Reprod. Med., Volume 1, Issue 3 (December 2020) – 6 articles

While standardized national residency education curricula have been successfully implemented in other specialties, there is no such curriculum in Obstetrics & Gynecology (Ob/Gyn). With this study, we sought to evaluate: (1) the current state of and satisfaction with resident didactic education (2) perceptions regarding centralization and standardization of resident didactic education and (3) the need for a standardized national Ob/Gyn residency education curriculum. In 2019, a web-based needs assessment survey was administered to residents and program leadership from all 267 Ob/Gyn residency programs nationwide. Main outcomes were reported with descriptive statistics. A total of 782 (83 program directors, 46 assistant program directors, and 653 residents) participants completed the survey. Respondents represented a diverse range of regions, program types, and program sizes. Almost all (97%) participants agreed or strongly agreed that residents nationwide should have equal access to high quality Ob/Gyn educational resources. Further, 92% agreed or strongly agreed that core resources should be centrally located. A majority (78%) agreed or strongly agreed that there is a need for a national Ob/Gyn residency education curriculum. Our results demonstrate a perceived need for a centrally located, standardized, national residency education curriculum in Ob/Gyn. Full article

Background: Dysmature cumulus cells are lower fertilization rates and abnormalities in embryonic development compared to maturation cumulus cells. Morphological evaluation of cumulus–oocyte complexes (COCs) considered the possibility that differences may also be found in gene expression. Purpose: To identify hallmarks for evaluating oocyte quality by investigating gene expression patterns in human cumulus cells surrounding oocytes. Methods: Cumulus cells were obtained from the cumulus–oocyte complex of infertile women treated with assisted reproductive technology. Based on maturity level, the cumulus cells were classified into two categories, i.e., dysmature cumulus cell (DCC) and maturation cumulus cell. DCCs were subjected to gene expression analysis using next-generation sequencing and compared with COCs that are in the process of maturation as controls. Results: The expression levels of genes involved in the Wnt signal/β-catenin pathway were significantly reduced in DCCs compared with those in control cells. Moreover, the expression levels of genes involved in multiple pathways associated with apoptosis were also significantly reduced compared with those in control cells. Conclusions: DCCs showed significant decreases in apoptosis- and Wnt/β-catenin signaling-associated gene expression. DCCs could be classified by morphological evaluation, and the method described in this study may be useful as an oocyte quality estimation tool. Full article

At the completion of training in obstetrics and gynecology (Ob/Gyn), residents are expected to have comprehensive knowledge of the field. However, there is no comprehensive Ob/Gyn residency education curriculum. We hypothesize that there is a need for a standardized curriculum. A needs assessment survey was administered to determine the current state of resident didactic education, the perceptions that Ob/Gyn residents, program directors (PDs), and assistant program directors (APDs) have regarding centralization and standardization of education, and the need for a standardized Ob/Gyn residency education curriculum. In 2019, a web-based survey was distributed to Ob/Gyn residents and program leadership from three institutions. The main outcomes were measured on a 5-pt Likert scale. A total of 50 (3 PDs, 5 APDs, and 42 residents) participants completed the survey with a response rate of 68% (50/73). Almost all (94%) participants agreed or strongly agreed that residents nationwide should have equal access to high-quality Ob/Gyn educational resources. Further, 92% agreed or strongly agreed that core Ob/Gyn resources should be centrally located. A majority, 76%, agreed or strongly agreed that there is a need for a national curriculum. This study demonstrates a perceived need for a centrally located, standardized Ob/Gyn residency education curriculum. Full article

The aim of this study was to build an Artificial Neural Network (ANN) complemented by a decision tree to predict the chance of live birth after an In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) treatment, before the first embryo transfer, using demographic and clinical data. Overall, 26 demographic and clinical data from 1193 cycles who underwent an IVF/ICSI treatment at Centro de Infertilidade e Reprodução Medicamente Assistida, between 2012 and 2019, were analyzed. An ANN was constructed by selecting experimentally the input variables which most correlated to the target through Pearson correlation. The final used variables were: woman’s age, total dose of gonadotropin, number of eggs, number of embryos and Antral Follicle Count (AFC). A decision tree was developed considering as an initial set the input variables integrated in the previous model. The ANN model was validated by the holdout method and the decision tree model by the 10-fold cross method. The ANN accuracy was 75.0% and the Area Under the Receiver Operating Characteristic (AUROC) curve was 75.2% (95% Confidence Interval (CI): 72.5–77.5%), whereas the decision tree model reached 75.0% and 74.9% (95% CI: 72.3–77.5%). These results demonstrated that both ANN and decision tree methods are fair for prediction the chance of conceive after an IVF/ICSI cycle. Full article

During the gestational period, women need to have optimal health to meet fetal requirements for growth and development. Nutrition is one of the most important factors that can ensure a mother`s health and also that of their offspring. The role of maternal diet, before and during pregnancy, has been associated with adverse birth outcomes and a worsening of maternal health. Medical conditions that are closely related to dietary intake and may affect women before or during pregnancy have also been associated with the appearance of pathology in a newborn. To date, several studies have been carried out in order to identify the role of diet as a factor associated with child physiological and psychological health, both in the short and long term. Educating mothers regarding the influence of maternal dietary intake during pregnancy on infants’ health could represent a simple but effective target for public health policies to improve pregnancy nutrition, and therefore help to avoid newborn diseases through the development. Full article

Decidual vasculopathy at late gestation was shown to be associated with spiral artery remodeling at implantation. Dramatic decidual vascular transformation from early to late stage pregnancy suggests a dynamic spatiotemporal relationship between the various vascular components in spiral artery remodeling and decidual vasculopathy. The central and peripheral portions of 105 placentas with decidual vasculopathy at term were examined with or without preeclampsia to see if temporal vascular regeneration was present. Central and peripheral vasculopathy and central and peripheral regeneration were compared. The peripheral portion showed more decidual vasculopathy (88 of total 105, 83.8%) than central portion (72 of total 105, 68.6%, p < 0.0001). However, central portion showed more vascular regeneration (51 of total 105, 48.6%) than the peripheral portion (23 of total 105, 21.9%, p < 0.0001). There was no difference in vasculopathy or regeneration with or without preeclampsia. Spiral artery remodeling is non-synchronous during placental growth and vascular regeneration. This spatiotemporal sequence may help interpretation of morphologic changes of decidual vasculopathy. Full article