To show how interstitial pregnancy can be safely managed with a laparoscopic resection.

Placenta is a linking temporary organ that connects the developing fetus and the mother. However, it cannot avoid the embryo against chromium (Cr) and nickel (Ni) exposure. Quantification of Cr and Ni in biological and ecological subjects is challenging. Accordingly, the first goal of this study was to provide a validated Graphite Furnace Atomic Absorption Spectrometry (GFAAS) method to determine Cr and Ni in mother-newborn specimens. However, the main objective of this work was to assess the reference Ni and Cr contents in cord blood, maternal blood, and placenta samples. Biological samples were collected from 100 healthy mother-newborn pairs. Metal levels were quantified by the GFAAS method. Method validation of this toxicological analysis was performed by the use of certified reference materials (CRM), which was based on accuracy, precision, specificity, range, quantitation, and detection limits. Mean Cr levels of maternal blood, placentas, and cord blood were 0.337±0.222 μg/L, 0.221±0.160 μg/kg, 0.121±0.096 μg/L, respectively. Besides, mean Ni concentrations of these biological specimens were 0.128±0.093 μg/L 0.124±0.067 μg/kg, 0.099±0.067 μg/L, respectively. The method showed linearity with excellent correlation coefficients (r2) for Cr and Ni equal to 0.9994 and 0.9999, respectively. Satisfactory recovery and coefficient of variation (CV) for Cr and Ni were obtained as 102.85% and 102.35%; 1.75% and 2.91%, respectively. Relative error (RE) did not exceed 3%, demonstrating the accuracy of the method. Control charts were drawn to assess inter-day stability. Last but not least, the predicted reference ranges for Cr and Ni concentrations in maternal blood, placenta and cord blood were as follows: Cr 0.033-0.75 μg/L; 0.032-0.526 μg/kg; 0.031-0.309 μg/L and Ni 0.011-0.308 μg/L; 0.024-0.251 μg/kg; 0.066-0.209 μg/L, respectively. The reported reference values of biological specimens in this paper will provide complementary aid to health professionals in terms of assessment of environmental and occupational exposure.

Hysteroscopy is frequently performed in infertile women and thought to improve pregnancy rates. The data obtained from studies searching the effect of hysteroscopy in in-vitro fertilization (IVF) cycles is variable. We aimed to evaluate the effect of hysteroscopy on the pregnancy outcomes of fresh and frozen-thawed embryo transfers done in the IVF cycles respectively. We scanned the data of the 765 patients who had IVF treatment between January 2015 and July 2017 in an infertility center retrospectively. Of those, 586 patients were done fresh embryo transfer, 179 patients were underwent frozen-thawed embryo transfer (FET). Hysteroscopy was scheduled 2 months before the transfer by a single experienced surgeon. 101 patients in the fresh embryo transfer group and 44 patients in the FET group were underwent hysteroscopy. The pregnancy outcomes of the groups were compared respectively within their own group. The mean age was similar in patients within in the fresh and frozen-thawed embryo transfer groups (p= 0.418 and p=0.277, respectively). There was no statistically difference according to transferred embryo numbers in the fresh and frozen-thawed groups (p=0.218). We achieved 246 pregnancy in the fresh embryo group (44 patients were underwent diagnostic hysteroscopy while 202 did not, p= 0.516) and 79 pregnancy in frozen-thawed embryo group (20 patients were underwent diagnostic hysteroscopy while 59 did not, p= 0.711). There was no statistically difference according to pregnancy rate between the groups (p= 0.538). Performing diagnostic hysteroscopy before fresh or frozen-thawed embryo transfer does not improve the pregnancy rates.

Gestation weight (GW), body mass index (BMI), and the blood 25-hydroxyvitamin D (25(OH)D) level during pregnancy are important determinants of the gestational outcomes. This study aims to study how these parameters vary between antenatal vitamin D recipients and non-recipients in gestational diabetes mellitus (GDM) patients. The randomized controlled trials comparing these outcomes between vitamin D recipient and non-recipient GDM patients were searched in electronic databases (PubMed, Embase, and Scopus). The reviewed studies' data were abstracted and critically appraised by the Cochrane tool. The estimation of the weighted mean difference for GW and BMI and standardized mean difference (SMD) for 25(OH)D levels occurred by juxtaposing the interventions meta-analytically (random-effect model). The statistical inconsistency was determined by Chi2 and I2 method. The statistical significance was estimated at p<0.05 and 95% confidence interval (CI). Eleven eligible trials (all Iran-based, except one) sourcing data from about 875 GDM patients were reviewed. Overall, the risk of bias was low, except for selection and performance bias. On random-effect model meta-analysis, the 25(OH)D levels of the GDM patients favored the vitamin D recipients when compared to non-vitamin D (SMD: 1.97, 95%CI, 1.06, 2.88, p, <0.001, I2, 96.2%, p of Chi2, <0.001) and placebo (SMD, 1.86, 95% CI, 0.95, 2.77, p,<0.001, I2, 95.3%, p of Chi2,<0.001) recipients, respectively. On meta-regression, sample size was a predictor of the observed heterogeneity. For GW and BMI the interventions did not differ statistically significantly. In GDM patients, antenatal use of vitamin D aids in the rise of blood 25(OH)D levels; however, it doesn't influence GW and BMI change. PROSPERO registration number: CRD42020149613.

To compare outcomes transferring one or two embryos in autologous frozen oocyte cycles. A retrospective cohort study conducted at an academic fertility center (January 2012 and December 2018). 114 patients underwent frozen oocyte transfers. 67 patients underwent SET and 47 underwent DET. No subjects had more than DET during the time period of study. Data were analyzed using t test and chi-squared testing. Multivariate logistic regression was used to control for confounding effects. Power analysis suggested an 82% power with alpha of 5% and effect size of 27%. Regarding the stage, 72 % were cleavage embryos and 28% were blastocyst embryos. Among those who had cleavage stage embryos, 48.8% had SET and 51.2% had DET. In the blastocyst embryos, group 84.4% had SET and 15.6% had DET. There were no statistical differences observed in pregnancy rate for SET (40.3%) vs. DET(36.2%) (P = 0,78). Additionally, the live birth rate was not different between SET (28.4%) & DET(19.1 %) (P= 0.26). The multivariate multilevel analysis provided an adjusted OR- [95% CI] of 1.85-[0.46 - 7.44] for pregnancy, 0.497-[0.05 - 4.86] for clinical pregnancy, and 0.82-[0.11 - 6.29] for live birth when comparing SET & DET. Multiple pregnancy rates were significantly lower in the SET (0%), compared with DET group (44.4%) (p< 0.002). There are excellent live birth outcomes returning single embryos in autologous frozen oocyte cycles. However DET results in significantly increased rates of multiple pregnancies. As such SET is a viable option in autologous frozen oocyte cycles.