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Background: Ovarian aging, often leads to increased use of a donor oocyte, which is associated with greater risk for age-related diseases. Objective: To evaluate the association between women conceiving through oocyte donation (OD) and future cancer-related morbidity, as compared with women conceiving through IVF (in vitro fertilization) with autologous oocytes (AO), spontaneous conceptions (SC), and nulliparas. Methods: This retrospective, cohort study was based on the electronic health records of a very large health maintenance organization. The cohort included mothers who delivered before age 45, during 2000–2019. The index date for surveillance was the delivery date of the relevant pregnancy. Each woman from the OD group was matched to a woman the same age at delivery and with the same number of children. Cancer diagnosis was the main outcome. Results: Matching: 664 OD cases to 664 AO, 700 OD cases to 700 SC, and 700 OD cases to 700 nulliparas. Mean follow-up times were 8.9 ± 3.8 OD, 10 ± 4.1 AO, and 6.4 ± 4.1 years SC. Cancer-related morbidity rates were comparable between OD and the other groups, but compared with nulliparas, a trend was noted (1.6% and 3.1%, respectively, p = 0.07). Survival analysis curves were not significantly different, although a trend was shown in the curve comparing to nulliparity (p = 0.07). In a Cox regression model corrected for BMI, smoking and hormone replacement therapy exposure, cancer in the OD group did not differ compared to the other groups. Conclusion: Women conceiving through OD do not have increased risk for cancer-related morbidity in the decade following delivery. [ABSTRACT FROM AUTHOR]

The objective was to evaluate the outcomes of in vitro maturation (IVM) cycles using gonadotropin releasing hormone agonist (GnRH-ag) triggering. A retrospective cohort of IVM cycles from January 2015 to December 2019 in a single university-affiliated centre was examined. Main outcome measures were: (i) IVM maturation rate; and (ii) IVM maturation result. Secondary outcome measures were: (i) metaphase II (MII) rate on the day of egg retrieval; (ii) final MII maturation rate; and (iii) pregnancy rates. A total of 98 IVM cycles were performed during the study period: 50 (51%) were triggered with GnRH-ag (17 received FSH priming and 33 did not) and 48 cycles (49%) were triggered by hCG (37 with FSH priming and 11 without). A significant (p = 0.01) difference was noticed in maturation rate on egg retrieval day, in favour of the GnRH-ag group, although not in the final maturation rate achieved. Pregnancy rates were comparable between treatment sub-groups. GnRH-ag triggering in IVM cycles is an optional triggering mode and can be considered an acceptable option, especially when fertility preservation is a concern. GnRH agonists resulted in higher maturation rate on day of oocyte retrieval, but no difference in the total maturation rate. [ABSTRACT FROM AUTHOR]

Reflecting the current trends, the utilization of frozen-thawed transfer cycles has been steadily increasing worldwide; outcome predictors of these cycles are therefore a major research goal. Our aim was to investigate whether the outcome of a fresh single blastocyst transfer (SBT) can serve as a prognostic factor for the subsequent vitrified–warmed SBT originating from the same cohort. A retrospective cohort study was performed at a single unit. Non-donor fresh cycles were analyzed as predictors of the following vitrified–warmed cycle. Only SBTs were included. Cycles designated to a freeze-all policy and cycles involving pre-implantation genetic analysis were excluded. A total of 1127 vitrified–warmed single blastocyst cycles were included. The indications for artificial reproductive technologies were comparable across the study groups. Vitrified–warmed cycles following a live birth outcome in the fresh cycle were more likely to result in a clinical pregnancy than those following a fresh cycle, which failed to reach a live birth. The same trend was observed for live birth rate following vitrified–warmed transfer in the fresh cycle. After correcting for possible confounders, age and embryo quality were significantly correlated with the chance for a live birth, but the previous fresh cycle did not affect the results. We therefore conclude that after adjustment for age, embryo quality and number of previous oocyte retrieval cycles, the fresh cycle outcome was not a significant influential factor for the following vitrified–warmed cycle. [ABSTRACT FROM AUTHOR]

