Addition of growth hormone to the microflare stimulation protocol among women with poor ovarian response.

OBJECTIVE: To assess the efficacy of adding growth hormone (GH) to the microflare stimulation protocol among women with poor ovarian response. METHODS: A parallel, open-label, randomized controlled trial was conducted among patients with poor ovarian response who attended a center in Cairo, Egypt, between July 10 and December 31, 2014. Participants were randomly assigned using a computer program (random block size of 4-8) to undergo the microflare protocol with or without GH. Primary outcomes were the mean numbers of mature oocytes retrieved and fertilized. Analyses were done per protocol: women with cycle cancellations were excluded. RESULTS: The analysis included 72 women in the GH group and 73 in the microflare only group. The mean number of oocytes collected was 7.2±1.5 in the GH group versus 4.7±1.2 in the microflare only group (P<0.001). The mean number of metaphase II oocytes was 5.2±1.2 in the GH group and 2.8±1.0 in the microflare only group (P<0.001). The mean number of fertilized oocytes was higher in the GH group (4.2±1.1) than in the microflare only group (2.5±0.7; P<0.001). CONCLUSION: Addition of GH to the microflare stimulation protocol provided some potential benefits to women with poor ovarian response. However, further studies are required before it could be recommended for routine clinical use. ClinicalTrials.gov:NCT02185326.

Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey.

BACKGROUND: To our knowledge, no large population - based studies have been performed on the topic of menstrual patterns among Egyptian adolescent in recent years. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among Egyptian adolescents. METHODS: A cross-sectional survey. A total of 800 questionnaires were administered to post-menarcheal Egyptian adolescents attending secondary schools in Giza, Egypt, from September 1, 2012, to December 1, 2013. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included items on girl's socio-demographic and menstrual pattern characteristics, concerning their age at menarche, menstrual cycle length and regularity, duration and amount of flow, type and severity of pain related to menstruation, need for analgesia; and symptoms suggestive of premenstrual syndrome (PMS) Main Outcome Measure: description of menstrual patterns, disorders and source of knowledge. RESULTS: Four hundred twelve (51.5 %) out of 800 adolescents completed the questionnaire. The mean age of the girls was 14.67 ± 1.7 years. Mean age at menarche was 12.49 ± 1.20 years. 382 respondents reported various menstrual disorders, giving a prevalence rate of 95 %. Dysmenorrhea was the most prevalent (93 %) menstrual disorder in our sample, followed by PMS (65 %), and abnormal cycle lengths (43 %). Menstrual disorders interfered with social and academic life of 33 and 7.7 % of respondents respectively. Most participants lacked menstrual health knowledge and only 8.9 % of girls reported consulting a physician. CONCLUSION: To the best of our knowledge, this is one of the largest studies on menstrual pattern and disorders among Egyptian adolescent girls. Our Findings of the present study are consistent with other studies and reported higher than expected prevalence of menstrual disorders.

Limited experience in early management of genitourinary tract fistulas.

INTRODUCTION: Genitourinary tract fistulas commonly occur as a complication of gynecologic operations. Vesicovaginal, ureterovaginal, and uterovesical fistulas are the most common fistulas occurring after these operations. In this study, we report the results of early repair of genitourinary fistulas using a retropubic, extraperitoneal, transvesical approach. TECHNICAL CONSIDERATIONS: In our study, 20 women with a genitourinary tract fistula (12 with vesicovaginal, 6 with ureterovaginal, and 2 with uterovesical fistulas) were diagnosed and treated within 2 weeks after a gynecologic operation. RESULTS: All patients reported a high quality of life postoperatively. None of the patients had urinary leakage after their fistula repair. Urinary urgency occurred after surgery in 7 patients. No urinary tract infections were reported. Follow-up of the patients showed no incidence of ureteral stricture and preservation of upper urinary tract function. CONCLUSIONS: The results of our study have shown that early repair of genitourinary tract fistulas results in a high quality of life, few postoperative complications, and a high success rate and preservation of renal function.