Assessment of the relationship between follicular fluid calcium ion concentration and reproductive outcomes

Background: Quantification of follicular fluid (FF) composition can provide valuable information about the oocyte state which can be helpful in distinguishing high and low quality oocyte. In the absence of appropriate calcium signaling at fertilization, the embryo may fail to implant and/or develop to full term. We herein aimed to investigate whether FF levels of Ca2+ ion concentrations vary between patients who achieved pregnancy and those who did not following a standard ICSI treatment regimen, and hence to determine whether FF Ca2+ levels could predict reproductive outcomes in patients undergoing ICSI.Methods: Patients seeking treatment for solely unexplained infertility were recruited in the period between June and December 2013 and were assigned to the groups according to their reproductive outcomes. Group 1 consisted of patients who conceived and Group 2 consisted of those who did not achieve pregnancy following ICSI. Parametric comparisons were performed using Student’s t-test. Categorical data were evaluated by using χ2 test.Results: Groups 1 and 2 consisted of 34 and 66 patients, respectively. Although FF Ca2+ ion concentrations were higher in those who did not achieve any pregnancy, the difference did not reached to statistical significance level (7.6±0.4 mg/dl and 7.9±0.9 mg/dl respectively, p=0.070).Conclusions: FF Ca2+ ion concentrations did not significantly differ between patients who achieved pregnancy and who did not followed ICSI attempts. Thus FF Ca2+ levels do not appear to be of benefit in predicting reproductive outcomes in unexplained infertility patients undergoing ICSI cycles

Does the number of prior oocyte retrieval practices increase the amount of blood loss in subsequent OPU procedures?

Background: Though OPU is a safe and simple procedure, it may cause damage to pelvic structures and bleeding. It is unclear whether history of a prior OPU poses any risk of increased blood loss in the OPU. We, herein, aimed to evaluate whether mean blood loss and hematologic parameters vary between women with and without the history of an OPU, in an unexplained infertility population.Methods: A prospective case-control study was conducted through the files of patients who underwent IVF/ICSI-ET between June and December 2013. Unexplained infertility patients with a CBC result were assigned to two groups; those undergoing OPU for the first time (Group 1, n=40) and those who were previously subjected to at least 1 procedure (Group 2, n=13). Blood samples were obtained before the ET. Hemoglobin values and changes were compared between the two groups.Results: Delta hemoglobin value did not significantly differ between the groups (p=0.469) and there were no significant difference between the pre- and post-procedure hemoglobin values in the patients with no and at least one OPUs and the total patient population (p=0.792, 0.259 and 0.442, respectively).Conclusions: Our study results reveal that the amount of the blood loss in OPU does not significantly vary between women subjected to the procedure for the first time and for more than 1 time.

Second trimester termination of pregnancy complicated with multiple fetal abnormalities and also placenta percreta

We read with great interest the article by Matsuzaki S and et al., in which the authors presented a case series named “Successful management of placenta percreta by cesarean hysterectomy with transverse uterine fundal incision”.

The Effect of Dehydroepiandrosterone on Ovarian Reserve in Ovarian Damage Caused by Methotrexate

To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (