ABSTRACT
PURPOSE: To reach a consensus among obstetrics and gynecology experts on the effects of micronutrient supplementation on fertility and pregnancy to aid clinicians in decision-making and create a unified approach to managing micronutrient deficiencies in women, by performing a modified Delphi study. METHODS: A three-round modified Delphi process was conducted among a Delphi panel of 38 Egyptian experts to define recommendations regarding the role of supplementation on fertility and pregnancy in women of reproductive age. A literature review was performed and supporting evidence was graded to help guide the recommendations based on available evidence. RESULTS: A total of 62 statements were developed for discussion and voting. Out of the 62 statements, 60 statements reached expert consensus. Statements were divided into two domains. The first domain discussed the role of supplementation in fertility: optimizing natural fertility, polycystic ovary syndrome (PCOS), in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), unexplained infertility, and endometriosis, whereas the second domain was concerned with the role of supplementation in pregnancy during the prenatal, antenatal, and postnatal periods. CONCLUSION: In this work, a modified Delphi methodology was implemented to reach a consensus on the use of micronutrient supplementation in women of reproductive age. These recommendations can help clinicians in their practice, guide future research, and identify gaps in the market for the pharmaceutical industry. This clinical guidance can be extrapolated to similar communities.
Subject(s)
Gynecology , Humans , Pregnancy , Male , Female , Consensus , Delphi Technique , Semen , Vitamins , Dietary SupplementsABSTRACT
OBJECTIVE: To study the association between polycystic ovary syndrome (PCOS) and congenital uterine (Müllerian) anomalies in infertile patients. The ultimate aim was to check for a common factor linking both reproductive health problems. DESIGN: A prospective observational study. SETTING: Tertiary referral infertility center. SUBJECTS AND METHODOLOGY: 3,900 infertile patients were included. The diagnoses of PCOS and uterine anomalies were made. Patients with or without PCOS were correlated to the presence or absence of uterine anomalies and statistically assessed. MAIN OUTCOME MEASURES: Study of the prevalence of PCOS/uterine anomalies in the studied population and the ratio of coexistence. RESULTS: The prevalence of PCOS in the studied cohort was 10.48 %. 409 (10.48 %) patients were confirmed to have PCOS, while 204 (5.23 %) were with confirmed uterine anomalies. Of the patients with confirmed PCOS, almost one-third (n = 149, 31.4 %) had uterine anomalies, while in patients with confirmed uterine anomalies, almost three-fourths (n = 149, 73 %) had PCOS. CONCLUSIONS: There is evident association between PCOS and uterine anomalies in infertile patients. We suggest a genetic rather than a developmental defect to be a possible common player for the development of both PCOS and uterine anomalies.
Subject(s)
Polycystic Ovary Syndrome/complications , Urogenital Abnormalities/complications , Uterus/abnormalities , Adult , Egypt/epidemiology , Female , Humans , Infertility, Female/epidemiology , Polycystic Ovary Syndrome/diagnostic imaging , Polycystic Ovary Syndrome/epidemiology , Prevalence , Prospective Studies , Risk Factors , Ultrasonography , Urogenital Abnormalities/diagnostic imaging , Urogenital Abnormalities/epidemiology , Uterus/diagnostic imagingABSTRACT
PURPOSE: To evaluate the impact of subtle progesterone (P4) rise on the day of HCG on pregnancy outcome in ICSI patients stimulated with long agonist protocol. METHODS: One hundred forty-nine consecutive controlled ovarian hyperstimulation cycles for ICSI using long luteal agonist protocol. RESULTS: Mean serum progesterone on day of hCG was 0.88+/-0.51 ng/mL values > or =1 ng/mL were found in 34.2% of cycles. Serum E2 on day of hCG and number of oocytes retrieved were significantly higher in the group with P4 > or = 1 ng/mL. The area under ROC for serum progesterone in prediction of pregnancy was 0.52, indicating that within the values studied, serum progesterone on day of hCG is not predictive of pregnancy outcome. CONCLUSION: P4 values > or =1 ng/mL on day of hCG are common in long agonist ICSI cycles particularly with high response. Within the P4 values encountered in this study, implantation and pregnancy rates are not adversely affected.
Subject(s)
Chorionic Gonadotropin/blood , Progesterone/blood , Sperm Injections, Intracytoplasmic/methods , Adult , Embryo Transfer , Estradiol/blood , Female , Follicle Stimulating Hormone/blood , Humans , Luteal Phase , Male , Ovarian Follicle/pathology , Ovary/pathology , Pregnancy , Pregnancy RateABSTRACT
PURPOSE: To evaluate leptin levels in a sample of obese women with PCOS and compare the results with obese and non-obese control, to be ultimately correlated with BMI, and insulin sensitivity. METHODS: Leptin and insulin assays by immuno-radiometric method, glucose assay by enzymatic colorimetric method. RESULTS: Leptin levels were significantly different between obese and non-obese subjects, and were significantly different between insulin resistant and non-insulin resistant obese PCOS, but were not significantly different between obese non-insulin resistant PCOS, and obese controls. CONCLUSIONS: Body mass index and insulin resistance are the two main factors governing serum leptin levels.
