Desogestrel+ethinylestradiol versus levonorgestrel +ethinyles tradiol Which one has better affect on acne, hirsutism, and weight change

To compare complications of third and second generation oral contraceptive pills [OCPs]. In a randomized clinical trial from October 2007 to October 2008, 100 healthy women of reproductive age referred to Amir Hospital Family Planning Clinic and some heath centers in Semnan, Iran were randomized in 2 equal groups. They received either a third generation OCP [150 micro g desogestrel [DSG] + 30 micro g ethinylestradiol [EE] or a second generation type [150 micro g levonorgestrel [LNG] + 30 micro g EE]. Six months later, changes of weight, acne, and hirsutism severity, as well as serum titers of sex hormone-binding globulin [SHBG] and free testosterone were compared between the 2 groups. Forty-five women were evaluated in the DSG+EE OCP group, and 46 women in the LNG+EE OCP group. The BMI was significantly higher in the second group [p=0.000] after 6 months duration. Likewise, the decrement of acne and hirsutism seventy was significantly higher in the DSG+EE users [p=0.000]. Mean changes of serum free testosterone [f=0.967] and SHBG [f=0.916] were comparable between the 2 groups. In comparison with the LNG+EE OCP, the DSG+EE OCP is a contraceptive pill that significantly decreases the severity of acne and hirsutism, without any significant change in weight

Age and fertility in women undergoing controlled ovarian hyperstimulation and intrauterine insemination

Fertility is an age dependent phenomena in male and female partner. Fertility declines with age but the causes of infertility are different in different age groups. In this study we will to evaluate the effect of women age on the pregnancy rate [PR] and causes of infertility in patients undergoing controlled ovarian stimulation [COH] and intrauterine insemination [IUI]. Three hundred and thirty six cases of infertility that underwent COH and IUI were evaluated. The study groups were women [35-40] years and the control groups were<35 years old. The two groups were the same in regard to treatment protocol [Clomiphene citrate+Human chorionic gonadotropin], causes and duration [4/48 +/- 2/92 vs 4/55 +/- 3/72, the p=0 /919] of infertility. The PR and the causes of infertility were evaluated in two groups by using of statistical tests. The PR was 23.5% and 20% [p=0/566] in study and control groups respectively. The most common cause of infertility was male and unexplained with the equal frequency between the study and the control group. The PR in women who are 35-40 years old that underwent IUI is the same with<35 years old and the most common cause of infertility in women who are 35-40 years old are male and unexplained factors with the same frequency. Induction of ovulation and intrauterine insemination, pregnancy rate woman age causes of infertility

Comparison of the efficacy of clotrimazole and itraconazole in the treatment of acute vulvovaginal candidiasis

A clinical trial to compare the efficacy of clotrimazole and itraconazole in the treatment of vulvovaginal candidiasis. The clinical trial was conducted in the Gynecological outpatient clinic of the University Hospital Amir, Semnan, Iran between the 1st of June 2006 and 31st of June 2007. Vulvovaginal candidiasis was diagnosed by history, examination, smear and culture. Patients [N=264 cases] were divided in two groups. One group was treated with Itraconazole [400mg two divided dose] and the second with clotrimazole vaginal cream [5 grams daily; to be given over 6 days duration]. Patients was considered cured if there were no clinical signs of infection and the smear and culture were negative ten days after the treatment. Statistical analysis for significance was conducted using Student T, chi-square and exact Fisher tests using SPSS package. The mean age of itraconazole and clotrimazole groups were 28.1 +/- 4.8 and 28 +/- 5.8 and cure rates were 88% [110 case] and 81% [103 cases] respectively. There was increased frequency of micturations in 4 cases of itraconazole and 7 cases of clotimazole group and dyspareunia in 2 cases of itraconazole and 6 cases of clotimazole group.The satisfaction rates with treatment were 94.4% [118 cases] and 86% [109 cases] respectively. So, there wasn't any significant statistical difference in cure rate, side effects and satisfaction rate between the two groups. No difference was found in the cure rate for vaginal clotrimazole and oral itraconazole after the treatment of vulvovaginal candidiasis and the side effects of both drugs were minimal

Laparoscopic removal of a round ligament translocated intrauterine contraceptive device

