Presentation Invasive Mole After Normal Pregnancy: A Very Rare Case Report

Gestational trophoblastic neoplasia (GTN) is a rare neoplasm and is a spectrum of proliferative disorders of placenta. Invasive mole is a subtype of GTN that almost always arises after molar pregnancy. This report presents a 35-year-old woman with an atypical presentation of invasive mole after a normal pregnancy. The patient presented with a complaint of vaginal bleeding after normal vaginal delivery. Invasive mole was diagnosed based on findings of imaging and elevated beta human chorionic gonadotropin (ß-hCG) levels. Hysterectomy was finally decided upon due to severe vaginal bleeding and the patient’s request. Although GTN occurs after normal delivery, the patient recovered without receiving chemotherapy. It is important to consider all subtypes of GTN as a differential diagnosis of patients with abnormal postpartum bleeding and elevated ß-hCG levels even after a normal pregnancy

GnRH antagonist versus agonist in normoresponders undergoing ICSI: a randomized clinical trial in Iran

AbstractBackground: General concern is that the pregnancy rate is higher with GnRH-agonist as a protocol of pituitary suppression. GnRH-antagonist protocol provides a shorter period of administration and an easy flexible protocol.Objective: In this study, the outcomes of GnRH agonist and antagonist in ICSI cycles are compared in normo responder patients.Materials and Methods: In this randomized clinical trial, 300 normoresponders undergoing ICSI were randomly divided to GnRh agonist (n=150) and GnRh antagonist (n=150) groups. The main outcome measurements were chemical, clinical and ongoing pregnancy rates (PR).Results: The mean duration of stimulation were 9.6±1.6 and 8.2±1.6 days in agonist and antagonist groups respectively (p=0.001). The mean number of MII oocyte retrieved in agonist and antagonist groups were 7.7±4.0 and 6.9±4.3 respectively (p=0.03). There was no significant difference between two groups regarding mean number of gonadotrophin ampoules, follicles, occytes, total embryos and good quality embryos, OHSS incidence, and abortion rate. Chemical pregnancy rate was 35.3% in agonist and 39.3% in antagonist group. Clinical pregnancy rate was 35.3% in agonist and 34% in antagonist group. Ongoing pregnancy rate was 45 (31.3%) in agonist and 44 (29.3%) in antagonist group. There was no significant difference between two groups in pregnancy rates.Conclusion: In this study antagonist protocol was shown to be an easy, safe and friendly protocol in Iranian normoresponder patients, having similar outcomes with standard agonist protocol but shorter period of stimulatio

Female Sexual Function During the Menopausal Transition in a Group of Iranian Women

Objective: To determine the prevalence of sexual problems in Iranian women and association of sexual dysfunction with menopausal symptoms. Materials and methods: In this cross-sectional study, 151 married women with the age of 40-60 yearsold who were referred for treatmentto Department of Gynecology in Vali-e-Asr Hospital (Tehran, Iran) from April to July 2012, were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire.Menopause rating scale (MRS) was developed for the diagnosis and quantification of climacteric symptoms. Results: Total frequency of sexual dysfunction was 53% with the domains of lubrication, arusal and desire being commonly affected 62%, 70% and 98.5% of cases respectively. There is a relationship between severity of somatic and urogenital symptoms with sexual dysfunction (p = 0.03, p = 0.00 respectively). Conclusion: A considerable percentage of women experienced sexual dysfunctions in this period. Somatic and urogenital symptoms during the menopausal period could be a factor to maintain or intensity of sexual dysfunctions

Impact of diabetes mellitus on epithelial ovarian cancer survival

Abstract Background Diabetes mellitus (DM) is associated with poorer outcomes in some cancers. Its effect on ovarian cancer is less clear. We consider the effect of DM on overall survival (OS) and progression free survival (PFS) in patients with epithelial ovarian cancer (EOC). Methods A retrospective cohort study of 215 patients with EOC diagnosed between 2009 and 2016 was performed. Records were reviewed for standard demographic, pathologic and DM diagnosis data. Cox regression was used to evaluate the relationship between disease status and survival after adjustment for age, body mass index (BMI), parity, stage, grade, histology, debulking status, hypertension (HTN), menopause status and neoadjuant chemotherapy. Results Patients with DM (27.97, 95%CI: 23.63 to 32.30) had a significantly shorter OS rates compared to patients without DM (41.01, 95%CI: 38.84 to 43.17). The unadjusted hazard ratio (HR) for the association between OS time and DM was 4.76 (95%CI: 2.99 to 7.59, P < 0.001). Following adjustment for demographic and pathologic variables, the HR was 3.93 (95% CI: 2.01 to 7.68; P < 0.001). The PFS in patients with DM (14.10, 95%CI: 11.76 to 16.44) was significantly shorter compared to patients without DM (28.83, 95%CI: 26.13 to 31.54). The unadjusted HR for PFS and DM was 5.69 (95% CI: 3.05 to 10.61; P < 0.001). After adjustment for demographic and pathologic variables, the HR was 2.73 (95% CI, 1.18 to 6.95; P < 0.001). Conclusions DM can negatively effect on PFS and OS in EOC patients independent of the effect of other variables

GnRH antagonist versus agonist in normoresponders undergoing ICSI: a randomized clinical trial in Iran

Background: General concern is that the pregnancy rate is higher with GnRH-agonist as a protocol of pituitary suppression. GnRH-antagonist protocol provides a shorter period of administration and an easy flexible protocol. Objective: In this study, the outcomes of GnRH agonist and antagonist in ICSI cycles are compared in normo responder patients. Materials and Methods: In this randomized clinical trial, 300 normoresponders undergoing ICSI were randomly divided to GnRh agonist (n=150) and GnRh antagonist (n=150) groups. The main outcome measurements were chemical, clinical and ongoing pregnancy rates (PR). Results: The mean duration of stimulation were 9.6±1.6 and 8.2±1.6 days in agonist and antagonist groups respectively (p=0.001). The mean number of MII oocyte retrieved in agonist and antagonist groups were 7.7±4.0 and 6.9±4.3 respectively (p=0.03). There was no significant difference between two groups regarding mean number of gonadotrophin ampoules, follicles, occytes, total embryos and good quality embryos, OHSS incidence, and abortion rate. Chemical pregnancy rate was 35.3% in agonist and 39.3% in antagonist group. Clinical pregnancy rate was 35.3% in agonist and 34% in antagonist group. Ongoing pregnancy rate was 45 (31.3%) in agonist and 44 (29.3%) in antagonist group. There was no significant difference between two groups in pregnancy rates. Conclusion: In this study antagonist protocol was shown to be an easy, safe and friendly protocol in Iranian normoresponder patients, having similar outcomes with standard agonist protocol but shorter period of stimulation