How to write a paper. Dimitrios G. Goulis

How to write a paper Dimitrios G. Goulis

Are you a scientist?

What is science?

Phenomenon Sacrifice to Gods Corinthos, circa 540 B.C. National Archeological Museum, Athens Knowledge

Phenomenon Parapsychology Knowledge Rhine JB. Extra-Sensory Perception after sixty years, 1966

Phenomenon Science Knowledge Francis Bacon (22 January 1561 9 April 1626)

Scientific method Observation Hypothesis Experiment F. Bacon, Novum Organum, 1620

Knowledge Applied knowledge Observation Hypothesis Experiment Science Application

Scientific method Understanding of the methods to produce new knowledge Critical appraisal Production of new knowledge Research

Scientific method Question setting Literature review Hypothesis set-up Experiment set-up Experiment conduction Data collection Data analysis Data interpretation Statement of conclusions Result distribution Introduction Methods Results Discussion

Why to write a paper? Wrong reasons To impress others To achieve respect To be promoted

Why to write a paper? Right reasons (for the science) No research is considered to be concluded until its results have been widespread to the scientific community Research is meaningless, if its results remain within the narrow circle of the scientists that have conducted it Publication in a peer-review journal is the cornerstone of scientific communication Published papers is a means to widespread ideas: the aim is to infect readers mind with our ideas

Why to write a paper? Right reasons (for the project) Published work is time-resistant

Why to write a paper? Right reasons (for the scientist) The decision, not only to write but to write well, is inherited to the scientific culture Since many years, the scientific community has valued the quantity and quality of published research as a mean to credit its members

Why not to write a paper? It is boring! «Even the most successful scientists would often prefer to conduct a new research project rather than drafting a new manuscript»

Why not to write a paper? A naturalist s life would be a happy one if he had only to observe and never write

And now let s write a paper!

IMRaD structure Introduction Materials and Methods Results And Discussion

Introduction Results Materials and Methods Discussion

Introduction The writing of a scientific paper begins where research begins: Statement of a research question

Aim Research hypothesis Research question(s) Primary aim(s) Secondary aim(s) PICO format Interrogative form?

Introduction Results Aim Materials and Methods Discussion

Introduction Main entities Results Aim Materials and Methods Discussion

Main entities Definition / Introduction of the main entities of the topic Be as specific as necessary Be innovative!

Main entities Osteoporosis

Main entities Trojan War Θα σας διηγηθώ μία ωραία ιστορία Ένα πρωί η ωραία Ελένη, στη Σπάρτη, Ένα μεσημέρι, η Ιφιγένεια, στις Μυκήνες Ένα απόγευμα, ο Αγαμέμνονας

Introduction Main entities Rationale Results Aim Materials and Methods Discussion

Rationale Why did you bother to deal with this topic? Which was your initial idea? Very often omitted!

Introduction Main entities Rationale (Systematic) review Results Aim Materials and Methods Discussion

(Systematic) review What is known about this subject? No need to be systematic In any case, the most important and recent publications have to be included

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Discussion

Knowledge gap What is not known about this subject? Which knowledge gap has to be filled? The Aim has to come as natural consequence

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Discussion

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Discussion

Study characteristics Study type Where was the study conducted? When was the study conducted?

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Discussion

Patients: inclusion exclusion criteria Patients Inclusion criteria Exclusion criteria Controls Inclusion criteria Exclusion criteria

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Discussion

Methods: study protocol Describe the protocol in the necessary detail Too little à no one can repeat the experiment Too much à instruction manual A figure may be necessary, in complex protocols

Methods: study protocol

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Discussion

Methods: techniques-instrumentation Describe the protocol in the necessary detail Too little à no one can repeat the experiment Too much à instruction manual For laboratory measurements Inter-assay co-efficient of variation (inter-assay CV) Intra-assay co-efficient of variation (intra-assay CV) Lower limit of detection (LOD) Manufacturer characteristics

Methods: techniques-instrumentation Describe the not-so-commonly used techniques You may refer to previous works for further details

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Discussion

Study outcomes Main outcome(s) Secondary outcome(s)

