Comparison of anticardiolipin antibody and antiphospholipid antibody in women with recurrent abortions

Recurrent abortion is a critical problem in which many factors play a crucial role such as anticordiolipin antibody and antiphospholipid antibody. This study was conducted to evaluate the frequency of anticardiolipin antibody and antiphospholipid antibody in pregnancy failures in women with the history of recurrent pregnancy loss. In 154 women with the history of two or more recurrent pregnancy losses, serum anticardiolipin and serum antiphospholipid were measured using ELISA method. The positive IgG anticardiolipin and IgG antiphospholipid were detected in 12. 34% [19 patients] and 6.5% [10 patients] of patients respectively. Although 16 out of 19 patients with positive IgG anticardiolipin were negative for IgG antiphospholipid and 7 out of 10 patients with positive IgG antiphosphplipid were negative IgG anticardiolipin, but there was a significant correlation between IgG anticardiolipin and IgG antiphaspholipid [r = 0.222 p=0.000]. Our data concluded that anticardiolipin antibody is found to be more important than anti phospholipid antibody in recurrent abortion

Comparison between two methods of ovulation induction: clomiphene alone and clomiphene +tamoxifen in pcos patients

Background: Infertility affects about 10-15% of reproductive-age couples. About half the causes of infertility are female related and approximately 40% of the cases are caused by anovulation, mostly in PCO women

Objective: This study was conducted to determine and compare the effects of two drug treatment regimens: higher dose of Clomiphene and a combination of lower dose of cloniiphene and tamoxifen in treating infertile women with PCO

Materials and Methods: The study was a randomized clinical trial conducted on 100 infertile patients who referred to Yazd-Iran Infertility Clinic between the years 2001-2003. The patients were selected who had received at least 3 periods of clomiphene, but no pregnancy had occurred. They were randomly divided into two groups. In the first group, clomiphene was increased to 100 mg and the second group 20 mg of tamoxifen was added to 50 mg of clomiphene from day 5-9 of menstruation cycle. Infertility duration, duration of medicine used, PCT score, endometrial thickness, ovulation, and pregnancy rate were studied in both groups

Results: Ovulation rate in clomiphene group was 54.9%; Tamoxifen + clomiphene group was 73.5% without significant differences in both groups. [PV = 0.053]. Positive pregnancy rate in clomiphene group was 39.2%; clomiphene + tamoxifen group was 61.2% [P value < 0.05], which could be concluded that pregnancy rate was higher in clorniphene/tamoxifen group than in the clomiphene group. The presence of a dominant follicle in the two treatment groups in women between 18-24 was not significant, but in women between 25-39 years was significant [PV= 0.049] [Table III]

Conclusion: The recommendation is to add Tamoxifen to Clomiphene in 35-39 women with 20< BMI <26.99 before the use of gonadotropins treatment in PCOS with or without IUI, because these options have higher risk of multiple pregnancy and ovarian hyperstirnulation syndrome