A systematic review and meta-analysis of Listeria monocytogenes isolated from human and non-human sources: the antibiotic susceptibility aspect.

Listeria monocytogenes causes listeriosis with a high mortality rate. This study systematically reviewed the antibiotic susceptibility of L. monocytogenes in the world. A literature search was done and the data of 33 studies that matched with the inclusion criteria, were used for meta-analysis. The random-effect model meta-analysis was applied to determine the frequency of overall L. monocytogenes and its antibiotic non-sensitive isolates. The frequency of L. monocytogenes contamination in non-human sources was 10.3%. The most frequent serotypes were 4b and 4ab in human and non-human isolates, respectively. The resistance of L. monocytogenes isolates to the first-line antibiotics namely penicillin, ampicillin/amoxicillin, gentamicin, and trimethoprim-sulfamethoxazole has been increased in recent years. Altogether, the results indicated a concern for the antibiotic resistance in L. monocytogenes isolates over time. The implement of the registry and surveillance systems is required to improve the insight of L. monocytogenes antibiotic susceptibility and its treatment choices.

Early oocyte triggering followed by in vitro maturation is a good approach in women with resistance ovary syndrome: A case-series.

BACKGROUND: Some women represent the inability to respond to endogenous and exogenous gonadotropins during in vitro fertilization/intracytoplasmic sperm injection cycles leading to the follicular developmental arrest. The women with resistant ovaries could benefit from in vitro maturation. CASE: This case-series presents pregnancies resulting from initially scheduled conventional in vitro fertilization which led to arrested cycles because of resistant ovary syndrome. The protocol was changed to early oocyte triggering for 15 women due to the small follicles ≤ 12 mm in diameter on day 15 after stimulation with high doses of exogenous gonadotrophins instead of cycle cancellation. Germinal vesicle and metaphase I oocytes that were retrieved from follicles were matured in vitro and inseminated by intracytoplasmic sperm injection. Twenty formed embryos were transferred on day 3 after oocyte retrieval. This resulted in a 30.76% chemical pregnancy out of which no abortion occurred. Therefore, we reported a 30.76% singleton ongoing pregnancy. CONCLUSION: It seems that early oocyte triggering followed by in vitro maturation may be considered as a good modality in women experiencing follicular resistance to gonadotropins. These cycles can be rescued from cancellation with satisfactory clinical outcomes.

Subcutaneous progesterone versus vaginal progesterone for luteal-phase support in frozen-thawed embryo transfer: A cross-sectional study.

BACKGROUND: Luteal-phase support is a complex and controversial issue in the field of reproductive management. OBJECTIVE: To compare the safety and efficacy of low-dose subcutaneous progesterone with the vaginal progesterone for luteal-phase support in patients undergoing rozen-thawed embryo transfer. MATERIALS AND METHODS: In this cross-sectional study, information related to 77 women that had frozen-thawed embryo transfer was reviewed. The patients were divided into two groups based on the route of progesterone administration used as a luteal-phase support. When the endometrial thickness reached ≥ 8 mm, in one group progesterone (Prolutex) 25 mg/ daily subcutaneous and in another group, vaginal progesterone (CyclogestⓇ) 400 mg twice or (EndometrinⓇ) 100 mg thrice daily, were administrated and continued until menstruation or in case of clinical pregnancy for 8 wk after the embryo transfer when the fetal heart activity was detected by ultrasonography. RESULTS: The patient's characteristics were matched and there was no significant difference. The chemical and clinical pregnancy rate was higher in the vaginal progesterone group compared to the prolutex group, but statistically unnoticeable, (40% vs. 29.6%, p = 0.367) and (28% vs. 22.2%, p = 0.581), respectively. CONCLUSION: The findings of this study demonstrate that the new subcutaneous progesterone can be a good alternative for intramuscular progesterone in women that dislike and do not accept vaginal formulations as luteal-phase support in assisted reproductive technology.

The relationship between menstrual disorders and education in women with intractable epilepsy.

OBJECTIVE: The study aimed to investigate the relationship between menstrual disorders and education in women with intractable epilepsy. METHOD: This was a descriptive-analytical study. Statistical population consisted of all female patients with intractable epilepsy in 15-45 age group who visited the third department of epilepsy in Ayatollah Kashani Hospital. The sample size was 380. They were selected using simple random sampling. A questionnaire was distributed among the patients to collect information on education, incidence and type of current menstrual disorder (each type of menstrual disorder was explained to the participants). Then, the relationship between education and prevalence of menstrual disorders in these women was investigated. FINDINGS: Analysis of Spearman correlation coefficient showed a significant and negative correlation between education and menstrual disorder (P≤0.05). Analysis of multivariate logistic regression also showed a significant relationship between education and types of menstrual disorders. There was also a significant relationship between education and regular and irregular menstruation (P≤0.05). CONCLUSION: There is a significant relationship between education and menstrual disorders in women with intractable epilepsy, and the higher education level indicates less prevalent menstrual irregularities.

Is there any correlation between Estradiol supplementation, as luteal phase support, and clinical pregnancy in ART cycles? A cross-sectional study.

