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Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative techniques because more than one level of pelvic devascularization was used. This cross-sectional study was conducted at Tanta University in the period from June 1, 2019 to October 31, 2022. Materials & Methods: All patients underwent conservative uterine sparing technique (Shehata's technique) were assessed by 2 D ultrasound at 6-18 months later to detect the integrity of the CS scar. Fifty women with a history of other conservative treatment of PAS used as control. Results: Women who were operated with Shehata's technique showed less incidence of scar dehiscence with less size of scar defects and more thickness of the myometrium over the scar site and more vascularity of these scars. Conclusion: Shehata's technique resulted in a more integrated scar with less incidence of dehiscence and more vascularity of the compared to other conservative methods of treatment of PAS. Therefore, it is an effective and safe method in treatment of PAS. [ABSTRACT FROM AUTHOR]

Background: Methotrexate (MTX) therapy for ectopic pregnancy (EP) is widely used as an alternative for surgical treatment. Its effects on ovarian reserve or pelvic anatomy are not well established. Aims: The aim was to evaluate anatomical changes and ovarian reserve in cases of tubal EP treated by MTX therapy. Materials and methods: A prospective cohort study was conducted at Tanta University. All patients with EP were enrolled. Eligible patients were treated by MTX. Ovarian reserve was assessed by anti-Mullerian hormone (AMH) level and antral follicle count (AFC) 3 months after treatment. Anatomical changes were assessed by laparoscopy 6 months after treatment. Statistical analysis used Mean, SD, χ² test, and Student's t-test were used. Results: The mean age was 28.24 ± 5.48 years, and the mean BMI was 21.85 ± 4.58. The basal β-human chorionic gonadotropin was 1788.48 ± 1171.92 mIU/ml. The mean gestational age was 42.6 ± 6.0 days. Serum level of AMH was 3.98 ± 1.11 and 3.54 ± 1.49 before and after MTX therapy, respectively, with no significant difference between AMH levels before and after therapy (P = 0.243). AFC after treatment was within normal range, with no significant difference in AFC before and after treatment, (P = 0.251). Peritubal and periovarian adhesions were the most common anatomical changes noticed during laparoscopy. Conclusion: MTX therapy is a safe and effective alternative to surgery for undisturbed tubal EP. Two-dose MTX regimen did not compromise ovarian reserve or affect pelvic anatomy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of vitamin D supplementation on ovulation and pregnancy rates in patients with polycystic ovary syndrome (PCOS). Material and Methods: This multicenter randomized controlled clinical trial was performed in the infertility clinics of Tanta University Hospital and Benha University Hospital. One hundred and sixty patients were recruited and allocated into two groups; group 1 served as a control group and group 2 (study group) where patient received vitamin D supplementation. Induction of ovulation with clomiphene citrate. Results: No significant differences were seen in in demographic data: basal hormonal levels, mature follicle size, serum progesterone levels, or pregnancy rate between both groups. Insulin resistance was greater in the control group and resumption of the cycle was higher in the study group. Conclusion: Vitamin D supplementation as an adjuvant to induction of ovulation induction in women with PCOS resulted in enhancement of ovulation and pregnancy rates. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of nontense vaginal hydrocele in male partner with oligoasthenospermia on the success rates of the intracytoplasmic sperm injection (ICSI). Patients and Methods: Enrolled patients (n = 60) were divided into two groups: Group I who have oligoasthenospermia with nontense vaginal hydrocele (study group) and Group II who have oligoasthenospermia with no hydrocele group (control group). The primary outcomes included the fertilization and pregnancy rates whereas the secondary outcomes included any complications occurred. Results: There were no differences in demographic characteristics between both groups. Semen parameters were poorer in the hydrocele group than in the nonhydrocele group regarding count and motility (P < 0.001). The volume of testis was reduced significantly in the hydrocele group (P < 0.001). The results of ICSI regarding fertilization rate, number and quality of developed embryos, and pregnancy rates are not statistically different between both groups. Conclusion: Hydrocele affects both sperm count and motility, but it has no effects on ICSI outcomes. Clinical pregnancy rate was comparable in patients with or without hydrocele. Hence, the surgical management of hydrocele before ICSI is not recommended. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women. [ABSTRACT FROM AUTHOR]