Human Papillomavirus infection in cervical precancerous lesions

Infection with high-risk HPV genotypes increases the risk for persistent or progressive cervical lesions. The aim of this study was to determine the frequency and correlation of the HPV infection with the cytological or histopathological diagnosis. A total of 6988 samples were analysed and after exclusion of the repeated samples and/or those containing degraded DNA, 4421 patients were included in the study group. PCR-RFLP technique was used as a method for HPV typing. HPV infection was detected in 1819 out of 4421 patients. The frequency of infection was 23% in the patients’ group with cytological and 60% in the group with histopathological diagnosis. The HPV frequencies in precursor lesions were as follows: 51% in patients with mild; 75% in patients with moderate; 91% in patients with severe dysplasia and 93% in carcinoma in situ lesions. The most prevalent HPV types in descending order were: HPV 16, 31, 53, etc. HPV infection was the most frequent in patients under 19 years old. In 169 out of 1253 samples with determined viral genotype, a multiple infections were found. This data for the prevalence and distribution of the HPV infection in Macedonian women accentuates the need for the establishment of organized screening programs

The day of embryo transfer affects delivery rate, birth weights, female-to-male ratio, and monozygotic twin rate

Objective To compare the reproductive outcomes between the transfer of cleavage-stage embryos and blastocysts in two different age groups of patients. The reproductive capacity of women decreases by age. This decrease in capacity is directly related to a lower ovarian reserve and errors in the meiotic spindle of the oocyte, which increase chromosomal abnormalities and the formation of aneuploidy embryos with lower chances of implantation. Materials and Methods A total of 1400 intracytoplasmic sperm injection cycles were analyzed. The study patients were divided into two age groups [aged < 36 years (Group I) and aged ≧ 36 years (Group II)]. The groups were subdivided according to the day of embryo transfer (ET)—Day 3 (ET3) and Day 5 (ET5). Results In both age groups, transfer of blastocysts resulted in a higher clinical pregnancy rate and deliveries. An increased twin birth rate was observed in patients who were younger than 36 years on both transfer days compared with those who were older than 36 years of age. There was an elevated percentage of newborn males on ET5 in both age groups. Monozygotic twinning (MZT) rate was observed only among younger patients (<36 years of age), specifically on ET5 compared with ET3. There was no significant difference in the mean birth weight of singleton and twins between the ET3 and ET5 subgroups in the younger group of patients except for the triplets who were significantly heavier in the ET5 group compared with the older group (≧36 years of age) where significant difference was found only on the mean birth weight of singleton. Conclusion The study suggests that if a blastocyst can be obtained in patients of advanced age (≧36 years), it improves their baby take-home rates. Younger patients (aged < 36 years) should undergo elective single blastocyst transfers to reduce multiple pregnancy rates

Different Timing of Adjuvant Low Dose hCG and GnRH Agonist Trigger Protocol, in OHSS High-Risk Patient with Peak E2 Level <4000 pg/mL

Objective: The aim of the study is to compare the live birth rates between 1,500 I.U. of Human chorionic gonadotropin at the time of Gonadotropin-releasing hormone agonist trigger day or 35-36 h later on the oocyte pick-up day, without affecting the risk of significant ovarian hyperstimulation syndrome development in high-risk patients with peak E2 level <4,000 pg/m