Effects of the levonorgestrel-releasing intrauterine system versus the copper intrauterine device on uterine artery Doppler indices.

OBJECTIVES: The aims of the study were to evaluate the effects of two types of intrauterine contraceptive device (IUCD) on uterine artery Doppler indices. METHODS: A multicentre randomised clinical trial was conducted between November 2019 and August 2020. Sixty-six multiparous women aged 18-45 years seeking intrauterine contraception were randomly assigned to receive either the levonorgestrel-releasing intrauterine system (LNG-IUS) or the copper intrauterine device (Cu-IUD). Each group comprised 33 participants. Primary outcome measures were menstrual changes and changes in uterine artery Doppler indices 3 and 6 months after IUCD insertion. Secondary outcomes measures were the relation between Doppler indices and menstrual changes, adverse effects of the assigned contraceptive method and user acceptability of the method. RESULTS: Uterine artery pulsatility index (PI) and resistance index (RI) were significantly higher among women in the LNG-IUS group (p < .001 at 6 months). Whereas the number of women reporting heavy menstrual bleeding decreased at 3 and 6 months in the LNG-IUS group it significantly increased in the Cu-IUD group (p < .001 at 6 months). Multiple logistic regression analysis of participant characteristics and occurrence of heavy menstrual bleeding revealed a significant association with uterine artery RI (p < .01) and the type of IUCD (p < .001). CONCLUSION: IUCDs are associated with Doppler changes that may be associated with their reported side effects.

Fetal gender, serum human chorionic gonadotropin, and testosterone in women with preeclampsia.

OBJECTIVES: Evaluation of the association between fetal gender, serum beta-human chorionic gonadotropin, and serum testosterone, and preeclampsia. METHODS: Case-control study conducted at the Obstetrics and Gynecology Department. 120 patients divided into study group (patients with preeclampsia subdivided into mild and severe) and control group (normotensive women). INTERVENTIONS: Fetal gender was determined. Serum testosterone and HCG levels were estimated at 32 weeks or at the time of diagnosis of preeclampsia (study group) or recruitment (control group). RESULTS: Positive association between the male gender of the fetus and preeclampsia. Increased HCG and Testosterone were associated with developing preeclampsia. CONCLUSION: The mechanism of preeclampsia could be androgen-mediated. There is a significant correlation between serum HCG and testosterone and preeclampsia.

Ovarian stimulation after dehydroepiandrosterone supplementation in poor ovarian reserve: a randomized clinical trial.

OBJECTIVE: This study aimed at improving fertility rates among infertile women with poor ovarian reserve. METHODS: This was a randomized clinical trial conducted in the outpatient clinic of a tertiary hospital. We recruited infertile women with poor ovarian reserve. The study population was divided into 2 groups, each of 25 participants. Both had induction of ovulation for three consecutive cycles. Study group took DHEA supplementation 25 mg/8 h for two consecutive cycles before induction of ovulation. Both groups were compared for outcomes of induction. Baseline ovarian reserve tests and antral follicle count (AFC) were done for both groups before induction of ovulation. The study group repeated these baseline tests after DHEA treatment to compare ovarian reserve before and after DHEA supplementation. Outcome measures were the number of mature follicles at the time of ovulation, the number of gonadotrophin ampoules needed for induction of ovulation, the duration of ovarian stimulation, E2 level at the day of HCG injection. RESULTS: The study group baseline investigations after DHEA treatment showed a statistically significant improvement compared to the control group. The outcomes of induction of ovulation in the study group showed a statistically better response than the control group. CONCLUSION: DHEA may help many poor responders so better considered for poor responder patients. TRIAL REGISTRATION NUMBER: PACTR201911829230395.

Effect of a gonadotropin-releasing hormone analogue on cyclophosphamide-induced ovarian toxicity in adult mice.

PURPOSE: To evaluate the possible protective effect of low and high dose of triptorelin, a GnRH analogue, on cyclophosphamide-induced ovarian toxicity in adult female mice. METHODS: Thirty-six sexually mature, virgin, female mice were divided randomly into six groups of six each: control group, low-dose triptorelin (TL) group, high-dose triptorelin (TH) group, cyclophosphamide (CPA) group, low-dose triptorelin plus cyclophosphamide (TL + CPA) group and high-dose triptorelin plus cyclophosphamide (T + CPA) group. Mice in both the TL + CPA and the TH + CPA groups were injected with 3.8 and 38 mg/kg of triptorelin subcutaneously, respectively. Four weeks later, mice in the CPA, TL + CPA and TH + CPA groups were injected with cyclophosphamide, intraperitoneally, at a dose of 50 mg/kg. Ovaries were removed 4 weeks later and processed for light microscopic examinations. RESULTS: Obvious destruction of ovarian structure and significant depletion of primordial, primary, secondary and antral follicles were demonstrated in the CPA group and compared with the control group, the difference was statistically highly significant (p < 0.001), affirming the ovarian toxicity of cyclophosphamide. In the TL + CPA group, there was a significant increase in primordial, primary, secondary and antral follicles compared with the CPA group (p < 0.05), showing the effect of triptorelin on ovarian protection. Regarding, the high-dose GnRH agonist the difference was statistically highly significant for primordial and primary follicles (p < 0.001). CONCLUSIONS: This study has showed a dose-dependent protective effect of GnRH analogue on ovarian reserve against ovarian toxic chemotherapy, thus demonstrating an important role of GnRH analogues in fertility preservation.