Role of suppression of endometriosis with progestins before IVF-ET: a non-inferiority randomized controlled trial.

BACKGROUND: Endometriosis affects the responsiveness to ovarian stimulation. This study aimed to assess the role of Dienogest pretreatment for endometriosis suppression as compared to Gonadotropin-releasing hormone agonist (GnRHa) in patients with endometriosis pursuing IVF treatment. METHODS: In this randomized controlled trial, 134 women with endometriosis-related infertility were randomly allocated to group A (n = 67) who had monthly depot GnRHa for 3 months before ovarian stimulation in IVF treatment (Ultra-long protocol), and Group B (n = 67) who had daily oral Dienogest 2 mg/d for 3 months before starting standard long protocol for IVF. The primary outcome measure was the number of oocytes retrieved. The secondary outcome measures included the number of mature oocytes, fertilization rate, quality of life assessed by FertiQoL scores, cost of treatment, and pregnancy outcomes. RESULTS: Although there was no statistically significant difference between both groups regarding ovarian stimulation, response parameters, and pregnancy outcomes, the Dienogest group had a lower cost of treatment (2773 vs. 3664 EGP, P < 0.001), lower side effects (29.9% vs. 59.7%, P < 0.001), higher FertiQoL treatment scores (33.2 vs. 25.1, P < 0.001) and higher tolerability scores (14.1 vs. 9.4, P < 0.001 < 0.001). CONCLUSION: Our study indicates that Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients. TRIAL REGISTRATION: NCT04500743 "Retrospectively registered on August 5, 2020".

Management of bleeding from morbidly adherent placenta during elective repeat caesarean section: retrospective -record -based study.

BACKGROUND: Controlling massive haemorrhage from morbidly adherent placenta (MAP) at caesarean section is a major surgical challenge to obstetricians. This study compares different intra-operative interventions to control haemorrhage from morbidly adherent placenta and its impact on maternal morbidity. METHODS: Retrospective analysis was done for baseline characteristics, intra-operative and postoperative complications of 125 patients with morbidly adherent placenta who had elective CS at 35-38 weeks gestation in the period from 01/2012 to 01/2017. The included patients were categorized into three groups according to intra-operative interventions they had for controlling bleeding; Group A (n = 42) had only balloon tamponade, Group B (n = 40) had balloon tamponade and bilateral uterine artery ligation, in Group C (n = 43) all cases were managed by bilateral uterine artery ligation and inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment using the cervix as a natural tamponade. RESULTS: There were no differences of baseline characteristics of patients in all groups. Group C had significantly better outcomes as compared with groups A and B; less total blood loss (Group C 2869.5 ml vs Group B 4580 ml, Group A 4812 ml, P <  0.001), less requirement of blood transfusion more than 4 units (Group C 4/43, Group B 10/40,Group A 12/42, P <  0.02), significant reduction in prolonged hospital stay over 10 days (Group C 2/43, Group B 9/40,Group A 14/42, P < 0.001) and lower risk of coagulopathy (Group C 4/43, B 8/40, A 9/42), visceral injuries (Group C 4/43 vs B 8/40, A 10/42,P < 0.01) and need for hysterectomy (Group C 4/43 vs B 11/40, A 13/42,P < 0.001). CONCLUSION: A combination bilateral uterine artery ligation and using the cervix as a natural tamponade are very effective and simple methods in controlling bleeding resulting from separated placenta accreta. TRIAL REGISTRATION: The findings are part of the research project registered in ClinicalTrials.gov NCT02590484 . Registered 28 October 2015.

Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers.

