Endometrial preparation using gonadotropin-releasing hormone agonist prior to frozen-thawed embryo transfer in women with repeated implantation failure: An RCT

Background: Preparation of endometrial thickness in frozen-thawed embryo transfer (FET) is extremely important, particularly in repeated implantation failure (RIF) patients. Objective: This study aimed to investigate the clinical outcomes of FET cycles among RIF women, based on the effects of administering gonadotropin-releasing hormone (GnRH) agonist prior to estrogen-progesterone preparation of the endometrium. Materials and Methods: In this randomized clinical trial, 67 infertile women who were candidates for FET were divided into two groups: A) case group (n = 34), treated with GnRH agonist prior to endometrial preparation and B) control group (n = 33), which received the routine protocol. (6 mg daily estradiol started from second day) The clinical outcomes) including chemical and clinical pregnancy, in addition to implantation rates, were compared between the two groups. Results: The results showed no significant differences in women’s age (p = 0.558), duration (p = 0.540), type (p = 0.562), and cause of infertility (p = 0.699). Regarding pregnancy and implantation rates, there was a trend toward an increase in the case group; however, differences were not statistically significant. Conclusion: Although our results showed no significant differences between groups. Because there are trends to better results in case group larger sample size may show significant difference. Key words: Implantation failure, Gonadotropin-releasing hormone, Embryo transfer, Pregnancy, Implantation

The exact synchronization timing between the cleavage embryo stage and duration of progesterone therapy-improved pregnancy rates in frozen embryo transfer cycles: A cross-sectional study

Background: Synchronization between the embryonic stage and the uterine endometrial lining is important in the outcomes of the vitrified-warmed embryo transfer (ET) cycles. Objective: The aim was to investigate the effect of the exact synchronization between the cleavage stage of embryos and the duration of progesterone administration on the improvement of clinical outcomes in frozen embryo transfer (FET) cycles. Materials and Methods: 312 FET cycles were categorized into two groups: (A) day- 3 ET after three days of progesterone administration (n = 177) and (B) day-2 or -4 ET after three days of progesterone administration (n = 135). Group B was further divided into two subgroups: B1: day-2 ET cycles, that the stage of embryos were less than the administrated progesterone and B2: day-4 ET cycles, that the stage of embryos were more than the administrated progesterone. The clinical outcome measures were compared between the groups. Results: The pregnancy outcomes between groups A and B showed a significant differences in the chemical (40.1% vs 27.4%; p = 0.010) and clinical pregnancies (32.8% vs 22.2%; p = 0.040), respectively. The rate of miscarriage tended to be higher and live birth rate tended to be lower in group B than in group A. Also, significantly higher rates were noted in chemical pregnancy, clinical pregnancy, and live birth in group A when compared with subgroup B2. Conclusion: Higher rates of pregnancy and live birth were achieved in day-3 ET after three days of progesterone administration in FET cycles. Key words: Endometrium, Embryo transfer, Pregnancy, Live birth, Progesterone

Microleakage comparison of resin modified glass ionomer and OrthoMTA used as a coronal barrier in nonvital teeth bleaching

Background and Aim: Common causes of dental discoloration include trauma, drugs, genetic defects, decay, and age. In order to correct discoloration of pulpless teeth, internal bleaching is recommended. The aim of this study was to compare microleakage of resin modified glass ionomer and OrthoMTA used as an intraorifice barrier in non-vital bleaching. Methods: In this experimental study, 36 extracted mandibular premolars were selected and randomly divided into two experimental (n = 16) and two control groups (n = 2). 2mm of OrthoMTA and RMGI cements were placed as intraorifice barriers in the experimental groups. Subsequently, we placed a mixture of sodium perborate and 30% hydrogen peroxide as internal bleaching material into the canal and replaced it every three days. Leakage was measured using pH diffusion method by a digital PH meter. Data were statistically analyzed by using T- independent test and repeated measures and variance analysis (P<0.05). Results: The pH value of the negative control group was as same as the PH of normal saline while the PH value of positive control group was significantly higher than those of other groups. PH values of Ortho MTA and RMGI at the baseline and on the first, sixth and ninth day did not show significant differences with one another, while microleakage of OrthoMTA group was significantly lower on the third day. Conclusions: In general, OrthoMTA had less leakage than RMGI but both materials can be used as suitable barriers for internal tooth bleaching Keywords: Tooth bleaching, OrthoMTA, Glass ionomer, leakag

A Comparative Investigation of the Microleakage of Biodentine and Mineral Trioxide Aggregate as Coronal Barrier in Nonvital Bleaching

