal blood pressure, heart rate, and comfort in pregnant women while performing the NST. MATERIALS AND METHODS: This crossover study evaluated 50 healthy pregnant women between 32 and 40 weeks of gestation with no obstetric complications for the effect of maternal positions on maternofetal physiological parameters and comfort. The NST was performed for 20 min in each position with a washout period of 10 min. The maternofetal physiological parameters were recorded by a calibrated sphygmomanometer and the electrocardiograph interpretations. The maternal comfort was assessed using a maternal comfort rating scale (MCRS) for each position after the NST. Relevant descriptive and inferential statistics are applied to compute the results. RESULTS: Statistically, there was a significant difference in the mean maternal blood pressure and heart rate between the left lateral and semi-fowler's positions at 0 and 20 min (P = 0.001), whereas within the groups, in the same position at 0 and 20 min, no significant difference was found. There was no significant difference in NST reactivity (P = 0.79) in different positions. There was no significant difference between the MCR scores of women in either of the positions (Z = −1.64, df = 49, P = 0.100). CONCLUSION: Semi-fowler's position demonstrated favorable maternal blood pressure and heart rate during the NST in the third trimester of pregnancy, though it was clinically not significant. There was no significant difference in the comfort of women in both positions. Hence, either of the positions can be implemented in practice as an alternative position while performing the NST, based on the women's preference.

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Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. Diagnosis of endometrial receptivity (ER) has posed a challenge and so far, the most available tests have been subjective and lack accuracy and a predictive value. Microarray technology has allowed identification of the transcriptomic signature of the receptivity window of implantation (WOI). This technology has led to the development of a molecular diagnostic tool, the ER array (ERA) for diagnosis of ER. Use of this test in patients with recurrent implantation failure (RIF) has shown that the WOI is displaced in a most of these patients and the use of a personalized embryo transfer (pET) on the day designated by ERA improves reproductive performance. In this retrospective study, 74 patients with history of recurrent implantation failures who underwent Endometrial Receptivity Assay in ARC fertility centre, Saveetha medical college over a period of one year were analysed and 44 patients were receptive and 30 non receptive. Out of those 44 receptive patients 37(84.1%) were positive for clinical pregnancy and 7(23.3%) patients were negative for clinical pregnancy after performing pET. Among 30 of the non-receptive patients 7(15.9%) were found positive for clinical pregnancy and 23(76.7%) were found negative for clinical pregnancy. The p value was <0.001 which is statistically significant. Hence this study proves that doing ERA and performing Personal of clinical pregnancy rate and its outcome. Though larger studies are required to validate these results ERA has become a useful tool in our diagnostic armamentarium for ER.