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Objectives: The high prevalence of poor ovarian response in women undergoing ovarian stimulation is a main therapeutic challenge that affects pregnancy outcomes in such patients. The current clinical trial aimed to compare the pregnancy outcome of corifollitropin alfa (CFA) versus recombinant follicle-stimulating hormone (rFSH) used in the gonadotropin-realizing hormone (GnRH) antagonist protocol in poor ovarian response patients. Materials and Methods: We performed an open-label balanced block randomized clinical trial on 117 Iranian women with poor ovarian responses who were seeking treatment for infertility. Reporting followed the CONSORT 2010 guidelines for parallel group randomized trials. Patients were randomly assigned to the CFA group (a single injection of 150 µg CFA) or the rFSH group (300 IU rFSH on a daily basis). To avoid premature luteinizing hormone (LH) surges, treatment continued with a daily subcutaneous injection of 0.25 ganirelix, starting from day 6 of stimulation up to the hCG administration day. The primary investigated outcomes were the number of obtained oocytes and the number of metaphase II oocytes. Implantation rate, chemical pregnancy, and clinical pregnancy were the secondary outcomes examined, and study participants were followed up to ascertain the interested outcome. Results: The average number of mature follicles in CFA was 5.0±2.1, which was significantly higher than the rFSH group (4.2±1.7) (P = 0.021). The average number of puncture follicles and the number of embryos were significantly higher in the CFA group than in the rFSH group (P < 0.05). Chemical pregnancy was observed in 32.2% and 30.5% of patients in the CFA and recombinant-FSH groups, respectively, and the observed difference was not statistically significant (P = 0.748). We observed no statistically significant difference despite a relatively higher clinical pregnancy in the CFA group (P = 0.398). Conclusions: A single injection of CFA and a daily injection of rFSH could improve pregnancy outcomes in women with poor ovarian responses who underwent IVF. These two alternative treatments could be used interchangeably, and we highlighted no superiority between CFA and rFSH. [ABSTRACT FROM AUTHOR]

Introduction: Numerous consensus documents worldwide address luteinizing hormone (LH) supplementation in controlled ovarian stimulation, yet to the best of our knowledge, only one consensus paper has been published in the Arab region. This study presents a Delphi consensus by seven Iranian infertility experts, offering real-world clinical perspectives. The aim was to develop evidence-based opinions on LH's role alongside FSH in various aspects of assisted reproductive technology (ART), including LHlevels, monitoring, r-hLHuse, and suggested activity. Methods: Employing the Delphi consensus approach, the Iran consensus unfolded in three steps. In Step 1, eight out of 10 statements gained approval, while two unclear statements were removed. In Step 2, the 20-member extended panel voted on the remaining eight statements. Results: Only one (statement 3) lacked consensus (55% agreement), prompting a modification. The revised statement (noted as statement 3') obtained an 83% agreement. Discussion: The clinical perspectives included in this consensus complement clinical guidelines and policies that help further improve treatment outcomes, especially for patients with FSH and LH deficiencies. [ABSTRACT FROM AUTHOR]

Repeated implantation failure (RIF) is a disorder in which good-quality embryos fail to implant in the endometrium following several in vitro fertilization (IVF) cycles. This study aimed to evaluate the efficiency and safety of intrauterine infusion of platelet-rich plasma (PRP) in improvement of pregnancy outcomes in RIF patients undergoing frozen embryo transfer (FET). A total of 438 women with a history of RIF undergoing FET were assessed for eligibility to enter the study. Patients were randomly assigned to the intervention (PRP) and control groups. The intervention group received an intrauterine infusion of 0.5 ml PRP 48 h before embryo transfer while the control group received standard treatment. The rates of chemical and clinical pregnancy were defined as the primary outcome values. All women were followed up until the study endpoints that included the number of neonates born and pregnancy-related complications. Three hundred and ninety-three participants accomplished the study and their data were analyzed. The chemical pregnancy, clinical pregnancy, and live birth rates were higher in the PRP group than control group (p value: <0.0001; p value: <0.0001; p value: <0.0001 respectively). However, there were no significant differences between the two groups in terms of multiple pregnancies and pregnancy complications except for spontaneous abortion. The spontaneous abortion rate was significantly higher in the control group compared to the PRP group (p value = 0.0262). These results suggest that intrauterine infusion of PRP is an effective and safe route to improve pregnancy outcomes in RIF patients undergoing FET. [ABSTRACT FROM AUTHOR]

Background: Recurrent implantation failure (RIF) is defined as three or more failed in vitro fertilization attempts and is due to several factors such as oocyte and embryo quality. Methods: Fifty-one RIF patients and 19 controls were selected based on the inclusion criteria. EFNB2, CAMK1D, AREG, and PTGS2 as well as miR-34, miR-145, miR-204-5p, and miR-26-5p were selected since the microRNAs (miRNAs) targeted the genes based on bioinformatic predictions and literature review. Total RNA was extracted from cumulus cells (CCs) and follicular fluid (FF) of the oocytes. We performed real-time polymerase chain reaction to evaluate the expression of the genes and the miRNAs in CC and FF of pregnant and nonpregnant RIF patients. The expression of CAMK1D, AREG, miR-34-5p, and miR-26-5p was higher in CC than FF. Results: The expression of CAMK1D, PTGS2, and miR-26-5p in CC of the pregnant group was higher than FF. The expression of EFNB2, PTGS2, miR-145, and miR-204-5p was lower in the CC, and the expression of EFNB2, AREG, miR-34-5p, mR-145, and miR-204-5p was lower in the FF of the pregnant group. The expression of CAMK1D, AREG, PTGS2, miR-34-5p, and miR-26-5p was higher in the CC and FF of the high quality (HQ) embryos than non-HQ (NHQ) embryos. The expression of EFNB2, miR-145, and miR-204-5p was higher in the CC and FF of the NHQ embryos. The difference was statistically significant for EFNB2 in CC and FF as well as miR-145 in CC. The level of progesterone and prostaglandin E2 in the FF of the pregnant group was higher than their level in the nonpregnant group. Conclusion: CAMK1D expression and overexpression of miR-34-5p and miR-26-5p could be considered as markers of successful pregnancy. In addition, the results show that normal FF treatment of RIF patients may result in the production of high-quality embryos. [ABSTRACT FROM AUTHOR]

Purpose: Unpredictability in acquiring an adequate number of high-quality oocytes following ovarian stimulation is one of the major complications in controlled ovarian hyperstimulation (COH). Genetic predispositions of variations could alter the immunological profiles and consequently be implicated in the variability of ovarian response to the stimulation. Design: Uncovering the influence of variations in AMHR2, LHCGR, MTHFR, PGR, and SERPINE1 genes with ovarian response to gonadotrophin stimulation in COH of infertile women. Methods: Blood samples of the women with a good ovarian response (GOR) or with a poor ovarian response (POR) were collected. Genomic DNA was extracted, and gene variations were genotyped by TaqMan SNP Genotyping Assays using primer-probe sets or real-time PCR Kit. Results: Except for PGR (rs10895068), allele distributions demonstrate that the majority of POR patients carried minor alleles of AMHR2 (rs2002555, G-allele), LHCGR (rs2293275, G-allele), MTHFR (rs1801131, C-allele, and rs1801133, T-allele), and SERPINE1 (rs1799889, 4G allele) genes compared to the GOR. Similarly, genotypes with a minor allele in AMHR2, LHCGR, MTHFR, and SERPINE1 genes had a higher prevalence among POR patients with the polymorphic genotypes. However, further genotype stratification indicated that the minor alleles of these genes are not associated with poor response. Multivariate logistic analysis of clinical−demographic factors and polymorphic genotypes demonstrated a correlation between FSH levels and polymorphic genotypes of SERPINE1 in poor response status. Conclusions: Despite a higher prevalence of AMHR2, LHCGR, MTHFR, and SERPINE1 variations in the patients with poor ovarian response, it seems that these variations are not associated with the ovarian response. [ABSTRACT FROM AUTHOR]

Copyright of Gynecological Endocrinology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Endometriosis, a chronic inflammatory disease, is identified by the presence of endometrial tissue outside the uterus. The prevalence of this disease among reproductive-age women is almost 10–15%. High levels of IL-6 and IL-8 have been found in the peritoneal fluid (PF) of women with endometriosis and are involved in its pathogenesis. Isolated stromal cells from 12 ectopic and eutopic endometrial biopsies of women with ovarian endometrioma and also 12 endometrial biopsies of nonendometriotic controls were treated with 1.1 µM pyrvinium pamoate, a Wnt/β-catenin signaling pathway inhibitor, for 72 hrs. Before treatment, mRNA gene expression and secretion of IL-6 and IL-8 were significantly higher in ectopic (EESCs) than eutopic (EuESCs) and control (CESCs) endometrial stromal cells. After treatment, mRNA gene expression and also secretion of IL-6 and IL-8 were significantly reduced. Our Findings showed that pyrvinium pamoate suppresses the mRNA gene expression and secretion of IL-6 and IL-8 in human endometriotic stromal cells. Additional investigations on this compound are required before clinical application. [ABSTRACT FROM AUTHOR]

