Abortion Rate Research Articles

Progress in High Intensity Focused Ultrasound Ablation for Fertility Preservation Therapy of Uterine Fibroids and Adenomyosis.

High intensity focused ultrasound (HIFU) is an effective and safe non-invasive treatment method, widely used in the treatment of uterine fibroids and adenomyosis in the field of gynecology. The side effects in HIFU is low in incidence and mild. HIFU can significantly alleviate the symptoms of patients, reduce lesion volumes, improve quality of life, and has good cost-effectiveness. HIFU can accurately ablate the uterine fibroids and adenomyosis lesions, without destroying normal myometrium and endometrium, and thus HIFU is a promising alternative to myomectomy in uterine fibroids patients with fertility desire. Several studies have shown that in terms of ovarian endocrine function protection, HIFU treatment is superior to uterine artery embolization, and similar to myomectomy. Existing limited researches show that patients with uterine fibroids have a favorable pregnancy rate and live birth rate, as well as a lower natural abortion rate after HIFU treatment. Pregnancy rate after HIFU treatment for uterine fibroids is not lower than myomectomy, and higher than uterine artery embolization. HIFU may have significant advantages in shortening pregnancy interval compared with myomectomy. However, the proportion of cesarean section delivery after HIFU treatment is relatively high, and gestational uterine rupture after HIFU treatment exist in literature. Higher quality clinical data is needed to confirm the pregnancy outcomes and safety after HIFU treatment in future.

Comparative analysis of pregnancy outcomes in different time intervals following GnRH antagonist stimulation and modified natural frozen-thawed embryo transfers

To evaluate whether the interval between oocyte retrieval and frozen-thawed embryo transfer (FET) affects clinical outcomes using modified natural cycle (mNC) regimen following freeze-all GnRH antagonist stimulation. A total of 542 patients underwent first mNC-FET were divided into two groups: immediate (FET conducted in the first menstrual cycle after freeze-all) and delayed (FET performed in the second or subsequent menstrual cycle) groups. The immediate group was associated with a notably reduced duration between oocyte retrieval and transfer day (35.5 ± 5.8 vs. 88.7 ± 35.5 d, P < 0.001). Regarding pregnancy results, the immediate cycles resulted in comparable implantation rate (55.3% vs. 57.2%, P = 0.624), clinical pregnancy rate (66.9% vs. 72.2%, P = 0.236), abortion rate (16.1% vs. 12.7%, P = 0.402), ongoing pregnancy rate (59.0% vs. 65.0%, P = 0.204), and live birth rate (56.1% vs. 63.0%, P = 0.149) with the delayed cycles. After the multivariable logistic regression analysis, the difference in live birth outcome between the two regimens remained insignificant (immediate vs. delayed protocol: adjusted odds ratio = 0.87, 95% confidence interval= 0.56–1.33). Immediate mNC-FET following a freeze-all antagonist cycle displayed promising clinical outcomes and significantly shortened the time to conception compared to delayed FET.

Influence of different concentrations of milk urea nitrogen on the reproductive performance of Holstein cows.

The purpose of this study was to assess how various MUN levels affected the reproductive performance traits of Iranian Holsteins. The dataset used in this study included reproduction performance records for 16,000 Holstein cows and was gathered by the Animal Breeding Center and Promotion of Animal Products of Iran on 30 large dairy herds during 2018-2021. The MUN concentrations were grouped into four classes: [Formula: see text] mg/dL (MUN1), [Formula: see text] mg/dL (MUN2), [Formula: see text] mg/dL (MUN3), and [Formula: see text] mg/dL (MUN4). The study took into account various reproductive and fertility traits, such as the number of inseminations per conception (NINS), the percentage of pregnant cows till 120 days in milk (PP120), the calving interval (CI), the days open (DO), the days from calving to the first service (DCFS), the first service conception rate (FSCR), and the abortion rate (ABR). The impact of MUN levels on the incidence of abortion and non-pregnancy in dairy cows was investigated using logistic regression models. Also, to evaluate the effect of MUN concentrations on reproduction traits, a generalized linear model was used. The MUN2 group had the greatest odds of non-pregnancy (P < 0.05; OR = 2.81; MUN2 vs. MUN1). Also, the MUN4 group had the greatest odds of abortion (P < 0.01, OR = 3.36; MUN4 vs. MUN1). The MUN2 and MUN4 groups had the greatest (51.91%) and the lowest (34.32%) FSCR, respectively. MUN classes had a significant influence on DO (P < 0.05), and MUN4 had the largest value (145.44 days). The results indicated the negative association between MUN with reproduction and fertility in Iranian Holsteins.

