Higher Pregnancy Rates Research Articles

Trisomy 18 and the possibility of choice: The importance of Perinatal Hospice’s support

Trisomy 18 is a severe aneuploidy associated with multiple malformations and a poor prognosis. The diagnosis is typically made prenatally, leading to a high rate of pregnancy terminations. The aim of this study is to demonstrate that even though the prognosis is heterogeneous, prolonged survival is possible and these children are an enrichment for their families after all. A retrospective, descriptive and monocentric study was conducted on fetuses diagnosed with trisomy 18, evaluated between March 2017 and June 2023 at our Institution. The objective was to investigate the natural history of trisomy 18 and the psychological impact on parents who choose to carry the pregnancy on, through a retrospective data collection and the use of a questionnaire. Sixteen couples with a diagnosis of trisomy 18 were cared for within the Perinatal Hospice Pathway during the study period. Cardiac defects were identified in 93.7% of cases, structural abnormalities in 71.4%, respiratory defects in 14.3% of the fetuses, while genitourinary defects affected nearly half of the study population. The survival rate was typically less than one day, however two babies survived for more than four years. All couples reported being satisfied with their decision to continue the pregnancy and would do so again if given the opportunity.Conclusions: despite the severity of the diagnosis, couples may choose to continue the pregnancy and give birth. Our study shows that trisomy 18 is not merely a lethal condition and the Perinatal Hospice plays a crucial role in supporting these families.What is Known:• Trisomy 18 is a severe aneuploidy with a poor prognosis and a high rate of pregnancy terminations.What is New:• Despite the severity of this condition, prolonged survival is a possibility. If couples are adequately supported by Perinatal Hospices, they may choose to continue the pregnancy, thereby enriching their experience.

Use Intensity of Progesterone Devices for Fixed-time Artificial Insemination in Gyr Crossbred Cows from the Peruvian Tropics

Background: The implementation of routine fixed-time artificial insemination programs can generate significant waste and costs, which good management practices can help mitigate. The objective of the study was to assess the effects of second- and third-use progesterone devices on estrus characteristics and pregnancy rates in synchronized crossbred Gyr cows. Methods: Ten cows were synchronized with first-use Bovine Intravaginal Progesterone Devices (DIB), nine with second-use DIB and ten with third-use DIB. All cows were ³90 days postpartum, had an average milk production of 6.9±1.9 L/day and were aged 4-10 years. Estrus signs were recorded at insemination and pregnancies were confirmed at 60 days by ultrasonography. Result: No significant associations were found between DIB use intensity and estrus detection patch response, mucus color, body condition score (CC), calvings, or breed purity (p greater than 0.05). Body condition was associated with uterine turgor tone (p less than 0.05) and 100% of cows with CC 3.0 showed turgor tone 3. The highest pregnancy rate was found in second-use DIB (55.6%) and CC 2.8 (47.1%), though neither association was significant (p greater than 0.05). DIBs may be used up to a second-use, as cervical mucosal stimulation and pregnancy rate remain unaffected.

Effect of circulating prolactin, lactation days, and seasonal variations on first artificial insemination pregnancy rates using the PG7G protocol in dairy cows

Background and Aim: Dairy farm profitability is linked to milk yield and reproductive efficiency. High prolactin levels during lactation can negatively impact fertility. Timed AI protocols like PG7G are used to improve pregnancy rates. This study investigates the effects of extending the voluntary waiting period (VWP) from 63 to 73 days after the PG7G protocol on reproductive parameters, including progesterone and prolactin levels, pregnancy rates, and pregnancy losses, in lactating Holstein cows during summer and winter seasons. Materials and Methods: A total of 2100 lactating dairy cows were divided into groups and assigned to the PG7G protocol based on their parity. Two groups were formed based on the number of days in milk (DIM) after the first PGF2α injection. The first group (PG7G-63) received a PGF2α injection 30-day postpartum (pp) and followed a specific protocol. The second group, PG7G-73, followed the same protocol but received a PGF2α injection 40-day pp. Pregnancy was confirmed, and blood samples were collected for analysis. Temperature and humidity were also recorded throughout the study. Results: Extension of the VWP to 73-day (PG7G-73 group) significantly improved pregnancy rates on day 47 pp compared with the 63-day VWP (PG7G-63 group). However, the PG7G-63 group exhibited lower PLs. Seasonality markedly influenced reproductive outcomes, with higher P/AI in the moderate season for primiparous cows and in the hot season for multiparous cows. Conversely, PL in both groups increased during the hot season. Conclusion: Extending the VWP from 63 to 73 days pp in lactating Holstein cows significantly improved pregnancy rates, while seasonality affected reproductive outcomes, with higher pregnancy rates in moderate temperatures and increased pregnancy loss during hot seasons. Keywords: dairy cows, days in milk, pregnancy rate, prolactin, season, timed artificial insemination.

