Effects of endometrial preparations and transferred embryo types on pregnancy outcome from patients with advanced maternal age

We explored the strategy of frozen-thawed embryo transfer (FET) in the women with advanced maternal age (AMA). We first determined the age cut-off point of AMA by retrospective analysis of pregnancy outcomes in the patients undergoing FET. The patients with AMA were divided into 3 groups including natural cycle (NC) group, controlled ovarian stimulation (COS) group, and hormone replacement therapy (HRT) group, and simultaneously were divided into 2 groups including cleavage-stage embryo transfer (CET) group and blastocyst-stage embryo transfer (BET) group. The clinical pregnancy, embryo implantation, abortion and live birth rates were compared between the 3 groups and the 2 groups, respectively. We found that in the women aged 38 years or over, the clinical pregnancy rate and live birth rate were all significantly decreased as compared with the younger than 38-year-old women (all P < 0.05), so the women aged 38 years or over were regarded as the patients with AMA in this study. In the patients with AMA, the clinical pregnancy rate and live birth rate were 22.95% and 18.03% in NC group, 23.68% and 15.79% % in COS group as well as 24.58% and 15.92% in HRT group, and there were no significant differences in the clinical pregnancy rate and live birth rate between the 3 groups. However, the clinical pregnancy rate (42.96% vs 15.87%) and embryo implantation rate (32.26% vs 9.67%) were all significantly higher in the BET group than in the CET group (all P < 0.01). We conclude that in the women aged 38 years or over, the choice of endometrial preparation protocols may depend on the individual specific conditions because the endometrial preparation protocols do not affect FET outcome, but BET can obtain better FET outcomes as compared with CET.

Abbreviations: AMA: advanced maternal age; FET: frozen-thawed embryo transfer; NC: natural cycle; COS: controlled ovarian stimulation; HRT: hormone replacement therapy; CET: cleavage-stage embryo transfer; BET: blastocyst-stage embryo transfer; LH: luteinizing hormone; HCG: human chorionic gonadotropin; HMG: human menopausal gonadotropin; FSH: follicle-stimulating hormone; BMI: body mass index     

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

There is no consensus regimen for the optimal endometrial preparation for cryopreservation and vitrified-thawed embryo transfer cycles. This is largely caused by the lack of sufficient investigation and analyses on the respective pregnancy and perinatal outcomes by different regimens. This study aimed to compare both pregnancy and perinatal outcomes between the modified natural and artificial cycles in vitrified-thawed day three embryo transfer for women with regular menstruation. A total of 1,482 vitrified-thawed day three embryo transfer cycles were reviewed including 427 modified natural cycles (NC), 132 ovulation induction cycles (OC), 794 artificial cycles (AC), and 129 GnRH agonist artificial cycles (GAC). The primary outcome that was evaluated was live birth rate. The NC regimen demonstrated a higher rate of ongoing pregnancy (43.8% vs. 30.2%, P = 0.002) and a lower rate of late abortion (2.8% vs. 14.0%, P = 0.003) than the GAC regimen as well as a higher implantation rate (31.9% vs. 27.1%, P = 0.008) and live birth rate (43.1% vs. 34.1%, P = 0.002) than the AC regimen. A significantly higher peak endometrial thickness before transfer was observed in patients using the NC and GAC regimens (10.0 ± 1.7, 9.9 ± 2.4) compared to the AC regimens (9.2 ± 1.5, P = 0.000). Multivariate logistic regression showed that the NC protocol was associated with a higher live birth rate. There were no significant differences in rates of pregnancy complications, neonatal mortality, birth defects, mean birth weight, and other perinatal outcomes among the regimens. Modified natural cycle endometrial preparation regimen for vitrified-thawed day three embryo transfer is associated with superior live birth pregnancy outcomes compared to artificial cycles. Future studies are warranted to investigate the underlying biologic mechanisms of these findings.

