Comparison of anti-mullerian hormone level in non-endometriotic benign ovarian cyst before and after laparoscopic cystectomy

Benign ovarian cysts are common among both pre- and postmenstrual women. Surgical intervention for excision of an ovarian cyst is mandated when symptomatic, or chance for malignancy is high. The damaging effect of surgical ovarian cystectomy on ovarian reserve is debated in recent studies. In the present study we investigated serum level of anti-mullerian hormone [AMH] as an indicator of ovarian reserve before and after surgical cystectomy. 60 patients with dermoid cyst, serous cystadenoma, and mucinous cystadenoma were recruited. Measurement of serum AMH was performed prior to surgery, and at one and 3 months after laparoscopic cystectomy. Serum AMH levels were compared before and after the surgery and between various types of ovarian cyst. Serum AMH level declined significantly after the surgery which recovered to 65% of its baseline value three months later. Decreased serum AMH can be contributed to decreased ovarian reserve after laparoscopic ovarian cystectomy. This can result from thermo-coagulation used for hemostasis during the operation

Intrauterine administration of recombinant human chorionic gonadotropin before embryo transfer on outcome of in vitro fertilization/ intracytoplasmic sperm injection: a randomized clinical trial

The direct effect of hCG on the human endometrium was studied several times. The objectives of this study were to evaluate the effectiveness of intrauterine injection of recombinant human chorionic gonadotropin [rhCG] before embryo transfer [ET]. In this randomized placebo-controlled clinical trial, a total number of 182 infertile patients undergoing their first in vitro fertilization/ intracytoplasmic sperm injection [IVF-ICSI] cycles were randomly assigned to receive 250 micro g intrauterine rhCG [n=84] or placebo [n=98] before ET. The implantation and pregnancy rates were compared between groups. Patients who received intrauterine rhCG before ET had significantly higher implantation [36.9% vs. 22.4%; p=0.035], clinical pregnancy rates [34.5% vs. 20.4%; p=0.044] and ongoing pregnancy rate [32.1% vs. 18.4%; p=0.032] when compared to those who received placebo. The abortion [2.4% vs. 2.0%; p=0.929] and ectopic pregnancy rates [1.2% vs. 1.0%; p=0.976] were comparable between groups of rhCG and placebo, respectively. Intrauterine injection of 250 micro g of rhCG before ET significantly improves the implantation and pregnancy rates in IVF/ICSI cycles.

Adenoid cystic carcinoma of bartholin's gland clinically mimics endometriosis, a case report

Adenoid cystic carcinoma of Bartholin's gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin's glands

Metformin versus chromium picolinate in clomiphene citrate-resistant patients with PCOs: a double-blind randomized clinical trial

Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients. To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients. The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the clinics which were affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The subjects were randomly assigned to two groups receiving either chromium picolinate [200micro g daily] or metformin [1500mg daily] for 3 months. Anthropometric and hormonal profile were measured and compared both before and after the treatment. Ovulation and pregnancy rate was measured in the two study groups, as well. Chromium picolinate significantly decreased fasting blood sugar [FBS] after 3 months of treatment [p=0.042]. In the same way, the serum levels of fasting insulin had significantly decreased leading to an increase in insulin sensitivity as measured by QUICKI index [p=0.014]. In comparison to the patients who received chromium picolinate, those who received metformin had significantly lower levels of testosterone [p=0.001] and free testosterone [p=0.001] after 3 months of treatment. Nevertheless, no significant difference was found between the two study groups regarding ovulation [p=0.417] and pregnancy rates [p=0.500]. Chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women. These effects were comparable with metformin; however, metformin treatment was associated with decreased hyperandrogenism. Overall, chromium picolinate was better tolerated compared to metformin; nonetheless, the two study groups were not significantly different regarding ovulation and pregnancy rates

pregnancy outcome in patients with minor beta-thalassemia

beta-thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the beta-thalassemia mutant gene are living in this country. To determine pregnancy outcome of women with beta-thalassemia minor. In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of beta-thalassemia minor. Patients in case and control groups were matched according to maternal age, gestational age and number of previous pregnancies. Cesarean delivery, hypertensive disorders, gestational diabetes mellitus, premature rupture of membranes and preterm labor were recorded in each group and were compared using the lampda 2 or Fisher exact tests. Overall 510 beta-thalassemia minor subjects and 512 healthy controls were studied. Cases with beta-thalassemia minor had significantly higher prevalence of oligohydramnios [p<0.001] and cesarean section delivery [p=0.001]. There was no significant difference regarding Apgar score in 1[st] [p=0.65] and 5[th] minute [p=0.25], IUGR [p=0.073], gestational diabetes mellitus [DM] [p=0.443] and preeclampsia [p=0.116] between two study groups. beta-thalassemia minor does not significantly influence the pregnancy outcome in the negative way