Perinatal intimate partner violence among teen mothers and children’s attachment disorders in Rwanda: potential mediating factors

ABSTRACT Background: The alarming prevalence of teen mothers’ exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children’s ADs. Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1). Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children’s ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs. Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children’s attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.

Clinical effectiveness of unilateral single-armed vasoepididymostomy in obstructive azoospermia: a single-center experience

BackgroundVasoepididymostomy (VE) is an important surgical treatment to achieve natural conception for patients with obstructive azoospermia (OA), and only unilateral VE can be performed under certain conditions, such as OA patients with congenital unilateral absence of the vas deferens (CUAVD) and some acquired OA. There is a lack of relevant reports assessing the clinical outcomes of unilateral VE in OA patients with different causes. This study is aimed to describe the clinical features and evaluate treatments and outcomes of unilateral single-armed VE in OA patients.MethodsFrom December 2015 to June 2021, 46 OA patients (including 13 CUAVD-associated OA and 33 acquired OA) underwent unilateral single-armed VE in Shanghai General Hospital (Shanghai, China). Patient information, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated.ResultsObstruction in distal of unilateral vas deferens (16/46) was the most common cause for OA patients underwent unilateral VE, and CUAVD accounts for 28.4% (13/46). The overall patency rate was 50.0% (23/46), with 38.5% (5/13) for the CUAVD group and 54.5% (18/33) for the acquired group (p > 0.05). The natural pregnancy rates in CUAVD group and acquired group were 20.0% and 33.3%, respectively (p > 0.05).ConclusionsThese findings suggest unilateral single-armed VE can achieve high patency and pregnancy rates in OA patients, whether for CUAVD or acquired OA patients.

Controlled Dynamic Microfluidic Culture of Murine, Bovine, and Human Embryos Improves Development: Proof-of-Concept Studies.

Classical preimplantation embryo culture is performed in static fluid environments. Whether a dynamic fluid environment, like the fallopian tube, is beneficial for embryo development remains to be determined across mammalian species. Objectives of these proof-of-concept studies were to determine if controllable dynamic microfluidic culture would enhance preimplantation murine, bovine, and human embryo development compared to static culture. This prospective randomized controlled trial tested static versus controlled dynamic culture of preimplantation mouse (n = 397), bovine (n = 242), and human (n = 512) zygotes to blastocyst stages with outcome measures of embryo cleavage, cellular fragmentation, apoptosis, and blastocyst conversion rates. Dynamic culture of mouse and bovine zygotes with microfluidics significantly improved embryo development. Mouse placental imprinted gene expression was significantly different between embryos derived in vivo, by static culture, and by dynamic culture. Using human sibling zygotes, this dynamic microfluidic culture system increased the number of blastomeres per cleavage-stage embryo, reduced cellular fragmentation or apoptosis, improved blastocyst conversion rates, and enhanced blastocyst developmental stages. In conclusion, species-specific longitudinal studies demonstrated that dynamic microfluidic culture significantly improved embryo development, independent of culture media composition, temperature, and gaseous environment. These cellular indicators represent improved embryo development that can translate into higher pregnancy rates in transgenics, domestic livestock and endangered species and treating human infertility.

Low doses of alkylating agents do not harm human ovarian tissue destined for cryopreservation.

