Effect of laparoscopic electrocautery of ovaries on ovarian response and fertility in poor response PCOS patients

Polycystic ovary syndrome is one of the most common endocrine disorders which can cause oligoovulation and anovulation in infertile women. Treatment of PCOS at first step is medical and in resistant cases surgery by laparoscope and electro-cauterization of the ovaries will be considered. The aim of this study was to evaluate the effect of laparoscopic cauterization of ovaries on ovulation, pregnancy, ovarian response to induction of ovulation and menstrual regulation. In a semi-experimental- [before and after study], cauterization of the ovaries by laparoscope was done in 44 PCOS patients who were resistant to medical treatment. Ovulation, pregnancy and menstrual regulation were evaluated in these patients in a period of 3 months. Then pregnancy rate, ovulation and regularity of menses were evaluated before and after cauterization. Sampling method was census and data were analyzed by paired T-test, Wilcoxon, and Fischer's exact test using SPSS soft ware. 44 patients aged from 18 to 36 with unsuccessful medical induction of ovulation and irregular menses were selected for the study. After cauterization of the ovaries, ovulation was evident in 32 [%72] and 15 [%34.09] of them became pregnant, with twin pregnancy in 3 cases. Ovarian hyperstimulation syndrome was not occurred in the patients. In spite of different results of different studies, our study revealed that the response of ovaries to medical treatment and also pregnancy outcome would be better after laparoscopic cauterization of the ovaries and this effect is better when combination of HMG and clomiphen citrate is used. Pregnancy and regulation of menses after cauterization had no relation to age and cause of infertility

Comparison of embryo quality cultured in Ham's F-10+%10 maternal serum and GI[III]

Appropriate culture media and environment for embryonic cell growth considered to be major factors for generation of an embryo in vitro. In this study two embryonic growth condition of Glm and Ham's F-10 + Maternal Serum [MS]%10 were compared. This investigation was prospectively performed on 100 infertile couples that were treated by IVF-iCSL The participants were divided into two equal groups. Ovules obtained from first group were treated with Ham's F[10] + Maternal Serum%10 culture media and the second group with Gl[III]. The variables affecting ovule and embryonic growth were measured, and collected data were analyzed by SPSS. The mean of age for tested ladies was 28.01 and the mean for duration of infertility was 6.87 years. The number of pronucleous with moderate quality were 2.14 in-group I and 3.22 in-group 11 [P=0.023]. The number of embryo with three cells were 1.26 and 0.54 and for grade B embryonic cell were 1.18 and 1.78 and grade C embryonic cell were 1.08 and 0.56 in group I and II respectively [p=0.29]. The mean of grade B blastomer in GI[III] media was more than Ham's F[10]+ Maternal Serum 10%. Compairing the means; the mean of grade B blastomers in Glm media was shown to be more than Ham's F[10] + Maternal Serum 10%. All of the findings showed that Gl[III] cultural condition is more effective than Ham's F[10] and the maternal serum as a supplement has no considerable impact

Correlation between basal antral follicle count and mean ovarian diameter with ovarian responsiveness in ART cycles

Since, ovarian response during assisted reproductive technology [ART] depends on ovarian reserve so it is important to evaluate ovarian reserve before the ART cycle. The purpose of this study was to determine correlation between basal antral follicle count and mean ovarian diameter before treatment with ovarian responsiveness. This study was performed on 94 infertile women who consecutively underwent ART in Fatemeh Zahra Center in Babol for one year. FSH, LH and FSH/LH were measured on day 3 of cycle, and basal antral follicle count and mean ovarian diameter were determined by vaginal sonography. GnRH Agonist was administered for hypophysial down regulation and then gonadotropin was administered for induction of ovulation. Ampules of gonodotropin, days of stimulation, numbers of oocytes, pregnancy rate and cycle cancellation were recorded. A positive linear correlation was seen between basal antral follicle count with recovered oocytes [p<0.05]. Also, pregnancy rate had a positive linear correlation with recovered oocyte, fertilized ovum and basal antral follicle count [p< 0.05]. A negative linear correlation was observed between basal antral follicle count with ampules of gonadotropin, days of stimulation that was not statistically significant [p>0.05]. It was not seen a significant correlation between mean ovarian diameter and pregnancy rate, recovered oocytes, days of stimulation and ampules of gonodotropin. The results show that antral follicle count on cycle day 3 has positive correlation with oocyte count and pregnancy rate. It is an easy and reliable method to predict ovarian responsiveness that allows physicians to evaluate patients immediately before ART stimulation and to optimize stimulation protocols