Abbreviations ART: assisted reproductive technology; BMI: body mass index; FET: frozen-thawed embryo transfer; HCG: human chorionic gonadotropin; IVF: in-vitro fertilization; IVF-ET: in-vitro fertilization and embryo transfer; OHSS: ovarian hyperstimulation syndrome; RCTs: randomized controlled trials     

Successful application of a single warming protocol for embryos cryopreserved by either slow freezing or vitrification techniques

The aim of this study was to evaluate the feasibility and efficiency of using a sucrose gradient-based warming protocol as a universal warming approach on human cleavage stage embryos. Between January 2013 and November 2014, a total of 118 warming cycles were performed on 705 embryos which had previously been cryopreserved/thawed by slow freezing protocols or cryopreserved by slow freezing and warmed by vitrification thaw solution. Clinical outcomes have been retrospectively analyzed depending on cryopreservation and warming techniques used, embryo viability, day of cryopreservation, clinical pregnancy, implantation, and live birth rate. Results indicate that, the use of the vitrification warming protocol for warming after slow freezing results in comparable post-warming survival (71.6% and 71.1%; p = 0.890). Higher clinical pregnancy, implantation, and live birth rates were obtained in the cryopreserved embryos by slow freezing and warmed by vitrification group in comparison to the cryopreserved/thawed by slow freezing protocols group but the results did not show statistically significant differences between groups (p > 0.05). These results indicate that such an approach can eliminate the need to search for a brand-dependent product, as well as case-dependent hands-on planning. Further research that evaluates the effectiveness of this approach on a larger case series is underway.

Abbreviations: CPA: concentrated cryoprotective agent; COH: controlled ovarian stimulation; FET: frozen embryo transfer; HSG: hysterosalpingogram; mHTF: modified human tubal medium; SSM: single step media; SSS: synthetic serum substitute; TV-USG: transvaginal ultrasound.     

No Change in 24-Hour Hydration Status Following a Moderate Increase in Fluid Consumption

Purpose: To investigate changes in 24-hour hydration status when increasing fluid intake.

Methods: Thirty-five healthy males (age 23.8 ± 4.7 years; mass 74.0 ± 9.4 kg) were divided into 4 treatment groups for 2 weeks of testing. Volumes of 24-hour fluid ingestion (including water from food) for weeks 1 and 2 was 35 and 40 ml/kg body mass, respectively. Each treatment group was given the same proportion of beverages in each week of testing: water only (n = 10), water + caloric cola (n = 7), water + noncaloric cola (n = 10), or water + caloric cola + noncaloric cola + orange juice (n = 8). Serum osmolality (S_osm), total body water (TBW) via bioelectrical impedance, 24-hour urine osmolality (U_osm), and volume (U_vol) were analyzed at the end of each 24-hour intervention.

Results: Independent of treatment, total beverage consumption increased 22% from week 1 to 2 (1685 ± 320 to 2054 ± 363 ml; p < 0.001). Independent of beverage assignment, the increase in fluid consumption between weeks 1 and 2 did not change TBW (43.4 ± 5.2 vs 43.0 ± 4.8 kg), S_osm (292 ± 5 vs 292 ± 5 mOsm/kg), 24-hour U_osm (600 ± 224 vs 571 ± 212 mOsm/kg), or 24-hour U_vol (1569 ± 607 vs 1580 ± 554 ml; all p > 0.05).

Conclusions: Regardless of fluid volume or beverage type consumed, measures of 24-hour hydration status did not differ, suggesting that standard measures of hydration status are not sensitive enough to detect a 22% increase in beverage consumption.     

Analysis of embryo intactness and developmental potential following slow freezing and vitrification

The aim of this study was to identify the parameters that are related to intactness and developmental potential of a day 3 embryo after warming to improve the selection criteria used to cryopreserve and transfer embryos. We also sought to compare slow freezing and vitrification methods of cryopreservation and to evaluate the viability of non-intact embryos. Embryos warmed following slow freezing (n=220) or vitrification (n=522) were divided into 3 groups according to the proportion of surviving blastomeres (I<50%; II=50-99%; and III=100%). The developmental potential of embryos, including the mitosis resumption rate, blastocyst formation rate, and formation rate of grade A blastocysts (i.e., fully expanded blastocysts with an inner cell mass and grade A or B trophectoderm) were retrospectively assessed in embryos. Cleavage-stage embryos with <50% blastomere survival were analyzed using next-generation sequencing (NGS). Logistic regression analysis showed that vitrification and grade 1 were independent predictive factors of embryo intactness and developmental potential (all p<0.05). On day 3, embryos with 4-6 cells or blastomere damage had lower developmental potential than those with 7-9 cells or intact blastomeres (all p<0.05). NGS results showed that the chromosomal status was completely normal in 8 embryos that developed into expanded blastocysts, whereas 4 out of 5 embryos in which development was arrested were abnormal. The results of this study suggest that vitrification is a better choice than slow freezing for embryo cryopreservation. Embryos showing poor quality (fragmentation >30% and/or a non-stage-specific cell size) and lower cell numbers (4-6 cells) on day 3 should be cultured to the blastocyst stage and then vitrified if they develop into good-quality blastocysts. The developmental potential of non-intact embryos is lower than that of intact embryos; however, after they are cultured to the fully expanded blastocyst stage, embryos with <50% blastomere survival appear to be better candidates for transfer.

