Efficacy of Salvia officinalis extract on the prevention of insulin resistance in euglycemic patients with polycystic ovary syndrome: A double-blinded placebo-controlled clinical trial.

OBJECTIVES: At the present study, we aimed at evaluating the effect of Salvia officinalis (S. officinalis) extract on "anthropometric indices" and "insulin resistance markers" in Polycystic Ovary Syndrome (PCOS) patients. DESIGN AND SETTING: This was a randomized, triple-blinded, controlled trial performed in gynecology hospitals affiliated to Iran University of Medical Sciences. PARTICIPANTS: Sixty PCOS patients diagnosed according to Rotterdam criteria. INTERVENTIONS: Consumption of the 330 mg oral S. officinalis extract or placebo capsules daily for eight weeks. MAIN OUTCOME MEASURES: Body mass index (BMI), waist to hip ratio (WHR), blood pressure, homoeostatic model assessment-insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI). RESULTS: Results showed a statistically significant decrease in the BMI (P = 0.001) in S. officinalis group, but, there were no significant differences between the two groups for WHR (P = 0.164). Although we failed to find a significant effect of S. officinalis extract on systolic blood pressure (P = 0.283) but using a multivariate model showed a significant difference between two groups regarding diastolic blood pressure (P = 0.025). Also, the consumption of S. officinalis extract, compared to the placebo, resulted in a significant decrease in Insulin levels (P < 0.001), and HOMA-IR (P < 0.001). As well as, S. officinalis extract supplementation resulted in a greater increase in QUICKI (P < 0.001) compared with placebo groups. CONCLUSION: S. officinalis extract at a dose of 330 mg/day could decrease BMI and systolic blood pressure, and it could enhance insulin resistance markers in euglycemic PCOS patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT201504146917N2, 2015-10-03).

Effect of serum vitamin D level on endometrial thickness and parameters of follicle growth in infertile women undergoing induction of ovulation.

In this paper, 153 infertile women undergoing induction of ovulation at an academic tertiary care centre were included in a cross-sectional study. Serum Vitamin D level was measured and the rate of clinical pregnancy (defined as a sonographic presence of FHR of an intrauterine gestational sac) and patient and cycle parameters were determined. The results showed that a correlation exists between endometrial thickness as well as the number of antral follicles and replete level of Vitamin D. Interestingly, the median level of these two parameters was of upmost level in the most replete tertile of serum Vitamin D level. There was no correlation between the serum level of Vitamin D and pregnancy rate. Vitamin D status was associated with endometrial thickness and number of antral follicles, but this study did not find a pivotal effect of serum Vitamin D level on pregnancy rate. Impact statement What is already known on this subject? Literature reviews have indicated that a Vitamin D deficiency is directly responsible for a reduced fertility and reproduction capacity. Women with higher level of Vitamin D in serum and follicular fluid are more likely to become pregnant. What do the results of this study add? This study, assessing the effect of serum level of Vitamin D on endometrial thickness and parameters of follicle growth in infertile women undergoing induction of ovulation showed that a correlation exists between endometrial thickness as well as the number of antral follicles and replete level of Vitamin D. It can be concluded that a replete Vitamin D status is associated with a better state of endometrial thickness and a number of antral follicles, but this study did not find a pivotal effect of serum Vitamin D level on the pregnancy rate. What are the implications of these findings for clinical practice and further research? If a relationship would be proved between Vitamin D deficiency and endometrial thickness and parameters of follicle growth it is possible that with prescribing supplemental Vitamin D as a relatively inexpensive and safe way along with the other more complex and costly infertility treatments, achieving the pregnancy would be easier.

Management of Abnormal Placenta Implantation with Methotrexate: A Review of Published Data.

Abnormally invasive placenta is characterized by direct attachment of chorionic villi to the uterine wall. This adherent placenta traditionally has been managed by peripartum hysterectomy. Nowadays, there is a lot of interest toward gradual shift from traditional management of invasive placentation to conservative ones leaving the placenta in situ to avoid the surgical morbidity of hysterectomy and loss of future fertility. Administration of methotrexate (MTX), as an adjunctive antimetabolite drug, resulted in conflicting data during conservative management of abnormal placentation. This review assessed all published data on efficacy and safety of MTX therapy as conservative management of invasive placentation. Fifty-three articles including one prospective cohort study, 2 retrospective cohort studies, 10 case series and 40 case reports were identified. Conservative management has beneficial effects on the avoidance of major surgery with the consequent morbidity and the preservation of future fertility. Infection and vaginal bleeding were main complications of MTX therapy. Although MTX therapy may result in accelerated involution or expulsion of placenta and has some beneficial effects on hemorrhagic events, but there is not enough evidence on its efficacy and safety to recommend its routine uses in all cases of invasive placenta.

Comparison of thyroid hormone levels between normal and preeclamptic pregnancies.

BACKGROUND: To investigate thyroid function in preeclamptic patients in comparison with normal pregnant women. METHODS: In this analytical cross-sectional study free Thyroxine (T4), and Thyroid Stimulating Hormone (TSH) levels were measured in 100 preeclamptic patients and were compared with Free T4 and TSH levels in 101 normal pregnant women in their third trimester of pregnancy. Patients with thyroid or other systemic disorders were excluded from this study. RESULTS: A significant difference in concentration of free T4 levels (0.729 ±0.324 ng/ dl versus 0.929± 0.314 ng/dl, p <0.001) was observed in the preeclamptic group compared with the normotensive group, but the mean TSH level was not significantly different (2.935±1.16 mIU/L versus 2.339±1/15 mIU/L, p = 0.170). CONCLUSION: Women who develop preeclampsia are more likely to have lower normal limits of thyroid function during their final weeks of pregnancy.