Obesity and assisted reproduction

Excess body weight impacts fertility during both natural and assisted reproduction (ART) cycles. In men, the immediate effect is hypoandrogenism through decreased testosterone levels and an increase in peripheral aromatization of androgens to estrogen, although this does not seem to cause significant change in conventional semen parameters. In women, the impact seems to be through various pathways, by both animal and human studies

Obesity as an Epidemic: Causes, Morbidities and Reproductive Performance

Obesity is an epidemic causing significant morbidity and mortality in United States. It is facilitated by many factors including sedentary life style, abundance of food, and unhealthy dietary habits. This review aims to briefly address causes and conditions associated with obesity, with a special emphasis on reproductive performance for Obstetricians and Gynecologists

Abdominal resection of a cornual heterotopic pregnancy using intraoperative ultrasound: case report

Background: Heterotopic pregnancy is a rare complication of in vitro fertilization (IVF) and diagnosis and treatment can be challenging, particularly with unusual ectopic sites and desire to maintain the intrauterine pregnancy. Case: We review the case of a 29-year-old female who presented with a cornual heterotopic pregnancy following IVF treated with exploratory laparotomy and ultrasound guided resection of the cornual pregnancy, resulting in an ongoing viable singleton intrauterine pregnancy. Conclusion: The management of cornual heterotopic pregnancies is limited by lack of data regarding ideal treatment although several surgical and non-surgical strategies have been described. This case uses abdominal resection of cornual ectopic pregnancy using intraoperative ultrasound as an optimal approach to remove the ectopic pregnancy without disrupting the viable intrauterine pregnancy, which was in close proximity of the cornual ectopic

Pregnancy predictors in the fresh cycle using dual trigger protocol

Dual trigger protocol using a combination of GnRH agonist and hCG for final oocyte maturation has been shown to minimize ovarian hyperstimulation syndrome (OHSS) risk without compromising fresh embryo transfer outcomes. Therefore, we sought to determine if any cycle characteristics were associated with predictive of pregnancy outcomes in fresh cycles that utilized this protocol for in-vitro fertilization

THE RELATIONSHIP BETWEEN THE PRE-SERVICE SCIENCE TEACHERS' SCIENTIFIC PROCESS SKILLS AND LEARNING STYLES

In the present study, the purpose is to determine the relationship between the pre service science teachers' scientific process skills and their learning styles. For this purpose, the study was carried out with 151 1th and 4th year students attending Science Teacher Education Department of Education Faculty at Muğla University. In the study, survey method is used. The pre-service teachers' learning styles were determined through "Kolb Learning Style Inventory" adapted to Turkish by Aşkar and Akkoyunlu (1993). In order to evaluate the pre-service teachers' scientific process skills; "Scientific Process Skills Test" developed by Burns, Okey and Wise (1985) to determine the scientific process skills of high school and university students and adopted to Turkish by Ateş ve Bahar (2004) was used. When SPS scores are generally examined, it is seen that the pre-service teachers having separating and changing learning styles have higher SPS scores when compared to the pre-service teachers having the other learning styles

THE RELATIONSHIP BETWEEN THE PRE-SERVICE SCIENCE TEACHERS' SELF-EFFICACY BELIEFS ABOUT SCIENCE TEACHING AND LABORATORY WORKS

The purpose of the present study is to determine the relationship between the pre-service science teachers' perceptions of their self-efficacies in science teaching and laboratory works. The sampling of the study consists of 70 pre-service science teachers grade 4 that have studied in Science Teacher Education Department at Muğla University. Survey method was used in the present study. The pre-service teachers' views of their proficiency in science laboratory works were determined through 18-item "Proficiency Determination Form" developed by Böyük, Demir and Erol (2010). The reliability of the scale was found to be.89. The pre-service teachers' perceptions of "Science Teaching Self-Efficacy (STSE)"were determined by means of 23-item "Science Teaching Efficacy Belief Instrument (STEBIB)" developed by Riggs and Enochs (1990) and adopted to Turkish by Özkan, Tekkaya and Çakıroğlu (2002). According to the results of factor analysis, science teaching self-efficacy perception consists of two dimensions as "personal science teaching efficacy beliefs" and "science teaching outcome expectancy". Alpha reliability coefficient of each dimension was found to be 0.86 and 0.79, respectively. The results of the analyses revealed that there is a significant correlation between science teachers' perceptions' of their self-efficacies in science teaching and science laboratory competencies

Dual trigger protocol is an effective IVF strategy in both normal and high responders without compromising pregnancy outcomes

To compare pregnancy outcomes between normal versus high responders after dual trigger of final oocyte maturation with gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) in fresh in-vitro fertilization (IVF) cycles, where ovarian stimulation was achieved by a flexible GnRH antagonist protocol

Amenorrhea and pituitary human chorionic gonadotrophin production in a 38-year-old presenting as pregnancy of unknown location: case report and review of literature

Background: Amenorrhea and extraplacental production of serum human chorionic gonadotropin (hCG), particularly in young women, can mimic a pregnancy of unknown location. Elevated serum hCG in the absence of pregnancy can pose a diagnostic dilemma and has led to potentially harmful and unwarranted interventions including chemotherapeutic agents like methotrexate or have led to delay in necessary medical interventions in women. We report a case to demonstrate that amenorrhea and extraplacental human chorionic gonadotropin (hCG) production in young women can mimic a pregnancy of unknown location. Furthermore, we performed a critical review of literature on pituitary hCG production. Case: A 38-year-old woman with a diagnosis of Silver-Russell syndrome, a unicornuate uterus, history of right oophorectomy for a benign serous cystadenoma and a desire for pregnancy presenting with a provisional diagnosis of pregnancy of unknown location.After performing a thorough review of history, physical examination, ultrasound exams, and a review of hormone analysis [including hCG, Tumor markers, Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Anti-Mullerian Hormone (AMH), Estradiol (E2) levels], we confirmed the diagnosis of premature ovarian insufficiency and pituitary hCG production. Conclusions: In women, serum levels of hCG may increase with age, and are not always an indicator of pregnancy. Therefore, it is imperative to interpret false-positive test results and rule out the extraplacental production of hCG. This will help prevent unnecessary surgical procedures and treatment, including chemotherapy

Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

OBJECTIVES: Acute ST-segment elevation myocardial infarction patients presenting persistent no-flow after wire insertion have a lower survival rate despite successful mechanical intervention. The neutrophil-to-lymphocyte ratio has been associated with increased mortality and worse clinical outcomes in ST-segment elevation myocardial infarction. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would also be associated with a persistent Thrombolysis In Myocardial Infarction flow grade of 0 after wire insertion in patients undergoing primary percutaneous coronary intervention. METHODS: A total of 644 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention within 12 hours of symptom onset were included in our study. Blood samples were drawn immediately upon hospital admission. The patients were divided into 3 groups according to their Thrombolysis In Myocardial Infarction flow grade: Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion, Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. RESULTS: The neutrophil-to-lymphocyte ratio was significantly higher in the group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion compared with the group with Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and the group with Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. The group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion also had a significantly higher in-hospital mortality rate. Persistent coronary no-flow after wire insertion was independently associated with the neutrophil-to-lymphocyte ratio. CONCLUSIONS: An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention