Reproductive outcome is optimized by genomic embryo screening,vitrification, and subsequent transfer into a prepared synchronous endometrium

Purpose

The aim of this study is to compare implantation and live birth rates (LBR) between fresh euploid embryo transfers versus cryo-all cycles with a subsequent embryo transfer into a prepared endometrium.

Material and Methods

This is a retrospective cohort study. Patients who underwent an IVF cycle with PGS with trophectoderm biopsy from January 2011 to July 2015 were included. Patients were divided into three groups: “Fresh Only,” “Frozen Embryo Transfer ('FET) Only,” and “Fresh ET then FET.” For “Fresh Only” group (n = 345), PGS results were received within 24 h. For “FET Only” group (n = 514), results were expected after 24 h, and embryos were cryopreserved after biopsy; only FET was performed in this group (no fresh transfer). For “FET with a previous fresh ET” (n = 139) group, patients underwent a fresh ET with a subsequent FET, in which the same cohort of embryos was utilized. The main outcome measures were pregnancy rate (PR), clinical PR, implantation rate (IR), LBR, and early pregnancy loss rate.

Results

IRs were statistically higher in the “FET Only” group when compared to the “Fresh Only” group (59.5 vs. 50.6 %, p < 0.01) and the “FET with a previous fresh ET” (59.5 vs. 50.6 %, p < 0.05). LBR was statistically significant in the “FET Only” group when compared to the “Fresh Only” group (57.6 vs. 46.5 %, p < 0.005) but not when compared to “FET with a previous fresh ET” group (57.6 vs. 47.7 %, p = 0.07).

Conclusions

This analysis suggests euploid embryos to be more likely to implant and achieve a LBR in a synthetic FET cycle than in a fresh cycle.

     

A Translational Randomized Trial of Perioperative Arginine Immunonutrition on Natural Killer Cell Function in Colorectal Cancer Surgery Patients

Annals of Surgical Oncology - Surgery results in severe impairment of natural killer (NK) cell cytotoxicity (NKC) and activity (NKA, cytokine secretion), and a dramatic drop in arginine levels....     

Expression and rearrangement of homologous immunoglobulin VH genes in two mouse strains.

A family of murine anti-p-azophenylarsonate (Ars) antibodies share a variable (V) region serologically defined marker, the 36-60 idiotype (Id36-60). Most mouse strains possess five genes highly homologous to the gene encoding the heavy (H) chain V region of antibodies bearing Id36-60 (VH36-60); however, only one of these genes is ever utilized by hybridomas whose antibodies bind Ars and bear Id36-60. The relevant VH genes were cloned from A/J and BALB/c mouse DNA libraries. Their DNA sequences were found to differ at only two positions. Southern blot analysis, protein sequence determination, and nucleic acid sequence determination indicate that the above hybridomas utilize the same joining (JH3), diversity (D), and VH gene segments regardless of BALB/c or A/J strain origin. Despite this virtual identity, BALB/c and A/J mouse strains express quite different serum levels of Id36-60-bearing antibodies when immunized with Ars. The basis of this regulatory process is discussed.     

Acceptability of the nestorone®/ethinyl estradiol contraceptive vaginal ring: development of a model; implications for introduction

Objectives

Develop and test a theoretical acceptability model for the Nestorone®/ethinyl estradiol contraceptive vaginal ring (CVR); explore whether domains of use within the model predict satisfaction, method adherence and CVR continuation.

Study Design

Four domains of use were considered relative to outcome markers of acceptability, that is, method satisfaction, adherence and continuation. A questionnaire to evaluate subjects' experiences relative to the domains, their satisfaction (Likert scale) and adherence to instructions for use was developed and administered to 1036 women enrolled in a 13-cycle Phase 3 trial. Method continuation was documented from the trial database. Stepwise logistic regression (LR) analysis was conducted and odds ratios (ORs) calculated to assess associations of satisfaction with questions from the four domains. Fisher's Exact Test was used to determine the association of satisfaction with outcome measures.

