Anti-Thyroid Antibodies in Unexplained Recurrent Pregnancy Loss

The aim of this study Observational study is to find out whether thyroid antibodies may serve as an additional independent marker for unexplained recurrent pregnancy loss irrespective of endocrine thyroid function. This study was carried in Tanta University Hospital on 60 pregnant women in the first 20 weeks of gestation. They were divided into three groups: the control group [Group I] included 20 euthyroid pregnant women, the second group [Group II] included 20 euthyroid women who were primary aborters and the third group [Group III] included 20 euthyroid women who were secondary aborters. Laboratory evaluation of serum T3, T4 and TSH was performed for each case. Anti thyroid antibodies [antithyroglobulin antibodies and antimicrosomal antibodies] levels were determined by ELISA test. serum antithyroglobulin and antimicrosomal antibodies levels were significantly elevated in the study groups compared with the control group. Serum antibodies levels were significantly elevated in group III [secondary aborters] compared with group II [primary aborters]. A highly significant association was observed between antibody positivity and missed abortion. Thyroid antibodies are associated with an increased risk of recurrent pregnancy loss and they may be an effective marker of miscarriage risk. Further studies including a larger number of women are needed to confirm the results of the current study

Revivification of direct trocar insertion technique at laparoscopy in Tanta University Hospital

A technique using direct trocar insertion for laparoscopy was used in 114 cases in Department of Obstetrics and Gynaecology, Unit A, of Tanta University Hospital. Critical surgical points were emphasized: adequate relaxation, sharp trocars, elevation of the abdominal wall and proper trocar insertion. The technique was safe and no complications were encountered except failure of the procedure in 3 cases only. It has had the following advantages one puncture less, time saving, pneumoperitoneum was done under vision, less amount of gas and proper steadiness of the sleeve in situ

Artificial ovulation by clomiphene citrate and human chorionic gonadotrophin followed by insemination for treatment of unexplained infertility

The aim of the present study was to compare the effectiveness of intrauterine [IUI] versus direct intraperitoneal insemination [DIPI] in treatment of cases of unexplained of infertility. This study was carried out on 60 couples during their reproductive period complaining of primary unexplained inferitility. The selected cases were randomly divided into two groups, thirty patients each. Women of first group were submitted to IUI and those of the second group were submitted to DIPI. Controlled induction of ovulation was performed by clompihene citrate [CC] given in a dose of 50 mg twice daily for five days starting from the 3rd day of menstrual cycle. Ultrasonographic monitoring of ovulation started from the 10th day of the cycle to determine the size of Graffian follicle. The female was injected with 10000 I.U. of hCG once the ovum reached the size of 17-18 mm. in diameter. Insemination was carried out twice, 24 and 48 hours after hCG injection using husband's semen after washing and swim up of the sperms. In the present study, the cumulative pregnancy rate with IUI was 16.67%; while that of the DIPI was 3.30% that was significantly lower than that of IUI. From the present study, one concluded that both IUI and DIPI plus induction of ovulation by CC/hCG are valuable methods for treatment of unexplained infertility. However, IUI is more effective and more physiological than DIPI. The latter approach should be practiced only when IUI would be difficult or failed

Microimmunofluorescent screening of chlamydia trachomatis antibodies in cases of first trimester spontaneous abortion

The prevalence of significant [1/16] Chlamydia trachomatis [CT] antibodies through handling microimmunoflourescent technique has been found to be 12% in normal fertile nonpregnant women, 24% in normal pregnant women, and 48% in cases of first trimester spontaneous abortion. About 55% of abortion serologically positive cases had history of OCS use and 31% had history of IUD use. We concluded that significant increase in prevalence of CT antibodies in aborters indicates that CT infection plays a role in the etiology of this process

role of mycoplasma in the pathogenesis of first trimester spontaneous abortion

This study was carried upon 20 women suffering from first trimester spontaneous abortion as a test group and 8 normal women with no history of abortion as a control group. From each women included, 2 samples were taken [a] an endocervical swab for isolation of Ureaplasma urealyticum [U.U] and Mycoplasma hominis [M.H,] by Mycofast ALL-IN technique, [b] blood sample for detection of serum mycoplasmal antibodies. The husbands of both groups were also tested for the presence of serum mycoplasmal antibodies. Isolation of U.U. form 35% of patients but nothing were obtained from the control group. No isolation of M..H from both patients or normal women had been detected. The D.B.V. international mycoplasma serology test showed that U.U. antibodies were found in 35% of aborted women and 15% of their husbands and M.H, antibodies were detected in 15% and 5% respectively. Of the control group, 25% of the women had antibodies of U.U. and 12.5% of them had antibodies of M.H. while their husbands have no antibodies at all. In general, mycoplasmal infection increases in old age group [40-45 ys] and with high gravidity. So, we conclude that these microorganisms play a role in the pathogenesis of first trimester spontaneous abortion

role of cervical score and ovarian ultrasonic scanning in assessment of low dose urinary follicle stimulating hormone and human menopausal gonadotropin therapy in polycystic ovarian disease

Cervical mucus and ultrasonic ovearian follicle monitoring for individualization of urinary follicle-stimualting hormone [ufsh] and human menopausal gonadotropin [hmg] therapy were used in clomiphene citrate resistant patients of polycystic ovarin disease [PCOD]. This study was carried out on 17 patients with PCOD, they were divided into group I : consisted of 7 patients receiving ufsh and group II: consisted of 10 patients receiving hmg. Cervical score and pelvic scanning for each patient were done daily. In this trial, the number of cycles in group I and II were 8 and 18 respectively. Ovulation and cycle fecundity were higher with hMG therapy than ufsh. This study revealed that low dose ufsh and hmg are effective in preventing the occurrence of hyperstimulation syndrome. Also, pelvic ultrasound is essential for follicular scanning and detection of ovulation while the cervical mucus score had a limited role in that aspect. Also, we conclude that hmg is more effective than ufsh in treating comiphene resistant PCOD

study of the relation between personality and state of intelligence with the different profiles of dysfunctional uterine bleeding

This study included 100 women complaining of dysfunctional uterine bleeding [DUB] and 20 normal cases, the latter were normal from the gynecological points of view. The intelligence quotient [I.Q.] and Minnesota multiphasic personality inventory [MMPI] scales were done for each case. Also endometrial biopsy was taken from each case to determine the endometrial pattern. The intelligence quotient was insignificantly lower among cases with dysfunctional uterine bleeding than that of the controls [P > 0.05]. The incidence of abnormal MMPI scales was 20% among the control cases and 40% among cases of DUB, the Chi-square was significant. The commonest abnormal MMPI scale among cases of DUB was depression in 26% of the cases, followed by musculinity/feminity in 11%, psychopathic deviation and hysteria scale, each was present in 7% of the cases, schizophrenia scale in 4% and psychathenia scale in 3% of cases. Most of the cases with ab normal scale was associated with non-secretory endometrium. So it can be concluded from this work that there is a positive relationship between the hormonal and the personality psychopathology or state of intelligence, yet it is difficult to elucidate which change is primary to the other