جستجوی مقالات مرتبط با کلیدواژه « نتایج بارداری » در نشریات گروه « پزشکی »

The effect of laparoscopic ovarian drilling (LOD) before in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) cycles on pregnancy outcomes is an unclear and challenging subject.

To evaluate the impact of LOD before IVF/ICSI cycles on controlled ovarian stimulation and pregnancy outcomes in polycystic ovary syndrome (PCOS) women with a history of more than 2 IVF failures.

In this randomized clinical trial, women with PCOS diagnosis who referred to Arash Women's hospital, Tehran, Iran for IVF/ICSI cycle from August 2015-January 2018 were evaluated. Eligible participants were allocated into 2 groups randomly (n = 17/each group). The participants in the LOD group (intervention) were treated with laparoscopic couture, and after one month, they underwent IVF/ICSI cycles using the gonadotropin-releasing hormone antagonist protocol. The control group had no intervention. The oocyte and embryo qualities, ovarian hyperstimulation syndrome rate, the rates of chemical and clinical pregnancy and early miscarriage, live birth, and pregnancy complications, were compared between groups.

Finally, 34 participants were evaluated. The controlled ovarian stimulation outcomes were similar between groups. The ovarian hyperstimulation syndrome rate in the LOD group was significantly lower than in the control group (p = 0.04). One case of spontaneous pregnancy was reported in the LOD group. No significant difference was observed between groups in clinical pregnancy, miscarriage, and live birth rates. The rates of pregnancy complications (gestational diabetes mellitus, preeclampsia, and preterm birth) were similar between groups.

Performing LOD before IVF/ICSI cycles did not improve the pregnancy outcomes in PCOS women, a clinical trial with a larger sample size is needed to prove these results.

The success rate of infertility treatment depends on many different factors.

This study aimed to determine the effect of platelet-rich plasma (PRP) on the improvement of pregnancy outcomes in participants with repeated implantation failure.

The study is a randomized triple-blind clinical trial. The study population was 118 women with repeated implantation failure during assisted reproductive technology treatment at Tabriz Jihad-e Daneshgahi ART Center from May 2017 to December 2019. Intervention: Intrauterine injection of autologous PRP. Standard treatment of fetal transfer to the uterine cavity was performed without intrauterine PRP injection in the control group: After 4 wk, the level of β-human chorionic gonadotropin hormone in participants' blood was measured.

Comparing the effect of intrauterine injection of PRP in 2 groups showed the level of β-human chorionic gonadotropin positive in the intervention group was 21 (43.8%), in the control group was 12 (26.1%), odds ratio = 2.20 (0.92-5.26) and p = 0.073.

The therapeutic effect in the intervention group compared to the control regarding the outcome of a successful pregnancy showed that intrauterine injection of PRP can be effective in improving pregnancy outcomes, although this improvement is not significant.

Gestational diabetes mellitus (GDM) is a major pregnancy endocrine problem that has several confirmed risk factors and is associated with adverse pregnancy-related outcomes (PRO).

To evaluate the relationship between GDM diagnosis and the associated risk factors of PRO (maternal, intrapartum, perinatal, and neonatal) in accordance with International Association of Diabetes and Pregnancy Study Groups criteria.

This prospective cohort study was performed with 531 singleton parturient (265 GDM and 266 non-GDM). They were selected consecutively from referral hospitals, and the maternal, intrapartum, perinatal, and neonatal outcomes were assessed.

The major risk factors influencing the GDM diagnosis were maternal age, obesity, family history of diabetes, previous history of GDM, and previous history of macrosomia. In the comparison of PRO between the groups, significant associations were detected for emergency cesarean delivery, preeclampsia, polyhydramnios, premature rupture of membrane, preterm delivery, and neonatal hyperbilirubinemia in the GDM group. In the multivariate logistic regression analysis, a previous history of stillbirth was significantly associated with maternal and perinatal outcomes. The odds ratios (CI 95%) of the PRO in the women with a GDM diagnosis were: maternal = 2.43 (1.51-3.90), intrapartum = 2.05 (1.35-3.11), perinatal = 2.00 (1.29-3.10), and neonatal = 1.68 (1.08-2.62). The PRO was significantly correlated with GDM diagnosis, but not with the risk factors.

The adverse pregnancy outcomes were significantly correlated with GDM diagnosis, and the outcomes were not directly affected by the risk factors. Given the related adverse outcomes for mothers and offspring, early screening and management of GDM is necessary especially in Asians and in low-/middle-income countries.

There is a lack of agreement among fertility specialists with regard to the routine use of mock embryo transfer (MET) before each in vitro fertilization (IVF) treatment cycle. While MET may be beneficial with previous difficult embryo transfer cases, its routine use before first IVF cycle has not been evaluated.

To find out the effect of MET before the first IVF cycle on clinical pregnancy rate.

This is a single-centre randomized controlled trial with a balanced randomization (1:1), carried out between November 2015 and October 2017, with 200 subjects at Homerton university hospital, London, randomized into either MET or control. The primary outcome was clinical pregnancy rate (detection of heart activity on the ultrasound scan), the secondary outcome measures were live birth rate, miscarriage and multiple pregnancy rates, difficult ETs, rate of blood or mucus on the catheter tip.

No significant differences were observed in the baseline or cycle characteristics between the two groups. The clinical pregnancy rate was similar between the MET and control groups based on both intension to treat and per protocol analyses (p = 0.98, p = 0.92, respectively). Additionally, no significant difference was seen in the live birth rate in both groups on intension to treat and per protocol analyses (p = 0.67, p = 0.47), respectively.

Our study concludes that MET prior to first IVF cycle may not improve the success rate in young women without risk factors for a difficult embryo transfer.

Although there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes.

To assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.

A total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively).

The subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively).

In conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles.

Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change.

To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL).

This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10.

The mean of cervical length was 36.5 mm (SD=8.4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm) was significantly associated with SPTL before 35 and 37 wk gestation.
Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94.5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p

Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.