Comparative study on pregnancy complications: PGT-A vs. IVF-ET with gender-specific outcomes

The safety and clinical effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) in improving pregnancy outcomes for sub-fertile patients remains controversial. Potential sex-based differences in the relationship between PGT-A and pregnancy complications have not been investigated, which could guide the appropriate clinical application of PGT-A. In this secondary analysis of data from a multicenter, randomized, controlled, non-inferiority trial (NCT03118141), 940 women who achieved singleton live birth during the trial were included to estimate the between-group differences in pregnancy complications following PGT-A versus conventional in vitro fertilization (IVF) vary with fetal sex. Logistic regression analysis was used to adjust for possible confounders, and subgroup analysis was also performed. Among male fetuses, the risk of maternal preeclampsia was significantly lower after PGT-A compared to conventional IVF treatment (3.37% vs. 7.88%; adjusted OR, 0.40; 95% CI, 0.17-0.92; P = 0.032). However, this protective effect was not observed in pregnancies with female fetuses (3.63% vs. 3.38%; adjusted OR, 1.04; 95% CI, 0.36-3.00; P = 0.937). In addition, no significant sex-dependent differences in the risks of other pregnancy complications or neonatal outcomes were detected between PGT-A and conventional IVF groups (P &amp;gt; 0.05). In summary, PGT-A was associated with a decreased risk of maternal preeclampsia in singleton pregnancies with male fetuses, highlighting its potential utility in preeclampsia prevention in addition to spontaneous abortion rate reduction.

Effects of the Affordable Care Act on Contraception, Pregnancy, and Pregnancy Termination Rates.

To investigate the effects of the Affordable Care Act (ACA) and its elimination of cost-sharing on contraception utilization, pregnancy rates, and abortion rates. We conducted a retrospective cohort study within a healthcare system serving over 4.5 million insured members across 21 medical centers and 250 clinics. The study included women aged 18-45 with continuous health plan membership for at least two years in the pre-ACA (2007-2012) and post-ACA (2013-2018) periods. We analyzed out-of-pocket (OOP) costs for contraception, including oral contraceptives and long-acting reversible contraception (LARC), before and after the ACA's implementation. We then examined how the elimination of OOP costs affected contraception use, pregnancy rates, and abortion rates. The study identified 1,523,962 women of childbearing age. In 2013, cost sharing for contraception sharply declined, with average annual OOP costs dropping from $88-$94 pre-ACA to nearly zero post-ACA. Contraceptive use increased overall, rising from 30.2% pre-ACA to 31.9% by the study's end, with a notable rise in LARC use. In interrupted time-series analyses, while contraception use continued to increase post-ACA, new pregnancy rates declined at a faster rate than pre-ACA, and abortion rates continued to fall, though at a slightly slower pace than pre-ACA (p<0.05 for all trends). The Affordable Care Act's elimination of contraception cost-sharing led to increased contraception use, particularly LARC methods, and contributed to declines in both pregnancy and abortion rates. This suggests that improving access to effective contraception is a key strategy in reducing unintended pregnancies.

Reproductive outcomes after fertility-sparing surgery for cervical cancer - results of the multicenter FERTISS study

IntroductionFertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity. MethodologyInternational multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode. ResultsOf the 733 patients treated at 44 centres in 13 countries, 49.7% attempted to conceive during median follow-up of 72 months and 22.6% (166/733) patients achieved a successful pregnancy. Success rate was significantly higher after non-radical surgery (63.2%; 122/193) compared to radical trachelectomy (25.7%; 44/171, p < 0.001). Available perinatological data shows that 89.5% (111/124) of the patients became pregnant naturally. There was no significant difference in the abortion rate in the first pregnancy nor delivery success rates between non-radical and radical procedures patients. Preterm delivery (<38 weeks gestation) occurred more frequently after radical than non-radical procedures (76.5% vs. 57.7%, p = 0.15). Almost all patients (97.3%; 73/75) who underwent regular ultrasound cervicometry in pregnancy with subsequent prophylactic procedures delivered a live fetus, compared to 30.6% (15/49) women without such management, p < 0.001. ConclusionPatients who underwent non-radical surgery had significantly higher pregnancy rates. Most pregnancies resulted in a viable fetus, but radical trachelectomy led to a higher rate of preterm births in the severe prematurity range. Half of the patients did not attempt pregnancy after FST.

Application of disposable digital hysteroscope for outpatient hysteroscopy in women undergoing artificial assisted reproductive procedures: a clinical research

BackgroundHysteroscopy is the preferred method for the diagnosis and treatment of uterine diseases. With the increasing demand for outpatient hysteroscopy, disposable digital hysteroscopy has emerged, which can meet the requirements of diagnosis and treatment integration, and greatly reduce the labour and storage costs.MethodsA total of 108 outpatients who underwent hysteroscopy using disposable digital hysteroscope were divided into two groups: the non-porous group (group A, n=49) and the married with child group (group B, n=59). The patients’ general information and clinical data were recorded and statistical analysis was performed.ResultsNo differences were found between the age, weight, body mass index, menopausal status and indication for hysteroscopy of the two groups. The most common indication was embryo transfer failure. The surgical success rate of 108 patients was 100%, the concordance rate between hysteroscopic diagnosis of chronic endometritis and pathological diagnosis was 94.44% (68/72), while the false positive rate stood at 38.89% (14/36). Additionally, incidental findings rate for endometrial polyps was 92.00% (23/25) with a low false positive rate of only 6% (5/83). The mean visual analogue scale score of group A was 2.285±0.180, which was not significantly different from group B (p=0.483, 95% CI(−0.60-0.44)). The pregnancy rate among patients who received assisted reproductive technology and were followed up for 1 year after surgery was 66.67% (40/60), while the abortion rate stood at 5.00% (3/60).ConclusionsThe disposable digital hysteroscope is a valuable and effective tool for outpatient hysteroscopy.

Sequence of events leading to medical abortion for fetal indications after 34 weeks' gestation: 23 years of experience in a single medical center.

Technical advances are rapidly improving the ability to detect anatomical malformations and genetic abnormalities during pregnancy. We aimed to identify the sequence of events leading to medical abortion ≥ 34 weeks' gestation, to determine whether the procedure could have been carried out earlier. Retrospective study of medical abortions in singleton pregnancies carried out in our department over a 23-year period from1998 to 2021. 36/4055 (0.88%) abortions were carried out ≥ 34 weeks' gestation. The indications were anatomical in 20 (55%), chromosomal or genetic in 14 (39%) and CMV infection In two. Evaluation of the sequence of events suggests that an earlier diagnosis would have been unfeasible before the third trimester in 18 cases (50%) because the disorder was developmental and ultrasound findings would not have presented earlier. By contrast, certain other cases might have been diagnosed earlier if the patient had not delayed routine screening or if screening had been administered on schedule. In this series, full adherence to local screening tests and protocols, and timely decision-making could have substantially reduced the late abortion rate by as much as half.

Ovule abortion accompanied by programmed cell death in Castanea mollissima

Chinese chestnut (Castanea mollissima Blume.) ovary contains 12-18 ovules, but only one can develop and grow normally, which indicates that the abortive rate of ovules can go as high as 94%. In this study, we observed the developmental characteristics and cytological changes of abortive ovules and fertile ovules during development. Morphological analysis showed it would take about 15∼20 days from globular to cotyledon embryo in fertile ovules, which is accompanied with the formation and apoptosis of endosperm. But there were stark differences in the nutrient transport, microstructure and ultrastructure of fertile and abortive ovules. The fluorescence disodium fluorescein and FDA indicated that all ovules were viable at early stages, but some ovules became inactive at different times as the ovary developed. Fluorescence labelling and ultrastructure showed cell nuclei of abortive ovules were disintegrated at 25 days after anthesis (DAA). Compared with the fertile ovules, starch grains were synthesized at earlier periods, but disappeared immediately, and the cells were usually irregular in shape, and had folded cell membranes in the abortive ovules. Furthermore, the Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was carried out to assess programmed cell death in fertile and abortive ovules, results showed that DNA fragmentation was occurred in the cells of abortive ovules. In short, these results provide new insights into ovule abortion in the angiosperm.

Effects of multilevel postpartum family planning intervention on the reduction of unintended pregnancy and induced abortion rates within 12 months of delivery: a cluster randomized controlled study in China

Effects of multilevel postpartum family planning intervention on the reduction of unintended pregnancy and induced abortion rates within 12 months of delivery: a cluster randomized controlled study in China

“When you provide abortion services, you are looked upon as a bad guy”: experiences of abortion stigma by health providers in Nigeria

ABSTRACT Background Abortion stigma as reported globally has been inadequately documented empirically in Nigeria, Africa’s most populous country with a restrictive abortion law and a high rate of unsafe abortions. Objective The objectives of this study were to investigate the ways in which abortion stigma is experienced by Nigerian health professionals and how such experiences influence health professionals’ practice of safe abortion and post-abortion care. Methods The study utilized qualitative research consisting of in-depth interviews with 10 abortion providers. We elicited information with an open-ended interview guide that investigated the understanding of participants’ experiences of abortion stigma in Nigeria. The data were analysed qualitatively and thematically using Atlas.ti. Results The themes centred on perceptions and experiences of stigma among the providers interviewed. Participants’ experiences of abortion stigma included the following: being treated differently to other health professionals; experiencing disapproval and disrespect; name-calling and societal judgement; tagging and profiling of clinics by anti-abortionists; and social isolation. Participants attributed stigma to cultural and religious beliefs, the restrictive national abortion law, and pointed to hypocrisy. Some reported effects of stigma on providers included a feeling of insecurity, social exclusion, secrecy, and insincerity in clinical practice, discouragement, and guilt feelings. Despite the negative impacts, many respondents reported a sense of satisfaction stemming from their views that they were saving lives. Conclusion Systematic efforts to address these adverse factors could reduce the level of stigma experienced by providers, with a potential follow-through effect of improving women’s access to safe abortion care in Nigeria.

A Forensic Investigation and Critique of Suicidal Ideation Reported in a Turnaway Study.

In a published report of suicidal ideation rates drawn from the Turnaway Study, the abortion advocacy group Advancing New Standards in Reproductive Health (ANSIRH) asserted that their findings proved that abortion has no effect on suicidal ideation. Therefore, laws requiring notification of abortion's link to higher suicide rates were not based on good science. But how good is the science ANSIRH offers to displace the evidence of an abortion-suicide connection? The Turnaway Study upon which they rely is drawn from a non-random, non-representative convenience sample that suffered from a 68% refusal rate and a 50% attrition rate. No conclusions applicable to the general population of aborting women can be drawn from such a sample. Moreover, on closer examination, ANSIRH's suicidal ideation trajectory analysis is severely flawed and violates Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Basic and critical information is withheld, specifically the mean scores and number of women identified as having suicidal thoughts. Instead, readers are provided with only highly massaged results from a mixed-effects logistic regression employing thirteen covariates that appear to have been chosen precisely to water down the confidence intervals to such a high degree that virtually nothing was statistically significant. In addition, ANSIRH suggested that an attrition analysis of three of the covariates used strengthened the reliability of their finding. However, the fact that they chose not to report on attrition rates associated with the other ten covariates, much less the two outcome variables related to suicidal ideation, actually exposes the falsity of this reliability claim. Rather than proving that abortion has no effect on suicidal behaviors, ANSRIH's published analysis provides evidence of deliberate obfuscation and disinformation by a group funded and dedicated to the expansion of abortion rates around the world.

The effects of fresh embryo transfer and frozen-thawed embryo transfer on the perinatal outcomes of single fetuses from mothers with PCOS.