Abbreviations ART: assisted reproductive technology; grade A blastocyst: fully expanded blastocyst with an inner cell mass and grade A or B trophectoderm; NGS: next-generation sequencing; IVF: in vitro fertilization; ICSI: intracytoplasmic sperm injection; FET: frozen-thawed embryo transfer     

Nutritional Routine of Tae Kwon Do Athletes Prior to Competition: What Is the Impact of Weight Control Practices?

Objective: The purpose of the present study was to investigate and assess the common dietary and weight management strategies of Tae Kwon Do (TKD) athletes prior to national competitions, as well as to examine the relationships between these strategies and body weight reduction and sensation of physical condition.

Methods: Sixty (n = 60) TKD athletes, 23 women (19.4 ± 2.9 years) and 37 men (20.4 ± 3.6 years), with at least 12.1 ± 3.1 years of experience, participated in the present study. The athletes recorded their dietary intake and physical activity for 3 training days and on a competition day. Bioelectrical impedance was used for body composition estimation.

Results: Male athletes consumed 1918 ± 685 kcal/24 hours and 1974 ± 669 kcal/24 hours on training and competition days, respectively, and women 1814 ± 446 kcal/24 hours and 1700 ± 439 kcal/24 hours. TKD athletes had significant negative energy balance (48.6% ± 17.8% to 60.3% ± 26.9%; p < 0.05), with the majority of macro- and micronutritional elements being lower than the recommended values, with significant differences between them, as well as within groups, between weekdays and weekend days (p < 0.05). Females lost most of their weight 2 weeks before the games (3.50 ± 1.00 kg), and males lost most of their weight 3 weeks before (3.16 ± 2.48 kg). The majority of TKD athletes were guided by their coaches for weight management strategies. No significant correlations were found between any body composition variable, weight loss, and any nutritional intake at any time point (p > 0.05).

Conclusions: These data suggest that the methods of TKD athletes for rapid weight loss are guided by unspecialized professionals, leading to significant malnutrition, because certain deficiencies in both macro- and micronutrient content are present, with no guaranteed specific reduction of their body mass.     

Evaluation of the impact of sperm morphology on embryo aneuploidy rates in a donor oocyte program

This study investigates the correlation between sperm morphology and the incidence of embryo aneuploidy in an oocyte donation program. A total of 1,165 embryos from 103 patients have been analyzed by fluorescent in situ hybridization (FISH) for numerical abnormalities in chromosome numbers 13, 18, 21, X, and Y. Data has been evaluated in five groups according to sperm morphology, which has been assessed according to the Kruger’s strict criteria. The results did not show any difference in paternal (p = 0.878), maternal (p = 0.873), and donor ages (p = 0.871), sperm counts (p = 0.782) and motility (p = 0.124), and fertilization rate (p = 0.080) among the groups. However, total aneuploidy rate (p < 0.001) and its derivatives (trisomy p = 0,042, monosomy p = 0,004) differed significantly and they were reversibly correlated with sperm morphology (rho correlation test; total aneuploidy p < 0.001, trisomy p < 0.001, monosomy p = 0.004). Therefore, these results suggested that diminished sperm quality is correlated to the aneuploidy rate in preimplantation embryos.

