Hasil untuk "Gynecology and obstetrics"

Leigh Ann Simmons, Jennifer E. Phipps, Sebastian Castro-Alvarez et al.

Abstract Background Rising rates of overweight and obesity globally have led to an increasing number of women who enter pregnancy with excess weight, posing significant health risks to mothers and infants. Mobile health interventions, such as smartphone apps, may be a solution to improving pregnancy outcomes, however, limited randomized studies have examined this approach for gestational weight gain (GWG) and postpartum weight retention (PPWR). We report results from a double-blinded, randomized control trial of Goals for Reaching Optimal Wellness (GROWell), a mobile app and text-based intervention designed to improve diet quality and associated weight outcomes in pregnant and postpartum women. Methods Women living in California with BMI = 25–42 kg/m2 and a singleton, uncomplicated pregnancy were recruited via social media or clinic in early pregnancy from January 2021 through March 2023. After completing a baseline survey, participants were randomized to GROWell or an educational control. Participants completed online surveys of diet quality and other health behaviors and self-weighed using study-provided Bluetooth scales. Modified Poisson regression tested for differences in excess GWG and 6-month PPWR. Results Using block randomization in permuted blocks of three based on prepregnancy BMI, race/ethnicity, and recruitment source) 453 racially and ethnically diverse participants (237 attention control, 216 intervention) were enrolled. Mean age was 33.6 ± 4.1 years and mean BMI was 30.9 ± 4.28 kg/m2. Excess GWG was observed in 36% of the control group and 35% of the intervention group. PPWR was observed in 26% of the control group and 23% of the intervention group. Conclusions Compared to an attention control, GROWell was not associated with lower rates of excess GWG or PPWR. However, study rates of excess GWG and PPWR were lower in both groups compared to averages in the US and several Western nations. Future studies should investigate the potential of text-based educational support on weight and other health indicators among childbearing women. Trial registration ClinicalTrials.gov identifier NCT04449432. Registered on June 26, 2020.

Monika Czerwińska, Marcin Gruszecki, Jacek Rumiński et al.

Abstract Background Lipedema is an adipose tissue disorder involving mostly women. One of the most characteristic lipedema symptoms is painful accumulation of adipose tissue in lower and upper extremities leading to disproportion. Due to the disproportionate body shape, it is recently thought that BMI (Body Mass Index) might not be fully sufficient to identify the weight ratios among lipedema patients and it is suggested to consider replacing BMI with WHtR (Waist-to-height ratio). Purpose The aim of the study is to present the characteristic features of lipedema patients and the usefulness of BMI and WHtR among lipedema patients in reference to symptoms severity, quality of life and body composition. Methods Forty-four women with lipedema were asked to rate their symptoms in a scale from 0 to 10, and to complete SF-36 questionnaire affecting quality of life. Participants also had body composition assessment. Results Participants experienced various lipedema symptoms such as: heaviness in affected areas (97.7%), pain at palpation (100%), spontaneous pain (82%), disproportionate body shape and tendency to bruising (88.6%). The level of pain was strictly correlated with patients’ daily functioning (R = 0.79, p = 1.9*10− 10). The quality of life among participants measured with SF-36 was 57.4/100. WHtR enabled the same group of patients to be divided into three nearly equal groups, while BMI only divided them into two groups. Statistically significant differences could be observed both between BMI and WHtR groups. Conclusion Lipedema symptoms have a direct impact on functioning of patients. Quality of life is decreased among women with lipedema. WHtR should be considered as a tool in identification of obesity among lipedema population.