To investigate the effects of fresh embryo transfer and frozen-thawed embryo transfer on perinatal outcomes among patients with PCOS. Patients who underwent in vitro fertilization and embryo transfer at the reproductive medicine center of the Affiliated Hospital of Guangdong Medical University from February 2013 to March 2021 were retrospectively analyzed. Patients were divided into the fresh embryo transfer group and frozen-thawed embryo transfer group according to whether fresh embryo transfer was performed. According to their conditions, patients were further classified into the ET-PCOS group (group A, n = 104), ET-non-PCOS group (group B, n = 212), FET-PCOS group (group C, n = 102), or FET-non-PCOS group (group D, n = 148); the general data, laboratory indicators and pregnancy outcomes of the patients were statistically analyzed, and the perinatal outcomes and related factors between the groups were compared and analyzed. The level of E2 on the HCG test day in the ET group was lower than that in the FET group. The natural birth rate of group D was lower than that of group A and group B, and the cesarean section rate was higher than that of group A and group B; the clinical pregnancy rate of group A was higher than that of group B and group D, and the difference was statistically significant (P < 0.05). There was no significant difference in the total abortion rate, early abortion rate or late abortion rate between the groups (P > 0.05). There was no significant difference in gestational age, neonatal sex or neonatal weight between the groups (P > 0.05). The incidence of placenta previa in Group B was significantly lower than that in Group D, and the difference was significant (P < 0.05). The incidence of fetal distress in Group B was significantly lower than that in Groups C and D, and the incidence of neonatal jaundice in Group D was significantly higher than that in Groups A and B (P < 0.05). In the multivariate analysis, the number of high-quality embryos was independent factors affecting clinical pregnancy, and the embryo transfer method was an independent factor affecting fetal distress and neonatal jaundice. Young PCOS patients without risk of OHSS have a high clinical pregnancy rate with fresh transplant cycles. PCOS disease itself has no significant effect on the perinatal outcomes of the mother or singleton infant. Frozen-thawed embryo transfer may increase the incidence of low placenta, fetal distress and neonatal jaundice.

Prevalence, reasons, and attitude towards abortion among Iranian married women of reproductive age in Qazvin province

Background and aimsAbortion influences the composition and size of population. Estimating the overall and type-specific abortion rates, the reasons to choose the abortion can be helpful in designing and implementing preventive intervention. Therefore, the present study was designed to determine the: (i) prevalence of abortion, (ii) attitude of married women of reproductive age towards abortion, and (iii) reasons for choosing abortion by married women of reproductive age in Qazvin province.MethodsA cross-sectional study was conducted between February and April 2023, and comprised married women of reproductive age (N = 1571) referred to urban and rural comprehensive health centers in five cities of Qazvin province. Utilizing multi-stage proportional sampling process, data for the survey (including demographic and fertility information, reasons for choosing abortion, and attitudes toward abortion) were collected online.ResultsThe lifetime prevalence of abortion was 18.6% (among the total sample). The past-year prevalence was 22.3% (among those who reported having had an abortion). Of those reporting having had an abortion, 73.6% reported it was their first one, and 65.1% reported it was non-spontaneous . Women’s reasons for choosing abortion fell into one of three main clusters: (i) couple’s behavior, health and relationship problems, (ii) fertility-related stressful experiences, and (iii) family economic situations. The main reported reason to choose abortion was a couple’s behavior (e.g., drug use), health (e.g., physical disease, psychological problems), and relationship problems (e.g., sexual infidelity, divorce) explaining 27% of the variance. Also, pro-abortion attitude was the most important attitude towards non-spontaneous abortion explaining 26.33% of variance. The variables that increased the likelihood of non-spontaneous abortion included choosing a reason for abortion vs. having no reason (OR = 1.77, p = 0.05), having poor vs. good mental health (OR = 1.74, p = 0.03), having a pro-abortion attitude (OR = 1.09, p = 0.09), and having ≥ 3 children vs. having no children (OR = 0.53, p = 0.06).ConclusionWomen in high-risk groups for non-spontaneous abortion (i.e., those aged over 35 years, those married for more than five years, those with an infertility history, those with a lower number of children, those living in rural areas, and those having poor mental health status) should be assessed by primary healthcare services during preconception and have early prenatal counseling to help in decisions regarding abortion.

Impact of gestational age on the management of acute appendicitis during pregnancy: A nationwide observational study.