To investigate the impact of non-gonadotoxic doses of alkylating agents on human ovarian cortex. Retrospective study. Academic research center. Biopsies from 78 patients who had undergone ovarian tissue cryopreservation were retrieved and analyzed. Among them, 42 had previously been treated with chemotherapy (alkylating agents, dose <3400mg/m2), making up the chemotherapy group, while 36 had not been given any chemotherapy, constituting the control group. Follicle count and classification, morphology study, immunostaining for apoptosis (cleaved caspase-3), immunostaining for activation (phospho-Akt), fibrosis (Masson's trichrome) and vascularization (von Willebrand factor and smooth muscle actin). In the prepubertal group, 271 follicles/mm³ were detected in control patients and 501 follicles/mm³ in chemotherapy-exposed subjects. In the adult group, 4916 follicles/mm³ were found in control patients and 6570 follicles/mm³ in chemotherapy-exposed patients. No difference in follicle density was observed between the two groups in any age category. Neither did we encounter any significant difference in follicle viability according to chemotherapy exposure or age. Proportions of non-growing follicles were >76 % in all age groups, irrespective of chemotherapy exposure, and higher, though not significantly, in the chemotherapy group compared to the control group. There were significantly fewer secondary follicles in the adult chemotherapy group than in the adult control group (p=0.009). Concerning apoptosis, no significant difference was observed between control and chemotherapy subjects in any age groups. Numbers of activated follicles were systematically higher in all age categories in the chemotherapy group than the control group. Areas of atypical follicles were noted in 4 out of 14 prepubertal patients in the chemotherapy group. In these areas, follicle density was 84570 ± 8837 follicles/mm³ and all follicles appeared non-viable but showed no sign of apoptosis. Low-dose chemotherapy had no major impact on ovarian tissue, suggesting that ovarian tissue exposed to some chemotherapy prior to cryopreservation is comparable to ovarian tissue free of any chemotherapy, as clinically demonstrated by high pregnancy rates after ovarian tissue transplantation in women exposed to chemotherapy. Previous chemotherapy should therefore no longer be a contraindication to ovarian tissue cryopreservation.

The effects of acupuncture on patients with premature ovarian insufficiency and polycystic ovary syndrome: an umbrella review of systematic reviews and meta-analyses.

Previous studies have suggested that acupuncture could improve the clinical outcomes of women with premature ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS). However recent meta-analyses have provided inconclusive findings. This umbrella meta-analysis aimed to explore the effect of acupuncture therapies on PCOS and POI outcomes. A systematic literature search was carried out in in PubMed, Scopus, Web of Science, and Chinese databases, including Wan Fang Data Knowledge Service Platform, CBM, CNKI, and VIP up until April 2024 to gather relevant studies. Inclusion criteria were meta-analyses on the effect of acupuncture or combined therapies with standard medications or traditional Chinese medicine (TCM) on PCOS and POI. The outcomes were pregnancy rates, ovulation rates, hormone levels, glycemic indices, resumption of menstruation, endometrial thickness, live birth rates, abortion rates, and body mass index (BMI). Studies with irrelevant interventions, animal studies, reviews without quantitative analysis, and studies with insufficient data were excluded. Standardized mean difference (SMD) with a 95% confidence interval (CI) and relative risk (RR) with a 95% CI were used as effect sizes to pool the data using a random effects model. A total of 38 meta-analyses, 20 studies (sample size: 27,106 patients) for PCOS and 18 studies (sample size: 19,098 patients) for POI, were included. Overall, in women with PCOS, acupuncture therapies were significantly associated with a higher pregnancy rate, ovulation rate, and reduced serum levels of luteinizing hormone (LH), testosterone, LH/follicle-stimulating hormone (FSH), insulin resistance, and BMI. Moreover, FSH, fasting glucose, and fasting insulin levels were improved in subgroup analyses. For POI, acupuncture significantly improved serum levels of LH, FSH, LH/FSH ratio, and estradiol. Acupuncture-related therapies improve pregnancy rate, and metabolic and hormonal imbalances in patients with POI and PCOS. The protocol of the study was registered in PROSPERO (CRD42024572893). Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024572893.

How does chronic endometritis influence pregnancy outcomes in endometriosis associated infertility? A retrospective cohort study

BackgroundEndometriosis (EMS) and chronic endometritis (CE) frequently coexist. This study aimed to examine the impact of CE on reproductive outcomes in patients with EMS.MethodsWe enrolled 685 patients with endometriosis-associated infertility from January 2018 to December 2020. The patients were divided into CE (318) and non-CE (367) groups. A subset of 123 clinically pregnant women from the CE group and 369 from the non-CE group was selected for detailed comparison. Pregnancy and delivery data were meticulously collected from hospital records and through telephone interviews.ResultsCE was diagnosed in 46.42% of EMS patients. Higher pregnancy rates were observed in patients with Endometriosis Fertility Index (EFI) scores of 7–10. EMS patients with CE had increased risks of placenta previa (13.01%), gestational hypertension (5.69%), and cesarean sections (59.34%).ConclusionsCE, which is prevalent among EMS patients, is linked to increased risks of pregnancy complications, including placenta previa, gestational hypertension, and cesarean delivery. Although combined hysteroscopy and laparoscopy improve pregnancy rates, they demand careful management of these complications.