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Discussion

Ethics Ethics committee approval Written informed consent Other ethical considerations

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion

Statistics Descriptive statistics Comparison between groups Correlation Regression models Special statistic procedures Sample size estimation Software used

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion

Results You may use paragraph headings Numbers, numbers, numbers Do not duplicate data between text and tables / figures Do not discuss findings

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion

Table 1. Characteristics of Patients Admitted on Weekends and Patients Admitted on Weekdays.* Characteristic 1987 1990 1991 1994 1995 1998 1999 2002 Weekdays (N = 42,076) Weekends (N = 15,490) P Value Weekdays (N = 41,167) Weekends (N = 14,745) P Value Weekdays (N = 42,525) Weekends (N = 15,375) P Value Weekdays (N = 44,244) Weekends (N = 15,542) Age (yr) 67.3±0.06 66.8±0.11 <0.001 67.5±0.07 67.1±0.11 0.004 68.4±0.07 68.0±0.11 0.004 69.5±0.07 69.2±0.12 0.05 Male sex (%) 60.5 61.7 0.008 60.1 61.2 0.02 59.4 59.7 0.44 57.9 58.3 0.37 White race (%) 86.0 86.2 0.24 85.9 86.0 0.21 85.5 85.4 0.06 82.3 82.4 0.88 Location and type of myocardial infarction (%) 0.11 0.002 0.66 0.69 Anterior 31.1 30.4 26.9 27.4 24.1 24.3 17.5 17.3 Inferior 34.1 35.0 33.3 34.3 30.0 29.9 22.4 22.7 Lateral 2.7 2.6 2.5 2.6 2.4 2.4 1.7 1.7 Other site 11.7 12.0 8.5 7.8 7.2 6.9 7.7 7.4 Non Q-wave 20.5 19.9 28.8 27.9 36.3 36.5 50.8 51.0 Q-wave 67.9 68.1 0.21 62.7 64.4 <0.001 56.5 56.7 0.33 41.5 41.7 0.49 Coexisting conditions (%) Diabetes 23.8 23.5 0.53 25.0 25.4 0.38 26.6 25.8 0.06 27.8 27.4 0.49 Hypertension 36.8 36.0 0.08 41.5 40.7 0.07 48.0 47.1 0.06 53.9 53.3 0.22 Renal disease 3.9 4.1 0.50 4.8 4.6 0.32 5.8 5.7 0.60 7.2 7.4 0.57 Liver disease 0.3 0.3 0.51 0.4 0.3 0.35 0.3 0.3 0.93 0.4 0.5 0.32 Anemia 7.4 8.2 0.002 10.5 9.8 0.03 10.6 10.6 0.98 12.5 12.7 0.44 Cancer 1.8 1.8 0.95 2.2 2.2 0.83 2.7 2.5 0.16 3.3 3.1 0.37 Cerebrovascular disease 4.7 4.6 0.35 5.8 5.1 0.19 5.0 5.0 0.85 5.2 5.3 0.70 Complications (%) Mechanical 37.2 38.4 0.007 34.0 35.0 0.03 31.6 32.6 0.02 31.4 32.2 0.06 Arrhythmic 43.6 45.2 <0.001 39.7 41.6 <0.001 36.6 37.9 0.002 33.1 33.7 0.16 Length of stay (days) 11.6±0.05 11.7±0.09 0.24 10.5±0.05 10.4±0.08 0.24 8.1±0.04 7.9±0.06 0.02 7.4±0.03 7.2±0.06 0.03 * Plus minus values are means ±SE. Race was ascertained from records of patient discharge data. P Value

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s)

Research question(s) and principal finding(s) Repeat research question(s) and principal finding(s) Use plain language One (1) paragraph

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses

Strengths and weaknesses Present the strengths and the weaknesses of the study, with equal emphasis to both of them The editors and the readers may be more interested in the weaknesses of the study

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature

Critical appraisal of the literature Our aim is not to show that our study is superior to the previous ones, but to compare their strengths and weaknesses in comparison to ours Do not suggest that your results are right and everyone else s wrong If you do not know why your results are different from the others, do not pretend that you do

