OAR@UM Community:

In-vitro fertilization outcomes in females of advanced maternal age with polycystic ovarian syndrome

Thu, 01 Jan 2026 00:00:00 GMT

Title: In-vitro fertilization outcomes in females of advanced maternal age with polycystic ovarian syndrome Abstract: Purpose: The aim of the study was to evaluate in vitro fertilization (IVF) outcomes in women of advanced maternal age (≥35 years) diagnosed with polycystic ovarian syndrome (PCOS), compared with age-matched women without PCOS. Given that advancing age is associated with declining ovarian reserve and fertility potential, this research sought to determine whether the hormonal and ovarian characteristics of PCOS confer any advantage in IVF outcomes within this population. Methodology: A retrospective quantitative analysis was conducted by collecting 267 entries from 174 IVF cycles performed at an Assisted Reproductive Technology (ART) Clinic at the main public hospital in Malta between January 2021 and 2024. Key outcome measures included oocyte yield, number of embryos created, clinical pregnancy rates, and viable pregnancy rates at 12 weeks gestation, meaning the pregnancy was still ongoing by the end of the first trimester. Results: Women with PCOS demonstrated significantly higher serum anti-Mullerian hormone (AMH) levels and oocyte yields (mean 12.35 vs. 6.67), alongside increased embryos and clinical pregnancy rates (29.2% vs. 17.8%; p = 0.016), compared with non-PCOS counterparts. However, viable pregnancy rates at 12 weeks didn’t differ significantly (p = 0.615), which could be influenced by the small sample size of sub-groups. Conclusions: Although women of advanced maternal age with PCOS exhibited a preserved ovarian reserve and enhanced initial IVF response, these advantages didn’t translate into higher sustained pregnancy outcomes. Implications for Practice: While further research can improve practice, it is evident that clinicians should provide individualized counselling and design tailored ovarian stimulation protocols for women with PCOS of advanced maternal age to optimize treatment outcomes while mitigating the risk of early pregnancy loss. Description: M.Sc. Radiography(Melit.)

Investigating the role of ultrasound assessment of cervical lenght in asymptomatic women at anomaly scan in Malta

Wed, 01 Jan 2025 00:00:00 GMT

Title: Investigating the role of ultrasound assessment of cervical lenght in asymptomatic women at anomaly scan in Malta Abstract: Purpose: Preterm birth is a major cause of neonatal morbidity and mortality. Although cervical shortening is considered an indicative factor for preterm birth, several aspects about cervical length measurement remain controversial. Objectives: The objectives of this study were to assess cervical length in asymptomatic pregnant women at anomaly scan; compare transabdominal and transvaginal ultrasound assessment; identify any relationship between demographic or clinical characteristics; cervical length or gestation at delivery; and establish a cut-off for cervical length. Methodology: A quantitative, non-experimental, prospective study design was adopted. The cervical length of 79 asymptomatic women was assessed between 19- and 24 weeks’ gestation, using transabdominal and transvaginal ultrasound. Statistical analyses examined correlations between demographic and clinical characteristics, cervical length, and gestation at delivery. Results: Transabdominal and transvaginal cervical length measurements showed a strong positive correlation (p <.001), with no statistically significant difference in mean values (1.19 mm, p = 0.214). Transvaginal cervical length was significantly associated with race-ethnicity, smoking status, termination of pregnancy, uterine anomalies, and mode and gestation at previous delivery. For spontaneous onset deliveries, gestation at delivery was significantly associated with BMI, and previous obstetric complications. For iatrogenic onset deliveries, gestation at delivery was significantly associated with race-ethnicity, smoking status, parity, uterine anomalies, age, and previous obstetric complications. The gestation at delivery was positively correlated with both transabdominal (p = .022) and transvaginal (p = .005) cervical length measurements. Conclusions: Cervical length assessment during the anomaly scan, using the transabdominal approach, may help identify low-risk women at increased risk of preterm birth, especially among Asian women or women who stopped smoking in pregnancy. Targeted cervical length screening may be considered in these women, pending cost benefit analysis. Further research with larger samples is recommended, particularly in women with prior termination of pregnancy or uterine anomalies. Description: M.Sc.(Melit.)