Repeated implantation failure is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on which is the most effective. This study was conducted to evaluate the effectiveness of autologous platelet-rich plasma in improving the pregnancy rate in repeated implantation failure. Between 2016 and 2017, a total of 138 patients who failed to conceive after 3 or more embryo transfers with high quality embryos and candidate for frozen-thawed embryo transfer were assessed for eligibility to enter the study. Intrauterine infusion of 0.5 ml platelet-rich plasma (PRP) that contained platelets at 4–5 times higher concentration than peripheral blood was performed 48 h before blastocyst transfer. A control group received standard treatment. Ninety-seven patients completed the study procedure. There were no significant differences between the two groups in terms of age, body mass index and number of previous embryo transfers. The chemical pregnancy rate was higher in the PRP group than control group (53.06% versus 27.08%, respectively; p value: 0.009). Clinical pregnancy rate was higher in PRP group than control group (44.89% versus 16.66%, respectively; p value: 0.003). In conclusion, intrauterine platelet-rich plasma may be effective in the improvement of pregnancy outcome in repeated implantation failure. [ABSTRACT FROM AUTHOR]

In the original article published, the values given in the variables are incorrect. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the association of time intervals between various steps of the intracytoplasmic sperm injection (ICSI) cycle with oocyte quality and reproductive outcomes.Methods: We conducted a prospective study among patients undergoing ICSI cycles in an academic hospital between May 2017 and January 2019. The time intervals between the various steps of cycles were recorded. The ICSI cycles were categorized according to the different time intervals; human chorionic gonadotropin (hCG) injection to oocyte pick up (hCG-OPU) (≤ 36 h and > 36 h), OPU-denudation (≤ 2 h and > 2 h), and denudation-ICSI (≤ 2 h and > 2 h). The main outcome measures were oocyte dysmorphisms, fertilization, cleavage, biochemical, and clinical pregnancy rates.Results: A total of 613 ICSI cycles using fresh autologous oocytes were included in this study. After adjusting for confounders, the hCG-OPU interval was associated with the presence of cytoplasmic granulation, inclusion body, and also the total number of morphologically abnormal premature oocytes in the cycle (P = 0.02, P = 0.04, P = 0.008, respectively). OPU-denudation interval was associated with cytoplasmic granulation and extended perivitelline space of the oocytes (P = 0.006 and P = 0.03, respectively). The denudation-ICSI interval was only associated with cytoplasmic granulation (P = 0.01). However, hCG-OPU, OPU-denudation, and denudation-ICSI intervals were not significantly associated with fertilization, cleavage, biochemical, and clinical pregnancy rates.Conclusions: All the studied time intervals between various steps of ICSI procedure could affect oocyte quality, but the oocyte dysmorphisms were mainly associated with hCG-OPU interval. However, the time intervals were not associated with fertilization, cleavage, and pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Choriocarcinoma spheroids, as acceptable three-dimensional (3D) models of the embryo, vary in the number of incorporated cells based on the procedures of production. Since the secretion of emitted signals from spheroids can modulate endometrial confrontation responses, improving a high throughput standard assay is precisely demanding for normalizing the characteristics of spheroids based on cellular enumeration. Materials and Methods: Spheroids derived from the suspension culture of the BeWo cell line were dimensionally categorized into three groups with sizes of 50, 100, and 200 µm in diameters. The volume of each spheroid was determined according to 4/3pr3 formula and MTT and neutral red uptake (NRU) assays were applied as conventional and modified procedures. Furthermore, the categorized groups of spheroids were enzymatically dissociated and stained by the Trypan blue dye to precisely enumerate the number of incorporated cells based on volume alterations. Results: The absorbance of spheroids in modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients with volume alterations. Similarly, modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients between the cells numeration and volume alterations. Finally, the sensitivity of modified MTT assay was higher than modified NRU assay regarding accurately estimating the number of incorporated cells per spheroid. Conclusion: In general, the modification of MTT and NRU procedures can amplify the potential of both assays to enumerate the cell number of 3D aggregates. Exclusively, the modification of MTT assay brought it as an ideal high throughput assay with high sensitivity to screen the cell number of spheroids with a diameter of 200 µm and less. [ABSTRACT FROM AUTHOR]

