lida saeed

One of the factors affecting the outcome of pregnancy is the primary body mass index (BMI) and the amount of weight gain during pregnancy. This study aimed to check the relationship between mother's initial body mass index and weight gain in pregnancy with pregnancy outcomes.

This cross-sectional study was conducted on 455 pregnant women referred to Afzalipour Hospital in Kerman, Iran, from August 2021 to August 2022. These pregnant women were included in the study through easy and accessible sampling. The mother's initial weight was recorded through the mother's health card. The height of the mother was measured using a standard meter and the final weight of the mother before delivery was measured using a standard scale available in the department. Other information of the mothers was extracted from their records. Weight gain during pregnancy and initial body mass index were calculated and divided into four categories, less than normal, normal, overweight and obese. Maternal-fetal complications were included in the information registration form. Descriptive and analytical statistical methods and SPSS version 24 software were used to analyze the data.

The average age of women was 27.56±6.82 years. Body mass index of more than 40% of them (44.4%) was normal (19.8-26) and more than 45% of them were overweight 11.5-16 (45.5%). There was a significant relationship between initial body mass index and weight gain during pregnancy (P=0.001), gestational diabetes (P=0.001) and newborn weight (P=0.019). There was also a significant relationship between weight gain during pregnancy with premature birth (P=0.001), vaginal delivery (P=0.001), gestational diabetes (P=0.001) and newborn Apgar (P=0.001).

High body mass index of the mother and weight gain during pregnancy can cause complications in the mother and the fetus. Therefore, prenatal care should be done more carefully and health care providers should place mothers who have abnormal body mass index and inappropriate weight gain in pregnancy in the high-risk group and under special care to minimize maternal and fetal complications.

Among several causes of infertility, urogenital infections seem to be influencing factors. The effect of bacterial or viral sexually transmitted infections (STIs) on human fertility is not well understood. The aim of this study was to determine the frequency of STIs in cervical samples of infertile and fertile women and study the relationship between these agents and infertility.

In this case-control study, cytobrush was used for collecting of cervical sample from each infertile and fertile woman (n=95) who attended Research and Clinical Centers for Infertility in Kerman, Iran. PCR and real-time PCR methods were used to detect the presence of bacterial (genital Ureaplasma species, genital Mycoplasma species, Chlamydia trachomatis (C. trachomatis), and Gardnerella vaginalis) and viral (herpes simplex virus, human papillomavirus (HPV), and Epstein- Barr virus) agents, respectively. Fisher's exact test and the logistic regression with the significance level of ≤5% were used for statistical analyses.

In general, 78.94% and 14.73% of specimens were positive for one or more studied microorganisms, respectively. Among studied agents, only the infection with HPV was significantly different between infertile and fertile groups (p=0.005) which may enhance the likelihood of female infertility (OR=5.30, 95% CI:1.47-19.11, p< 0.05). After adjusting for age, irregular menstrual cycle, abnormal vaginal discharge, and ectopic pregnancy, the odds ratio of infertility in HPV-infected women increased (OR=7.02, 95% CI:1.52-32.3, p<0.05).

Since HPV infection is asymptomatic, periodic screening of women in reproductive age especially infertile couples is recommended for early diagnosis and prevention of infection progression and cross contamination.

Anxiety before Cesarean section (C-section) is one of the common disorders that is caused by different reasons. According to Iranian traditional medicine, temperament indicates the specific characteristics of each person and its understanding is of great benefit in prevention and treatment of diseases and implementing interventions. The present study was conducted to determine the relationship between temperament and anxiety before C-section.

This descriptive analytical study was conducted in 327 pregnant women candidates for C-section in Kerman, Iran 2020-2021. Spielberger State-Trait Anxiety Inventory and Salmannezhad Temperament (Mizaj) Questionnaire were completed at gynecology ward before C-section. Analysis of quantitative data was done applying ANOVA and T-test and analysis of qualitative variables was done using Chi-square test in SPSS V21.

The average age of pregnant women was 29.24±6.33 years and 37.3% were experiencing their second pregnancy. The mean scores for latent anxiety before C-section in cold-tempered mothers and warm-tempered mothers were 54.43±8.29 and 34.44±9.81, respectively, (P=0.001).

