NIRRH Annual Report 2012-13_Intro Pages.indd

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Annual Report 2012 - 2013
2012 - 2013
National Institute for Research in Reproductive Health
On the Cover: (Clock wise from Top Left Corner):
1. Community Sensitization Meeting
2. Immunofluorescence of T-complex protein-1(TCP-1) in control stage VII-VIII seminiferous tubules of
the rat testis.
3. Session with adolescent girls
4. Immunohistochemical localization of HSP90 in the antral follicle of normal mouse ovary
5. Figure shows balanced viaprical translocation between chromosomes 1 and 9 in a female carrier
presently with recurrent spontaneous abortions.
Limited number of copies of the Annual Report are available from:
Director : National Institute for Research in Reproductive Health, Parel, Mumbai 400012, India
Tel.: [phone] E-mail: [email protected]
Fax: [phone] Website: www.nirrh.res.in
No part of the report should be reproduced in part or whole without prior permission of the
Director, NIRRH.
Annual Report 2012 - 2013
CONTENTS
From the Desk of the Director
Summary of Research Activities i – xviii
1. Expanding Contraceptive Choices 1
2.1 Infertility and Reproductive Disorders – Female 10
2.2 Infertility and Reproductive Disorders – Male 39
3. Reproductive Tract Infections 63
4. Menopause and Osteoporosis 89
5. Maternal and Child Health 93
6. Adolescent Reproductive Health 97
7. Genetic Disorders 100
8. Structural Biology and Biomedical Bioinformatics Center 106
9. Stem Cell Biology 116
10. Preclinical and Reproductive and Genetic Toxicology 126
11. Sexual and Reproductive Health –HIV Linkages 132
12. Reproductive Cancers 136
13. Research Support Facilities 140
14. Publications 145
15. Meetings/Conferences/Seminars/Workshops Attended 153
16. Capacity Building 159
17. Honors and Awards 162
18. Members of Advisory Committees 163
19. Extramurally Funded Projects 169
20. Staff and Students 176
21. From the Desk of the Director (Hindi) 181
22. Activities for year 2012- 2013 183
National Institute for Research in Reproductive Health
Annual Report 2012 - 2013
From the Desk of the Director…
I am gratified to present this report on the research activities of the
NIRRH and GRC for the year 2012-2013. As in the previous years, the
institute continued to strive towards the excellence in research on basic,
clinical, operational, epidemiological and socio-behavioural aspects of
reproductive health. During the year, we have moved few inches closer to
accomplishing our mandate i.e. increasing contraceptive choices; preventing
unsafe abortions, making pregnancy and child birth safer; understanding
the causes of various reproductive disorders including infertility, detecting
and preventing RTIs/STIs/HIV/AIDS; improving quality of life of post-
menopausal women; and devising strategies for reducing gender based
violence. During the year, recognition and appreciation came our way in
the form of awards and as always, international recognition as publications
in high impact international journals.
We, at NIRRH, are cognizant of the Council’s goal i.e. to bring the benefits of research to people. User friendly and affordable
kits, developed for assessment of the sperm quality, are being distributed to get the end-users’ report. A PCR based technology
for the detection of Chlamydia is also available for commercialization. Four urinary hormone (estrone glucuronide, preganaediol
glucuronide, LH and FSH) based tests for fertility assessment is being prepared. These kits will be provided to HLL Life-care
Limited for clinical validation and mass scale production. During the year, 5 applications were submitted for patents.
Researchers at the institute have developed a formulation with a potential to prevent HIV entry into vaginal epithelial cells and
PBMCs. A multicentric study has also been initiated to validate the utility of a peptide based test, developed at the institute, for an
early detection of endometriosis. Human leukocyte antigen (HLA) based molecular markers, with a potential to predict cervical
cancer in HPV infected women, have also been identified.
The multidisciplinary bone health clinic has been functional. This research- cum- community based clinic has started catering to
the health needs of low socio-economic strata, with special emphasis on prevention and treatment of osteoporosis. The institute
has played a pivotal role in initiating ARSH services at 8 PHCs in Maharashtra. It is indeed satisfying to report that now these
ARSH clinics have grown and are self- sustained.
The institute had submitted guidelines for prevention and management of infertility in the public health care system to the health
ministry in April, 2012. To strengthen the operational aspect of the guidelines, a new study has been undertaken to assess the
services for prevention and management of infertility in the primary health care system.