RESEARCH QUESTION: What is the association of endometrial thickness with pregnancy losses and live births in IVF treatment and the optimal threshold that optimizes the IVF outcome? DESIGN: Data were analysed from 25,767 IVF cycles from centres of the CARE Fertility Group in the UK between 2007 and 2016. Transvaginal ultrasound was conducted to measure the maximum endometrial thickness during gonadotrophin stimulation. Live birth rates were per embryo transfer. Pregnancy loss rates included the combination of biochemical and clinical pregnancy losses. RESULTS: The live birth rate was 15.6% with 5 mm or less endometrial thickness and gradually increased to 33.1% with an endometrial thickness of 10 mm. On the other hand, the pregnancy loss rate was 41.7% with 5 mm or less endometrial thickness and gradually decreased to 26.5% with an endometrial thickness of 10 mm. Statistical modelling for optimal endometrial thickness threshold found 10 mm or more maximized live births and minimized pregnancy losses. This association was independent after adjusting for confounders such as age, oocyte number, number of transferred embryos, ovarian stimulation protocol and embryo quality for live births (crude RR 1.27; 95% CI 1.21 to 1.33; Adjusted RR 1.18; 95% CI 1.12 to 1.23) and pregnancy losses (crude RR 0.83; 95% CI 0.77 to 0.89; adjusted RR 0.86; 95% CI 0.8 to 0.92). CONCLUSIONS: Endometrial thickness is strongly associated with pregnancy losses and live births in IVF, and the optimal endometrial thickness threshold of 10 mm or more maximized live births and minimized pregnancy losses.

Advancing the Use of Passive Sampling in Risk Assessment and Management of Sediments Contaminated with Hydrophobic Organic Chemicals: Results of an International Ex Situ Passive Sampling Interlaboratory Comparison.

This work presents the results of an international interlaboratory comparison on ex situ passive sampling in sediments. The main objectives were to map the state of the science in passively sampling sediments, identify sources of variability, provide recommendations and practical guidance for standardized passive sampling, and advance the use of passive sampling in regulatory decision making by increasing confidence in the use of the technique. The study was performed by a consortium of 11 laboratories and included experiments with 14 passive sampling formats on 3 sediments for 25 target chemicals (PAHs and PCBs). The resulting overall interlaboratory variability was large (a factor of ∼10), but standardization of methods halved this variability. The remaining variability was primarily due to factors not related to passive sampling itself, i.e., sediment heterogeneity and analytical chemistry. Excluding the latter source of variability, by performing all analyses in one laboratory, showed that passive sampling results can have a high precision and a very low intermethod variability (

Using Polyethylene Passive Samplers To Study the Partitioning and Fluxes of Polybrominated Diphenyl Ethers in an Urban River.

In the aquatic environment, the behavior of hydrophobic organic contaminants (HOCs), such as polybrominated diphenyl ethers (PBDEs), depends on the congeners' physicochemical properties, environmental conditions and the presence of competing natural sorbents, including particulate and dissolved organic carbon (DOC) and black carbon (BC). Although BC is known as an important sedimentary sorbent for HOCs, its affinity for PBDEs has been poorly constrained. To better understand the biogeochemical controls on PBDEs, 12 PBDE congeners were measured in air, water, sediment and porewater of the lower Passaic River. BDE-47 and BDE-99 dominated in all media. In sediments and water, the dual OC + BC approach better predicted PBDE partitioning compared to the simple OC isotherm. Field-derived KBC values for PBDEs were inversely correlated with aqueous solubility [log KBC sediments(water) = -log Cwsat * 0.95 (1.2) + 0.36 (-0.69)]; they reflected near background to highly contaminated regions across the Passaic River. In the water column, PBDEs appeared at equilibrium partitioning between particles and colloids: OC + BC were responsible for the sorption of 65% of PBDEs, followed by colloids (30%); only 5% of PDBEs were truly dissolved. Calculated sediment-water diffusive fluxes greatly overwhelmed the atmospheric depositional flux to the river.

Organochlorine pesticides and polychlorinated biphenyls in sewage sludge from Egypt.

The purpose of this study was to determine the levels, distribution and toxicological potential of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in sewage sludge samples from several WWTPs in the Alexandria area, Egypt. The POPs of interest were 26 PCBs and 16 OCPs. Analyses were performed by gas chromatography with electron impact mass spectrometric detection in the selected ion monitoring mode (GC-MS-SIM) using deuterated organochlorines as internal standards. Total concentrations of OCPs and Σ7 PCBs (ICES) in sludge ranged from 44.2 to 489 µg/kg dw. and 5,600 to 11,000 µg/kg dw., respectively. The highest concentration levels were found for PCBs, HCHs, DDTs, and HCB, in this order. The PCB homologue profiles in sludge samples were dominated by penta- and hexa-chlorinated biphenyls. Seasonal variations were observed for OCPs with higher levels in summer, which reflects more usage in warmer climates. Composite profiles of OCP metabolites indicated new inputs of lindane and technical endosulfan and earlier usage of DDT and technical chlordane. Contamination levels of OCPs and PCBs for Egyptian sludge can be categorized as moderate to high compared to other countries worldwide. The OCP content in none of the samples exceeded limits set by the European Commission for use of sludge in agriculture; while all the concentrations of PCBs in sludge samples were higher by one order of magnitude than the upper limit for land application.

