Does Maternal Vitamin D Level Affect the Ovarian Reserve of Female Newborn Infants?

OBJECTIVE: To evaluate whether maternal vitamin D levels affect cord blood Anti Müllerian Hormone (AMH) levels, reflecting ovarian reserve, in female offspring. METHODS: Cord blood AMH from healthy pregnant women delivering term female infants were compared in groups with different maternal vitamin D levels. RESULTS: Maternal age, weight gain during pregnancy, usage of vitamin D supplements, newborn birth weight, and 5th-min Apgar scores were significantly higher in the normal vitamin D level group (All p < 0.05). AMH levels were similar among all groups (p = 0.6). There was no significant correlation between newborn AMH and maternal vitamin D levels (rho = 0.006, p = 0.9). The stepwise regression analysis showed that the maternal age and birth weight had lower AMH levels, whereas the maternal vitamin D level did not. (p = 0.03, p = 0.04, p = 0.5, respectively). CONCLUSION: Maternal vitamin D levels did not have a significant effect on AMH, a reflection of ovarian reserve.

Does Follicle-Stimulating Hormone Receptor Polymorphism Status Affect In vitro Fertilization-Intracytoplasmic Sperm Injection Results and Live Birth Rate? A Retrospective Study.

Background: Follicle-stimulating hormone (FSH) plays a key role in fertility and shows its effect through the FSH receptor (FSHR), which is localized in cells. Aims: The aim of this study was to examine pregnancy outcomes and responses to controlled ovarian stimulation according to FSHR polymorphism types. Study Setting and Design: The study was retrospective, and included patients who applied to the University of Health Sciences Tepecik Training and Research Hospital in vitro fertilization (IVF) Unit during 2018 and 2019. Materials and Methods: Patients who underwent IVF-intracytoplasmic sperm injection and at the same time studied FSHR gene polymorphism in the genetic unit of our hospital were included in the study. Statistical Analysis: The Kruskal-Wallis test was used for multiple comparisons of continuous variables. The Chi-square test was used for categorical variables between groups. Results: A total of 143 patients who met our criteria were included in the study. 14% (n = 20) of the patients are also homozygous natural (Asn/Asn) type; 44.7% (n = 64) of the heterozygous mutant (Asn/Ser) type; 41.3% (n = 59) of them were homozygous mutant (Ser/Ser) type. There was no statistically significant difference between the groups in terms of pregnancy rate per started cycle, ongoing pregnancy per started cycle, ongoing pregnancy per embryo transfer and live birth per embryo transfer. A significant difference was observed between peak E2 and peak progesterone levels between Asn/Ser and Ser/Ser groups, and the levels of these hormones were lower in the Ser/Ser group (P = 0.018 and P = 0.016, respectively). Ovarian responses were classified as poor (≤3 oocytes), normal (4-20 oocytes) and hyperresponse (≥20 oocytes) according to the oocyte count. Accordingly, the number of patients with poor response was higher in the Ser/Ser group (P = 0.011). Conclusions: Ser/Ser polymorphism is characterised by a poor ovarian response. Despite this, polymorphisms in the FSHR gene do not seem to affect the results of pregnancy per started cycle, ongoing pregnancy per started cycle, ongoing pregnancy per embryo transfer and live birth per embryo transfer.

Can the difference of Doppler indexes at the different points of the umbilical artery predict to the umbilical cord length?

Background: The aim of the study is to investigate whether the Doppler indexes which measured at different points of the umbilical cord (UC) are related to the cord length.Materials and methods: In this prospective study, umbilical artery (UA) Doppler indexes were measured at the fetal and placental insertion, free loop (FL) and intra-abdominal (IA) portion at 37-42 weeks of gestation in low-risk singleton pregnancies. After birth, the UC was measured. The difference of Doppler indexes of different points was evaluated by nonparametric Kruskal-Wallis test or analysis of variance (ANOVA) test and significant values have been adjusted by the Bonferroni correction for multiply tests. The correlation of between UC length and change of Doppler indexes which measured at different points of the UC was evaluated using Spearman's rank correlation test.Results: The data of 74 participants were analyzed in this study. Mean UC length was 58 cm (min: 38 cm and max: 84 cm). There was no difference between characteristics of two groups that UC length <58 cm and ≥58 cm and different percentiles. UA systole/diastole (S/D) rate, resistance index (RI), and pulsatility index (PI) were higher at the IA portion than other measurement points (p = .003, <.001, and <.001, respectively). The mean differences (delta values) of UA blood velocity between the fetal and placental ends (PEs) were correlated UC length (c = 0.32, p = .04).Conclusions: The differences of UA blood velocities between the fetal and PEs may be a useful marker for UC length prediction during antenatal period.

The impact of intrahepatic cholestasis of pregnancy on fetal cardiac and peripheral circulation.

OBJECTIVE: The aim of this study was to evaluate changes in fetal cardiac and peripheral circulation in pregnancies complicated with intrahepatic cholestasis. MATERIAL AND METHODS: The Doppler examination results of 22 pregnant subjects complicated with intrahepatic cholestasis of pregnancy (ICP) and 44 healthy controls were compared. The parameters of fetal cardiac circulation were pulmonary artery and aortic (Ao) peak systolic velocity (PSV), pulmonary vein (Pv), peak velocity index (PVI) and pulsatility index (PI), mitral valve (MV) and tricuspid valve (TV), early diastole (E)- and atrial contraction (A)-wave peak velocity ratio (E/A), and isthmus aortic peak systolic velocity (IAo PSV). The parameters of fetal peripheral circulation were middle cerebral artery (MCA) and umbilical artery (UA) PI, resistance index (RI), systolic/diastolic (S/D) ratio. Fetal obstetric Doppler monitoring was conducted weekly before 36 weeks and biweekly after that, and the results were compared with the normal reference values for gestational age. RESULTS: The Doppler parameters of fetal cardiac and peripheral circulation did not significantly differ between the two groups. S/D ratio readings in the ICP group were significantly above 2 SD before 35 weeks of gestation. Women with ICP had increased risks of preterm delivery, neonatal unit admission, and meconium-stained amniotic fluid compared with those in the controls. CONCLUSION: Fetuses of pregnant women with ICP showed no differences in the evaluation of cardiac and peripheral Doppler measurements compared with fetuses of healthy mothers. The Doppler investigation of the umbilical artery may be useful in monitoring of pregnancies complicated by early onset intrahepatic cholestasis.