Reproductive Medicine
Zahra Rezaei; Mehrnaz Valadan; Pooneh Shojaee Asl
Volume 5, Issue 3 , November 2020, , Pages 84-87
Abstract
Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate ...
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Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate and regulation of the menstrual cycle following laparoscopic ovarian electrocautery (LOE).Materials & Methods: This prospective cohort study was conducted on 54 infertile metformin- and clomiphene citrate-resistant women with PCOS at Yas Hospital in 2007. These patients initially took a glucose tolerance test and then classified into two groups (i.e., insulin-resistant and non-insulin-resistant) based on the obtained results. Both groups, then, underwent LOE. Patients were evaluated for pregnancy rate and regulation of the menstrual cycle up to six months.Results: Out of 54 patients, 37 patients (68.5%) were non-insulin-resistant, and 17 patients (31.5%) were insulin-resistant. In the insulin-resistant group, after six months, menstrual cycles were less regular than those of the non-insulin-resistant group (OR=0.2; 95%CI, 0.07-0.87). Fifteen (40.5%) women in the non-insulin-resistant group became pregnant; in contrast, three (17.6%) women in the insulin-resistant group became pregnant. In the logistic regression analysis, the results demonstrated that age, duration of infertility, body mass index (BMI), and insulin resistance had no significant effects on pregnancy rate.Conclusion: Insulin resistance can be an important marker of the poor outcomes of PCOS infertility treatment, and LOE significantly improves insulin resistance in women with PCOS.
Obstetrics and Gynecology
Mehrnaz Valadan; Mohadeseh Mojarad; Elham Feizabad
Volume 5, Issue 3 , November 2020, , Pages 88-92
Abstract
Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol ...
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Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol has some side effects, including uterine cramps, vaginal hemorrhage, nausea, vomiting, and fever-like feelings, the severity of which escalates by increasing the dosage. Therefore, in this study, we aimed to compare vaginal misoprostol in two different dosages of 200 and 400 μg with a control group to prescribe the lower dosage of misoprostol in case they were equally effective.Materials & Methods: In this randomized clinical trial study, 87 patients, who had hysteroscopy indications at Yas Hospital, were randomly assigned into three groups (i.e., 200 μg vaginal misoprostol, 400 μg vaginal misoprostol, and placebo). Afterward, the dilatation time of the cervical response and side effects associated with medication and surgery were assessed.Results: The mean dilatation time in the 200 μg misoprostol, 400 μg misoprostol, and placebo groups were 46.7±35.8, 36.8±31.1, and 67.6±49.5 seconds, respectively. These differences were significant (P=0.038). Conclusion: It seems that administering vaginal misoprostol is an easy, effective, and safe procedure for cervical preparation before the hysteroscopy. Considering that increasing the dosage of misoprostol did not significantly change the dilatation time, it is recommended that 200 μg misoprostol be used to reduce the side effects.
Obstetrics and Gynecology
Zahra Rezaei; Mehrnaz Valadan; Elahe Zabihi Soltani
Volume 5, Issue 2 , October 2020, , Pages 44-48
Abstract
Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or ...
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Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or two ovaries in women with PCOS.Materials & Methods: This study was a prospective cohort study. The study population included infertile women with PCOS resistant to clomiphene referred to the Infertility Clinic of Yas Hospital. They were candidates for LOD in 2016–2017. The serum levels of AMH and FSH were measured before and after three months in two groups of unilateral and bilateral LOD. Data were analyzed using Stata software.Results: A total of 35 female patients were enrolled in the study, 18 (51.4%) in bilateral and 17 (46%) in unilateral LOD groups; the average age of patients was 27 ± 3.4 years old. AMH levels significantly (P < /em><0.001) decreased in both unilateral and bilateral groups after LOD. FSH levels significantly (P < /em><0.001) increased in both groups after LOD, but this increase was higher in the unilateral group than in the bilateral group, and this difference was statistically significant (P < /em><0.001).Conclusion: It seems women with clomiphene-resistant PCOS when underwent unilateral or bilateral ovarian drilling experienced a significant decrease in AMH and a significant increase in FSH, indicating a decrease in their ovarian reserve.