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications

Clinical implications The reader must be allowed to arrive at his own conclusions regarding the findings of the study Anyway, he will do it! Many times, it is useful to emphasize what the results DO NOT mean, in order to prevent the readers from arriving at dramatic and unjustified conclusions Do not allow the evidence provided by the study to be corroded by speculations

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research

Future research Which questions remained unanswered? Which new questions have emerged from this study? In which way future studies will fill these knowledge gap Write the Aim of your next paper

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Conclusions Conclusions are not summary Three types of conclusions: I have solved the problem! More studies are needed I did not prove anything!

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Abstract Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Abstract Background / Aim Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Abstract Background / Aim Materials and Methods Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Abstract Background / Aim Materials and Methods Results Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures Supplementary material Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Results Chronological order Main aim / Secondary aims Tables Figures References Supplementary material Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

References Use a reference manager!

Introduction Results Authors / Affiliations Main entities Chronological order References Rationale Main aim / Secondary aims Supplementary material (Systematic) review Tables Knowledge gap Figures Aim Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Authors and affiliations Order of authors has to be agreed upon at the beginning of the project First author Writing author Last (senior) author Be careful of what constitutes authorship Corresponding author Watch for multiple affiliations

Introduction Results Acknowledgments Authors / Affiliations Main entities Chronological order References Rationale Main aim / Secondary aims Supplementary material (Systematic) review Tables Knowledge gap Figures Aim Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Title Introduction Results Acknowledgments Authors / Affiliations Main entities Chronological order References Rationale Main aim / Secondary aims Supplementary material (Systematic) review Tables Knowledge gap Figures Aim Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

Working with titles Too long? Establishment and characterization of baboon embryonic stem cell lines: An Old World Primate model for regeneration and transplantation research Too short? Embryonic stem cell lines of non-human primates

Working with titles Main title Necessary entities Connection Subtitle Study type Sample size

Working with titles Editorial check number of words no abbreviations Author check concise: every word must add something precise: neither wide nor narrow

Working with titles Neutral Comparison of A vs. B Affirmative A is better than B Interrogative Is A better than B? Non-medical phrasing Apples and Bananas

Τίτλος; H εξαφάνιση της γυναίκας του αρχιμηχανικού συντάραξε την τοπική κοινωνία. Οι αρμόδιες αρχές έψαξαν παντού, αλλά μάταιος κόπος. Οι φονιάδες είχαν κρύψει τέλεια το πτώμα. Όταν ολοκληρώθηκε η ζεύξη του Αράχθου, έφυγαν ανενόχλητοι.

Το γεφύρι της Άρτας Μία μυστηριώδης εξαφάνιση Έγκλημα στον Άραχθο Ποιος σκότωσε τη γυναίκα του αρχιμηχανικού; Άλλο;

Τίτλος; H εξαφάνιση της γυναίκας του αρχιμηχανικού συντάραξε την τοπική κοινωνία. Οι αρμόδιες αρχές έψαξαν παντού, αλλά μάταιος κόπος. Οι φονιάδες είχαν κρύψει τέλεια το πτώμα. Όταν ολοκληρώθηκε η ζεύξη του Αράχθου, έφυγαν ανενόχλητοι.

Το γεφύρι της Άρτας H εξαφάνιση της γυναίκας του αρχιμηχανικού συντάραξε την τοπική κοινωνία. Οι αρμόδιες αρχές έψαξαν παντού, αλλά μάταιος κόπος. Οι φονιάδες είχαν κρύψει τέλεια το πτώμα. Όταν ολοκληρώθηκε η ζεύξη του Αράχθου, έφυγαν ανενόχλητοι.

