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Journal of Psychosomatic Obstetrics and... Jun 2022This study aims to explore women's experiences with embryo transfer (ET) until pregnancy test and their conceptualization of their embryo.
AIM
This study aims to explore women's experiences with embryo transfer (ET) until pregnancy test and their conceptualization of their embryo.
METHOD
The sample of this descriptive phenomenology study consists of 17 women with ET. The data were collected through in-depth interviews. The thematic analysis developed by Braun and Clarke was used for data analysis.
RESULTS
Analysis of the interviews led to the emergence of five themes and 14 sub-themes. The theme "pregnancy in biological terms" has two sub-themes: "" and "". The theme "not an embryo, my child" has three sub-themes: "", and The theme "daily life after ET" has three sub-themes: "", "", and "". The theme "seeking ways to ensure fertility" has four sub-themes: ", "", " and "". Finally, the theme "caring after the transfer" has two sub-themes: " and "".
CONCLUSION
In this study, it was determined that women had intense physical and emotional experiences during the waiting period after ET and their daily lives were affected. It was also understood that the embryo means "baby/child/son/daughter" to them and that they establish a close bond with their embryos. Women's needs are not sufficiently known until post-ET pregnancy testing. Explaining the experiences of women after IVF-ET and the meanings of their embryo will help determine the issues they need in holistic care.
Topics: Concept Formation; Embryo Transfer; Female; Humans; Infertility; Pregnancy; Pregnancy Tests; Qualitative Research
PubMed: 33397187
DOI: 10.1080/0167482X.2020.1865909 -
Scientific Reports Mar 2020Assessing the viability of a blastosyst is still empirical and non-reproducible nowadays. We developed an algorithm based on artificial vision and machine learning (and...
Assessing the viability of a blastosyst is still empirical and non-reproducible nowadays. We developed an algorithm based on artificial vision and machine learning (and other classifiers) that predicts pregnancy using the beta human chorionic gonadotropin (b-hCG) test from both the morphology of an embryo and the age of the patients. We employed two high-quality databases with known pregnancy outcomes (n = 221). We created a system consisting of different classifiers that is feed with novel morphometric features extracted from the digital micrographs, along with other non-morphometric data to predict pregnancy. It was evaluated using five different classifiers: probabilistic bayesian, Support Vector Machines (SVM), deep neural network, decision tree, and Random Forest (RF), using a k-fold cross validation to assess the model's generalization capabilities. In the database A, the SVM classifier achieved an F1 score of 0.74, and AUC of 0.77. In the database B the RF classifier obtained a F1 score of 0.71, and AUC of 0.75. Our results suggest that the system is able to predict a positive pregnancy test from a single digital image, offering a novel approach with the advantages of using a small database, being highly adaptable to different laboratory settings, and easy integration into clinical practice.
Topics: Adult; Algorithms; Bayes Theorem; Embryo Transfer; Female; Fertilization in Vitro; Humans; Machine Learning; Neural Networks, Computer; Oocytes; Pregnancy; Pregnancy Outcome; Pregnancy Tests
PubMed: 32157183
DOI: 10.1038/s41598-020-61357-9 -
Alternative Therapies in Health and... Dec 2023To explore the prognostic significance of the Glucose Disposal Index (DI) concerning unfavorable pregnancy outcomes in mothers and newborns affected by Gestational...
OBJECTIVE
To explore the prognostic significance of the Glucose Disposal Index (DI) concerning unfavorable pregnancy outcomes in mothers and newborns affected by Gestational Diabetes Mellitus (GDM).
METHODS
Our investigation encompassed 75 GDM patients who received treatment at Anhui Mingguang People's Hospital between January 2019 and July 2023. Subjects were divided into two groups: those with adverse pregnancy outcomes (n = 18) and those without (n = 57). Between weeks 24 and 28 of gestation, all participants underwent a 75 g Oral Glucose Tolerance Test (OGTT), and relevant details such as height, weight, and complete pregnancy information were gathered. The Insulin Sensitivity Index (ISI) and the area beneath the insulin-to-glucose curve from 0 to 120 minutes (AUC_INS120/AUC_GLU120) were computed from the 75 g OGTT findings, and their multiplication was represented as DI. Comparisons between groups were made using t tests, Wilcoxon rank-sum tests, and χ2 tests. Binary logistic regression was applied to probe the relationship between DI and the risk of adverse pregnancy outcomes, and the Receiver Operating Characteristic (ROC) curve was employed to evaluate the predictive capacity of DI.
