Hyperemesis gravidarum (HEG), associated with pregnancy, is a severe form of nausea and vomiting causing decrease in nutrient antioxidants. Hence, we hypothesize that oxidation injury may be involved in the pathogenesis of HEG. Plasma levels of the ubiquitous antioxidant, reduced glutathione (GSH) may serve as a sensitive measure for systemic oxidative stress. Women with pregnancies complicated by HEG (study group) were compared with pregnant women without HEG (pregnant control group) and with healthy nonpregnant women (nonpregnant control group). Plasma GSH levels were determined in the study group at the time of admission to hospital, and when the vomiting had ceased, it was compared with those of the two control groups. Plasma GSH levels were significantly higher in the pregnant control group than in nonpregnant controls (6.13 +/- 2.9 microM vs. 1.01 +/- 0.3 microM p <0.01). In contrast, values in the HEG women at the time of admission were significantly lower than the pregnant controls (3.12 +/- 1.6 microM, p <0.01). At the second sampling, when the women had ceased vomiting, plasma GSH values were higher than at the acute stage of the illness and were no longer significantly different from the pregnant control group (4.43 +/- 1.6 microM). Low values of plasma GSH in HEG patients suggest that oxidative stress is associated with this condition.
Purpose
To evaluate the association between a rise in serum luteinized hormone (LH) levels during artificial FET cycles and clinical pregnancy rate.
Methods-Retrospective cohort study of women undergoing artificial FET cycles. We compared cycles in which LH double itself from early follicular phase and further(group-A), to cycles without rise in LH(group-B). Endometrium preparation was achieved by administration of 2mg*3\day estradiol-valerate tablets. Embryo transfer(ET) was conducted after achieving endometrial thickness>7mm and vaginal progesterone was added according to embryo's-age. A beta-hCG was measured 13-14 days after ET. Clinical pregnancy was diagnosed on trans-vaginal-ultrasound.
Results:
Data from 984-FET cycles were retrieved. LH, E2, progesterone-values, endometrial thickness and pregnancy outcomes were available in all patients. From 984-FET cycles 629(63.9%) had a doubling and 355(36.07%) had no rise in LH. Mean patient age was 30 years, similar in both groups. Overall pregnancy rate was 24.8%. Overall pregnancy rate per FET cycles in group-A was higher, however, it was not statistically significant(25.8% vs. 23.1%, P=0.3.9). A multivariable logistic regression analysis was calculated to assess the effect of LH rise and pregnancy outcomes, after adjusting for confounders including rise in E2 level and endometrial thickness. In this model, there was no association between doubling LH values and pregnancy rates(aOR 1.06 95%CI:0.75-1.5, P=0.74).
Conclusion:
LH rise during artificial FET cycles does not alter pregnancy rates. Apparently, hormonal monitoring of LH levels may not yield useful information in artificial FET cycle, and may be omitted.
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