Background Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB. Methods In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30 mg oral Dydrogesterone daily, 250 mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery. Results Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06 ± 17.29 vs. 29.44 ± 15.6 and 22.20 ± 4.51 days, respectively; P < 0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P < 0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes. Conclusion Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.

Introduction Gestational diabetes mellitus (GDM) is a metabolic disease that affects mother and foetus during pregnancy, causing acute and chronic adverse effects. Irisin is proposed as a novel marker to predict GDM. The aim of this study was to assess the role of irisin peptide serum levels in gestational diabetes and compare with healthy pregnant women. Methods This case–control study was conducted on women at 24 to 34 weeks of gestation in Ghaem Hospital affiliated with Mashhad University of Medical Sciences between May 2016 and June 2019. In two study groups, GDM and non‐GDM women, an association between maternal serum irisin levels and clinical and biochemical parameters were evaluated. Maternal serum irisin levels were measured by an enzyme immunoassay method. Body mass index, serum levels of glucose, oral glucose tolerance test (OGTT), insulin, haemoglobin A1C, homeostatic model assessment of insulin resistance (HOMA IR) and irisin were evaluated. Results Totally, 56 participants (30 non‐GDM women and 26 women with GDM) were enrolled. Not statistically significant was observed in serum irisin levels between GDM and non‐GDM women. (p = .814) Irisin levels were not significantly associated with maternal age, systolic and diastolic blood pressure, the number of pregnancies, gestational age, fasting blood sugar, insulin, HOMA IR, one‐hour and two‐hour serum glucose and body mass index. Conclusions There is no significant difference between GDM and non‐GDM groups in the case of irisin value and later, no association of irisin with metabolic and anthropometric parameters. These findings need to be assessed in future experiments.

Purpose Since December 2019, the whole world has been affected by coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)]. However, the effects of COVID-19 infection on pregnancy and fetal transmission are still unclear. Therefore, this study was conducted to evaluate placenta samples regarding detection of SARS-CoV-2 RNA in women affected with COVID-19. Method This study was a part of a cohort study carried out on pregnant women with a diagnosis of COVID-19 infection who had been admitted to the Imam Reza Hospital in Mashhad, Iran, from March 20 to August 5, 2020. Clinical and laboratory information of all the patients was collected and chest computed tomography (CT) scans were reviewed. Totally, 16 placental tissue were prepared for real time polymerase chain reaction (RT-PCR) testing. All samples were tested by PowerChek PCR real-time kit (South Korea) with 2 target genes (E gene and Rd Rp gene), and Pishtaz Teb kit, (Iran) with 2 target genes (N gene and RdRp gene). Result In the first RT-PCR kit by PowerChek kit, 6 samples were positive for a single gene (E gene) and 2 samples were positive for both genes (E gene and Rd Rp gene). In the second RT-PCR kit by Pishtaz Teb kit, 3 samples were positive for two genes (N gene and RdRp gene). Conclusion This present study showed that infection of placenta with SARS-CoV-2 may occur in pregnancy. However, whether this infection leads to neonatal infection and serious complication in pregnancy remains unclear.

Objective: The use of frozen embryos in the treatment of infertility with assisted reproductive techniques has been increased. Different methods are used to prepare the endometrium for frozen embryo transfer (FET). The aim of this study was to compare pregnancy outcomes after treatment with tamoxifen and hormonal replacement therapy (HRT) in FET.Methods: This randomized clinical trial was carried out with 214 infertile women in the infertility research center of Milad Hospital in Mashhad during 2018-2020. We had 84 patients receiving tamoxifen and 92 took HRT. Endometrial thickness (ET) and pregnancy outcome were measured in both groups.Results: Mean infertility duration (p=0.328), number of embryos (p=0.649), FSH (p=0.390), LH (p=0.051) and LH/FSH ratio (p=0.287) as well as type of infertility (primary or secondary) (p=0.295), causes of infertility (p=0.750) and pattern of menstruation (p=0.676) were not significantly different in the two groups. Mean ET in the TMX and HRT groups were 8.72±1.45mm and 9.00±1.69mm, respectively (p=0.423). There was no statistically significant difference between chemical pregnancy (p=0.663), clinical pregnancy (p=0.994) and ongoing pregnancy (p≥0.999) in the TMX and HRT groups.Conclusions: Treatment with tamoxifen can be as effective as GnRH agonist for endometrial preparation in FET.

BACKGROUND:Gonadotrophin-releasing hormone (GnRH) agonist has been proposed as an alternative drug to human chorionic Gonadotropin (hCG) for triggering. The purpose of this study to analyze the effects of three types of trigger hCG, GnRH-a or combine of them (dual) on quality of oocyte and embryoand ovarian hyperstimulation syndrome (OHSS)in the ICSI cycle. METHODS:A prospective case control study was conducted on 320 women who referred to Milad, IVF Center, Mashhad, Iran, between May 2016 and June 2019. All patients underwent antagonist protocol and were classified according to the type of trigger in three groups, 118 patients in the GnRH-agroup, 49 patients in the hCG group, and 153in dualgroup. The oocytes were retrieved after 36 hours of injection of the trigger. The outcome measures were the number ofmetaphase I,metaphase II oocyte, Germinal vesicle (GV) oocytes, high-quality embryo and rate of OHSS.RESULTS:Three groups were not significantly different in terms of the proportion of retrieved oocytes, the number of embryos, M I oocyte, M II oocyte, and the number of GV oocytes. The quality of embryos between the three groups was difference significantly (p<.05). In comparison to dual and GnRH-a group trigger, women who received hCG group had a higher number of OHSS, and the number of severe OHSS in dual trigger was higher than GnRH-a vs and hCG groups.CONCLUSIONS: GnRH agonist alone and dual trigger (hCG, GnRHagonist) can be as effective as hCG trigger. GnRH agonist is preferable in high risk patient. Therefore, it should be used according to the patient’s condition.