Differences In Pregnancy Outcomes Research Articles

The frequency and clinical significance of intra-amniotic inflammation in twin pregnancies with preterm labor and intact membranes

Objective: The objective of this study is to evaluate the frequency and clinical significance of intra-amniotic inflammation in twin pregnancies with preterm labor and intact membranes.Study design: Amniotic fluid (AF) was retrieved from both sacs in 90 twin gestations with preterm labor and intact membranes (gestational age between 20 and 34 6/7 weeks). Preterm labor was defined as the presence of painful regular uterine contractions, with a frequency of at least 2 every 10 min, requiring hospitalization. Fluid was cultured and assayed for matrix metalloproteinase-8. Intra-amniotic inflammation was defined as an AF matrix metalloproteinase-8 concentration >23 ng/mL.Results: The prevalence of intra-amniotic inflammation for at least 1 amniotic sac was 39% (35/90), while that of proven intra-amniotic infection for at least one amniotic sac was 10% (9/90). Intra-amniotic inflammation without proven microbial invasion of the amniotic cavity was found in 29% (26/90) of the cases. Intra-amniotic inflammation was present in both amniotic sacs for 22 cases, in the presenting amniotic sac for 12 cases, and in the non-presenting amniotic sac for one case. Women with intra-amniotic inflammation observed in at least one amniotic sac and a negative AF culture for microorganisms had a significantly higher rate of adverse pregnancy outcome than those with a negative AF culture and without intra-amniotic inflammation (lower gestational age at birth, shorter amniocentesis-to-delivery interval, and significant neonatal morbidity). Importantly, there was no significant difference in pregnancy outcome between women with intra-amniotic inflammation and a negative AF culture and those with a positive AF culture.Conclusion: Intra-amniotic inflammation is present in 39% of twin pregnancies with preterm labor and intact membranes and is a risk factor for impending preterm delivery and adverse outcome, regardless of the presence or absence of bacteria detected using cultivation techniques.

Pregnancy outcome variables and associated factors in different nationalities living in Kuwait.

This study aimed to investigate differences in pregnancy outcome among various nationalities residing in Kuwait. Cross-sectional data were collected from 369 mother-infant dyads at delivery on mother height (MH), mother haemoglobin (mHb), child haemoglobin (cHb), mid-upper arm circumference (MUAC), gestational age (GA), placental weight (PW), birth weight (BW), crown-heal length (CHL), and head circumference (HC). Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH. Kuwaiti and Indian women had lower PW and their babies had lower HC and CHL. Prevalence of anaemia (Hb <11.0 g/dL) ranged from 7.1% (Lebanese) to 30.0% (Kuwaiti) with the overall prevalence of 19.5%. Prevalence of low birth weight was 3.5%. Multiple linear regression analysis revealed PW as a significant predictor of BW, CHL and HC. Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH.The significance of these differences and their contributing factors needs further research.

Paternal Age Is Not Associated With Pregnancy Outcomes After Single Thawed Euploid Blastocyst Transfer.

Although controversial, increasing paternal age has been shown to negatively affect assisted reproductive technology (ART) outcomes and success rates. Most studies investigating the effect of paternal age on ART outcomes use a donor oocyte model to minimize maternal aneuploidy contribution. This study sought to determine whether increasing paternal age is associated with adverse in vitro fertilization (IVF) outcomes when aneuploidy is minimized using preimplantation genetic screening. There were 573 single thawed euploid embryo transfers from 473 patients undergoing oocyte donor and autologous IVF cycles. Cycles were categorized according to paternal age at oocyte retrieval, and an age adjustment was performed for maternal age in order to evaluate for an isolated paternal age effect. Fertilization rate was found to decrease significantly with increasing paternal age ( P = .04). After controlling for oocyte age, there was no significant difference in pregnancy outcomes across all paternal age categories after euploid embryo transfer, including implantation rate ( P = .23), clinical pregnancy rate ( P = .51), and spontaneous abortion rate ( P = .55). Therefore, if a couple is able to produce and transfer a single thawed euploid embryo, no difference in IVF pregnancy outcomes is identified with increasing paternal age.

Are pregnancy rates affected by day of blastocyst cryopreservation in single euploid frozen embryo transfer cycles?

