Effects of levonorgestrel-releasing intrauterin system on endometrial hyperplasia: a prospective observational study

Levonorgestrel [LNG], delivered locally into the uterine cavity has a profound effect on the endometrium, The aim of the study was to use a LNG intrauterine system to treat non-atypical and atypical endometrial hyperplasia in women and to evaluate the long-term cure [remission] rate. Prospective observational study of 85 women diagnosed with endometrial hyperplasia and treated with LNG-IUS between March 2004 May 2006 at zagazig University Teaching hospitals. Baseline characteristics and outpatient endometrial Pipelle sampling were undertaken at 3 and 6 months poet LNG-IUS insertion and 6-monthly intervals thereafter in all cases. Outcome included histological data derived from both Pipelle and uterine histology at 1 and 2 years LNG-IUS therapy. The trial was performed at zagazig University Teaching hospitals between March 2004-May 2006. 85 women diagnosed with endometrial hyperplasia without intracavitary abnormalities documented by preliminary hysteroscopy included in the study. Women were treated with LNG-IUS. LNG-IUS achieved endo 231 metrial regression in 81.2% [69/85] of cases by 2 years, with a significant proportion [82.4%, 70/85] achieving this within 1 year. Regression rates of 88.2% [67/76] and 67% [6/9] for non-atypical and atypical hyperplasia, respectively. Regression rates did not differ between histological types of hyperplasia. Twenty women [23.5%] underwent hysterectomy of which 11 were performed for persisting hyperplasia and reversion to hyperplasia following initial regression to normal histology and 9 were performed at pat ent request or patient fear of progression to cancer despite regressed endometrium. LNG-IUS is highly effective in treating endometrial hyperplasia. Beneficial effects are observed by the majority within 1 year. Treatment can be reliably monitored through regular 6-montly outpatient endometrial Pipelle surveillance. LNG-l US treatment of non-atypical hyperplasia is likely to reduce the number of hysterectomies performed in this subgroup

Antiphospholipid autoantibodies in women with unexplained infertility and recurrent first trimester abortion

To assess the presence of antiphospholipid auto-antibodies [aPLA] in women who are suffering from unexplained infertility or recurrent first trimester abortion to evaluate their pathogenic role in these disorders. King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia. Between January 2004 and June 2005, a prospective study was carried out on 20 women with unexplained infertility [group A], 20 women with recurrent first trimester abortion [group B], compared to 20 healthy women as control [group C]. IgA, IgM, and IgG against phospholipids were detected in the sera of all cases. It was found that IgA, IgM, and IgG levels were significantly higher in groups A, B when compared to group C. Venereal Disease Research Laboratory [VDRL] test was positive in 2 [10%] cases in group A and in 3 [15%] cases in group B but it was negative in group C. Lupus anticoagulant [LA], tested by the activated partial thromboplastin time [APTT], was prolonged in 4 [20%] group A and 3 [15%] cases in group B. From the results of this study it can be concluded that reproductive performance may be affected by the abnormal presence of antiphospholipid auto-antibodies