Fasting and post-prandial plasma glucose screening for gestational diabetes mellitus

Background: gestational diabetes mellitus [GDM] is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy

Aims: the purpose of this study was to investigate the prevalence of pregnant women who were not screened for gestational diabetes mellitus and compare the maternal and fetal outcomes of women who had undergone GDM screening

Methods: women who refused to attend the gestational diabetes screening test [n= 162] at a maternity hospital in Ankara, Turkey, between October 2014 and January 2015 were included in this prospective cohort study. The control group [matched for age and body mass index] was recruited from women who agreed to have the gestational diabetes screening test [n= 194]

Results: just 12% of pregnant women did not attend gestational diabetes screening test; these women were at higher risk for idiopathic polyhydramnios [P = 0.026]. Prevalence of GDM was 8.8% [n= 17] in the control group and 30.9% [n= 50] in those who refused GDM screening. The maternal and fetal outcomes of GDM patients were similar in both groups. Women who did not attend GDM screening test had increased risk for mild idiopathic polyhydramnios in late gestation

Conclusions: fasting and postprandial plasma glucose screening can replace gestational diabetes mellitus screening in women who refuse to have the glucose load test

Do serum vitamin D levels have any effect on intrauterine insemination success?

Background: Recent studies have shown that vitamin D has an essential role in the reproductive system. In this study, we aimed to investigate the effect of vitamin D levels in patients undergoing ovulation induction [OI], and subsequent intrauterine insemination [IUI] procedure

Materials and Methods: One hundred and four infertile and one hundred and three fertile women were recruited in this cross-sectional study which was conducted in a tertiary level maternity hospital. Infertile patients were divided into pregnant and non-pregnant subgroups after treatment. Individual characteristics and 25-hydroxyvitamin D3[25 [OH] D3] levels were compared between the groups

Results: The vast majority of our study population consisted of women who had vitamin D deficiency [96.6%]. There was no statistically significant difference between infertile and fertile groups in terms of serum 25 [OH] D3 levels [P=0.512]. Similarly, no significant difference was observed between the pregnant and non-pregnant subgroups of infertile patients regarding 25 [OH] D3levels [P=0.267]

Conclusion: There is no association between female infertility and serum vitamin D levels. Vitamin D does not predict pregnancy in infertile women undergoing OI with IUI. Further research which will provide a comparison between much more women who have deficient and sufficient 25 [OH] D3levels is warranted

Clomiphene citrate treatment cycle outcomes of polycystic ovary syndrome patients based on basal high sensitive C-reactive protein levels: a cross-sectional study

Background: Polycystic ovary syndrome [PCOS] is highly associated with an ovulatory infertility, features of the metabolic syndrome, including obesity, insulin resistance and dyslipidemia. Serum concentrations of high sensitive C-reactive protein [hs-CRP] were significantly higher in obese than in non-obese PCOS patients at baseline, suggesting a relationship between elevated hs-CRP levels and obesity. The aim of this study was to evaluate whether cycle day 3 hs-CRP levels before clomiphene citrate [CC] treatment would predict cycle outcomes in women with PCOS

Materials and Methods: This cross-sectional study was conducted among 84 infertile women with PCOS who were treated with CC at Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey, between January 2014 and January 2015. Based on the exclusion criteria, cycle outcomes of remaining 66 infertile women with PCOS treated with CC were analyzed. The hs-CRP levels and insulin resistance indexes were evaluated on day 3 of the CC treatment cycle. The primary outcome measures were number of preovulatory follicles measuring>/=17 mm and pregnancy rates

Results: The mean +/- SD age of the patients was 24.0 +/- 3.8 years [range 18-36]. The mean +/- SD body mass index [BMI] of the patients was 25.7 +/- 4.9 [range 17-43]. Fifty patients developed dominant follicle [75%] and 5 patients established clinical pregnancy during the study [clinical pregnancy rate: 7%]. The mean +/- SD baseline hs-CRP, fasting insulin and Homeostasis Model Assessment-Insulin Resistance [HOMA-IR] values of the patients with and without dominant follicle generation during treatment cycle were 6.42 +/- 7.05 and 4.41 +/- 2.95 [P=0.27], 11.61 +/- 6.94 and 10.95 +/- 5.65 [P=0.73], 2.68 +/- 1.79 and 2.41 +/- 1.30 [P=0.58], respectively. The mean +/- SD baseline hs-CRP, fasting insulin and HOMA-IR values of the patients with and without clinical pregnancy establishment following treatment cycle were 6.30 +/- 2.56 and 5.90 +/- 6.57 [P=0.89], 11.60 +/- 7.54 and 11.44 +/- 6.61 [P=0.95], 2.42 +/- 1.51 and 2.63 +/- 1.70 [P=0.79], respectively

Conclusion: In this study, we did not observe a predictive value of cycle day 3 hs-CRP levels on preovulatory follicle development and pregnancy rates among infertile PCOS patients treated with CC. Also, no relationship between HOMA-IR values and dominant follicle generation or clinical pregnancy establishment was demonstrated in our study, confirming the previous studies emphasizing the neutral effect of metformin utilization before and/or during ovulation induction to pregnancy rates

Only female age, and not blood type, is associated with ovarian reserve

Background: The association between blood types and ovarian reserve is investigated in this study

Materials and Methods: As an index of ovarian reserve, women with a follicle stimulating hormone [FSH] level of >/=10 mIU/ml in the early follicular phase were designated as having diminished ovarian reserve. In this prospective study, early follicular phase serum FSH and estradiol levels and blood types were evaluated in 500 patients who were admitted to the Infertility Department of Ministry of Health Etlik Zubeyde Hanim Women's Health Training and Research Hospital between January 2012 and June 2012. Women with serum FSH level <10 mIU/ml formed group I, and women with serum FSH >/=10 mIU/ml formed group II. The prevalence of blood types in each group and their association with ovarian reserve were analyzed

Results: Out of 500 patients, 438 women were in group I, while 62 women were in group II. There was no statistically significant difference among the two groups in terms of blood group proportions [p=0.69], this did not change after age adjustment [p=0.77]. The presence of A antigen [in A and AB blood type] [p=0.91], the blood type O [p=0.70], and the blood type B [p=0.51] were not statistically related to ovarian reserve after age adjustment. There was also no statistically significant correlation between rhesus factor and ovarian reserve after age adjustment [p=0.83]. The only factor that affected ovarian reserve was age of patients [p=0.006]

Conclusion: Blood groups do not constitute a risk or protective factor for ovarian reserve. Therefore, blood groups do not have any predictive value in evaluating ovarian reserve