The level of latent anxiety before C-section was higher in cold-tempered mothers than warm-tempered and moderate-tempered mothers. Therefore, necessary measures considering traditional medicine are recommended for cold-tempered mothers before surgery.

Vitamin D and glucose play an important role in the female reproductive system.

The aim of this study was to assess the effect of serum and follicular fluid vitamin D on assisted reproductive technique (ART) outcomes.

102 infertile women were enrolled in the study. All cases received the routine in vitro fertilization protocol. On the oocyte retrieval day, a sample of their peripheral blood and follicular fluid was obtained to determine the level of vitamin D and glucose. We also evaluated ART outcomes including oocytes, 2 pronucleus and embryo number, implantation, chemical and clinical pregnancy, and abortion rate. Finally, the effect of serum and follicular fluid vitamin D and glucose on the ART outcomes was assessed.

There was no difference in the characteristics, serum vitamin D, follicular fluid vitamin D, fasting blood sugar (FBS), or follicular fluid glucose between the women with vs. without a positive clinical pregnancy. There was no significant difference between the ART outcomes based on vitamin D level. The mean follicular fluid glucose levels in women who were deficient, insufficient and sufficient in vitamin D were 65.20 ± 14.65, 63.47 ± 14.90 and 55.97 ± 15.64, respectively. Follicular fluid glucose was lower in women with sufficient vitamin D levels and this difference was statistically significant (p = 0.01). There was no relationship between the three follicular fluid vitamin D levels and ART outcomes. In women with normal FBS levels, the level of follicular fluid vitamin D was significantly lower than in the women with pre-diabetic FBS status (p < 0.001).

The present study showed that serum vitamin D level, follicular fluid vitamin D level, FBS, and follicular fluid sugar were not predictive parameters for ART outcomes.

Several mediators play an important role in implantation. One of these mediators is human chorionic gonadotropin (HCG).

To evaluate the effects of HCG intrauterine injection on the day of oocyte retrieval on the result of assisted reproductive techniques (ART).

In this randomized clinical trial study, 126 women who were referred to Afzalipour Infertility Center between December 2018 to December 2019 undergoing in vitro fertilization/intracytoplasmic sperm injection cycles were enrolled and assigned to two groups of: a case (n = 62) and a control group (n = 64). The protocols for both groups were the same; except that the case group was injected with the protocols for both groups were the same, except that the case group was injected with 1000 IU of HCG into uterine cavity following the oocyte puncture, while no medication was administered to the control group. The implantation rate, chemical pregnancy, clinical pregnancy, and abortion rates were compared between the two groups.

Positive chemical pregnancy was seen in 15 (27.3%) cases of the case group and 14 (25.5%) of the control group. No significant difference was seen in the chemical and clinical pregnancy rates between the groups. The abortion rate was higher in the control group but that was not significant.

A 1000 IU of HCG intrauterine injection after oocyte retrieval does not improve implantation, chemical or clinical pregnancy rates in ART cycles. Further studies are needed to clearly understand the role of HCG intrauterine injection in the day of oocyte retrieval in ART outcomes.

The authors regret that the start date of the study was published incorrectly (Pages 671 and 672). The start date must be changed from August 2018 to May 2018. The authors would like to apologize for any inconvenience caused. The online version of article has been updated on July 14, 2021.

Endometrial thickness is regarded as an indicator of the receptivity of the endometrium. Patients preparing for frozen embryo transfer need some interventions in case their endometrium is thin.

This study aimed to compare the clinical outcomes of oral administration of estradiol valerate with its vaginal type in women with inappropriate endometrial thickness.

This cross sectional study comprised of 79 women (cycles) who had undergone frozen-thawed embryo transfer. On the 13th day of the cycle, vaginal sonography was performed in case the thickness of the endometrium was < 7 mm; in the oral group, the patients continued using oral estradiol valerate tablet. However, in the vaginal group, the participants applied estradiol valerate tablet vaginally. Finally, the chemical and clinical pregnancy rate, also, early miscarriage rate were compared between the two groups.

