OC04.03: The effect of melatonin on ultrasound markers of follicular development: a double‐blind placebo‐controlled randomised trial

Abstract

Objectives:The objectives of this study were to identify sonographic changes of the endometrium following endometrial biopsy (EB) and correlate these with IVF pregnancy outcomes. Methods: In this prospective controlled study, unselected infertile women were randomised to undergo a Pipelle endometrial biopsy or no procedure during the mid-luteal phase of the cycle directly preceding IVF. Following EB, all participants underwent IVF using standard local protocols. A transvaginal ultrasound scan (TVUS) was performed at oocyte retrieval (OR) and embryo transfer (ET). 2D, 3D and Doppler ultrasound data were acquired (Voluson E8, GE Healthcare). Clinical pregnancy rates were the primary outcome. Student's t-test and Chi 2 statistics were used as appropriate. Research Ethics Committee approval was obtained. Results: A total of 151 women were recruited and randomised: 76 to the biopsy group and 75 to the control group. TVUS data of adequate quality were available for 49 and 50 of these women respectively. Mean age was 33.7±4.0 and 32.8±4.3 years in the treatment and control group, respectively (P=0.21). Both clinical groups were matched for duration of infertility, BMI, AMH, and cycle number (P<0.05). At OR, 19/49 (38.8%) women in the biopsy group and 10/50 (20.0%) control subjects had a triple endometrial pattern (P=0.04). There were no statistically significant differences in other TVUS markers (P>0.05). The clinical pregnancy rates were 31/49(63.3%) and 27/50(54.0%) in the treatment and control group, respectively (P=0.35). Women whom achieved pregnancy were more likely to have a triple pattern endometrium at OR (P=0.035). There were no statistically significant differences in other TVUS markers at ET. Conclusions: In conclusion, a mid-luteal EB may influence endometrial response during the peri-ovulatory phase of a subsequent cycle, as evident by an ultrasound appearance of a triple pattern at the time of OR. Molecular and histological studies are required to provide clues to the underlying mechanisms. Objectives: To compare the performance of oocyte retrieval with and without follicular flushing on the reproductive outcomes in women undergoing IVF. Methods: Only RCTs were included in this review (PROSPERO CRD42016037960); the searches were run in PubMed and Scopus. The evaluation of the risk of bias within each study was structured using the Cochrane risk of bias and the overall quality of the body of evidence was assessed through the GRADE criteria. Results: Ten studies encompassing 910 women were included. There was no evidence of a difference for live birth (RR = 1.04 [0.83, 1.30], I 2 = 0%, 7 RCTs, moderate quality evidence of no effect, downgraded by imprecision); clinical pregnancy (RR = 1.05 [0.80, 1.37], I 2 = 27%, 6 RCTs, moderate quality evidence of no effect, downgraded by imprecision); miscarriage (RR = 1.13 [0.66, 1.95], I 2 = 0%, 5 RCTs, low quality evidence of no effect, downgraded two-levels by imprecision); or for the number of oocytes retrieved (high quality evidence of no effect -Fig 1). We obser...

Serum calprotectin levels as markers of inflammation, insulin resistance and hyperandrogenism in women with polycystic ovary syndrome

“…Levels of serum calprotectin were measured as 347 ± 28.8 and 188 ± 15.3 ng/mL in the PCOS and healthy control groups, respectively (P = .009). The mean homeostatic model assessment for insulin resistance [1] index and total testosterone levels were significantly higher in the PCOS group than in the control group (both P < .001). Spearman's correlation test demonstrated linear correlations between calprotectin and C-reactive protein, waist circumference, insulin resistance index, and total testosterone levels in the PCOS group (all P < .05).…”