Treatment results of high dose cabergoline as an adjuvant therapy in six patients with established severe ovarian hyper stimulation syndrome

The beneficial role of cabergoline as a prophylactic agent to prevent ovarian hyper stimulation syndrome [OHSS] among high-risk patients has been demonstrated in previous studies. But data for its role as a treatment for established severe OHSS is still limited. We represent the treatment results of high dose oral cabergoline in management of six patients after the syndrome is established. High-dose oral cabergoline [1 mg daily for eight days] was prescribed as an adjuvant to symptomatic treatment for six hospitalized patients with established severe OHSS following infertility treatment cycles. In two cases OHSS resolved rapidly despite the occurrence of ongoing pregnancy. Considering the treatment outcomes of our patients, high dose cabergoline did not eliminate the need for traditional treatments, but it was a relatively effective and safe therapy in management of established severe OHSS, and prevented the increase in its severity following the occurrence of pregnancy

Comparison of oral dydrogesterone with suppository vaginal progesterone for luteal-phase support in in vitro fertilization [IVF]: a randomized clinical trial

Luteal phase support is mandatory in assisted reproductive technologies [ART] for optimizing outcome, so the luteal phase is supported with either progesterone, addition of estradiol to progesterone, hCG or gonadotropin releasing hormone [GnRH] agonists. Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. To compare oral dydrogestrone with vaginal progesterone for luteal-phase support in IVF. We performed this prospective, randomized trial in a tertiary infertility care unit in Taleghani Hospital, Tehran, Iran. In total 80 Women with a history of male factor infertility undergoing controlled ovarian stimulation for IVF treatment [fresh cycle] randomly were divided in two groups [group A or oral dydrogesterone group and group B or vaginal progesterone group]. The inclusion criteria were the use of GnRH analogue down-regulation and age less than 40 years old with regular menstrual cycles. All women were euthyroid and normoprolactinemic. Group A [n=40] received 10 mg dydrogesterone QID [40mg daily] and group B [n=40] received 400 mg suppository vaginal progesterone [cyclogest] twice per day [800 mg daily]. Clinical pregnancy rate in cyclogest group was higher than dydrogesterone group but the difference was not significant [p=0.52], furthermore the miscarriage rate in two group was the same .The difference between two groups regarding antral follicle, embryo number, luteal-phase duration, endometrial thickness, oocyte number and metaphase-II was not significant [p>0.05]. The results showed that oral dydrogesterone is as effective as vaginal progesterone for luteal-phase support in women undergoing IVF

[ value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009]

Although the Pap smear screening test has showed a great success in early diagnosis of cervical cancer in different countries over the past 60 years, cervical cancer has remained the fifth most common cancer among Iranian women. The diagnostic value of Pap smears which are done in health centers around the country compared with international standards for cervical cancer screening requires further consideration. The purpose of this study was to compare Pap test's findings with colposcopic biopsies as the gold standard. In this cross-sectional study, all non-pregnant women attended to Taleghani hospital gynecology clinic between 2007 and 2009 for routine Pap smear and were volunteer to participate in this research, and based on clinical findings as well as colposcopist's opinion had an indication for colposcopy, were included. Eligible women had a Pap test as well as colposcopy and cervical biopsy thereafter. Sensitivity, specificity, positive and negative predictive value [PPV and NPV] of Pap test was calculated compared with cervical biopsy as the gold standard. Overall,%67 of women had abnormal biopsy [mostly HPV appearance], whereas only%21 of Pap smear results indicated abnormal cervical screening test results. The sensitivity, specificity, PPV, and NPV of Pap smear for detecting cervical neoplasia in our study was%23.9,%84.8,%76.2, and%35.4, respectively. The sensitivity of Pap smear was less than other reports. It needs more quality control, including sampling, sample preparation and interpretation in this center. Studies with more samples in other hospitals and particularly in different health care centers in Iran are highly recommended