Clinical pregnancy and delivery of a healthy baby by a 44-year-old woman after a successful in vitro fertilization frozen cycle using her own oocytes.

OBJECTIVE: To present a successful IVF frozen-embryo replacement cycle in a 44-year-old woman, using her own oocytes. DESIGN: Case report. SETTING: Assisted reproduction unit in a university hospital. PATIENT(S): A 44-year-old woman underwent IVF frozen-embryo replacement cycle after three unsuccessful IVF fresh cycles with her own oocytes. The couple were unable to achieve pregnancy for 4 years and were advised to have IVF because of the long duration of subfertility and woman's age. INTERVENTION(S): In vitro fertilization. MAIN OUTCOME MEASURE(S): Pregnancy, live birth, baseline FSH on day 3, and IVF outcome. RESULT(S): The woman achieved pregnancy through a frozen-embryo replacement cycle and gave birth to a healthy girl who weighed 3,330 g. CONCLUSION(S): Pregnancy is difficult to achieve for women >40 years of age and especially so for a woman at the age of 44 years. In vitro fertilization cycles may not lead to the desired result, but the availability of a frozen embryo replacement cycle is associated with better prognosis.

A comparison of the dietary and total intake of micronutrients in a group of pregnant Greek women with the Dietary Reference Intakes.

OBJECTIVE: We compared the dietary and total (diet and supplement) intake of micronutrients with the Dietary Reference Intakes (DRIs) from the USA in a population of pregnant Greek women. METHODS: Two hundred pregnant women participated in a nutritional survey, 98 in the second trimester and 102 in the third trimester in a random sampling. To examine dietary intake we used two questionnaires, the nutritional questionnaire for pregnant women from the California Department of Health Services, and a semi-quantitative questionnaire (Walter Willet) with modifications for use in Greece. Dietary intake analysis was performed using the Diet Analysis Plus software, Version 3, ESHA Research. Statistical analysis was performed with Minitab for Windows, Release 12. A simple complementary questionnaire concerning demographic and socio-economic features was also completed. RESULTS: The average total intake of vitamins A, B(1), B(2), B(3), B(6), B(12) and C, calcium and phosphorus was higher than the respective DRIs. Folic acid and iron intake exceed the highest values specified for pregnancy. Vitamin E and zinc was lower than the DRIs, while vitamin D, magnesium and thiamin did not differ. CONCLUSIONS: The results of our study suggest that in a Greek population, sufficient micronutrients appear to be received in adequate amount from diet, except for folic acid and iron, which also had to be taken in the form of nutritional supplements.

The influence of vacuum extractor on fetal oxygenation and newborn status.

AIM: The aim of this study was to determine the effects of vacuum extractor assisted delivery on fetal oxygenation and acid-base balance. METHODS: Sixty-one women were enrolled in the present study. The subjects were divided into two groups. Group A, consisting of 39 women, had normal vaginal deliveries. Group B, consisting of 22 women, underwent a vacuum extractor assisted vaginal delivery. Fetal arterial oxygen saturation (SpO2) monitoring was used in all women after full cervical dilatation. After delivery, umbilical artery pH, pCO2, pO2 and base deficit (BDecf) levels were determined in all neonates. RESULTS: The mean FSpO2 value in Group A was 51.53+/-5.87% and in Group B 48.03+/-6.39% (p<0.03). The mean cord pH value in fetuses of Group A was 7.26+/-0.05, and in Group B 7.17+/-0.09. There was also a significant difference between the two groups with regards to mean pO2, pCO2 and BDecf values. CONCLUSIONS: Vacuum assisted vaginal delivery was associated with lower fetal arterial oxygen saturation levels as well as lower cord blood pH values compared to those seen after unassisted vaginal delivery. Although decreased, however, the above parameters remained within normal ranges.

The effect of valacyclovir treatment on natural killer cells of infertile women.

PROBLEM: The aim of this study was to investigate the effect of valacyclovir treatment on natural killer (NK) cell concentration in the peripheral blood of infertile women. METHOD OF STUDY: Peripheral blood NK cell concentration of 104 non-pregnant women with a history of infertility was determined by flow cytometry. The controls were 14 fertile non-pregnant women. A cohort of 42 out of 104 women--whose NK cell levels were 175/microL or higher--was prospectively studied for the presence of HSV-1, 2, VZV, cytomegalovirus, HHV-6, HHV-7 and HHV-8 DNA in the peripheral blood and was orally administered valacyclovir (open label study). RESULTS: Herpes virus DNA was detected in 64.3% of the 42 women examined. Prior to valacyclovir treatment mean NK cell concentration in herpes-negative group was statistically higher from control group but lower from herpes positive group (P = 0.0007, ANOVA). Following valacyclovir treatment the mean NK cell concentration was statistically decreased in all studied women (P = 0.000453), in herpes-negative (P = 0.01622) and in herpes positive group (P = 0.0056). Sufficient decrease was observed in 31 (73.8%) of 42 women who received the drug. CONCLUSIONS: Valacyclovir treatment is associated with a decrease of NK cell levels in most of the women with a history of infertility.