Superoxide dismutase in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection.

PURPOSE: Polycystic ovary syndrome (PCOS) is associated with oxidative stress (OS) and serum superoxide dismutase (SOD) activity has been reported with mixed results. The objective of this study was to examine the activity of SOD both in the serum and FF from women with PCOS undergoing ICSI, as well as the expression of Cu/Zn-SOD mRNA in the cells recovered from the FF. METHODS: Forty women undergoing an ICSI trial were divided into: group I, included 20 PCOS cases, group II included 20 age-matched controls with tubal factor infertility. Both groups were similarly stimulated. A total of 204 metaphase II (MII) oocytes were aspirated; (108) from PCOS, and (96) from the control group. SOD activities in the serum and FF, as well as Cu/Zn-SOD (SOD1) mRNAs in follicular fluid (FF) cells were analyzed. RESULTS: There was a statistically highly significant decrease (p < 0.001) both in the mean serum SOD (45.56 ± 18.06) and FF SOD activity (42.49 ± 11.46) in PCOS than the control group (77.38 ± 7.82), (74.37 ± 6.15) respectively. The mean relative levels of Cu, Zn SOD mRNAs was significantly lower (p < 0.001) in cells isolated from the FF in PCOS (0.36 ± 0.14) than the control group (0.81 ± 0.15). SOD activity in FF had no effects on fertilization rate (p > 0.05), or embryo quality after intracytoplasmic sperm injection (ICSI). CONCLUSION: Although decreased SOD activity in FF has no effect on fertilization rate and/or embryo quality, serum SOD activity could be a clinical parameter for determining systemic oxidative stress in PCOS.

Does combined prednisolone and low molecular weight heparin have a role in unexplained implantation failure?

PURPOSE: To study the effect of combined oral prednisolone and LMW heparin in ICSI in women with previously unexplained, failed implantation. METHODS: A prospective quasi-randomized, controlled trial was conducted at a university teaching hospital and a private practice setting. A total of 334 cycles (women with previously unexplained, failed one or two ICSI attempts) were assigned randomly to receive standard treatment or combined prednisolone (20 mg/day), starting on the first day of ovarian stimulation and LMW heparin 1 mg/kg/day starting 1 day after oocyte retrieval in addition to standard treatment. RESULTS: The mean age, number of previously failed IVF attempts, and basal FSH levels were comparable between both groups. The pregnancy and the implantation rates were significantly different between the study and control groups. CONCLUSIONS: A combination of oral prednisolone and low molecular weight heparin may have a significant effect on pregnancy and implantation rates in prior unexplained, failed implantation.

Novel modification of B-Lynch uterine compression sutures for management of atonic postpartum hemorrhage: VV uterine compression sutures.

AIM: The aim of this study was to demonstrate a novel modification of uterine compression sutures for use in women with primary postpartum hemorrhage and to evaluate its effectiveness. MATERIAL AND METHODS: This was a prospective observational study. Nineteen patients with atonic postpartum hemorrhage were subjected to the novel VV uterine compression sutures at the time of cesarean delivery. RESULTS: The procedure was successful in 18 out of 19 women (94.7%) in controlling the bleeding and preserving the patient's uterus. Only one patient required supravaginal hysterectomy. CONCLUSIONS: VV compression sutures comprise an easy, safe and effective procedure that can be applied in cases of atonic postpartum hemorrhage.

Agreement of histopathological findings of preoperative uterine curettage and hysterectomy specimens: impact of time factor and hormonal therapy.

OBJECTIVES: To study the agreement of preoperative curettage and definitive histology after hysterectomy as well as the correlation of time factor and hormonal therapy to this agreement. METHODS: This retrospective study was done in the Departments of Obstetrics and Gynecology and Pathology, Faculty of Medicine, Mansoura University, Egypt. Pathology reports of patients exposed to dilatation and curettage followed by hysterectomy during the period from May, 2004 to April, 2011 were reviewed. RESULTS: We reviewed 83 cases who fulfilled the inclusion criteria. There were non-significant differences between findings of D&C and hysterectomy specimens (P = 0.42). The concordance rate between D&C and hysterectomy was 79.5%. One case of endometrial carcinoma (1.2%), one case of simple endometrial hyperplasia, one case of atrophic endometrium, and two cases of endometrial polyp were diagnosed only after hysterectomy (4.8%). Furthermore, histologic examination of hysterectomy specimens confirmed only 8 of 13 cases (61.5%) of endometrial hyperplasia with atypia. No significant correlation of time factor and hormonal therapy to the agreement between findings of D&C and hysterectomy specimens (P = 0.58 & 0.19 respectively). CONCLUSION: There was no significant difference between preoperative endometrial histology and hysterectomy specimens (P = 0.41).This agreement had not been significantly affected by time interval and hormonal therapy. Future researches with larger number of cases are needed to confirm or disagree with our findings.