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Folic acid supplements are commonly used by infertile women which leads to a positive folate status. However, the effect of folic acid supplements on pregnancy outcome in women with unexplained infertility has not been well investigated. This study evaluated folic acid supplement use and folate status in women with unexplained infertility in relation to IVF pregnancy outcome. In addition, use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile, nonpregnant control women. Women with unexplained infertility used significantly more folic acid supplements and had higher median total folic acid intake from supplements compared with fertile control women (both P < 0.001). Women with unexplained infertility also had significantly higher median plasma folate and lower median plasma homocysteine concentrations than fertile women (both P < 0.001), but folic acid supplementation or folate status were not related to pregnancy outcome in women with unexplained infertility. In conclusion, folic acid supplementation or good folate status did not have a positive effect on pregnancy outcome following infertility treatment in women with unexplained infertility. Folate is one of the B vitamins which has been suggested to be related to infertility. Folic acid is an artificial form of folate which is commonly used in dietary supplements. Folic acid supplementation has been shown to increase folate concentrations and decrease concentrations of the amino acid homocysteine in the blood. Folic acid supplementation is commonly used by infertile women, but the effect on pregnancy outcome in women with a diagnosis of unexplained infertility has not been thoroughly investigated. In the present study, folic acid supplement use and folate status (concentrations of folate and homocysteine) in women with unexplained infertility were evaluated in relation to pregnancy outcome. In addition, the use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile control women. Our results showed that women with unexplained infertility used considerably more folic acid supplements and had higher total folic acid intake from supplements compared with fertile control women. Women with unexplained infertility had better blood folate and homocysteine concentrations than fertile women, but folic acid supplementation or folate status were not related to pregnancy outcome following the infertility treatment. In conclusion, high folic acid intake or good folate status did not increase the possibility of a birth of a healthy baby after infertility treatment in women with unexplained infertility., (Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate whether seasonal variations and meteorological factors influence pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment. Design: Retrospective cohort study. Setting: University-affiliated reproductive medical center. Subjects: Women aged < 35 years undergoing IVF from June 1, 2015, to June 1, 2019. Interventions: Cycles were divided into four groups according to the date of the beginning of ovulation induction: spring (659 cycles), summer (578 cycles), autumn (519 cycles), and winter (534 cycles). Results: The high-quality embryo rate was higher in autumn and winter than in cycles in which ovulation induction occurred in spring and summer (58.70% vs. 58.78% vs. 62.67% vs. 63.42%; P < 0.001). The results of linear regression analysis showed that the high-quality embryo rate was significantly correlated with the daily average temperature of ovulation induction (P = 0.037). The clinical pregnancy rates of cycles starting ovulation induction in spring, summer, and autumn were significantly higher than those starting in winter (70.71% vs. 73.18% vs. 70.13% vs. 65.17%; P = 0.031), while the biochemical pregnancy rate, early abortion rate, and live birth rate were not significantly different (P > 0.050). Multivariate logistic regression analysis showed significant seasonal variation in clinical pregnancy (OR = 1.643, 95% CI = 1.203–2.243; P = 0.002), and that a higher daily average temperature at the time of ovulation induction increased the clinical pregnancy rate (OR = 1.012, 95% CI = 1.001–1.022; P = 0.031). Conclusions: In women younger than 35 years who undergo IVF treatment, the season and ambient temperature on the date of the beginning of ovulation induction may have an impact on embryo development and clinical pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore whether the coronavirus disease (COVID-19) vaccination of both partners in infertile couples, different types of COVID-19 vaccines, and the interval between complete vaccination and oocyte retrieval or embryo transfer (ET) affect the quality of embryos and pregnancy rates in in vitro fertilization (IVF). Methods: This was a prospective cohort study, comprising 735 infertile couples conducted between December 6, 2021, and March 31, 2022, in a single university hospital-based IVF center. The patients were divided into different groups according to the vaccination status of both partners in infertile couples, type of vaccine, and interval between complete vaccination and IVF treatment. The embryo quality and pregnancy rates were compared among different groups. Results: The results showed that embryo quality and pregnancy rates had no significant differences among different groups. The multivariate regression model showed that the vaccination status of both infertile couples, types of vaccines, and intervals had no significant effects on the clinical pregnancy rate. Conclusions: The vaccination status of both partners in infertile couples, different types of vaccines, and time intervals have no effect on embryo quality and pregnancy rates in IVF. This is the first study to compare the vaccination status of both partners in infertile couples and the impact of different vaccine types on pregnancy rates and embryo quality in detail. Our findings provide evidence of vaccine safety for infertile couples wishing to undergo IVF treatment. This evidence is crucial for decision-making by clinicians and policymakers involved in IVF cycles. