masoumeh golsorkhtabar amiri

Endometriosis is one of the gynecological disorders and its prevalence is estimated to 8‑10% of reproductive‑age women. In Iran, the frequency of endometriosis was reported at 29% among infertile women. The etiology of endometriosis is still unclear. Numerous environmental contaminants such as polychlorinated biphenyls (PCBs) may play important roles in endometriosis development and etiology. Iranian population has relatively low levels of PCBs. However, no studies have evaluated PCBs levels in Iranian endometriosis patients so far. At present, there is no systematic review of the relationship between only PCBs exposure and the risk of endometriosis. The aim of this systematic review and meta‑analysis protocol will be to evaluate the association between only PCBs exposure and the risk of endometriosis. PubMed/MEDLINE, Web of Science, Scopus, Google Scholar, Embase, key journals, conferences/congress research papers, and the references of included primary studies will be searched. Observational studies (cross‑sectional, case‑control, and cohort) in humans that investigated the association between PCBs exposure and the risk of endometriosis will be included. The outcome will be endometriosis risk in association with PCBs exposure. The primary screening and data extraction will be performed by three team members independently and will be judged by opinion with the fourth member. The modified Newcastle‑Ottawa Scale (NOS) will be used for the quality assessment of studies. Findings from this study will recognize the association between PCBs exposure and the risk of endometriosis. Results may provide a new window for identifying the role of PCBs as environmental risk factors in relation to the development of endometriosis.

Polycystic ovary syndrome (PCOs) is an endocrine-metabolic disorder. This study intends to determine the comparison of insulin resistance (IR) and metabolic disturbance in overweight/obese and normal-weight of young women with polycystic ovary syndrome.
Using a comparative cross-sectional study design in 2015, 27 normal weight (18
112 women with PCOS participated in this study. The mean age was 22.4±3.48 years in the normal PCOS group (n=27) and 24.4±5.06 years in the overweight/obese PCOS patients (n=85). BMI had a significant straight correlation with insulin resistance (p3.15) vs. 8.3% (5) in the normal group (P13µU/ml) vs. 10.3% (7) in the control group (p Overweight/obese PCOs patients revealed higher insulin resistance and lower insulin sensitivity, and also greater TG and LDL cholesterol. Priority of management of insulin resistance and lipid profile should be considered on identifying these potentially major complications.

 

 
 

 

 

 



both mothers and fetuses. The aim of the study was to investigate the effect of dexamethasone on the augmentation and the duration of labor in prolonged latent phase of labor.

The design of the study was a randomized double-blind clinical trial design, which was conducted in delivery center of Rouhani hospital in Babol (Iran). A total 121 nulliparrous women with a singleton pregnancy and cephalic presentation at 40–42 gestational weeks in prolonged latent phase were randomly assigned to receive 2 ml ampoule dexamethasone 4 mg/mL (the intervention group) and 2 ml ampoule of sterile water for injections (the control group), which were both intramuscularly administered. Then, the Then, the augmentation of labor with the use of intravenous oxytocin infusion (Caspian Tamin Company Iran) (2.5 m units/ per minute) began in both groups. The primary outcome was the duration of time between the onset of augmentation and the second stage of labor.

The duration of time between the onset of labor augmentation and the second stage of labor (hours) was 5.6±1.9 in the study group, whereas it was 7.7±1.5 in controls with a significant difference (p ≤ <0.001). In the study group, the duration of time between the onset of labor augmentation and the active phase of labor was lower than that of the control group (p= 0.02). In addition, the duration of the second stage of labor (p <0.001) and the third stage (p <0.001) was lower in the study group compared with that of the control group.

It is imperative that midwives administer dexamethasone to improve the prolonged latent phase in women during the labour.

* The formula is not displayed correctly.

Many women with polycystic ovary (PCO) are obese. These women have lower clinical pregnancy rates when compared with their lighter counterparts. We hereby present a case of an obese PCOs woman, who referred to our clinic, underwent a microinjection, and failed in pregnancy. Then, she was recommended to have a change of lifestyle and lose weight along taking insulin-sensitizer medicines. In the following 6 months, she lost 19 Kilograms and referred to us with a spontaneous pregnancy. The object of this report was to determine the role of insulin intolerance medicines and lifestyle improvement on enhancing the rate of pregnancy in the PCOs obese women.

