Age of women and the number of antral follicles in predicting ovarian response in intrauterine insemination (IUI)

Background: Fertility specialists assess ovarian responses prior to estimating the prognosis for women who are suffering from anovulation. To diagnose the inconsistencies between chronological and biological age of ovaries and predict ovarian response, transvaginal sonography (TVS) ovarian act as an operant method. The aim of the current study was to assess the correlation between the number of antral follicles in both ovaries and the age of women in predicting the ovarian response in intrauterine insemination (IUI).  Methods: The research design of the present study was a cross-sectional. A total of 171 individuals, who were non-smoker patients and had already undergone a standard regimen of ovarian stimulation for IUI, were selected as participants of this study from the Infertility and Reproductive Health Research Center in Babol (Iran). On the third day of the cycle, TVS was conducted to measure the mean of every ovary and also to count the number of antral follicles on the both ovaries.  Results: The mean age of our patients was 27.7. The increased aged of women is significantly associated with lower total number of antral follicles. (P = 0.001). The mean ovarian diameter was significantly correlated with high number of antral follicles (p = 0.0001).  Conclusion: The findings of the present study indicated that the age of women and the ovarian diameter are leading factors to help determine ovarian response as well as basal antral follicle counts

Vaginal wall cysts in a prepubertal girl: a case report

A vaginal cyst is an encapsulated sac, situated on or under the lining of vagina, and contains liquid or semi liquid substance. Vaginal cysts have rarely proved to be more troublesome than causing a bit of discomfort and slight pain, but in some cases, they can develop into tumors. A 5-year-old girl, who was complaining about a weird pain in her lower abdomen, was referred to the gynecology center of the hospital. Ultrasonography revealed a vague large cyst in her uterus and vagina. Surgical procedure was necessary to remove it. The patient was followed up for 6 months, and no sign of recurrence of the cyst was observed

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

Maternal serum C - reactive protein and fibrinogen concentration in women with pre-eclampsia

Background: Despite many studies published in recent years concerning pathogenic mechanisms of pre-eclampsia, but this issue remains controversial. The aim of the present study was to compare C-reactive protein (CRP) level and fibrinogen concentration obtained from pregnant women with pre-eclampsia with those obtained from women with normal pregnancies. Methods: In a case-control study, 40 pregnant women with mild pre-eclampsia were studied. The maternal serum CRP and fibrinogen concentration of the 40 patients were compared with 55 pregnant women with non-preeclampsia as a control group. CRP was examined using quantitive nephlometry and fibrinogen concentration was measured by clotting system. An independent sample t-test was used for analysis. Results: Maternal serum CRP was higher in women pregnant with pre-eclampsia compared with those from pregnant women normal pregnancies (p= 0.01). The independent t-test did not reveal any statistically significant differences in the fibrinogen concentration between these pregnant women, either with or without pre-eclampsia. Conclusion: The findings of this study indicated that a novel increased CRP was identified among pregnant women with pre-eclampsia, making inflammatory marker as a promising new approach for the detection of pre-eclampsi

Are children born through Intra-Cytoplasmic Sperm Injection (ICSI) having a lower intelligence quotient?

Background: There is still concern about delayed mental development for children born through Intra-Cytoplasmic Sperm Injection (ICSI). In the present study, the intelligence quotient (IQ) of ICSI children at the age of 5–6 years was compared with that of the control group of naturally born (NB) children. Outcome measure: Full-scale IQ of the mental development in children born through ICSI in 5–6 years. Design: Cross-sectional study. Setting: Fatemehzahra Infertility and Reproductive Health Research Center of Babol – Iran. Participants: 28 live-birth singleton children 5–6 years of the first generation born after ICSI treatment. Methods: The mental development of 28 born through ICSI children at 5–6 years compared with 32 naturally born children as control using intelligence quotient (IQ) test obtained from the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) (Iranian version). Results: The mean full-scale IQ was 105.9 ± 14 for ICSI and 107.2 ± 12.9 for NB children which showed no significant difference. The only significant possible predictors of slightly lower full-scale IQ in ICSI children were lower parental education level and longer childcare in day center. Conclusion: Our finding provides some reassurance for parents of children born through ICSI regarding the child’s preschool IQ

Women’s satisfaction in early versus delayed postcaesarean feeding: A one-blind randomized controlled trial study

Background: The early postoperative feeding after caesarean section (C- section) has remained controversial. This study was designed to evaluate the safety and efficacy of early versus delayed postcaesarean section oral feeding regarding gastrointestinal complications and patients postoperative satisfaction after C- section. Methods: This clinical trial study was conducted on 200 pregnant women undergoing planned C-section under spinal anesthesia (Registration Number: IRCT: 138712211760N1). Women were randomly divided in two groups group A (early feeding group) comprised of 101 patients who were encouraged to take oral fluid. If they tolerated, they continue semi-solid and solid foods starting 2 h after caesarean section. Group B (delayed feeding group) comprised of 99 patients who were given oral fluid 8 h after surgery. After beginning of feeding the patients’ tolerance, first flatus, first defecation, beginning of regular diet, the length of hospital stay and also patient satisfaction level were evaluated in each group by visual scale analog (VAS). Results: The mean time of the first passage of flatus was 10.2±1.7 hours for the early oral feeding group versus 10.7±1.6 hours for the delayed feeding group and the difference was significant (P=0.03). Duration to first defecation and length of hospital stay as well as patient satisfaction level did not differ significantly between the two groups.  Conclusion: The results of this study suggest early postcaesarean feeding. It is well tolerated and helps return normal feeding habits