There is inconclusive evidence whether day of cryopreservation of euploid embryos affects pregnancy rates. We sought to compare pregnancy outcomes between euploid blastocyst embryos cryopreserved on either day 5 or 6. Retrospective cohort study. 126 cycles performed at a large university-based center during a period of January 2013 through December 2016 were evaluated. Euploid embryos cryopreserved on either day 5 (n=77) or day 6 (n=51) and utilized in a single frozen embryo transfer (FET) cycle were included for analysis. Preimplantation genetic screening was performed by either array Comparative Genomic Hybridization or Next-Generation Sequencing. Only high quality blastocyst embryos were biopsied and frozen. The primary outcome was ongoing pregnancy rate (OPR). Secondary outcomes included implantation rate (IR), clinical pregnancy rate (CPR), clinical loss rate (CLR) and multiple gestation rate (MGR). Student’s t-test and Mann-Whitney test were used to assess continuous variables depending on how the data was distributed. Chi-square was used to assess categorical variables. Multivariate logistical regression was performed to control for potential confounding variables. A p-value <0.05 was considered statistically significant. No significant differences were noted between the groups for age (35.5±4.3 vs. 35.5±4.0), BMI (25.8±5.8 vs. 25.2±4.6), AMH level (3.1±2.3 vs. 3.6±4.4), previous live birth (37.7% vs. 49.0%), diagnosis of recurrent pregnancy loss (RPL) (23% vs. 14%) and number of prior FET cycles (0.3±0.7 vs. 0.6±0.9). There were no differences in pregnancy outcomes between the two groups (Table). Using bivariate analysis there was no difference in OPR between the two groups (OR: 0.84, 95% CI 0.40 - 1.73, p=0.63). A multivariate regression analysis was performed to control for the potential confounding variables of age, BMI, previous live birth, diagnosis of RPL, or prior FET resulting in an adjusted odds ratio for OPR of 0.78 (95% CI 0.37 - 1.65, p=0.51). Day of cryopreservation does not affect pregnancy outcomes in single euploid blastocyst transfers. Rate of multiples remains low in single embryo transfer cycles.Tabled 1Pregnancy OutcomesDay 5Day 6p-valueIR, n (%)55/77 (71.4)36/51 (70.6)nsCPR, n (%)53/77 (68.8)35/51 (68.6)nsOPR, n (%)45/77 (58.4)32/51 (62.7)nsCLR, n (%)8/53 (15.1)3/35 (8.6)nsMGR, n (%)1/53 (1.9)2/35 (5.7)nsns=not significant Open table in a new tab

Pregnancy in women with hypertrophic cardiomyopathy: data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC).

We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. non-obstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of ≥II and signs of HF before pregnancy, were associated with MACE. Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

Interpregnancy weight changes and impact on pregnancy outcome in a cohort of women with a macrosomic first delivery: a prospective longitudinal study

ObjectiveTo determine the median interpregnancy maternal weight change between first and second pregnancies, and second and third pregnancies and to assess the impact of this weight change on pregnancy outcome...

Associations of pre-pregnancy obesity with adverse pregnancy outcomes and the optimal gestational weight gain in Japanese women

The authors determined associations of maternal pre-pregnancy obesity with adverse pregnancy outcomes and evaluated how gestational weight gain affects risks for such outcomes in Japanese obese pregnant women. Among women who delivered at the Perinatal Center for Maternity and Neonatal, Yokohama City University Medical Center, between January 2001 and December 2012, the authors ascertained adverse pregnancy outcome incidences in 207 pre-pregnancy obese (body mass index [BMI] = 30 kg/m², obese group), 661 pre-pregnancy overweight (BMI = 25-29.9 kg/m², overweight group), and 6,801 pre-pregnancy normal weight (BMI= 18.5-24.9 kg/m², normal group) women. Subjects were stratified by weekly weight gain during the second/third trimesters to investigate associations between gestational weight gain and adverse pregnancy outcomes. Optimal weight gain for obese pregnant women was also examined. In the obese and overweight groups, incidences of pregnancy induced hypertension (PIH), gestational diabetes mellitus (GDM), large for gestational age (LGA), preterm birth, preterm prelabor rupture of membranes (PPROM), and spontaneous preterm birth were significantly higher than in the normal group. Incidences of adverse pregnancy outcomes were ap- parently higher in the obese than in the overweight group. In the latter, the incidence of large for gestational age was significantly higher in women with weight gains of 0.5 kg/week, whereas no difference in pregnancy outcomes was observed in the obese group regardless of gestational weight gain. In obese women, incidences of adverse pregnancy outcomes were higher, and pregnancy out- comes were difficult to improve with gestational weight control. Thus, it.is important to reach an optimal weight before pregnancy.