Evaluating Lipiodol Efficacy in Proximal Tubal Occlusion Treatment: Single-Center Experience and Literature Review.

BACKGROUND Tubal infertility caused by proximal occlusion of fallopian tubes is a common cause of female infertility. Lipiodol (ethiodized oil) is an oil-based iodinated contrast medium, previously used in hysterosalpingography, and is now used as a therapeutic agent. This single-center study aimed to evaluate the experience of outcomes from the use of Lipiodol in 96 women with infertility due to fallopian tube occlusion. MATERIAL AND METHODS In total, 96 women with infertility caused by tubal obstruction, confirmed in hysterosalpingography and/or laparoscopy, who underwent tubal recanalization followed by Lipiodol injection were enrolled. Information regarding the reproductive outcome at a minimum of 6 months following the treatment was collected by a telephone survey or direct contact. Pregnancy rate was calculated. RESULTS Average age on admission was 33±4.1 years. In most cases (79%, 76/96), infertility was primary. Average duration of infertility was 2.8 years. Comorbidities included endocrinopathies and endometriosis. Complete patency was achieved in 96% of cases (92/96 patients). In 4 cases (4%), distal occlusion of 1 ovary was observed, resulting in partial procedural success. Tubal catheterization was needed in 29 patients (30%). No procedural complications were noted. Thirty-four patients conceived, resulting in a 35.8% pregnancy rate. Miscarriage was noted in 5 patients, and tubal ectopic pregnancy in 1 patient. No long-term complications were reported. CONCLUSIONS Our results show that use of oil-based contrast for tubal recanalization is safe and effective treatment for proximal tubal occlusion, with a relatively high pregnancy rate (36%). Further studies are required to fully discover its potential benefits.

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.

ANA-positive versus ANA-negative Antiphospholipid Antibody-positive Patients: Results from the APS ACTION Clinical Database and Repository.

This study focused on the prevalence and impact of antinuclear antibodies (ANA) in antiphospholipid antibody (aPL)-positive patients without concomitant systemic autoimmune rheumatic diseases (SARDs). Data from aPL-positive patients with or without Revised Sapporo APS classification criteria were retrieved from the APS ACTION Registry. Patients with concomitant SARDs were excluded. 430 aPL-positive patients were included in the analysis, 56% ANA-positive and 44% negative. ANA positivity was significantly associated with history of hematologic manifestations (persistent autoimmune hemolytic anaemia, thrombocytopenia, leukopenia and/or lymphopenia) (16% of ANA-positive vs 7% of ANA-negative, p= 0.006). Triple aPL-positivity was more frequent in the ANA-positive subgroup (p= 0.02), along with low baseline C3 and C4 levels (p= 0.05 and p= 0.009, respectively), and higher frequency for extractable nuclear antigens (ENA). Among aPL-positive patients with no APS classification, ANA-positive patients showed a higher rate of arthritis (p= 0.006). Among female patients who have experienced at least one pregnancy, 113 were ANA-positive and 96 were ANA-negative; ANA-negative patients had a higher number of pregnancies (p= 0.018), and number of live births (p= 0.014). A wider proportion of ANA-positive patients were treated with hydroxychloroquine (HCQ) (p< 0.001). When we analysed aPL-positive patients with no other SARDs, ANA status was not associated with thrombosis or pregnancy morbidity. Interestingly, ANA-positive patients showed higher rates of systemic autoimmune features, including hematologic manifestations, multiple aPL positivity, lower complement levels, ENA positivity, and joint involvement, and were more often treated with HCQ. Finally, aPL-positive subjects who were ANA-negative had a higher rate of pregnancies and live births.