Lei Chen

Background: This study aims to investigate the delivery modes, indications for cesarean section, and perinatal outcomes of infants with macrosomia in primiparous women, with a particular focus on those with gestational hyperglycemia who have achieved satisfactory glycemic control, as well as those with normal blood glucose levels. Methods: A retrospective cohort study was conducted in 269 primiparous women with infants affected with macrosomia at Haidian Maternal and Child Health Hospital in Beijing (2022–2024). These women had no prior history of uterine surgery, breech presentation, placenta previa, or any other conditions that would necessitate a cesarean section. The participants were categorized into two groups based on their blood glucose levels: a hyperglycemic group consisting of 107 cases (after excluding 2 cases due to inadequate blood glucose control) and a normal blood glucose group with 160 cases. This study compared various factors between the two groups, including basic demographic information, mode of delivery, reasons for the cesarean sections, and any complications that arose during delivery. Primary outcomes included cesarean section rates and perinatal outcomes. Results: The cesarean section rate was notably higher in the hyperglycemic group compared to those with normal blood glucose levels, while the rate of vaginal deliveries, including those assisted by forceps, was lower in the hyperglycemic group. This difference in delivery methods was statistically significant (χ2 = 4.132; p < 0.05). Additionally, within the hyperglycemic group, babies born via cesarean section due to fetal macrosomia had a significantly greater birth weight than those delivered vaginally (Z = 3.500; p < 0.05). A similar trend was observed in the normal blood glucose group, where cesarean section deliveries also resulted in higher birth weights compared to vaginal deliveries (Z = 3.750; p < 0.05). Furthermore, the hyperglycemic group exhibited a higher incidence of shoulder dystocia and intrapartum fever compared to the normal blood glucose group, with these differences being statistically significant (p < 0.05). Conclusions: For primiparous women with infants who possessed macrosomia, the cesarean section rate in the hyperglycemic group was higher than that in the normal blood glucose group, and the incidence of shoulder dystocia in the hyperglycemic group was higher than that in the normal blood glucose group. Therefore, using a fetal weight of ≥4150–4190 g as the cesarean section indication for macrosomia is recommended, whether for pregnant women with normal blood glucose levels or those with gestational hyperglycemia who have good blood glucose control.

Ohad Regev, Apurba Shil, Tal Bronshtein et al.

Abstract Background Recent evidence suggests that certain fetal anomalies detected upon prenatal ultrasound screenings are associated with autism spectrum disorder (ASD). In this cross-sectional study, we aimed to identify genetic variants associated with fetal ultrasound anomalies (UFAs) in children with ASD. Methods The study included all children with ASD who are registered in the database of the Azrieli National Center of Autism and Neurodevelopment and for whom both prenatal ultrasound and whole exome sequencing (WES) data were available. We applied our in-house integrative bioinformatics pipeline, AutScore, to these WES data to prioritize rare, gene-disrupting variants (GDVs) probably contributing to ASD susceptibily. Univariate statistics and multivariable regression were used to assess the associations between UFAs and GDVs identified in these children. Results The study sample comprised 126 children, of whom 43 (34.1%) had at least one UFA detected in the prenatal ultrasound scan. A total of 87 candidate ASD genetic variants were detected in 60 children, with 24 (40%) children carrying multiple variants. Children with UFAs were more likely to have loss-of-function (LoF) mutations (aOR = 2.55, 95%CI: 1.13–5.80). This association was particularly noticeable when children with structural anomalies or children with UFAs in their head and brain scans were compared to children without UFAs (any mutation: aOR = 8.28, 95%CI: 2.29–30.01; LoF: aOR = 5.72, 95%CI: 2.08–15.71 and any mutation: aOR = 6.39, 95%CI: 1.34–30.47; LoF: aOR = 4.50, 95%CI: 1.32–15.35, respectively). GDVs associated with UFAs were enriched in genes highly expressed across all tissues (aOR = 2.76, 95%CI: 1.14–6.68). There was a weak, but significant, correlation between the number of mutations and the number of abnormalities detected in the same children (r = 0.21, P = 0.016). Conclusions The results provide valuable insights into the potential genetic basis of prenatal organogenesis abnormalities associated with ASD and shed light on the complex interplay between genetic factors and fetal development.