Transmyometrial versus very difficult transcervical embryo transfer: efficacy and safety.

A difficult and traumatic embryo transfer can negatively impact on embryo implantation. This study retrospectively compared the outcomes of "very difficult transcervical embryo transfer" (vdTCET) versus transmyometrial embryo transfer (TMET) in a single centre over 10 years, reporting on 128 patients with vdTCET and 46 patients with TMET. The definition of vdTCET was a procedure rated by an experienced practitioner (with more than 100 transfers per year for >2 years) as very difficult and required two or more of the following: use of tenaculum, change of embryo transfer catheter and use of a stylet, reloading of the embryos or cancelling the procedure and freezing the embryo to transfer after cervical dilatation. The clinical pregnancy rates for TMET and vdTCET were 32.6% and 25%, respectively and the live birth rates were 26.1% and 16.4%, respectively. There was only one case of minor bleeding in the TMET group (2.2%). This study showed that TMET is a good alternative option in cases of vdTCET where it is impossible to achieve transcervical embryo transfer and may benefit cases with repeated failed cycles after vdTCET. Its superiority over vdTCET however could not be demonstrated.

The effect of peri-implantation administration of uterine relaxing agents in assisted reproduction treatment cycles: a systematic review and meta-analysis.

Sub-endometrial junctional zone peristalsis is increased by ovarian stimulation and traumatic embryo transfer, and is linked with decreased implantation and pregnancy rates in assisted reproduction treatments. Various agents have been used to inhibit uterine hyper-peristalsis at the time of embryo transfer with conflicting results. This systematic review aimed to identify if uterine relaxants administered in the peri-implantation period during assisted reproduction treatments could improve pregnancy outcomes through literature search with no language restrictions. The review reports on 3546 patients in 17 randomized controlled trials published between 1993 and 2014. Women undergoing assisted reproduction techniques who either received a uterine relaxant agent in the peri-implantation period versus placebo or no treatment were included. Primary outcome was live birth rate. The meta-analyses did not show statistically significant benefit of any uterine relaxing agents on live birth rate. Other meta-analyses did not show a significant effect on the clinical pregnancy, spontaneous abortion, ectopic pregnancy and multiple pregnancy rate. Most of the included studies were of low quality and lacked significant power to detect minimally important effect. Evidence is insufficient to recommend using these agents in routine practice. Further methodologically robust randomized controlled trials with more refined selection criteria might reveal a beneficial effect.

Estimation of Uncertainty in Air-Water Exchange Flux and Gross Volatilization Loss of PCBs: A Case Study Based on Passive Sampling in the Lower Great Lakes.

Compared with dry and wet deposition fluxes, air-water exchange flux cannot be directly measured experimentally. Its model-based calculation contains considerable uncertainty because of the uncertainties in input parameters. To capture the inherent variability of air-water exchange flux of PCBs across the lower Great Lakes and to calculate their annual gross volatilization loss, 57 pairs of air and water samples from 19 sites across Lakes Erie and Ontario were collected using passive sampling technology during 2011-2012. Error propagation analysis and Monte Carlo simulation were applied to estimate uncertainty in the air-water exchange fluxes. Results from both methods were similar, but error propagation analysis estimated a smaller uncertainty than Monte Carlo simulation in cases of net deposition. Maximum likelihood estimations (MLE) of wind speed and air temperature were recommended to quantify the site-specific air-water exchange flux. An assumed 30-40% of relative uncertainty in overall air-water mass transfer velocity was confirmed. MLEs of volatilization fluxes of total PCBs across Lakes Erie and Ontario were 0.78 and 0.53 ng m-2 day-1, respectively, and gross volatilization losses of total PCBs over the whole lakes were 74 kg year-1 for Lake Erie and 63 kg year-1 for Lake Ontario. Mass balance analysis across Lake Ontario indicated that volatilization was the uppermost loss process of aqueous PCBs.

