Comparison between unilateral and bilateral ovarian drilling in clomiphene citrate resistance polycystic ovary syndrome patients: a randomized clinical trial of efficacy

Laparoscopic ovarian drilling [LOD] is an alternative method to induce ovulation in polycystic ovary syndrome [PCOS] patients with clomiphene citrate [CC] resistant instead of gonadotropins. This study aimed to compare the efficacy of unilateral LOD [ULOD] versus bilateral LOD [BLOD] in CC resistance PCOS patients in terms of ovulation and pregnancy rates. In a prospective randomized clinical trial study, we included 100 PCOS patients with CC resistance attending to Al-Zahra Hospital in Rasht, Guilan Province, Iran, from June 2011 to July 2012. Patients were randomly divided into two ULOD and BLOD groups with equal numbers. The clinical and biochemical responses on ovulation and pregnancy rates were assessed over a 6-month follow-up period. Differences in baseline characteristics of patients between two groups prior to laparoscopy were not significant [p>0.05]. There were no significant differences between the two groups in terms of clinical and biochemical responses, spontaneous menstruation [66.1 vs. 71.1%], spontaneous ovulation rate [60 vs. 64.4%], and pregnancy rate [33.1 vs. 40%] [p>0.05]. Following drilling, there was a significant decrease in mean serum concentrations of luteinizing hormone [LH] [p=0.001] and testosterone [p=0.001] in both the groups. Mean decrease in serum LH [p=0.322] and testosterone concentrations [p=0.079] were not statistically significant between two groups. Mean serum level of follicle stimulating hormone [FSH] did not change significantly in two groups after LOD [p>0.05]. Based on results of this study, ULOD seems to be equally efficacious as BLOD in terms of ovulation and pregnancy rates

Effect of vaginal misoprostol on pregnancy rate after intrauterine insemination: a randomized controlled trial

Intrauterine insemination [IUI] is one of the most appropriate and cost-effective methods in infertility treatment. We aimed to investigate effect of vaginal misoprostol on pregnancy rate after IUI. Two hundred and ten infertile women who were referred to Infertility Clinic of Alzahra Hospital by an indication of IUI during 2012-2013 were randomly assigned to receive 200 microg vaginal misoprostol [n=105] or vaginal placebo [n=105] after IUI. For detecting pregnancy, past 2 weeks, beta human chorionic gonadotropin evaluation was made and if positive, transvaginal sonography was done for evaluation of pregnancy 2-3 weeks later and clinical pregnancy was recorded. Pregnancy had been noted in 24 patients in misoprotol [22.9%] and 27 patients in placebo [25.7%] groups that this difference was not significant [p=0.748]. In misoprostol group, 3 case of nausea and vomiting [2.9%] had been observed. According to the results, administering 200 microg vaginal misoprostol after IUI doesn't have significant effect on the success rate of IUI