A qualitative analysis of the experience of women who receive a false-positive result at the National Breast Screening Unit

Wed, 01 Jan 2025 00:00:00 GMT

Title: A qualitative analysis of the experience of women who receive a false-positive result at the National Breast Screening Unit Abstract: Background: Women's experiences during breast screening appointments significantly influence their future participation. This study explores the impacts of false-positive results on the overall experience of women attending further investigation clinics in the Malta National Breast Screening Unit (MNBSU). Objectives: The objectives were to examine the effects of false-positive results on women’s emotional experiences and their willingness to re-attend future screenings, to assess the differences if any between non-invasive and invasive follow-up procedures, to evaluate perceptions of the screening programme, and to identify strategies to support women during these experiences. Study Design and Approach: A qualitative exploratory approach was adopted to address a gap in local research. Women aged 50–69 who attended further investigation clinics at the MNSBU and received a false positive result were invited to participate. Open-ended semi-structured interviews were conducted with 12 consenting participants, and in-depth data was collected. Thematic analysis was undertaken to identify, analyse, and interpret patterns and emerging themes within the data collected, allowing for a comprehensive exploration of participants' experiences. Findings: The findings revealed that further investigation often caused anxiety, fear, and overwhelming emotions, particularly among women undergoing invasive procedures. Despite these challenges, participants expressed relief upon receiving normal outcomes and maintained a positive perception of the screening programme, appreciating its thoroughness and role in early detection. Participant recommendations highlighted the need for faster reporting and results systems, enhanced emotional support during stressful periods, and improved communication to alleviate distress during follow-up assessments. Conclusion and Recommendations: Recommendations for future research and clinical practice; emphasise the need for larger sample sizes, longitudinal studies, and evaluations of support mechanisms to enhance the breast screening experience. Insights into factors influencing re-attendance and long-term psychological effects are also proposed to further improve patient-centred care in breast screening programmes. Description: M.Sc. Radiography(Melit.)

Investigating fetal growth restriction due to placental insufficiency in the 35–40 age group

Wed, 01 Jan 2025 00:00:00 GMT

Title: Investigating fetal growth restriction due to placental insufficiency in the 35–40 age group Abstract: Purpose: Fetal growth restriction (FGR) due to placental insufficiency is a growing concern, particularly in women of advanced maternal age. With the global trend toward delayed childbearing, it is important to evaluate whether routine screening methods such as umbilical artery Doppler (UAD) should be introduced in this population. Objectives: The study aimed to assess whether UAD measurements can identify FGR risk in women aged 35–40 years; compare UA blood flow parameters between FGR-affected and unaffected pregnancies in this age group; and determine if sociodemographic and obstetric factors influence fetal blood flow. Methodology: A quantitative, prospective, quasi-experimental design was employed, recruiting 198 pregnant women aged 35–40 years in their third trimester from a public general hospital in Malta. Each participant underwent a UAD and fetal biometry scan. A control group of 16 high-risk FGR participants was included for comparison. Participants completed a questionnaire on sociodemographic characteristics and medical history. Statistical analyses were performed to compare fetal growth parameters between groups. Results: The study revealed statistically significant higher mean pulsatility index, resistance index, and systolic/diastolic ratios in the control group, indicating increased placental insufficiency (p<0.001) in FGR-affected fetuses. Conversely, mean fetal biometrics, including head circumference, abdominal circumference, and estimated fetal weight (EFW) % were significantly higher in the experimental study group (p<0.001). Ethnic differences were observed, with white participants having a higher EFW% compared to other groups (p=0.029). Parity and smoking were the only characteristics that were statistically significantly associated with fetal growth parameters. Conclusion: This study demonstrated that UAD indices were significantly higher in FGRaffected pregnancies in women aged 35–40 years. Although no correlation with maternal age was found, further research should investigate routine Doppler use, personalised monitoring, standardised US techniques, and tailored prenatal care to further explore whether it’s possible to improve detection and management of FGR in this age group. Description: M.Sc. Radiography(Melit.)