Gaseous and Freely-Dissolved PCBs in the Lower Great Lakes Based on Passive Sampling: Spatial Trends and Air-Water Exchange.

Polyethylene passive sampling was performed to quantify gaseous and freely dissolved polychlorinated biphenyls (PCBs) in the air and water of Lakes Erie and Ontario during 2011-2012. In view of differing physical characteristics and the impacts of historical contamination by PCBs within these lakes, spatial variation of PCB concentrations and air-water exchange across these lakes may be expected. Both lakes displayed statistically similar aqueous and atmospheric PCB concentrations. Total aqueous concentrations of 29 PCBs ranged from 1.5 pg L(-1) in the open lake of Lake Erie (site E02) in 2011 spring to 105 pg L(-1) in Niagara (site On05) in 2012 summer, while total atmospheric concentrations were 7.7-634 pg m(-3) across both lakes. A west-to-east gradient was observed for aqueous PCBs in Lake Erie. River discharge and localized influences (e.g., sediment resuspension and regional alongshore transport) likely dominated spatial trends of aqueous PCBs in both lakes. Air-water exchange fluxes of Σ7PCBs ranged from -2.4 (±1.9) ng m(-2) day(-1) (deposition) in Sheffield (site E03) to 9.0 (±3.1) ng m(-2) day(-1) (volatilization) in Niagara (site On05). Net volatilization of PCBs was the primary trend across most sites and periods. Almost half of variation in air-water exchange fluxes was attributed to the difference in aqueous concentrations of PCBs. Uncertainty analysis in fugacity ratios and mass fluxes in air-water exchange of PCBs indicated that PCBs have reached or approached equilibrium only at the eastern Lake Erie and along the Canadian shore of Lake Ontario sites, where air-water exchange fluxes dominated atmospheric concentrations.

Spatial Distribution, Air-Water Fugacity Ratios and Source Apportionment of Polychlorinated Biphenyls in the Lower Great Lakes Basin.

Polychlorinated biphenyls (PCBs) continue to be contaminants of concern across the Great Lakes. It is unclear whether current concentrations are driven by ongoing primary emissions from their original uses, or whether ambient PCBs are dominated by their environmental cycling. Freely dissolved PCBs in air and water were measured using polyethylene passive samplers across Lakes Erie and Ontario during summer and fall, 2011, to investigate their spatial distribution, determine and apportion their sources and to asses their air-water exchange gradients. Average gaseous and freely dissolved ∑29 PCB concentrations ranged from 5.0 to 160 pg/m(3) and 2.0 to 55 pg/L respectively. Gaseous concentrations were significantly correlated (R(2) = 0.80) with the urban area within a 3-20 km radius. Fugacity ratios indicated that the majority of PCBs are volatilizing from the water thus acting as a secondary source for the atmosphere. Dissolved PCBs were probably linked to PCB emissions from contaminated sites and areas of concern. Positive matrix factorization indicated that although volatilized Aroclors (gaseous PCBs) and unaltered Aroclors (dissolved PCBs) dominate in some samples, ongoing non-Aroclor sources such as paints/pigments (PCB 11) and coal/wood combustion showed significant contributions across the lower Great Lakes. Accordingly, control strategies should give further attention to PCBs emitted from current use sources.

Metals bioavailability in surface sediments off Nile delta, Egypt: Application of acid leachable metals and sequential extraction techniques.