Subclinical hypothyroidism is related to poor outcome of pregnancy, which is reported in more recent researches. The aim of this study was to determine the correlation between pre-conception of thyroid-stimulating hormone (TSH) level and pregnancy outcomes in patients undergoing in vitro fertilization (IVF).
This retrospective cohort study was done on 115 IVF candidate patients undergoing long protocol of ovulation induction that became pregnant from 2007 to 2012. Pregnancy outcomes, including abortion rate, termination age of pregnancy and birth weight in women with low pre-conception TSH (≤2.5 mIU/L) and high pre-conception TSH (>2.5 mIU/L) were compared with each other.
Among 115 pregnancies, 30.2% of the women had pre-conception TSH >2.5 mIU/L. Preterm delivery (2.5 than them with a pre-conception TSH ≤2.5 (P= 0.044). There was no statistically significant difference in abortion, pregnancy termination, and birth weight between two groups. A pre-conception thyroid-stimulating hormone level >2.5 mIU/L is associated with a lower gestational age at delivery in women undergoing in vitro fertilization.
The results of this research indicated that a pre-conception thyroid-stimulating hormone level >2.5 associated with preterm labor in women undergoing IVF. Therefore, it is suggested that screening for hypothyroidism before IVF could be have significant public health implications.

A vaginal cyst is an encapsulated sac, situated on or under the lining of vagina, and contains liquid or semi liquid substance. Vaginal cysts have rarely proved to be more troublesome than causing a bit of discomfort and slight pain, but in some cases, they can develop into tumors. A 5-year-old girl, who was complaining about a weird pain in her lower abdomen, was referred to the gynecology center of the hospital. Ultrasonography revealed a vague large cyst in her uterus and vagina. Surgical procedure was necessary to remove it. The patient was followed up for 6 months, and no sign of recurrence of the cyst was observed.

Despite many studies published in recent years concerning pathogenic mechanisms of pre-eclampsia, but this issue remains controversial. The aim of the present study was to compare C-reactive protein (CRP) level and fibrinogen concentration obtained from pregnant women with pre-eclampsia with those obtained from women with normal pregnancies.
In a case-control study, 40 pregnant women with mild pre-eclampsia were studied. The maternal serum CRP and fibrinogen concentration of the 40 patients were compared with 55 pregnant women with non-preeclampsia as a control group. CRP was examined using quantitive nephlometry and fibrinogen concentration was measured by clotting system. An independent sample t-test was used for analysis.
Maternal serum CRP was higher in women pregnant with pre-eclampsia compared with those from pregnant women normal pregnancies (p= 0.01). The independent t-test did not reveal any statistically significant differences in the fibrinogen concentration between these pregnant women, either with or without pre-eclampsia.
The findings of this study indicated that a novel increased CRP was identified among pregnant women with pre-eclampsia, making inflammatory marker as a promising new approach for the detection of pre-eclampsia.

Infertility is a common problem as it is observed in 10 - 15% of couples to whom developing approaches for treatment is an issue of utmost importance. The aim of the current study was to determine the accuracy of diagnostic transvaginal ultrasongraphy (TVS) for the investigation of uterin pathologies in women before the application of assisted reproductive technique (ART).
In this observational, cross-sectional study, TVS and diagnostic hysteroscopy were performed consecutively on 100 infertile women, who were candidates for ART. All the findings of TVS were compared with hysteroscopic appearance of uterine cavity. The sensitivity, specificity, and positive and negative likelihood ratios were also calculated for diagnostic polyp and uterine anomalies.
Polyp was detected through diagnosis hysteroscopy in 6 cases (6.0%), out of whom 4 were diagnosed by TVS. The sensitivity and specificity ratios with TVS, diagnosed for polyp, were 50.00% and 98.94%, respectively. In addition, the sensitivity and specificity ratios with TVS, diagnosed for uterine abnormalities were 27.78 % and 98.78%, respectively.
The researchers concluded that TVS allows for the diagnosis of polyp uterine in the most cases, but its sensitivity for diagnosis of uterine anomalies is low. Therefore, TVS is not useful technique, compared with hysteroscopy, in patients who are candidates for ART. Thus, hysteroscopy is highly recommended.