MP89-01 TIME TO IMPROVEMENT IN SEMEN ANALYSIS PARAMETERS AFTER VARICOCELECTOMY

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-01 TIME TO IMPROVEMENT IN SEMEN ANALYSIS PARAMETERS AFTER VARICOCELECTOMY Melissa St.Aubin, Dane Johnson, Kate Cohen, and Jay Sandlow Melissa St.AubinMelissa St.Aubin More articles by this author , Dane JohnsonDane Johnson More articles by this author , Kate CohenKate Cohen More articles by this author , and Jay SandlowJay Sandlow More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2799AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicoceles are the most common identifiable cause of male factor subfertility. The impact of varicocelectomy on pregnancy outcome has been debated. We sought to evaluate the time frame for changes in semen parameters following varicocelectomy and examine the impact on natural conception. METHODS We performed a retrospective chart review on all patients who presented to our Reproductive Medicine Center for male factor subfertility and abnormal semen analysis (SA) parameters. Inclusion criteria were limited to men with clinically palpable varicoceles, who had at least one abnormal semen parameter on pre-operative SA, and had post-operative SA data available at both 3 and 6 months. Patients with at least 50% increase in total progressively motile sperm per ejaculate on their post-operative SA were classified as having improved semen parameters after varicocelectomy. Pregnancy outcomes were gathered retrospectively, and successful pregnancy was defined as live birth after intrauterine insemination or spontaneous pregnancy. RESULTS A total of 126 patients who underwent sub-inguinal varicocelectomy between 2006 and 2015 were included in this study. Following varicocelectomy, 72 patients (57%) had improvement in semen parameters. Spontaneous pregnancy or pregnancy from intrauterine insemination was more likely to occur in patients who had improved SA parameters (31% vs 10% p = 0.004). Of the patients that improved, 50 patients (69%) did so by 3 months. Another 22 patients (31%) saw eventual improvement in SA parameters by 6 months post-operative. There was no statistically significant difference in pregnancy outcomes between early improvement and delayed improvement in SA parameters ( 26% vs 41% respectively, p = 0.21). CONCLUSIONS Varicocelectomy resulted in a significant improvement in semen parameters in half of our patients. Of these, the majority who improved did so by 3 months post procedure; however, ~30% of patients without improvement at 3 months subsequently improved at 6 months. Pregnancy rates were statistically higher in patients who had >50% increase in total progressive motile sperm, regardless of the time it took to see this improvement. This data may be useful in counseling couples post varicocelectomy as to the time course for improvement and pregnancy outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1202 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Melissa St.Aubin More articles by this author Dane Johnson More articles by this author Kate Cohen More articles by this author Jay Sandlow More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Analysis of Pregnancy Outcomes among Interracial Couples in Korea.

Although the prevalence of interracial marriages in Korea is increasing, little is known regarding the pregnancy outcomes of interracial couples. The aim of this study was to investigate the differences in pregnancy outcomes between Korean and interracial Korean-foreign couples. Data for infants born in 2011 and 2012 were obtained from the national birth registry of the Korean Statistical Office. The couples were subdivided into Korean father-Korean mother, Korean father-foreign mother, and foreign father-Korean mother groups. Pregnancy outcomes included neonates with low birth weight (< 2,500 g) and those with high birth weight (> 4,000 g). In 2010 and 2011, 888,447 Korean father-Korean mother, 36,024 Korean father-foreign mother, and 4,955 foreign father-Korean mother neonates were delivered in Korea. After adjustment for parental age, educational level, parity, gestational age at delivery, and neonatal sex, the birth weights were found to be different between groups, with the highest number of foreign father-Korean mother and lowest number of Korean father-foreign mother pregnancies. Based on multivariate logistic regression analysis, the risk of low and large birth weights was higher in the Korean father-foreign mother and foreign father-Korean mother groups, respectively, compared with that in the Korean father-Korean mother group. There are significant differences in pregnancy outcomes including birth weights between Korean and interracial Korean-foreign couples.

