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Objective: To evaluate the predictive value of the first-trimester aspartate aminotransferase (AST)/platelet count ratio [AST to platelet ratio index (APRI) score] for intrahepatic cholestasis in pregnancy (ICP)., Methods: This study consisted of a patient group diagnosed with ICP (n = 37) and a control group (n = 66) who presented to the hospital perinatology clinic between 2018 and 2020. Laboratory tests of both groups were analysed retrospectively. Age, gravida, parity, body mass index, third-trimester laboratory tests and first-trimester APRI scores were compared between the two groups. A receiver operating characteristic (ROC) analysis of the study was performed to determine the cut-off value for APRI score that is predictive of ICP., Results: Patients with ICP had significantly higher first-trimester APRI scores compared with controls (p < 0.001). In the ROC analysis, the cut-off value for APRI score was 0.57, with 86.5 % sensitivity and 77.3 % specificity. Spearman's correlation indicated that there was a significant positive association between first-trimester APRI score and third-trimester fasting bile acid level (r = 0.641, p < 0.001). The demographic characteristics of patients in the third trimester did not differ, except for AST and alanine transferase values., Conclusions: The APRI score calculated in the first trimester of pregnancy seems to be predictive of the development of ICP in the third trimester., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: To assess the effects of heavy metal and trace element concentrations in blood and follicular fluid on assisted reproductive technology cycle outcome., Study Design: A prospective study was conducted between January 2012 and July 2012 in a university hospital infertility clinic. One hundred and one patients with unexplained infertility who underwent intracytoplasmic sperm injection using GnRH-antagonist protocol were recruited. Concentrations of four toxic metals (Cd, Pb, Hg, As) and three trace elements (Cu, Zn, Fe) were measured both in blood and follicular fluid specimens. Patients were evaluated in two groups; the study group consisted of patients with ongoing pregnancy (n=20) and the reference group consisted of patients experienced assisted reproductive technology failure, miscarriage or biochemical pregnancy (n=81)., Results: Demographics and cycle parameters were comparable between the groups except for median number of day 3 Grade A embryos. Statistically significant negative correlations were found between blood Pb levels and number of MII oocytes, implantation, clinical pregnancy and ongoing pregnancy rates. Results of the log binomial regression revealed 2.2% lower risk for ongoing pregnancy for each 1μg/dL higher blood Pb concentration while holding the other variables in the model constant (RR 0.978; 95% CI 0.956-0.998; P=.041). Also, the results revealed 71.9% lower risk for ongoing pregnancy for each 1μg/dL higher follicular fluid Cu concentration while holding the other variables in the model constant (RR 0.288; 95% CI 0.085-0.92; P=.039)., Conclusion: Blood concentrations of Pb and follicular fluid concentrations of Cu seem to have significant impacts on assisted reproductive technology cycle outcome., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)