Obstetrics and Gynaecology

Assist in the preparation of Fertility Guidelines for the World Health Organisation

Supervisor

Cynthia Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS189

In 2018-2019 Professor Farquhar will be leading a process to develop evidence summaries for fertility guidelines for the World Health Organisation. We are looking for a student to work on one aspect of the study - to help develop the evidence tables and to complete the framework for decision making.

Skills required include attention to detail, an understanding of study design, an ability to follow instructions about completing the framework, to undertake literature reviews.

Must be familar with excel and power point.

This project will be one part of the overall project. I have not yet decided on the clinical topic which will be the focus of this summer studentship.

Core outcome measures in infertility trials (COMMIT) project

Supervisor

Cynthia Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS205

COMMIT is a project where core outcome measures are being developed for infertility trials.

We are looking for a student to assist in this project. A three day meeting is being held at the end of November 2018 with international experts attending. The student will be involved in mapping current clinical trials to the outcomes that are being considered. The skills needed are attention to detail, understanding of clinical trials and outcomes, and be proficient in all the Microsoft office programmes including excel and powerpoint. The student will learn a lot about clinical research and infertility. There is also the opportunity to get involved in a priority setting exercise at the same time.

Placental Extracellular Vesicles

Supervisor

Larry Chamley
Qi Chen

Discipline

Obstetrics and Gynaecology

Project code: MHS068

The human placenta is bathed in maternal blood and extrudes a vast array of extracellular vesicles into the maternal blood each day. Extracellular vesicles are lipid enclosed packages of cellular contents. While exosomes are a well-known type of extracellular vesicle there are many other types. We have recently published that different placental vesicle types have different cargoes and are targeted to different maternal organs. We hypothesize that placental extracellular vesicles contribute to the remarkable adaptations of the maternal immune and cardiovascular systems to normal pregnancy but that these vesicles or their cargoes change in diseased pregnancies, especially preeclampsia and contribute to the parthenogenesis of these conditions.
By understanding more about the biology of placental extracellular vesicles we hope to enlarge our knowledge of what controls maternal adaptation in normal pregnancy and mal-adaptation in diseased pregnancies.

This project will investigate the cargoes and targeting molecules found on placental extracellular vesicles. Techniques that we will teach are human placental explant culture, cell culture, microscopy, immunoassays including western blots and ELISAs. Possibly also RT-PCR.

Identifying the gaps in systematic reviews and wastage in primary research (Fertility)

Supervisor

Marian Showell
Dr Vanessa Jordan
Professor Cindy Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS112

The Cochrane Fertility and Gynaecology Group (CGFG) conducts high-quality systematic reviews which investigate and summarise randomised controlled Trials (RCTs) that are important for clinical decisions in the scope of gynaecology and fertility. This project will identify whether current systematic reviews, in the scope of fertility, are covering the major areas which are being investigated by random controlled trials (RCTs).To do this, we will first identify the fertility RCTs held in the Cochrane and Gynaecology and Fertility Group's (CGFG) specialised register. We will identify whether these RCTs have been used already in Cochrane systematic reviews (SRs). Those that have not been used in SRs will then be coded by their population and intervention and classified into the topics for the development of new review titles.

By analysing those areas in fertility that are not covered in the CGF systematic reviews, we will be able to identify the gaps between RCTs and the systematic reviews being conducted and therefore reduce the numbers of RCTs that are not used. These gaps in evidence may or may not be clinically significant, which we aim to determine. We will present and disseminate these results by publication in a high profile peer review journal. This will act as a guide to identify new topics for future high-quality reviews, prioritise review proposals that cover these gaps in clinical evidence, and inform trialists on topics that are or are not clinically relevant, thus helping to reduce waste in primary research. This will bring forward new understandings of evidence for fertility treatments and other clinical interventions that have not yet be covered by CGF reviews, and can be of significant benefit to clinicians and fellow researches in this field.

Design

Cohort of fertility trials from the Cochrane Gynaecology and Fertility specialised register published 2010-2013.

Methods

1st phase: We will take all those fertility trials published from 2010-2013 from the CGFG database and allocate them according to their intervention and condition, these will include full texts and conference abstracts.
2nd phase: We will then match these trials to existing Cochrane systematic reviews and protocols.
3rd phase: We will identify the gaps i.e. the trials that are not yet covered by Cochrane reviews. We also aim to search for non- Cochrane reviews to see if these topics are covered or not.
4th phase: We will assess the priority and clinical importance of the trials that are not incorporated into a review and develop a list of potential new review topics.