Follicular loss and tissue degeneration are great challenges in ovarian tissue culture systems. Mesenchymal stem cells (MSC) secrete a cocktail of growth factors and cytokines which supports adjacent cells and tissues. The aim of the current study was to investigate the impact of human bone marrow (hBM)-MSC, as co-culture cells, on human follicular development in ovarian cortical tissue (OCT) culture. For this purpose, warmed OCT fragments were co-cultured with hBM-MSC for 8 days and compared to monocultured OCT. During the culture period, ovarian follicle survival and development in the OCT were evaluated using histological observation, follicular developmental-related genes expression, and estradiol production. Furthermore, cell proliferation and apoptosis were assessed. The results showed that there were no significant differences in conserved ovarian follicles with a normal morphology between the two groups. However, the percentage of developing follicles, as well as follicular developmental gene expression, significantly increased in the co-culture group compared to the monoculture group. On the other hand, compared with the monoculture group, the co-culture group demonstrated a significant increase in cell proliferation, indicated by Ki67 gene expression, as well as a dramatic decrease in apoptotic cell percentage, revealed by TUNEL assay. These findings indicated that co-culturing of hBM-MSC with OCT could improve follicular activation and early follicular development in human ovarian tissue culture systems. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to determine the effects of chromium supplementation on the gene expression of insulin, lipid, and inflammatory markers in infertile women with polycystic ovary syndrome (PCOS) who were candidate for in vitro fertilization (IVF). Methods: Forty women, aged 18–40 years, who had been selected for IVF were recruited in this randomized double-blinded, placebo-controlled trial. They (n = 20/group) were randomly assigned into intervention groups to take either 200 μg/day of chromium or placebo for 8 weeks. Inflammatory markers were measured at baseline and end of the trial. Genes related to insulin, lipid, and inflammation were expressed in peripheral blood mononuclear cells (PBMCs), using RT-PCR method. Results: Chromium supplementation led to a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) (−1.4 ± 1.5 vs. + 0.2 ± 2.2 mg/L, p = 0.01) compared with the placebo. RT-PCR findings indicated that chromium supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p = 0.01), glucose transporter 1 (GLUT-1) (p = 0.001) and low-density lipoprotein receptor (LDLR) (p = 0.01), as well as downregulated gene expression of interleukin-1 (IL-1) (p = 0.004) in PBMCs of patients with PCOS compared with the placebo. Chromium supplementation had no significant effect on gene expression of IL-8, tumor necrosis factor alpha (TNF-α), transforming growth factor beta (TGF-β) and vascular endothelial growth factor (VEGF). Conclusion: Overall, our findings demonstrated that infertile women with PCOS, who were candidate for IVF benefited from chromium supplementation for 8 weeks in terms of lowering hs-CRP and improving gene expression of PPAR-γ, GLUT-1, LDLR, and IL-1, though chromium had no effect on the gene expression of IL-8, TNF-α, TGF-β, and VEGF. Clinical Trial Registration Number: http://www.irct.ir:IRCT20170513033941N32. [ABSTRACT FROM AUTHOR]

Background: In this study, the effect of testosterone gel administration during ovulation induction on the fertility rate was examined in women with a poor ovarian response in in vitro fertilization (IVF) cycles. Materials and Methods: The current study is a single-blinded, randomized clinical trial. Patients who met inclusion (Bologna) criteria were placed in the antagonist cycle group. The patients were randomly divided into two groups each included 25 participants treated with a placebo (lubricant gel, the controls) and testosterone gel (intervention). Fertility outcomes were compared between two study groups. Results: The mean ± standard deviation (SD) age of intervention (41.04 ± 3.77) versus control group (39.69 ± 3.29) was not statistically different. The two studied groups were not statistically different in terms of follicle-stimulating hormone; antral follicle count, IVF, anti-Mullerian hormone, and the duration of infertility. The mean ± SD of oocyte 2.48 ± 1.64 versus 1.17 ± 1.27 and embryo 1.60 ± 1.58 versus 0.39 ± 0.58 in intervention group was significantly higher than control group (P < 0.01). The rate of pregnancy 16% versus 0% and embryo of quality A--B was significantly higher in intervention group than control (60% versus 17.4%, P < 0.05). Conclusion: The results of the current study showed that the testosterone gel has a significant impact on the fertility rate in women with a poor response in the IVF cycles. Further, randomized clinical trials with larger sample sized are recommended. [ABSTRACT FROM AUTHOR]

