RESUMO
Objectives: to compare the efficacy and safety of the combination of unfractionated heparin]UFH[and Low Dose Aspirin [LDA] with that of low-molecular-weight heparin]LMWH[and LDA in the management of pregnant women with recurrent pregnancy loss secondary to antiphospholipid syndrome [APS]
Methods : In a randomized prospective study, 60 women with a history of 3 or more consecutive spontaneous abortions and positive antiphospholipid antibodies were assigned in equal numbers to receive either UFH [5000 units, twice daily] plus LDA, or LMWH [enoxaparin 40 mg, once daily] plus LDA as soon as pregnancy was diagnosed
Results: Twenty-four women in the LMWH group [80%] compared to 20 women in the UFH group [66.67%] delivered a viable infant [p >0.05]. There was no significant difference in pregnancy complications or neonatal morbidity between the 2 groups. There were no incidences of excessive bleeding, thrombocytopenia, or osteoporotic fractures of excessive bleeding, thrombocytopenia, or osteoporotic fractures in either group
Conclusion: In this study, the use of LDA in combination with LMWH during pregnancy for the prevention of recurrent pregnancy loss in women with antiphospholipid syndrome seems to be as safe as UFH plus LDA. Large randomized trials will be required to determine differences in outcome with LMWH and LDA compared with treatment with UFH combined with LDA in this group of patients
RESUMO
Background: Intracytoplasmic sperm injection [ICSI] is an in vitro fertilization procedure in which a single sperm is injected into an oocyte
Objective: Aim of the Work: Comparing three-dimensional ultrasound parameters, with anti-Mullerian hormone [AMH] and other conventional endocrine markers for the prediction of ovarian response in patients undergoing intracytoplasmic sperm injection cycles
Methods: This observational prospective study was conducted at Alexandria Armed Military Hospital, on a sample of 100 women aged between 25 and 35 years, enrolled for intracytoplasmic sperm injection [ICSI]
Results: a good correlation between inhibin B and other numerical variables. There was strong positive correlation between inhibin B and AMH, strong negative correlation between inhibin B and both FSH and LH. Inhibin B correlated moderately negatively with age and moderately positively with AFC, number of collected oocytes. Inhibin B correlated positively with the number of oocytes and number of grade 1 embryos. As regard pregnancy rate, the good-response group had significantly higher chemical and clinical pregnancy rates, as there was no chemical or clinical pregnancy occurred in poor responders
Conclusion: AFC, AMH and Inhibin B are effective in predicting the ovarian reserve as well as the response to induction, and both AFC and AMH are the most significant predictors of response to ovarian stimulation during ICSI
Recommendations: Larger scale studies including higher number of patients are needed to verify the validity of this parameter as a marker of ovarian reserve in patients undergoing ICSI