Pregnancy rate following luteal phase support in Iranian women with polycystic ovarian syndrome

To assess the efficacy of luteal phase support [LPS] using intravaginal progesterone [P] on pregnancy rate in Iranian women with polycystic ovarian syndrome [PCOS] who used a combination for ovulation induction consisting of letrozole or clomiphene citrate [CC] and human menopausal gonadotropin [HMG]. This was a randomized clinical trial undertaken in a fertility clinic in Kashan, Isfahan Province, Iran. A total of 198 patients completed treatment and follow up. Base on chosen ovulation induction programs, they were divided into two following groups: i. CC group [n=98] used a combination consisting of CC [100 mg x 5 day] and HMG [150 IU x 5 day] and ii. letrozole group [n=100] used a combination consisting of letrozole [5 mg x 5 day] and HMG [150 IU × 5 day]. After human chorionic gonadotropin [hCG] administration [5000 IU], the patients [n=122] who randomly received intravaginal P [Cyclogest, 400 mg daily] were included in LPS group, while the rest [n=123] were included in non-P cycles group. The outcome was the comparison of chemical pregnancy rate between the groups. Our findings showed that LPS was associated with a 10% higher pregnancy rate than in non-P cycles, although this difference did not reach statistical significant [p=0.08]. LPS improved pregnancy rate in both CC [4%] and letrozole [6%] groups. In addition, patients who used letrozole for ovulation induction along with intravaginal P showed higher pregnancy rates than CC group. Administration of vaginal P for LPS may improve the pregnancy rate in women with PCOS using letrozole or CC in combination with HMG for ovulation induction [Registration Number: IRCT201206072967N4]

[Antifungal activities of fluconazole and ketoconazole agents against Malassezia species]

Malassezia, a yeast-like fungus found in normal skin flora is known to be associated with various skin diseases, along with systemic infections. Our aim was to determine the in -vitro susceptibility of Malassezia spp. to ketoconazole and fluconazole. In this study, we identified 99 Malassezia isolates from patients with pityriasis vesicular by morphological and biochemical criteria. In vitro susceptibility testing was in macro-broth dilutions, conducted based on the National Committee for Clinical Laboratory Standards [NCCLS] M27-A proposed standard. The results were analyzed statistically by Mann-Whitney. The Malassezia isolates were identified as M. globosa [42], M. furfur [39], M. obtusa [10], M. sympodialis [6], and M. slooffiae [2]. The rate of MFC of ketoconazole against Malassezia spp. was 0.06-2 micro g/ml, while the MFC of fluconazole against Malassezia spp. was 2-64 micro g/ml. The minimal inhibitory concentration [MIC90] of ketoconazole against Malassezia spp. was 0.03-1 micro g/ml, while the minimal inhibitory concentration [MIC90] of fluconazole against Malassezia spp. was 0.5-32 micro g/ml. Although fluconazole can be an effective treatment option for pityriasis versicolor, in our study, fluconazole MICs were higher than ketoclonazole