COVID-19 infection and vaccine have no impact on in-vitro fertilization (IVF) outcome.

To investigate the effect of COVID-19 infection or vaccine on IVF outcome. This is a multicenter retrospective study. Data were collected from all patients treated in the ART units between September and November 2021 after the vaccination of the general population began. Medical records of all patients who had IVF/intracytoplasmic sperm injection (ICSI) were retrospectively reviewed. Patients were categorized into four groups: previously infected by COVID-19, vaccinated by COVID vaccine, previously infected and vaccinated, or neither infected nor vaccinated. Total number of participants 151 (vaccinated only 66, infected only 18, vaccinated and previously infected 34, and control 33. Outcomes (ET on day of trigger, number of oocytes retrieved, quality of oocytes, number of fertilized oocytes, number and quality of embryos, number of embryos transferred, number of embryos frozen, implantation rate and clinical pregnancy rate) were compared between these four groups. Moreover, we compared the outcome before and post infection, as well as before and post vaccine in a group of patients. No evidence was found to suggest that COVID-19 disease or SARS-CoV-2 Vaccine adversely affects Clinical pregnancy rates (positive fetal heartbeat) (OR 0.9, CI 0.5-1.9, OR 1.8, CI 0.9-3.6, respectively) and the following parameters: fertilization rate, implantation rate, positive bHcg) (OR 0.9, CI 0.5-1.8, OR 1.5, CI 0.7-2.9, respectively). Although a limitation of our study is the small comparison groups, and the wide confidence intervals in the Odds Ratio estimates.

COVID-19 and Semen Fluid Parameters, a Retrospective Study from Infertility Clinics.

The study of the effects of SARS-CoV-2 infection and/or vaccination on semen fluid analysis (SFA) parameters is still incomplete. The aim of this study is to assess the effect of COVID-19 infection and vaccination on sperm parameters for a sample of individuals visiting multi-infertility clinics in Jordan. SFA records were collected retrospectively between September and November 2021 and analyzed using Jamovi software (version 2.2.5 for Windows); p-values < 0.05 were considered statistically significant. Sperm concentration, progressive motility, normal morphology, and semen liquefaction time, volume, and viscosity were compared among two data categories. In the first category of data, SFA records from 354 participants were separated into four groups: only vaccinated, infected and vaccinated, neither infected nor vaccinated, and only infected. In the other category, SFA from 49 subjects before their infection and/or vaccination and after were classified into the same mentioned groups and analyzed. There were no statistically significant differences between the studied parameters in the SFA records in the first data category and the second. Nevertheless, the sperm concentration was higher among vaccinated subjects compared to unvaccinated ones (p = 0.04). It is concluded that SARS-CoV-2 infection and vaccines have no negative effects on SFA parameters.

Conception Preferences during COVID-19 Pandemic Lockdowns.

Background: The COVID-19 lockdowns imposed new challenges to couples who were planning to conceive. In this research paper, we aimed to study the perceptions of women in Jordan during the pandemic regarding fertility behavior, the desire to use assisted reproductive technology (ART) and the awareness and beliefs of potential risks related to conception. Methods: A validated online-based questionnaire was distributed to women from April-May 2020, Statistical analysis was performed using the statistical software SPSS version 22 and R software (2020); p values ≤ 0.05 were considered statistically significant. Results: The total number of participants was 814 women, with 78.2% of the participants (58.7% fertile and 76.6% infertile) believing that pregnancy during the COVID-19 pandemic could be risky. Among them, 16% and 40%, respectively, were trying to conceive during the pandemic, and 97.4% and 89.9%, respectively, were not willing to use ART if needed during the pandemic. Young, nulliparous women who were married for less than one year were significantly associated with the desire to conceive during the COVID-19 pandemic. Conclusion: This study concluded that the fertility behavior of women in Jordan changed during the pandemic, and their desire for natural conception and for using ART declined, as they believed that there were potential risks related to conceiving during the pandemic. However, the effect was greater among the general fertile population than the infertile.

