Fine-tuning the dose of recombinant human follicle-stimulating hormone alfa to individualize treatment in ovulation induction and ovarian stimulation cycles: a real-world database analysis.

Introduction: Fine-tuning of injectable gonadotropin doses during ovulation induction (OI) or ovarian stimulation (OS) treatment cycles with the aim of using doses low enough to minimize the risk of excessive ovarian response while maintaining optimal efficacy may be facilitated by using an adjustable-dose pen injector. We examined the incidence and magnitude of individualized gonadotropin dose adjustments made during cycles of OI or OS, followed by either timed intercourse or intrauterine insemination, with or without oral medications, and assessed the relationship between patient characteristics and dosing changes using real-world evidence.

Methods: This was an observational, retrospective cohort study using electronic medical records from a large US database of fertility centers.

COVID-19 in pregnancy.

Evidence continues to emerge on the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) in pregnancy. Compared with previous coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome), recent reports suggest that pregnant women who contract SARS-CoV-2 have lower rates of maternal and fetal complications; however, the incidence of preterm birth remains elevated. The potential for vertical transmission is still under investigation.

Follicle flushing does not improve live birth and increases procedure time: a systematic review and meta-analysis of randomized controlled trials.

Objective: To determine whether follicle flushing during oocyte retrieval improves live birth or secondary outcomes in assisted reproductive technology (ART).

Design: Systematic review and meta-analysis.

Setting: Not applicable.

Polycystic Ovarian Syndrome: Impact on Adult and Fetal Health.

Women with the polycystic ovarian syndrome (PCOS) may have an increased risk for complications in pregnancy including miscarriage, gestational diabetes mellitus, hypertensive disorders of pregnancy, higher rates of cesarean delivery, and abnormalities in fetal growth. In addition, PCOS has been associated with the development of type II diabetes mellitus, hypertension, cardiovascular disease, obstructive sleep apnea, endometrial cancer, depression and anxiety, and nonalcoholic fatty liver disease. In understanding that PCOS is a disease impacting more than just a woman's fertility, prevention and early identification of risk factors for affiliated conditions is essential.

Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military.

Active duty military service and deployment has the potential to compromise fertility through combat-related genitourinary injury, gonadotoxic exposures, and physical separation from a partner. Despite a growing interest among the military community as well as promising efficacy and safety data, fertility preservation remains an uncovered benefit for active duty soldiers. In 2016, the Pentagon proposed a program that would cover oocyte and sperm cryopreservation for any member of the active duty military desiring its use.

Assisted Reproductive Technology and Epigenetics.

Assisted reproductive technology (ART) is responsible for 1.7% of births in the United States annually. Despite a large number of studies promoting the efficacy and safety of these practices, there have been reports of imprinting disorders occurring at higher frequencies in children born through ART.

Evaluating the Utility of Intralipid Infusion to Improve Live Birth Rates in Patients with Recurrent Pregnancy Loss or Recurrent Implantation Failure.

Context: Intralipid is used to improve clinical outcomes in patients with recurrent pregnancy loss (RPL) or recurrent implantation failure (RIF) with elevated natural killer (NK) cells. Data supporting this practice is conflicting but suggestive of minimal benefit.

Aims: The aims of this study are to determine if intralipid infusion improves live birth rates and if is a cost-effective therapy in the RPL/RIF population.

Isolated Absent Thelarche in a Patient With Neurofibromatosis Type 1 and Acromegaly.

Background: Isolated absent thelarche is a rare condition that is infrequently reviewed in the literature.

Case: A 28-year-old woman with neurofibromatosis type 1 and acromegaly presented with absent breast development despite hormone therapy. Examination noted a normally developed woman with acromegalic features and Tanner stage I breasts.