Abbreviations: FISH: fluorescence in situ hybridization; ICSI: intracytoplasmic sperm injection; HCG: human chorionic gonadotropin     

Ectopic pregnancy in frozen-thawed embryo transfer: A retrospective analysis of 4,034 cycles and related factors

We analyzed the incidence of ectopic pregnancy in frozen-thawed embryo transfer (FET) as a function of natural and hormone replacement cycles and ectopic pregnancy-related factors. In this study, there were 4,034 FET cycles performed in our center between January 2005 and December 2010, and the rates of ectopic pregnancy were compared between natural and hormone replacement cycles. The analysis of ectopic pregnancy-related factors in FET was performed with 1:4 age-matched chi-square tests. The rate of ectopic pregnancy was lower in natural FET cycles (1.46%) than in hormone replacement FET cycles (3.31%) with a statistical significance (P?<?0.05). Many factors were associated with ectopic pregnancy in FET, but only treatment protocols were considered as a controllable factor. We conclude that the incidence of ectopic pregnancy is significantly lower in natural FET cycles than in hormone replacement FET cycles. The application of exogenous sex hormones in assisted reproductive cycles may be an important factor to cause ectopic pregnancy in FET. This suggests that care should be taken when selecting the treatment protocol in order to avoid ectopic pregnancy.     

Postprandial Lipid Response to High-Saturated and High-Monounsaturated Fat Meals in Normal-Weight or Overweight Women

Purpose: We evaluated postprandial response of the lipid metabolism markers after the intake of a high-saturated fat (HSM) or high-monounsaturated fat meal (HMM).

Methods: A randomized, controlled and acute intervention study included 63 women (age 26.9 ± 6.1 years): 35 normal weight (NW) and 28 overweight (OW) (total body fat [TBF] 24.7 ± 3.9% and 36.6 ± 3.9%, respectively). After 12 hours of fasting, each subject was given one of the two test meals standardized, including 2 muffins and water (HSM, 42.1% of saturated fat acid, or HMM, 34.5% of monounsaturated fat acid). Plasma fatty acid profile and concentrations of apolipoproteins A1 and B100, complement C3, and triacylglycerols were analyzed during fasting and at 2, 3, and 5 postprandial hours.

Results: Among the markers studied, the triacylglycerol (TAG) and complement C3 were significantly higher in the OW group, compared to NW. The increment in the C3 concentration was higher after HSM intake, compared with HMM (iAUC = 4365.5 ± 5477.4 vs. 1215.2 ± 882.4; p = 0.006), with no differences between groups. After 5 hours postprandial, plasma oleic acid values remained high compared with the fasting value in the NW group, but not in the OW group (26.0 ± 4.2 vs 23.7 ± 3.9%; p < 0.001). Women with high percentage of total plasma saturated fatty acids (SFA) at the beginning of the intervention had higher incremental area under the curve (iAUC) for the palmitic, stearic, and total fatty acids (p < 0.005). Those women with a high percentage of monounsaturated fatty acids (MUFA) showed lower iAUC values for the same fatty acid profile (p < 0.005).

Conclusion: This study demonstrated the effect of the HSM on postprandial increment of C3 concentration, suggesting another mechanism for saturated fat metabolism. The postprandial response to HSM appears to be the mediated by baseline lipid profile of the individuals, while the response to HMM was correlated to the weight status.     

Treating donor cells with 2-PCPA corrects aberrant histone H3K4 dimethylation and improves cloned goat embryo development

Epigenetic modifications extensively occur in mammalian embryonic development and cell differentiation process. They play an essential role in the reprogramming of nuclei during somatic cell nuclear transfer (SCNT) and subsequent in vitro embryonic development. Recently, SCNT embryos have been verified to contain a subnormal level of histone H3K4 dimethylation (H3K4me2) in contrast to in vitro fertilized embryos. This finding suggested that increasing H3K4me2 levels may ameliorate the aberrant development of cloned embryos. In this study, we investigated the influence of treating donor cells with trans-2-Phenylcyclopropylamine (2-PCPA), a specific inhibitor of lysine-specific demethylase 1 (LSD1), on embryogenesis, H3K4me2 level, and gene expression in cloned goat embryos. Treated goat fetal fibroblast cells (GFFs) with 2-PCPA served as donor cells for subsequent SCNT. Results showed that H3K4me2 levels in treated GFFs increased gradually with the increasing 2-PCPA concentration (p < 0.05) and had no obvious influence in cell viability. The 2-PCPA-induced up-regulation of H3K4me2 levels led to G0/G1 cell cycle arrest and the difference was significant at 2μM compared with the control group (p < 0.05). Interestingly, the development rate of goat SCNT embryos in vitro was significantly improved and aberrant H3K4me2 levels were effectively corrected in 2-PCPA-treated SCNT embryos in contrast to that in SCNT control embryos. Moreover, 2-PCPA treatment promoted the mRNA expression of key developmental genes Oct4 and Sox2 (p < 0.05) without affecting the expression levels of imprinted genes IGF2R and H19 in goat SCNT embryos. These results indicated that abnormal H3K4me2 status can be corrected and SCNT embryo development can be promoted through treatment of donor cells with 2-PCPA.

