The relationship between oxidative stress and preeclampsia. The serum Ischemia-modified albumin levels and thiol/disulfide homeostasis

Objective: Preeclampsia (PE) is a dangerous complication of pregnancy and still a major cause of maternal-fetal morbidity and mortality. Its etiology remains largely unknown, but researchers have suggested oxidative stress-mediated inflammation for the same. The purpose of this study is to investigate the relationship between oxidative stress and PE as well as the usability of oxidative stress indicators such as serum ischemia-modified albumin (IMA) levels and thiol/disulfide balance in the prediction of PE. Materials and Methods: The study included 47 pregnant women with PE and 57 healthy pregnant women. We measured their serum IMA, native thiol, total thiol, and disulfide levels. Additionally, we determined the optimal cutoff values via the receiver operating characteristic curve analysis. Results: There were no differences between the two groups with respect to the maternal age, body mass index, gravida, and parity. The native and total thiol levels were found to be low when the disulfide and IMA levels were high in the patients with PE (p<0.05). When the IMA level was corrected by the albumin level (IMAR), the significant difference between the two groups disappeared. We also found that the native and total thiol concentrations were correlated with the systolic and diastolic blood pressures. The optimal cut-off values calculated for the prediction of PE were as follows: 178.45 µmol/L (with sensitivity of 72% and specificity of 83%) for native thiol, 232.55 µmol/L (with a sensitivity of 75% and specificity of 85%) for total thiol, and 29.05 µmol/L (with sensitivity of 65% and specificity of 72%) for disulfide. Conclusion: The balance of thiol/disulfide may play a role in the pathogenesis of PE and could be used as a biological marker for PE. © 2020 by Turkish Society of Obstetrics and Gynecology Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House

Parental diet, pregnancy outcomes and offspring health:metabolic determinants in developing oocytes and embryos

The periconceptional period, embracing the terminal stages of oocyte growth and post-fertilisation development up to implantation, is sensitive to parental nutrition. Deficiencies or excesses in a range of macro- and micronutrients during this period can lead to impairments in fertility, fetal development and long-term offspring health. Obesity and genotype-related differences in regional adiposity are associated with impaired liver function and insulin resistance, and contribute to fatty acid-mediated impairments in sperm viability and oocyte and embryo quality, all of which are associated with endoplasmic reticulum stress and compromised fertility. Disturbances to maternal protein metabolism can elevate ammonium concentrations in reproductive tissues and disturb embryo and fetal development. Associated with this are disturbances to one-carbon metabolism, which can lead to epigenetic modifications to DNA and associated proteins in offspring that are both insulin resistant and hypertensive. Many enzymes involved in epigenetic gene regulation use metabolic cosubstrates (e.g. acetyl CoA and S-adenosyl methionine) to modify DNA and associated proteins, and so act as 'metabolic sensors' providing a link between parental nutritional status and gene regulation. Separate to their genomic contribution, spermatozoa can also influence embryo development via direct interactions with the egg and by seminal plasma components that act on oviductal and uterine tissues

Comparison of Controlled Ovarian Stimulation Protocols on IVF Outcome in Normal and Poor Responders

OBJECTIVE: Aim of this study is determining the influence of luteal long GnRH agonist and GnRH antagonist protocols on IVF/ICSI cycle outcome in group of patients considered “normal responder” and influence of luteal long GnRH agonist, microdose flare-up agonist and GnRH antagonist protocols on IVF/ICSI cycle outcome in a group of patients considered “poor responder”. STUDY DESIGN: This was a retrospective analysis performed in the Hacettepe University School of Medicine IVF Center, Ankara, from January 2005 to December 2007. Normal responders (first arm) were stimulated either with luteal long GnRH analogues, (193 patients and 300 cycles) or with GnRH antagonists (215 patients and 300 cycles). Poor responders (second arm) were stimulated either with luteal long GnRH analogues, (20 patients and 32 cycles), with GnRH antagonists (21 patients and 45 cycles) or microdose flare-up protocol (27 patients and 74 cycles). RESULTS: In the first arm; the clinical pregnancy, implantation and multiple pregnancy rates were comparable between the two groups in the first arm. In the second arm; clinical pregnancy, implantation and multiple pregnancy rates were comparable between three groups. CONCLUSION: There is insufficient evidence to recommend GnRH agonist or GnRH antagonist protocols for patients considered “normal’ and ‘poor responder’

Functional Cyst Aspiration At The Beginning Of ICSI Cycle Does Not Have Detrimental Effect on ICSI Outcomes

OBJECTIVE: The aim of our study is to investigate the effect of functional simple cyst aspiration at the beginning of intracytoplasmic sperm injection (ICSI) cycles on controlled ovarian hyperstimulation (COH) and ICSI outcomes. Design retrospective case-control study. STUDY DESIGN: Fifty consecutive patients (69 cycles, Group I) who underwent functional cyst aspiration at the beginning of ICSI cycle were enrolled retrospectively via our computerized IVF database system. The control group was constituted from the 70 patients (99 cycles, tubal factor infertility, Group II). RESULTS: Controlled ovarian hyperstimulation responses, embryological data and pregnancy outcome of both groups were all comparable. CONCLUSION: Functional simple cysts aspiration at the beginning of ICSI cycles does not have detrimental effect on both COH and ICSI outcomes

Adnexal Torsion in the Third Trimester of Pregnancy After in Vitro Fertilization: A Case Report

Adnexal torsion causes venous and lymphatic blockade complicated by congestion. Adnexal torsion is seldom in pregnancy, occuring approximately 1 in 5000 pregnancies, more frequently in the first trimester. Acute abdominal pain and abdominal disturbances are challenging issues during pregnancy for the diagnosis. The clinical symptoms are non-specific. Colour and power Doppler sonography may be useful for the early diagnosis. Adnexal torsion is generally due to ovarian stimulation treatment or ovarian masses in pregnancy. The correct diagnosis of maternal ovarian torsion might be delayed or underestimated in the second half of gestation because the increased dimensions of the uterus could blockade the abdominal palpation and make the sonography inefficient. Laparoscopy should be preferable for the adnexal torsion suspicion. But as the gestational age increases laparotomy should be a choice because of the risk of injury to the uterus related to the enlarged volume by the fetus