[ comparision of insulin level and some cardiovascular risk factors in patients with polycystic ovary syndrome and healthy subjects women]

Polycystic ovary syndrome [PCOS] seems to be the most common endocrine disease in women of reproductive age. This study has shown that PCOS is associated with hyperlipidaemia and hypertension. The aim of this study was to compare the cardiovascular risk factor in PCOS and normal women. It is a case - control study that was done on 60 barren and non-affected women and 60 barren women affected to PCOS that had clinical examples and sonographic PCOS. All of women were studied from the characteristics point of view such as age, BMI, the size of around waist and buttocks, time and kind of infertility and Blood pressure. Necessary tests were done such as total cholesterol, LDL, HDL triglyceride, insulin level and fasting blood sugar. Data were analyzed with SPSS. Triglyceride, cholesterol, LDL and BMI of the patients affected to PCOS were significantly higher than normal women [P<0.05]. HDL level reduction was significant in patients affected PCOS [P<0.05], also systolic and diastolic blood pressure in affected women was higher than control group [P<0.05]. PCOS women have higher cardiovascular risk compared to normal women

[Comparison of the effectiveness of double IUI versus single IUI in pregnancy rate in infertility]

In infertility without suffering tubal factor, WI is the choice therapeutic method. Some studies recommended double IUI for every cycle. Since double IUI needs more laboratory materials and more expenses, so in this study it was tried to evaluate pregnancy rate in infertile couples after single and double IUI. This clinical trial study was performed on infertile couples referred to Fatemeh Alzahra or Babol Clinic hospital for IUI cycles. Patients divided into two groups. In the first group, 36 hours after HCG injection, IUI was done as a single protocol and in the other group; IUI was done 24 and 72 hours after HCG injection as double protocol. Then data were analyzed by fisher's exact test. Two hundred and fifteen women participated in our study and their mean age was 26.02 +/- 5.5 and the mean [ +/- SD] duration of infelicity was 3.73[ +/- 2.75] years. In the first group, pregnancy rate was 16.9% and in second group it was 19.6% without any significant difference between two groups. Also, there was no significant difference between groups in pregnancy rate with different etiology of infertility. Some studies recommended that double IUI is more successful than single IUI. But present findings suggest that there is no difference in pregnancy rate between single IUI and double IUI

Comparison of hysterosonography and hysterosalpangiography in the diagnosis of intrauterine abnormalities in infertile women

Uterine abnormalities are found in approximately 34-62% of infertile women. Because of this relatively high prevalence of uterine abnormalities, evaluation of uterine cavity is performed in the primary evaluation of infertility. The purpose of this study was to compare the diagnostic accuracy of hysterosonography with that of hysterosalpangiography for the evaluation of abnormalities of uterine cavity of infertile women. Sixty six infertile women were prospectively evaluated with hysterosalpangiogram [HSG] and hysterosonogram [H/S] as a part of their infertility workup. The result of each examination was compared with what was obtained by hysteroscopy as a golden standard. The results of H/S agreed with hysteroscopy in 95.5% [K=0.86] while HSG agreed with hysteroscopy in 87.9% [K=0.64] of cases. Sensitivity of H/S was 85.7% and its specificity 98.1%, while sensitivity of HSG was 71.4% and its specificity 92.3%. Hysterosonography was in general more accurate test and appeared to be an acceptable first-line evaluation for intrauterine structure. We recommend use of hysterosonography as a noninvasive, easy, inexpensive, effective and well-tolerated method of investigating the intrauterine cavity in infertile women instead of hysterosalpangiography