فهرست مطالب sedigheh amooee

Granulocyte colony stimulating factor (GCSF) has been introduced as an immunomodulatory agent by increasing implantation rate in vitro fertilization (IVF) patients but it has not been studied in intrauterine insemination (IUI) patients. The aim of this study is to answer the role of GCSF in implantation rate of IUI.

In this prospective double-blind randomized control trial, 320 eligible patients were enrolled, who were referred to the referral infertility clinic of Shiraz University of Medical Sciences from February 2018 till the end of 2019. They were divided into two groups randomly. After collecting the demographic data, all patients received clomiphene citrate from the 5th day of the menstruation cycle for 5 days. 50-150 units of recombinant purified follicle-stimulating factor (FSH) were started from the 8th day of the cycle. Follicle monitoring was done by transvaginal sonography till a mature follicle of 18 mm or more was developed. Human chorionic gonadotropin (HCG) injection was done in both groups with intrauterine administration of 300 μg GCSF in the case group and normal saline in the control group simultaneously. After 36 hours, IUI was performed. The clinical pregnancy, miscarriage, and ongoing pregnancy rates of both groups were calculated by SPSS software.

The results showed improvement of clinical pregnancy rate [15.38% vs. 13.81% OR=1.17 (0.62-2.21)], miscarriage rate [3.84% vs. 5.26% OR=0.74 (0.25-2.20)] and ongoing pregnancy rate [11.53% vs. 8.55% OR=1.37 (0.65-2.92)] in the GCSF group compared to the control. However, the results revealed no statistically significance (P>0.05).

Although it was not statistically significant, 300 μg Intrauterine GCSF administration simultaneously with hCG injection in standard IUI procedure might increase the pregnancy outcomes. Further studies are warranted (registration number: IRCT201212079281N2).

Infertility is a critical condition in women with polycystic ovary syndrome (PCOS), caused not only by anovulation but also by endometrial abnormality.

This study aimed to evaluate and compare the hysteroscopic and histological findings of endometrial biopsies in infertile women with PCOS and normal endometrial thickness and women with unexplained infertility (UI).

This cross-sectional study compared the initial hysteroscopy and endometrial histological findings of 70 infertile women with PCOS and normal endometrial thickness with those of 35 women with UI. The relationship between endometrial histology and clinical parameters such as including luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, testosterone, prolactin, fasting blood sugar, body mass index (BMI), and infertility duration was analyzed.

The mean age of women with PCOS was significantly lower than that of women with UI (27.5 ± 4.1 vs. 30 ± 4.5 years, respectively) (p < 0.001). The mean BMI was higher in women with PCOS than in women with UI (28.7 ± 4.4 vs. 25.1 ± 3 kg/m2) (p < 0.001). The hysteroscopic findings of all women with PCOS were normal, whereas 91.4% of women with UI had normal hysteroscopic findings, 2.9% had a polyp, and 5.7% had endometrial thickening. The histological findings of women with PCOS revealed proliferative endometrium in 54.3%, disordered proliferative endometrium in 17.1%, secretory endometrium in 8.6%, and endometrial polyp in 17.1%, whereas these percentages in women with UI were 28.6%, 0%, 54.3%, and 20%, respectively.

The hysteroscopic evaluation alone of infertile women might not detect all probable endometrial pathologies in women with PCOS.

Perineal warm packs with an increase in subcutaneous temperature and the stimulation of cutaneous receptors are advocated in the belief of pain and probably increase comfort during labor and delivery. This study aimed to investigate the effectiveness of warm compress bi-stage on pain strength in the first two stages of labor and after delivery in primiparous women.

This study was a randomized clinical trial that was conducted in Shiraz hospitals from July 2012 to March 2013, in which 150 women participated and were separated into intervention (15-20-minute warm compress bi-stage in the first two stages of normal delivery at 7 and 10 cm dilations and zero position) and control (just usual hospital cares) groups. Then, pain strength was evaluated in both groups in the first two stages of normal delivery and after delivery similar to the frequency of episiotomy. The chi-square, t test, and odds ratio analysis were used for data analysis

The results of the t test showed that the mean intensity of pain reduced significantly in intervention group in both first (P < 0.002) and second stages (P < 0.001) and on the day after delivery (P < 0.001). Besides, the frequency of episiotomy meaningfully decreased in the intervention group in comparison with the control group (P < 0.001).

The research participants experienced less pain through the labor and after delivery by using warm compress bi-stage at 7 and 10 cm dilatations. Thus, this method might be suitable for reducing perineal pain resulting from episiotomy.

Teaching religious principles can inevitably strengthen the mothers’ motivation and may improve the infant’s growth indices. This study aimed to investigate the effect of teaching religious principles on the infants’ growth and development from birth up to the age of 3 months.

In a randomized controlled tria1, 84 primiparous women who had average or weak religious attitude were randomly divided into intervention and control groups in 2013. The intervention group attended six 90‑min sessions of religious education held once a week. The control group received the routine pregnancy care. Data were collected through physical growth indices and Denver’s questionnaire.

A significant difference was found between the intervention and control groups regarding the head circumference at birth (34.61 ± 1.51 vs. 32.97 ± 6.98). Besides, a significant relationship was observed between religious knowledge before delivery and infants’ development in gross motor skills (P = 0.047, r = 0.114) and major motor skills (P = 0.019, r = 0.359) at 1 month of age, and also language skills (P = 0.015, r = 0.119), major motor skills (P = 0.008, r = 0.404), and fine motor skills (P = 0.035, r = 0.425) at the age of 3 months in the intervention group.

Training the pregnant mothers regarding religious principles was effective in some indices of infants’ physical growth and development.

