Objectives: Polycystic ovary syndrome (PCOS) is associated with insulin resistance and impaired oocyte competence. In vitro maturation (IVM) is a viable alternative, and supplementation with platelet-rich plasma (PRP) may improve outcomes. However, previous studies have primarily focused on autologous PRP. This study aimed to evaluate the effect of 5% allogeneic PRP supplementation in IVM medium on oocyte maturation in women with PCOS, using growth differentiation factor-9 (GDF-9) and bone morphogenetic protein-15 (BMP-15) as surrogate biomolecular markers of oocyte maturation. Materials and Methods: This quasi-experimental study was conducted between 2024 and 2025. Immature germinal vesicle (GV)stage oocytes (n=24) from patients with PCOS were allocated to either a non-PRP group (n=12 oocytes) cultured in standard G-IVF (TM) medium or a PRP group (n=12 oocytes) cultured in G-IVF (TM) supplemented with 5% allogeneic PRP. After 24 hours, GDF-9 and BMP-15 concentrations in the culture media were quantified using ELISA. Results: Post-IVM, GDF-9 and BMP-15 levels were significantly higher in the PRP group (1.036 +/- 0.004 pg/mL and 0.888 +/- 0.008 pg/ mL, respectively) than in the non-PRP group (1.032 +/- 0.003 pg/mL and 0.878 +/- 0.004 pg/mL) (P= 0.020 and P= 0.001, respectively). Multivariate analysis confirmed that PRP supplementation was the only significant variable associated with increased GDF-9 (B=0.004, P= 0.047, R-2=33.7%) and BMP-15 (B=0.012, P = 0.002, R-2=50.7%) levels. Although the absolute changes were small (Delta GDF-9 = 0.004 pg/mL; Delta BMP-15 = 0.012 pg/mL), large effect sizes were observed (Cohen's d = 1.13 and 1.58). Conclusions: Supplementing IVM medium with 5% allogeneic PRP was associated with increased GDF-9 and BMP-15 levels, which are considered surrogate biomarkers of oocyte maturation.
Introduction: Placenta increta is a major obstetric complication that can lead to life-threatening postpartum hemorrhage (PPH), particularly when it is undiagnosed during vaginal delivery. Case Report: This report presents two cases of vaginally delivered pregnancies complicated by placenta increta, both treated with uterine artery embolization (UAE) followed by placental extraction at different time intervals. In both cases, UAE proved highly effective in controlling acute and severe vaginal bleeding. In case 1, immediate placental extraction was attempted after UAE; however, uncontrolled vaginal bleeding recurred, necessitating a laparotomy for further placental extraction. This was followed by ligation of the bilateral uterine arteries and application of uterine body compression sutures. In case 2, manual placental extraction was performed 48 hours after UAE, when ultrasound Doppler indicated adequate uterine contraction and minimal placental blood flow. The placenta was successfully extracted intact with minimal bleeding. Conclusions: Delayed placental extraction following UAE may reduce the risk of recurrent massive vaginal bleeding in vaginal deliveries complicated by placenta accreta spectrum (PAS).
Objectives: Episiotomy is a surgical intervention to decrease the risk of obstetric anal sphincter injuries (OASIs) that adversely affect normal vaginal delivery (NVD). However, the intervention itself may lead to significant perineal laceration and postpartum anal incontinence. This research aimed to compare the suture angle and postpartum anal incontinence of mediolateral episiotomy aided with a 60-degree triangular set square (TRSS-60) with those of a routine mediolateral episiotomy. Materials and Methods: This prospective study was performed on primiparous pregnant women with NVD requiring episiotomy inYas hospital from April 2020 to November 2020. The subjects were assigned to control and intervention groups at a 1:1 ratio. Outcome measures included suture angle and Wexner fecal incontinence scores between the groups. Results: Forty primiparous women have enrolled in the study. The average perineal body length was 3.64 +/- 0.54 cm at the first stage of labor and 4.86 +/- 0.71 cm during crowning. The mean suture angle varied significantly (P < 0.001) between the intervention and control groups (48.5 vs. 33.7). The suture angle of all participants in TRSS-60 was higher than 40 degrees. Wexner score assessment revealed that the most frequent complaint was gas incontinence in postpartum women (four in the control group and one in the intervention group). Conclusions: This study suggests thatTRSS-60 could be used as an affordable, highly accessible, inexpensive, and effective approach to reach the safe zone angles during episiotomies, reduce OASIs, and supply an appropriate replacement for EPICSISSOR-60 in low-resource areas.
Objectives: Stem cell factor (SCF) is a crucial cytokine growth factor that significantly contributes to hematopoiesis, as well as the development of melanocytes and germ cells. This study aimed to compare the levels of SCF in serum and seminal plasma among patients with non-obstructive azoospermia (NOA), oligozoospermia, and men with normozoospermic controls, and to determine whether it could serve as a potential biomarker for the local testicular biomarker. Materials and Methods: This cross-sectional comparative study enrolled 132 patients who were divided into three equal groups: normozoospermia, NOA, and oligozoospermia (n = 44 each). A comparison was made in all groups based on age, hormones, and SCF level. SCF level in serum and seminal fluid was measured by ELISA. Results: Our research indicated the concentrations of SCF in both seminal plasma and serum across three groups. Seminal plasma SCF levels showed a significant difference between groups (P = 0.002), with higher levels observed in the oligozoospermia group compared with both NOA and normozoospermia groups; no significant difference was observed between NOA and normozoospermia. In contrast, serum ligand levels were significantly elevated in the NOA and normospermia groups compared to the oligospermia group P < 0.001). Units are expressed as ng/mL. Conclusions: Our findings identified that seminal plasma SCF, in contrast to its serum, was significantly elevated in oligozoospermia and may serve as a promising and direct biomarker of the active local testicular microenvironment in states of diminished sperm production.
Objectives: The aim of this study was to explore the constructs of the theory of planned behavior (attitude, subjective norms, perceived behavioral control) in health information seeking behavior among Iranian pregnant women. Methods: This is a qualitative study with an interpretive phenomenological approach involving 23 in-depth semi-structured interviews with pregnant women at 12-36 weeks of gestation. The data were analyzed using inductive qualitative content analysis by MAXQDA software. For validation, the coding process was performed by two independent researchers, and a Cohen's kappa agreement coefficient of 0.85 was calculated. The extracted codes were reviewed and finalized in group discussion sessions with the research team. In addition, some of the findings were confirmed by the participants, and the researchers' triangulation method was used to increase reliability. Results: A total of 115 concepts were identified across three main constructs and 10 components. Attitude toward behavior (30 concepts) included positive/negative beliefs and outcome assessments; subjective norms (32 concepts) included injunctive/descriptive norms and motivation to comply; and perceived behavioral control (53 concepts) included internal/external control, barriers and facilitators. Attitude toward behavior emerged as the most salient construct in participants' accounts of health information seeking. Conclusions: Health information seeking behavior of pregnant women is affected by complex interactions of three theoretical constructs. Cultural, social, and economic factors play moderating roles in this regard. The results provide a foundation for designing targeted interventions to improve this behavior and enhance maternal and fetal health.
