study of menarcheal age in northern Iran [Rasht]

The event of menarche is an exceptional phenomenon, which occurs once in a lifetime. It is the precursor of future fertility. The onset of menarche is mainly dependent on genetic factors, however geographical and nutritional factors among other factors have been attributed to the events of menarche. The aim of this study is to determine the age of onset of menarche and the factors which induce it in northern Iran. This is a cross sectional study which will assess the onset of menarche in girls between the age of 11-16 years. The subjects were either in middle or high school and had experienced menarche within 6 months prior to the study. This study revolves around 600 girls who were selected using stratified randomized sampling techniques. The data was collected in the form of a questionnaire which focused on age, weight [was measured to the nearest 0.1 kg using a balance beam scale], height [was measured to nearest 0.1 cm with a manual height board], and Body Mass Index [BMI: kg/m2] was used as an index of relative weight. Principal Component Analysis [PCA] was applied to analyze Socio-economic Status [SES]. The defined standard age of the first menstrual event was applied as the standard. The data collected was analyzed using the Statistical Package for the Social Sciences [SPSS.10] statistical analysis software and the Chi-square and Analysis of Variance [ANOVA] tests were applied. In an effort to establish the factors associated with the age of menarche, multivariate analysis was performed based on linear logistic regression which was performed using a model where all the variables changing the risk estimated by more than 10%. Statistical significance was determined at P<0.05. The mean age at menarche was observed to be 12.99 +/- 1.33 yrs [ranging from 10.16 to 15.91 yrs]. The study showed that menarche occurred during the summer for 270 [45%] patients making it the most common season for menarche while winter was the least common season. The mean age of menarche was delayed in patients from low SES groups and it occurred earlier in patients from high SES. In girls with low BMI, menarche occurred earlier in comparison to girls with high BMI. There was a significant correlation between session and age of menarche [p<0.05]. There was no significant relationship statistically between BMI and age of menarche [p>0.05]. Linear regressions showed no significant effect of BMI on the age of menarche but there was a significant correlation between season and SES on the age of menarche. The age of menarche and the most common seasons for menarche were similar to previous studies. Results from this study showed that the age of menarche decreased with higher SES. And also the age of menarche in girls with high and low BMI occurred earlier. However, previous studies showed that it occurred earlier in high BMI and later in low BMI. It appears that genetic and environmental factors have influenced these differences

Vaginal sonography and hysteroscopy; comparison in infertility patients

Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. To evaluate the consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women before assisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsy performed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosis was confirmed by histological studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterine cavity specimens. Sensitivity and specificity, predictive were calculated for hysteroscopy considering the histological study as 100%. Sensitivity and specificity of sonography in diagnosing the polyp were stated 81% and 64% respectively. Sensitivity and specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that sensitivity and specificity of sonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myoma were expressed 50% and 93% respectively. Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believe it should be replaced by the diagnostic hysteroscopy as a first line infertility investigation

Propofol vs. thiopental NA; pregnancy outcome and postoperative nausea and vomiting [PONV] in art cycle

The aim of this study was to compare the side effects, fertilization rate and pregnancy rate [PR] and duration of recovery between Propofol and Thiopental Na after ICSI-vaginal retrieval of oocyte in ART cycle. This study was a prospective, randomized clinical trial. Ninety eight ASA [American Society of Anesthesiologist] physical status I and II women participating in an intracytoplasmic sperm injection [ICSI] program were assessed. All of the patients underwent general anesthesia induction with Propofol and Thiopental Na. The first group [49 cycles] received 2-2.5mg/kg of Propofol, and the second group [49 cycles] received 5mg/kg Thiopental during transvaginal oocyte retrieval. An informed consent form was obtained for each patient's treatment. Variables under study included: female age, cause and duration of infertility postoperative nausea and vomiting [PONV], heamodynamic changes, mean number of oocyte retrieved, oocyte metaphase II, embryo cleaved, embryo transferred, embryo quality and pregnancy rate [PR] and duration recovery. Statistical analysis was carried out by using SPSS. 10 software and statistical test of T-test and chi-square. The PR in Propofol group was 18 [36.7%] and in Thiopental Na group was 19 [38.8%] with no significant differences the mean duration of infertility and weight weren't statistically significant. The mean number of oocyte retrieved [metaphase II], embryo cleaved, embryo transferred and embryo quality weren't significant between the two groups. The incidence of nausea in Propofol group in comparison with Thiopental Na group was lower with significant differences. The incidence of vomiting between two groups was statistically significant [46.9% vs. 28.6% respectively] [p<0.05] between two groups Duration of recovery in Propofol group was 15 +/- 3 min and in Thiopental Na group was 25 +/- 5 min that was statistically significant [P<0.05]. Propofol offered lowerincidence of post operative nausea and vomiting and a quick recovery from anesthesia without any adverse effect on pregnancy outcome. These findings showed that Propofol was a good alternative for Thiopental Na in short time operation, like ICSI -vaginal retrieval of oocytes

Administration of NTG before embryo transfer does not increase pregnancy rate

Recent studies of uterine contractility in IVF-embryo transfer led us to consider an alternative, and possibly complementary, explanation for the high implantation rates of blastocysts. It has been demonstrated that myometrial contractile activity influences embryo implantation, possibly through mechanical displacement of embryos. The aim of this study was to examine the effect of nitroglycerine [NTG] treatment for priming the uterus on the pregnancy outcome of ICSI-ET programs. This study was a prospective, randomized, double-blinded placebocontrolled clinical trial. One hundred consecutive cycles of ICSI-ET on infertile couples were randomly divided into treatment and control groups. The treatment group [50 cycles] received an oral dose of 0.4 mg of NTG, and the control group [50 cycles] received a placebo, 15 minutes before fresh ET. An informed consent from was obtained from each patients. The main outcomes were implantation rate [IR] and pregnancy rate [PR]. The mean age of females in the control group and in the treatment group were 30.1 +/- 5.1 and 31 +/- 5.5 years respectively. Data showed that the mean duration of infertility was not significantly different between control and treatment groups [6.6 +/- 5.8 versus 7.8 +/- 5.1 years, respectively]. The mean number of oocyte retrieval [metaphase II], 2pn, embryo cleaved, embryo transferred and PR weren't different between two Groups [p>0.05]. Overall PR was 36%, it was 38% in treatment group and 34% in control group but there wasn't statistically significant difference between two groups. [p>0.05] NTG didn't increase PR compared to placebo group. These results suggest that NTG treatment before ET isn't effective in the priming of a uterus