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Background Poor ovarian response (POR) is among the common findings in infertile women with no significant underlying condition. The aim of this study was to investigate the intra-ovarian potential of platelet-rich plasma (PRP) administration on oocytes-dependent variables in the POR women grouped according to the POSEIDON criteria. Methods This retrospective study was performed on POR women with no underlying condition who have undergone intra-ovarian PRP injection. As well as patients’ age, the number of total and MI, MII, and GV oocytes were extracted from the files. The laboratory variables including anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol were also gathered. In order to reduce any bias due to the possible differences in kits or devices, a single laboratory with the highest number of cases was selected and others were excluded from the study. Then, the included cases were grouped into four according to the POSEIDON criteria and analyzed for the mentioned variables by SPSS, version 25. The statistical significance level was set as P-value Results From 383 cases, a total number of 96 women were enrolled in this study. According to the POSEIDON criteria, group 4 (Age ≥ 35 years, AMH P P P = 0.002). Conclusion This study showed that PRP treatment was effective on total and MII oocyte numbers in the patients with POR, however, further studies are required.

Regarding the risk of antibiotic therapy during pregnancy, any medication given to the mother should be according to the indications due to the risk of possible side effects. Antibiotics are one of the most important groups of these medications to be considered. Along with direct antibiotic-induced side effects, indirect pathways also affect the fetus through the maternal changes. According to the data, different cytokines including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) are involved in both term and preterm parturition. These cytokines could trigger expression of different substances such as prostaglandins (PGs), their receptors, and PGs synthetizing molecules with already proven roles in parturition. Moreover, IL-1, IL-6, and TNF-α knocked -out mice have delayed parturition and lower levels of PGs compared to the wild types. The earlier -mentioned cytokines are able to induce matrix metalloproteinases and are also involved in parturition. Certain antibiotics have been shown capable of inducing inflammation cascade directly. Both in -vivo and in -vitro studies in human have also demonstrated this inflammation as elevated levels of inflammatory cytokines especially IL-1, IL-6, and TNF-α. This increase has been observed both in the presence and the absence of lipopolysaccharide (LPS). Moreover, antibiotics can induce endotoxemia in healthy cases which finally leads to the pro-inflammatory cytokine release. Regarding the role of mentioned pro-inflammatory cytokines in both term and preterm parturition, it seems that non-indicated use of antibiotics during pregnancy may increase the risk of preterm labor.

Background Polycystic ovary syndrome (PCOS) is known as an important etiology of ovulation failure which probably is related to resistance to insulin and other possible related metabolic states. The current study aimed to investigate the effect of supplements such as calcium, vitamin D, and magnesium on cardiometabolic risk factors of infertile PCOS patients. Methods This randomized trial was registrered at Iranian Registry of Clinical Trial (reference code: IRCT2013110615307N1). First, bio-demographic data were gathered and complete physical examinations were performed, for all cases. After meeting the inclusion and exclusion criteria, 106 individuals were randomized into the metformin and vitamin D/calcium (37 patients), metformin and magnesium (34 patients), and metformin (35 patients) groups. After 12 weeks, cardiometabolic parameters including blood pressure, fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and dehydroepiandrosterone-sulfate (DHEA-S) were compared among the mentioned groups. In order to compare treatment groups per protocol analysis was performed. All data were analyzed by SPSS and any p-value less than 0.05 was considered statistically significant. Results The results showed no significant difference in age, infertility duration, frequency of metabolic syndrome, and the cause and duration of infertility among the groups. Also, no statistically significant difference was found between patients diagnosed with (N=12, 35%) and without metabolic syndrome. Many of the metabolic factors (body mass index (BMI), blood pressure (BP), FBS, LDL, and cholesterol) were decreased significantly in all groups after the treatments (p

The impact of infections and inflammation during pregnancy on the developing fetal brain remains incompletely defined with important clinical and research gaps. Though the classic infectious TORCH pathogens [i.e. Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex virus] are known to be directly teratogenic, emerging evidence suggests that these infections represent the most extreme end of a much larger spectrum of injury. We present the accumulating evidence that prenatal exposure to a wide variety of viral and bacterial infections – or simply inflammation – may subtly alter fetal brain development, leading to neuropsychiatric consequences for the child later in life. The link between influenza infections in pregnant women and an increased risk for development of schizophrenia in their children was first described more than 30 years ago. Since then, evidence suggests that a range of infections during pregnancy may also increase risk for autism spectrum disorder and depression in the child. Subsequent studies in animal models demonstrated that both pregnancy infections and inflammation can result in direct injury to neurons and neural progenitor cells or indirect injury through activation of microglia and astrocytes, which can trigger cytokine production and oxidative stress. Infectious exposures can also alter placental serotonin production, which can perturb neurotransmitter signaling in the developing brain. Clinically, detection of these subtle injuries to the fetal brain is difficult. As the neuropsychiatric impact of perinatal infections or inflammation may not be known for decades after birth, our construct for defining teratogenic infections in pregnancy (e.g. TORCH) based on congenital anomalies is insufficient to capture the full adverse impact on the child. We discuss the clinical implications of this body of evidence and how we might place greater emphasis on prevention of prenatal infections. For example, increasing uptake of the seasonal influenza vaccine is a key strategy to reduce perinatal infections and the risk for fetal brain injury. An important research gap exists in understanding how antibiotic therapy during pregnancy impacts the fetal inflammatory load and how to avoid inflammation-mediated injury to the fetal brain. In summary, we discuss the current evidence and mechanisms linking infections and inflammation with the increased lifelong risk of neuropsychiatric disorders in the child, and how we might improve prenatal care to protect the fetal brain.

Cesarean delivery (CD) has been known as the most common surgery in the United States. This procedure might associate with different complications, the most important of which is surgical site infection (SSI). Among the major SSI categories, incisional type is more common than the others. Regardless of its notable expense, the use of prophylactic wound healing technics (such as negative pressure therapy) has been advised for the patients with high SSI risk. Herein, use of patient's own human amniotic membrane in an autologous form (as a free of charge treatment) would be suggested for prevention of SSI in CD wounds. Human amniotic membrane (hAM) has been used for treatment of acute and chronic wounds and shown to be able to reduce the infection and the pain along with accelerating the healing process. Moreover, it has been shown in a systematic review and meta-analysis that hAM could significantly improve the treatment rate in comparison to the standard of care dressing (RR 2.057-3.665, P 0.001) during a set time of six weeks. Wound duration on the other hand, has been shown to negatively associate with SSI. Furthermore, there is data supporting the critical role of tissue perfusion in the acceleration of wound healing along with decreasing the rate of wound infection. Angiogenesis, the formation of new blood vessels from their existing capillaries, is among the most crucial pathways involved in increasing tissue perfusion and wound healing. Interestingly, hAM is a rich source of pro-angiogenic and other tissue growth factors with the ability of inducing angiogenesis as well as strong antibacterial peptides. Taken together, authors suggest autologous application of hAM in the high (even low) risk patients undergoing CD in order to decrease wound related complications such as SSI and accelerate the healing time as a free wound healer. However, further randomized clinical trials are necessary.