Filip Herbst, Paul W. Dickman, Louise Moberg et al.

Abstract Background An investigation of trends of incidence and net survival (NS) for endometrial cancer in Sweden. Methods Morphologically verified endometrial carcinoma diagnosed 1960 to 2014 were collected from the nation-wide Swedish Cancer Registry. Endometrial cancer patients were assessed with regards to time trends for incidence and 54,825 cases remained for survival analyses. Cases diagnosed 1995 to 2014 were categorized according to detailed morphology and from 2005 to 2014 FIGO stage was also categorized. Results There was a trend of increasing incidence of endometrial carcinoma for women above 55 years of age. NS was improved at 5- and 10-year follow-up. The 5-year net survival in 2010–2014 was 86%. The most prominent improvement in NS was found in the elderly women above 75 years of age. Conclusions This study observed increased incidence of endometrial cancer in Sweden from 1960 to 2014. The progress in diagnostics and treatment, seem to have improved the net survival, especially in elderly women.

Eudu James, Benon Wanume, Milton W. Musaba et al.

Abstract Background A rapid increase in community transmission of COVID-19 across the country overwhelmed Uganda’s health care system. In response, the Ministry of Health adopted the home-based care strategy for COVID-19 patients with mild-to-moderate disease. We determined the characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care during the second wave in Kapelebyong district, in eastern Uganda. Methods We conducted a sequential explanatory mixed-methods study. We first collected quantitative data using an interviewer-administered questionnaire to determine characteristics and treatment outcomes of COVID-19 patients under home-based care. Cured at home was coded as 1 (considered a good outcome) while being admitted to a health facility and/or dying were coded as 0 (considered poor outcomes). Thereafter, we conducted 11 in-depth interviews to explore the experiences of COVID-19 patients under home-based care. Multivariable logistic regression was used to assess factors associated with poor treatment outcomes using Stata v.15.0. Thematic content analysis was used to explore lived experiences of COVID-19 patients under home-based care using NVivo 12.0.0 Results A total of 303 study participants were included. The mean age ± standard deviation of participants was 32.2 years ± 19.9. Majority of the participants [96.0% (289/303)] cured at home, 3.3% (10/303) were admitted to a health facility and 0.7% (2/303) died. Patients above 60 years of age had 17.4 times the odds of having poor treatment outcomes compared to those below 60 years of age (adjusted odds ratio (AOR): 17.4; 95% CI: 2.2–137.6). Patients who spent more than one month under home-based care had 15.3 times the odds of having poor treatment outcomes compared to those that spent less than one month (AOR: 15.3; 95% CI: 1.6–145.7). From the qualitative interviews, participants identified stigma, fear, anxiety, rejection, not being followed up by health workers and economic loss as negative experiences encountered during home-based care. Positive lived experiences included closeness to friends and family, more freedom, and easy access to food. Conclusion Home-based care of COVID-19 was operational in eastern Uganda. Older age (> 60 years) and prolonged illness (> 1 months) were associated with poor treatment outcomes. Social support was an impetus for home-based care.

Rebecca A. Heidenberg, B.S., Elizabeth S. Ginsburg, M.D., Catherine E. Gordon, M.D. et al.