Surface sediments from Nile Delta coast were analyzed for texture, CaCO3, organic matter, fractionation, and acid leachable metals (Cr, Fe, Mn, Ni, Pb, and Zn). The distribution pattern of acid leachable heavy metals in the sediment follows the sequence: Fe>Mn>Pb>Zn>Ni>Cr. All the acid leachable metals didn't exceed the sediment quality guidelines values (effects range low (ERL) and effects range medium (ERM)) and therefore doesn't represent a danger to marine organisms. The correlation of acid leachable Fe, Ni, and Mn indicates a similarity in the association of metals of similar origin. The negative correlation of sand with acid leachable Cr, Fe, Ni, Pb, and Zn indicates that these elements can be easily released by ion exchange processes due to the electrostatic interaction of trace metals as they are weakly bound and is bioavailable to the liquid phase. The acid leachable Cr, Pb, and Zn indicate their association with the CaCO3, while acid leachable Fe, Mn, and Ni are hardly combined with carbonates. All the contents of acid leachable metals are negatively correlated or uncorrelated with OM, which indicates that the studied heavy metals are hardly combined with OM. The results of the partitioning study showed that the residual form was the dominant fraction of the Cr, Fe, and Ni among most of the studied locations. Among the non-lithogenic fractions, the Fe-Mn oxy-hydroxide is the main scavenger for all metals. In terms of risk assessment code (RAC) value, a decrease order in environmental risk by heavy metals was Pb>Mn>Zn>Ni>Cr>Fe. Although the results of the two techniques were not consistent with each other in terms of predicting the metals bioavailability, a combination of total metal concentrations, acid leachable metals, and sequential extraction analysis is necessary to acquire the comprehensive information on the baseline, anthropogenic input, and bioavailability of heavy metals.

Spatial trends, sources, and air-water exchange of organochlorine pesticides in the Great Lakes basin using low density polyethylene passive samplers.

Polyethylene passive samplers were deployed during summer and fall of 2011 in the lower Great Lakes to assess the spatial distribution and sources of gaseous and freely dissolved organochlorine pesticides (OCPs) and their air-water exchange. Average gaseous OCP concentrations ranged from nondetect to 133 pg/m(3). Gaseous concentrations of hexachlorobenzene, dieldrin, and chlordanes were significantly greater (Mann-Whitney test, p < 0.05) at Lake Erie than Lake Ontario. A multiple linear regression implied that both cropland and urban areas within 50 and 10 km buffer zones, respectively, were critical parameters to explain the total variability in atmospheric concentrations. Freely dissolved OCP concentrations (nondetect to 114 pg/L) were lower than previously reported. Aqueous half-lives generally ranged from 1.7 to 6.7 years. Nonetheless, concentrations of p,p'-DDE and chlordanes were higher than New York State Ambient Water Quality Standards for the protection of human health from the consumption of fish. Spatial distributions of freely dissolved OCPs in both lakes were influenced by loadings from areas of concern and the water circulation patterns. Flux calculations indicated net deposition of γ-hexachlorocyclohexane, heptachlor-epoxide, and α- and ß-endosulfan (-0.02 to -33 ng/m(2)/day) and net volatilization of heptachlor, aldrin, trans-chlordane, and trans-nonachlor (0.0 to 9.0 ng/m(2)/day) in most samples.

Trophodynamic behavior of hydrophobic organic contaminants in the aquatic food web of a tidal river.

The bioaccumulation and biomagnification of sediment-bound hydrophobic organic contaminants (HOCs) are of major concern for environmental and human health. In dynamic estuaries, HOCs can be taken up from sediments, porewater, or the overlying water column concentrations directly or via the diet. The transfer of HOCs including polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) to resident/migratory biota was investigated in 11 finfish species and blue crabs (Callinectes sapidus) in the Passaic River estuary. Concurrently, passive samplers were deployed to assess porewater and overlying water column concentrations. Biota were assigned to three trophic levels based on their tissue 15N isotope values and published life history strategies. There were no significant differences in trophic magnification factors (TMFs) calculated based on life-history scenarios, implying that the migratory species, mostly juveniles, had equilibrated with in situ sources of pollutants at the time they were sampled. Bioaccumulation factors and TMFs were >1 for most PCBs and tetra- and penta-CDD/DFs, indicating that they underwent biomagnification in the food web. All PAHs, PCB 11, and other lower chlorinated PCBs and PCDD/Fs did not magnify. Results from the analysis of HOC profiles implied that biota accumulated HOCs from sediments, porewater, and diet but not from overlying water.

Significance of population centers as sources of gaseous and dissolved PAHs in the lower Great Lakes.

Polyethylene passive samplers (PEs) were used to measure concentrations of gaseous and dissolved polycyclic aromatic hydrocarbons (PAHs) in the air and water throughout the lower Great Lakes during summer and fall of 2011. Atmospheric Σ15PAH concentrations ranged from 2.1 ng/m3 in Cape Vincent (NY) to 76.4 ng/m3 in downtown Cleveland (OH). Aqueous Σ18PAH concentrations ranged from 2.4 ng/L at an offshore Lake Erie site to 30.4 ng/L in Sheffield Lake (OH). Gaseous PAH concentrations correlated strongly with population within 3-40 km of the sampling site depending on the compound considered, suggesting that urban centers are a primary source of gaseous PAHs (except retene) in the lower Great Lakes region. The significance of distant population (within 20 km) versus local population (within 3 km) increased with subcooled liquid vapor pressure. Most dissolved aqueous PAHs did not correlate significantly with population, nor were they consistently related to river discharge, wastewater effluents, or precipitation. Air-water exchange calculations implied that diffusive exchange was a source of phenanthrene to surface waters, while acenaphthylene volatilized out of the lakes. Comparison of air-water fluxes with temperature suggested that the significance of urban centers as sources of dissolved PAHs via diffusive exchange may decrease in warmer months.

The use of immunomodulation therapy in women with recurrent implantation failure undergoing assisted conception: A multicentre cohort study.

PROBLEM: Recurrent implantation failure (RIF) after multiple embryo transfers remains a vexing problem and immunomodulators have been used with conflicting results. This study aims to assess the effect of immunomodulation therapy on live birth rate (LBR) in women with RIF undergoing assisted reproduction treatment (ART). METHOD OF STUDY DESIGN: This is a retrospective cohort study in multicentre network of private assisted conception units in the UK. The study included women who had at least two failed attempts of embryo transfers at CARE fertility network in the period from 1997 to 2018. Women in the treatment group had immunomodulator drugs in the form of corticosteroids, low molecular weight heparin (LMWH), and intravenous intralipid (IVIL) infusions, either separately or in combination, after immunological testing, in addition to standard ART whilst women in the control group had only ART without immunomodulators. The primary outcome was LBR per cycle. Secondary outcomes included the rates of clinical pregnancy (CPR), cumulative live birth (CLBR), and miscarriage. RESULTS: A total of 27 163 ART cycles fulfilled the inclusion criteria, of which 5083 had immunomodulation treatment in addition to standard ART treatment, and 22 080 had standard ART treatment alone. Women in the treatment group were significantly older (mean age 38.5 vs. 37.1 years, p < .001), and had a higher number of previous failed ART cycles (mean 4.3 vs. 3.8, p < .01). There was a higher LBR in women who received immunomodulation therapy when compared with the control group (20.9% vs. 15.8%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.29-1.53, p < .001). Multivariate regression analysis showed that immunomodulation treatment was a significant independent predictor of live birth after adjusting for other confounders (adjusted OR [aOR] 1.33, 95% CI 1.15-1.54, p < .001). Survival analysis showed a higher CLBR in the treatment group (adjusted hazard ratio [aHR] 1.78, 95% CI 1.62-1.94, p < .001). CONCLUSION(S): This study provides evidence of a potential beneficial effect of immunomodulation therapy in women with RIF after immunological testing. There remains a need for high quality, adequately powered multicentre RCTs to robustly address the role of immunomodulation in women with RIF. There is also an urgent need for standardised screening tests for immune disorders that could preclude implantation.

Assessment of priority phenolic compounds in sediments from an extremely polluted coastal wetland (Lake Maryut, Egypt).