A helpful hand

Tips for successful writing - 1 Start early, very early Structure is everything Materials: too little à no one can repeat the experiment Materials: too much à instruction manual Results: numbers, numbers, numbers Results: do not duplicate data between text and tables / figures Results: do not discuss There is no such thing as a short paper Take your time: allow enough time for each writing step

Tips for successful writing - 2 Sloppy scientific writing indicates sloppy scientific thinking A badly written or premature publication may accompany a scientist until the end of his career

Which characteristics would you appreciate? The paper I would like to read has to be: Simple Concise Comprehensive

Which characteristics would you appreciate? Then, write in a way : Simple Concise Comprehensive

A working example

and almost anything else Dimitrios G. Goulis

Write an abstract

Construct a poster

Deliver an oral presentation

Title Introduction Results 3-4 slides Acknowledgments Authors / Affiliations Main entities 1-2 slides Chronological order References 1 slide Rationale (Systematic) review Main aim / Secondary aims Tables Supplementary material Knowledge gap Aim 1 slide Figures Abstract Background / Aim Materials and Methods Results Conclusions Materials and Methods 2 slides Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions 1 slide

Η επίδραση της θυρεοειδικής λειτουργίας και της θυρεοειδικής αυτοανοσίας στην έκβαση μεθόδων υποβοηθούμενης αναπαραγωγής Γεσθημανή Μηντζιώρη, Ελευθέριος Γιαλαμάς, Κωνσταντίνος Δοσόπουλος, Δημήτριος Ζούζουλας, Γεώργιος Γήτας, Χρήστος Βενέτης, Ευστράτιος Μ. Κολυμπιανάκης, Δημήτριος Γ. Γουλής, Βασίλειος Κ. Ταρλατζής Μονάδα Ενδοκρινολογίας Αναπαραγωγής και Μονάδα Ανθρώπινης Αναπαραγωγής, Α Μαιευτική - Γυναικολογική Κλινική, Ιατρική Σχολή, Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης

Το πρόβλημα Τα υπάρχοντα δεδομένα για τη σχέση της θυρεοειδικής λειτουργίας ή της θυρεοειδικής αυτοανοσίας (TAI) με το αποτέλεσμα των μεθόδων υποβοηθούμενης αναπαραγωγής είναι ελλιπή. Δεν υπάρχουν οδηγίες για προληπτικό έλεγχο (screening) για τη θυρεοειδική λειτουργία ή τη θυρεοειδική αυτοανοσία σε γυναίκες που πρόκειται να υποβληθούν σε IVF (Ιn Vitro Fertilization). Mintziori G et al. Fertil Steril 2011, Stagnaro-Green A et al. Thyroid 2011

Σκοπός Να καταγραφούν τα αποτελέσματα της IVF και η σχέση τους με τη λειτουργία του θυρεοειδή αδένα ή την ύπαρξη ΤΑΙ σε ευθυρεοειδικές γυναίκες.

Ασθενείς και Μέθοδοι Ι Αναδρομική μελέτη Εκατόν εξήντα εννέα γυναίκες οι οποίες υποβλήθησαν σε IVF Ιανουάριος 2006 - Δεκέμβριος 2010 TSH 0.5-4.5 µiu/ml, με ή χωρίς θεραπεία με LT4

Ασθενείς και Μέθοδοι ΙΙ Εξαρτημένες μεταβλητές: ποσοστό γέννησης ζώντων νεογνών Εμβρυολογικές και κλινικές παράμετροι: (Ληφθέντα ωάρια, γονιμοποιημένα ωάρια (2PN) έμβρυα που μεταφέρθηκαν, βιοχημικές κυήσεις, κλινικές κυήσεις, απώλειες κύησης) Στατιστική ανάλυση: SPSS 17 for Windows (SPSS Inc., Chicago, Ill., USA).