Objective: To study the difference in the live birth rates between anovulatory women with hypothalamic hypogonadism (HH) and those with polycystic ovary syndrome (PCOS) and normo-ovulatory women undergoing fresh embryo transfer or frozen embryo transfer (FET). Design: Retrospective cohort study. Setting: Academic medical center. Patient(s): Patients with oligoanovulation (HH, n = 47; PCOS, n = 533) and normo-ovulation (tubal factor infertility, n = 399) undergoing in vitro fertilization and intracytoplasmic sperm injection cycles from January 1, 2012, to June 30, 2019. Intervention(s): None. Main Outcome Measure(s): Live birth rate. Result(s): Patients with HH had longer stimulation durations than both patients with PCOS and tubal factor infertility. Patients with HH had fewer oocytes retrieved than patients with PCOS, but their numbers of blastocysts were similar. Patients with HH and tubal factor infertility had similar numbers of oocytes retrieved and blastocysts. In fresh embryo transfer cycles, the live birth rates were similar among patients with HH, PCOS, and tubal factor infertility (37.5% vs. 37.1% vs. 29.3%, respectively). When evaluating FET cycles, patients with HH had lower live birth rates than patients with PCOS (26.5% vs. 46.7%) and tubal factor infertility (42.6%). Conclusion(s): Live birth rates are similar among patients with HH, PCOS, and normo-ovulation undergoing fresh embryo transfer but are significantly lower in women with HH undergoing FET.

Lianyong Liu, Xinglu Zhou, Juan Chen et al.

IntroductionMetabolic syndrome-associated cardiovascular disease (MetS-CVD) is a cluster of metabolism-immunity highly integrated diseases. Emerging evidence hints that mitochondrial energy metabolism may be involved in MetS-CVD development. The physiopathological role of ATP5MG, a subunit of the F0 ATPase complex, has not been fully elucidated.MethodsIn this study, we selected ATP5MG to identify the immunity-mediated pathway and mine drugs targeting this pathway for treating MetS-CVD. Using big data from public databases, we dissected co-expressed RNA (coRNA), competing endogenous RNA (ceRNA), and interacting RNA (interRNA) genes for ATP5MG.ResultsIt was identified that ATP5MG may form ceRNA with COX5A through hsa-miR-142-5p and interplay with NDUFB8, SOD1, and MDH2 through RNA–RNA interaction under the immune pathway. We dug out 251 chemicals that may target this network and identified some of them as clinical drugs. We proposed five medicines for treating MetS-CVD. Interestingly, six drugs are being tested to treat COVID-19, which unexpectedly offers a new potential host-targeting antiviral strategy.ConclusionCollectively, we revealed the potential significance of the ATP5MG-centered network for developing drugs to treat MetS-CVD, which offers insights into the epigenetic regulation for metabolism-immunity highly integrated diseases.

R. Short, M. Greenwade, A. Bonebrake

Katherin Faviola Moreno Reyes, Félix Dasio Ayala Peralta, Carlos Velasquez Vasquez

La infección por el virus de la inmunodeficiencia humana (VIH) continúa siendo un problema de salud perinatal a nivel global y en nuestro país, por el incremento de contagio en mujeres embarazadas que corren el riesgo para la transmisión vertical del VIH hacia su bebé durante el embarazo, parto y lactancia materna. Diversas publicaciones mencionan que la prevalencia de transmisión vertical del VIH varía según distintos autores entre 3,8% a 17 %. En el Perú se reporta en 4%. Entre los factores de riesgo asociados a transmisión vertical del VIH se mencionan: ausencia de terapia antirretroviral durante la atención prenatal con razón de posibilidades ajustada (ORa) que varían entre 2,41 a 17,20; ausencia de programa de prevención de la transmisión de madre a hijo del VIH con ORa de 4,6 a 40,6; ausencia de control prenatal ORa 4,6; parto domiciliario con ORa de 3,35 a 8,10; parto por cesárea de emergencia con OR de 4,32; ausencia de profilaxis antirretroviral al recién nacido ORa de 3,4 a 5,83 y alta carga viral en el embarazo entre  4,0 % a 8,5%.

Susan D. Brown, Monique M. Hedderson, Samantha F. Ehrlich et al.

