Mutation analysis of exon1 of bone morphogenetic protein-15 gene in Iranian patients with polycystic ovarian syndrome

Background: with the prevalence of 6-10%, polycystic ovarian syndrome [PCOS] is considered the most common endocrinological disorder affecting women in their reproductive age. It has been suggested that genetic factors participate in the development of PCOS. Follicular development has been considered as one of the impaired processes in PCOS. Bone morphogenetic protein-15 [BMP-15] gene is a candidate gene in follicular development and its variants may play role in pathogenesis of PCOS

Objective: to investigate whether BMP-15 gene mutations are present in Iranian women with PCOS

Materials and Methods: in this cross-sectional study 5 ml venous blood samples was taken from 70 PCOS women referring to Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran, between January to December 2014. Genomic DNA was extracted from the blood sample by salting out method. Then a set of PCR reactions for exon1 of BMP-15 gene was performed using specific primers followed by genotyping with direct sequencing

Results: two different polymorphisms were found in the gene under study. In total 20 patients [28.6%] were heterozygote [C/G], and 2 patients [2.86%] were homozygous [G/G] for c.-9C>G in 5´UTR promoter region of BMP-15 gene [rs3810682]. In addition, in the coding region of exon1, three patients [4.3%] were heterozygote [G/A] for c.A308G [rs41308602]. Two PCOS patients [2.86%] appeared to have both c.-9C>G [C/G] and c.A308G [G/A] variants simultaneously

Conclusion: our research detected two polymorphisms of BMP-15 gene among PCOS patients, indicating that even though it cannot be concluded that variants of BMP-15 gene are the principal cause of polycystic ovarian syndrome; they could be involved in pathogenic process in development of PCOS

effectiveness of luteal phase support with cyclogest in ovarian stimulated intra uterine insemination cycles: a randomized controlled trial

Controlled ovarian stimulation combined with intra uterine insemination [IUI] is a convenient treatment of infertility with a success rate of 11%. The clinical observation and pattern of progesterone secretion in this method is suggestive of luteal phase defect and postulated as an implicating factor of treatment failure. To investigate the efficacy of luteal phase support with intravaginal cyclogest in women undergoing controlled ovarian stimulation combined with intrauterine insemination. In this single-blinded clinical trial, 196 consecutively seen women eligible for the study protocol, were randomized to receive either intravaginal progesterone [cyclogest pessary, Actavis] or no medication in luteal phase. Blood samples were collected and serum progesterone level in 7th and 11th day of the cycle, biochemical and clinical pregnancy and luteal phase duration were compared in case and control groups. The mean age in case and control group was 28 and 27.9 years, respectively and the most frequent cause of infertility was unexplained. Additionally, ovulatory dysfunction was the most common cause of female infertility in both groups. Based on these variables, there was no statistically significant difference between the two groups. Mean serum progesterone level in the case group were 48.34 and 34.24nmol/day on day 7 and 11 after insemination, respectively and both values were significantly higher than the control group. There was no difference between the two groups in terms of biochemical and clinical pregnancy. Luteal phase duration in the case group was significantly longer than the control group. Luteal phase support by Cyclogest pessary increases progesterone level and prolongs the luteal phase, but does not affect success rate of IUI cycles in terms of achieving pregnancy

Screening utility of umbilical artery Doppler indices in patients with preeclampsia

Doppler indices of umbilical artery are used as indicator of fetal well being. To compare Doppler parameters of umbilical artery including pulsatility index [PI] and resistance index [RI] in patients with preeclampsia with those of normal pregnancies and to evaluate the diagnostic characteristics of these parameters in preeclampsia. In a case control study, umbilical artery pulsatility and resistance indices were calculated at a free loop of umbilical cord in 25 preeclamptic patients and 75 uneventful pregnancies. Measurements were compared and diagnostic characteristics of the indices were determined. Mean of pulsatility and resistance index were significant higher in preeclampsia patients than the control group. Besides, patients with severe preeclampsia showed significantly higher values of PI and RI in comparison to those with mild preeclampsia. For PI, the cut-off of >/= 0.98 yielded the highest sensitivity and specificity. Also, RI of 0.64 acquired a sensitivity of 100% and specificity of 44%. Umbilical artery pulsatility index and resistance index increase in preeclampsia and these changes tend to be greater in severe preeclampsia. Umbilical artery PI and RI seem to be more appropriate in excluding preeclampsia rather than confirming it, and we propose the cut-off values of 0.98 for PI and/or 0.64 for RI, to rule-out the disease