Results

A final acceptability model was developed based on the following determinants of CVR satisfaction: ease of use, side effects, expulsions/feeling the CVR and sexual activity including physical effects during intercourse. Satisfaction was high (89%) and related to higher method adherence [OR, 2.6 (1.3, 5.2)] and continuation [OR, 5.5 (3.5, 8.4)]. According to the LR analysis, attributes of CVR use representing items from the four domains — finding it easy to remove, not complaining of side effects, not feeling the CVR while wearing it and experiencing no change or an increase in sexual pleasure and/or frequency — were associated with higher odds of satisfaction.

Conclusion

Hypothesized domains of CVR use were related to satisfaction, which was associated with adherence and continuation. Results provide a scientific basis for introduction and future research.

Implications Statement

Acceptability research is important when introducing a new method of contraception and determining whether it can be a successful option in meeting the reproductive health needs of women and men. This study was designed to test a conceptual model of acceptability and identify factors associated with successful use of a new contraceptive delivery modality. Original research was conducted for this publication.     

Serum copeptin levels in adolescents with primary hypertension

Background

The prevalence of hypertension continues to rise in the pediatric population. In recent years, there has been an increasing amount of reports on serum arginine vasopressin and its derivative, copeptin, in blood pressure control, but its role is still unclear. The objective of this study was to assess serum copeptin in adolescents with essential hypertension.

Methods

The study cohort consisted of 84 subjects (30 girls and 54 boys) aged 11–18 years, divided into two groups: hypertension (HT) – 53 subjects with confirmed primary hypertension and R - reference group – 31 subjects in whom hypertension was excluded on the basis of ambulatory blood pressure monitoring (ABPM) (white-coat hypertension). Serum copeptin concentration was measured using a commercially available enzyme-linked immunosorbent assay kit (USCN).

Results

Hypertensive patients had higher serum copeptin levels (median, 267 [Q1–Q3: 151.1–499.7 pg/ml]) than controls (median, 107.3 [Q1–Q3: 36.7–203.4 pg/ml]), (p?<?0.01). Statistically significant difference was found both in males and females. In both groups, positive correlations between serum copeptin and uric acid levels (r?=?0.31, p?<?0.01), albuminuria (r?=?0.45, p?<?0.01), serum triglycerides (r?=?0.3, p?<?0.05), body mass index (BMI) standard deviation score (SDS) (r?=?0.24, p?<?0.05) and 24-h systolic blood pressure (SBP) (r?=?0.37, p?<?0.01) and diastolic blood pressure (DBP) (r?=?0.23, p?<?0.05) were found.

Conclusions

In summary, higher serum copeptin levels, a surrogate for arginine vasopressin (AVP) release, are associated not only with systolic and diastolic blood pressure but also with several components of metabolic syndrome including obesity, elevated concentration of triglycerides, albuminuria, and serum uric acid level. However, for the time being, more research is needed in order to confirm the role of serum copeptin as a novel marker of elevated blood pressure and predictor of metabolic syndrome.     

Can Diet Prevent Urological Cancers? An Update on Carotenoids as Chemopreventive Agents

Urological cancers, namely prostate, bladder, kidney, testicular, and penile cancers, are common conditions that constitute almost one-quarter of all malignant diseases in men. Urological cancers tend to affect older individuals, and their development is influenced by modifiable metabolic, behavioral, and environmental risk factors. Phytochemicals may have cancer-fighting properties and protect against cancer development, slow its spread, and reduce the risk of cancer deaths in humans. This paper aims to review the current literature in regard to the effects of carotenoids in reducing urological cancer risk.     

Microwave-Assisted Hydrothermal Synthesis of Zinc-Aluminum Spinel ZnAl2O4

The drawback of the hydrothermal technique is driven by the fact that it is a time-consuming operation, which greatly impedes its commercial application. To overcome this issue, conventional hydrothermal synthesis can be improved by the implementation of microwaves, which should result in enhanced process kinetics and, at the same time, pure-phase and homogeneous products. In this study, nanometric zinc aluminate (ZnAl₂O₄) with a spinel structure was obtained by a hydrothermal method using microwave reactor. The average ZnAl₂O₄ crystallite grain size was calculated from the broadening of XRD lines. In addition, BET analysis was performed to further characterize the as-synthesized particles. The synthesized materials were also subjected to microscopic SEM and TEM observations. Based on the obtained results, we concluded that the grain sizes were in the range of 6–8 nm. The surface areas measured for the samples from the microwave reactor were 215 and 278 m² g⁻¹.