Although high concentrations of trace organic pollutants were recorded along the Egyptian Mediterranean Coast and its corresponding coastal wetlands, no published data are available for the levels of phenolic compounds. Thus, this work aimed to investigate the levels of phenolic compounds in sediments of a heavily polluted coastal wetland (Lake Maryut, Egypt). For that purpose, a method was optimized for the extraction and detection of chlorophenols, methylphenols, and nitrophenols in sediments using GC-MS. Sediments were extracted with 0.1 M NaOH/methanol by sonication. Cleanup of sediment extracts using liquid-liquid extraction and SPE was found important to remove most of the interfering co-extracts. The proposed analytical methodology was validated by analysis of matrix spikes. Detection limits were 0.063-0.694 µg/kg dw for sediments. Good recoveries (70-110%) and precision values (RSD < 20%) were obtained from the fortification experiments at the parts per billion level in sediments. The method was applied to investigate the level of contamination with phenols in 19 sediment samples from Lake Maryut. Results revealed that higher concentrations were observed in the main basin (MB) of Lake Maryut affected by the discharge of effluents from a primary wastewater treatment plant, direct discharge of industrial effluents, domestic wastes, and agricultural effluents from Qalaa Drain (QD). Chlorophenols (CPs) were the major group detected in the lake sediments followed by methylphenols (MPs) and nitrophenols (NPs). CPs were dominated by 2-, 4-, and 3-chlorophenols. Concentrations of CPs were higher at the north and northwestern parts of the MB indicating the influence of industrial effluents discharged into the lake. On the other hand, higher concentrations of NPs were observed at the south and southwestern parts of the MB, which is subjected to the discharge of agricultural and domestic effluents via QD. Results of the risk assessment revealed that phenol, cresols, 2,4-dinitrophenol, 4-NP, 2-CP, 2,3,4,6-tetrachlorophenol and 2,4-dimethylphenol are contaminants of concern and that adverse ecological effects could possibly occur to benthic species from the exposure to these pollutants in Lake Maryut and thus phenols should be included in monitoring and pollution prevention programs in the Egyptian aquatic environment affected by anthropogenic activities.

Field validation of polyethylene passive air samplers for parent and alkylated PAHs in Alexandria, Egypt.

Polyethylene samplers (PEs) were deployed at 11 locations in Alexandria, Egypt during summer and winter to test and characterize them as passive samplers for concentrations, sources, and seasonal variations of atmospheric concentrations of polycyclic aromatic hydrocarbons (PAHs). PE-air equilibrium was attained faster for a wider range of PAHs during the winter season possibly due to increased wind speeds. Calculated PE-air partitioning constants, K(PE-A), in our study [Log K(PE-A) = 0.9426 × Log K(OA) - 0.022 (n = 12, R(2) = 0.99, Std error = 0.053)] agreed with literature values within <46%. For parent (except naphthalene), mono- and dialkylated PAHs, active sampling based concentrations of PAHs were within an average factor of 1.4 (1.0-5.6) compared to the PE based values. For C(3-4) alkylated PAHs, K(PE-A) values were lower than predicted, on average by ~0.8 log units per carbon in the alkylation. Enthalpies of vaporization (ΔH(vap)) accurately corrected K(PE-A)s for temperature differences between winter and summer sampling. PAH profiles were dominated by naphthalene, phenanthrene, and alkylated phenanthrenes. Calculated diagnostic ratios indicated that PAHs originated mainly from vehicle emissions.

Legacy halogenated organic contaminants in urban-influenced waters using passive polyethylene samplers: Emerging evidence of anthropogenic land-use-based sources and ecological risks.

Legacy halogenated organic pollutants, including organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), remain ubiquitous in the environment and continue to pose potential (eco-)toxicological threats because of their ongoing releases from land-based sources. This study investigated the spatial trends of freely dissolved PCBs and OCPs by polyethylene passive samplers, and provided evidence of their land-use-based sources and ecological risk in an urbanized estuary area of Narragansett Bay. Dissolved Σ29PCB concentrations ranged from 0.01 to 1.37 ng L-1, and exhibited higher concentrations in the upper, more urban/built-up watershed, and in north coastal areas. Major inputs of PCBs were urban stormwater or treated wastewater that might carry past releases of Aroclors, pigment manufacturing byproducts, and volatilization-associated PCBs from ageing buildings from the Narragansett watershed to the bay. The dioxin toxicity equivalent values of Σ5PCBs were 8.6E-03 pg L-1 in water. Dissolved OCP concentrations had similar spatial trends to PCBs and were dominated by DDTs (average 230 pg L-1), followed by chlordanes (average 230 pg L-1), and HCB (average 22 pg L-1). Secondary sources of past usage and historic contamination were expected to re-enter the surface water via atmospheric transport and deposition. The risk quotients of DDE, DDD, DDT and α-Endosulfane showed medium to high ecological risks in the northern area, while chlordane, HCB, oxychlordane, and heptachlor epoxide showed low to negligible risks in all zones. This study presented new insights into the presence, sources and transport of legacy halogenated organic contaminants in an urban estuary's watershed by combining passive samplers and geographic information system (GIS) technology. The approach is promising and could be extended to get better understand of terrestrial pollutant mobilization into estuaries affected by anthropogenic activities.