BACKGROUND: Endometrial receptivity is one of the important factors in assisted reproductive technology (ART) success. In the luteal phase of an ART cycle, serum estradiol (E2) and progesterone are often placed in low levels. Supporting the luteal phase with progesterone is a usual method. OBJECTIVE: To evaluate the effects of E2 supplementation plus progesterone on the luteal phase support in the antagonist protocol who have undergone intracytoplasmic sperm injection-embryo transfer cycles. MATERIALS AND METHODS: In this cross-sectional study, 200 patients with antagonist stimulation protocol, who had undergone intracytoplasmic sperm injection treatment, were divided into two groups based on the use of E2 supplementation. In both groups, 400 mg progesterone suppositories (CyclogestⓇ), twice a day/vaginally, was administered starting from the day of oocyte collection until the fetal heart activity. However, in the E2 group, in addition to progesterone, 4 mg tablet of E2 was received daily. Beta hCG was checked 14 days after the embryo transfer, and the clinical pregnancy rate was the main endpoint. RESULTS: The patients' characteristics were matched, and insignificant differences were observed, except for endometrial thickness. The clinical outcomes showed the rate of pregnancy was higher in the E2 group compared to the control group; nonetheless, statistically, there was no noticeable difference. CONCLUSION: E2 supplementation had no beneficial effect in the luteal phase support of IVF cycles. Nevertheless, more studies are required to confirm the supportive role of E2 supplementation for embryo implantation and to improve the outcomes in ART cycles.

The effect of low-dose aspirin on the pregnancy rate in frozen-thawed embryo transfer cycles: A randomized clinical trial.

BACKGROUND: The results of previous studies on the effect of low-dose aspirin in frozen-thawed embryo transfer (FET) cycles are limited and controversial. OBJECTIVE: To evaluate the effect of low-dose aspirin on the clinical pregnancy in the FET cycles. MATERIALS AND METHODS: This study was performed as a randomized clinical trial from May 2018 to February 2019; 128 women who were candidates for the FET were randomly assigned to two groups receiving either 80 mg oral aspirin (n = 64) or no treatment. The primary outcome was clinical pregnancy rate and secondary outcome measures were the implantation rate, miscarriage rate, and endometrial thickness. RESULTS: The endometrial thickness was lower in patients who received aspirin in comparison to the control group. There were statistically significant differences between the two groups (p = 0.018). Chemical and clinical pregnancy rates and abortion rate was similar in the two groups and there was no statistically significant difference. CONCLUSION: The administration of aspirin in FET cycles had no positive effect on the implantation and the chemical and clinical pregnancy rates, which is in accordance with current Cochrane review that does not recommend aspirin administration as a routine in assisted reproductive technology cycles.

Frozen-thawed cleavage stage versus blastocyst stage embryo transfer in high responder patients.

Clinical outcomes following frozen-thawed cleavage embryo transfer versus frozen-thawed blastocyst transfer in high responder patients undergoing in vitro fertilisation/intracytoplasmic sperm injection cycles are still debated. In a retrospective study, 106 high responder patients who were candidate for 'freeze-all embryos' were recruited. Frozen-thawed embryos were transferred at the cleavage stage (n = 53) or the blastocyst stage (n = 53). Clinical pregnancy was considered as the primary outcome and chemical pregnancy, ongoing pregnancy, implantation rate, and fertilization rate, as well as miscarriage rate, were measured as the secondary outcome. Clinical (47.2% vs. 24.5%), chemical (56.6% vs. 32.1%), and ongoing pregnancy rates (37.7% vs. 17%) as well as implantation rates (33.6% vs. 13.5%) were significantly higher in the blastocyst group compared with the cleavage group respectively (P < 0.05). Miscarriage rate was comparable between groups (P > 0.05). Transfer of frozen-thawed embryos at the blastocyst stage was preferable in the high responder patients to increase implantation, pregnancy and live birth rates compared with cleavage stage embryo transfer.

Dual stimulation in unexpected poor responder POSEIDON classification group 1, sub-group 2a: A cross-sectional study.

BACKGROUND: Poor ovarian response management is a complex and controversial issue in the field of reproductive medicine. OBJECTIVE: The aim of this study was to apply double stimulation in the same cycle in unexpected poor responders in POSEIDON classification group 1, sub group 2a and compare assisted reproductive technology outcomes between luteal phase and follicular phase ovarian stimulation. MATERIALS AND METHODS: In this cross-sectional study, 10 women with age < 35 yr, antral follicle count > 5, and anti-müllerian hormone > 1.2 ng/mL were enrolled. All participants received conventional antagonist protocol in the follicular phase and only the cycles with retrieved oocytes < 4 in this phase included. The luteal phase ovarian stimulation was initiated from the day of first oocytes retrieval by 300 IU of human menopausal gonadotropin / day. When dominant follicles amounted to 14 mm in mean diameter, 0.25 mg/day of gonadotropin-releasing hormone antagonist was initiated and 10,000 IU human chorionic gonadotropin was injected when at least two follicles with a mean diameter of 17 mm were observed. Oocyte retrieval was carried out 34-36 hr following human chorionic gonadotropin injection. Finally, a comparison was made between the two phase in terms of the number of retrieved oocytes as well as the number of obtained embryos and fertilization rates. RESULTS: Numbers of retrieved oocytes (p = 0.004), mature oocytes (p = 0.016), and embryos (p = 0.013) was significantly higher in luteal phase in compared with follicular phase. Quality of embryos was similar in two phases. CONCLUSION: Double stimulation protocol can increase number of retrieved oocytes in unexpected PORs.