Background: Lipids are an important source for energy production during oocyte maturation. The accumulation of intracellular lipids binds to proteins to form lipid droplets. This may lead to cellular lipotoxicity. The impact of lipotoxicity on cumulus and granulosa cells has been reported. This pilot study evaluated their correlation to oocyte and embryo quality. Design: Prospective case-control study. Setting: Referral IVF unit. Patients: Women younger than age 40, undergoing IVF with intracytoplasmic sperm injection. Interventions: 15 women with BMI > 30 (high BMI) and 26 women with BMI < 25 (low BMI) were enrolled. IVF outcomes were compared between groups based on BMI. Lipid content in cumulus and granulosa cells was evaluated using quantitative and descriptive methods. Lipid profile, hormonal profile and C-reactive protein were evaluated in blood and follicular fluid samples. Demographic and treatment data, as well as pregnancy rates were collected from electronic medical records. Results: Higher levels of LDL and CRP, slower cell division rate and lower embryo quality were found in the group with high BMI. There was no difference in pregnancy rates between groups. In light of these findings, treatment outcomes were reanalyzed according to patients who became pregnant and those who did not. We found that patients who conceived had significantly lower fat content in the granulosa cells, reflected by mean fluorescence intensity recorded by flow cytometry analysis (23,404 vs. 9370, P = 0.03). Conclusions: BMI has no effect on lipid content in cumulus and granulosa cells, and does not affect likelihood of pregnancy. However, women who achieved pregnancy, regardless of their BMI, had lower lipid levels in their granulosa cells. This finding is important and further study is needed to evaluate lipid content in granulosa cells as a potential predictor of IVF treatment success.

Gestational diabetes mellitus (GDM) is manifested by carbohydrate intolerance that develops during pregnancy and is associated with adverse maternal and neonatal outcomes. 1 In 2014, the US Preventive Services Task Force made a recommendation to screen all pregnant women for GDM at or beyond 24 weeks of gestation. 2 Screening is generally performed using the two steps approach: a 50-g glucose challenge test (GCT) at 24-28 weeks, followed by a diagnostic 100-g oral glucose tolerance test (OGTT) for those who screen positive. Women with increased risk for GDM (obesity, previous GDM, strong family history of diabetes, or previous macrosomia) are advised to directly undergo the diagnostic OGTT. GDM is classically diagnosed by two or more abnormal

Spontaneous rupture of the uterus during the 2

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