Reproductive Outcome following Hysteroscopic Monopolar Metroplasty: An Analysis of 203 Cases

Abstract Background: The aim of this study was to evaluate the reproductive outcome of women with history of infertility or recurrent miscarriage following hysteroscopic septum resection

Oxybutynin and tolterodine in a trial for treatment of overactive bladder in Iranian women.

Objective: To evaluate the efficacy and side effects of Oxybutinin in comparison to tolterodine in treatment of overactive bladder (OAB) with detrussor overactivity (DOA) in Iranian women. Materials and methods: One hundred Iranian old women with clinical symptoms of OAB who show IDO in the filling cystometry participated in this randomized double-blinded parallel-group by using two kinds of the drugs for 4- week course (2 mg tolterodine twice-daily, or oxybutinin 5 mg, three times a day) in alike packages. We collected data from 3-day FVC before and after the treatment course. The effectiveness of each drug was studied using the paired t-test and improvement after treatment between two groups was compared by independent T-test. Results: Positive changes in urinary urgency, Frequency and Urge incontinence after treatment in both groups were seen but mean improvements in the all were larger in the patients who treated by oxybutinin especially in terms of urgency and Urge incontinence. Dry mouth was the most common side-effect in two groups. Unlike other studies it was higher in the tolterodine group but the difference was not significant. Conclusion: Four week treatment with oxybutinin was better than tolterodine in improving urgency and urge incontinence but there were not statistically significance between them

Effect of Urinary Incontinence on Quality of Life among Iranian Women.

Objective: Present study aimed to evaluate the effects of stress, urge and mixed urinary incontinence on the quality of life and mental health of Iranian women with urinary incontinence (UI). Materials and methods:This was a cross sectional study of quality of life and mental health among women without and with different types of urinary incontinence (n = 140). Quality of life (QOL) and mental health were compared and measured using the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the 12-items General Health Questionnaire (GHQ-12). Results: Women with any types of urinary incontinence showed a significant lower degree of mental health. Women with mixed incontinence reported significantly lower QOL and mental health (P < 0.0001) compared to those with stress and urge incontinence, while there was no significant difference between women with stress and urge incontinence (P= 0.95). Conclusion: Patients with UI showed inferior mental health and QOL while these symptoms were more severe among patients with mixed urinary incontinence

Comparison Pregnancy Outcomes Between Minimal Stimulation Protocol and Conventional GnRH Antagonist Protocols in Poor Ovarian Responders

Objective: To compare the pregnancy outcomes achieved by in vitro fertilization (IVF) between minimal stimulation and conventional antagonist protocols in poor ovarian responders (PORs). Materials and methods: In this randomized controlled trial, 77 PORs undergoing IVF were selected and divided into two groups. First group was the minimal stimulation group (n = 42) receiving 100 mg/day clomiphene citrate on day 2of the cycle for 5 day that was followed by150IU/day human menopausal gonadotropin (hMG) on day 5 of the cycle. Second group was the conventional group (n = 35) receiving at least 300 IU/daygonadotropin on day 2 of the cycle. Gonadotropin-releasing hormone (GnRH) antagonist protocol was applied for both groups according to flexible protocol. Number of retrieved oocytes and chemical pregnancy rate were the main outcomes. Results: There was no difference in number ofretrieved oocyte and pregnancy rate (2.79 ± 1.96 vs. 2.20 ± 1.71 and 5.6% vs. 4.1%; p > 0.05) between both groups. The gonadotropin dose used in the minimal stimulation group was lower than conventional group (1046 ± 596 vs. 2806 ± 583). Conclusion: Minimal stimulation protocol with lower gonadotropin used is likely to be considered as a patient- friendly and cost-effective substitute for PORs.

Analysis of ovarian reserve markers (AMH, FSH, AFC) in different age strata in IVF/ICSI patients

Background: The predictive roles of follicle stimulating hormone (FSH), anti-mullerian hormone (AMH) and antral follicle count (AFC) as ovarian reserve markers in women with different age groups are not established well. Objective: This study compares the value of FSH, AMH and AFC at the time of in vitro fertilization (IVF) treatment in different age groups. Materials and Methods: In this cross-sectional study, 103 women aged 20-43 years candidates for IVF/ICSI cycle were recruited. FSH, AMH and AFC on day 3 of menstrual cycle were measured. The relationship of these measured markers with outcome variables (oocytes number, number of frozen/fresh embryo and chemical and clinical pregnancy) was assessed in different age groups (i.e. 20-32, 33-37 and 38-43 years). Results: our results show that age was correlated with clinical pregnancy, oocyte count and fresh and frozen embryo (p<0.001). AMH, AFC and FSH were not correlated with clinical or chemical pregnancy at total population or age subgroups except the significant correlation of AFC with clinical pregnancy at 33-37 years old group. AFC was correlated with oocyte count and the number of fresh and frozen embryos in the ages group 20-32 years. In this age group, AMH was correlated with fresh and frozen embryos. AMH, AFC and FSH were correlated with oocyte count and the number of fresh embryos in age group 33-37 years. AMH was correlated with oocyte count and the number of fresh embryos in 38-43 years old group. Conclusion: We concluded that the age is the superior predictor of IVF outcome and AMH and AFC are variable predicting markers of ovarian reserve in different age groups