Polycystic Ovary Syndrome Develops the Complications of Assisted Reproductive Technologies.

Ovarian hyperstimulation syndrome (OHSS) is a serious complication that remains a threat to every patient experiencing stimulation of ovulation. Polycystic ovary syndrome (PCOS) appears to be the most important predisposing factor for OHSS. The severity of OHSS is associated with the degree of the follicular response to the ovulation inducing agents. The objective of this study was to investigate the relationship between PCOS with the risk of moderate-to-severe OHSS in intracytoplasmic sperm injection treatment patients. Sixty patients in the reproductive ages (20-38), including OHSS patients and age-matched normoresponders were included in this study. Patients who had larger follicle counts on the day of hCG injection were considered at risk for developing moderate-to-severe OHSS. In addition, oocyte quality was assessed about 20-30 min after oocyte pickup. The incidence of OHSS in PCOS patients increased significantly up to 13.9 times higher than in patients without PCOS (OR=13.900; P=0.007). Moreover, moderate-to-severe OHSS increased significantly (OR=3.860; P=0.043) in patients with primary infertility than those with secondary infertility. In addition, oocyte quality was not affected with the severity of OHSS. In conclusion, the risk of moderate-to-severe OHSS is correlated with PCOS and primary infertility without affecting oocyte quality.

Comparison of lidocaine 1% and normal saline in paracervical anesthesia for decreasing of pain in curettage.

The objective of this study was to compare the efficiency oflidocaine with that of plain saline for paracervical pain relief during fractional curettage. The double-blind randomized clinical trial was performed on 150 patients presenting from 2004 to 2005 for curettage. The patients were assigned randomly in two groups to receive lidocaine 1% or normal saline. Number of patients at each group was 75 women. The pain intensity was assessed in four stages: (1) after speculum insertion, (2) during cervical dilatation, (3) during curettage and (4) 30 min after curettage completion. The pain intensity was graded as 0 to 100 according to the Likert Scale. The Mean +/- SD of pain intensity after speculum insertion, during dilatation, during curettage and 30 min after curettage in lidocaine group were 11.33 +/- 9.70, 24.93 +/- 15.36, 37.00 +/- 17.35, 6.47 +/- 6.42 and in normal saline group were 11.73 +/- 9.81, 28.20 +/- 13.19, 49.47 +/- 21.55 and 7.33 +/- 6.22, respectively. There was no significant difference between pain intensity after speculum insertion, during dilatation and during 30 min after curettage but there was a significant difference in pain intensity during curettage between lidocaine 1% group and normal saline group (p < 0.05). Normal saline is as effective as lidocaine 1% in low pain in curettage (distention of nerve capsule) but when increase pain in curettage (third time point), lidocaine 1% is more effective than normal saline. Nerve capsule distention is not the only factor for pain control in paracervical block and analgesic agent is still an important factor.