RESULTS
Statistically meaningful differences in FPG, HbA1c, and DI were noted between the groups (P < .05), whereas the difference in 2hPG was not significant (P > .05). Pearson correlation analysis revealed a negative correlation between DI and both FPG and HbA1c (P < .05). Multivariate logistic regression showed that DI (OR = 0.599) was a determining factor of adverse pregnancy outcomes (P < .05). The ROC curve disclosed an AUC of 0.837 for DI in forecasting adverse pregnancy outcomes (95% CI: 0.741-0.933), with a specificity of 82.10% and a sensitivity of 80.65% at the optimal threshold value of 2.1.
CONCLUSION
An elevation in DI among GDM patients is closely linked to a reduced risk of adverse pregnancy outcomes, corroborating DI's prognostic value for such outcomes in gestational diabetes.
PubMed: 38295312
DOI: No ID Found -
Nederlands Tijdschrift Voor Geneeskunde Nov 2022A molar pregnancy is a rare complication of (non-viable) pregnancy and produces high levels of hCG-hormone. hCG has characteristics similar to TSH, and therefore...
BACKGROUND
A molar pregnancy is a rare complication of (non-viable) pregnancy and produces high levels of hCG-hormone. hCG has characteristics similar to TSH, and therefore (severe) hyperthyroidism can occur. The incidence of molar pregnancy is approximately 1 in 1000-1500 pregnancies.
CASE DESCRIPTION
A 23-year-old woman had complaints of discomfort, nausea and vomiting. A urine pregnancy test was negative and laboratory tests showed a severe hyperthyroidism. After referral a molar pregnancy was diagnosed (hCG 1.7 million IU/L). She was treated by curettage. hCG levels insufficiently decreased in the following weeks, and gestational trophoblastic neoplasia was diagnosed. She needed several courses of methotrexate after which she completely recovered.
CONCLUSION
Severe hyperthyreoidism can be caused by a molar pregnancy. A urine pregnancy test can be negative because of too high hCG-levels, also known as the hook effect. Early recognition and treatment are very important because of the risk of severe complications.
Topics: Female; Humans; Pregnancy; Young Adult; Chorionic Gonadotropin; Hydatidiform Mole; Hyperthyroidism; Uterine Neoplasms
PubMed: 36633053
DOI: No ID Found -
AJOG Global Reports Aug 2023Pregnancy of unknown location (PUL) is a term used when there is a positive pregnancy test but no sonographic evidence for an intrauterine pregnancy (IUP) or ectopic...
BACKGRO
Pregnancy of unknown location (PUL) is a term used when there is a positive pregnancy test but no sonographic evidence for an intrauterine pregnancy (IUP) or ectopic pregnancy (EP). This term is a classification and not a final diagnosis.
OBJECTIVE
This study aimed to evaluate the diagnostic value of the Inexscreen test on the outcome of patients with pregnancies of unknown location.
STUDY DESIGN
In this prospective study, a total of 251 patients with a diagnosis of pregnancy of unknown location at the gynecologic emergency department of the La Conception Hospital, Marseille, France, between June 2015 and February 2019 were included. The Inexscreen (semiquantitative determination of intact human urinary chorionic gonadotropin) test was performed on patients with a diagnosis of pregnancy of unknown location. They participated in the study after information and consent collection. The main outcome measures (sensitivity, specificity, predictive values, and the Youden index) of Inexscreen were calculated for the diagnosis of abnormal pregnancy (nonprogressive pregnancy) and ectopic pregnancy.
RESULTS
The sensitivity and specificity of Inexscreen for the diagnosis of abnormal pregnancy in patients with pregnancy of unknown location were 56.3% (95% confidence interval, 47.0%-65.1%) and 62.8% (95% confidence interval, 53.1%-71.5%), respectively. The sensitivity and specificity of Inexscreen for the diagnosis of ectopic pregnancy in patients with pregnancy of unknown location were 81.3% (95% confidence interval, 57.0%-93.4%) and 55.6% (95% confidence interval, 48.6%-62.3%), respectively. The positive predictive value and negative predictive value of Inexscreen for ectopic pregnancy were 12.9% (95% confidence interval, 7.7%-20.8%) and 97.4% (95% confidence interval, 92.5%-99.1%), respectively.
