Patients with systemic lupus erythematosus have a poor prognosis of pregnancy, since it is associated with significant maternal and fetal morbidity, including spontaneous miscarriage, pre-eclampsia, intrauterine growth restriction, fetal death and pre-term delivery. We report a case with successful pregnancy in a patient with systemic lupus erythematosus and hypertension.A 39-year-old nulliparous woman presented with systemic lupus erythematosus with antinuclear and antiphospholipid antibodies, hypertension and recurrent pregnancy loss presented for assisted reproduction. The patient responded well to enoxaparin and prednisone during both assisted reproduction and prenatal treatment.This case report indicates that prescription of immunosuppressant and blood thinners can be safely recommended throughout the whole prenatal period in patients with systemic lupus erythematosus. Enoxaparin and prednisone may be prescribed concurrently during pregnancy.

Objective: To describe embryonic profile up to blastocyst stage in a time-lapse system. Methods: A retrospective, longitudinal, analytical study of patients submitted to in vitro fertilization. The embryos were grouped according to the degree of expansion, internal cell mass and trophectoderm classification, the morphokinetic parameters were associated with the time periods stated in each evolution phase. Results: The appearance of a second polar corpuscle (CPap) occurred earlier in the embryos classified as excellent (2.99h; p <0.05), in relation to the embryos classified as good (3.40h), average (3.48h) and poor (3.55h). The embryos classified as excellent took less time for the pronuclei to disappear (PNbd) (21.80h; p <0.05), when compared to the good embryos (22.96h), the average (23.21h) and the poor (23.47h). As for the morphokinetic parameter, the end of the two-cell division (T2) occurred first in the excellent blastocysts (24.38h; p <0.05), when compared to the other groups: good (25.57h), average (25.53h) and poor (25.78h). With respect to synchronization with the division of three to four cells (S2), the poor embryos presented longer times for such division to occur (3.67h; p <0.05). When compared to the embryos from the groups excellent (1.97h), good (2.70h) and average (2.09h). At the time point of the blastocoel formation (TB), the excellent embryos (104.04h) did not differ from the good embryos (104.10h). However, when compared to average (107.27h) and poor (106.86h) embryos, there was statistical significance ( p <0.05). Conclusions: Embryos of better quality had a shorter time in some morphokinetic parameters when compared to the other groups, thus increasing the possibilities to establish new parameters for the classification and selection of embryos.

Objective: The present study aims at evaluating the results obtained after in vitro fertilization in bad responders, using controlled ovarian hyperstimulation together with the use of gonadotrophin releasing hormone (GnRH) antagonist (cetrorelix acetate) in a short protocol.Methods: This is an analytical, longitudinal, retrospective and controlled study involving patients who underwent in vitro fertilization (IVF) procedures in the assisted reproduction program of the Reproferty clinic, in the municipality of São José dos Campos/SP, from January 2012 to December 2016. We collected the data obtained from the medical records of patients considered to have undergone controlled ovarian hyperstimulation using GnRH antagonist (cetrorelix acetate) and Growth Hormone (GH) in a short cycle protocol. The patients considered controls were those submitted to the same hyperstimulation process, without using GH.Results: There were significant differences in the following analyzed parameters: gonadotrophin regimen dose, stimulation duration, and estradiol levels on the day of HCG administration, number of follicles, number of retrieved oocytes, number of mature oocytes and number of good-quality embryos. On the other hand, the GH administration was not significant in the number of cycles that achieved transfer, the number of embryos transferred and the number of frozen cycles. In the case group, there was no increase in the number of cycles that reached pregnancy rate βhCG+; however, the clinical pregnancy rates and live birth rates were significant. Conclusion:The present investigation demonstrated that GH administration as a supplement in poor responders improves the majority of the parameters to achieve a full term pregnancy in these patients.

The objetive of the present study was to investigate the effect of the reduction of blastocele fluid before vitrification with the application of collapsing and the effects of this procedure on the expected results of in vitro fertilization protocols. Methods: A retrospective casecontrol study was conducted with patients who sought assisted fertilization services from January 2015 to October 2017 at Reproferty Clinic. After submission to the ethics committee, data from 106 patients were divided into two groups: 42 cases represented by those who had artificially collapsed blastocysts per laser pulse before vitrification and 64 controls corresponding to patients where artificial shrinkage of expanded blastocysts was not performed. By statistical analysis, the means and standard deviation of each group were obtained, which were compared by the Mann-Whitney test, at a 95% significance level. Results: the results showed that there was statistical significance comparing the group of cases and controls in the parameters related to embryo freezing, survival and transference as well as to the rates of positive beta human chorionic gonadotropin, clinical pregnancy and live births. Conclusions: the study demonstrated evidence that vitrification after artificial laser collapse of the blastocyst is safe, effective, and more efficient than vitrification of non-collapsed blastocysts in vitro fertilization protocols, however further studies are needed to evaluate the efficiency of artificial shrinkage in routine protocols.