Prepregnancy Hypothyroidism versus Gestational Hypothyroidism: A Comparative Study.

Introduction:Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important.Objectives:The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes.Study Design:Prospective designMaterials and Methods:The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism.Statistical Analysis:Chi-square and Mann–Whitney test.Results:A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II had 196 (43.36%) and 256 (56.64%) patients, respectively. Age at presentation (years) was 27.09 ± 4.19 in Group I versus 25.74 ± 4.29 in Group II (P = 0.003); gestational age (weeks) was 9.04 ± 5.41 in Group I versus 13.81 ± 9.12 in Group II (P = 0.000). There was one case of congenital hypothyroidism in baby in each group. Mean birth weight was 2.90 ± 0.39 kg in Group I versus 2.88 ± 0.36 kg in Group II; P = 0.608. There were four abortions in Group I versus ten in Group II (P = 0.231), 104 cesarean sections in Group I compared to 133 in Group II; (P = 0.382). There was no difference in number of cesarean sections, abortions and low birth weight babies between overt and subclinical hypothyroidism subgroups.Conclusions:Group I patients presented earlier for testing suggesting awareness was good in this group. There was no difference in pregnancy outcome between the two groups. Overt versus subclinical status did not have any different effects on pregnancy outcomes in any group.

Effects of Cd-based Quantum Dot Exposure on the Reproduction and Offspring of Kunming Mice over Multiple Generations

The potential health risks associated with heavy-metal containing quantum dots (QDs) are a major concern accompanying their increased application in both research and industry. In this contribution, we investigate the effects of QDs on reproductive outcomes in Kunming mice across three generations. Rather than being exposed to QDs during pregnancy, mice were intravenously injected with phospholipid micelle encapsulated CdSe/CdS/ZnS QDs at a dosage of 0.81 mg Cd/kg two weeks before mating. Four treatment groups were studied: non-injected control, female injected, male injected and both parents injected with QDs. Although QDs accumulated in the major organs of treated mice, we did not detect any pregnancy complications or adverse effects. No significant difference in pregnancy outcomes could be identified between the QD treated groups and the control group. More importantly, through behavior monitoring, blood tests and histological evaluations, two generations of the offspring were observed to be in normal and healthy condition. Our results show that QD exposure with a short buffering period before conception does not cause obvious pregnancy complications or significant toxicity effects in treated mice or their offspring. This indicates that a short buffering period after QD exposure may reduce potential risk of QDs to reproductive health.

Day three versus day two embryo transfer following in vitro fertilization or intracytoplasmic sperm injection.

Embryo transfer (ET) was traditionally performed two days after oocyte retrieval; however, developments in culture media have allowed embryos to be maintained in culture for longer periods. Delaying transfer from day two to day three would allow for further development of the embryo and might have a positive effect on pregnancy outcomes.To determine if there is any difference in live birth and pregnancy rates when ET is performed on day three, compared with day two, in infertile couples undergoing treatment with in vitro fertilization (IVF), including intracytoplasmic sperm injection (ICSI).We searched the Cochrane Menstrual Disorders & Subfertility Group trials register (17th December 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003) and Biological Abstracts Databases (1980 to 2003), the National Research Register (NRR), the Medical Research Council's Clinical Trials Register, the NHS Centre for Reviews and Dissemination, citation lists of relevant publications, review articles and included studies, as well as abstracts of appropriate scientific meetings.Randomized controlled trials that compared day three versus day two embryo transfer after oocyte retrieval during an IVF or ICSI treatment cycle in subfertile couples.Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. The primary outcome measures were live birth rate and ongoing pregnancy rate.Ten studies involving 2027 women were included, but only three studies reported live birth and four reported ongoing pregnancy rates. The pooled odds ratios (day three compared to day two) were 1.07, 95% CI 0.84 to 1.37 for live birth and 1.05, 95% CI 0.83 to 1.32 for ongoing pregnancy. From ten studies, the pooled odds ratio for clinical pregnancy was 1.26, 95% CI 1.06 to 1.51. Sub-group analysis revealed that this advantage occurred in those undergoing ICSI cycles. A higher miscarriage rate with day 3 ET in ICSI cycles works to negate the increased clinical pregnancy rate, in agreement with the finding of no significant difference between treatments in live birth rate.Although an increase in clinical pregnancy rate with day three embryo transfer was demonstrated, at present there is not sufficient good quality evidence to suggest an improvement in live birth when embryo transfer is delayed from day two to day three.

