Background: In vitro fertilization (IVF) is a progressing common reproduction method and if the number of transferred embryo increases, the pregnancy rate and multiple pregnancies will increase which may lead to higher medical costs and human suffering. We compared pregnancy and multiple pregnancies rate after two or three transferred embryo via IVF. Methods: From April 2003 to June 2004, 301 referred infertile women to Isfahan infertility center underwent IVF with transferring two or three good quality embryos. Results: From 298 patients, 2 and 3 embryos were transferred in 155 patients and in 143 patients, respectively. Pregnancy rate was 19.4% versus 24.5% in 2 and 3 embryos transferred patients, respectively. Twin gestations were found in 5(3.2%) of 2 embryos transferred patients and in 11(7.7%) of 3 embryos transferred patients. Discussion: Transferring two or three embryos with good quality increase the rate of twin gestations in young women, without significant improve in the chance of singleton conception.

Objective: Triplet or higher-order multiple pregnancies are often caused due to ovulation induction. Spontaneous quadruplet pregnancy is a rare phenomenon which is associated with maternal and fetal complications. Here in, we report a spontaneous quadruplet pregnancy with no family history and as a result of an unwanted pregnancy. Case report: The patient was a 34-year-old, G4 L2 Ab1. She noticed being pregnant during breastfeeding, a spontaneous quadruplet pregnancy. There was no case of multiple pregnancies in her or her husband's family. In week 29 she was hospitalized due to the diagnosis of preterm labour. At 32 weeks and 4 days of gestation, because of the restart of labour contractions and dilatation development, she underwent a cesarean section. The outcome was the birth of 4 healthy neonates weighing between 1800 to 2100 gram and normal Apgar score. Conclusion: Quadruplet pregnancy can rarely occur spontaneously even unintentionally, and can reach the third trimester without prophylactic cerclage.

Introduction: Globally, breast cancer is the most common malignancy causing extensive mortality in women. In most cases, there is no known risk factor for breast cancer. Extensive hormonal changes that occur during pregnancy appear to be involved in the etiology of breast cancer. Since identifying risk factorshelps with primary prevention and early diagnosis of breast cancer, this study was performed to systematically review studies about pregnancy-related variables and the risk of breast cancer in Iran and worldwide.Methods: In this systematic review, we searched PubMed, Google Scholar, Scopus, SID, and Science Direct databases using keywords of “pregnancy-related variables” and “breast cancer” to retrieve articles published during 2000-2017. Then, those articles that obtained a score of ³ 6 based on the Newcastle–Ottawa Scale were entered to the study. The results were reported qualitatively.Results: Fifty articles consisting of 26 case-controls and 24 cohort articles, which met the inclusion criteria, were investigated. Our evaluations indicated that among the factors examined, abortion and preeclampsia had a stronger relationship with breast cancer.Conclusion: History of abortion seems to increase the risk of breast cancer. Also, history of preeclampsia plays a protective role in breast cancer. Further studies are needed to examine the relationship of gestational diabetes and multiple gestations with breast cancer.

Fetal reduction is suggested in multiple gestations (3 or more), when the number of fetuses endanger the delivery of the other fetuses or endanger the health of the mother and after chorionic villus sampling (CVS) in multiple gestations when one of the fetuses  has chromosal abnormalities or thalassaemia.In this study, under the guide of sonography, 65 mothers with multiple gestations underwent selective (genetically involved) or nonselective (multiple gestations) fetal reduction.The gestational age was between 9-12 weeks, with no injection of any substance (KCL or hypertonic salin) in order to reduce complications. We used the traumatic method by targeting the fetal heart with a spinal needle under sonographic guide. We had minimal complications and follow-up sonography revealed the normal growth of the remaining fetuses.

Purpose: To report a patient with MEWDS.Patient and findings: A 65-year-old man presented with sudden decrease of vision in his right eye. On ophthalmoscopy of the involved eye, numerous small discrete white lesions were detected superficially and deep in the retina around the disc and macula. On visual field examination, enlargement of the blind spot was detected. Fluorescein angiography was unremarkable. On electroretinography, the a-wave was decreased minimally. The patient was followed and after 2 months, significant improvement of visual acuity and visual field was observed.Conclusion: MEWDS is a rare intraocular inflammatory disease of unknown etiology and in contrast to our patient, more frequent in females. The natural course is generally benign with spontaneous disappearance of the lesions and improvement of vision in 6 to 8 weeks.

The incidence of anomalies is high in multiple gestations especially in monochorionic twins. This paper reported a case of an acardiac parabiotic twin, a rare deformed fetus which occurs typically in monochorionic twin gestations. It is a severely deformed fetus without heart and limited development of the upper half of the body.