We report a 24-year-old woman presented to university hospital Amir-Semnan on 10-Jan -2007 with history of lower abdominal pain and spotting after insertion of intrauterine device [copper-T 380A], 1 2 days earlier. On pelvic examination, abdominal ultrasonography, and hysteroscopy the IUCD was not inside the endometrial cavity. A laparoscopy was performed and a small [3-4 mm] perforation was seen in posterior left lateral portion of uterus and another perforation of the left round ligament and the end of one of horizontal arms of the IUCD was visible in the perforated round ligament. IUCD was removed by laparoscopic forceps from perforated left round ligament without any complication

Cause of infertility and response to ovulation induction drugs -a hospital based study

This study was performed to investigate the most common causes of infertility and the choice of the more suitable and more easily achievable treatment. A detail history and physical examination were done for all the patients who were referred to Mahdishahr Hospital with chief complaint of infertility from October 2004 to September 2005. Patients who failed to become pregnant after unprotected intercourse for 1 year were chosen as the criteria for to this study. At first semen analysis was performed for all couples. Among the patients who were complaining of oligomenorrhea, galactorrhea or in their laboratory test hyperprolactinemia was found, the treatment started with ovulation induction drugs. In all these groups of patients endometrial thickness and the size of follicles was measured by sonography in the 13th days of their period, among the patients with two or four follicles bigger or equal to 18 mm [If they were treated with clomiphene citrate, bromocriptine or dexamethasone] or when two or four follicles were bigger or equal to 16 mm [if they were treated with Human Menopausal Gonadotropin [HMG] and endometrial thickness or equal to 6mm and Human Chorionic Gonadotropin [HCG] Ampoule [10000 unit] was injected. All these patients were followed to control their response to the treatment and during the whole period of pregnancy. In the other patients hystrosalpingography or post-coital test used for finding the cause of infertility. In 57% of the patients [40 persons] there were symptoms of oligomenorrhea, galactorrhea or hyperprolactinemia. For these patients ovulation induction is started by clomiphene citrate, bromocriptine, dexamethasone and HMG. 27 cases [67%] of them conceived. Term pregnancy with normal child in 20 cases, abortion in 5 cases and unexpected preterm birth both in 21 weeks of pregnancy happened. Twenty eight percent [20 cases] of cause of infertility was male factor. 7% [5 cases] and 1/4% [lease] of causes were tubal and cervical factors respectively. It's concluded that the most common cause of infertility in Mahdishahr is the ovulatory factor. Other causes respectively are male-factor, tubal, cervical, and other factors. Besides, in a large percent of these patients who were treated by ovulation induction pregnancy happend which is noticeable

Evaluation of spontaneous abortion and multiple gestation rates in patients undergoing ovulation induction and intrauterine insemination

Cohort analytic study to assess risks of spontaneous abortion and multiple gestations in patients undergoing induction of ovulation. In this study we compared the spontaneous abortion and multiple gestation rates of 361 cases that they were undergoing ovulation induction with clomiphene citrate alone or with human menopausal gonadotropin and they were candid for intrauterine insemination with a control group consisting of 350 cases who were conceived naturally. We matched the two groups with regard to age and weight. Abortion considered as spontaneous termination of pregnancy below 20 week of pregnancy and multiple gestation diagnosis was based on sonography in any time during pregnancy. We used chi-square test for statistical analysis and determination of differences between groups. Intrauterine insemination was performed in 361 cases and pregnancy happened in 70 cases [19/4%] of study group. The spontaneous abortion happened in 10 cases [14/2] and in control group among 350 cases spontaneous abortion happened in 50 cases [14/2]. Statistical analysis with chi-square test revealed that there isn, t Significant statistical difference between the study group and control group. In regard to multiple gestations there were 1 cases of multiple gestations in study Group. Six cases were twin and one of them was quadruplet. In control group there were 6 cases of multiple pregnancies, 5 cases were twin and one of them was triplet. Statistical analysis with chi-square test showed that there is a significant statistical difference between the study group and control group. In this study there was not significant statistical difference in abortion rate between the patients who they were undergoing ovulation induction/intrauterine insemination and normal fertile group but there was significant statistical difference in multiple gestations between two groups