Abbreviations: SCNT: somatic cell nuclear transfer; H3K4me2: H3K4 dimethylation; 2-PCPA: trans-2-Phenylcyclopropylamine; LSD1: lysine-specific demethylase 1; GFFs: goat fetal fibroblast cells; IVF: in vitro fertilization; iPS: induced pluripotent stem; PBS: phosphate-buffered saline; IVM: in vitro maturation; RNAPII: RNA polymerase II; HMTs: histone methyltransferase     

电针干预对体外受精-胚胎移植患者的作用研究

目的:探讨电针干预在体外受精-胚胎移植(1VF-ET)中的作用。方法:将接受IVF-ET助孕的患者94例随机分为观察组和对照组各47例,两组均给予促性腺激素释放激素激动剂长方案,观察组加用电针干预,比较两组治疗效果。结果:观察组促性腺激素(Gn)用量少于对照组(30.5±4.7支vs38.8±7.1支,P<0.05);受精率高于对照组(80.5%vs72.8%,P<0.05);优质胚胎率高于对照组(71.5%vs58.8%,P<0.05);冷冻胚胎数高于对照组(4.1±0.42vs1.94±0.65,P<0.05);临床妊娠率高于对照组(46.8%vs34.04%),但无统计学意义,而Gn.用药时间、HCG注射日子宫内膜厚度及血LH、P、E2水平、直径>14mm卵泡数、获卵数两组间均无显著性差异。结论:在IVF-ET中配合电针治疗可取得较好的临床效果。     

输卵管积水及其处理方法对冻融胚胎移植妊娠结局的影响

目的:讨论输卵管积水及其处理方法对冻融胚胎移植(FET)周期妊娠结局的影响。方法:对FET304个周期进行回顾性分析,观察组43周期,为FET周期中阴道B超检查提示输卵管积水者;对照组261周期,为B超检查无输卵管积水者。同时按积水的处理方式将观察组分为3组:A组29例,FET前行积水抽吸术;B组3例,FET前行双侧输卵管近端结扎术;C组11例,采用药物理疗。结果:观察组种植率、妊娠率(8.43%,23.79%)低于对照组(16.28%,39.85%),差异有统计学意义(P0.05);而流产率、异位妊娠率(2.33%,8.81%)与对照组(1.91%,2.32%)比较,差异无统计学意义(P0.05);A、B组与C组进行种植率、妊娠率、流产率、异位妊娠率的比较(6.67%,16.67%,13.04%;13.7%,33.33%,18.18%;3.45%,0%,0%;3.45%,0%,0%),差异均无统计学意义(P0.05)。结论:输卵管积水可明显降低FET种植率及妊娠率,而进行输卵管积水抽吸术未能明显改善FET的妊娠结局,行输卵管近端结扎术处理积水因例数较少,有待进一步探讨。     

Effects of Supplementation with Beef or Whey Protein Versus Carbohydrate in Master Triathletes

Objective: The present study compares the effect of ingesting hydrolyzed beef protein, whey protein, and carbohydrate on performance, body composition (via plethysmography), muscular thickness, and blood indices of health, including ferritin concentrations, following a 10-week intervention program.Methods: After being randomly assigned to one of the following groups—beef, whey, or carbohydrate—24 master-age (35–60 years old) male triathletes (n = 8 per treatment) ingested 20 g of supplement mixed with plain water once a day (immediately after training or before breakfast). All measurements were performed pre- and postinterventions.Results: Only beef significantly reduced body mass (p = 0.021) along with a trend to preserve or increase thigh muscle mass (34.1 ± 6.1 vs 35.5 ± 7.4 mm). Both whey (38.4 ± 3.8 vs 36.9 ± 2.8 mm) and carbohydrate (36.0 ± 4.8 vs 34.1 ± 4.4 mm) interventions demonstrated a significantly (p < 0.05) decreased vastus medialis thickness Additionally, the beef condition produced a significant (p < 0.05) increase in ferritin concentrations (117 ± 78.3 vs 150.5 ± 82.8 ng/mL). No such changes were observed for the whey (149.1 ± 92.1 vs 138.5 ± 77.7 ng/mL) and carbohydrate (149.0 ± 41.3 vs 150.0 ± 48.1 ng/mL) groups. Furthermore, ferritin changes in the beef group were higher than the modification observed in whey (p < 0.001) and carbohydrate (p = 0.025) groups. No differences were found between whey and carbohydrate conditions (p = 0.223). No further changes were observed.Conclusion: Ingesting a hydrolyzed beef protein beverage after workout or before breakfast (nontraining days) can be effective in preserving thigh muscle mass and in improving iron status in male master-age triathletes.     