Fibroids that do not distort the uterine cavity and IVF success rates: an observational study using extensive matching criteria.

To assess the impact of non-cavity-distorting fibroids on in vitro fertilisation (IVF) pregnancy outcomes. A retrospective, matched, single-centre, cohort study was performed. The IVF unit of a tertiary, university hospital. We analysed all women with non-cavity-distorting uterine fibroids undergoing IVF/intracytoplasmic sperm injection (ICSI) cycles from 1 January 2011 to 1 May 2015. Each woman was matched with two separate controls of the same age (±6 months), stimulation protocol (gonadotropin-releasing hormone agonist or antagonist), starting dose of follicle-stimulating hormone (FSH), number of embryos transferred (one or two), day of transfer (day 3 or day 5), and no uterine fibroids identified by transvaginal ultrasound. Clinical pregnancy and live birth rates. Our study demonstrates that the presence of non-cavity-distorting fibroids appears to negatively affect clinical pregnancy (odds ratio, OR 0.62; 95% confidence interval, 95% CI 0.41-0.94) and live birth rates (OR 0.58; 95% CI 0.48-0.78) in patients undergoing their first IVF/ICSI cycle, when matched with controls of the same age, starting dose of FSH, stimulation protocol, number of embryos, and day of embryo transfer. The deleterious effect of fibroids on live birth rates was significant in women with two or more fibroids (OR 0.47; 95% CI 0.26-0.83) and in women with fibroids of ≥30 mm in diameter (OR 0.41; 95% CI 0.19-0.89). The negative impact of non-cavity-distorting fibroids was also present in women with an embryo transfer on day 5 (OR 0.58; 95% CI 0.35-0.94). Conversely, in women with single fibroids of <30 mm in diameter, no difference in pregnancy outcomes was identified. A well-designed, adequately powered, randomised controlled trial is required to address the role of medical or surgical interventions in patients with intramural and subserosal fibroids before undergoing fertility treatment. Non-cavity-distorting fibroids negatively affect pregnancy rates after IVF.

Особенности влагалищного биотопа беременных с несостоятельностью обтурационной функции шейки матки и возможности их коррекции

The article presents the investigation results of the vaginal biotope of pregnant women with incompetence of cervix obstructive function. The frequency growth of this complication in nulliparous women, the absence of significant differences in pregnancy outcomes without regard to the correction methods, the increase of number of obstructed and pathological labors among these women, were the basis for the factors analysis that deteriorate the prognosis for the mother and fetus. The vaginal microbiocenosis pathology plays one of the leading roles in the premature birth development) in women with incompetence of cervix obstructive function. The objective: to study the vaginal biotope in pregnants with incompetence of cervix obstructive function in order to improve the antenatal care tactics and increase the effectiveness of non-surgical treatment modality of this pathology. Patients and methods. 63 pregnants at term 22–32 weeks who had been treated at the department of pathology of pregnancy and childbirth of SE «IPAH NAMS of Ukraine» with the verified incompetence of cervix obstructive function (main group) were examined. The control group was formed by 34 pregnants with physiological state of cervix obstructive function. Results. The predominance of alkaline or slightly alkaline vaginal biotope’s reaction expressed leukocyte reaction, high desquamated epithelium content and a sharp decline in the numbers of Lactobacillus spp. at the background of mostly associated coccal microflora, Gram-negative microorganisms and Candida albicans fungi is typical for the main group of pregnants. The association of anaerobic microorganisms from bacterial-viral and bacterial-chlamydial urogenetal infections is typical for every third main group of pregnant women. Conclusion. The pathogenetically justified antibiotic therapy with a long-term correction of vaginal microbiocenosis dysbiotic disorders before the introduction of the perforated silicone cervical pessary provides the absence of discomfort which is associated with vaginal secret overproduction and allows stabilizing the leukocyte vagina microbiocenosis reaction within the physiological one and reducing the risk of preterm labor in these pregnants. Key words: the incompetence of cervix obstructive function, cervix, microbiocenosis, pregnancy, miscarriage.

Effect of Natural Cycle Endometrial Preparation for Frozen-Thawed Embryo Transfer in Patients with Advanced Endometriosis

BackgroundThe aim of this study was to investigate the effect of natural cycle (NC) endometrial preparation for frozen-thawed embryo transfer (FET) in women with advanced endometriosis.Material/MethodsThis retrospective study included 179 patients with stage III–IV endometriosis who underwent 233 FET cycles at a tertiary care academic reproductive medical center between March 2011 and August 2013 (group A). The control group included 258 patients with tubal factor infertility who underwent 300 FET cycles (group B). Both groups were prepared for FET using a NC protocol. Rates of implantation, clinical pregnancy, live birth, ongoing pregnancy, miscarriage, and pregnancy complication were recorded.ResultsThe implantation rate (A: 36.0%, B: 30.4%, P=0.06), the pregnancy rate (A: 50.2%, B: 45.3%, P=0.263), and the live birth rate (A: 39.91%, B: 39.0%, P=0.428) were similar between the stage III–IV endometriosis and tubal factor infertility groups. No differences were observed in ongoing rates of pregnancy, miscarriage, and pregnancy complications, independent of endometriosis severity. No congenital birth defects were found. When high-quality embryos are transferred, pregnancy results were not affected by active endometriosis. Although severe endometriosis did not affect birth rate, higher frequencies of premature delivery (mean gestational age A: 37 weeks, B: 38.3 weeks, P=0.044) and low birth weight were observed (<2500 g A: 26.4%, B: 16.6%, P=0.047).ConclusionsThere was no difference in pregnancy outcomes between patients with endometriosis and those with tubal infertility. Pregnancy outcomes in patients with endometriosis were not affected by endometriosis severity. Pregnancy outcomes were not affected by active endometrial cyst.

Differences in pregnancy outcomes in donor egg frozen embryo transfer (FET) cycles following preimplantation genetic screening (PGS): a single center retrospective study

PurposeThis study aims to test the hypothesis, in a single-center retrospective analysis, that live birth rates are significantly different when utilizing preimplantation genetic screening (PGS) compared to not utilizing PGS in frozen–thawed embryo transfers in our patients that use eggs from young, anonymous donors. The question therefore arises of whether PGS is an appropriate intervention for donor egg cycles.MethodsLive birth rates per cycle and live birth rates per embryo transferred after 398 frozen embryo transfer (FET) cycles were examined from patients who elected to have PGS compared to those who did not. Blastocysts derived from donor eggs underwent trophectoderm biopsy and were tested for aneuploidy using array comparative genomic hybridization (aCGH) or next-generation sequencing (NGS), then vitrified for future use (test) or were vitrified untested (control). Embryos were subsequently warmed and transferred into a recipient or gestational carrier uterus. Data was analyzed separately for single embryo transfer (SET), double embryo transfer (DET), and for own recipient uterus and gestational carrier (GC) uterus recipients.ResultsRates of implantation of embryos leading to a live birth were significantly higher in the PGS groups transferring two embryos (DET) compared to the no PGS group (GC, 72 vs. 56 %; own uterus, 60 vs. 36 %). The live birth implantation rate in the own uterus group for SET was higher in the PGS group compared to the control (58 vs. 36 %), and this almost reached significance but the live birth implantation rate for the SET GC group remained the same for both tested and untested embryos. Live births per cycle were nominally higher in the PGS GC DET and own uterus SET and DET groups compared to the non-PGS embryo transfers. These differences almost reached significance. The live birth rate per cycle in the SET GC group was almost identical.ConclusionsSignificant differences were noted only for DET; however, benefits need to be balanced against risks associated with multiple pregnancies. Results observed for SET need to be confirmed on larger series and with randomized cohorts.