CONCLUSION
Inexscreen is a rapid, non-operator-dependent, noninvasive, and inexpensive test that allows the selection of patients at high risk of ectopic pregnancy in case of pregnancy of unknown location. This test allows an adapted follow-up according to the technical platform available in a gynecologic emergency service.
PubMed: 37334250
DOI: 10.1016/j.xagr.2023.100223 -
Human Fertility (Cambridge, England) Dec 2023We assessed whether estimation of follicular growth, rather than actual measurement of follicular size on the day of hCG trigger, affected pregnancy rates in...
We assessed whether estimation of follicular growth, rather than actual measurement of follicular size on the day of hCG trigger, affected pregnancy rates in intrauterine insemination (IUI) cycles. Patient and cycle characteristics were extracted from an existing database. Comparisons were made between the pregnant (defined as a positive beta hCG) and non-pregnant groups for the following variables: patient's age, number of previous IUI cycles, type of ovarian stimulation, endometrial thickness, number of follicles measuring 14 mm and above, pre and post wash sperm parameters, cycle day when IUI was done and number of days between last ultrasound scan and ovulation trigger. A total of 7302 cycles were included in the final analysis. In 4055 cycles (55.5%) the hCG trigger was on the day of the last ultrasound, in 2285 cycles (31.3%) the hCG trigger was 1 day after the last ultrasound, in 850 (11.6%) it was 2 days after the last ultrasound and in 112 (1.5%) it was 3 or more days after the last ultrasound. Sperm parameters, younger maternal age, and the number of follicles above 14 mm were all associated with pregnancy. No association was found between positive pregnancy test rates and the time from last ultrasound to hCG trigger. Planning IUI based on the estimation of follicular growth 1-4 days before trigger, does not affect pregnancy rates.
Topics: Female; Pregnancy; Humans; Male; Infant, Newborn; Insemination, Artificial; Semen; Pregnancy Rate; Fertilization in Vitro; Ovulation Induction; Chorionic Gonadotropin
PubMed: 36398709
DOI: 10.1080/14647273.2022.2145916 -
Revue Medicale Suisse Oct 2022Early pregnancy is frequently accompanied by abnormal symptoms such as pelvic pain and metrorrhagia. In these situations, it is quite frequent to be unable to identify...
Early pregnancy is frequently accompanied by abnormal symptoms such as pelvic pain and metrorrhagia. In these situations, it is quite frequent to be unable to identify the pregnancy and in particular its location, even if the pregnancy test is clearly positive. Many clinical, biological and ultrasound approaches have been proposed to try to predict the location and development of the suspected pregnancy, without the individualization of a truly reliable tool. Currently the HCG dosage at 48 heures-interval remains one of the best tools available, but it is challenged by mathematical models such as the M6 model. The M6 model has shown in our experience a very good predictive value with also an ability to reduce the follow-up of patients with low progressive risk, thus allowing a reduction in costs and anxiety for patients and caregivers.
Topics: Pregnancy; Female; Humans; Risk; Pelvic Pain; Ultrasonography
PubMed: 36259703
DOI: 10.53738/REVMED.2022.18.800.1968 -
Pregnancy Hypertension Jan 2020The objective of this study is to investigate possible changes in aspirin resistance during and after pregnancy over time.
OBJECTIVES
The objective of this study is to investigate possible changes in aspirin resistance during and after pregnancy over time.
STUDY DESIGN
A longitudinal cohort study in obstetric high risk women with an indication for aspirin usage during pregnancy to prevent placenta mediated pregnancy complications.
MAIN OUTCOME MEASURES
Aspirin resistance measured in the first, second and third trimester of pregnancy and at least three months postpartum by four complementary test: PFA-200, VerifyNow®, Chronolog light transmission aggregometry (Chronolog LTA) and serum thromboxane B (TxB) level measurements. Correlation between the devices was investigated.
