International Journal of Reproductive BioMedicine
Volume:21 Issue: 11, Nov 2023

 Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes.

 This systematic review aimed to assess the relationship between ART and maternal outcomes.

 In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies.

 A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally.

 In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.

 The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are different treatments for sexual disorders, including herbal therapies.

 This study aimed to do a comparison of phytoestrogens and non-phytoestrogens medicinal plant’s effects on sexual health in pre- and postmenopausal women.

 This systematic review and meta-analysis was performed to identify relevant articles in electronic databases such as Web of Science, Scopus, PubMed, Cochrane Library, Google Scholar, and SID for English- and Persian-language articles published up to December 2021. The Cochrane collaboration tool was used to assess the risk of bias. Heterogeneity was assessed using I2 statistics.

 Of 5428 records retrieved by searching the databases, after removing duplicate and irrelevant articles, 39 articles were included based on the inclusion criteria in the study. Finally, 18 articles with 1299 participants were included in the meta-analysis. 18 randomized clinical trial studies of phytoestrogens (n = 13) and non-phytoestrogens (n = 5) plants that used the female sexual function index questionnaire and reported the mean difference (MD) and standard deviation were included in the meta-analysis. The effects of phytoestrogens and non-phytoestrogens plants on the sexual health of postmenopausal women appear to differ significantly from one another, according to the meta-analysis (MD = 7.59; 95% CI = 4.56-10.60 and MD = 3.19; 95% CI = 1.25-5.13, respectively) but this difference was not observed in premenopausal women.

 The effect of phytoestrogens plants is more in menopausal women and they can be advised to use these herbs.

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.

One of the major challenges that hospitals and clinicians face is the early identification of newborns at risk for adverse events. One of them is neonatal respiratory distress syndrome (RDS). RDS is the widest spared respiratory disorder in immature newborns and the main source of death among them. Machine learning has been broadly accepted and used in various scopes to analyze medical information and is very useful in the early detection of RDS.

This study aimed to develop a model to predict neonatal RDS and affecting factors using data mining.

The original dataset in this cross-sectional study was extracted from the medical records of newborns diagnosed with RDS from July 2017-July 2018 in Alzahra hospital, Tabriz, Iran. This data includes information about 1469 neonates, and their mothers information. The data were preprocessed and applied to expand the classification model using machine learning techniques such as support vector machine, Naïve Bayes, classification tree, random forest, CN2 rule induction, and neural network, for prediction of RDS episodes. The study compares models according to their accuracy.

Among the obtained results, an accuracy of 0.815, sensitivity of 0.802, specificity of 0.812, and area under the curve of 0.843 was the best output using random forest.

The findings of our study proved that new approaches, such as data mining, may support medical decisions, improving diagnosis in neonatal RDS. The feasibility of using a random forest in neonatal RDS prediction would offer the possibility to decrease postpartum complications of neonatal care.

 Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments.

 This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy's success.

 This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique.

 In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF.

 OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome.

 In vitro fertilization has advanced in many ways, and new techniques are challenging. Blastocyst transfer is an alternative method for embryo transfer (ET) to improve in vitro fertilization outcomes.

 The present study was performed to determine the effect of pregnancies resulting from ET in the blastocyst stage compared to the cleavage stage in frozen cycles to select a better method of assisted reproduction.

 This cross-sectional study was conducted on 194 women who referred to the Yazd Reproductive Sciences Institute, Yazd, Iran, between April 2019 and December 2020. They had a frozen ET as either cleavage or blastocyst (n = 97/each group). The study compared the pregnancy and fetal outcomes in the 2 groups of ET at the cleavage and blastocyst stages.

 The results showed that the blastocyst stage group had higher levels of anti-Mullerian hormone, ovule number, 2 pronuclear number, and embryo number than the cleavage stage group. The frequency of chemical pregnancies was 52.6% and 36.1% in blastocyst and cleavage group respectively (p = 0.02). Also, the frequency of clinical pregnancies was 41.2% and 22.7% in blastocyst and cleavage group respectively (p < 0.001). No statistically significant difference was observed between 2 groups in abortion, preterm delivery, multiple births, preterm premature rupture of membranes, gestational diabetes and preeclampsia, ectopic pregnancy, neonatal hospitalization in Neonatal Intensive Care Unit, and fetal abnormalities (p > 0.05).

 The results showed that transmission in the blastocyst stage compared to the cleavage stage is associated with an increase in chemical and clinical pregnancy, while other pregnancy outcomes are the same in both groups.

 Uterine blood supply has been identified as a potential factor in implantation failure.

 This study aimed to investigate Doppler indices in the uterine artery, including vascular flow and resistance, as well as the amount of sub-endometrial blood supply in women with a history of repeated implantation failure (RIF) compared to the non-RIF group.

 This cross-sectional study was conducted with 139 women candidates for frozen embryo transfer in Yazd Reproductive Sciences Institute, Yazd, Iran from February to July 2023. Group A (n = 68) included women with a history of more than 2 RIF, and group B (n = 71) included women candidates for implantation for the first time without RIF. Doppler ultrasound indices of uterine artery and sub-endometrium, including sub-endometrial flow, uterine artery flow, uterine artery resistance, and peak systolic velocity, were recorded.

 No significant differences were observed in uterine artery Doppler pulsatility index and peak systolic velocity between groups, but the uterine artery resistance index was significantly higher in the A group (p < 0.001). A significant difference was observed in the perfusion area between groups. 60/68 women in the group A had endometrial perfusion in areas 2 and 3 (p < 0.001).

 Our study revealed that women with RIF exhibited higher resistance index in sub-endometrial arteries compared to the non-RIF group.

 Clomiphene citrate (CC) has been suggested to increase the chance of sperm retrieval with microdissection testicular sperm extraction (micro-TESE).

 This study aimed to evaluate the effect of CC on micro-TESE results, due to the great controversy in this regard.

 112 participants were included in this cross-sectional study and were divided into a case (n = 54) and a control group (n = 58) diagnosed with non-abstractive azoospermia. The case group received 25 mg of CC daily for 3 months, while the control group did not receive anything. All participants underwent micro-TESE by an andrologist, and at the end, the results were compared between groups. Hormone tests, including follicle-stimulating hormone, luteinizing hormone, testosterone, and prolactin were analyzed.

 The mean age of participants was the same in the case and the control groups, and no significant relationship was observed between the 2 groups (p = 0.16). 25.9% of sperm and 31.0% of sperm were observed and extracted in the CC-treated and the control group, respectively.

 Our findings showed that after receiving CC, the number of sperm extraction did not increase but it rather decreased. However, the initial level of hormones such as testosterone, follicle-stimulating hormone, luteinizing hormone, and prolactin, and the men's age, testicle size, smoking, and opium addiction, underlying diseases had no significant relationship in the 2 groups and did not affect the results.