A prospective study to evaluate the gender prediction of blastocysts by using cell-free DNA within a culture medium

Background: Preimplantation genetic diagnosis (PGD) has been used as an option for couples with the possibility of having a baby with a genetic disorder. The common method for performing this test involves isolating 1 cell from day 3 or a few cells from day 5 embryos and performing genetic studies on the cell-extracted DNA. This method is invasive and can cause abortion after implantation in the uterus. Because of this, 2 noninvasive methods for performing a PGD have been studied: PGD using blastocyst fluid and PGD using embryo culture medium. Objective: The aim of this study is to determine the sensitivity of the polymerase chain reaction (PCR) technique to detect the Y chromosome using cell-free DNA within a culture medium for gender prediction of blastocysts. Materials and Methods: In this study, the gender of 30 embryos on day 5 was determined using embryonic DNA extraction from the culture medium and the PCR technique to evaluate the sex-determining region Y and fragile X mental retardation genes. Then, the accuracy was assessed using ultrasound. Results: The results of the PCR technique showed that 7 embryos were male, but an ultrasound revealed that 13 were male. Conclusion: The given results indicated that, because of the low amount of DNA extracted from the culture medium, the diagnosis of the existence of the Y chromosome by this method is still not accurate enough for detecting the gender of the embryo. Key words: Preimplantation diagnosis, Embryo implantation, Culture media, Blastocyst, Polymerase chain reaction

Clinical Study Using Celecoxib for the Suppression of Preterm Labor Instead of Magnesium Sulfate

We aimed to use celecoxib to suppress preterm labor instead magnesium sulfate (MgSO 4 ) to prevent preterm labor. Methods. It was a randomized clinical trial study, which was done on 600 pregnant women. All subjects were divided into two groups by simple random sampling. One group was given 4 grams of MgSO 4 intravenously and second group was given 100 mg of celecoxib orally every 12 hours for at least 2 days. The data were entered and analyzed using SPSS 11 and performed using -test and chi-square test. Results. The finding of this study has shown that preterm labor may be prevented in 75.7% of subjects who had received celecoxib and there were no significant difference between two groups in frequency of history of preterm labor ( = 1), frequencies of nulliparity ( = 0.99), duration of drug use and arrest contraction ( = 0.29), delivery before 48 hours ( = 0.20), and mean gestational age in lack of response to treatment ( = 0.24). Conclusions. Result has shown that celecoxib was similar to MgSO 4 as a medication to prevent preterm labor; it was recommended to be prescribe to prevent preterm labor, because it was cheaper than magnesium sulfate

Sonography in Comparison to Urinary Kit in Intra-Uterine Insemination Timing

Background: Despite all attempts to increase pregnancy rates, overall success rate of Intrauterine Insemination (IUI) is still not acceptable. Proof of ovulation is an important indicator to determine the time of IUI, but to date there is no test proving that the ovulation has definitely occurred. Objective: This study was aimed to compare the efficiency of ultrasound in measuring the size of follicles and urinary Luteinizing Hormone (uLH) kit in determining LH surge for IUI timing. Method: In this comparative, nonrandomized, not blinded clinical trial, 311 IUI cycles in 262 infertile couples who were candidate of IUI were assigned into two groups of ultrasound (n=100 cycles) and uLH kit (n=211 cycles) for IUI timing. Two weeks after doing the IUI, the ßHCG was checked, and chemical pregnancy was confirmed. Four weeks after positive chemical pregnancy test, the fetal heart activity was confirmed by pelvic ultrasonography to confirm clinical pregnancy. Results: Chemical pregnancy rate was lower in ultrasonography group but not significant in comparison to LH kit (14.3% and 18.4%, respectively (P= 0.11)). Clinical pregnancy rate in the groups of ultrasonography and LH kit was respectively 10.3% and 10.3% which did not differ significantly (P= 0.3). Conclusion: Considering that the use of uLH kit is a simple and low cost way and can be done at home by the patients, so the patients can have an active participation in their treatment process

Comparing the occurrence rate of gestational hypertension during pregnancy with frozen embryo transfer and natural pregnancy

Introduction: Recent researches have indicated that pregnancies with frozen embryo transfer are associated with the increment of risk of maternal and neonatal complications, especially hypertension during pregnancy. The present study aimed to compare the occurrence rate of gestational hypertension in pregnancy with frozen embryo transfer and normal pregnancy. Materials and Methods: This research, as a retrospective cross-sectional study, was performed on pregnant women with frozen embryo transfer (n = 97) and women with normal pregnancies (n = 164) referring to medical centers under the supervision of Ahvaz University of Medical Sciences in 2021. Women aged 18–35 were included in the study after week 20th of pregnancy. Maternal and neonatal outcomes including hypertensive disorders of pregnancy (including gestational hypertension and preeclampsia), preterm birth (before the week 37th), low birth weight (lower than 2500 g), neonatal asphyxia (Apgar score >7 in minute 5th), intrauterine growth restriction (IUGR) and bleeding in the first trimester of pregnancy were evaluated. The association between frozen embryo transfer and pregnancy outcomes was evaluated using multiple logistic regressions. Results: The findings of this study indicated that pregnancy hypertension was observed in 23 people (23.7%) from the frozen embryo transfer group vs. 18 people (11.0%) from the normal pregnancy group (P = 0.006). Frozen embryo transfer pregnancy has a higher risk of gestational hypertension (OR = 2.521, 95% CI: 1.281-4.962; P = 0.007), preterm birth (OR = 2.264, 95% CI: 1.335-3.840; P = 0.002), and low birth weight (OR = 2.017, 95% CI: 1.178-3.455; P = 0.011). However, the incidence of birth asphyxia (P = 0.850), intrauterine growth restriction (P = 0.068), first-trimester bleeding (P = 0.809), and placenta accreta (P = 0.143) did not show a significant difference between two types of normal pregnancy and frozen embryo transfer pregnancy. Conclusion: Frozen embryo transfer pregnancy was associated with a higher risk of maternal and neonatal complications, hypertension, preterm birth, and low birth weight compared to natural and spontaneous pregnancies