AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2578-8965/117
1Resident Physician, Obstetrics and Gynecology Baylor College of Medicine Houston, Texas
2Associate Professor, Division of Gynecology Oncology and Reproductive Medicine University of Texas MD Anderson Cancer Houston, Texas
3Associate Professor Baylor College of Medicine, Division of Reproductive Endocrinology and Infertility Houston, Texas
*Corresponding Author: Laurie J. McKe, Associate Professor, Division of Gynecology Oncology and Reproductive Medicine University of Texas MD Anderson Cancer Houston, Texas
Citation: Ayyar A., Laurie J. McKenzie (2022) How to Optimize Conception: Timing is everything! J. Obstetrics Gynecology and Reproductive Sciences; 6(4) DOI:10.31579/2578-8965/117
Copyright: © 2022, Laurie J. McKe, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 02 March 2022 | Accepted: 19 March 2022 | Published: 11 March 2022
Keywords: spinnbarkeit; egg white; mittelschmerz
Infertility is defined as the inability to conceive within 12 months of regular unprotected intercourse for women under 35 years of age and affects approximately 15% of reproductive aged couples [1]. A diagnosis of infertility is often emotionally, physically, and financially devastating and many patients will seek fertility assistance with their obstetrician and gynecologist. While there may be underlying factors contributing to infertility that that require specific treatments (i.e. fibroids requiring myomectomies), there are also many patients that are unaware of how best to optimize conception timing. Counseling patients regarding the science of reproduction and adjusting at home practices may increase their chances for success.
Timing is key for successful conception. The reproductive window is much narrower than many patients assume and coincides directly with ovulation. While motile sperm may survive in the reproductive tract up to five days after coitus, the oocyte is only capable of fertilization for approximately 12-24 hours [2]. A sentinel study that assessed 625 attempted conception cycles found conception occurred when intercourse took place during the 5 window prior to ovulation. Fecundability (the possibility of conception in one month) was 10% five days prior to ovulation, and increased to 33% when intercourse occurred the day of ovulation [3]. If coitus occurred after ovulation however, conception rates plummeted. Therefore, precise ascertainment of ovulation timing can maximize home fertility efforts.
Ovulation timing can fluctuate, even for women with regular cycles [4]. Fortunately, there are multiple methods that can assist in detecting ovulation. This includes monitoring cervical mucus, basal body temperature, utilizing mobile applications that track menstrual cycles, and ovulation predictor kits.
At the onset of menstruation, cervical fluid is created and is typically thick in consistency. Around the time of ovulation, the mucus becomes thinner, clearer, and stretchy resembling that of an “egg white” consistency called “spinnbarkeit” (German word origin “able to be spun out in threads”). After ovulation, the mucus once again becomes viscus. This change in cervical mucus secretion is a convenient and useful method to detect ovulation [5]. A prospective cohort study monitored 161 conception and 2,594 non-conception cycles with daily documentation of mucus characteristics and intercourse timing. Fecundability was low (less than 5%) when intercourse occurred on days without subjective evidence of cervical mucus, however rose markedly (to nearly 30%) when intercourse occurred on days with appropriate cervical mucus [6]. Another study utilized what they referred to as a “Two-Day” algorithm which predicted fertility the day prior to and the day of cervical mucus production, regardless of the quality of the secretions (i.e. thin versus thick, clear versus white). This study found that simply the presence of secretions closely correlated with basal body temperature and more accurately predicted ovulation compared to a menstrual cycle tracking alone [7].
Another method to identify ovulation is monitoring the basal body temperature (BBT). The BBT rises approximately 0.3 degrees during the luteal phase in response to progesterone production [8]. The increase in body temperature is attributed to the thermogenic effect of progesterone, with a rise in core body temperature evident approximately 24 hours after a detectable increase in plasma progesterone levels [9], plateaus within 48 hours [10], and remaining high until the approach to menstruation. It is important to note that this rise in temperature does not prospectively alert the patient to their fertile window, but rather is used to indicate that ovulation already occurred [5]. Thus, this may not be as useful as the other methods for those attempting to conceive unless a woman has consistent cycle length.
For women with regular cycles of predictable length, menstrual calendar tracking may be useful to identify their fertile window. The follicular phase of a menstrual cycle is less predictable, yet the luteal phase is typically a consistent 14 days. While some may utilize a physical calendar, many women have turned to mobile applications (apps) that assist with cycle tracking. Menstrual tracking apps are growing in popularity with a reported 200 million downloads to date in 2016, of which some are detailed in Table 1 [11, 12]. Furthermore, some of these apps alert patients regarding impending ovulation. While one study demonstrated the accuracy of ovulation prediction by calendar/app method was only 21%, this is a tool that patients can use in conjunction with other tracking methods [13]. Importantly, some of these applications allow users to anonymously interact with other women also struggling with infertility and can provide psychosocial support.