Identifying the gaps in systematic reviews and wastage in primary research (Menopause and Gynaecology Surgery)

Supervisor

Marian Showell
Dr Vanessa Jordan
Professor Cindy Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS113

The Cochrane Fertility and Gynaecology Group (CGFG) conducts high-quality systematic reviews which investigate and summarise randomised controlled Trials (RCTs) that are important for clinical decisions in the scope of gynaecology and fertility. This project will identify random controlled trials published between 2010-2013 in the areas of menopause and gynaecological surgery. To find these trials we will search the CGFG specialised register. We will then identify as to whether these RCTs have been used or not used in Cochrane systematic reviews (SRs). Those that have not been used in SRs will then be coded by their subgrouped population and intervention and classified into the topics for the development of new review titles. By analysing those areas in menopause and Gynaecological surgery that are not covered in the CGF systematic reviews, we will be able to identify the gaps between RCTs and the systematic reviews being conducted and therefore reduce the numbers of RCTs that are not used. These gaps in evidence may or may not be clinically significant, which we aim to determine in consultation with consumers and experts in the field.

We will present and disseminate these results by publication in a high profile peer review journal. This will act as a guide to identify new topics for future high-quality reviews, prioritise review proposals that cover these gaps in clinical evidence, and inform trialists on topics that are or are not clinically relevant, thus helping to reduce waste in primary research. This will bring forward new understandings of evidence for menopause and gynaecology surgical treatments that have not yet be covered by CGF reviews, and can be of significant benefit to clinicians and fellow researches in this field.

The role of placental extracellular vesicles in preventing endometrial epithelial cell damage

Supervisor

Qi Chen
Larry Chamley

Discipline

Obstetrics and Gynaecology

Project code: MHS079

There is rapidly growing interest in extracellular vesicles (EVs) and their potential role in biology and medicine, including in cancer. EVs are lipid enclosed packages of cellular contents that are produced by all eukaryotic cells to facilitate intercellular communication and regulation. The EVs produced by most cells/tissues are separated by size into nano-vesicles (including exosomes) and micro-vesicles. But the human placental produces macro-vesicles. EVs act like multifunctional hormones and are capable of altering the function of recipient cells including normal and cancer cells, via different mechanisms for example by transfer of proteins, mRNAs and regulatory RNAs.
The human placenta produces large amount of EVs that are important in controlling the adaptations of the maternal immune and vascular systems to pregnancy. Studies have showed that placental EVs have multiple functions on recipient cells including inducing maternal immune cell death and inhibiting maternal endothelial cell activation induced by a number of activating stimuli. Our previous study also showed that placental EVs inhibited ovarian and endometrial cancer cell growth. Therefore in this study we will investigate the potential mechanism of this effect.
The aims of this project are to investigate (1) whether placental EVs can prevent normal endometrial epithelial cell DAN damage induced by chemicals. (2) Whether cell recovering signaling pathways are involved in this effect.

Skills

Cell and tissue culture
Western blotting
Immunohistochemistry
General laboratory skill

Discrepancies in outcome reporting from trial registration to publication

Supervisor

Vanessa Jordan
Marian Showell
Prof Cindy Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS127

Reporting bias in clinical research occurs when researchers publish some of the measured outcomes and suppress other measured outcomes based on findings. Previous work has shown that researchers are more likely to switch the pre-identified primary outcome with another secondary outcome if the secondary outcomes proved to be more interesting (i.e. showed a statistically significant result).
We have an ongoing project looking at trials registered in the ANZCTR (Australian and New Zealand Clinical Trials Registry) database.

This summer studentship would involve looking at previously identified trials that were prospectively registered and comparing the predetermined outcomes detailed in the registration with those published following the completion of the research.

This project is based at Cochrane New Zealand which is part of the Obstetrics and Gynaecology Department on level 12 of Building 599.

Skills gained would include understanding improved understanding of trial methodology, data collection using Excel spreadsheets, and skills in scientific writing. We would ultimately be hoping to publish the findings of this work.

Quality appraisal of abstracts looking at fertility RCT research presented at ESHRE and ASRM

Supervisor

Vanessa Jordan
Marian Showell
Prof Cindy Farquhar

Discipline

Obstetrics and Gynaecology

Project code: MHS128

Researchers disagree on the inclusion of conference abstracts as a source of evidence for systematic reviews. The main objection to the inclusion of conference abstracts is the poor reporting of trial methods and results in a conference abstract. The aim of this project is to determine if the reporting of conference abstracts has improved over time.
The first stage of this project will be to identify randomised controlled trials (RCT’s) from the annual meeting ESHRE (European Society of Human Reproduction and Embryology) and ASRM (American society of reproductive medicine). The student would then use the CONSORT tool to evaluate the reporting of RCT in journal and conference abstracts and compare this to RCT’s presented at these meetings in 2010. This project is based at Cochrane New Zealand which is part of the Obstetrics and Gynaecology Department on level 12 of Building 599. Skills gained would include understanding improved understanding of trial methodology, data collection using Excel spreadsheets, and skills in scientific writing. We would ultimately be hoping to publish the findings of this work.