Prevalence and Factors related of psychiatric symptoms in low risk pregnancy

Background: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. Methods: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. Results: The prevalence of depressive disorders was 15.4 for Edinburg scores ≥13.  The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5. The prevalence of psychiatric symptoms was high; for 25 somatization, 258 anxiety, obsession-compulsion disorders or OCD 6.4, 8.8 interpersonal sensitivity, 5.3 phobia, 7.6 paranoid ideation, and 1.2 psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (β=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). Conclusion: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women

Impact of dexamethason

Objective: Infertile women with polycystic ovary (PCOs) involve with anovulatory cycles. Various adjuvant treatments have been suggested to improve ovarian response in these patients. In this study, we aimed to evaluate the role of dexamethasone in the outcome of IVF/ICSI in PCOs infertile women. Study design: 129 PCOs infertile women undergone IVF/ICSI were enrolled for this single blind clinical trial study in 2012–2013. Setting: Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran. Method: 43 patients who underwent IVF received dexamethasone (0.5 mg, 4 tab/day) in the treatment group and 74 patients were considered as the placebo group. Main outcome measure: Pregnancy rate was compared between the two groups. In addition, number of dominant follicle, oocytes retrieved, embryos transferred, and number of gonadotropin ampoule were evaluated. Results: The pregnancy rate in the group receiving dexamethasone was 17.5% significantly higher versus 4.3% in the placebo group (P < 0.05). The mean number of embryos in the patients received dexamethasone was 6.7 ± 4.3, significantly greater than placebo which was 4.9 ± 4.9 (P < 0.05). The mean number of gonadotropin ampoules used in the group received dexamethasone was 3.5 ± 1.6, significantly lower versus the placebo which was 5.3 ± 2.5 (P < 0.05). The mean number of oocytes in the group received dexamethasone was 11.8 ± 8 and in the placebo group was 9.6 ± 5.8 that was not significant. Conclusion: Dexamethasone enhances embryos and pregnancy rate; in addition, it reduces gonadotropines ampoule used for stimulation, hence, and we recommend using of dexamethasone in women with PCOs undertreatment of IVF/ICSI

Effects of olive oil sitz bath on improvement of perineal injury after delivery

Introduction: Episiotomy is one of the common surgeries in the world with few complication and perineal pain. Since the olive oil has antiseptic and healing effects, this study was performed to evaluate the effects of olive oil sitz bath on improvement of perineal injury after delivery.Materials and Methods: This double blind clinical trial was carried out on 60 selected eligible women who they had mediolateral episiotomy or perineal tear grade 1 and 2. Following repairing episiotomy, the subjects were randomly allocated into two groups: the Study group was undergone care by olive oil sitz bath and the control group by distilled water sitz bath for 10 days. Data were collected through demographic data, REEDA scale and visual analog scale of pain. Results: There was a significant difference between the study and control group with regards to pain severity after 5 and 10 days (p<0.05), wound redness after 5days (p<0.0001) and redness (p<0.000), edema (p<0.05) 10 days after delivery. Any case of ecchymosis, discharge and approximation (distance between the wound edges) was not observed in the olive group but those signs were observed in the control group. However, this difference was not statistically significant.Conclusion: This study suggests that olive oil to be added to routine water sitz bath for post-episiotomy car

Effect of the time in administration of clomiphene on follicular growth, endometrium and pregnancy rates in PCOS patients

