Many studies reported that vitamin D can protect against various types of cancers. The mechanism of vitamin D action is mediated by the vitamin D receptor (VDR). VDR may have anti-stress function because it has been identified as p53 direct target gene. This research was designed to investigate the role of VDR polymorphisms BsmI (rs 1544410), ApaI (rs 7975232), TaqI (rs 731236), and FokI (rs 10735810) in pathogenesis of breast cancer using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The study included 130 postmenopausal breast cancer cases aged 49 to 65 years and 100 controls aged 50 to 72 years. A significantly increased risk of breast cancer among carriers of BsmI bb genotype was observed (OR = 2.5 (1.1-5.6), P = 0.025). Also, a significantly increased risk of breast cancer was detected among women carrying ApaI aa genotype (OR = 2.2 (1.02-4.5), P = 0.04), while no significant associations were observed between breast cancer risk and genotypes and allele frequencies of FokI and TaqI polymorphisms (P > 0.05). Our study showed that VDR gene polymorphisms (BsmI and ApaI) may contribute to breast cancer risk among postmenopausal women.

Research question: Does the incorporation of the aromatase inhibitor (letrozole) in hormonal replacement therapy (HRT) improve the pregnancy outcome in vitrifiedwarmed blastocyst transfer cycles.Design: A randomized clinical trial (registration number: NCT04507022). HRT used in all cycles. Exogenous estradiol (E 2 ), 6 mg daily started on day 2 or 3 of cycle. Tri-laminar endometrium ≥ 9 mm was the targeted cutoff. Thereafter, participants were randomized into two groups. Group A (HRT plus letrozole), 2.5 mg oral letrozole was given twice daily for 5 days only with continuation of daily estradiol. Then, daily intramuscular (IM), progesterone (P) started, with continuation of E 2 . Group B (HRT only), daily IM P administered in addition to daily E 2 . In both groups, good quality day 5 blastocyst transfer was planned on 6 th progesterone day with continuation of E 2 and P. Ongoing pregnancy rate was the primary outcome.Results:112 patients were randomized, 56 in each group. Three participants did not have good quality blastocyst after warming; one in group A and two in group B and excluded from the study. Group A and B included 55 and 54 participants, respectively. Ongoing pregnancy rate was significantly higher in group A than group B (RR 1.39; 95% CI: 1.04 to 1.86). Additionally, clinical pregnancy rate was significantly higher in group A (RR 1.31; 95% CI: 1.02 to 1.68). Conclusions:A new protocol of incorporating letrozole in HRT cycles appears to significantly increase probability of pregnancy, compared to HRT alone.

Background: Thyroid dysfunction in pregnancy may be accompanied by both maternal and fetal complications. Hypothyroidism in pregnancy is associated with premature birth, fetal cardiac complications, low birth weight, increased frequency of cesarean delivery, placental complications, preeclampsia and gestational hypertension, perinatal morbidity-mortality, and cognitive dysfunction. Objective: The aim of the current work was to study early diagnosis of thyroid dysfunction in pregnant women for better health care.