The effect of frozen embryo transfer regimen on the association between serum progesterone and live birth: a multicentre prospective cohort study (ProFET).

STUDY QUESTION: What is the association between serum progesterone levels on the day of frozen embryo transfer (FET) and the probability of live birth in women undergoing different FET regimens? SUMMARY ANSWER: Overall, serum progesterone levels <7.8 ng/ml were associated with reduced odds of live birth, although the association between serum progesterone levels and the probability of live birth appeared to vary according to the route of progesterone administration. WHAT IS KNOWN ALREADY: Progesterone is essential for pregnancy success. A recent systematic review showed that in FET cycles using vaginal progesterone for endometrial preparation, lower serum progesterone levels (<10 ng/ml) were associated with a reduction in live birth rates and higher chance of miscarriage. However, there was uncertainty about the association between serum progesterone levels and treatment outcomes in natural cycle FET (NC-FET) and HRT-FET using non-vaginal routes of progesterone administration. STUDY DESIGN SIZE DURATION: This was a multicentre (n = 8) prospective cohort study conducted in the UK between January 2020 and February 2021. PARTICIPANTS/MATERIALS SETTING METHODS: We included women having NC-FET or HRT-FET treatment with progesterone administration by any available route. Women underwent venepuncture on the day of embryo transfer. Participants and clinical personnel were blinded to the serum progesterone levels. We conducted unadjusted and multivariable logistic regression analyses to investigate the association between serum progesterone levels on the day of FET and treatment outcomes according to the type of cycle and route of exogenous progesterone administration. Our primary outcome was the live birth rate per participant. MAIN RESULTS AND THE ROLE OF CHANCE: We studied a total of 402 women. The mean (SD) serum progesterone level was 14.9 (7.5) ng/ml. Overall, the mean adjusted probability of live birth increased non-linearly from 37.6% (95% CI 26.3-48.9%) to 45.5% (95% CI 32.1-58.9%) as serum progesterone rose between the 10th (7.8 ng/ml) and 90th (24.0 ng/ml) centiles. In comparison to participants whose serum progesterone level was ≥7.8 ng/ml, those with lower progesterone (<7.8 ng/ml, 10th centile) experienced fewer live births (28.2% versus 40.0%, adjusted odds ratio [aOR] 0.41, 95% CI 0.18-0.91, P = 0.028), lower odds of clinical pregnancy (30.8% versus 45.1%, aOR 0.36, 95% CI 0.16-0.79, P = 0.011) and a trend towards increased odds of miscarriage (42.1% versus 28.7%, aOR 2.58, 95% CI 0.88-7.62, P = 0.086). In women receiving vaginal progesterone, the mean adjusted probability of live birth increased as serum progesterone levels rose, whereas women having exclusively subcutaneous progesterone experienced a reduction in the mean probability of live birth as progesterone levels rose beyond 16.3 ng/ml. The combination of vaginal and subcutaneous routes appeared to exert little impact upon the mean probability of live birth in relation to serum progesterone levels. LIMITATIONS REASONS FOR CAUTION: The final sample size was smaller than originally planned, although our study was adequately powered to confidently identify a difference in live birth between optimal and inadequate progesterone levels. Furthermore, our cohort did not include women receiving oral or rectal progestogens. WIDER IMPLICATIONS OF THE FINDINGS: Our results corroborate existing evidence suggesting that lower serum progesterone levels hinder FET success. However, the relationship between serum progesterone and the probability of live birth appears to be non-linear in women receiving exclusively subcutaneous progesterone, suggesting that in this subgroup of women, high serum progesterone may also be detrimental to treatment success. STUDY FUNDING/COMPETING INTERESTS: This work was supported by CARE Fertility and a doctoral research fellowship (awarded to P.M.) by the Tommy's Charity and the University of Birmingham. M.J.P. is supported by the NIHR Birmingham Biomedical Research Centre. S.F. is a minor shareholder of CARE Fertility but has no financial or other interest with progesterone testing or manufacturing companies. P.L. reports personal fees from Pharmasure, outside the submitted work. G.P. reports personal fees from Besins Healthcare, outside the submitted work. M.W. reports personal fees from Ferring Pharmaceuticals, outside the submitted work. The remaining authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT04170517.