ABSTRACT
OBJECTIVE: To estimate birth weight differences between patients randomized to fresh or thawed ET. DESIGN: Post hoc analysis of results from two similar randomized trials. SETTING: Private fertility center. PATIENT(S): One hundred thirty-four first-time IVF patients, ages 18-40 years at oocyte retrieval, who had live birth. INTERVENTION(S): Patients were randomly assigned to have either fresh blastocyst transfer or all bipronuclear oocytes frozen followed by thaw, extended culture, and blastocyst transfer in a subsequent cycle. Preimplantation genetic screening was not allowed. MAIN OUTCOME MEASURE(S): Mean birth weight. RESULT(S): After allowing for the contributions of multiple significant variables (gestational age at birth, the presence of a vanished twin, number of infants delivered) in multiple linear regression, the adjusted mean birth weight was 166 g (95% confidence interval, 43-290 g) lower after fresh blastocyst transfer when compared with transfer of blastocysts derived from thawed bipronuclear oocytes. CONCLUSION(S): Birth weights are lower in cycles with fresh blastocyst transfer after controlled ovarian stimulation than in transfers of frozen-thawed embryos in the absence of ovarian stimulation. This finding confirms similar results reported in many retrospective studies. CLINICAL TRIAL REGISTRATION NUMBERS: NCT00963625 and NCT00963079.
Subject(s)
Birth Weight , Blastocyst/physiology , Cryopreservation , Embryo Transfer , Fertilization in Vitro , Infertility/therapy , Ovulation Induction , Adolescent , Adult , Embryo Culture Techniques , Embryo Transfer/adverse effects , Female , Fertility , Fertilization in Vitro/adverse effects , Humans , Infant, Newborn , Infertility/diagnosis , Infertility/physiopathology , Live Birth , Oocyte Retrieval , Ovulation Induction/adverse effects , Pregnancy , Pregnancy Rate , Risk Factors , Treatment Outcome , Young AdultABSTRACT
The epigenetic patterns established during development may influence gene expression over a lifetime and increase susceptibility to chronic disease. Being born preterm (<37 weeks of gestation) is associated with increased risk mortality and morbidity from birth until adulthood. This brief review explores the potential role of DNA methylation in preterm birth (PTB) and its possible long-term consequences and provides an overview of the physiological processes central to PTB and recent DNA methylation studies of PTB.
ABSTRACT
OBJECTIVE: To compare surgical outcomes of patients with symptomatic leiomyomas after robot-assisted ("robotic") or laparoscopic myomectomy. STUDY DESIGN: Retrospective chart review of 81 patients undergoing robotic (n=40) or laparoscopic (n=41) myomectomy. Data included fibroid characteristics (number, weight, location, and pathologic findings), operating time, blood loss, complications, and postoperative hospitalization length. RESULTS: Patients undergoing laparoscopy had a significantly larger mean uterine size, larger mean size of the largest fibroid, and greater number of fibroids. When adjusted for uterine size and fibroid size and number, no significant differences were noted between robotic vs laparoscopic groups for mean operating time (141 vs 166 minutes), mean blood loss (100 vs 250 mL), intraoperative or postoperative complications (2% vs 20% and 11% vs 17%, respectively), hospital stay more than 2 days (12% vs 23%), readmissions, or symptom resolution. CONCLUSION: Short-term surgical outcomes were similar after robotic and laparoscopic myomectomy; long-term outcomes were not assessed.