مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 46 (هفته چهارم فروردین 1392)

One of the most important steps in success of assisted reproductive techniques is appropriate ovulation induction and effective ovarian follicles stimulation. The aim of this study was to investigate the comparison of low-dose hCG plus gonadotropin releasing hormone (GnRH) agonist on ovulation induction and with standard dose hCG alone in intrauterine insemination technique with antagonist protocol. This clinical trial was conducted on 100 infertile couples who referred to infertility research center in Shahid Sadoughi university of medical sciences، Yazd، 2010 - 2011. Infertile women aged 18 to 35 who were treated with antagonist protocol were divided randomly into two groups after development of at least 3 follicles beyond 18mm diameter. Low dose of hCG (2500 IU) plus GnRH agonist (0. 2mg Triptorelin، intra muscular) were given to one group (n=70) and the next group (n=70) received hCG alone (10،000 IU، intra muscular). After 34 to 36 hours of injection intrauterine insemination was done in both groups. Data were analyzed with SPSS software version 11. 5 and T student and Chi-square tests. P value less than 0. 05 was considered significant. The patients were not different in terms of endometrial thickness، estradiol levels on day of hCG injection and the number of used gonadotropin ampoules (p=0. 1). Higher incidence of ovarian hyperstimulation syndrome (OHSS) was seen in the only hCG group، but this difference was not statistically significant (p=0. 1). Chemical pregnancy was significantly higher in low dose of hCG plus GnRH agonist (p=0. 03). However، no differences were observed between two groups in terms of clinical pregnancy (p=0. 07). Using low dose hCG plus GnRH agonist can be considered as an appropriate and alternative method instead of standard methods of hCG in ovulation induction with antagonist protocols.

Women who do not use contraception methods correctly and regularly، also those who use withdrawal method which is traditional and common in Iran are high risk for unwanted pregnancy. The aim of this study was to determine the effective factors on choosing unsafe contraception methods. This retrospective study was conducted on 174 pregnant women who were referred to health center of Torghabeh، Mashhad، Iran، 2012 for pregnancy health care. Demographic data، reproductive variables and the type of contraception methods collected from prenatal care health records and analyzed using SPSS software version 13، t-test، chi-square and Fisher tests. P value less than 0. 05 was considered significant. 42 women of 174 (24%) did not use any kind of contraception methods before their pregnancy، from the remaining cases، 52 women (39. 4%) used safe contraception and 80 women (60. 6%) used withdrawal method. Mean age of women was 26. 5±4. 8 years. 61 women (46. 2%) had diploma or higher education level، 125 women (94. 7%) were housewives and 50 cases (37. 8%) were in their first pregnancy. The number of previous pregnancies had a significant relationship with the type of contraception methods (p<0. 05) and women who had no previous pregnancy experience، used withdrawal method 1. 5 times more. History of pregnancy and number of previous pregnancies were the only effective factors on unselecting unsafe contraception methods and women who had no previous pregnancy were more susceptible to select and use withdrawal method.

Dysmenorrhea is a common gynecologic disorder that affects 50 percent of women who have menstrual periods. This study investigated the effects of brisk walking on primary dysmenorrhea on girl students. In this clinical trial، 45 students of exercise group and 45 students of control group who were studied in faculty of nursing and midwifery were studied in Mashhad، Iran، 2012. Exercise group performed brisk walking for half an hour in the first 3 days of menstruation in three consecutive menstrual cycles. Research tools included visual pain scale، demographic data questionnaire and menstrual characteristics before and after exercise. Data were analyzed using SPSS software version 19، paired t-test، Mann-Whitney and Wilcoxon tests. P value less than 0. 05 was considered significant. The mean age of participants was 20. 74 years. The mean of dysmenorrhea duration of each cycle and days of bleeding were 2. 49 days and 6. 96 days، respectively. The mean of pain scores was similar in two groups before the intervention but it was significant after the intervention (p<0. 001). There was a significant difference in the exercise group in terms of pain severity before and after intervention (p<0. 001); while، there was no difference in the control group in this regard (p=0. 81). Brisk walking for half an hour in the first 3 days of menstruation reduces pain of primary dysmenorrhea.

Abnormalities of reproductive system occurs in 6-79% of women who are involved in sports activities. However، menstrual dysfunctions exist in female college athletes، but few studies have been conducted on this topic and effective sports factors. Menstrual dysfunctions have a wide range and may lead women to infertility. The aim of this study was to investigate the role of exercise indices on menstrual dysfunctions in female college athletes. This study was a descriptive analytical one conducted on 246 female college athletes studying in Azarbaijan Shahid Madani university، Azarbaijan، Iran، 2012. Sampling was convenience. Data were collected by a questionnaire of demographic information، exercise indices and information about menstrual cycles. Data were analyzed by descriptive and inferential statistical methods and SPSS software version 14. P value less than 0. 05 was considered significant. There was a significant positive relationship between volume of exercising (the number of hours of exercising per week) and menstrual dysfunctions (menorrhagia، metrorrhagia and polymenorrhea) (p<0. 05)، but، no significant relationship was found between these dysfunctions and parameters of type of sport، its frequency and duration of the exercise (p>0. 05). Exercise with high volume can lead to irregular uterine bleeding، including prolonged or severe bleeding (menorrhagia)، bleeding between menstrual periods and irregular (metrorrhagia) and recurrent bleeding (polymenorrhea) in female college athletes.