Comparison between unilateral and bilateral ovarian drilling in clomiphene citrate resistance polycystic ovary syndrome patients: a randomized clinical trial of efficacy

Laparoscopic ovarian drilling [LOD] is an alternative method to induce ovulation in polycystic ovary syndrome [PCOS] patients with clomiphene citrate [CC] resistant instead of gonadotropins. This study aimed to compare the efficacy of unilateral LOD [ULOD] versus bilateral LOD [BLOD] in CC resistance PCOS patients in terms of ovulation and pregnancy rates. In a prospective randomized clinical trial study, we included 100 PCOS patients with CC resistance attending to Al-Zahra Hospital in Rasht, Guilan Province, Iran, from June 2011 to July 2012. Patients were randomly divided into two ULOD and BLOD groups with equal numbers. The clinical and biochemical responses on ovulation and pregnancy rates were assessed over a 6-month follow-up period. Differences in baseline characteristics of patients between two groups prior to laparoscopy were not significant [p>0.05]. There were no significant differences between the two groups in terms of clinical and biochemical responses, spontaneous menstruation [66.1 vs. 71.1%], spontaneous ovulation rate [60 vs. 64.4%], and pregnancy rate [33.1 vs. 40%] [p>0.05]. Following drilling, there was a significant decrease in mean serum concentrations of luteinizing hormone [LH] [p=0.001] and testosterone [p=0.001] in both the groups. Mean decrease in serum LH [p=0.322] and testosterone concentrations [p=0.079] were not statistically significant between two groups. Mean serum level of follicle stimulating hormone [FSH] did not change significantly in two groups after LOD [p>0.05]. Based on results of this study, ULOD seems to be equally efficacious as BLOD in terms of ovulation and pregnancy rates

Role of dyslipidemia in preeclamptic overweight pregnant women

Obesity is an independent risk factor of preeclampsia with unknown mechanism and hyperlipidemia might be a probable case of it. The objective of this study was to determine the role of hyper-triglyceridemi in association with high prepregnancy body mass index and the risk of preeclampsia. The authors conducted this case-control study of 42 preeclamptic and 41 normotensive overweight pregnant women. The two groups were comparable with respect to age, gestational age, and body mass index. Blood samples were collected at the time of diagnosis of preeclampsia, after 14 hour fasting to determine plasma lipid concentrations. Enzymatic photometric tests were used to determine lipid profile. Data was analyzed with independent "t-test", Chi-square and one-way ANOVA and post HOC Tukey HSD test. The statistical significance was set at 0.05 levels. In the subjects with preeclampsia, serum triglyceride and total cholesterol levels were significantly increased and plasma HDL-cholesterol concentrations were decreased compared with the controls, [p<0.05], but plasma LDL cholesterol levels didn't differ between the two groups. Women who developed severe preeclampsia had higher concentrations of TG and cholesterol and lower levels of HDL compared to noromotensive group. Mean TG: 375.16 vs. 202.85, p<0.001, Mean cholesterol: 245.64 vs. 214.32, p=0.04, Mean HDL: 40.80 vs. 48.95, p=0.03]. We noted that dyslipidemia, particularly hypertriglyceridemia was highly correlated with prepregnancy high BMI in preeclamptic women. These findings continue to support a role for dyslipidemia in BMI related preeclampsia