Use of antiseptic mouthrinse during pregnancy and pregnancy outcomes: a randomised controlled clinical trial in rural China.

To determine whether an antimicrobial mouthrinse intervention reduces adverse pregnancy outcomes in a low-resource rural area. Randomised controlled trial. A county-level maternal health care hospital in China. Pregnant women of less than 20weeks of gestation having periodontal disease. Women with periodontal disease were randomised into the intervention (n=232) and control group (n=234). Participants in the intervention group were provided with free mouthrinse (alcohol-free mouthrinse containing 0.7% cetylpyridinium chloride) throughout the pregnancy and given education on oral health. Women in the control group only received oral hygiene education. All participants had a periodontal re-examination at the third trimester and were followed-up to childbirth. The primary outcome was gestational age. Secondary outcomes included birthweight, periodontal disease score, pregnancy complications (small-for-gestational-age, gestational hypertension, gestational diabetic mellitus, severe anaemia, premature rupture of membrane). The general periodontal status of the intervention group at the third trimester was significantly better than that of the control group (measured by periodontal disease score: 11.26±3.60 versus 11.92±3.01; P=0.04). There was no difference in pregnancy outcome between the two groups exceptfor premature rupture of the membranes. The women in the intervention group had a significantly reduced risk of premature rupture of the membranes compared with the control group (1.4 versus 5.7%, OR=0.23, 95% CI 0.07-0.84; P=0.03). The mouthrinse intervention during pregnancy improved periodontal health. The intervention did not lead to a change in gestational age but it reduced the rate of premature membrane rupture. Further studies are needed to explore the biological mechanism of this association. Use of antiseptic mouthrinse during pregnancy may improve maternal oral health and pregnancy outcomes.

Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea: A nationwide epidemiological study.

Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13–19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P < 0.001). About 14.4% of teenage mothers had never received prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P < 0.001). Teenage mothers more often experienced preterm delivery and perineal laceration (P < 0.001). Teenage mothers (<20 years) were 2.47 times more likely to have preterm delivery than older mothers (20–34 years; P < 0.001). Teenage mothers had higher risk of inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001).

Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care.

This study sought to examine the differences in pregnancy outcomes with a focus on gestational weight gain for women attending group prenatal care compared to standard individual prenatal care. A matched case-control study was conducted including 65 women who chose group care and 130 women who chose standard individual care. Women were matched based on prepregnancy body mass index (BMI) category, eligibility for midwifery care, and age within 5 years. Women choosing group prenatal care and women choosing standard individual care had similar gestational weight gain, birth weight, gestational age at birth, and mode of birth. Women choosing group prenatal care did have a significantly higher rate of exclusive breastfeeding at 6 weeks postpartum (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.81-9.15; P < .001) than women choosing individual care. Group prenatal care participation resulted in equivalent gestational weight gain as well as pregnancy outcomes as compared to standard individual care. Breastfeeding rates were improved for women choosing group prenatal care. Randomized controlled trials are needed in order to eliminate selection bias.

Study of the effects of three luteal phase supporting strategies on clinical outcomes of intrauterine insemination

To explore the effects of three luteal phase supporting strategies on clinical outcomes of intrauterine insemination (IUI). 1 779 subjects who underwent IUI at the Center of Reproductive Medicine, Peking University Third Hospital from November 2014 to June 2015 were enrolled in this retrospectively study.According to the luteal phase supporting strategies, all the subjects were divided into three groups: subjects receiving Dydrogesterone were group A; subjects receiving oral micronized progesterone were group B; subjects receiving vaginal micronized progesterone were group C. The pregnancy outcomes, including clinical pregnancy rate, early miscarriage rate, biochemical pregnancy rate and ectopic pregnancy rate were compared in the three groups. There was no significant difference in the three groups in constituent ratio, average IUI times, rate of the natural cycle, rate ofovulation cycle and dropout rate(P>0.05). Similarly, there was also no significant difference in pregnancy outcomes in all groups.Subsequent stratified analysis demonstrated that pregnancy outcomes in subjects of natural cycle and ovulation cycle still showed no significant difference(P>0.05). Our study suggested that the effects of three luteal phase supporting strategies on clinical outcomes of IUI were similar.The medication in clinic should be individualized.