Fertility specialists assess ovarian responses prior to estimating the prognosis for women who are suffering from anovulation. To diagnose the inconsistencies between chronological and biological age of ovaries and predict ovarian response, transvaginal sonography (TVS) ovarian act as an operant method. The aim of the current study was to assess the correlation between the number of antral follicles in both ovaries and the age of women in predicting the ovarian response in intrauterine insemination (IUI).
The research design of the present study was a cross-sectional. A total of 171 individuals, who were non-smoker patients and had already undergone a standard regimen of ovarian stimulation for IUI, were selected as participants of this study from the Infertility and Reproductive Health Research Center in Babol (Iran). On the third day of the cycle, TVS was conducted to measure the mean of every ovary and also to count the number of antral follicles on the both ovaries.
The mean age of our patients was 27.7. The increased aged of women is significantly associated with lower total number of antral follicles. (P = 0.001). The mean ovarian diameter was significantly correlated with high number of antral follicles (p = 0.0001).
The findings of the present study indicated that the age of women and the ovarian diameter are leading factors to help determine ovarian response as well as basal antral follicle counts.

The early postoperative feeding after caesarean section (C- section) has remained controversial. This study was designed to evaluate the safety and efficacy of early versus delayed postcaesarean section oral feeding regarding gastrointestinal complications and patients postoperative satisfaction after C- section. This clinical trial study was conducted on 200 pregnant women undergoing planned C-section under spinal anesthesia (Registration Number: IRCT: 138712211760N1). Women were randomly divided in two groups; group A (early feeding group) comprised of 101 patients who were encouraged to take oral fluid. If they tolerated, they continue semi-solid and solid foods starting 2 h after caesarean section. Group B (delayed feeding group) comprised of 99 patients who were given oral fluid 8 h after surgery. After beginning of feeding the patients’ tolerance, first flatus, first defecation, beginning of regular diet, the length of hospital stay and also patient satisfaction level were evaluated in each group by visual scale analog (VAS). The mean time of the first passage of flatus was 10.2±1.7 hours for the early oral feeding group versus 10.7±1.6 hours for the delayed feeding group and the difference was significant (P=0.03). Duration to first defecation and length of hospital stay as well as patient satisfaction level did not differ significantly between the two groups. The results of this study suggest early postcaesarean feeding. It is well tolerated and helps return normal feeding habits.

This study was designed to investigate the effect of metformin and flutamide alone or in combination with anthropometric indices and laboratory tests of obese/overweight PCOS women under hypocaloric diet. This single blind clinical trial was performed on 120 PCOS women. At the beginning, hypocaloric diet was recommended for the patients. After one month while they were on the diet, the patients were randomly divided in 4 groups; metformin (500 mg, 3/day), flutamide (250 mg, 2/day), combined, metformin (500 mg, 3/day) with flutamide (250 mg, 2/day) and finally placebo group. The patients were treated for 6 months. Anthropometric indices and laboratory tests (fasting and glucose-stimulated insulin levels, lipid profile and androgens) were measured. A one-way ANOVA (Post Hoc) and paired t-test were performed to analyze data. A p≤0.05 was considered statistically significant. After treatment, reduction in weight, BMI, hip circumference was significantly greater in the metformin group in comparison to other groups (p<0.05). In addition, the fasting insulin was significantly greater in metformin group and flutamide group in comparison to metformin flutamide and placebo groups after treatment (p<0.05). Within groups, insulin level showed significant changes (before and after treatment) in metformin flutamide group and LDL reduction was significant in flutamide group before and after treatment. Post hoc tukey and two-tailed with p≤0.05 were used to define statistical significance. Using combination of metformin and flutamide improves anthropometric indices and laboratory tests in obese/overweight PCOS women under hypocaloric diet.

In some traditional therapies, it has been claimed that camphor (a crystalline ketone obtained from cinnamomum camphora) would be a suppressor of sexual behaviors and sex hormones. This study evaluated the effects of camphor on sex hormones, like luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone. In this experimental study, 56 male rats were divided into 5 groups, including control (n=12), sham (n=11) and three treatment groups (n=11) in three different doses. The sham groups received daily intra peritoneal (IP) injections of the vehicle (ethanol 10%) for 30 days. Three treatment groups received different daily IP injections of the camphor (1, 2 and 5 mg/Kg) for 30 days and the control groups didn’t received anything. Serums were used for assaying LH, FSH and testosterone. The level of LH significantly increased in all doses of camphor among the treatment groups as compared to the control (p<0.05), but camphor in doses 2 and 5 mg/Kg significantly reduced the FSH level as compared to control group (p<0.05). No significant changes were seen in testosterone levels. Camphor increased level of LH, decreased level of FSH, whereas it failed to change level of testosterone. The claim of inhibitory effect of camphor on sexual activity could not be confirmed by this study. More investigations in this field are suggested.