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether androgen conversion rates after supplementation with dehydroepiandrosterone (DHEA) differ, and whether differences between patients with diminished ovarian reserve (DOR) are predictive of pregnancy chances in association with in vitro fertilization (IVF). Methods: In a prospective cohort study we investigated 213 women with DOR, stratified for age (≤38 or >38 years) and ovarian FMR1 genotypes/sub-genotypes. All women were for at least 6 weeks supplemented with 75 mg of DHEA daily prior to IVF, between initial presentation and start of 1st IVF cycles. Levels of DHEA, DHEA-sulfate (DHEAS), total T (TT) and free T (FT) at baseline () and IVF cycle start () were then compared between conception and non-conception cycles. Results: Mean age for the study population was 41.5 ± 4.4 years. Forty-seven IVF cycles (22.1 %) resulted in clinical pregnancy. Benefits of DHEA on pregnancy rates were statistically associated with efficiency of androgen conversion from DHEA to T and amplitude of T gain. Younger women converted significantly more efficiently than older females, and selected FMR1 genotypes/sub-genotypes converted better than others. FSH/androgen and AMH/androgen ratios represent promising new predictors of IVF pregnancy chances in women with DOR. Conclusions: DOR at all ages appears to represent an androgen-deficient state, benefitting from androgen supplementation. Efficacy of androgen supplementation with DHEA, however, varies depending on female age and FMR1 genotype/sub-genotype. Further clarification of FMR1 effects should lead to better individualization of androgen supplementation, whether via DHEA or other androgenic compounds. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the sizes of the placenta and umbilical cord in women with natural pregnancy versus those undergoing in vitro fertilization (IVF).Methods: Overall, 1610 cases of uncomplicated single pregnancies with vaginal delivery at ≥ 37 weeks of gestation were included in this study. The patients were divided into two groups: natural pregnancy group (n = 1453) and IVF pregnancy not including intracytoplasmic sperm injection (ICSI) treatment (n = 157). The groups were compared in terms of gestational week, maternal age, parity, maternal weight gain, prepregnancy maternal BMI, infant weight at birth, infant head circumference, placental weight, cross section of the placenta, cross section of the umbilical cord, insertion site of the umbilical cord, and umbilical cord length. Stepwise selection and multivariate logistic regression were used for statistical analysis to correct the result as an independent factor.Results: There was no difference in the size of the placenta and umbilical cord between women with natural pregnancy and with IVF, but the incidence of velamentous insertion of the cord was significantly increased in women with IVF pregnancy (adjusted odd ratio [AOR] 1.72, 95% confidence interval [CI] 1.08-2.72, p = 0.026).Conclusions: Although there is no difference in placental weight and cord size, velamentous insertion of the umbilical cord increases in IVF pregnancy and needs careful observation during the delivery process. [ABSTRACT FROM AUTHOR]

IVF (in vitro fertilization) often represents the ultimate step in our attempt to treat infertility. Nowadays this method is more and more used, couple's expectations are higher and higher, so that optimizing the chance that one IVF pregnancy became a healthy newborn child is becoming an important issue. In this study we analyzed the controlled ovarian hyperstimulation impact on IVF pregnancy prognosis. We studied 307 patients who had IVF fresh procedures in "Panait Sirbu" Clinical Hospital of Obstetrics and Gynecology - Department of Assisted Human Reproduction between 01.01.2008 - 31.12.2010 and obtained pregnancy; pregnancy rate according to our statistics is 34%. For statistic analysis we used the odd Student test. Our data proved better results (defined as a better birth/abortion ratio) for the patients where recombinant FSH was used towards patients where highly purified urinary gonadotropin or the combination of the two drugs was used. Our statistical data also proved that none of the variables: age, BMI (body mass index), endometrium thickness, number of oocytes, number of embryos or number of days of stimulation is a favorable variable for this better result, but the number of units of gonadotropin is a favorable variable for a better birth/abortion ratio. We consider that our data gives an interesting perspective upon the connection between controlled ovarian hyperstimulation and pregnancy outcome, especially these days when tendencies are to obtain as many oocytes in one procedure as we can, which often means to use high doses of gonadotropin.

A 39- year-old woman, who conceived following in vitro fertilisation (IVF) treatment, presented at 12 weeks gestation with symptoms of ovarian hyperstimulation syndrome (OHSS), abdominal pain, vomiting and diarrhoea. Subsequent investigations found small bowel obstruction  secondary to ovarian torsion. Surgical management to remove a necrotic ovary and fallopian tube led to a good recovery from the acute illness. A postoperative ultrasound scan confirmed a viable pregnancy and the patient was discharged. Her case demonstrates a rare complication of OHSS and ovarian torsion leading to small bowel obstruction.