Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility and is associated with an increased risk of premature luteinizing hormone (LH) surges during controlled ovarian stimulation. Progestin-primed ovarian stimulation (PPOS) using Medroxyprogesterone Acetate (MPA) has emerged as a convenient alternative to conventional gonadotropin-releasing hormone (GnRH) antagonist protocols. This study aimed to compare the effects of MPA-based PPOS and GnRH antagonist protocols on oocyte yield, maturation, fertilization, and embryo quality in women with PCOS undergoing ICSI . This prospective, randomized, open-label controlled clinical trial included 108 women with PCOS undergoing ICSI at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq, between 2023 and 2024. Participants were allocated to an MPA-based PPOS group (n=49) or a flexible GnRH antagonist group (n=59). Oocyte yield, metaphase II (MII) oocytes, fertilization rate, embryo quality, ovarian sensitivity index (OSI), gonadotropin consumption, stimulation duration, and LH profiles were evaluated.No significant differences were observed in baseline characteristics or hormonal profiles between groups. The MPA group showed a numerically higher number of retrieved oocytes (20.65 ± 7.50 vs. 13.39 ± 4.41; p=0.083) and MII oocytes (15.10 ± 5.20 vs. 11.24 ± 4.12; p=0.09), although these differences were not statistically significant. Fertilization rates were comparable between groups (72.4 ± 10.6% vs. 71.2 ± 11.3%; p=0.68), as were embryo quality, OSI, gonadotropin consumption, and stimulation duration. Both protocols effectively suppressed premature LH surges without premature ovulation or cycle cancellation. MPA-based PPOS appears to be an effective and practical alternative to GnRH antagonist protocols for PCOS patients undergoing ICSI, providing comparable fertilization and embryological outcomes with effective LH suppression. Its oral administration and potential cost advantages may be particularly valuable in resource- limited ART settings.
Monosodium glutamate (MSG) is a widely used flavor enhancer in many foods. However, excessive consumption during pregnancy may adversely affect embryonic development and reproductive functions. This study aimed to investigate the effects of maternal MSG consumption during pregnancy on pregnancy outcomes and the reproductive system of female offspring in mice. Thirty adult pregnant female mice, aged 42–49 days, were used in this study. The animals were equally divided into two groups: an experimental group (G1) and a control group (G2). The experimental group received MSG extract orally at a dose of 1 mg/kg body weight dissolved in 1 ml of distilled water (D.W.) throughout the three weeks of pregnancy, whereas the control group received 1 ml of distilled water alone for the same duration. After delivery, litter size and litter weight were recorded. Forty days after birth, the weights of the female reproductive organs were measured, and the diameters of the ovaries and oviducts were assessed. In addition, blood samples were collected for the evaluation of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels in both groups. The experimental group showed a significant reduction in litter size and a significant decrease in litter weight compared with the control group. Female offspring born to MSG- treated mothers also exhibited a significant decrease in reproductive organ weight, ovarian diameter, and oviduct diameter. Furthermore, significant reductions in the levels of FSH, LH, and estradiol were observed in the experimental group. Maternal consumption of MSG during pregnancy may negatively affect pregnancy outcomes and impair the development and function of the reproductive system in female offspring.
Iraq is one of the countries that have suffered from decades of heavy conflict, industrial activity, and little environmental regulation. As a result, notable environmental degradation has occurred. Urban environments, in particular, suffer severely from air pollution, which may be affecting reproductive health outcomes .This study examined the environmental pollution rates and infertility rates in 5 large urban areas in Iraq from 2019- 2023 .A cross-sectional ecological study was conducted across five large Iraqi cities. Air pollution data were obtained from monitoring stations and included PM2.5, PM10, NO2, SO2, and O3 measurements. Infertility rates were obtained from hospital records and fertility clinics. Statistical analysis was conducted employing Pearson correlation coefficients and multiple regression models .Overall, we found strong positive relationships between air pollution and infertility rates in both men (r=0.73, p<0.001) and women (r=0.68, p<0.001) with respect to PM2.5 concentrations. NO2 levels were also associated with decreased sperm quality parameters (r=-0.61, p<0.01). In areas where PM2.5 concentrations were >50 μg/m3, the infertility rates were 34% higher than those in areas with lower PM2.5 concentrations. Higher air pollution levels in urban Iraqi cities show associations with reproductive health outcomes. Meaning, there is an urgent need to address environmental health and policy reform in Iraq.
Preeclampsia-eclampsia still continues to be one of the major causes of maternal and fetal mortality and morbidity. Recent evidence suggests that there may be several underlying causes or predispositions leading to develop this syndrome, which not only affects the mother but significantly affects the fetal growth and development.The objective of the study was to assess the difference in birth weight in pregnancy with and without preeclampsia . A case – control study at Al-kadhmya teaching hospital The study included 200 pregnant women with singleton viable gestation presented in labor who were admitted to hospital.A comparison of 100 women in the preeclamptic group and 100 women in the non-preeclamptic group in terms of maternal age, parity, gestational age at delivery, placental weight, and fetal birth weight and sex. Detailed obstetric and general medical history was taken and general and obstetric examination performed. The newborn infants were carefully examined and weighed, and the APGAR score was assessed after delivery. The fresh placenta was examined and then weighed with the membranes and cord attached.At low placental weight, preeclampsia had significant association with low birth weight (35%). However, at high placental weight, preeclampsia had non-significant association with high birth weight (4%). Birth weight of neonatal case group was close to birth weight of control group especially at late onset of preeclampsia but this was not significant statistically .Preeclampsia is multisystemic disorder and it is (the disease of theories) these result suggest that preeclampsia may represent different entities with different degree of placental involvement and different degree of fetal growth and development.