Αποτελέσματα Ι 169 γυναίκες, ηλικίας 37 (7)* ετών, µε Δ.Μ.Σ.(kg/m 2 ) 24.6 (7.1)* και TSH ορού 1.8 (1.2) µiu/ml. Αίτια υπογονιµότητας Σαλπιγγικός παράγοντας 56 (33.1) Ανδρικός παράγοντας 54 (31.9) Διαταραχές ωοθυλακιορρηξίας 29 (17.2) Ιδιοπαθής υπογονιµότητα 18 (10.7) Ενδοµητρίωση 12 (7.1) Τα δεδομένα παρουσιάζονται ως median (interquartile range) ή ως αριθμός (ποσοστό %)

Όλες οι TSH 2.5 TSH > 2.5 p value * γυναίκες µiu/ml µiu/ml N (%) 169 (100) 127 (75.1) 42 (24.9) Ληφθέντα ωάρια 5 (6) 5 (6) 5 (6) 0.915 Γονιµοποιηµένα ωάρια (2PN) 5 (6) 5 (6) 4 (5) 0.842 Έµβρυα που µεταφέρθηκαν 2 (2) 2 (2) 2 (1) 0.490 Βιοχηµικές κυήσεις 71 (42.0) 56 (44.1) 15 (35.7) 0.340 Κλινικές κυήσεις 62 (36.7) 48 (37.8) 14 (33.3) 0.603 Απώλειες κύησης 7 (11.3) 7 (14.6) 0 (0) 0.195 Γέννηση ζώντων νεογνών 55 (32.5) 41 (32.3) 14 (33.3) 0.900 Τα δεδομένα παρουσιάζονται ως median (interquartile range) ή ως αριθμός (ποσοστό %)

All Παρουσία TAI Απουσία ΤΑΙ p value * women N (%) 87 (100) 18 (19) 69 (81) Ληφθέντα ωάρια 6 (7) 7 (5) 5 (7) 0.139 Γονιμοποιημένα ωάρια (2PN) 5 (6) 6 (4) 5 (6) 0.192 Έμβρυα που μεταφέρθηκαν 2 (2) 3 (1) 2 (2) 0.043 Βιοχημικές κυήσεις 35 (40.2) 7 (38.9) 28 (40.6) 0.896 Κλινικές κυήσεις 32 (36.8) 6 (33.3) 26 (37.7) 0.733 Απώλειες κύησης 5 (15.6) 2 (33.3) 3 (11.5) 0.275 Γέννησηζώντων νεογνών 27 (31) 4 (22.2) 23 (33.3) 0.568 Τα δεδομένα παρουσιάζονται ως median (interquartile range) ή ως αριθμός (ποσοστό %)

Συζήτηση - Συμπεράσματα Ι Η μελέτη αυτή δεν έδειξε ότι η αυξημένη TSH (<4.5μIU/ml) ή η παρουσία θυρεοειδικής αυτοανοσίας πριν την ΙVF σχετίζονται με το ποσοστό γέννησης ζώντων νεογνών σε ευθυρεοειδικές γυναίκες. Η υποκατάσταση με LT 4 συσχετίζεται με χαμηλότερο ποσοστό γέννησης ζώντων νεογνών.

Συζήτηση- Συμπεράσματα ΙΙ Περιορισμοί: Σχετικά μικρό μέγεθος δείγματος Τύπος μελέτης (Αναδρομική)

Συζήτηση- Συμπεράσματα ΙΙΙ Νέα ερευνητικά ερωτήματα Μπορεί ο υποθυρεοειδισμός σε γυναίκες καλά ρυθμισμένες με LT4 να αποτελεί ανεξάρτητο παράγοντα κινδύνου για χαμηλή επιτυχία στην επίτευξη κύησης μετά από IVF; Ποια είναι η πλήρης εικόνα της σχέσης της IVF και του θυρεοειδή αδένα και ποιος τελικά είναι ο ορθός ενδοκρινολογικός χειρισμός των γυναικών που πρόκειται να υποβληθούν σε IVF;

Ευχαριστώ πολύ!

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Title Authors / Affiliations Abstract Background / Aim Materials and Methods Results Conclusions Introduction Main entities Rationale (Systematic) review Knowledge gap Aim Materials and Methods Study characteristics Patients: inclusion-exclusion criteria Methods: study protocol Methods: techniques-instrumentation Study outcomes Ethics Statistics Results Acknowledgments Chronological order References Main aim / Secondary aims Supplementary material Tables Figures Budget Timeline Deliverables Discussion Research question(s) and principal finding(s) Strengths and weaknesses Critical appraisal of the literature Clinical implications Future research Conclusions

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