Introduction. Polycystic ovary syndrome (PCOS) is a common disorder in reproductive age. This pilot study investigated the effects of myoinositol (MI) treatment on metabolic and cardiovascular profile in PCOS women over 30 years of age. Methods. Between 2015 and 2016, 50 women with diagnosis of PCOS by the Rotterdam Criteria were included in the study. All women received MI 2 g plus 200 μg of folic acid (Inofolic, Health Parsian, Iran; twice daily) for 3 months. Baseline and 3-month serum samples were taken after an overnight fast to evaluate the insulin resistance index (HOMA-IR), fasting glucose, and the levels of triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine, systolic blood pressure, and diastolic blood pressure. Participants’ weight was measured before and after treatment and body mass index (BMI) was calculated. Results. The data showed a significant improvement in the serum level of insulin sensitivity and a reduction of cholesterol, LDL, and homocysteine after three months of treatment. Furthermore, blood pressure was significantly reduced in the treated patients. Three participants became pregnant during treatment. Conclusion. Results showed that supplementation with MI and folic acid in PCOS patients over 30 years of age could decrease the risk of cardiovascular problems by normalizing the metabolic profile. [ABSTRACT FROM AUTHOR]

Copyright of Gynecological Endocrinology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Embryo transfer (ET) is one of the most important steps in assisted reproductive technology (ART) cycles and affected by many factors namely the depth of embryo deposition in uterus. In this study, the outcomes of intracytoplasmic sperm injection (ICSI) cycles after blind embryo transfer and embryo transfer based on previously measured uterine length using vaginal ultrasound were compared. Materials and Methods: This prospective randomised clinical trial included one hundred and forty non-donor fresh embryo transfers during January 2010 to June 2011. In group I, ET was performed using conventional (blind) method at 5-6cm from the external os, and in group II, ET was done at a depth of 1-1.5 cm from the uterine fundus based on previously measured uterine length using vaginal sonography. Appropriate statistical analysis was performed using Student’s t test and Chi-square or Fisher’s exact test. The software that we used was PASW statistics version 18. A p value <0.05 was considered statistically significant. Results: Chemical pregnancy rate was 28.7% in group I and 42.1% in group II, while the difference was not statistically significant (p=0.105). Clinical pregnancy, ongoing pregnancy and implantation rates for group I were 21.2%, 17.7%, and 12.8%, while for group II were 33.9%, 33.9%, and 22.1, respectively. In group I and group II, abortion rates were 34.7% and 0%, respectively, indicating a statistically significant difference (p<0.005). No ectopic pregnancy occurred in two groups. Conclusion: The use of uterine length measurement during treatment cycle in order to place embryos at depth of 1-1.5cm from fundus significantly increases clinical and ongoing pregnancy and implantation rates, while leads to a decrease in abortion rate (Registration Number: IRCT2014032512494N1). [ABSTRACT FROM AUTHOR]

We present super infection of an ovarian dermoid cyst with actinomyces in an infertile patient. This is a case-report study for evaluation a couple with male factor infertility, who was a good candidate for intracytoplasmic sperm injection (ICSI), while a 10 cm dermoid cyst was found in the woman's right ovary. Patient complained of pelvic pain, intermittent fever, dysmenorrhea, and dyspareunia. The cyst was extracted using laparoscopy, whilst in histopathological examination, an actinomycosis super infection was reported. Actinomyc super infection of an ovarian dermoid cyst is a very rare incident which can also occur in women with no history of intrauterine device (IUD) usage or previous fertility. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of oral N-acetylcysteine (NAC) administration as an adjuvant to clomiphene citrate (CC) on induction of ovulation outcomes in patients with polycystic ovary syndrome (PCOS). Material and Methods: In this placebo-controlled double-blind randomized clinical trial, 180 PCOS infertile patients were randomly divided into two groups for induction of ovulation. Patients in group 1 received CC 100 mg/d plus NAC 1.2 g/d and patients in group 2 received CC plus placebo for 5 days starting at day 3 of the cycle. On the 12th day of the menstrual cycle in the presence of at least one follicle with an 18-20-mm diameter in ultrasound evaluation, 10 000 U hCG was injected intramuscularly and timed intercourse was advised 36 h after hCG injection. Serum β-hCG level was measured on the 16th day after hCG injection. Results: The number of follicles >18 mm and the mean endometrial thickness on the day of hCG administration were significantly higher among the CC+NAC group ( P-value = 0.001). The ovulation and pregnancy rates were also significantly higher in the CC+NAC group ( P-value = 0.02 and 0.04, respectively). No adverse side-effects and no cases of ovarian hyperstimulation syndrome were observed in the group receiving NAC. Conclusion: NAC as a safe and well-tolerated adjuvant to CC for induction of ovulation can improve the ovulation and pregnancy rates in PCOS patients. It may also have some beneficial impacts on endometrial thickness. [ABSTRACT FROM AUTHOR]

