[Ovarian response during IVF cycle following laparascopic cystectomy of ovarian endometrioma]

Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF [In vitro fertilization] cycle following laparoscopic unilateral cystectomy of endometrioma. In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary. The mean age [ +/- SD] of patients was 32.3 [ +/- 3.4]. The mean [ +/- SD] diameter of excised ovarian endometrioma was42.4 [ +/- 10.4] mm. Interval since ovarian surgery to induction ovulation was2.7 [ +/- 2.6] years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was2.5 [ +/- 1.2] with the range of1 to 5 and in the control ovary 3.9 [ +/- 1.4] with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one [P<0.001]. Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Polycystic ovarian syndrome [PCOS] is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients. This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone [LH], and follicle-stimulating hormone [FSH] plasma levels in the blood sample of the 3[rd] day of their menstrual cycle. Insulin resistance was determined with the fasting glucose [mmol/L] to insulin [mIU/L] ratio and HOMA-IR [Homeostasis model assessment-Insulin resistance]. Independent-samples T-test and linear regression test were utilized to analyze the obtained data. Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant [IR] [LogHOMA-IR >/= 0.57] and non insulin resistant [NIR] patients. The IR group had significantly higher homocysteine [p-value=0.02], fasting insulin and glucose levels [p-value<0.001] rather than NIR group. PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine level