General Gynecology and Pelvic Floor
Zahra Rezaei; Negin Azimi
Volume 6, Issue 1 , January 2021, , Pages 6-9
Abstract
Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy ...
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Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy of methotrexate (MTX) administration in the prevention of PEP after linear laparoscopic salpingostomy in tubal pregnancy.Materials & Methods: This randomized clinical trial study was conducted on 140 subjects with a diagnosis of unruptured tubal pregnancy, who were randomly divided into intervention and control groups. While the intervention group underwent a prophylactic injection of 50 mg MTX, the control group did not receive any dose of MTX. PEP was considered if there was an increase in serum BHCG levels or a decrease of less than 20% in serum BHCG levels.Results: There was no significant difference between the intervention and control groups in terms of baseline variables such as age, severity, parity, and gestational age. While in the intervention group only one patient (1.4%) had PEP, in the control group 11 (15.7%) patients had PEP (P < /em>=0.003).Conclusion: MTX administration seems to be an effective method in preventing PEP after linear laparoscopic salpingostomy in tubular pregnancy.
Obstetrics and Gynecology
Zahra Rezaei; SeyedeMahsa Hadifar
Volume 5, Issue 3 , November 2020, , Pages 80-83
Abstract
Background and objective: Current study was conducted to determine the effects of Oxytocin drip on operative blood loss and fluid overload during hysteroscopy.Materials and Methods: In this double-blind randomized clinical trial, 54 women with abnormal uterine bleeding who were candidates for ...
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Background and objective: Current study was conducted to determine the effects of Oxytocin drip on operative blood loss and fluid overload during hysteroscopy.Materials and Methods: In this double-blind randomized clinical trial, 54 women with abnormal uterine bleeding who were candidates for hysteroscopy were consecutively enrolled and randomly assigned to receive either oxytocin or normal saline and the alterations in serum hemoglobin, sodium, albumin, and hematocrit were compared between two groups.Results: The results demonstrated that alterations in serum hemoglobin, sodium, albumin, and hematocrit did not significantly differ between the two groups (P < /em>>0.05).Conclusion: It seems using oxytocin drip during hysteroscopy in patients with intrauterine lesions would have no effect on operative blood loss and fluid overload.
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
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.
Obstetrics and Gynecology
Zahra Rezaei; Sedigheh Taghdisi
Volume 5, Issue 2 , October 2020, , Pages 61-67
Abstract
Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation ...
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Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation between the ovaries and fallopian tubes. Tubal surgery is hypothesized to reduce ovarian reserve due to the anatomical relationship between the ovarian arteries and nerves and fallopian tubes. There is no consensus on whether or not salpingectomy affects ovarian reserve. Some authors believe that salpingectomy has no effects, while others suggest that it diminishes ovarian reserve. Therefore, comparing fertility rates between women undergoing in vitro fertilization with tubal factor infertility with surgery, tubal factor infertility without surgery, and unexplained infertility can provide valuable data.Materials & Methods: Eighty patients who met the inclusion criteria were studied. Study groups included people with a history of tubal surgery, individuals who had tubal problems without a history of surgery, and cases with unexplained infertility. Anti-Mullerian hormone (AMH) was measured every day of the cycle and other hormones, including follicle-stimulating hormone (FSH), luteinizing hormone, prolactin, and thyroid-stimulating hormone (TSH) were assessed on days 2-5 of the cycle. On the third day of the menstrual cycle, the uterus, endometrial thickness, ovaries, the size of the ovaries, and antral follicle count were evaluated using transvaginal sonography. Following ovulation induction, treatment-related factors, namely endometrial thickness, gonadotropin (Gn) time and count, E2, viable embryos, and good quality embryos, were examined.Results: Our findings showed no difference between the study groups in terms of treatment-related factors. No significant correlation was observed between the studied groups and chemical pregnancy (P < /em>=0.9514). moreover, the studied groups were not significantly correlated with clinical pregnancy (P < /em>=0.5052).Conclusion: The AMH was correlated with FSH, AFC, E2, and gonadotropin time and count. According to the results of the present study, tubal surgery does not affect the outcome of assisted reproductive cycles.
