انسیه فولادی

The coronavirus epidemic has had a significant impact on people's lives and has created many problems in the economic, scientific, environmental, and personal dimensions of people's lives. Fertility in women was one of the threats addressed during the Covid-19 pandemic. The purpose of this study was to evaluate the quality of life, marital satisfaction, and anxiety, depression, and stress in women of reproductive age referring to medical centers covered by Mazandaran University of Medical Sciences during the COVID-19 pandemic.

The current study was descriptive and analytical in a cross-sectional manner. The statistical population included all women referred to medical centers covered by Mazandaran University of Medical Sciences from March 1399 to March 1400, who were questioned in two periods. Data were collected using a questionnaire that included demographic information, pregnancy, and COVID-19 disease. Also, the information related to the quality of life of the participants in the study was evaluated using the SF-12 questionnaire, anxiety, depression, and stress of the participants with the Lovebond scale (DASS), and marital satisfaction with the Enrich questionnaire. The collected data were analyzed using SPSS 24 software.

1759 women of reproductive age participated in this study. All participants (100%) were married, with an average duration of marriage of 8.5±1.5 years. 14.1% of women were infected with COVID-19 during the study. 7.2% of women had at least one underlying disease, hypothyroidism (4.3%), diabetes (1.3%) and hypertension (0.1%) being the most common cases. There were diseases. The results indicated a decrease in people's physical health and emotional problems due to the changes in their quality of life due to the outbreak of Covid-19. About 99% of women showed mild and moderate symptoms of mental disorders, including depression, anxiety, and stress, during the study. The participants' stress levels decreased over time (9.6±8.83 vs 8.3±69.7), and their marital satisfaction increased (2.91±0.3 vs 2.95±0.31, P=0.0). Also, the findings of the research showed that people's quality of life had a negative and significant relationship with the amount of mental disorders.

The results of the study revealed an increase in marital satisfaction during the Covid-19 period. The study participants' quality of life had a significant difference in the two time periods. Consequently, special attention to Women of reproductive age, increasing their general and sexual awareness, and providing positive psychological programs in crisis conditions are recommended in formulating health policies and programs

Background and

Infertility is defined as the inability to conceive after 12 months of regular coitus. Anovulatory processes are the most common cause of infertility in women. The aim of this study was to compare the efficacy of combination treatment of clomiphene citrate (CC) and letrozole versus letrozole alone for ovulation induction and pregnancy rate in infertile women with polycystic ovarian syndrome (PCOS).

This is a single-blind, controlled trial study. A total of 102 infertile PCOS women were randomly divided into two groups. Group one (n=51) received 100 mg CC plus 5 mg letrozole daily on cycle days 3-7 for a single treatment cycle and group two (n=51) received 5 mg letrozole daily on cycle days 3-7 for a single treatment cycle. When at least one follicle reached a diameter of 18-19 mm, the patients received human gonadotropin hormone (5000 U-IV injection). The couples had regular intercourse, 2-3 times a week, as they had been instructed.

The number of follicles with a diameter of 14 mm was significantly higher in women who received the combination treatment of letrozole and clomiphene compared to the ones who received letrozole treatment (P=0.04). There were no statisticaly significant differences in the number of 18 mm follicles (P=0.07), mean endometrial thickening (P=0.37), clinical pregnancy rate (P=0.99), ongoing pregnancy rate (P=0.59), multiple pregnancy rate (P=0.99), and live birth (P= 0.99) between the two groups.

According to our study, the combination treatment of letrozole and CC is more effective than letrozole and can be used as the first-line therapy for infertility in women with PCOS. Moreover, the cost and risk of this treatment may be lower than other induction ovulation treatments.