To compare conservative management and appendectomy for acute appendicitis during pregnancy by trimester. This retrospective cohort study used data from a national inpatient database from July 2010 to March 2022. Pregnant women diagnosed with acute appendicitis were included. Multivariable analysis using generalized estimating equations was performed to compare outcomes between conservative management and appendectomy across trimesters. The main outcomes were preterm labor, preterm delivery, or abortion; antepartum hemorrhage; duration of hospitalization; and duration of antibiotic use. A total of 3158 individuals from 632 acute-care hospitals were eligible. The proportion of conservative management versus appendectomy by trimester were 507 (49.1%) versus 525 (50.9%) in the first, 690 (44.6%) versus 856 (55.4%) in the second, and 337 (58.1%) versus 243 (41.9%) in the third. In the second trimester, appendectomy was associated with a higher rate of preterm delivery, preterm labor, or abortion (odds ratio [OR], 2.91 [95% confidence interval (CI), 1.62-5.25]). Antepartum hemorrhage occurred more frequently for appendectomy in the first (OR, 2.12 [95% CI, 1.31-3.43]) and third (OR, 2.43 [95% CI, 1.79-3.31]) trimesters. Appendectomy was associated with a longer duration of hospitalization in the second (2.15 days; 95% CI, 1.14-3.17 days) and third (3.97 days; 95% CI, 2.22-5.71 days) trimesters. Antibiotic use duration was shorter for appendectomy in the first (-1.20 days [95% CI -1.51 to -0.90 days]) and second (-0.61 days [95% CI -0.90 to -0.32 days]) trimesters. Clinical outcomes of acute appendicitis during pregnancy vary by trimester. Considering the appendectomy risks, conservative management may be viable depending on the clinical context and trimester.

Occurrence of Abortion in Different Breeds of Goats Reared under Semi-intensive Farming System at Organized Farms in Semi-arid Region of India

Background: Abortion is a major health problem of animals including goats, which results in significant financial losses for the farmers. The aim of the current study was to determine the occurrence of abortion in different breeds of goats reared under semi-intensive farming system at the organized farms in the semi-arid region of India, and to determine the relationship between the parity, season, and pregnancy stage of the aborted goats with the incidence of abortions. Methods: The data on the caprine abortions was collected and analyzed. The caprine abortions that occurred at the organized farms under a semi-intensive management system were categorized according to the season at the time of abortion, parity and pregnancy stage of the aborted goats. The Chi-Square test and ANOVA methods were used for the statistical analysis of the abortion data. Result: The occurrence of abortion in goats (combined farm) had a significant association with seasons and stages of pregnancy, whereas it was not associated with parities. Barbari, Jakharana and Jamunapari goats individually showed significant differences in abortion rates across various seasons, but did not exhibit significant variation in abortion rates with respect to different stages of pregnancy or parities. In the study, the majority of abortions were found in the winter season, followed by the rainy and summer seasons; similarly, most of the abortions were noticed in the later stage of pregnancy, followed by the mid- and early stages. There was the highest abortion rate in the goats with parity 3 and above, followed by the first and second parities. Further investigation is required to validate the current findings. In conclusion, the study revealed that abortion rates in goats are significantly influenced by seasonal changes and the stages of pregnancy.

Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer

Objective: To compare the pregnancy outcome of the fresh cycle or freeze-thaw cycle embryo transfer of patients treated with a long follicular phase regimen and antagonist regimen, and explore the clinical therapeutic effect of the two regimens. Methods: This was a retrospective study. The data of a total of 543 patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) or frozen-thawed embryo transfer (FET) in Baoding Maternal and Child Health Care Hospital from January 2020 to December 2022 were retrospectively analyzed in this study and were divided into four group to analyze the basic conditions, medication, laboratory indicators and clinical outcomes after embryo transfer of patients in each group. Results: The pregnancy rate and implantation rate in Groups A, B and C were higher than those in Group-D, and the differences were statistically significant (p&lt;0.05). The difference in multiple pregnancy rate and abortion rate among groups was not statistically significant (p&gt;0.05). The influencing factors of clinical pregnancy rate were identified by binary Logistic regression analysis. Advanced age was found to be a risk factor for improving the pregnancy rate, while the increase in the number of oocytes retrieved is a protective factor for improving the pregnancy rate. The differences were statistically significant (p&lt;0.05). Conclusion: The antagonist regimen has a low dosage and short medication time and can achieve a high embryo utilization rate and blastula formation rate, saving time and cost for patients. doi: https://doi.org/10.12669/pjms.40.10.9050 How to cite this: Li P, Zhai J, Liu T, Guo M, Wang Y. Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer. Pak J Med Sci. 2024;40(10):2170-2175. doi: https://doi.org/10.12669/pjms.40.10.9050 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Optimal treatment strategies for gallbladder disease in pregnancy: a systematic review with dual network meta-analyses.