No data exist on the population prevalence of, or risk factors for, human papillomavirus (HPV) infection in Iran or the Middle East. Cervical specimens were obtained from 825 married women aged 18-59 years from the general population of Tehran, Iran and from 45 locally diagnosed invasive cervical cancers (ICC) according to the standardized protocol of the International Agency for Research on Cancer HPV Prevalence Surveys. HPV was detected and genotyped using a GP5+/6+ PCR-based assay. HPV prevalence in the general population was 7.8% (95% confidence interval: 6.0-9.8) (5.1% of high-risk types), with no significant variation by age. HPV positivity was significantly higher among divorced women, women in polygamous marriages and those reporting husband's absence from home for >7 nights/month. HPV16/18 accounted for 30 and 82.2% of HPV-positive women in the general population and ICC, respectively. Cervical cancer prevention policies should take into account the relatively low HPV prevalence in this population. [ABSTRACT FROM AUTHOR]

The article presents a study that examined the effects of high-protein, low-glycemic-load hypocaloric diet on overweight women who also have polycistic ovary syndrome (PCOS). The study was participated by 60 women who did not use insulin-sensitizing agents. They were grouped into two, the conventional hypocaloric diet group and the modified hypocaloric diet with high protein and low-glycemic load. The study indicated significant weight loss in the two groups.

Background: To determine the level of plasma homocysteine in patients with polycystic ovary syndrome (PCOS) compared with healthy controls. Materials and Methods: In this prospective case-control study on 85 PCOS women and 83 controls matched by body mass index (BMI), homocysteine levels were assessed. Results: The mean level of homocysteine was 16.25 ± 11.94 μmol/L in patients with PCOS and 11.58 ± 3.82 μmol/L in controls (p=0.002). Patients with PCOS had a significantly higher risk for hyperhomocysteinemia compared with BMI-matched control women. Conclusion: These data suggest that homocysteine levels are elevated in the PCOS population. Further studies are needed to characterize this relationship. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) was first introduced by Leventhal and Stein in 1935. It has a wide range of manifestations such as hyperandrogenism, irregular menstruation and central body obesity. The lack of definite diagnostic criteria has made the diagnosis a difficult task. Moreover, the disturbing aspects of the syndrome range from hirsutism in an adolescent girl to infertility in a young woman. Based on the Rotterdam 2003 Criteria, current diagnostic criteria must include two of the following three symptoms: 1. Either oligo-ovulation or anovulation, 2. Clinical or laboratory manifestations of hyperandrogenism, 3. Polycystic ovaries on sonographic examination (more than 12 follicles of less than 10 mm in diameter in each ovary). In this study, we have focused on the enrollment of a large sample size to assess the prevalence and clinical features of PCOS such that a wide range of basic information can be utilized for further investigations. Materials and Methods: This was a cross-sectional study with multi-stage random sampling. Subjects were selected from 15-18 years old girls from a number of high schools in Tehran. After interview and clinical examination, those individuals with either menstrual irregularities, hirsutism or obesity were referred for further laboratory evaluations and abdominal sonography in order to diagnose PCOS and estimate its prevalence. We also aimed to assess the predominant features of this disorder among adolescents. Results: The overall prevalence of the syndrome was 3.42%. Out of the 1430 girls, 49 were diagnosed with PCOS. Conclusion: Despite its high prevalence, this syndrome has not been widely studied. Most of the conducted studies have enrolled small samples within a short time period. Thus, more accurate policy making in this regard can be achieved through definition of the prevalence of PCOS and accurate estimation of its burden. [ABSTRACT FROM AUTHOR]

Aortic aneurysm is a rare but potentially lethal complication during pregnancy. In this article we described a 30-year-old woman with a large size descending aorta aneurysm (11 cm in length and 5.6 cm in its greatest diameter), who had two term uncomplicated pregnancies. The patient received prophylactic β-blocker drug during her second pregnancy. Both pregnancies were terminated by caesarean section without any serious complications. Postpartum period was recovered successfully, but a noticeable increase in aneurysm's length was detected in the period between two pregnancies. [ABSTRACT FROM AUTHOR]