ABSTRACT
Background: The aim of the current study is to compare quinagolide with cabergoline in prevention of ovarian hyperstimulation syndrome [OHSS] among high risk women undergoing intracytoplasmic sperm injection [ICSI]
Materials and Methods: This randomized clinical trial study was performed from March 2015 to February 2017. One hundred and twenty six women undergoing ICSI who were at high risk of developing OHSS [having over 20 follicles of >12 mm], were randomized into two groups. The first group received cabergoline 0.5 mg and the second group received quinagolide 75 mg every day for 7 days commencing on the day of gonadotropin-releasing hormone [GnRH] agonist administration. Then OHSS symptoms as well as their severity were assessed according to standard definition, 3 and 6 days after GnRH agonist administration. Ascites were determined by trans-vaginal ultrasound. Other secondary points were the number of oocytes and the number of embryos and their quality. Quantitative and qualitative data were analyzed using Student's t test, and Chi-square or fisher's exact test, respectively. A P<0.05 was considered statistically significant
Results: The incidence of severe OHSS in the quinagolide-treated group was 3.1% while it was 15.8% in cabergolinetreated subjects [P<0.001]. Ascites were less frequent after treatment with Quinagolide as compared to cabergoline [21.9 vs. 61.9%, respectively] [P=0.0001]. There was no significant statistical deferences between the two groups in terms of mean age, number of oocytes, metaphase I and metaphase II oocytes, and germinal vesicles. There was a significant difference between cabergoline and quinagolide groups regarding the embryo number [P=0.037] with cabergoline-treated group showing a higher number of embryos. But, the number of good quality embryo in quinagolide-treated individuals was significantly higher than that of the cabergoline-treated group [P=0.001]
Conclusion: Quinagolide seems to be more effective than Cabergoline in prevention of OHSS in high-risk patients undergoing ICSI
ABSTRACT
Background: The purpose of triggering in ovulation induction is to induce the final maturation of oocytes and their release from the ovary for fertilization
Objective: The aim of the present study was to compare the effectiveness of gonadotropin-releasing hormone [GnRH] agonist and human chorionic gonadotropin [HCG] on the final maturation of oocytes and pregnancy rates in intrauterine insemination [IUI] cycles
Materials and Methods: In this randomized clinical trial, 110 infertile women who were selected for IUI entered the study. Ovulation induction was performed. Group I received 0.1 mg GnRH agonist as triggering and group II received 10,000 IU of HCG. The serum Estradiol [E[2]], Luteinizing Hormone [LH], and Follicle-Stimulating Hormone [FSH] levels were measured at 12 and 36 hr after injection
Results: LH surge was detected in all patients. LH levels at 12 and 36 hr after triggering was higher in Group I and it washed out earlier than group II [p=0.00]. The pregnancy rate was higher in Group I, but the difference was not statistically significant [26.9% vs. 20.8%, respectively p=0.46]. Also, the incidence of ovarian hyperstimulation syndrome was not different between the two groups [p=0.11]. There was a significant difference regarding the estradiol levels at 36 hours after triggering [p=0.00]
Conclusion: Effects of GnRH on endogenous LH surge is sufficient for oocyte releasing and final follicular maturation. Pregnancy rates and ovarian hyperstimulation syndrome incidence were not different between the groups. We suggest that GnRH agonists might be used as an alternative option instead of HCG in IUI cycles
ABSTRACT
The aim of this study, we have compared the advantages of oral dydrogestrone with vaginal progesterone [cyelogest] for luteal support in intrauterine insemination [IUI] cycles. Progesterone supplementation is the first line treatment when luteal phase deficiency [LPD] can reasonably be assumed. This study was conduct to compare the effect of oral dydrogestrone with vaginal Cyelogest on luteal phase support in the IUI cycles. This prospective, randomized, double blind study was performed in a local infertility center from May 2013 to May 2014. It consisted of 150 infertile women younger than35years old undergoing ovarian stimulation for IUI cycles. They underwent ovarian stimulation with oral dydrogesterone [20 mg] as group A and vaginal cyelogest [400 mg] as group B in preparation for the IUI cycles. Clinical pregnancy and abortion rates, mid luteal progesterone [7 days after IUI] and patient satisfaction were compared between two groups, The mean serum progesterone levels was significantly higher in group A in comparison with group B [p=0.001]. Pregnancy rates in group A was not statistically different in comparison with group B [p =0.58]. Abortion rate in two groups was not statistically different [p =0.056] although rate of abortion was higher in group B in comparison with A group. Satisfaction rates were significantly higher in group A compared to group B [p<0.001]. We concluded that oral dydrogestrone is effective as vaginal progesterone for luteal-phase support in woman undergoing IUI cycles. Moreover, the mean serum progesterone levels and satisfaction rates in dydrogestrone group were higher than cyelogest group
Subject(s)
Female , Humans , Adult , Progesterone , Prospective Studies , Luteal Phase , Dydrogesterone , Gonadal Hormones , Double-Blind MethodABSTRACT
The obligate intracellular bacterium Chlamydia trachomatis causes sexually transmissible diseases in human. Timely and sensitive detection of this pathogen is very important. There are many cross-reactions in bacteriological and serological methods in detection of this type of pathogens. The aim of this study was to achieve a more specific antigen for serological tests. Blood samples were taken from 192 women with suspected chlamydial infection and sera were isolated. ELISA plate wells were coated with recombinant C. trachomatis OMP2 as antigen. Cut-off system was determined with 40 negative sera. The final results of this research were compared with Euroimmun commercial kit. The ELISA system cut-off was calculated at 0.27 using negative sera samples. ODs of positive samples were higher than 0.27 and negative samples were lower than it. We obtained 30 samples [15.62%] as positive and 162 cases [84.37%] as negative. Sensitivity and specificity of the recombinant antigen were 90% and 86%, respectively. This antigen showed no cross-reactivity with sera of patients infected with Hydatid cyst, HCV, Epstein barr virus, HBV, Helicobacter pylori, Toxoplasma gondii, Cytomegalovirus, Mycoplasma, Measles and Varicella zoster virus. The sensitivity and specificity of rOMP2 in ELISA for detection of C. trachomatis were 90% and 86%, respectively. Though the sensitivity was higher than results of Euroimmun commercial kit, its specificity was calculated lower than reference kit
ABSTRACT
Pregnant patients with mechanical heart valves require anticoagulation. The risk of bleeding and embryopathy associated with oral anticoagulants must be weighed against the risk of valve thrombosis. In this prospective study, undertaken between 1999 and 2009, 53 pregnancies [47 women with mechanical mitral valves; 29.8 +/- 4.8 years old] were studied. Patients were divided into two groups: group I [n = 43] received Warfarin throughout the pregnancy, while group II [n = 10] received Heparin in the first trimester and then Warfarin until the 36th week. Thirty-two [60.4%] pregnancies resulted in live births, whereas 18 [34%] abortions, 2 [3.8%] stillbirths, and one [1.9%] maternal death occurred. In group I, there were 26 [60.5%] live births, one [2.3%] stillbirth, and 15 [34.9%] abortions. In group II, there were 6 [60%] live births, one [10%] stillbirth, and 3 [30%] abortions. There were no significant differences between the two groups in terms of fetal outcome. Thirty-nine [90.7%] of the pregnancies in group I and 50% of those in group II [p value = 0.001] were without complications. There were no congenital malformations in the two groups. Fetal outcome was almost the same between the Warfarin and Heparin regimens. In maternal outcome, the Warfarin regimen is safer than Heparin
ABSTRACT
There is an increased risk of thromboembolism, anticoagulant-related hemorrhage, fetal-wastage and congestive cardiac failure in pregnant women with mechanical heart valves. In order to have a good outcome, the care of such patients must necessarily be multidisciplinary and in a well- equipped centre with adequate support services. One such patient who had mechanical mitral and aortic valves replacement in 2000 receiving warfarin anticoagulant therapy, presented with a first trimester pregnancy by ICSI method in 2006. She remained in stable homodynamic state and went through pregnancy without event. Delivery was done by caesarian section at 37 weeks gestation age. With considering use of warfarin during pregnancy, use of stimulation protocol during ICSI and delivering normal neonate ultimately, this interesting case is presented here