It gives me immense pleasure to witness the Genetic Research Centre (GRC) going from strength to strength in last 4 years. The
bustling 2nd floor corridor, with patients from different parts of the country, testifies a new life infused into the GRC. GRC has
also become prolific with regard to publishing research data. The Center has assumed status of National Referral Center and been
designated as one of the ICMR Task Force Centers in Human Genetics and for Lysosomal Diseases. Now, its faculty is making
efforts to diagnose several morbid and fatal disorders such as infantile hyalinosis, infantile malignant osteoporosis at prenatal
stage.
Human resource development is one of our very important societal obligations. During the year, 9 students received their
doctorate degree. We also disseminate knowledge on research methodologies, observations and advancements to young students,
teachers and researchers at various stages of their career. During the year an international conference on millineum developmental
goals related to reproductive health, was organized. In addition, nine scientific meetings were conducted in the areas related to
RTIs, pharmacovigilance, bioinformatics, maternal and newborn health and medical genetics.
We earnestly appreciate support from the Secretary, Department of Health Research, Government of India and Director General,
ICMR; Joint Secretory and Sr Deputy Director General (Administration), ICMR; Joint Secretary and Senior Financial Advisor,
ICMR and Staff of the Reproductive and Child Health Division, ICMR. Their ceaseless support and encouragements always
make our tasks less trying.
In essence, we continued our research endeavors aimed towards the betterment of reproductive health. Challenges were galore,
but so were the rewards, which make us more determined to tread our path with fervor and enthusiasm.

Dr. Sanjiva D. Kholkute
Director
National Institute for Research in Reproductive Health
Annual Report 2012 - 2013
SUMMARY OF RESEARCH ACTIVITIES
1. EXPANDING CONTRACEP- 1.3 Studies with Sperm Proteins for
TIVE CHOICES Development of Antifertility Vaccine
Immunobiologically mimicking Synthetic Peptides
of 80kDa Human Sperm Antigen (80kDa HSA) and
1.1 Identification and Characterization of
human Seminal Plasma Inhibin (hSPI) have been
Sperm Antigens Using Multifaceted Approach found to be the potential candidates for development of
antifertility vaccine. Synthetic Peptide1 of 80kDa HSA
Using differential proteomics, several sperm proteins
induced immunological infertility in male rats, rabbits
were identified and one such protein is Liprin α-3. This
and marmosets. Active immunization with synthetic
is the first report of liprin α-3 on sperm. It was seen
Peptide1 using Muramyl Dipeptide (MDP) as an
at 133 kDa in both testicular and epididymal extract.
adjuvant and emulsified with squalene and
It is an integral protein anddevelopmentally regulated
arlaceelicitedelicited a gradual increase in antibody titer
by estrogen and conserved across different mammalian
and animals failed to impregnate normal fertile females.
species. It localizes with golgi marker (gm-130) in
The animals are being investigated for regaining
testicular cells indicating its involvement in acrosomal
fertility with decline in antibody titer. Immunized
biogenesis. Polyclonal antibody against Liprin α3
animals did not show changes in their biochemical
showed reduced acrosomal reaction.
and hematological parameters.The synthetic Peptide1
investigated for preclinical safety in collaboration with
1.2 Harnessing the Superfluity of National Institute of Nutrition was found safe following
acute toxicity tests.
Reproductive Tract Fluids: Identification of
Client Proteins to Testis Specific Antigen, TSA70 Active immunization with N-terminal 17 amino acid
Peptide (R-17) of hSPI also elicited gradual increase
Studies were initiated to evaluate the effect of male
in antibody titer in male marmosets. The animals failed
and female reproductive tract fluid proteins on the
to impregnate normal fertile females and these animals
sperm tail protein Testis Specific Antigen (TSA-
regained fertility with decline in antibody titer. The
70), which is a component of the Outer Dense Fibers
R-17 peptide is being further investigated for preclinical
(ODFs) and is known to interact with a cytokine,
efficacy and safety.
