Asian Pacific Journal of Reproduction

118-123

Authors: Ivan Sini, Nining Handayani, Adinda Pratiwi, Arie A Polim, Arief Boediono

Objective: To compare the effectiveness of blastocyst elective single embryo transfer (eSET) and double embryo transfer (DET) in reducing low birth weight, preterm birth, and perinatal mortality in in vitro fertilization (IVF) cycles of Indonesian women. Methods: A retrospective observational study was conducted at Morula IVF Clinic, Jakarta, Indonesia. A total of 179 women who underwent either eSET or DET and had met the eligibility criteria were included. Seventy-six women underwent eSET while 103 underwent DET in their IVF cycles. Low birth-weight rate, preterm birth rate, and perinatal mortality rate of both groups were measured as the primary study outcomes. Neonatal intensive care unit (NICU) admission rate, Apgar score, multiple pregnancy, and maternal complications during pregnancy were also evaluated. Results: The risk of low birth weight [odds ratio (OR)=0.21, 95% confidential interval (CI): 0.10-0.45, P<0.001] and preterm birth (OR=0.25, 95% CI: 0.13-0.49, P<0.001) was significantly lower in the eSET group compared with the DET group. Furthermore, eSET efficiently reduced the incidence of NICU admission and multiple pregnancy (P=0.01 and P<0.001, respectively). No significant difference was observed in terms of perinatal mortality rate, Apgar score, and maternal complications including gestational diabetes, preeclampsia as well as pregnancy-induced hypertension (P≥0.05). However, a lower incidence of antepartum hemorrhage was noticed in the eSET group than in the DET group (P=0.03). Conclusions: Compared with DET, infants conceived through IVF cycles with eSET have a significantly lower risk of low birth weight, preterm birth, and NICU admissions. Moreover, eSET is shown to reduce multiple pregnancy rate, yet no significant differences are observed in the perinatal mortality rates, Apgar score and maternal complications (except for the incidence of antepartum hemorrhage) between both groups.

129-134

Authors: Farhang Abed, Morteza Fallah-Karkan, Masoumeh Majidi Zolbin, Pegah Naghizadeh, Fereshte Aliakbari, Hossein Yazdekhasti

Objective: To evaluate whether the use of vascular endothelial growth factor (VEGF) with alginate increases oocyte maturation following in vitro maturation. Methods: This experimental study was performed on 150 immature oocytes (germinal vesicle oocytes) from females who were candidates for assisted reproductive technology. The germinal vesicle oocytes were randomly placed in the control, alginate, and VEGF plus alginate groups. The basic culture medium for oocytes culture (tissue culture medium 199, follicle-stimulating hormone 0.075 IU/mL, and fetal bovine serum 10%) was used in the control, alginate, and VEGF plus alginate groups. For the treatment groups (alginate, and VEGF plus alginate groups), alginate (8%) and VEGF (5 ng/mL) were added to the basic culture medium. After culture, immature oocytes were considered as oocytes unchanged in the nucleus whereas oocytes with a polar body were considered as mature oocytes (metaphase Ⅱ stage). The mature oocytes in each group were fertilized by intracytoplasmic sperm injection and formed embryos were evaluated by reverse microscope. Results: The oocyte maturation rate (metaphase Ⅱ) significantly (P<0.05) increased in the alginate plus VEGF group as compared with the alginate alone and control groups during in vitro maturation. On day 2, the cleavage rates were significantly different in the matured oocytes between the treatment groups and the control group. The percentage of the two-cell stage, four-cell stage and eight-cell embryos was significantly higher in the treatment groups compared with the control group (P<0.05). Conclusions: Supplementation of VEGF with alginate can improve oocyte maturation in culture media. VEGF with alginate may promote the quality of nuclear and cytoplasmic maturation of human oocytes in vitro.

142-147

Authors: Gayatri Rai, Narendra Namdev, Payal Mahobiya

Objective: To study the protective effect of ascorbic acid and curcumin against the abnormal estrous cycle and morphological changes in cells induced by repeated ultraviolet B (UVB) radiation in female Wistar rats. Methods: Sixteen female sexually mature Wistar rats weighing 130-150 g and aged 12-16 weeks were randomly divided into four groups. The control group received normal food and water ad libitum. The UVB group was exposed to a dose of 280 nm of UVB radiation for 2 h daily. The UVB+curcumin group received a dose of 280 nm of UVB radiation for 2 h daily and also an oral dose of curcumin (25 mg/kg body weight) daily. The UVB+ascorbic acid group received a dose of 280 nm of UVB radiation for 2 h daily and also an oral dose of ascorbic acid (250 mg/kg body weight) daily. All the treatments last for 15 consecutive days. Body and ovary weight and gonadosomatic index were measured. The stages (proestrus, estrus, metaestrus and diestrus) of the estrous cycle were determined by the cell types observed in the vaginal smear. Results: UVB radiation caused irregular alterations on the estrous cycle and morphological changes of the female Wistar rat as compared with the control group. Ascorbic acid and curcumin protected UVB-induced estrous phases and their cells. But curcumin showed greater protection than ascorbic acid. Conclusions: Ascorbic acid and curcumin at low doses can alleviate abnormal estrous cycle and morphological changes in cells induced by UVB radiations in female Wistar rats.

156-158

Authors: Hayder M. Al-kuraishy, Thabat J. Al-Maiahy, Ali I. Al-Gareeb, Rasha A. Musa, Zaid H. Ali

Rationale: Coronavirus disease 2019 (COVID-19) is a highly infectious disease due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2). Vertical transmission and clinical presentation of COVID-19 in pregnancy is still obscure. Additionally, the potential hazard of COVID-19 in pregnancy on the fetus and post-delivery risk for the neonate remain under investigations. Patient concern: A young-aged Asian pregnant woman with 28 weeks of gestation presented with fever, dyspnoea, headache, and joint pain with decreased fetal movement for about one week. Diagnosis: The patient was diagnosed with COVID-19 pneumonia. Interventions: The patient was referred to the quarantine sector and was treated with chloroquine orally, intravenous fluid and other supportive treatment. Outcomes: After one week of treatment, the patient improved. Seventeen days after admission to hospital and at 30 weeks of gestation, she started vaginal preterm delivery of a viable healthy neonate with negative COVID-19 test for two occasions. Lessons: COVID-19 pneumonia during pregnancy presents with similar clinical presentation of non-pregnant women. COVID-19 pneumonia during pregnancy increases the risk of preterm labour without evidence of vertical transmission.