Recombinant versus urinary gonadotropins for ovarian stimulation in infertile women undergoing intracytoplasmic sperm injection [ICSI] treatment

This study included 64 women underwent controlled ovarian hyper stimulation and ICSI. Patients were prospectively randomized to receive either urinary hMG or r-FSH for controlled ovarian hyper stimulation after a long protocol of pituitary down-regulation was achieved in all patients by giving analogues on day 21 of the menstrual cycle. The main endpoint was ongoing pregnancy rate following one treatment cycle. Secondary outcomes included total dose and cost of gonadotropin used, cycle cancellation due to poor response, number and quality of oocytes collected, fertilization rate, embryos transferred and adverse effects; ovarian hyper stimulation syndrome, multiple pregnancy and abortion rates. The results revealed that there was insufficient evidence of significant statistical difference between hMG and FSH in clinical ongoing pregnancy rate. Furthermore, there was no difference on any of the secondary outcomes. However, the cost of a treatment cycle was 47% cheaper in hMG group than in FSH group

Polycystic ovary syndrome [PCOS] - the highly significant associated hormonal and biochemical parameters in normal and polycystic-appearing ovary groups

To evaluate what hormonal and/or biochemical parameters are highly associated with polycystic ovary syndrome [PCOS] in ultrasonically normal and polysticappearing ovary groups. A prospective randomized comparative study El Galaa Maternity Teaching Hospital Patients[s]: Thirty two women fulfilling the entry diagnostic criteria for PCOS were randomly subdivided into two groups-group I [n=16] with ultrasonically normal-appearing ovaries and group II [n=16] with characteristic polycystic ovarian morphology. The two groups were matched for age and body mass index [BMI]. All patients had elevated serum testosterone [T] level between 80 and 150 ng/dL i.e. androgen excess. Insulin infusion for the purpose of performing insulin tolerance testing to evaluate insulin resistance or sensitivity. We measured serum androgens [T, DHEAS and androstenedione], gonadotorophins [FSH and LH], binding proteins [sex hormone-bending globulin SHBG and insulin-like growth factor binding protein-1, IGFBP-1], insulin-like growth factor-1 [IGF-1] and insulin resistance by insulin tolerance testing [ITT]. Serum androgens and binding proteins were not significant different in both groups. Insulin tolerance testing demonstreated a slower glucose disappearance in the polycystic-appearing ovary group. K-itt] glucose was 4.58% +/- 1.4% / min and 2.07% +/- 1.07% min in the normal and polucystic-appearing ovaries group respectively. Women with PCOS and polcystic ovarian morphology do not demonstrate any definitive serum hormonal differences compared with women with PCOS and normal-appearing ovaries. The presence of polycystic-appearing ovaries correlates significantly with the presence of insulin resistance, a findings that highlights the long-term health consequences of the syndrome