Awareness of Health Outcomes Associated with Insufficient Physical Activity and Associations with Physical Activity Intentions and Behavior

Introduction: Little is known about people’s awareness of the link between insufficient physical activity and increased risk for multiple health outcomes.

Methods: Of 1161 respondents to an online cross-sectional survey of the US population, we randomly selected 361 and used content analysis to code up to three responses to an open-ended question asking what illnesses are caused by insufficient physical activity. Chi-square and Fisher’s exact tests examined relations between disease codes and socio-demographics; t-tests and Mann–Whitney U tests examined relations between codes and physical activity intentions and behavior.

Results: Ten codes emerged: cardiovascular (63.5% of participants), metabolic (65.8%), musculoskeletal (10.5%), fatigue (2.0%), psychiatric (8.0%), respiratory (3.4%), gastrointestinal (0.9%), cancer (3.4%), other (2.8%), unexpected interpretation (1.4%). 55.6% of participants named < 3 diseases. Code frequencies were generally similar across demographic groups, ps > .05. Physical activity intentions and behavior were higher among people who either mentioned cardiovascular (p_intentions = .001, p_behavior = .001) or metabolic (p_intentions = .01, p_behavior = .005) conditions, or who named < 3 diseases (p_intentions = .006, p_behavior = .001).

Conclusion: In our socio-demographically diverse sample, awareness of diseases that are associated with insufficient physical activity was largely related to cardiovascular and metabolic problems. Future health communication efforts should raise awareness of the harms of insufficient physical activity for cancer and other diseases.     

Heme Iron Concentrate and Iron Sulfate Added to Chocolate Biscuits: Effects on Hematological Indices of Mexican Schoolchildren

Objective: Food fortification is one of the most effective strategies for increasing iron intake in the population. A simple blind trial was conducted to compare the effect of 2 forms of iron fortification and assess the changes in hemoglobin and iron status indices among preschool children from rural communities.

Methods: Hemoglobin was evaluated in 47 children aged 3–6 years old. For 72 days (10-week period), children ate Nito biscuits. Thirteen pupils with elevated hemoglobin levels were assigned to the biscuit control group, and pupils with hemoglobin equal to 13.5 mg/dL or less were randomly allocated to consume fortified biscuits with a heme iron concentrate (n = 15) or iron sulfate (n = 19). Changes in hemoglobin, plasma ferritin, and other hematological indices were evaluated with analysis of variance (ANOVA) for repeated measurements.

Results: Except mean corpuscular hemoglobin concentrations (+1.27 ± 2.25 g/dL), hematological indices increased significantly across the study: Mean corpuscular volume (+2.2 ± 1.0 f/dL), red blood cells (+0.30 ± 0.37 M/μL), mean corpuscular hemoglobin (+1.8 ± 1.74 pg), hemoglobin (+1.68 ± 0.91 g/dL), hematocrit (+3.43% ± 3.03%), and plasma ferritin (+18.38 ± 22.1 μg/L) were all p < 0.05. After 10 weeks, the adjusted effect of the iron-fortified chocolate biscuits in the hemoglobin levels was higher than the control group (+1.1 ± 0.2 g/dL) but no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate (+1.9 ± 0.2 g/dL and +2.0 ± 0.2 g/dL, respectively).

Conclusion: Heme iron concentrate and iron sulfate were equally effective in increasing Hb levels and hematological indices. Processed foods were shown to be an effective, valuable, and admissible intervention to prevent anemia in preschool children.     

