RESUMO
This retrospective cohort study examines the impact of EmbryoGlue® - a culture medium comprising high-concentration hyaluronan and low-concentration recombinant human albumin (rHA) - on assisted reproductive technology (ART) outcomes in 1,298 cycles across 13 centers. The study focused on live birth rates, clinical pregnancy, and miscarriage rates between a standard treatment arm and an EmbryoGlue® arm in frozen embryo transfer (FET) cycles. Propensity score matching ensured comparable baseline variables. Findings showed higher live birth rates (60.6% vs. 47.5%) and clinical pregnancies (69.5% vs. 57.6%) in the EmbryoGlue® group, correlating with factors like patient age and blastocyst transfer. Specifically, EmbryoGlue® showed a significant association with higher live birth rates (OR 1.593; CI 1.170-2.168; P = 0.003). These findings underscore the impact of personalized approaches and highlight EmbryoGlue®'s potential in improving successful embryo implantation, thus enhancing pregnancy rates in ART procedures. Univariate and multivariate analyses identified EmbryoGlue®, female age, and blastocyst transfer as predictors of live birth. EmbryoGlue® exhibited significance in improving clinical outcomes, mirroring previous studies' findings. Limitations in the study's design warrant further prospective research for validation. In conclusion, EmbryoGlue® appears promising for enhancing live birth rates in FET cycles, presenting a potential advancement in ART protocols.
RESUMO
Objective To assess the surgical outcome of supine percutaneous nephrolithotomy (PCNL) in patients with co-morbidities. Materials and methods We retrospectively reviewed the data of 15 patients who underwent supine PCNL at our centre from September 2019 to May 2021. Preoperatively, a complete examination of the patients, along with biochemical and radiological investigations, was done. The data, which included patient demographics, comorbidities, complexity of renal calculi, complications, and stone clearance rate, were collected from the patients' medical records. Results Patients aged between 31 and 70 years were included in the study. The mean (SD) BMI was 26.01 (2.31). Twelve patients (80%) were overweight with a BMI of 25.3 to 29.3 kg/m2. The most common comorbidities were diabetes (33.3%) and hypertension (26.7%). In our study, six patients were American Society of Anesthesiologists (ASA) grade 3 (40%), followed by grade 2 in five patients (33.3%), grade 4, and grade 1 in two patients (13.3%) each. The Guy's Stone score was one in nine patients (60%) and two in six patients (40%). Complete clearance was achieved in 13 (86.7%) patients. Two patients (13.3%) had a stone clearance of more than 80%. Data analysis showed that 14 patients (93.3%) had no perioperative complications. Postoperative abdominal distension was noted in one patient (6.7%), which was managed conservatively (Clavien-Dindo grade 1). We did not encounter any cases of organ injury following supine PCNL. Postoperatively, none of our patients received blood transfusions. Conclusion Our study shows that supine PCNL is a good surgical option, especially for high-risk patients with good stone clearance and low complication rates.