Abstract Background Excess gestational weight gain (GWG) is common among women with overweight or obesity, increasing their risks for pregnancy complications, delivering a large infant, and postpartum weight retention. To date, only intensive interventions have had success and few interventions have been designed for implementation in healthcare settings. Methods We describe the development, rationale, and methods of GLOW (GestationaL Weight Gain and Optimal Wellness), a randomized controlled trial evaluating the efficacy of a lifestyle intervention to prevent excess GWG among racially/ethnically diverse women with overweight or obesity in an integrated healthcare delivery system. Participants in Kaiser Permanente Northern California will be randomized, within 2 weeks of completing a study baseline clinic visit at 10 weeks’ gestation, to either usual medical care or a multi-component pregnancy lifestyle intervention adapted from the Diabetes Prevention Program (target N = 400). Informed by focus groups with patients and designed to be feasible in a clinical setting, the intervention will include 13 weekly individual sessions (11 delivered by telephone) focused on behavior change for weight management, healthy eating, physical activity, and stress management. Outcomes will be assessed in women and their infants from randomization to 12 months postpartum. The primary outcome is GWG. Secondary outcomes include changes in diet and physical activity during pregnancy and infant birthweight. Exploratory outcomes include cardiometabolic profile assessed via pregnancy blood samples and cord blood samples; and postpartum weight retention and infant anthropometrics up to 12 months of age. The trial includes systematic approaches to enhance intervention fidelity, intervention adherence, and participant retention in trial assessments. Discussion GLOW is among few trials targeting excess GWG among diverse women with overweight or obesity in a healthcare setting, with long-term maternal and infant outcomes assessed up to 12 months after delivery. This evaluation of a multi-component intervention is designed to produce generalizable results to inform potential adoption of the intervention in clinical settings. Trial registration ClinicalTrials.gov (NCT02130232): submitted April 30, 2014; posted May 5, 2014.

Guodong Zhang, Jijun Li, Jun Tang et al.

Abstract Background The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP). Methods A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. The 24 patients were divided into two groups based on whether they underwent technically successful collateral embolization (UAE-SCE group) or failed collateral embolization (UAE-FCE group) in addition to UAE. The baseline characteristics and clinical outcomes including time for serum β-human chorionic gonadotropin (β-hCG) levels normalization, blood loss, secondary anemia, and pelvic pain were compared between the two groups. The paired t test and Man Whitney test were used for comparisons of discrete and numerical variables, respectively. Results Collateral embolization was techinically successful in 16 (66.7%, 16/24) patients and failed in the other 8 (33.3%, 8/24) patients. There were no significant differences between the two groups in baseline characteristics. The mean blood loss and secondary anemia in the UAE-SCE group were significantly less than UAE-FCE group. No significant difference was found between the two groups in the mean time for β-hCG levels normalization and pelvic pain. Conclusions During the management of UAE combined with hysteroscopic curettage for CSP, additional embolization of non-gonadal collateral supplying GS during UAE is feasible and safe in patients with non-gonadal collateral supplying GS, and the additional embolization of the collateral may reduce blood bloss related to hysteroscopic curettage.

