ABSTRACT
Background: We sought to compare diagnostic values of two-dimensional transvaginal sonography [2D TVS] and office hysteroscopy [OH] for evaluation of endometrial pathologies in cases with repeated implantation failure [RIF] or recurrent pregnancy loss [RPL]
Materials and Methods: This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL. Uterine biopsy was performed in cases with abnormal diagnosis in TVS and/or hysteroscopy. We compared the diagnostic accuracy values of TVS in detection of uterine abnormalities with OH by receiver operating characteristic [ROC] curve analysis
Results: TVS examination detected 545 [69%] normal cases and 244 [31%] pathologic cases, which included 84 [10.6%] endometrial polyps, 15 [1.6%] uterine fibroids, 10 [1.3%] Asherman's syndrome, 9 [1.1%] endometrial hypertrophy, and 126 [15.9%] septate and arcuate uterus. TVS and OH concurred in 163 pathologic cases, although TVS did not detect some pathology cases [n=120]. OH had 94% sensitivity, 95% specificity, 62% positive predictive value [PPV], and 99% negative predictive value [NPV] for detection of endometrial polyps. In the diagnosis of myoma, sensitivity, specificity, PPV, and NPV were 100%. TVS had a sensitivity of 50% and specificity of 98% for the diagnosis of myoma. For polyps, TVS had a sensitivity of 54% and specificity of 80%. Area under the ROC curve [AUROC] was 70.69% for the accuracy of TVS compared to OH
Conclusion: TVS had high specificity and low sensitivity for detection of uterine pathologies in patients with RIF or RPL compared with OH. OH should be considered as a workup method prior to treatment in patients with normal TVS findings
ABSTRACT
CYP2D6, an enzyme, metabolizes a large number of commonly prescribed drugs. Variations in CYP2D6 gene encoding this enzyme have been associated with individual differences in drug metabolism rates. The purpose of our study was to identify some allelic variants of CYP2D6 gene and to detect defective CYP2D6 alleles, as part of a pharmacogenetic screening program. A prospective study was done on 120 participants referred to Royan Institute in 2013. Allele and genotype frequencies for polymorphism of CYP2D6 gene in exons 1 and 4 were determined by polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP] analysis and sequencing on PCR products, respectively. We identified a novel variant of the gene encoding cytochrome P450 2D6 [CYP2D6] at position +90 of intron 4 by sequencing method. This novel polymorphism of CYP2D6 has been deposited in GeneBank under the accession number KF225465 in Jun 2013. In the current study, we identified novel polymorphism in intron 4. This single nucleotide polymorphism [SNP] is known as +90G>A in the fourth intron
ABSTRACT
Background: Polycystic ovary syndrome [PCOS] is one of the most common endocrine women's disorders in reproductive age. Hyperandrogenism has a critical role in the etiology of PCOS and it can cause fault in Steroidogenesis process. During steroidogenesis, steroidogenic acute regulatory protein [StAR] seems to increase the delivery of cholesterol through mitochondrial membrane. Therefore, polymorphisms of StAR might effect on this protein and play a role in the etiology of PCOS
Objective: The aim of this study was to investigate the association between StAR SNPs with PCOS. Thus, seven polymorphisms in this gene: rs104894086, rs104894089, rs104894090, rs137852689, rs10489487, rs104894085 were detected
Materials and Methods: In this case control study, 45 PCOS women, 40 male factor/unexplained infertile women, and 40 fertile women as two control groups were participated from 2008-2012. Polymorphisms were detected using restriction fragment length polymorphism [PCR-RFLP] method
Results: Heterozygote genotyping for rs 137852689 SNP [amino acid 218 C > T] was only seen in seven PCOS patients, one in normal ovulatory women, and five in male factor/unexplained infertile women [15.5%, 2.5%, 12.5%, respectively] [p= 0.12]. While, it has shown no association between other SNPS with PCOs
Conclusion: The RFLP results for seven chosen SNPs, which located in exon 5 and 7 showed normal status in three groups, it means no heterozygous or homozygous forms of selected SNPs were observed. So, it seems evaluation of the active amino acid sites should be investigated and also the study population should be increased
ABSTRACT
Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too
Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound [2-DUS] and real time three dimensional ultrasound [3-DUS] in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard
Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study [unicornuate, bicornuate and didelphys anomalies]. The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic [ROC] curve, cut off points for predicting the kind of anomalies were proposed
Results: The women were evaluated by 2-DUS [n=89] and [II] 3-DUS [n=126]. All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa [K] index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate
Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS
ABSTRACT
With recent improvements in maternal fetal medicine and neonatal intensive care, the survival rates of extremely low birth weight infants have been improved. In this report we describe the case of an extremely low birth weight infant due to preeclampsia, who was conceived by in vitro fertilization and is in complete physical and mental health after a one-year follow-up