aromatase inhibitor letrozole improves the fertilization, and ongoing pregnancy rate in low responder patients undergoing IVF cycles

Objective: the aim of this study was to see the effect of adding aromatase inhibitor, letrozole to a high doses of rFSH/hMG-antagonist regimen on the number of the mature follicles, retrieved oocytes, egg's quality, clinical pregnancy rate, and rate of cycle cancellation in poor responder patients with a previous history of at least 2 cancelled IVF cycles

Study Design: this study included 83 infertile couples who had at least two cancelled IVF trials due to poor ovarian response. Those patients were divided into two groups, letrozole group, included 41 infertile couples, and control group included 43 infertile couples, and compared

Results: patients.in both groups were comparable in terms of age [37.3 +/- 1.2 versus 35.7 +/- 2.4 years], .day 3 FSH, LH, and E2 serum levels as shown in table 1. There was no significant differences among both groups regarding the number of stimulation days [10.3 +/- 0.6 versus 9.6 +/- 0.4], mean FSH/hMG dose administered [4,236 +/- 219 versus 4,463 +/- 238], and endometrial thickness [8.6 +/- 1.3 versus 9.8 +/- 0.9]. However, there were significant differences between both groups in terms of cancellation rate due to poor response [12.2% versus 34.9, p < 0.001], number of mature follicles [5.8 +/- 1.2 versus 3.4 +/- 0.6, p = 0.039], and in the number of retrieved oocytes [8.3 +/- 1.6 versus 4.2 +/- 0.6, p < 0.001]. In addition, there were significant differences in the terms of fertilization rate [86.4% versus 64.9%, p = 0.038], and in the clinical pregnancy rate [44.4% versus 25%, p = 0.36] between the two groups, however, there is no significant difference between them regarding the percentage of the multiple pregnancies [25% versus 28.6%, p = 0.43]

Conclusion: in conclusion, addition of aromatase inhibitors, letrozole in the first 10 days of the stimulation induction using a high doses of rFSH/hMG antagonist regimen, were associated with a higher number of mature follicles, less cancellation rate, more retrieved mature oocytes, and higher clinical· pregnancy rate in low responder patients with a previous history of at least 2 cancelled IVF cycles

Haematologial manifestations in HCV infected patients at Sharkia Governerate, Egypt

The aim of this study was to evaluate the hematological manifestations occurring in patients suffering from chronic hepatitis C virus [HCV] infection. Positive HCV-RNA cases [109] were subjected to complete blood count [CBC], prothrombin time [PT], partial thromboplastin time [PTT], bleeding time [BT], coagulation time [CT], detection of fibrinogen degradation products [FDPs], measurement of plasma alpha- antitrypsin [AAT], then bone marrow [BM] aspiration and examination for 20 cases. The patients were classified into three groups according to the histopathological staging and grading of liver biopsy. The comparison between groups according to histopathological grading and staging for hematological and chemical parameters revealed a significant statistical difference in platelets count, S albumin, ALT and AST levels. The comparison between groups according to histopathological grading and staging for coagulation profile, AAT level and FDPs revealed a significant statistical difference between all parameters. Bone marrow aspiration and examination revealed mild hypocellularity with an increased number of lymphocytes and a relevance of plasmacytoid-lymphocytes

Autoantibodies in HCV infected patients at Sharkia Governerate, Egypt

The aim of this study was to evaluate some immunological manifestations in chronic hepatitis C patients and to find out its relationship with liver pathology. The study included 109 positive HCV-RNA patients classified according to liver histopathology into three groups: Group I included 22 patients [G1S1], group II included 67 patients [G2S2] and group III included 20 patients [G3S3], where G = the degree of necro-inflammatory process and S = the stage of liver fibrosis. All patients were investigated for the presence of cryoglobulin, antineutrophil cytoplasmic [ANCA], anti-liver kidney microsomes [LKM], anti-double stranded DNA, [ds-DNA], anti-nuclear [ANA], anti-mitochondrial [AMA] and anti-smooth muscle [ASMA] autoantibodies. The high prevalence of autoantibodies in chronic HCV patients suggests that HCV may trigger an autoimmune reaction, but most probably do not indicate a distinct autoimmune mechanism. Cryoglobulins and ANCA may be considered as useful prognostic indicator for the increased risk of cirrhosis in chronic HCV patients. Follow up studies were recommended