Comparable ongoing pregnancy and pregnancy loss rates in natural cycle and artificial cycle frozen embryo transfers with intensive method-specific luteal phase support; a retrospective cohort study.

STUDY OBJECTIVE: The absence of corpus lutea in artificial cycle (AC) frozen embryo transfers (FET) may increase the chances of pregnancy loss. In this retrospective cohort study, the efficacy of AC endometrial preparation was compared natural cycle (NC) endometrial preparation in terms of ongoing pregnancy. METHODS: One thousand six hundred and eighteen consecutive vitrified-warmed blastocyst FET performed between December 2021 and November 2022 were included, with 1023 compared after exclusions according to the endometrial preparation method; 293 NC-FET, 143 modified NC-FET, 204 unprogrammed AC-FET, and 383 oral contraceptive pill (OCP) programmed AC-FET. Intensive method-specific luteal phase support (LPS) was administered in NC- (human chorionic gonadotropin and micronized vaginal progesterone), mNC- (micronized vaginal progesterone), and in AC-FET (micronized vaginal progesterone, intramuscular progesterone, and oral dydrogesterone). RESULTS: Clinician choice of endometrial preparation method resulted in the NC- or AC-FET groups having distinct differences, with female age, antral follicle count and body mass index as well as the percentage of DOR or PCOS diagnosed patients significantly different. The unadjusted ongoing pregnancy and total pregnancy loss rates for NC-, mNC-, AC-, and ocp-AC-FET were 61.8 %, 55.2 %, 57.4 %, and 58.5 %, and 19.2 %, 24.0 %, 23.5 % and 23.8 %, respectively. In multivariate logistic regressions to predict the dependent outcomes of ongoing pregnancy and total pregnancy loss, none of the FET methods were selected as independent predictors. CONCLUSION: Patients undergoing NC- and AC-FET with method-specific progesterone LPS had comparable ongoing pregnancy rates as well as total pregnancy loss rates, with NC-FET ranked first in the regression analysis.

Clinical practice guidelines for the diagnosis and treatment of scabies.

Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.