مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 155 (هفته اول و دوم امرداد 1394)

Using ovulation induction regimen antagonist has been recently suggested in Infertility centers for resolving of the problems of the patients with poor ovarian response. The antagonist regime is selected in this study because it has low cost، it takes shorter time to obtain the results and has not been used so far in this center. Therefore، this study was performed with aim to evaluate and compare the results of ovulation induction with Antagonist GnRH regimen (cetrotite) in patients with poor ovarian response in previous ART (Assisted Reproductive Technique).

This interventional and experimental study which had no control group was performed on 41 infertile women by before and after plan in Kerman Afzalpour hospital infertility center from 2013-2014. People with poor ovarian response in previous ART cycles were selected and underwent antagonist regimen in new cycle. Then، the results of previous and current cycle of the patients including the number of follicles، number of oocytes، oocyte quality، the number of embryo and embryo quality were compared. Data was analyzed by SPSS software (version 16) and chi-square test and paired t-test or nonparametric equivalents. P<0. 05 was considered statistically significant.

The number of follicles، oocyte quality، endometrial thickness، grading، the number of transferred embryo، and the number of pregnancy in the previous regime had no significant relationship with Antagonist regime (P>0. 001). But significant difference was observed in terms of the number of oocytes and the number of embryos in antagonist regimen.

Ovulation induction with antagonist regimen is a good choice for poor ovarian response patients.

Early maladaptive schemas and insecure attachment styles are the basis of many psychological disorders. This study was performed with aim to identify the early maladaptive schemas and attachment styles in women with vaginismus and comparing with normal women.

This scientific-comparative study was performed on two 30 cases groups (women with vaginismus and normal women) in 2014. Women with vaginismus were selected by convenience and purposeful sampling method by referring from gynecologist، psychiatrists and psychologists in Tehran، and were compared with normal women who were matched with first group in term of age and education. Data collection was performed by Young Schema Questionnaire- short form (YSQ-SF) and Collins and Read Revised Adult Attachment Scale (RAAS). Data were analyzed by SPSS software (version 20) and multiple variance analyses (MANOVA). P<0. 05 was considered statistically significant.

The mean score of all early maladaptive schemas in women with vaginismus was significantly more than normal women (P<0. 01). Attachment styles of two groups were significantly different in terms of closeness and anxiety (P<0. 01). So that، the women vaginismus significantly more used the anxiety style and less used closeness style than normal women. There was no significant difference between two groups in dependent attachment style (P=0. 1).

The women with vaginismus had more early maladaptive schemas and anxiety attachment style comparing to normal women.

Episiotomy means cutting the muscles of perineum during the second stage of labor to widen pelvic outlet and speed up the withdrawal of the fetal head; it is the most common surgical incision in midwifery. Today، a variety of non-pharmacological methods during pregnancy and labor are used to reduce need for episiotomy and after delivery for pain reduction and early recovery. This study was performed with aim to review some of these approaches. In this study، all clinical trials which have been conducted to reduce the need for episiotomy and quick recovery and pain reduction after that until 2014 were used. To obtain the necessary information، the databases of PubMed، Sciencedirect، googlescholar، SID and Iranmedex were used. A total of 20 studies were evaluated based on the Jadad criteria and among them، there were 17 Iranian paper and 3 English articles. The results showed that the majority of methods used during pregnancy and childbirth for reducing the need to episiotomy (perineal massage، Kegel exercises، etc.)، as well as medicinal plants (Aloe vera، turmeric، lavender، marigold، pineapple، chamomile، etc.) used after episiotomy for wound healing and reducing pain are effective، but generally، further studies are needed for better understanding of these plants and their possible complications. In general، most of the methods used to reduce the need for episiotomy and improve healing are effective، but more studies should be performed for better understanding of their possible complications.