Transplacental SARS-CoV-2 protein ORF8 binds to complement C1q to trigger fetal inflammation

Prenatal SARS-CoV-2 infection is associated with higher rates of pregnancy and birth complications, despite that vertical transmission rates are thought to be low. Here, multi-omics analyses of human placental tissues, cord tissues/plasma, and amniotic fluid from 23 COVID-19 mother-infant pairs revealed robust inflammatory responses in both maternal and fetal compartments. Pronounced expression of complement proteins (C1q, C3, C3b, C4, C5) and inflammatory cytokines (TNF, IL-1α, and IL-17A/E) was detected in the fetal compartment of COVID-19-affected pregnancies. While ~26% of fetal tissues were positive for SARS-CoV-2 RNA, more than 60% of fetal tissues contained SARS-CoV-2 ORF8 proteins, suggesting transplacental transfer of this viral accessory protein. ORF8-positive fetal compartments exhibited increased inflammation and complement activation compared to ORF8-negative COVID-19 pregnancies. In human placental trophoblasts in vitro, exogenous ORF8 exposure resulted in complement activation and inflammatory responses. Co-immunoprecipitation analysis demonstrated that ORF8 binds to C1q specifically by interacting with a 15-peptide region on ORF8 (C37-A51) and the globular domain of C1q subunit A. In conclusion, an ORF8-C1q-dependent complement activation pathway was identified in COVID-19-affected pregnancies, likely contributing to fetal inflammation independently of fetal virus exposure.

Socioeconomic determinants of male contraceptive use in South Africa: a secondary analysis of the 2016 SADHS data

BackgroundHistorically, family planning discussions have predominantly centred on women, overlooking the crucial role men play in contraception. This is particularly concerning in regions like Sub-Saharan Africa (SSA), where reproductive health challenges are pronounced. South Africa, a key country within SSA, continues to grapple with issues such as high unintended pregnancy rates and increasing pregnancy-related mortality. Understanding the factors that deter male contraceptive use is essential for achieving universal access to sexual and reproductive health (SRH) services. This study investigates the socioeconomic disparities influencing male contraceptive use in South Africa, drawing on data from the 2016 South Africa Demographic Health Survey.MethodsThe study utilised data from the 2016 South African Demographic and Health Survey, which employed a stratified, two-stage sampling design across all provinces based on the 2011 Census. The survey focused on men aged 15–59 using the “Man’s Questionnaire.” Various socio-demographic and attitudinal variables were analysed using STATA 17. The analysis included multinomial logistic regression to identify determinants of male contraceptive use and the Erreygers Normalized Concentration Index to assess socioeconomic inequalities in contraceptive uptake.ResultsAmong the surveyed men, 47% reported not using any contraception, 40% used male methods, and 13% relied on their partners’ contraceptive use. A majority began sexual activity between the ages of 14–17 (54%), resided in urban areas (56%), were unmarried (67%), and had attained secondary education (70%). Notably, 78% disagreed that contraception is solely a woman’s responsibility, and 64% expressed positive attitudes toward contraception. Age, marital status, and education level emerged as significant factors influencing contraceptive use. The study revealed a slight pro-rich inequality in male contraception use, with socioeconomic status (SES) being the most significant contributor to this disparity (223.22%). This suggests that higher SES is associated with increased inequality in the adoption of modern male contraceptive methods.ConclusionThese findings highlight the impact of socioeconomic disparities and entrenched cultural beliefs on male contraceptive use in South Africa. To address these challenges, comprehensive strategies that prioritise education, expand family planning media campaigns and ensure equitable access to contraception are urgently needed.

Investigation of the Effect of Different Hormone Applications on Pregnancy Rates in Repeat Breeder Cows

The current study aimed to investigate the effects of GnRH during insemination and progesterone administration on conception on the fourth- and fifth days following insemination in Repeat Breeder (RB) cows. The study included 40 Holstein breed RB cows housed under identical care and feeding circumstances. The animals were divided into four groups: group I (GnRH administered immediately after insemination), group II (GnRH administered immediately after insemination + progesterone administered on days 4 and 5 after insemination), group III (progesterone administered on days 4 and 5 after insemination), and group IV (control). All animals in the study had their ovulation checked at the 24th and 36th hours after insemination, and the pregnancy was examined by USG on the 45th day. The initial estrus of non-pregnant animals and their days were established. The ovulation rates at the 24th hour was 70% in group I, 90% in group II, 50% in group III, and 50% in group IV, whereas in the 36th hour they were 30% in group I, 10% in group II, 50% in group III, and 50% in group IV, respectively. The pregnancy rates were 70% in group I, 80% in group II, 60% in group III, and 30% in group IV. The untreated control group had lower pregnancy rates (p &lt; 0.05) compared to the treatment groups. As a result, higher pregnancy rates were seen in the treatment groups compared to the control group, indicating that three distinct treatments can be used to increase pregnancy rates in RB cows.

