Effect of and the association between vitamin D and outcomes of assisted reproductive techniques among infertile men and women: protocol for an overview of systematic reviews and meta-analysis.

INTRODUCTION: Vitamin D is associated with many functions of the human reproductive system. Accordingly, it seems that on infertile couples undergoing assisted reproduction technology (ART), treatment outcomes may be affected by the vitamin D. This overview aims to show the effect of vitamin D on infertility treatments outcomes in recent studies by concluding systematic reviews and meta-analyses to achieve a comprehensive result. METHODS AND ANALYSIS: This overview protocol is being reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement and was registered in the International Prospective Register of Systematic Reviews. We will include all peer-reviewed systematic reviews and meta-analyses of randomised controlled trials published from inception until December 2022. PubMed, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, Scopus, Cochrane Central Register of Controlled Trials and Embase will be searched from the time of publication of the first articles onwards with a comprehensive search strategy. Endnote V.X7 software (Thomson Reuters, New York, New York, USA) will be used to store and manage records. The results will align with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions and the PRISMA statement. ETHICS AND DISSEMINATION: This overview will be evaluating the effect of vitamin D status and vitamin D supplementing on results of ART in women and men who are undergoing treatment for infertility. The high prevalence of vitamin D deficiency worldwide and its effects on an important issue such as human fertility might be a very influential factor that leads scientists to strongly recommend its use. However, the more critical concern is that there is no definitive agreement in studies on the relationship between vitamin D and an increased chance of better fertility in men and women undergoing infertility treatment. PROSPERO REGISTRATION NUMBER: CRD42021252752.

Effects of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparas women.

Introduction. The reduction of the duration and pain of the active phase of labor is a very important issue and therefore always under serious investigation. Objective. The purpose of the present study is to evaluate the effect of acupressure at the Sanyinjiao point (SP6) on the duration and pain of the active phase of labor in nulliparas women. Method. A single blind randomized clinical trial was performed on 120 eligible nulliparas women who were at the beginning of active phase of labor (3-4 cm dilatation of cervix plus proper uterine contractions). The women were randomly assigned into two groups. The case group (n = 60), received acupressure at Sanyinjiao point (above the ankle), for 30 min during contractions. In the control group (n = 60), simply a touch at this point without massage was performed. Two hours later a second pelvic examination was performed and in the absence of good forceful contractions oxytocin in the classical form was infused. Finally, duration of active phase, severity of pain (using the Visual Analogue Scale), the amount of necessary oxytocin and necessity to administer oxytocin and the route of delivery were compared between the two groups and statistical analyses were performed using SPSS 15. Results. The mean duration of active phase was shorter in the case group (252.37 +/- 108.50 min vs. 441.38 +/- 155.88, p = 0.0001). Six patients (10%) in the case group and 25 patients (41.7%) in the control group delivered via cesarean section (p = 0.0001). The severity of pain in the case group was less than the control group (5.87 +/- 1.77 vs. 6.79 +/- 1.52, p = 0.003). Twenty-five women (41.7%) in the case group and 38 women (63.3%) in the control group needed oxytocin (p = 0.017) The amount of necessary oxytocin in the case group was less than the control group (73.33 +/- 97.19 ml vs. 126.6 +/- 97.19 ml, p = 0.003). Conclusion. Acupressure at Sanyinjiao point (SP6) reduced the duration and severity of pain of the active phase of labor, cesarean section rates, and necessity and amount of oxytocin.