Metformin alone versus metformin and clomiphene citrate in treatment of obese insulin resistant POCS women

Polycystic ovary syndrome [PCOS] is a syndrome of ovarian dysfunction. Its clinical manifestations may include menstrual irregularities, signs of androgen excess, and obesity. This study aimed to compare ovulation rate in women receiving metformin to women receiving both of Metfomin and Clomiphene citrate. Eighty women, among those attended at the infertility clinic at Beni-Sweif Hospital, were enrolled in this randomized study. They were classified into two equal [40 patients, each]. Group I received metformin [1700mg/day] alone, group II received a combination of metformin [1700mg/day] and clomiphene citrate [50mg/day, increasing doses up to 250mg/day]. The ovulation rate was 32.5% [13 patients] in group I versus 40% [16 patients] in group II and P value was 0.642. The pregnancy rate in group I was 20% [8 patients] versus 17.5% [7 patients] in group II and P-value 1.000. The use of metformin therapy alone can induce ovulation and early pregnancy in insulin resistant obese PCOS patients

Prediction of Pre-eclampsia with maternal mid-trimester activin A and uterine doppler velocimetry

Pre-eclampsia considered as one of the most serious conditions affecting about 8% of pregnant women. Signs usually begin in the second trimester. Delivery of the baby is thought to be the only cure of this condition. This study was conducted to assess the potential value of combining uterine artery Doppler ultrasonography with the measurement of maternal serum activin A at 22-24 weeks' gestation, in the prediction of pregnancies that subsequently develop pre-eclampsia. Seventy normotensive women were prospectively included in this cohort study. Peripheral venous blood samples were obtained and Doppler examination of the uterine arteries was performed between 22 and 24 weeks' gestation. Serum level of activin A was measured by ELISA. Mid-trimester maternal serum activin A and resistance index of uterine artery were significantly higher in women who subsequently developed pre-eclampsia than those remained normotensive. The best cut-off value for predicting pre-eclampsia for activin A based on ROC curve analysis was 15 ng/ml. While, measurement of serum activin-A has a role predicting pre-eclampsia in pregnant women, the midtrimesteric uterine artery Doppler is more applicable and accurate