E. V. Matyanova, N. M. Kosheleva, O. M. Kostareva et al.

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are the most common autoimmune rheumatic diseases (RD) that occur mostly in women of childbearing age, and the occurrence of pregnancy is an expected fact. Due to the ongoing disputes over the ethics of maintaining birth rates among an unhealthy population, modern researchers focus attention on studies of the mutual impact of RD and pregnancy, on the safety of pharmacotherapy during conception and gestation, and on the health of the offspring born to female patients with RD.Objective: to evaluate the neonatal outcomes of pregnancy in patients with RA and SLE.Subjects and methods. An investigation was conducted to study the health status of 73 babies born to 72 female patients with RD (76 cases of pregnancy), of whom 29 patients with RA (32 cases of pregnancy) and 43 with SLE (44 cases of pregnancy) were followed up prospectively at the V.A. Nasonova Research Institute of Rheumatology and the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology. The health status of the babies was evaluated in the first year of their life. Supervising neonatologists and pediatricians recorded abnormalities in the newborns and subsequently analyzed using their medical records (extracts from maternity hospitals, children's hospitals, and outpatient cards).Results and discussion. Of the 76 supervised pregnancies, 72 (94.7%) resulted in 73 live births (one twin pregnancy in a patient with SLE). There were three (6.8%) cases of pregnancy loss in the second trimester in patients with SLE having antiphospholipid syndrome (APS) and one (3.1%) case of perinatal death (a boy and a girl from a monochorionic diamniotic twin with reversed arterial perfusion) in a patient with seropositive RA. The height and body weight of all the newborns conformed to gestational age. Patients with RA and SLE compared to the population more often gave birth to low birthweight babies (9.7 and 21.4% versus 60.9 per 1,000 live births in the Russian population). In the groups of mothers with RA and SLE, their infants had a high Apgar score of 8–9 at one and five minutes. Various abnormalities were detected in 5 (16.1%) and 15 (35.7%) babies born to mothers with RA and to those with SLE, respectively. Among the neonatal congenital anomalies (malformations), there was patent foramen ovale, patent ductus arteriosus, and hip joint dysplasia, which were more common in the babies born to mothers with SLE having APS and exceeded the population-based incidence of these anomalies. The babies were more commonly diagnosed with congenital pneumonia than those in the population; there were single cases of umbilical hernia, hemangioma, thrombocytopenia, hemorrhagic disease of the newborn, perinatal encephalopathy, and congenital hearing loss.Conclusion. The mothers with RA and SLE more often gave birth to low birthweight babies than did those in the population. The infants born to mothers with RA and SLE had significantly more frequently congenital heart defects (patent foramen ovale, patent ductus arteriosus) and congenital pneumonia. The detected abnormalities were more common in the newborns born to mothers with SLE having APS. Maternal RA and SLE activities and/or performed therapy were not found to have a negative impact on the incidence of abnormalities in babies.

M. Patabendige, G. Barnasuriya, I. Mampitiya

Antiphospholipid syndrome (APS) is associated with vascular thrombosis and pregnancy complications. It causes recurrent miscarriage and it is associated with other adverse pregnancy outcomes such as preterm delivery, intrauterine growth restriction, preeclampsia, and HELLP syndrome. Obstetric morbidity is one of the major manifestations of APS with a wide variety of clinical manifestations. This case describes a case of a severe preeclampsia in a 16-year-old primigravida at 29 weeks resulting in a caesarean delivery and subsequent finding of an ulnar artery thrombosis in postpartum period. APS was diagnosed on further investigations of her symptoms and signs.

Jessica N. DiBari, Stella M. Yu, Shin M. Chao et al.

This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB) study (N = 4,075) were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women’s health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women’s health care.

فریده صالحی, حمید معرفتی, شهرزاد عربپور et al.

مقدمه: سندرم پیش از قاعدگی و دیسمنوره از شایعترین اختلالات قاعدگی دختران جوان است که غیبت کوتاه مدت از مدرسه، دانشگاه یا محل کار را به دنبال دارد. با توجه با اینکه مطالعات محدود با نتایج متناقض در این زمینه انجام شده، مطالعه حاضر با هدف مقایسه سندرم پیش از قاعدگی و دیسمنوره اولیه در دانشجویان فعال و غیر فعال انجام شد. روشکار: این مطالعه توصیفی- مقایسه ای در سال 1390 با انتخاب 80 دانشجوی دختر (40 نفر فعال، 40 نفر غیر فعال) با دامنه سنی 18 تا 25 سال از میان 1700 دانشجو، انجام گرفت. گروه فعال افرادی بودند که حداقل به مدت یک سال، سه جلسه در هفته فعالیت ورزشی منظم داشته؛ و افراد گروه غیرفعال عضو هیچ تیم ورزشی نبوده و یا فعالیت ورزشی منظمی نداشتند. گردآوری دادهها با استفاده از پرسشنامه سنجش علائم سندرم پیش از قاعدگی و دیسمنوره اولیه و تجزیه و تحلیل دادهها با استفاده از آزمون های آماری تی مستقل و کای دو انجام شد. مقادیر p کمتر از 0/05 معنی دار در نظر گرفته شد. یافتهها: در رابطه با علائم سندرم پیش قاعدگی از نتایج مطالعه حاضر نشان داد که دانشجویان فعال، علائم جسمی (p

Luis Távara Orozco

Jhenifer Kliemchen Rodrigues, Luciana Azôr Dib, Rui Alberto Ferriani et al.

