Impact of Body Mass Index and advanced maternal age on in vitro fertilization outcomes.

OBJECTIVE: To evaluate the impact of body mass index associated with advanced maternal age on pregnancy outcomes. METHODS: A retrospective and observational study that included 808 in vitro fertilization cycles and evaluated: age, weight, height, number of oocytes and mature oocytes, number of embryos and transferred embryos, fertilization and clinical pregnancy rates. Four categories of body mass index: underweight, adequate weight, overweight and obesity. We classified age into 4 categories: 35-37; 38-40; 41-42 and over 42 years of age. The means and rates were calculated and compared between different ages and body mass index groups. RESULTS: For the fresh group, women who achieved clinical pregnancy had a lower mean age than those who did not become pregnant, being the higher the pregnancy rate the lower the age (p<0.0001). After logistic regression analysis for data associated with clinical pregnancy in the fresh group, the number of transferred embryos remained higher in the overweight category (p=0.0001). Overweight and obese women had a significantly higher rate of mature oocytes when compared with adequate weight (p=0.015). Analysis using the ROC curve indicated an area under the curve of 60% (p=0.002) for the fresh group. CONCLUSIONS: The adverse effect of high BMI on clinical pregnancy rates is greater in women under 35 years compared to older women; and age had a higher impact on live birth rate rather than BMI, when the analysis was performed on older women, with the impact of BMI on the probability of having a live birth depending on maternal age.

Zika virus testing of asymptomatic patients undergoing assisted reproduction in Curitiba, Brazil.

OBJECTIVE: The objective is to report recent data on the infection and detection of Zika virus in infertile couples and to discuss the need to make disease surveillance compulsory in this population in order to decrease the burden on the healthcare system and expedite treatment onset. METHODS: We collected and analyzed the results of Zika virus infection screening tests of infertile couples in a private clinic in the low-incidence region of Curitiba - Brazil. RESULTS: Among the 1189 serologies performed, 98.5% were negative for Zika virus, 0.75% were positive, and 0.75% were inconclusive. The twenty-one reverse transcription polymerase chain reaction tests performed for confirmation of infection were negative. CONCLUSION: Zika virus infection screening for asymptomatic patients may lead to delayed fertility treatment initiation in addition to excessive expenses for the patients. Based on our results, we challenge the validity of mandatory screening, especially in low-incidence regions.

Estudo clínico-epidemiológico de fibromialgia em um hospital universitário do Sul do Brasil / Clinical and epidemiological study of fibromyalgia in a university hospital in Southern Brazil

JUSTIFICATIVA E OBJETIVO: A fibromialgia é uma condição caracterizada por dor generalizada, comumente associada à fadiga e a distúrbios cognitivos, afetivos e do sono. O objetivo deste estudo foi descrever o perfil socioeducacional e o desempenho em escalas de avaliação da doença, além de comparar os diferentes critérios de classificação da fibromialgia e descrever outras características dos pacientes atendidos em um ambulatório de fibromialgia de um hospital universitário. MÉTODOS: Estudo realizado por meio de análise de questionários com padrão EpiFibro aplicados a 146 mulheres com fibromialgia durante consulta ambulatorial. RESULTADOS: Entre os resultados, destacaram-se os seguintes: maior sensibilidade dos critérios do Colégio Americano de Reumatologia de 2010 em relação aos de 1990; baixas renda e escolaridade das pacientes; alta prevalência de distúrbios do sono, cefaleia e parestesias; longo tempo entre o início dos sintomas e o diagnóstico; e não utilização dos tratamentos farmacológicos e não farmacológicos de primeira linha na fibromialgia. CONCLUSÃO: Em nosso meio, os pacientes com fibromialgia geralmente passam por problemas como a demora diagnóstica, mau controle dos sintomas e tratamento não otimizado...

BACKGROUND AND OBJECTIVE: Fibromyalgia is acondition featured by generalized pain, usually associated with fatigue, and cognitive, affective, and sleep disorders. The aim of this study was to describe the social-economical profile, and the performance in scales for evaluation of the disease; to compare the different classification criteria of fibromyalgia; and to describe other features of patients seen in an outpatient clinic of a university hospital. METHODS: The study was conducted through the analysis of EpiFibro questionnaires, applied to 146 women with fibromyalgia during medical consultation. RESULTS: Among the results, we highlight: greater sensibility of the 2010 American College of Rheumatology Criteria, compared to those of 1990's; patients low income and instruction levels; high prevalence of sleep disorders, headache and numbness; the long time between symptoms onset and diagnosis, and non-utilization of first line pharmacological and non-pharmacological therapies for fibromyalgia. CONCLUSION: In our area, patients with fibromyalgia have problems such as delay in diagnosis, poor symptom control and non-optimized treatment...