Background: Cell-free fetal DNA (cffDNA) is a novel screening method for fetal aneuploidy that facilitated non-invasive prenatal testing (NIPT) through analysis of cffDNA in maternal plasma. However, despite increased sensitivity, it has a number of limitations that may complicate of its results interpretation. Therefore, elucidating factors affecting fetal fraction, as a critical limitation, guides its clinical application. Methods: In this report, systematic search was carried out through PubMed, Web of Science, and Scopus databases until February 11, 2022 by using keywords consist of "noninvasive prenatal screening", "NIPT", "noninvasive prenatal", "cell free DNA" and "fetal fraction". The articles were screened for eligibility criteria before data extraction. Results: A total of 39 eligible studies, most published between 2010 and 2020, were included. Based on the results of studies, a negative correlation between maternal age and BMI/body weight with fetal fraction was found. Furthermore, LDL, cholesterol, triglyceride level, metformin, heparin and enoxaparin therapy, hemoglobin-related hemoglobinopathies, and physical activity showed to have negative associations. Interestingly, it seems the ethnicity of patients from South and East Asia has a correlation with fetal fraction compared to Caucasians. Positive correlation was observed between gestational age, free β-hCG, PAPP-A, living in high altitude, and twin pregnancy. Conclusion: Considering each factor, there was significant inconsistency and controversy regarding their impact on outcomes. Indeed, multiple factors can influence the accuracy of NIPS results, and it is worth noting that the impact of these factors may vary depending on the individual’s ethnic background. Therefore, it is important to recognize that NIPS remains a screening test, and comprehensive pre- and post-NIPS counseling should be conducted as part of standard clinical practice

Preeclampsia (PE) is a complex pregnancy disorder characterized by hypertension and organ dysfunction, significantly impacting maternal and fetal health. This systematic review investigates the epigenetic modifications, specifically DNA methylation patterns, in placental tissue from PE pregnancies. We conducted a comprehensive literature search across multiple databases including PubMed, Scopus, Web of Science, and Embase for studies published up to November 2024. The review analyzed genome-wide methylation studies and gene-specific methylation patterns in placental tissue, revealing significant differential methylation in numerous genes and pathways associated with PE pathogenesis. Our findings highlight distinct methylation profiles between early-onset and late-onset PE, tissue-specific methylation patterns within the placenta, and potential therapeutic and diagnostic implications. This review contributes to understanding the epigenetic mechanisms underlying PE and identifies promising biomarkers for early detection and intervention strategies.

Background: The emergence and fast spread of coronavirus disease 2019 (COVID-19) threatens the world as a new public health crisis. Little is known about its effects during pregnancy. This study aimed to investigate the clinical manifestations of COVID-19 on maternal and neonatal outcomes. Methods: In this systematic review, PubMed, Scopus, Web of Science, and Google Scholar databases were searched focusing on pregnancy and perinatal outcomes of COVID-19. Results: The initial search yielded 1236 articles, from which finally 21 unique studies, involving 151 pregnant women and 17 neonates, met the criteria. Mean ± SD age of included mothers and mean ± SD gestational age at admission were 30.6 ± 6.2 years and 30.8 ± 8.9 weeks, respectively. The common symptoms were fever, cough, fatigue, dyspnea and myalgia. The mortality rates of pregnant women and neonates were 28 out of 151 (18.5%) and 4 out of 17 (23.5%), respectively. Most of the neonates were preterm at the time of delivery. Three neonates had positive RT-PCR test on the first day after birth and three others on day two. On the average, neonate’s PCR became positive on day 4 for the first time. Conclusion: Early diagnosis of COVID-19 is crucial due to the possibility of the prenatal complications. Strict prevention strategies may reduce the risk of mother to infant transmission.

Background: Assisted reproductive technologies (ARTs) have been implemented in Iran for nearly thirty years. However, except for embryo donation, none of the other cases, including embryo and sperm donation have not yet been legalized through parliamentary resolutions. This study aims to explore the challenges of these three types of donations from the perspective of fertility experts. Methods: This qualitative exploratory research was conducted in Tehran in 2024. Participants consisted of 12 specialists with experience in infertility treatment or other fields related to embryo, sperm and egg donation, who were selected through purposive sampling. Data were collected via focus group discussions and analyzed based on conventional content analysis using MAXQDA 20. Results: Data were classified into 12 categories. Eight categories describe the challenges and problems of egg, sperm, and embryo donation and 4 categories describe the solutions recommended by experts. Conclusion: According to the study findings, sperm donation faces the most legal and medical challenges compared to egg and embryo donation. Designing a comprehensive national protocol could be the best solution proposed to Iranian health policymakers. Conducting more qualitative and mixed methods studies related to sperm, egg, and embryo donation could confirm and strengthen the findings of this study.

Vitrification has important application in assisted reproductive technology (ART) and this technique has been widely used in the cryopreservation of oocytes and embryos. However, due to susceptibility of epigenetic modifications to environmental changes induced by cryopreservation procedures, there are concerns about the potential epigenetic consequences of oocyte and embryo vitrification. This review comprehensively summarized the effect of cryopreservation—especially the vitrification method in ART-on oocytes and embryos. Various studies have reported changes in different aspects of genomic status which directly affect the quality of fertilized embryos. The objective of this review is to assess existing literature on the epigenetic modifications that occur in vitrified oocytes and early embryos resulting from oocyte vitrification, including DNA modifications, RNA methylation, histone modification and microRNAs related to ART.