Dual trigger with gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves oocyte yield in normal responders on GnRH-antagonist cycles.

OBJECTIVE: During in vitro fertilization (IVF) cycles, final oocyte maturation is usually triggered by human Chorionic Gonadotropin (hCG) for its known effect in mimicking Luteinizing Hormone (LH) surge; however, with the widespread use of the 'antagonist protocol', Gonadotropin Releasing Hormone agonist (GnRHa) is being more commonly employed as a trigger in order to minimize or eliminate the risk of ovarian hyper-stimulation syndrome (OHSS). Many studies proved its efficacy in inducing oocyte maturation and its safety in preventing OHSS in high-risk groups. Moreover, some studies showed that GnRHa trigger may improve oocyte yield. This study aimed to further explore any beneficial effect of adding GnRHa to hCG (dual trigger) on oocyte yield and fertilization rate in normal responder women. METHODS: We retrospectively reviewed and analyzed the data from 127 patients on antagonist protocol (67 dual trigger and 60 HCG trigger). RESULTS: The number of total oocytes, the number of MII oocytes and the number of fertilized oocytes were all significantly higher with the dual trigger protocol compared to hCG-only trigger. However, there is no significant difference in clinical pregnancy rate. CONCLUSIONS: Using the dual trigger improved the number and quality of oocytes, and the fertilization rate in normal responders.

Negative histology in surgically managed tubal ectopic pregnancy.

OBJECTIVE: To determine the rate of negative histology following salpingectomy for suspected ectopic pregnancy. METHODS: A retrospective case series in a university hospital in the southwest of England was carried out. The records of all patients who had a salpingectomy for suspected ectopic pregnancy between January 2007 and December 2012 were reviewed. The primary outcome was the histology result. RESULTS: In total, 359 salpingectomies were performed for suspected ectopic pregnancy over 6 years. On histologic examination, 4.7% of fallopian tubes did not have evidence of an implantation site or trophoblastic tissue. When the macroscopic appearance of the fallopian tube was correlated with the surgical findings (e.g., rupture with large hemoperitoneum) and follow-up notes were reviewed thoroughly, the histology of 0.84% of all salpingectomies was not consistent with a tubal ectopic pregnancy. CONCLUSIONS: True negative histology for surgically managed ectopic pregnancy is less than 1%.

Maternal and fetal serum leptin levels and their association with maternal and fetal variables and labor: A cross-sectional study.

BACKGROUND: Leptin is a polypeptide hormone that may be implicated in the pathogenesis of various disorders during pregnancy. We sought to determine serum leptin levels among pregnant women and their fetuses and to investigate their association with fetal and maternal variables. METHOD: 452 pregnant women who attended to labor ward between January 2020 and August 2020 were included in the study. Serum leptin concentrations were measured using enzyme-linked immunosorbent assay method. Mann-Whitney U test and Spearman's correlation test were used for statistical analysis. A multivariate linear regression analysis was then performed. Significance level was considered at alpha <0.05. RESULTS: The median maternal and fetal serum leptin levels were 6.42 [4.16-8.51] ng/mL and 2.9 [1.03-5.36] ng/mL respectively. There was no significant correlation between maternal and fetal serum leptin levels (p = 0.064). Maternal serum leptin levels correlated positively with maternal body mass index (BMI) (r = 0.117, p = 0.005). Besides, maternal serum leptin levels were significantly higher in nulliparous women (7.57 [4.45-9.30] ng/mL vs. 6.22 [4.02-8.30] ng/mL, p = 0.037) and in women who were in active labor (6.83 [4.39-8.92] ng/mL vs. 6.25 [4.04-8.30] ng/mL, p = 0.047). Fetal serum leptin levels were significantly higher in large for gestational age (LGA) fetuses (4.81 [2.13-7.22] ng/mL vs. 2.80 [0.96-5.16] ng/mL, p = 0.003) and in fetuses with preterm premature ruptures of membranes (PPROM) (5.23 [2.42-8.07] ng/mL vs. 2.86 [1.00-5.23] ng/mL, p = 0.021). CONCLUSION: Maternal serum leptin levels were influenced by maternal BMI, parity and labor. Fetal serum leptin levels were higher among LGA fetuses and in fetuses with PPROM.