This study sought to determine the optimal treatment strategy and timing for cholecystectomy in managing gallbladder diseases during pregnancy. It evaluated the effectiveness of conservative management (CM), laparoscopic cholecystectomy (LC), and open cholecystectomy (OC) in pregnancy and compared cholecystectomy outcomes across three trimesters. Studies comparing CM, LC, and OC or evaluating cholecystectomy outcomes across trimesters were included in a literature search until February 2024. Studies included were required to have at least 10 cases per treatment group and perform statistical comparisons. Two Bayesian network meta-analyses (NMAs) were conducted, and surface under cumulative ranking area (SUCRA) values, risk ratio (RR), mean difference (MD), and 95% credible intervals (CrIs) were calculated for outcomes of interest. Our study included 17 studies with 63,523 pregnant patients. The first NMA included data from 12 studies involving 29,052 pregnant women, revealing that LC had the lowest risk for preterm delivery, significantly lower than CM (RR: 0.23, 95% CrI: 0.07-0.55). LC also had a significantly reduced risk of fetal complications (RR: 0.42, 95% CrI: 0.16-0.57) and maternal complications (RR: 0.44, 95% CrI: 0.15-0.50) compared to OC. LC was associated with a significantly shorter length of stay than OC (MD: -2.77, 95% CrI: -8.37 to -2.87). The second NMA analyzed data from five population-based studies with 34,471 pregnant patients, finding no significant differences in preterm delivery and abortion rates across the three trimesters following cholecystectomy. Cholecystectomy performed in the third trimester significantly increased the risk of maternal complications, with relative risks compared to first (RR: 0.48, 95% CrI: 0.22-1.00) and second trimesters (RR: 0.42, 95% CrI: 0.21-0.93). LC is deemed the optimal treatment for gallbladder diseases during pregnancy. While cholecystectomy is safe to be performed across all trimesters, careful deliberation is recommended during the third trimester due to an increased risk of maternal complications.

A Statement on Abortion by 170 Obstetricians/Gynecologists after the Reversal of Roe v Wade.

In a recent American Journal of Obstetrics and Gynecology, 900 professors submitted a Special Report calling for reinstating federal protection for abortion. Here, we provide an alternative consensus statement. Induced abortion is not a constitutional right. We, too, value patient autonomy, but autonomy does not allow for causing harm to another human being, in this case, the human fetus. We share concern about maternal mortality in the United States, but evidence shows that induced abortion increases, not decreases, maternal mortality. We share the authors' concern for the effect of induced abortion on minority populations and mourn the fact that the abortion rate in non-Hispanic black patients is three times that of non-Hispanic white patients and twice that of Hispanic patients. Many obstetricians/gynecologists, like ourselves, do not support abortion, and most obstetricians/gynecologists do not perform abortions. Induced abortion is not necessary to provide evidence-based care. We also have seen tragic situations and misinformation and want to work toward addressing these issues. We support the highest level of clinical practice, bodily autonomy, reproductive freedom, and evidence-based care for both our patients-the pregnant woman and the human being in utero-whom we have dedicated our lives to serving.

Evaluation of the phase-specific antibody response in water buffalo (Bubalus bubalis) after two doses of an inactivated phase I Coxiella burnetii vaccine

The control and management of Q fever outbreaks in ruminants are currently based on vaccination. Although buffalo (Bubalus bubalis) are intensively farmed in several countries and represent a reservoir for Coxiellosis, no evidence has been described regarding the efficacy of vaccination in this species. This work aimed to evaluate the humoral response, using appropriate phase-specific ELISAs, and the effects on abortion rate in buffalo by a field study. A total of 15 seropositive and 20 seronegative animals were vaccinated twice, three weeks apart, with a commercial phase I vaccine, and phase-specific antibodies were determined in the course of vaccination. Although anti-phase II antibody reactivity predominated after vaccination compared to phase I, both anti-phase I- and -phase II-antibody-reactivity significantly increased after the first (p = 0.001) and again after the second vaccination (p = 0.05). Seroconversion did not significantly depend on age or natural infection status. Once the vaccination cycle was completed, the herd study observed a reduced rate of abortion and placenta retention. Our data demonstrated that the vaccine principally induced a similar antibody response as in goats and sheep. These preliminary data appeared to support vaccination in buffalo, even in seropositive animals, although further studies are needed to better define the dynamics concerning seroconversion in this species.