The association of the betatrophin level with metabolic and inflammatory parameters in infertile women with polycystic ovary syndrome: A case-control study

Background: Betatrophin may be associated with metabolic diseases. Objective: To investigate the betatrophin level and its association with metabolic and inflammatory parameters in infertile women with polycystic ovary syndrome (PCOS) and other infertile women during the intrauterine insemination cycle. Materials and Methods: This case-control study was conducted with 90 infertile women (45 with PCOS and 45 without) chosen by convenience sampling, in the infertility clinic of Imam Khomeini Hospital in Tehran, Iran. Participants were interviewed to obtain their age, body mass index, and reproductive history. Fasting brachial venous blood samples were obtained on the 3rd day of the menstrual cycle to measure the levels of betatrophin, fasting blood sugar, insulin, luteinizing hormone, folliclestimulating hormone, low-density lipoprotein cholesterol, estradiol, and high-sensitivity C-reactive protein. Results: The results showed that the level of betatrophin in women with PCOS was significantly higher than in the control group (p = 0.05). Based on multiple linear regression analyses, the effects of metabolic and inflammatory parameters on betatrophin were not significant (p = 0.19). The results showed no significant difference between groups in folliculogenesis (p = 0.57). Conclusion: According to the results, betatrophin levels were higher in infertile women with PCOS than in those without. The findings suggest that there may be an association between increased betatrophin and increased incidence of PCOS. Further studies with a larger sample size are needed to investigate the role of betatrophin in insulin resistance and lipid metabolism, and its effects on infertility treatment outcomes. Key words: ANGPTL8 protein human, Infertility, Polycystic ovary syndrome, Iran

Effects of Changing GnRH Agonist to Antagonist or Vice Versa on M2 Oocytes, Clinical Pregnancy and Live Birth Rates in Two Consequent IVF Cycles

Objectives: The objective of this study was to investigate the impact of changing the ovarian stimulation protocol from gonadotropinreleasing hormone (GnRH) agonists to antagonists, or vice versa, on the outcomes of in vitro fertilization (IVF) in the same groups of patients. Materials and Methods: This study was a cohort study of women with infertility who had a history of two consequent IVF cycles due to an unsuccessful previous attempt and were recruited between 2016 and 2019. The patients were treated with either an agonist or antagonist protocol in the first or second round. They were categorized into two groups based on whether the second round was the same as the first one or different. The primary outcomes included the number of M2 oocytes, the number of transferred embryos, the chemical pregnancy rate, and the clinical pregnancy rate. The secondary outcome was the live birth rate. Statistical analyses were performed using SPSS version 26 software. Results: A total of 39 women and 78 cycles with a history of infertility, with a mean age of 29.72 (5.36, SD), were evaluated in two groups: same (17, 43.6%) and different (22, 56.4%) protocols. Primary infertility was the most frequent type of infertility, recorded in 31 (79.6%) individuals. No significant differences were found between the two groups in terms of mean endometrial diameter (P=0.820), HCG administration (P=0.069), mean stimulation duration (P=0.931), mean total dose of administered gonadotropins (P>0.05), and embryo transfer types (P= 0.051). Also, no significant differences were found in the primary outcomes between the same and different protocol groups (P>0.05). The live birth rate also showed no significant difference as a secondary outcome (P = 0.954). Conclusions: This study found no significant difference in IVF outcomes when switching between GnRH agonist and antagonist protocols or using the same protocol for consecutive rounds

Meconial amniotic fluid and maternal and neonatal outcomes

Introduction: One of the major problems of the fetus is the excretion of the contents of the fetal intestine in the amniotic fluid sac or the amniotic fluid stained with meconium. If the time of stained with meconium is long or if the meconium is thick, it leads to serious risks for the mother and the fetus. The present study was conducted with aim to investigate the prevalence of babies born with meconial stained amniotic fluid and the associated maternal and fetal complications. Methods: This cross-sectional study was conducted in a period of 6 months (Dec 2014 to June 2015) on 1383 women with a singleton pregnancy and a gestational age of more than 28 weeks who had referred to Omolbanian Hospital in Mashhad due to the onset of labor pains. The investigated information included: mother's age, gestational age, number of pregnancies, mode of delivery, amniotic fluid condition, baby's gender, baby's Apgar, ABG (arterial blood gas), birth weight and the need for baby resuscitation. Data analysis was done using SPSS statistical software (version 22) and t-test and chi-square statistical tests. P< 0.05 was considered statistically significant. Results: In the present study, out of 1383 cases of normal delivery, 114 cases had meconium-stained amniotic fluid (prevalence of 8.2%). The number of cesarean section was higher in the thick meconial group (26 cases (%43.3)) compared to thin meconial group (9 cases (16.7%)) (p=0.002). The amount of abnormal ABG was 10 cases (8.7%) in the meconial group, of which 6 cases (5.2%) were in the fetal distress group. The amount of abnormal ABG was 8%, which was significantly higher in the thick meconial group (p=0.002). First minute Apgar less than 7 was more in the thick meconial group (p=0.01) and 5th minute Apgar had no difference between the two groups. There were no cases of convulsions or death of infant in the two groups. Conclusion: In this study, the prevalence of amniotic fluid stained with meconium was 8.2%. Although the rate of cesarean delivery was higher in the thick meconial group, there was no significant difference in fetal distress in the thick and thin meconial groups. Considering the complications of cesarean section for the mother, natural delivery can be a choice method in these mothers and cesarean section is limited to cases of fetal distress or thick meconium far from delivery