Age and dual trigger were found to be significant predictors of live birth in POSEIDON group 3 and 4 women treated with the GnRH antagonist protocol: a retrospective cohort study.

OBJECTIVE: Despite recent advancements in assisted reproductive technology (ART), the effective management of patients with poor ovarian response (POR) remains a formidable challenge. While various treatment strategies and predictors of live births have been documented to provide guidance to fertility specialists in managing poor responders, research efforts have predominantly encompassed all POSEIDON groups. In this study, our objective was to analyze the factors correlated with live births (LB) within a subset of the POSEIDON groups, with a particular focus on POSEIDON groups 3 and 4. PATIENTS AND METHODS: Charts of 406 patients belonging to POSEIDON groups 3 and 4 who underwent ART treatment at a university-affiliated infertility clinic following a gonadotropin-releasing hormone (GnRH) antagonist cycle between January 2016 and December 2021 were analyzed. Clinically significant factors associated with live births were incorporated into a logistic regression model for multivariate analysis to ascertain independent predictors of LB. Additionally, a receiver operating characteristic (ROC) curve analysis was conducted to establish the optimal cut-off values. RESULTS: Live births were achieved in 48 cycles (8.7%). Female age (OR, 0.930; 95% CI: 0.874-0.991; p < 0.024), baseline serum luteinizing hormone (LH) levels (OR, 0.854; 95% CI: 0.741-0.984; p < 0.029), and dual triggers (OR, 4.004; 95% CI: 1.290-12.426; p < 0.016) were identified as independent factors associated with LB following multivariate logistic regression analysis. The optimal age cut-off was determined to be 33 years, with a sensitivity of 70.8% and specificity of 75%. CONCLUSIONS: Younger age, lower baseline serum LH levels, and dual-trigger administration appear to enhance the likelihood of live birth in POSEIDON groups 3 and 4 following treatments with the GnRH antagonist protocol.

Satisfactory medium-long term patient reported outcomes after laparoscopic single-mesh sacrohysteropexy.

Background: There is scarce information on the effectiveness of the laparoscopic single mesh sacrohysteropexy (smSHP). Attachment of a single sheet of flat mesh posteriorly to the cervix provides less mesh use and a less invasive distal mesh fixation. Objectives: To assess medium to long-term follow-up results of patients who underwent laparoscopic smSHP utilising a less invasive technique with single sheet flat mesh. Materials and Methods: In the present retrospective cohort study, the data of 71 women who underwent laparoscopic smSHP for apical uterine prolapse with or without colporrhaphy (anterior and/or posterior) at the urogynaecology unit of a university hospital between January 2008 and January 2020 was reviewed. Data was collected on demographics, presenting symptoms, preoperative findings, surgery, and postoperative outcomes. Main Outcome Measures: Medium to long-term patient-reported outcomes. Results: The median age of the study population was 44 years. Median follow-up duration was 5 years (1-12). Symptomatic recurrence over time and repeat surgery rates were 13.1% and 3.1% respectively. Comparison of the pre-operative and medium to long-term evaluation scores of the pelvic floor distress inventory-20 (PFDI-20) and assessment of the patient global impression of improvement (PGI-I) revealed long-standing improvement in pelvic floor dysfunction. Conclusions: Laparoscopic smSHP appears to be successful and safe with low recurrence and complication rates and provides satisfactory patient reported outcomes. What's new?: Medium to long-term patient-reported outcomes based on PFDI-20 and PGI-I surveys are satisfactory following smSHP.

Lung ultrasound and computed tomographic findings in pregnant woman with COVID-19.

Imaging modalities play a crucial role in the management of suspected COVID-19 patients. Before reverse transcription polymerase chain reaction (RT-PCR) test results are positive, 60-93% of patients have positive chest computed tomographic (CT) findings consistent with COVID-19. We report a case of positive lung ultrasound findings consistent with COVID-19 in a woman with an initially negative RT-PCR result. The lung ultrasound-imaging findings were present between the negative and subsequent positive RT-PCR tests and correlated with CT findings. The point-of-care lung-ultrasound examination was easy to perform and, as such, could play an important role in the triage of women with suspected COVID-19. The neonatal swabs, cord blood and placental swab RT-PCR tests were negative for SARS-CoV-2, a finding consistent with the published literature suggesting no vertical transmission of this virus in pregnant women. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.