AFC vs. AMH: prediction of ovarian response in women with endometrioma undergoing controlled ovarian stimulation.

OBJECTIVE: To assess the clinical value of antral follicle count (AFC) and anti-Mullerian hormone (AMH) for the prediction of ovarian response in women with endometrioma undergoing controlled ovarian stimulation for IVF using GnRH antagonist treatment. PATIENTS AND METHODS: Fifty patients with endometrioma who underwent their first IVF/ICSI cycle with GnRH antagonist treatment were included in the study. The average AMH values were recorded as 1.5-2 ng/mL. Fifty infertile women are not suffering from endometrioma were selected from those with male factor infertility as control. They were matched according to both serum AMH levels and age. Serum samples have been collected before the IVF treatment for determining AMH levels in both groups of subjects. Likewise, each group of subject underwent ultrasound scan for AFC on day 3. Total number of oocytes retrieved during OPU, the number of transferred embryo, implantation and clinical pregnancy rates, live birth and abortion rates, total dose of rhFSH were noted in both groups of subjects. RESULTS: Day 3 AFC was significantly higher in the control group compared to women with endometrioma. Both the number of retrieved oocytes during oocyte pick-up, MII oocytes and 2 PN embryo were significantly lower in the endometrioma. Likewise, the fertilization, implantation, clinical pregnancy and live birth rates of endometrioma group were significantly lower than those in the control group. The total rFSH dose was higher in the endometrioma group than those in control. The percentage of abortion in the endometrioma group was found to higher compared to those with controls. CONCLUSIONS: AFC is more sensitive than the AMH in detecting ovarian response in women with ovarian endometrioma. The individualization of GnRH antagonist protocols in subjects having endometrioma might be improved by using an AFC-tailored approach instead of AMH.

Vitamin C ameliorates high dose Dexmedetomidine induced liver injury.

BACKGROUND: We investigated whether vitamin C has protective effects on rat liver tissue treated with different dexmedetomidine doses. MATERIAL AND METHODS: Thirty five wistar albino rats were randomly divided into 5 groups (Control (0.9% NaCl intraperitoneally (i.p.), Dexmedetomidine 5 µg.kg(-1) (i.p.), Dexmedetomidine 5 µg.kg(-1) i.p. plus Vitamin C (100 mg.kg(-1)), Dexmedetomidine 10 µg.kg(-1) i.p. and Dexmedetomidine 10 µg.kg(-1) i.p. plus Vitamin C (100 mg.kg(-1)). Histopathological liver injury, superoxide dismutase (SOD) activity and tissue Malondialdehyde levels were investigated. RESULTS: Hepatocyte degeneration was significantly higher in D10 group than those in other study groups (p < 0.0001, p = 0.002, p < 0.0001, p = 0.005, respectively). Similarly, liver tissue sinusoidal dilatation and hepatocyte necrosis were significantly higher in D10 group than those in other groups (p < 0.0001, p < 0.0001, p = 0.002, p < 0.0001 and p < 0.0001, p = 0.046, p < 0.0001 and p = 0.002, respectively). Tissue MDA levels in D10 group were significantly higher than those in control, D5+Vit C and D10+Vit C groups (p = 0.028, p = 0.004, p = 0.031, respectively). SOD enzyme activity in D10 group was significantly lower than in control, D5+Vit C and D10+Vit C groups (p < 0.0001, p = 0.023 and p = 0.031, respectively). CONCLUSION: High dose dexmedetomidine can induce hepatic injury and oxidative stress in rats while pre-treatment with vitamin C may be effective in protecting liver tissue against this newly recognized undesirable dexmedetomidine effect (Tab. 2, Fig. 5, Ref. 30).

Effects of intravenous ibuprofen and lornoxicam on erythrocyte deformability in rats undergoing hind limb ischemia reperfusion injury.

BACKGROUND AND AIM: Acute hind limb ischemia reperfusion (I/R) injury is a common consequence of abdominal aorta cross­clamping during aortic surgery. Erythrocyte deformability is affected by I/R process and may lead to increased tissue and organ injury. Lornoxicam and intravenous ibuprofen are becoming commonly used as non-steroidal anti-inflammatory drugs (NSAID) for postoperative analgesia. In this study, we aimed to investigate the effects of lornoxicam (2 mg/kg iv) and intravenous ibuprofen (30 mg/kg iv) on erythrocyte deformability in I/R model in rats. MATERIALS AND METHODS: Four study groups, each containing 6 Wistar rats were created. Laparotomy was performed in all groups under general anesthesia with ketamine and xylazine. In all groups except sham group, ischemia and reperfusion were achieved by clamping and declamping the infrarenal abdominal aorta for 120 minutes. Rats in Group IR+L received intravenous infusion of lornoxicam (2 mg/kg) while rats in Group IR+I received intravenous infusion of ibubrofen (30 mg/kg) following 2 hours of ischemic period. At the end of reperfusion period, erythrocyte packs were prepared from heparinized blood samples. Erythrocyte suspensions with hematocrit at a concentration of 5% in a phosphate­buffered saline (PBS) were used in order to perform deformability measurements. The value of p<0.05 was considered statistically significant. RESULTS: Relative resistance has increased in ischemia reperfusion group when compared to control group (p < 0.0001). Lornoxicam or ibuprofen intravenous treatments did not change the erythrocyte deformability during ischemia reperfusion period in rats (p=0.851, p=0.690). CONCLUSION: Intravenous ibuprofen or lornoxicam administrations during ischemia reperfusion period in rats have no negative effect on erythrocyte deformability. The findings of the study should be supported with more detailed and extensive clinical/experimental studies in the future (Fig. 1, Ref. 18).

Effect of alprostadil on erythrocyte deformability in ischemia reperfusion injury.

BACKGROUND: Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. Protective effect of alprostadil on local and distant organ injury due to I/R has been well-documented but its effect on erythrocyte deformability needs further investigation. Our aim was to investigate the effect of alprostadil on erythrocyte deformability in infrarenal aorta of rats undergoing I/R. MATERIALS AND METHODS: Our study was conducted with 18 Wistar albino rats. Rats were divided into 3 groups; randomized control group (group C; n=6), I/R group without alprostadil (group I/R; n=6) and I/R group with alprostadil 20 mcg.kg(-1), intraperitoneal (group I/R-A; n=6). Packs of erythrocytes were prepared from heparinized blood samples and deformability measurements were done. RESULTS: Comparisons of the control and I/R-A groups revealed similar results (p=0.240). The values of the IR group were significantly higher than those of the control and IR-A groups (p=0.009, p=0.026, respectively). CONCLUSION: In our study, we detected unfavourable effects of I/R on erythrocyte deformability, which may lead to disturbance in blood flow and hence tissue perfusion in infrarenal rat aorta. We also found that alprostadil had beneficial effects by reversing undesirable effects of I/R (Fig. 1, Ref. 22).