Background: Internal bleaching is recommended to correct the discoloration of pulpless teeth. This study aimed to compare the microleakage of biodentine and mineral trioxide aggregate (MTA) used as an intracanal barrier in non-vital bleaching. Methods: An experimental study was performed in which 36 extracted mandibular premolars were randomly divided into two experimental groups (n= 16) and two control groups (n= 2). In experimental groups, 2mm of OrthoMTA and biodentine cement were placed as intracanal barriers. The control groups were prepared similar to experimental groups, except that in positive control group the orifice barrier material was not used and in negative control group the whole root surface was covered with nail polish and orifice barrier material was not used. Subsequently a mixture containing sodium perborate and 30% hydrogen peroxide was placed into the pulp chambers and replaced every three days. Microleakage was measured using a pH diffusion method by digital pH meter. pH was checked before placement and at days 1, 3, 6, and 9 after placement. Data analysis was done in SPSS V24 Results: The pH value in negative control group was similar to that in normal saline group, while the pH value in positive control group was found to be significantly higher than other groups (P< 0.05). Nosignificant differences were seen in pH values between the experimental groups at baseline and days 1 and 6, but pH values of biodentine were significantly higher than orthoMTA at days 3 and 9 (P< 0.05). Conclusions: MTA can be used as an efficient orifice barrier during internal bleaching, specifically in cases where there is probability for cervical root resorption. Keywords: tooth bleaching, mineral trioxide aggregate, dental leakag

Noninvasive assays of in vitro matured human oocytes showed insignificant correlation with fertilization and embryo development

Purpose Recently, the upgrading of in vitro maturation (IVM) of human oocytes as a promising strategy has emerged in assisted reproductive technology (ART). The goal was to evaluate the correlation of the in vitro matured oocytes selected on the basis of the zona pellucida (ZP) birefringence and meiotic spindles (MS) detection with fertilization and subsequent embryo development in ICSI program. Methods A total of 168 immature oocytes [germinal vesicle (n = 140) and metaphase I (n = 28)] obtained from patients undergoing oocytes retrieval for ICSI. After in vitro culture for 24–40 h, 112 (67 %) oocytes reached to MII stage. Using a polarized microscopy, the presence of MS and ZP birefringence were assessed in matured oocytes, followed by ICSI performance. Results The rates of fertilization in oocytes with spindles (51.3 %) were similar to that of the oocytes without spindles (50.7 %; P = 1.00). Moreover, the fertilization rates in high birefringence (HB) oocytes was not statistically different than oocytes with low birefringence (LB) (P = 0.44). The findings also showed that 64.9 % of the fertilized oocytes developed to embryos, in which 33.3 % were derived from spindle-detected oocytes. Regarding the ZP birefringence, 35.5 % of the embryos were derived from HB oocytes. Conclusions There were insignificant relationships between the MS detection and ZP birefringence score with the rates of fertilization and embryo development in IVM oocytes

Explaining the Religious Strategies of Parents and Nurses of Infants Admitted to the Neonatal Intensive Care Unit: A Qualitative Study

Background and Objectives: Paying attention to religious beliefs is not a new approach but has attracted the attention of various scientists for many years, both to analyze the reasons for turning to religion and in the direction and manner of its impact on behavior. The more people pay attention to strengthening their beliefs, religious beliefs, and religious behaviors, the better they can protect themselves from psychological harm. Therefore, this study aims to explain the religious strategies of parents of infants admitted to the neonatal intensive care unit (NICU). Methods: This qualitative study was conducted in 2020. The statistical population included parents and nurses. The research sample was selected by purposeful sampling, including 16 mothers, 6 fathers, and 6 nurses. Data were collected via in-depth quasi-structured interviews. Data analysis was performed by conventional qualitative content analysis. Results: Data analysis was obtained in three categories, search for hope and trust in God (2 categories), neglect of the health team to the spiritual needs of parents (2 categories), spirituality, and coping with illness (2 categories). Conclusion: The results of this research can be useful at both theoretical and practical levels. The present study helps to improve healthcare team knowledge about parents’ religious strategies in the NICU. Educational interventions should be performed to familiarize nurses with the correct communication with parents’ religious beliefs

Missed estradiol determination resulting in oocyte retrieval and embryo development following controlled ovarian hyperstimulation at early pregnancy: Case report

This paper is a case report on the success of oocyte retrieval and good quality embryo development following controlled ovarian hyperstimulation at early pregnancy. A 30-year-old patient underwent controlled ovarian hyperstimulation by gonadotropin-releasing hormone agonist long protocol. On the day of oocyte collection, a 5-week gestational sac was observed by exact sonography monitoring. However, via ultrasound guided follicle puncture, 7 oocytes were collected. After intarcytoplasmic sperm injection, 3 developed good quality embryos were cryopreserved. Moreover, the natural pregnancy was continued and finally a healthy live birth was achieved. Despite physiological hormonal changes during pregnancy, the follicular growth occurred and followed by oocyte retrieval and embryo development, subsequently