Revolutionizing Fertility: A Review Of High-Intensity Focused Ultrasound On Uterine Fibroids

Background: The aim of the study is to review the safety and the success in fibroid patients by using high intensity focused ultrasound and compare with those of other surgeries for treatment of fibroid. Materials and Methods: We searched in Google Scholar, PubMed, Scopus and Web of Science by using the keywords MRHIFU and High Intensity Focused Ultrasound, uterine fibroid, fertility sparing and pregnancy. The literature reviews for the recent 7 years were searched. The database search was limited to English although much of publications and studies were those of China. Results: HIFU has significant advantage over other methods and improving the health related quality of life. It has a significant effect in shortening pregnancy interval thereby preserving ovarian function. HIFU treatment displayed a relatively higher pregnancy rate, shorter pregnancy interval by preserving ovarian function. This, it is an excellent option for treating symptomatic fibroid patients willing to conceive. Conclusion: HIFU is a safe and effective non-invasive treatment for patients with symptomatic fibroids,offering a good quality of life with minimal complications.

Effects of Switching FSH Preparations on Sperm Parameters and Pregnancy: A Prospective Controlled Study

Objective: To study the effect of switching to a follicle-stimulating hormone (FSH) preparation other than that to which infertile male patients have not had an effective response. Patients and methods: Seventy-four normogonadotropinemic, non-obstructive, oligozoospermic patients who were poor responders to the administration of highly purified FSH (hpFSH) (Group 1 (n = 22) and Group 3 (n = 15)) or to recombinant human FSH (rhFSH) (Group 2 (n = 22) and Group 4 (n = 15)) were selected for this prospective study. After 3 months of washout from treatment with the first FSH preparation of choice, rhFSH was administered to patients in Groups 1 and 4 and hpFSH to those in Groups 2 and 3. Serum luteinizing hormone, FSH, total testosterone levels, conventional sperm parameters, testicular volume, and the number of pregnancies were evaluated at study entry and after the first and second treatment cycles. Results: Comparing treatment groups, the greatest improvement in sperm parameters was recorded in the groups of patients prescribed the switch in FSH preparation. Group 1 had the greatest benefit from therapy, with the highest pregnancy rate after the second treatment cycle. Indeed, eight couples achieved pregnancy (36.4%), compared to Groups 2 (n = 4; 18.2%), 3 (n = 1; 6.7%), and 4 (n = 2; 13.3%) (p = 0.04). Conclusions: The results of this study suggest that a therapeutic scheme involving the “switching” of the FSH preparation yields better results than a protocol using the same FSH preparation for six months. These findings, if confirmed by further studies, will help us better design a treatment strategy with FSH for infertile patients with oligozoospermia.

Enhancing predictions of embryo implantation in thin endometrium: a comparative analysis of endometrial thickness in frozen versus fresh IVF cycles

This study investigated whether the difference between endometrial thickness in the frozen embryo transfer (FET) cycle and the preceding fresh stimulated cycle predicts clinical pregnancy in women with thin endometrium. A retrospective analysis of 335 cycles in 227 women (age < 43) with endometrium < 8 mm in the FET cycle was conducted. Endometrial thickness was assessed using the ratio (ETfrozen/fresh) and absolute difference (ETfresh-frozen) between the maximal endometrial thickness measured during the stimulated IVF cycle and that measured in the FET cycle. We hypothesized that a smaller difference and higher ratio during FET will be associated with higher pregnancy rate. No embryo implantation occurred in women with an FET endometrial thickness < 5.9 mm and an ETfrozen/fresh < 0.86. Cycles with a positive beta-human chorionic gonadotropin (ß-hCG) showed a significantly lower mean ETfresh-frozen (1.89 ± 1.78 vs 2.30 ± 1.81, p = 0.03), and a significantly higher ETfrozen/fresh ratio (0.82 ± 0.17 vs. 0.77 ± 0.15, p = 0.024). Endometrial thickness in the FET cycle normalized to the preceding stimulated cycle is associated with implantation and may constitute a novel predictor of FET success in women with thin endometrium.