Polycystic ovary syndrome (PCOS) is a common, complex endocrine disorder for women of productive age. A high incidence of ovulation failure in women with PCOS is related to insulin resistance. Some studies have assessed the effects of hyperinsulinemia and insulin resistance in relationship with insulin sensitizing agents such as Metformin (Met). These medicines have been suggested new scope for ovulation stimulation enhancement with Clomiphene Citrate (CC) in PCOs women. The aim of this study is to compare the effectiveness of adding Met to CC in women with PCOS. This multicenter, single-blind, randomized controlled trial study was performed on 334 PCOS patients from 2007 to 2009. Patients were randomly divided into two groups and ovulation induction was performed with either CC alone or CC + Met. The treatment was continued for three cycles, then the mature follicle and pregnancy rates were evaluated. In the CC + Met group, 68% had at least one dominant follicle in the first cycle that was significant (p<0.001), and 31.7% had one in the second cycle. In the CC group 54.5% in the first cycle, 31.7% second cycle, and 6.9% ovulated in the third cycle. The pregnancy rate was 28.7% in CC + Met group and 24.6% in the CC group, with no significant differences between the two groups. Adding Met to CC is significant for ovulation, but it does not enhance the pregnancy rate (Registration Number: IRCT138904174306N1).

In sever oligospermia; one of the paths used for surgical sperm retrieval (SSR) is to extract sperm via a testicular biopsy. The aim of our study is to determine the reliable time interval between testicular biopsy and intracytoplasmic sperm injection (ICSI) procedure in order to obtain optimumsperm parameters (Count, motility and normal morphology). This cohort study was carried out on 30 patients which were candidates for ICSI. After collection and keeping the samples obtained from the testicular biopsy in Ham’s F10 environment, the concentration, motility and morphology of the sperm in each sample was evaluated immediately as well as 2 and 4 hours after processing. The Data were then compared with each other. For the statistical analysis, Friedman, Willcoxon and Cochran tests were used. The mean of sperm concentration was 5.69 ± 6.14 million and the motility was10.83 ± 12.63% at 2 hours following biopsy which was significantly higher than those obtained after 0 and 4 hours of the biopsy (p <0.05). The reliable preincubation time which resulted in the highest rate of spermatozoa parameters after testicular biopsy and before incubation was 2 hours.

A common cause of anovulation is polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) is the first line of treatment in PCOS patients however approximately 25% of patients may be CC-resistant. This study aimed to evaluate the efficacy of adding dexamethasone (dex) to CC in CC-resistant PCOS patients with the intent to improve ovulation. This randomized controlled trial study was performed on 60 infertile PCOS patients referred to our infertility research center from 2007 to 2009. Patients were randomly divided in two groups and stimulation performed with dex+CC or CC+placebo. Rates of ovulation, pregnancy and number of mature follicles were evaluated. Ovulation rate in the dex+CC group was 21 out of 30 (70%) and in the CC+placebo group it was 17 out of 30 (56.7%). The pregnancy rate was 5 (16.7%) in the dex+CC group and 3 (10%) in the CC+placebo group. There was no significant difference between rates of ovulation and pregnancy in both groups, but the number of follicles ≥18 mm were significant in the dex+CC group (p<0.05). Our results showed that addition of dex to CC significantly increased the number of matured follicles, however the ovulation and pregnancy rates were comparable between the two groups (Registeration Number: IRCT 138807041760 N2).

The pattern of Islamic fasting differs from other forms of fasting, therefore its effect on health also differs. This research studies the effect of Islamic fasting on gonadotropin hormones around the time of the ovulatory cycle and ovulation. This self-controlled study was performed on 24 adult females. Blood sampling was performed during Ramadan and two months later to determine the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and progesterone. Ultrasonography was done in order to detect ovulation and the results were compared. The mean values of FSH, LH and estrogen during the 14th day of menstruation were comparable with non-fasting values. There was no significant difference in ovulation. Islamic fasting causes neither significant variation in hormone secretion around ovulation nor does it influence the occurrence of ovulation.

Basal FSH levels reflect ovarian response and more formed embryos. We investigated a reliable FSH range to retrieve more oocytes and embryos. Two hundred patients in ART cycles underwent this study from Apr 2007 to Sep 2008. Patients were divided in three groups based on value of FSH: group A≤8 IU/ml, 8 IU/ml < group B≤10 IU/ml, group C>10 IU/ml and results of ART cycles were compared with each other. Retrieved and fertilized oocytes and transferred embryos in group A differed significantly in comparison with group B and C (p<0.05), but pregnancy rates in three groups were comparable. In our study the reliable range of FSH level to predict more retrieved oocytes and embryos was ≤8 IU/ml.