The number of patients with poor ovarian response (POR) for in vitro fertilization (IVF) varies from 9 to 25%, especially high in patients of advanced maternal age. Although various stimulation protocols have been developed to improve clinical outcomes in patients with POR, a typical and effective protocol remains improvement. Some physicians prefer a mild stimulation protocol, while others like hyper stimulation protocol to obtain more eggs. This study was designed to compare the efficiency of a mild stimulation protocol with hyper stimulation protocol in patients with POR, particularly focused on live birth rate after IVF. Data were collected from 30 poor responders (over 39 years old). Patients were assigned to 2 protocols at the start of ovarian stimulation: Patients in group A were treated with a hyper stimulation (GnRH-antagonist) protocol and patients in group B were treated with a mild stimulation protocol. The ovarian stimulation characteristics, gonadotropin doses, number of eggs collected, number of high quality embryos, clinical pregnancy rates and live birth rates were compared between two groups.Although number of eggs, number of high quality embryos, clinical pregnancy rates were significantly higher in group A than in group B, miscarriage rate was also higher in group A than group B, which eventually resulted in a similar live birth rate (6.7%) in both groups. However, dosages of gonadotropins were smaller and stimulation days were shorter in group B than in group A. When poorly responding patients were treated for IVF, similar live birth rates were observed with mild stimulation protocol and hyper-stimulation protocol. After considering the higher dosages of gonadotropins and longer stimulation days in patients with hyper-stimulation protocol, it is suggested that poor responders may benefit with the mild stimulation protocol for IVF. Show less

The currently reported study employed the curiously named (but simple) quantitative, nondestructive technique of Multiple Attenuated Internal Reflection InfraRed (MAIR-IR) spectroscopy to assess daily variations of both saliva and vaginal secretions from a panel of consenting volunteers. The project goal was to determine whether the protein-to-carbohydrate (starch) ratio, determined by MAIR-IR analysis of salivary and vaginal secretions is an objective measure of the co-variation of mucinous secretions with daily menstrual cycle. Overall, the spectral data were found to provide valid signatures of vaginal mucus chemical changes that also correlated with cyclic periods of presumed fertility, such periods exhibiting repeat times of 14-16 days and 27-29 days in the thoroughly analyzed records. At mid-cycle, associated with ovulatory events, the protein-to-carbohydrate ratio of vaginal mucin maximizes. Higher carbohydrate ratios are associated with stiffer cervical mucus plug formation, which usually prevents infection, spontaneous abortion, and pre-term birth, but may also be responsible for infertility. Mucin relaxation compounds, such as the FDA-approved oral rinse, delmopinol, may induce fertility in such cases.   Show less

This preliminary study explores misoprostol as a preventive strategy for ovarian hyperstimulation syndrome. It outlines rationale, dosing considerations, and early safety signals, and calls for controlled trials to establish efficacy and risk–benefit. Show less

A novel technological innovation called Elective Oocyte Freezing (EOF) has emerged as a solution for women who wish to preserve their fertility to delay childbearing for non-medical reasons. This technology has grown in popularity as women have undertaken a greater role in the workforce and faced the dilemma of balancing work and family. In spite of the rising trend of Singaporean women postponing childbearing to advance their careers, EOF is currently prohibited in Singapore. Many Singaporean individuals have declared this policy to be both outdated and a threat to women’s reproductive rights. However, prior to this survey, no research, to my knowledge, has analyzed Singaporean female professionals' interests in EOF, if made available. Through this quantitative, cross-sectional, 4-part survey, I conclude that if EOF was permitted, encouraged, and subsidised by the Singaporean government, Singaporean women possess a strong interest in freezing their eggs for social purposes This paper further demonstrates an existing positive relationship between 48 Singaporean female professionals’ interest in EOF prior to and following reading an information leaflet. Specifically, after being informed of the social benefits presented by EOF, participants were significantly more inclined to freeze their eggs if such practice was permitted in Singapore. This conclusion suggests that the Singaporean government should re-evaluate their position on EOF in order to facilitate childbearing dilemmas faced by the increasing number of women entering the country’s workforce each year. Additionally, as this policy is currently a subject of debate in Singapore, the implications of this research, revealing Singaporean female professionals’ interest in EOF, create a foundation for both future research and the possible evaluation of this policy. If this conclusion is corroborated with subsequent research, further evidence may substantiate my findings regarding the desires of Singaporean women and possibly result in a change of legislation. Show less