A Comparative Study of Serum and Follicular Fluid Leptin Concentrations among Explained Infertile, Unexplained Infertile and Fertile Women.

BACKGROUND: The relationship between metabolism and reproduction has been always considered as an important topic in female endocrinology. It seems that leptin is one of the involved factors in infertility. Leptin, in addition to regulating body weight plays an important role in regulation of endocrine, reproductive and immune systems. The aim of this stduy is to compare serum and follicular fluid leptin concentrations in order to find the role of leptin level in infertility. MATERIALS AND METHODS: This case-control study was performed from September 2010 to March 2013. A total of 90 women referred to the Infertility Center of Afzalipour Hos- pital, Kerman, Iran, and divided into three equal groups (n=30/per group) of explained infertile (including 4 subgroups), unexplained infertile and normal fertile (control group). The three groups were matched in regard to demographic features [age: 20-40 years and body mass index (BMI): 20-25]. In order to determine leptin level, blood sample and fol- licular fluid were taken one hour prior and at the time of follicular puncture, respectively. Serum and follicular fluid leptin levels were measured using enzyme-linked immune sorbent assay (ELISA). Data were analyzed using descriptive-analytic tests, like Mann- Whitney and Kruskal Wallis tests, through Statistical Package for the Social Sciences (SPSS) version 16. RESULTS: In explained infertile and fertile groups, as opposed to unexplained infertile group, mean leptin level was lower in follicular fluid than in serum. Mean follicular fluid leptin concentration in women with unexplained infertility was higher com- pared to the other two groups. Women with unexplained infertility had lower level of serum leptin in comparison to the other two groups. Follicular fluid leptin level in all subgroups of explained infertile group was lower as compared to unexplained and fertile women. CONCLUSION: The results suggested that high leptin level of follicular fluid is one of the main factors involved in infertility.

Serum leptin level in the first trimester in ectopic versus normal pregnancies.

OBJECTIVE: To determine whether maternal serum leptin level is different or not in ectopic and normal pregnancy. METHODS: In this cross sectional study, we included 47 women with normal pregnancy (group A), and 47 women with ectopic pregnancy (group B) attending the Department of Obstetrics and Gynecology, Afzalipour Medical Centre, Kerman, Iran from January 2009 to February 2010. Previous history of miscarriage or ectopic pregnancy, body mass index equal to or more than 25 and equal or less than 19 kg/m2, using drugs during pregnancy except for multivitamin and folic acid, unstable conditions requiring emergency laparatomy, and cigarette smoking were considered as exclusion criteria. The maximum gestational age in both groups was 8 weeks. Maternal serum leptin level was determined using enzyme-linked immunosorbent assay kit. Data were analyzed using one-way analysis of variance. RESULTS: There were no statistically significant differences between the 2 groups in maternal age, gestational age, and body mass index. Women in group B (median [range]: 30.93 [14.8-84.2]) showed significantly higher serum leptin level in comparison with group A (median [range]: 32.74 [8.4-8.61]). CONCLUSION: Serum leptin level in the first trimester of pregnancy may be a useful marker in the differential diagnosis of ectopic pregnancy.

Comparing intramuscular progesterone, vaginal progesterone and 17 -hydroxyprogestrone caproate in IVF and ICSI cycle.

BACKGROUND: Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. OBJECTIVE: The objective of this study was to compare the efficacy of three types of progesterone on biochemical, clinical and ongoing pregnancy rates and abortion and live birth rates. MATERIALS AND METHODS: A prospective randomized study was performed at Royan Institute between March 2008 and March 2009 in women under 40 years old, who use GnRH analog down-regulation. One hundred eighty six patients in three groups were received progesterone in oil (100 mg, IM daily), intravaginal progesterone (400 mg, twice daily) and 17-α hydroxyprogestrone caproate (375mg, every three days), respectively. RESULTS: Final statistical analysis after withdrawal of some patients was performed in 50, 50 and 53 patients in group 1, 2 and 3 respectively. No differences between the groups were found in baseline characteristics. No statistical significance different was discovered for biochemical, clinical and ongoing pregnancies. Although the abortion rate was statistically higher in group 1 (p=0.025) the live birth rate was not statistically significant between the three groups. CONCLUSION: The effects of three types of progesterone were similar on pregnancies rate. We suggest the use of intravaginal progesterone during the luteal phase in patients undergoing an IVF-ET program because of the low numbers of abortions, and high ongoing pregnancy rates.

The effect of Ramadan fasting on amniotic fluid volume.

OBJECTIVE: This cross-sectional study was carried out to assess the influence of Ramadan fasting on amniotic fluid volume. METHODS: For this purpose 2 groups of fasting (n=28) and non-fasting (n=25) pregnant women were investigated for amniotic fluid index (AFI) and deepest vertical pocket of amniotic fluid in November (Ramadan month) of 2001-2002 in Kerman Prenatal Clinics in Kerman, Iran. Mean of gestational age based on the last menstrual period and ultrasound reports were 29.6 +/- 5.8 week and 29.5 +/- 4.2 week in fasting and non-fasting groups. RESULTS: There was no significant difference between the 2 groups in age, gestational age, gravidity, parity and systolic/diastolic blood pressures. The mean deepest vertical pocket in fasting and non-fasting groups were 65.9 +/- 12.9 mm and 62.7 +/- 6.5 mm and there was no significant difference between the 2 groups in this regard. Mean AFI in fasting group (189.9 +/- 35.9 mm) and in non-fasting group (166.8 +/- 25.3 mm) showed a significant difference (p less than 0.05). CONCLUSION: Based on the results of the present study fasting in Ramadan has no significant effect on the decrease of AFI, deepest vertical pocket and amniotic fluid volume.