Preference of and factors that influence future specialty among medical students in Jordan: A cross-sectional study.

BACKGROUND: Choosing future specialty is an important issue that face undergraduate medical students during their university years. Several factors may assist to formulate students' final decision. We aimed to explore the future specialty preferences and the factors that influence the choice of undergraduate students in medical schools in Jordan. METHODS: A cross sectional study conducted among the sixth year students of two medical schools in Jordan. A questionnaire was used to collect data from the students. It consisted of demographic data in form of gender, GPA, family income, and parents' level of education. In addition to data about preferred specialties, and factors that influence medical students' choice of future specialty. RESULTS: A total of 223 medical students from two medical schools were recruited to participate. Males were 49.3% while females were 50.7%, and around 22% scored an excellent GPA. Most parents of the students were bachelor degree holders (63.6% for fathers and 62.3% for mothers). Medicine (19.4%), dermatology (12.6%), and obstetrics and gynecology (11.7%) were the most chosen future specialties. Specialty appeal and thoughts of future creativity was the most chosen factor that influenced future specialty (55.2%) choice, followed by family time and less on-call duties (14.8%). Students who selected chances of fellowships as an influencing factor were more likely to prefer medicine as future specialties (p < 0.001). CONCLUSION: Medicine, dermatology, and obstetrics and gynecology were the most popular future specialty choices among undergraduate medical students. Most of our medical students claimed that selection of their specialty is based on the interest and potential creativity, family time and less on call duties. Further studies are required in a wide range to accommodate more students from the other academic years.

Effect of hookah (water pipe) smoking on semen parameters.

Hookah (water pipe) smoking, an old method of tobacco smoking, is regaining widespread popularity all over the world. Although the research in this field is still deficient, it has been proven for its harmful effect on human's health by increasing the risk of cardiovascular disease, infection and lung, oral and bladder cancer (Al-Numair et al., J Food Agric Environ, 5: 17, 2007; Bou Fakhreddine et al., Respir Med, 108: 1241-1253, 2014; Chaouachi, J Negat Results Biomed, 5: 17, 2006). However, no research was found to address its effect on human fertility or reproductive outcome. In this cross-sectional study, we aim to explore the effect of smoking hookah on human semen parameters among men attending In Vitro Fertilization LABs for seminal fluid analysis testing. 104 patients aged between 25 and 45, who are noncigarette smokers and have no chronic medical illness, were enrolled in the study: 50 hookah nonsmokers and 54 hookah smokers. Their semen parameters were compared. Semen volume, normal morphology and progressive motility were slightly lower in the hookah smoker (3.21 ml; 10.2%; 29.56%) versus (3.45 ml; 11.5%; 33.20%), respectively, in nonhookah smokers; however, the difference was not statistically significant. The effect of hookah smoking on semen observed in our study was not statistically significant. Further studies are needed to explore more and confirm any unfavourable effect.

Unilateral triplicate ureter with ipsilateral ureterocele a case report.

INTRODUCTION: Triplicate ureter is a rare congenital anomaly of the upper urinary tract. PRESENTATION OF CASE: In this case we present a triplicate ureter with ipsilateral ureterocele in a 9 years old boy. After literature review we found out this presentation very rare. DISCUSSION: Ureteral triplication classified by Smith into 4 subtypes, and usually associated with other congenital abnormality, most common one is contralateral ureteric duplication. Usually this anomaly is asymptomatic. We present a type 3 ureteral triplication. CONCLUSION: Although triplicate ureter is a rare congenital anomaly, we must keep it in our differential diagnosis of unexplained urinary symptoms.