RESULTS
In total, 23 pregnant women participated in the present study. Aspirin resistance according to the PFA-200, VerifyNow®, Chronolog LTA and serum TxB, was 30.4%, 17.4%, 26.1% and 23.8% respectively. Resistance by any device was 69.6%. Aspirin resistance measured by the VerifyNow®, Chronolog LTA, serum TxB and aspirin resistance by any device during pregnancy was demonstrated more frequently than aspirin resistance after pregnancy. Correlation between the different devices was weak.
CONCLUSION
Aspirin resistance was found in a considerable part of the participants. Considerable variation between participants, within participants over time and between the different devices was found. Prevalence of aspirin resistance during pregnancy differs from after pregnancy. More research on aspirin resistance and clinical obstetric outcome is needed.
Topics: Adult; Aspirin; Cohort Studies; Drug Resistance; Female; Humans; Hypertension, Pregnancy-Induced; Longitudinal Studies; Platelet Aggregation Inhibitors; Platelet Function Tests; Pregnancy; Pregnancy Trimesters
PubMed: 31865169
DOI: 10.1016/j.preghy.2019.11.008 -
Biomarkers : Biochemical Indicators of... Sep 2021Hypercoagulation starts as early as the first-trimester pregnancy and is a risk factor for thromboembolic events which are associated with miscarriage. Our study aimed...
BACKGROUND
Hypercoagulation starts as early as the first-trimester pregnancy and is a risk factor for thromboembolic events which are associated with miscarriage. Our study aimed to investigate coagulation, platelets, and fibrinolysis parameters alteration amongst trimester-specific normal pregnancy and first-trimester miscarriage patients. We also test the accuracy of haemostatic parameters determination for prediction of first-trimester miscarriage.
METHODS
Retrospective investigation of 50 women whose most recent pregnancy had ended in the first trimester and 54 age-matched consecutive normal pregnancy between 2016 and 2019. Furthermore, 51 non-pregnant, age-matched women were included in parallel to healthy controls. Twelve screening tests for coagulation and platelet parameters were assessed.
RESULTS
We found plasma levels of aPTT, FBG, and TT were significantly prolonged or decreased in miscarriage subjects than the corresponding first phase in normal pregnancies. PT, INR, aPTT, and d-dimer all shift back to normal in miscarriage patients compared with non-pregnant women. Shortened aPTT combined with TT and FBG can predicted the occurrence of first-trimester miscarriage with an AUC of 0.831.
CONCLUSIONS
Routine assessment of aPTT combined with TT and FBG is a low-cost, widely available marker for prediction of first-trimester miscarriage.
Topics: Abortion, Spontaneous; Adult; Biomarkers; Case-Control Studies; Female; Hematologic Tests; Hemostasis; Humans; Monitoring, Physiologic; Pregnancy; Pregnancy Trimester, First; Retrospective Studies; Risk Factors
PubMed: 34020571
DOI: 10.1080/1354750X.2021.1933592 -
Nederlands Tijdschrift Voor Geneeskunde Nov 2022A medical termination of pregnancy can be carried out effectively and safely up to 9 weeks' amenorrhea by general practitioners. In the case of an early pregnancy,...
A medical termination of pregnancy can be carried out effectively and safely up to 9 weeks' amenorrhea by general practitioners. In the case of an early pregnancy, reliable anamnesis and absence of risk factors for an EUG, ultrasound diagnostics are not strictly necessary before a medical termination of pregnancy. Anamnesis and/or b-HCG monitoring are a sound alternative. If there is no loss of blood 4 hours after insertion of misoprostol the woman can insert the extra 2 tablets of misoprostol. If there is heavy blood loss (soaking more than two large pads per hour for two consecutive hours) and/or suspicion of an EUG, the general practitioner should consult a gynecologist. In the event of a positive pregnancy test after 3 weeks, the test can be repeated after a week if there are no symptoms. Rhesus prophylaxis is not necessary.
Topics: Female; Pregnancy; Humans; Misoprostol; Abortion, Induced; General Practitioners; Pregnancy Trimester, Second; Abortifacient Agents, Nonsteroidal
PubMed: 36633027
DOI: No ID Found