Macrophage Migration Inhibitory Factor (MIF), a 12.5
kDaepididymal fluid protein. This may help in sperm
maturation during epididymal transit by inducing zinc 1.4 Study on Determinants of Vasectomy
elimination and affecting the amount of free sulphydryl Acceptance in a Block of Thane District in
groups in sperm flagella. Studies are underway to
Maharashtra
determine interaction with such MIF-like client proteins
found in the epididymal, uterine and oviductal fluids The overall objective of the study is to investigate
using the recombinant TSA-70 variant 2 [rTSA70(2)]. the determinants of comparatively high acceptance
of vasectomy in Jawhar block in Thane district of
Surface Plasmon Resonance studies with rTSA70(2) as
Maharashtra State.
bait showed a oxidoreductase based interaction with the
reproductive tract fluid proteins. Based on the finding, Four groups were interviewed in Jawhar block: (i)
CNBr coupling based pull down experiments were vasectomy acceptors and their spouses (ii) tubectomy
undertaken to identify epididymal fluid client proteins acceptors and their spouses, community leaders,
to rTSA 70(2). The study was limited to small molecular motivators and health care providers. Systemic
weight proteins in the range of <25kDa. Bound random sampling was applied on R3 registers records
protein(s) were eluted with and resolved on a 10 % SDS for vasectomy and tubectomy acceptors in both the
PAGE gel. The silver stained profile consistently shows blocks. In addition two FGDs in each block, one each
three bands, one at 66 kDa and two bands between 17 with vasectomy and tubectomy acceptors were also
and 26 kDa. The identity of these proteins is yet to be conducted.
established and is underway.
Major observations based on vasectomy acceptors’
data from Jawhar block are as follows: (i) Early
i
National Institute for Research in Reproductive Health
marriage, early completion of family and early adoption household was contacted to screen women with unmet
of permanent FP method seems to be norm in the need for family planning. House-listing and rapid
community; (ii) low awareness about spacing methods assessment survey was carried out simultaneously to
and low utilization; (iii) high awareness on vasectomy identify and screened eligible women with unmet need
among males, major source being paramedicals, friends of family planning. Total samples of 568 women with
and PHC doctors; (iv) good agreement among couples unmet need for family planning were selected. One fifth
on acceptance of vasectomy as 79% took joint decision; (19.7%) of women had ever experienced violence from
(v) major reason on acceptance by male is the concern their husbands. Data collection in Tunga village is in
for wife’s health, wife also aware of health risks to her, progress.
male responsibility and knowledge of NSV as safe and
simple procedure.
1.7 Acceptability and Feasibility of using
Female Condom in Family Planning Setting
1.5 Gender Equity-Focused, Male-Centered
Female condoms are estimated to be highly effective
Family Planning for Rural India
in preventing pregnancy and HIV/STIs. Introducing
The study aims to enhance young couple’s contraceptive and integrating female condom in family planning
knowledge and acceptance of spacing methods through programme will expand the contraceptive choices for
gender equity focused family planning interventions women and also preventing HIV/STIs. There is no
delivered by the village health care providers. Key literature available in Indian context on acceptability
components of Counselling Husbands to Achieve of female condom and perception of women in family
Reproductive Health and Marital Equity (CHARM) planning settings.
intervention were identified and survey instrument,
The objectives are: i) to study awareness and
intervention manual and Information, Education and
acceptability of female condom among the couples
Communication (IEC) material was developed and
using contraception. ii) To understand attitudes and
tested in the field. All these documents were translated
perceptions of the couples towards female condom. It is
into local language (Marathi). Subsequently, research
a clinic based prospective study, involving 120 eligible
and pilot intervention was carried out. Based on pilot
couples using contraceptive methods such as Oral pills,
study, refinement of CHARM intervention model and
CuT, and Male/Female sterilization. The present study
evaluation tools were assessed.
will explore the acceptability of female condom and
A Baseline survey and intervention program was future possibility of introducing it in family planning
initiated in two PHC villages and three days training programme.
program was conducted to train 12 private health care
practitioners in three PHC villages. Two refresher
training programs were conducted for the village health 2. INFERTILITY
care providers for two cohorts. A total of 1080 young
married couples from experimental and control (469
and 611 couples respectively) villages have been part
2.1 Female Infertility
of the study.
A Polycystic Ovary Syndrome
1.6 Intervention to Enhance Acceptance of
Contraceptive Use among Couples by Reducing
2.1.1 A Genetic Analysis of Polycystic Ovary
Domestic Violence from Husband
Syndrome (PCOS) with Special Emphasis on
The study aims to understand the effectiveness of an
Genes involve in Insulin Resistance
intervention to improve contraceptive use among
couples where the woman has reported of experiencing Polycystic ovary syndrome (PCOS) is a complex
domestic violence. The study was carried out in two polygenic disorder in women. Insulin resistance
low income areas (Kajupada and Tunga Village) in is a major pathogenic factor and related genes are
Mumbai. The study area Kajupada was divided into suggested to be candidate genes. During the reporting
four clusters. Systematic random sampling i.e every 6th year, we have completed genotyping of coding region
ii