Many women will also track ovulatory pain or “mittelschmerz” (German word origin middle + pain) to assess for presumptive evidence of ovulation. However, this ovulatory pain does not appear to coincide with actual follicular rupture, but rather the follicle expansion that occurs prior to ovulation [14] which can be misleading for ovulation timing. Furthermore, direct observation of human ovulation demonstrates that the release of the oocyte from the follicle is a slow extrusion over time as opposed to a rapid release [15, 16].
Lastly, urine ovulation predictor kits (OPK) can be utilized. These over the counter tests typically assess for (LH) levels, however some also monitor for estradiol or pregnanediol glucuronide levels. Ovulation usually occurs ~36 hours after onset of the LH surge, and ~12 hours after its peak. While multiple studies correlate urine LH detection and ovulation, these ovulation predictor kits may underestimate the fertile window [17] and approximately 7% have false positives [18]. Many kits instruct patients to utilize OPKs any time of the day, but often encourage testing at approximately the same time each day. Other instructions may include limiting water intake and avoidance of urination for four prior to testing to concentrate the urine and avoid missing the LH surge. Therefore, many patients opt to test their OPKs with first morning urine.
Patients often inquire regarding optimal coital frequency. In men with normal semen quality, sperm paraneters remain normal even with daily ejaculation, thus dispelling the myth of needing to abstain for a period time to allow for sperm recovery [19]. In a prospective study of 221 women attempting conception, coital timing and frequency was recorded over 625 menstrual cycles. Patient’s fecundability was 37 percent with daily intercourse, 33 percent with every other day coitus, and decreased to 15 percent with untimed intercourse once per week [3]. All 192 conceptions occurred with coitus in the 5 days prior to and including day of ovulation. No pregnancies occurred with intercourse the day after ovulation, again underscoring the importance intercourse relative to ovulation. Mandating coital frequency however can result in significant stress for couples and this should ultimately be determined by patient and partner preference.
As maternal age is such a significant factor impacting fertility, an infertility work-up is recommended for women younger than 35 who have been trying to conceive (TTC) for 12 months or greater, women older than 35 TTC for 6 months or more, and immediately for women TTC over 40 years of age [20]. Instances for immediate evaluation include oligo or amenorrhea, known reproductive tract disease, Stage III or IV endometriosis, or known/ suspected male infertility. In addition to a detailed medical, obstetric, and gynecologic history, it is important to investigate for underlying thyroid, breast, or endocrine disorders. Furthermore, imaging should be considered to evaluate the patient’s ovarian reserve and anatomy. It is important to acknowledge that a male factor infertility contributes to 40-50% of infertile heterosexual couples. Thus, a basic medical history of the partner as well as semen analysis should be obtained. Referrals to male infertility providers may be performed in lieu or in addition to the history taking [20].
Every patient encounter with a reproductive capable woman is an opportunity to counsel regarding a potential pregnancy. The goal is to optimize the health of the woman, fetus, and neonate. It is important to counsel women to inform their provider prior to attempting for pregnancy or as early in their pregnancy as possible. If a patient indicates they are TTC, addressing their current chronic conditions such as diabetes or HIV, vaccination status, and reviewing current medications is indicated. Sexual and social habits should be addressed, offering preconception genetic screening, and testing for STD’s may be warranted. Lastly, patients should be encouraged to initiate prenatal vitamins that contain folic acid for three months prior to conception [21].
Timing intercourse relative to ovulation is important to optimize success. The goal is to be aware of when ovulation is about to occur and to have intercourse prior to ovulation. There are a multitude of ways to detect ovulation, and the patient should select the option that is most convenient for her. Patients should be encouraged to discuss with their physician when they are ready to conceive. It is helpful to know both when to initiate an infertility work up and the importance of optimizing their patient’s health prior to conceiving to improve pregnancy outcomes.
Frequent ejaculation can decrease male fertility
Frequent ejaculation does not decrease male fertility in men with normal sperm parameters. Conversely, abstinence for periods of 5 days or greater may negatively impact sperm counts [22].
Position during and after coitus can affect fecundability
Remaining supine after intercourse does not increase fecundability. Sperm is recovered in the cervical canal within seconds of ejaculation, regardless of position during coitus [4].
Position during intercourse can impact the gender of the baby
There is no evidence that position during intercourse impacts the gender of the baby [4].
Timing of intercourse can determine the gender of the baby
Timing of intercourse relative to ovulation does not impact the gender of the baby [4].
Diet affects fecundability
Yes and no. While no specific type of diet has reliably shown to affect fecundability, patients with a normal body mass index (BMI) are shown to have increased fecundability and a decrease in pregnancy complications [2, 23].
Lubrication should be avoided if the couple is trying to conceive
Some lubricants decrease sperm motility in vitro, however, these effects have not been shown to alter cycle fecundability [24]. Lubricants that are hydroxyethylcellulose-based (such as Pre-Seed and ConceivEase) have not demonstrated adverse impact on semen parameters unlike water-based lubricants (such as K-Y jelly, K-Y touch, or Astroglide) [4]. While these fertility friendly lubricants will not improve a patient’s chances of getting pregnant, it will not hinder sperm motility. Other cost-friendly alternatives that are seemingly safe for those TTC include canola oil or mineral oil 25-27).
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