Prevalence and correlates of prenatal HIV testing among female sex workers in Nigeria.

Female sex workers (FSWs) face a significant and persistent risk of contracting HIV. While evidence indicates high rates of pregnancy among FSWs in sub-Saharan Africa, studies on the coverage of HIV testing during pregnancy among them are sparse. The objective of this study was to estimate the prevalence of prenatal HIV testing and determine the associated factors among FSWs in Nigeria. This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey (IBBSS) among key populations in Nigeria. We performed weighted descriptive statistics and multivariable binary logistic regression to assess the associations between prenatal HIV testing and sociodemographic characteristics, risk behaviours, HIV knowledge and risk awareness, stigma, and access to healthcare. Of the 1598 FSWs included in the study, 71.0% (95%CI = 68.7%-73.1%) had HIV testing during their last pregnancy. In the regression model, tertiary education (aOR = 2.98, 95%CI = 1.48-6.01), consistent condom use (aOR = 1.95, 95%CI = 1.39-2.75), and receipt of antenatal care (aOR = 35.52, 95%CI = 23.40-53.92) were associated with higher odds of prenatal HIV testing. Compared with the South South geopolitical zone, FSW residing in South East (aOR = 3.38, 95%CI = 1.80-6.35), South West (aOR = 2.97, 95%CI = 1.88-4.68), North Central (aOR = 4.43, 95%CI = 2.80-7.01), North East (aOR = 4.22, 95%CI = 1.64-10.34), North West (aOR = 4.40, 95%CI = 2.59-7.48) had higher odds of reporting prenatal HIV testing. However, being a non-brothel-based FSW (aOR = 0.66, 95%CI = 0.47-0.92), and engaging in sex work during pregnancy (aOR = 0.45, 95%CI = 0.31-0.66) were significantly associated with lower odds of prenatal HIV testing. The prenatal HIV testing among FSWs in this study was suboptimal. The results highlight the need to improve access to antenatal care and implement regional and typology-specific interventions to bridge the gap in prenatal HIV testing among FSWs.

Optimising Laparoscopic Artificial Insemination in Lohi Sheep: Effects of Timing, Sperm Concentration and Body Condition on Fertility Outcome in Subtropical Climates.

The objective of this study was to determine the optimal timing, sperm concentration, and body condition score (BCS) for laparoscopic artificial insemination (LAI) in the subtropical Lohi sheep breed. In Experiment 1, Lohi ewes (n = 80) were synchronised through progestin-sponges (day 0-day 11), administering PGF2α (d-cloprostenol 75 μg/mL; i.m. @ 75 μg /ewe) on day 09 and eCG (i.m. @ 300 IU/ewe) on day 11. Ewes were divided equally into four groups (n = 20 each) and then LAI was performed at 48 (T48), 60 (T60), 72 (T72) and 96 (T96) hours post-sponge removal using 200 million sperm/insemination. In Experiment 2, ewes (n = 81) were synchronised as in Experiment I. Following synchronisation ewes were divided into four groups, each subjected to LAI employing varying sperm concentrations: 10 (S10; n = 21), 20 (S20; n = 20), 50 (S50; n = 20), or 100 (S100; n = 20) million per insemination. Inseminations were performed within a time window of 48-60 h post-sponge removal, based on the findings from Experiment 1. In both experiments ewes were categorised according to BCS, that is, medium 3 and high > 3. Results of Experiment 1 revealed a quadratic response that ewes inseminated at 60-h post-sponge removal exhibited significantly higher pregnancy and twinning rates (p = 0.02). The results of Experiment 2 revealed that sperm concentration had a quadratic effect, 50 million sperm per insemination resulted in maximal pregnancy rates (p = 0.01). Additionally, ewes with medium BCS (≤ 3) had higher pregnancy rates than high BCS (> 3) ewes. In conclusion, ewes with medium BCS (≤ 3) are ideal candidate for LAI and can be inseminated at 60 h with minimal sperm 50 × 106/dose post-sponge removal to achieve a maximum pregnancy rate.