Objectives: To investigate female fertility in patients with rheumatoid arthritis (RA) exposed to biological drugs., Methods: In this retrospective cohort study, based on an electronic health record database, 4517 women with RA were compared to 1415 patients with psoriatic arthritis (PsA). Patients were 18-40 years-of-age at diagnosis. Biological treatments included tumor necrosis factor inhibitors, anti-CD-20 monoclonal antibodies, interleukin blockers and T-cell inhibitors. Main outcome measure was positive pregnancy test rate. Secondary outcome measures were pregnancy attempts and use of in vitro fertilization (IVF) RESULTS: Mean age at diagnosis and at initiation of biological treatments was not statistically different between RA and PsA (30.7 ± 6.3 vs. 30.9 ± 6; p = 0.260 and 34.2 ± 8 vs. 34.2 ± 7.5 years; p = 0.729, respectively). Both groups demonstrated lower rates of positive beta hCG after diagnosis, as compared to baseline rates before diagnosis. However, exposure to biological treatment did not negatively affect the likelihood of conception in either group. Beta hCG testing increased in both groups after initiation of biological treatments (RA p < 0.01, PsA p = 0.07). Use of fertility medications before diagnosis was about 8 % in both groups (p > 0.5). After diagnosis, before exposure, this percentage dropped to approximately 4 % in both groups (p > 0.5) but recovered to baseline values. Post-exposure IVF rate among RA patients was lower (p < 0.01) than the pretreatment state but was not significantly different in the PsA group., Conclusions: This large cohort study provides reassuring data regarding spontaneous and medicated fertility in patients exposed to biological medications. Further studies, as well as data on live birth rates are required to consolidate these findings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To study the perinatal outcomes of children born from different conception methods: in vitro fertilization (IVF) with autologous oocytes or IVF with donor egg versus those conceived without medical assistance by using a sibling analysis., Design: Retrospective cohort study conducted using electronic medical record data from 2000 through 2018, of a national healthcare organization., Subjects: The cohort included mothers who had two pregnancies and their children. Cohort A compared women with two medically unassisted conceptions with those with an unassisted first conception followed by an IVF conception. Cohort B compared women with two medically unassisted conceptions with those with an unassisted conception followed by a second pregnancy from oocyte donation., Exposure: None MAIN OUTCOME MEASURES: Perinatal outcomes, including small for gestational age (SGA) and preterm birth (PTB) <37weeks were investigated. Secondary outcomes included low birth weight (LBW), very low birth weight (VLBW), and large for gestational age (LGA)., Results: Cohort A comprised women who had 2 medically unassisted pregnancies and those with 1 medically unassisted pregnancy followed by IVF (n=1080 in each). Gestational age at delivery for the second conception was significantly lower in the unassisted + IVF group compared to the medically unassisted group (38.1 ± 2.1 weeks vs. 39.1 ± 1.4 weeks, p=0.001). The unassisted + IVF group had higher rates of prematurity <37 weeks (12% vs. 3.5%, p=0.001) and SGA compared to the medically unassisted group (5.4% vs. 3.4%, p=0.048). The adjusted OR (aOR) for PTB was 3.32 (95% CI, 2.11 to 5.29) and for SGA aOR 1.88 (95% CI, 1.07 to 3.32.) Cohort B included 94 women in each group. No differences were found between the medically unassisted and medically unassisted + donor egg groups regarding PTB <37 weeks (p=0.52) and SGA (p=0.32). The rate of LGA was higher in the egg donation group (24% vs. 16.5%, p=0.02)., Conclusions: This sibling analysis suggests that IVF pregnancies with autologous eggs are more susceptible to PTB, LBW, VLBW, and SGA, while donor egg pregnancies appear relatively unaffected, except for higher rate of LGA., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To assess the correlation between maternal mobility after cesarean delivery and postoperative morbidity., Methods: A prospective study was conducted in a tertiary hospital among patients after cesarean delivery. The women were recruited after surgery and before ambulation. Each participant received an accelerometer and routine instructions for mobilization. The patients were asked to wear the accelerometer constantly. It was collected at discharge. Electronic files were reviewed and patients' outcomes were analyzed. The Mann-Whitney U test was used to compare groups and a receiver operating characteristic curve was calculated for the threshold of number of steps., Results: Data were analyzed for 199 patients, among which 107 (54.4%) deliveries were urgent and 90 (45.6%) were elective. The median number of steps was higher for multiparous women compared to nulliparous women (P = 0.035). Patients who developed complications after discharge walked significantly less during their hospitalization compared to those who did not. There was a trend toward increased risk for in-hospitalization complications among patients who walked less while hospitalized. A threshold of more than 9716 steps per hospitalization was found to be associated with fewer post-discharge complications., Conclusion: There is a significant correlation between the extent of ambulation after cesarean delivery and fewer postoperative complications., (© 2021 International Federation of Gynecology and Obstetrics.)