A Lean Pork-Containing Breakfast Reduces Hunger and Glycemic Response Compared to a Refined Carbohydrate-Containing Breakfast in Adults with Prediabetes

Objective: Replacing dietary refined carbohydrates (CHO) with protein may impact appetite and glucose and lipid metabolism in metabolically at-risk individuals. The objectives of this study were to assess the effects of consumption of a lean pork–containing, high-protein (pPro) breakfast versus a refined-CHO-rich breakfast for 2 weeks on appetite and cardiometabolic parameters in overweight or obese adults with prediabetes.

Methods: In this crossover study, overweight or obese men and women with prediabetes were provided with either a pPro breakfast meal or a refined-CHO breakfast meal to consume each day (2-week intervention, ≥ 2-week washout). On the last day of each period, fasting and postprandial glucose, insulin, and lipid values were assessed. Visual analog scales were used to evaluate appetite, mental energy, and focus; energy intake at a lunch meal was also evaluated.

Results: Data from 21 participants (13 females and 8 males) were analyzed and participants had a mean (± standard error of the mean) age of 44.4 ± 3.1 years and body mass index of 30.4 ± 0.9 kg/m². Mean hunger net incremental area under the curve to 240 minutes postmeal (niAUC_0–240 min) and desire to eat niAUC_0–240 min were both significantly (p < 0.05) lower following the pPro breakfast intakes compared to the refined-CHO breakfast intakes. Mean incremental area under the curve to 240 minutes postmeal for glucose and insulin were significantly lower (p = 0.003 and p = 0.001, respectively) following the pPro breakfast versus refined-CHO breakfast, and mean percentage change from baseline for triglycerides (TG) at 120 minutes was also less pronounced, 10.0% ± 6.8% versus 32.3% ± 7.7%, respectively (p = 0.001). No other significant differences were observed for outcome variables.

Conclusions: Intake of a higher-protein, lean pork–containing breakfast may favorably impact appetite and lower postprandial glucose, insulin, and TG values, although longer-term studies are warranted.     

Bio-monitoring of DNA damage in matchstick industry workers from Peshawar Khyber Pakhtunkhwa,Pakistan

Background: Safety protocols are usually neglected in most of the matchstick industries rendering the laborer prone to various occupational hazards.

Objective: The present study highlights DNA damage among matchstick factory workers (n = 92) against a control group (n = 48) of healthy individuals.

Methods: Genotoxicity was measured in peripheral blood lymphocytes of the test subjects using a Single Cell Gel Electrophoresis assay (SCGE/comet assay).

Results: Our results substantiate a high Total Comet Score (TCS) for factory workers (74.5 ± 47.0) when compared to the control group (53.0 ± 25.0) (P ≤ 0.001). Age and duration of occupational exposure had no significant effect (P > 0.05) on TCS value. As for job function, the TCS value was greatest in sweepers (91.0 ± 56.1) and lowest in box-making operators (26.0 ± 25.0) indicating that waste disposal poses the higher risk of DNA damage.

Conclusions: Our study corroborates that matchstick chemicals can potentially damage the DNA of exposed subjects.     

The Effect of Vitamin D Supplementation on Glycemic Control and Lipid Profile in Patients with Type 2 Diabetes Mellitus

Aim: The aim of this study was to evaluate the effect of vitamin D supplementation in patients with type 2 diabetes mellitus (T2DM) with regard to their glycemic control and lipid profile.

Methods: One hundred subjects with T2DM were recruited and given 4500 IU/day of vitamin D for 2 months. 25-Hydroxyvitamin D [25(OH)D], fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), and lipid profile were measured pre- and postsupplementation.

Results: There was a significant increase in the mean value of 25(OH)D level after supplementation (baseline level 16 ± 5.3 ng/ml vs. after supplement level 49.2 ± 17.7 ng/ml, p < 0.05). Both FBG and HbA1c but not lipid profile were significantly decreased after supplementation. However, the univariate general linear model between 25(OH)D percentiles and lipid profile levels showed that diabetic subjects with high 25(OH)D levels (>61 ng/ml) had significantly lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) in comparison to those in the low or middle percentiles. Furthermore, participants in a higher percentile had a significantly higher level of high-density lipoprotein cholesterol (HDL-C) than those in the middle percentile. Lipid profile levels were not affected by the supplement except for triglycerides (TG) levels in females, which were significantly decreased.