Short, semi-short or long GnRH agonist treatment regimens in women ICSI candidate; which is proper in

Objectives: Investigation of two discontinuous GnRH agonist (GnRH-a) protocols (Short and semi-short) versus traditional long protocol in preventing premature LH surge in women undergoing Intra-cytoplasmic sperm injection (ICSI). Study design: Single blind randomized trial study. Setting: Fatemezahra Infertility and Reproductive Health Research Center, Babol, Iran. Materials and methods: 139 patients who were undergone ICSI, randomly divided into three groups. In short protocol group (n = 40), GnRH-a (buserelin acetate) was initiated midluteally and ceased at the onset of the next cycle. Group of semi-short protocol (n = 41) initiated GnRH-a the same as short protocol group and discontinued at the fourth day of the next cycle. Group of long protocol (n = 38) was initiated midluteally and continued until the day of HCG injection. Ovarian stimulation was performed with gonadotropin. As primary outcome occurrence of premature LH surge was evaluated and as secondary outcome the duration and total dose of consumed gonadotropin, number of oocytes retrieval, number of formed blastocyst and pregnancy rate were investigated. Main outcome measures: No undesired LH surge occurred in the three groups, although the mean of LH at administration day of HCG was significantly higher in short protocol group (P ⩽ 0.05). No significant difference was observed in the number of mature oocyte, and number and quality of blastocyst, duration and total dose of consumed gonadotropin and pregnancy rate among three groups. Major conclusion: In the ICSI protocol, discontinuation of GnRH-a on the first or fourth day of ovarian stimulation does not enhance a premature LH surge

The effect of dexamethasone therapy on prolonged latent phase of labor: a randomized double-blind clinical trial

Background: Shortening the interval between the onset of labor and delivery is useful for both mothers and fetuses. The aim of the study was to investigate the effect of dexamethasone on the augmentation and the duration of labor in prolonged latent phase of labor. Method: The design of the study was a randomized double-blind clinical trial design, which was conducted in delivery center of Rouhani hospital in Babol (Iran). A total 121 nulliparrous women with a singleton pregnancy and cephalic presentation at 40–42 gestational weeks in prolonged latent phase were randomly assigned to receive 2 ml ampoule dexamethasone 4 mg/mL (the intervention group) and 2 ml ampoule of sterile water for injections (the control group), which were both intramuscularly administered. Then, the Then, the augmentation of labor with the use of intravenous oxytocin infusion (Caspian Tamin Company Iran) (2.5 m units/ per minute) began in both groups. The primary outcome was the duration of time between the onset of augmentation and the second stage of labor. Results: The duration of time between the onset of labor augmentation and the second stage of labor (hours) was 5.6±1.9 in the study group, whereas it was 7.7±1.5 in controls with a significant difference (p ≤ <0.001). In the study group, the duration of time between the onset of labor augmentation and the active phase of labor was lower than that of the control group (p= 0.02). In addition, the duration of the second stage of labor (p <0.001) and the third stage (p <0.001) was lower in the study group compared with that of the control group. Conclusion: It is imperative that midwives administer dexamethasone to improve the prolonged latent phase in women during the labor

Thyroid-stimulating hormone (TSH) and pregnancy outcome in patients undergoing in vitro fertilization (IVF)

Introduction: Subclinical hypothyroidism is related to poor outcome of pregnancy, which is reported in more recent researches. The aim of this study was to determine the correlation between pre-conception of thyroid-stimulating hormone (TSH) level and pregnancy outcomes in patients undergoing in vitro fertilization (IVF).  Methods: This retrospective cohort study was done on 115 IVF candidate patients undergoing long protocol of ovulation induction that became pregnant from 2007 to 2012. Pregnancy outcomes, including abortion rate, termination age of pregnancy and birth weight in women with low pre-conception TSH (≤2.5 mIU/L) and high pre-conception TSH (>2.5 mIU/L) were compared with each other. Results: Among 115 pregnancies, 30.2% of the women had pre-conception TSH >2.5 mIU/L. Preterm delivery (2.5 than them with a pre-conception TSH ≤2.5 (P= 0.044). There was no statistically significant difference in abortion, pregnancy termination, and birth weight between two groups. A pre-conception thyroid-stimulating hormone level >2.5 mIU/L is associated with a lower gestational age at delivery in women undergoing in vitro fertilization. Conclusion: The results of this research indicated that a pre-conception thyroid-stimulating hormone level >2.5 associated with preterm labor in women undergoing IVF. Therefore, it is suggested that screening for hypothyroidism before IVF could be have significant public health implications

Obese women with polycystic ovary syndrome and Pregnancy: a case report and a literature review

Many women with polycystic ovary (PCO) are obese. These women have lower clinical pregnancy rates when compared with their lighter counterparts. We hereby present a case of an obese PCOs woman, who referred to our clinic, underwent a microinjection, and failed in pregnancy. Then, she was recommended to have a change of lifestyle and lose weight along taking insulin-sensitizer medicines. In the following 6 months, she lost 19 Kilograms and referred to us with a spontaneous pregnancy. The object of this report was to determine the role of insulin intolerance medicines and lifestyle improvement on enhancing the rate of pregnancy in the PCOs obese women