Efficacy of Assisted Reproduction Techniques: In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)

Introduction. Infertility is a relatively common condition in the general population, affecting up to 15% of couples worldwide. Currently, the procedures and interventions used to assist reproduction are not fully capable of achieving a complete success rate, generating significant controversy regarding the use of IVF and/or ICSI. Objective. To evaluate the effectiveness of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) as treatments for infertility, considering the probable cause. This includes analyzing the fundamental mechanisms of each technique, their advantages, disadvantages, and the most suitable therapeutic options according to the characteristics of each couple. Methodology. A search was conducted in scientific databases, selecting articles based on reliability, validity, and clinical relevance, prioritizing publications in English and Spanish from the last five years. Fifteen high-evidence articles that met the established criteria were selected. Results. In vitro fertilization showed some degree of superiority over ICSI regarding fertilization rates; however, ICSI resulted in a higher rate of high-quality embryos, although the difference was not statistically significant. Ultimately, it was determined that the live birth rate is indirectly proportional to maternal age, regardless of the procedure performed. Conclusion. In vitro fertilization has become the preferred assisted reproductive technique for various conditions such as unexplained infertility, endometriosis, and ovarian and male factors. On the other hand, ICSI is reserved for specific cases of male infertility despite its higher level of intervention. Each approach has its own indications and considerations, emphasizing the importance of careful selection based on individual diagnosis.

Evelyn Johanna Solano Benalcázar, Ariana Nicole Sari Yánez, Víctor Peñafiel Gaibor, Verónica Gabriela López Ullauri

6-18

A Comprehensive Evaluation of Hearing Loss due to Head Trauma: Pathophysiology, Diagnosis and Treatment

Introduction.  The human capability to perceive and interpret sound is given by a set of structures such as the ear, the brainstem and the brain. Hearing loss following craniocerebral trauma, with the middle ear or cochlea being the most affected, often goes unnoticed; primary audiological deficit does not only appear as a result of direct trauma to the inner or middle ear, as occurs in skull base fractures or tears of the central neural pathways. In the case of early secondary injury, there is an increase in intracranial pressure in response to hematomas, hemorrhages or diffuse axonal degeneration. The incidence of post-traumatic hearing loss occurs in approximately 5-10% of cases of hearing loss, the age group most affected are young people, especially those who practice sports or participate in risky activities, in addition, workers exposed to very loud noises and physical injuries. Objective.  To analyze the impact of cranial trauma on the auditory system and its relationship with hearing loss determined by diagnostic tools and early intervention. Methodology. Original studies, clinical investigations, meta-analyses published during the five years (2020-2024) with emphasis on the diagnosis and management of hearing loss due to head trauma are included. Results.  Cranioencephalic trauma (TBI) has significant effects on hearing, which is evidenced in several studies. On one hand, in mice it shows that repetitive mild TBI can cause early neuronal damage although it does not directly affect hair cells, but causes degeneration of the spiral ganglion. An accurate evaluation of hearing loss and exposure history are essential for successful treatment of hearing loss after TBI. Studies agree that early intervention is vital to prevent progression to chronic deafness. As research progresses, the integration of objective diagnostic methods, such as DpOAE, along with an understanding of the context of trauma, may significantly improve treatment outcomes in patients with post-TBI hearing loss. Conclusion.  Cranioencephalic trauma (TBI) has significant effects on hearing, which is evidenced in several studies. On one hand, in mice it shows that repetitive mild TBI can cause early neuronal damage although it does not directly affect hair cells, but causes degeneration of the spiral ganglion. An accurate evaluation of hearing loss and exposure history are essential for successful treatment of hearing loss after TBI. Studies agree that early intervention is vital to prevent progression to chronic deafness. As research progresses, the integration of objective diagnostic methods, such as DpOAE, along with an understanding of the context of trauma, may significantly improve treatment outcomes in patients with post-TBI hearing loss.

Ariana Nicole Sari Yánez, Nicole Estefanía Malliquinga Salazar , Sara Abigail Paredes Pilco, Víctor Peñafiel Gaibor

19-33

Nursing professionals' perspectives on open-door ICU: an integrative review.

Introduction: The intensive care unit is characterized by being a hostile environment where the patient may experience negative feelings, therefore, strategies such as open doors have been established to humanize care, however, it is essential to take into account the perspective of nursing professionals, who are responsible for providing comprehensive care and including family members in the activities they perform. Objective: To know what has been published in the literature about the perspectives of nursing professionals on open-door ICU. Methodology: An integrative review was conducted, obtaining 456 studies from the databases consulted. Articles published in the last 10 years (2014-2024) in Spanish, Portuguese and English were considered as inclusion criteria. Results: Of the 17 articles selected, 7 categories were identified according to the perspectives of nursing professionals on open-door ICU: characterization, positive impact of humanized care, effect of the visit on staff, effect and beliefs of the visit on the patient, effect of the visit on the family, open-door ICU visitation policy, and requirements for the implementation of the visit. Conclusion: Nursing professionals perceive open-door ICU as a strategy that improves the quality of care and patient recovery but requires appropriate protocols. For some, it is a model of humanization and family participation, while others warn that the family's lack of knowledge and mistrust can generate conflicts in care. General Area of Study: Medicine. Specific area of study: Nursing. Type of study: Review article.

Adriana Paola Parrales Remache, Meilyn Piedad Cortez Romero, Angela María Quintero De Contreras, Eddison Josué Ramírez Merchán

34-58

Oral health-related quality of life in adult patients of dental clinics at the Catholic University of Cuenca

Introduction: According to the World Health Organization (WHO), health includes physical, mental, social, and emotional well-being. Oral health influences this balance, as it affects relationships and psychological state, especially through dental appearance. Dissatisfaction with smiling has a negative influence on quality of life. Objectives: The study evaluated the Oral Health-Related Quality of Life (CVRSO) in adult patients from the dental clinics of the Catholic University of Cuenca. Methodology: A descriptive cross-sectional study was conducted, applying the IOPD (Oral Impacts on Daily Performances) instrument to measure the impact of oral health between December 2024 and March 2025. The sample included 280 patients between 18 and 60 years of age, selected by simple random probability sampling. Results: The results showed that the most affected deficiencies were eating and enjoying food, smiling, or laughing, cleaning teeth, and sleeping or relaxing. Sociodemographic factors such as age, educational level, and origin significantly influence CVRSO. In addition, women, and young adults (20 to 40 years old) reported a greater impact on their quality of life due to oral health problems. Conclusions: In conclusion, these findings highlight the need for personalized dental care, considering sociodemographic factors to improve quality of life and reduce the impact of oral health on daily activities and emotional well-being. General area of study: Dentistry. Specific area of study: Dentistry. Type of item: original.

Michelle María Aguilar Granda, María de Lourdes Cedillo Armijos

59-76