Conclusions: Vitamin D supplementation may be beneficial to diabetic subjects because it improved glycemic control. Diabetic subjects with high 25(OH)D levels (>61 ng/ml) had better lipid profiles.     

Shortening gametes co-incubation time improves live birth rate for couples with a history of fragmented embryos

Short gamete co-incubation (SGCO) consists in decreasing the duration of contact between oocytes and sperm from the standard overnight insemination (SOI) toward 2 hours. However, the effectiveness of this technique to improve in vitro fertilization and embryo transfer (IVF-ET) outcomes remains controversial. Our study was designed to evaluate the efficiency of SGCO in a poor prognosis population with a history of fragmented embryos defined by the presence of at least 50% of the embryos with more than 25% of cytoplasmic fragments. From January 2010 to January 2014, 97 couples were included in a SGCO protocol. We separated women into 2 subgroups: younger and older than 35 years. Compared to SOI, after SGCO, 2-cell stage embryos were higher in all women (p<0.001) and less fragmented in women over 35 years (p<0.05). On day 2, top quality embryos obtained and transferred were higher with SCGO than with SOI, independently of the age of the women (p<0.001). Moreover, the number of embryos with less than 25% of fragmentation was higher after SGCO than SOI (p<0.001) whereas the number of multinucleated embryos was lower (p<0.001). We observed that after fresh ET, independently of the age of the women, the clinical pregnancy rate was 3 times higher after SGCO than after SOI. However, the live-birth rate was 4 times higher with SGCO than with SOI in women above 35 years but 3 times higher with SGCO than with SOI in women younger than 35 years. The present results indicate that for a particular indication, reducing the time of oocytes and sperm co-incubation may improve IVF-ET outcomes in terms of live-birth rate.

Abbreviations: AMH: anti mullerian hormone; COC: cumulus-oocytes complex; E2: estradiol; ET: embryo transfer; FET: frozen embryo transfer; FSH: follicle stimulating hormone; GnRH: gonadotrophin releasing hormone; hCG: human chorionic gonadotropin hormone; hMG: human menopausal gonadotropin hormone; IRB: institutional review board; IVF: in vitro fertilization; IVF-ET: in vitro fertilization and embryo transfer; MNB: multinucleated blastomere; mRNA: messanger ribonucleic acid; OC: oocyte retrieval; O2: oxygen; ROS: reactive oxygen species; SGCO: short gamete co-incubation; SOI: standard overnight insemination.     

Granulocyte colony stimulating factor treatment of resistant thin endometrium in women with frozen-thawed blastocyst transfer

The aim of the study was to assess the granulocyte-colony stimulating factor (G-CSF) effect on unresponsive thin (<7 mm) endometrium in women undergoing frozen-thawed embryo transfer at the blastocyst stage. A total of 62 women with thin unresponsive endometrium were included in the study, of which, 29 received a G-CSF infusion and 33 who opted out of the study served as controls. Patients in both groups had similar endometrial thickness at the time of the initial evaluation: 6.50 mm (5.50-6.80) in the G-CSF and 6.40 mm (5.50-7.0) in the control group. However, after the infusion endometrial thickness increased significantly in the G-CSF group in comparison with the controls (p=0.01), (Δ) 0.5 (0.02-1.2) (p=0.005). In the G-CSF group endometrium expanded to 7.90 mm (6.58-8.70) while in the control group to 6.90 mm (6.0-7.75). Five women in each group conceived. The clinical pregnancy rate was 5/29 (17.24%) in the G-CSF treated group and 5/33 (15.15%) in the control group (p>0.05). The live birth rate was 2/29 (6.89%) in the G-CSF group and 2/33 (6.06%) in the control group (p>0.05). We concluded that G-CSF infusion leads to an improvement in endometrium thickness but not to any improvement in the clinical pregnancy and live birth rates. Until more data is available G-CSF treatment should be considered to be of limited value in increasing pregnancy rate. Abbreviations: G-CSF: granulocyte colony-stimulating factor; M-CSF: macrophagecolony-stimulating factor; GM-CSF: granulocyte-macrophage colony-stimulating factor; FET: frozen embryo transfer; IVF: in vitro fertilization