OBJETIVO: comparar os níveis séricos de cinco marcadores de estresse oxidativo e os resultados de reprodução assistida (RA), entre pacientes com infertilidade por fator tubário e/ou masculino e portadoras de síndrome dos ovários policísticos (SOP). MÉTODOS: foram inclusos 70 pacientes, sendo 58 com infertilidade por fator tubário e/ou masculino e 12 com SOP, que foram submetidas à estimulação ovariana controlada para realização de injeção intracitoplasmática de espermatozoide (ICSI). A coleta de sangue foi realizada entre o terceiro e o quinto dia do ciclo menstrual, no mês anterior à realização da estimulação ovariana. Foram analisados os níveis de malondialdeído, hidroperóxidos, produtos de oxidação proteica, glutationa e vitamina E, pela leitura da absorbância em espectrofotômetro e por cromatografia líquida de alta eficiência (HPLC). Para a análise estatística, utilizou-se o teste t de Student e o teste exato de Fisher. RESULTADOS: entre as pacientes com SOP, foi constatado maior índice de massa corporal, volume ovariano e número de folículos antrais e uma menor dose total utilizada de hormônio folículo estimulante. Não observamos diferença em relação à resposta à estimulação ovariana, aos resultados de RA e aos níveis séricos de malondialdeído, hidroperóxidos, produtos de oxidação proteica, glutationa e vitamina E entre os grupos. CONCLUSÕES: no estudo não evidenciamos diferença entre os níveis séricos de marcadores de estresse oxidativo, nem nos resultados de RA, comparando pacientes inférteis não-obesas com SOP e controles. Estes dados sugerem que, neste subgrupo específico de portadoras de SOP, os resultados de RA não estejam comprometidos. Todavia, as interpretações acerca da ação do estresse oxidativo sobre os resultados de RA ainda não estão claras e as implicações reprodutivas do estresse oxidativo precisam ser mais bem avaliadas.<br>PURPOSE: to compare the serum levels of five markers of oxidative stress and assisted reproduction (AR) outcomes among infertile patients, with tubal and/or male factor and with polycystic ovary syndrome (PCOS). METHODS: 70 patients were included, 58 with tubal and/or male factor infertility and 12 with PCOS, who underwent controlled ovarian stimulation to perform intracytoplasmic sperm injection (ICSI). A blood sample was collected between the third and fifth day of the menstrual cycle in the month prior to ovarian stimulation. We analyzed the levels of malondialdehyde, hydroperoxides, protein oxidation products, glutathione and vitamin E, by reading the absorbance with a spectrophotometer and by high performance liquid chromatography (HPLC). Data were analyzed statistically by the Student's t-test and Fisher's exact test. RESULTS: significant increases in the body mass index, ovarian volume and number of antral follicles were observed in PCOS patients, as well as the use of a lower total dose of follicle stimulating hormone for these patients. There were no differences in the response to ovarian stimulation, in the results of AR or serum levels of malondialdehyde, hydroperoxides, advanced oxidation protein products, glutathione and vitamin E between groups. CONCLUSIONS: the present data did not demonstrate a difference in the levels of serum markers of oxidative stress or in AR results when comparing non-obese infertile patients with PCOS and controls. These data suggest that the results of AR may not be compromised in this specific subgroup of patients with PCOS. However, interpretations of the action of oxidative stress on the results of AR are still not clear and the reproductive implications of oxidative stress need to be better evaluated.

A. G. King

D. Maulik