The early miscarriage rate was lower in the vaginal group in comparison with the oral group (p = 0.040). Women in the vaginal group showed a lower rate of chemical pregnancy compared to the oral group, but this difference was not statistically significant (25.0 vs. 34.4%, p = 0.440). The rate of clinical pregnancy in the two groups was not statistically significant, although the vaginal group had a higher pregnancy rate (22.5% vs. 15.6%, p = 0.464), especially in women older than 34 years (37.5% vs. 11.1%, p = 0.355).

Vaginal administration of estradiol tablet in women with thin endometrium leads to a lower rate of early miscarriage.

Aromatase inhibitors prevent the aromatization of androgens into estrogens, which reduces the negative feedback of estrogen on the hypothalamicpituitary axis. It is clear that increasing the secretion of follicle-stimulating hormones results in an increased follicular growth.

This study aimed to evaluate the effect of adding letrozole to gonadotropin on in vitro fertilization outcomes in normal responders.

In this randomized clinical trial, 100 normal responder women candidate for controlled ovarian stimulation were randomly enrolled in two groups (n = 50/each). In the case group letrozole was added to gonadotropin in the antagonist protocol. The control group received the conventional antagonist protocol. The main outcome was clinical and chemical pregnancy; and the second outcomes were the number of mature oocytes, the fertilization rate, estradiol level, and the total dose of gonadotropins.

Basic clinical and demographic features were comparable between the groups. Estradiol level on the day of human-chorionic-gonadotropin administration and the total gonadotropin consumption were significantly higher in the control group than the case group (p = 0.045). In addition, the number of MII oocytes was higher (but not significantl) in the case group than the control group (p = 0.09). Moreover, the endometrial thickness was significantly lower in the case group. There were no significant differences in fertilization rate and chemical and clinical pregnancy rates between the two groups.

Although adding letrozole to gonadotropin in normal responders reduces the total dose of gonadotropin, it does not improve the pregnancy outcomes.

In vitro fertilization is an important therapy for women with polycystic ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet required.

This study was aimed to investigate the efficacy of progesterone primed ovarian stimulation (PPOS) and compare with conventional antagonist protocol in PCOS.

A total of 120 PCOS women who were candidates for assisted reproductive technology treatment from August to January 2019 were enrolled in this RCT and were placed into two groups, randomly (n= 60/each). The PPOS group received 20 mg /day Dydrogesterone orally since the second day of the cycle and the control group received antagonist protocol. The pregnancy outcomes including the chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational sacs/ transferred embryos was compared in two groups.

Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p = 0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS group was higher than antagonist group (p = 0.005). Although there wasn’t sever ovarian hyper simulation syndrome in any participants, mild and moderate ovarian hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical and clinical pregnancy rate were higher in the antagonist group, althoughit was not statistically significant (p = 0.136, p = 0.093 respectively).

Our study demonstrate that PPOS does not improve chemical and clinical pregnancy rate of the infertile women with PCOS.

Embryo transfer (ET) is the last and the most clinical process in assisted reproductive technology cycle. It has been suggested that cervical mucus interacts with an adequate embryo transfer in different ways. A few studies showed that catheter rotation could discharge mucus entrapped in the embryo to neutralize embryo displacement.

The aim of this present study was to compare the outcome of frozen embryo transfer (FET) based on catheter rotation during withdrawal.

In this case-control study, the clinical documents of 240 women who experienced frozen embryo transfer cycles were reviewd. The subjects were divided into two groups (n = 120/each), including A) the rotation treatment group (360°) that underwent ET using catheter rotation and B) the control group including the subjects who experienced ET with no catheter rotation. Clinical and chemical pregnancies and implantation rates were compared between two groups.

Results showed that there is no significant difference between the basic clinical and demographic features of both groups (p > 0.05). A significant difference was observed in terms of the rate of chemical pregnancy between groups (21.7% vs 43.3%, p = 0.001 respectively). In addition, the rate of clinical pregnancy was significantly higher in study group than the control (33.35% vs 14.2%, p = 0.002 respectively).

Our results demonstrated that catheter rotation during withdrawal increased the implantation rate and clinical pregnancy.