Fertility - the ability to produce offspring - is considered a prerequisite for the development and perpetuation of species. Several factors may positively or negatively affect one's reproductive capabilities, such as regular exercises and maintaining a healthy bodyweight, versus aging, obesity, and stress. Follicular fluid (FF) is a liquid composed primarily of hormones, enzymes, anticoagulants, electrolytes, reactive oxygen species and antioxidants, which fills the follicular antrum and acts as an important mediator in the communication between cells in the antral follicle while bathing and carrying nutrients to the oocyte. Thus, human FF is a key element to the success of natural fertilization present in every stage of the conception process, from the communication between gametes to the development of fully viable embryos, and a vital component in the occurrence of spontaneous pregnancies. This literature review aimed to describe the possible effects of human follicular fluid on the natural fertilization process and to assess its role in follicular growth, oocyte quality, sperm capacitation, fertilization, and early embryonic development.

Our findings showed that the characteristics associated with IUC expulsion were age under 25 years, having had less than two deliveries and being users of Cu-IUD.

The mean CM score of all evaluations, independent of the length of use of the LNG-IUS and normal levels of serum E2, was below 10 was according to the WHO is inadequate for sperm penetration.

Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera®, Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA. Cumulative termination rates due to sterilization or because the woman had reached menopause were computed using single decrement life-table analysis over 32 years. We also examined all records of surgical sterilization at our hospital between the years 1980-2012. Results Three hundred thirty-two women had continuously used the same contraceptive until menopause, and 555 women had discontinued the method because they or their partners underwent sterilization. From year 20 to year 30 of use, levonorgestrel intrauterine-releasing system (LNG-IUS -Mirena®, Bayer Oy, Turku, Finland; available since 1980), copper intrauterine device (IUD -available since 1980) and DMPA users showed a trend of cumulative higher discontinuation rates due to menopause when compared with the discontinuation rates due to sterilization. Over the study period, a steep decline in the use of sterilization occurred.

ResumenAntecedentes: se ha reportado mayor riesgo de trombosis y eventos clínicos en pacientes que reciben bioprótesis luego de sustitución quirúrgica de la válvula aórtica, o del implante transcatéter (TAVI). Objetivo: evaluar si el uso de anticoagulación oral (ACO), como mínimo por 90 días, disminuye o previene la aparición de eventos clínicos tromboembólicos o trombosis subclínica, en pacientes con sustitución valvular aórtica biológica. Evaluar el sangrado y mortalidad asociados con esta estrategia. Método: se efectuó una búsqueda de artículos en bases de datos PubMed, Cochrane Central, Biblioteca Cochrane y SciELO. Los términos utilizados fueron: "Anticoagulation AND aortic bioprosthesis" y "Anticoagulation AND TAVI OR TAV". Se establecieron criterios de inclusión y exclusión, y se realizó el análisis de eventos clínicos y subclínicos por separado. El estadístico utilizado fue odds ratio (OR). Se usó un modelo de efectos randomizados para calcular el estadístico y su intervalo de confianza (IC) de 95%. Los resultados del metaanálisis se presentaron como diagrama de bosque. Consideramos significativa una p<0,05. Resultados: se identificaron 233 artículos; seleccionando ocho para trombosis clínica y cinco para trombosis subclínica. No se evidenció diferencia significativa en la incidencia de eventos embólicos con el uso de ACO (OR=1,01; IC95%: 0,63-1,61; p=0,98), ni de mortalidad a corto plazo (OR=1,10; IC95%: 0,77-1,56; p=0,61). Se demostró una superior incidencia de sangrados mayores en pacientes que recibieron ACO (OR=1,60; IC95%: 1,04-2,48; p=0,03). El riesgo de trombosis subclínica protésica fue mayor en pacientes que no recibieron ACO (OR=5,52; IC95%: 3,37-9,05; p=0,001). Conclusiones: la ACO se asocia a un menor riesgo de trombosis protésica subclínica aumentando el riesgo de sangrado. En los grupos comparados no existe diferencia en mortalidad o fenómenos embólicos a mediano plazo. Palabras clave:REEMPLAZO DE LA VÁLVULA AÓRTICA TRANSCATÉTER BIOPRÓTESIS TROMBOSIS ANTICOAGULANTES Prevention of prosthetic thrombosis with anticoagulation after aortic valve replacement with bioprosthesis. Meta-analysis Summary Background: increased risk of thrombosis and clinical events has been reported in patients receiving bioprostheses after aortic valve replacement or transcatheter aortic valve implant. Objective: to assess whether the use of anticoagulation for at least 90 days decreases and / or prevents occurrence of thrombo-embolic or subclinical thrombosis in patients with biological aortic valve replacement. To evaluate the incidence of bleeding and mortality associated with this strategy.Methods: we searched articles in databases: PubMed, Central Cochrane, Cochrane Library and SciELO. The terms used were: "Anticoagulation AND aortic bioprosthesis" and "Anticoagulation AND TAVI OR TAVR". Inclusion and exclusion criteria were established, performing the analysis of clinical and subclinical events separately. The statistic used was odds ratio (OR). A randomized effects model was used to calculate the statistic and ...