Background: Clomiphene citrate is very successful in inducing ovulation; there is usually a discrepancy between ovulation and pregnancy rate. If treatment is started early in the cycle this negative effect is reduced. The aim of this study was to investigate the effect of the time of administration of clomiphene citrate on follicular growth, endometrial thickness and ovulation and pregnancy rates in PCOS (Polycystic ovary syndrome) patients. Methods: This randomized controlled trial study was performed on 115 PCOS (Polycystic ovary syndrome) women in Fateme Zahra Fertility and Infertility Research Health Center in April 2012. Patients randomly divided into two groups. Patients in the early group (No. 55) received 100 milligrams of clomiphene citrate tablet daily starting the next day after finishing medroxyprogesterone acetate tablet for 5 day, whereas the patient in the late group (No. 60) received 100 milligrams of clomiphene citrate tablet daily for 5 day starting on day 3 of the menstrual cycle. Then on follicular growth, endometrial thickness and ovulation and pregnancy rates by SPSS software, version 16 (Armonk, NY, USA) were compared in two groups. Results: 36.4% of patients of early administration of clomiphene and 60% of patients in the later administration of Clomiphene were able to build dominant follicle. This difference was statistically significant (P<0.011). There was no statistically significant difference between the two groups on age, body mass index, duration of infertility. Findings showed that in the early group 14 (63.6%) and in the late groups 8 (36.4%) women who made dominant follicle, were pregnant. There was significant difference between these two groups (P<0.001). But, in the number of follicles, endometrial thickness and pregnancy rate, there were no significant difference. In the early administration of clomiphene, the pregnancy rate was 25.5%. However in the later administration of clomiphene it was 13.3% (P=0.882). Conclusion: According to the results of this study, if the dominant follicle was made, with administration of clomiphene citrate in luteal phase the incidence of successful pregnancy is higher

Factors influencing the ovarian response in intracytoplasmic sperm injection (ICSI)

Background: Ovarian response to gonadotropin stimulation can predict the success rate of Assisted Reproductive Technology. The purpose of this study was not only to determine the ovarian response rate in patients on whom intracytoplasmic sperm injection (ICSI) did not successfully work but also to assess the influence of factors on ovarian response. Methods: In a retrospective study, the medical records of 220 women undergoing their first cycle of ICSI from March 2012 to October 2016 were thoroughly examined. Special attention was paid to ovarian response with regards to age, body mass index, the history of menstrual cycle, the type of infertility, the duration of infertility, and the cause of infertility with respect to measures of women’s hormones. The ovarian response expressing the number of mature MII oocytes after oocyte retrieval was regarded as “poor response” representing a yield of 1–4 oocytes, and “appropriate response” representing a yield of 5 or more oocytes. Results: Out of 220 infertile women, 45 subjects (20.5%) had poor response, 175 subjects (79.5%) had appropriate response to ovulation stimulation with gonadotropin. The results of indicated that lower female age (p=0.005) and lower female FSH (p=0.006) were consistent with appropriate ovarian response. After adjusting the variables, the age (age <30 years) (OR= 2.45, 95% CI= 1.19-5.07) and the female FSH (FSH <30 years) (OR= 2.59, 95% CI= 1.16-5.71) were found to be associated with an appropriate ovarian response. Conclusion: It can be concluded that entering the first cycle of ICSI with FSH test and considering the age of women seem to be acceptable strategies

Evaluation of Preincubation Time Interval in TesticularBiopsy to Obtain Optimum Sperm Parameters

Objective: In sever oligospermia; one of the paths used for surgical sperm retrieval (SSR) is to extract sperm via a testicular biopsy. The aim of our study is to determine the reliable time interval between testicular biopsy and intracytoplasmic sperm injection (ICSI) procedure in order to obtain optimumsperm parameters (count, motility and normal morphology).Materials and Methods: This cohort study was carried out on 30 patients which were candidates for ICSI. After collection and keeping the samples obtained from the testicular biopsy in Ham’s F10 environment, the concentration, motility and morphology of the sperm in each sample was evaluated immediately as well as 2 and 4 hours after processing. The Data were then compared with each other. For the statistical analysis, Friedman, Willcoxon and Cochran tests were used.Results: The mean of sperm concentration was 5.69 ± 6.14 million and the motility was10.83 ± 12.63% at 2 hours following biopsy which was significantly higher than those obtained after 0 and 4 hours of the biopsy (p <0.05).Conclusion: The reliable preincubation time which resulted in the highest rate of spermatozoa parameters after testicular biopsy and before incubation was 2 hours