The aim of this study was to assess the effect of two-stage warm compress technique on the pain duration of the first and second labor stages and neonatal outcomes.
The clinical trial was done on 150 women (75 subjects in each groups) in Shiraz-affiliated hospitals in 2012 A two-staged warm compress was done for 15-20 minutes in the first and second labor phase (cervical dilatation of 7 and 10 cm with zero status) while the control group received hospital routine care. The duration of labor and Apgar score were evaluated.
According to t-test, the average of labor duration was lower in the intervention group compared to the control group at the second stage. However, there was no significant difference for labor duration at the first stage and the first and fifth minute Apgar score.
According to the result, this intervention seems a good method for decreasing labor duration at the second stage of parturition.

Postpartum blues is a transient change of moods occurring in the first few days after delivery. The present study aimed to investigate the effect of religious doctrines on postpartum blues in primiparous women. In this randomized controlled tria1, 84 primiparous women who had average or weak religious attitude were randomly divided into intervention and control groups. In the intervention group, religious doctrines were instructed from 20th to 28th weeks of gestation through 6 weekly sessions of 60–90 min each. The control group, however, just received the routine care. Spielberger’s anxiety scale and the questionnaires assessing religious knowledge and attitude were completed by both groups before, immediately after, and 1–2 months after the intervention. Also, postpartum blues were evaluated by Edinburg Postnatal Depression Scale (EPDS) 10 days after delivery. Then, the data were analyzed using Chi‑square, paired t‑test, independent t‑test, analysis of variance (ANOVA), and Pearson correlation coefficient. The results showed postpartum blues in 59.5% of the study participants. Besides, the results of independent t‑test revealed a statistically significant difference between the two groups regarding the mean score of postpartum blues (P = 0.036). Although the intervention group’s knowledge and attitude scores were higher than those of the control group, no significant difference was found between the two groups regarding the correlation coefficient between postpartum blues and religious knowledge (P = 0.088) and religious attitude (P = 0.7). The results of the study show that instruction of religious doctrines was effective in increasing the religious knowledge and attitudes and reducing the postpartum blues.

Benign ovarian cysts are common among both pre- and postmenstrual women. Surgical intervention for excision of an ovarian cyst is mandated when symptomatic, or chance for malignancy is high. The damaging effect of surgical ovarian cystectomy on ovarian reserve is debated in recent studies.

In the present study we investigated serum level of anti-mullerian hormone (AMH) as an indicator of ovarian reserve before and after surgical cystectomy.

60 patients with dermoid cyst, serous cystadenoma, and mucinous cystadenoma were recruited. Measurement of serum AMH was performed prior to surgery, and at one and 3 months after laparoscopic cystectomy. Serum AMH levels were compared before and after the surgery and between various types of ovarian cyst.

Serum AMH level declined significantly after the surgery which recovered to 65% of its baseline value three months later.

Decreased serum AMH can be contributed to decreased ovarian reserve after laparoscopic ovarian cystectomy. This can result from thermo-coagulation used for hemostasis during the operation.

Adenoid cystic carcinoma of Bartholin’s gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin’s glands.

To evaluate the effectiveness of intrauterine injection of recombinant human chorionic gonadotropin (rhCG) before embryo transfer (ET). In this randomized placebo-controlled clinical trial, a total number of 182 infertile patients undergoing their first in vitro fertilization/ intracytoplasmic sperm injection (IVF-ICSI) cycles were randomly assigned to receive 250μg intrauterine rhCG (n=84) or placebo (n=98) before ET. The implantation and pregnancy rates were compared between groups. Patients who received intrauterine rhCG before ET had significantly higher implantation (36.9% vs. 22.4%; p=0.035), clinical pregnancy rates (34.5% vs. 20.4%; p=0.044) and ongoing pregnancy rate (32.1% vs. 18.4%; p=0.032) when compared to those who received placebo. The abortion (2.4% vs. 2.0%; p=0.929) and ectopic pregnancy rates (1.2% vs. 1.0%; p=0.976) were comparable between groups of rhCG and placebo, respectively. Intrauterine injection of 250μg of rhCG before ET significantly improves the implantation and pregnancy rates in IVF/ICSI cycles.

Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients. To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients. The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the clinics which were affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The subjects were randomly assigned to two groups receiving either chromium picolinate (200μg daily) or metformin (1500mg daily) for 3 months. Anthropometric and hormonal profile were measured and compared both before and after the treatment. Ovulation and pregnancy rate was measured in the two study groups, as well. Chromium picolinate significantly decreased fasting blood sugar (FBS) after 3 months of treatment (p=0.042). In the same way, the serum levels of fasting insulin had significantly decreased leading to an increase in insulin sensitivity as measured by QUICKI index (p=0.014). In comparison to the patients who received chromium picolinate, those who received metformin had significantly lower levels of testosterone (p=0.001) and free testosterone (p=0.001) after 3 months of treatment. Nevertheless, no significant difference was found between the two study groups regarding ovulation (p=0.417) and pregnancy rates (p=0.500). Chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women. These effects were comparable with metformin; however, metformin treatment was associated with decreased hyperandrogenism. Overall, chromium picolinate was better tolerated compared to metformin; nonetheless, the two study groups were not significantly different regarding ovulation and pregnancy rates.

? -thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the? -thalassemia mutant gene are living in this country.

To determine pregnancy outcome of women with? -thalassemia minor.

In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of? -thalassemia minor. Patients in case and control groups were matched according to maternal age, gestational age and number of previous pregnancies. Cesarean delivery, hypertensive disorders, gestational diabetes mellitus, premature rupture of membranes and preterm labor were recorded in each group and were compared using the? 2 or Fisher exact tests.

Overall 510? -thalassemia minor subjects and 512 healthy controls were studied. Cases with? -thalassemia minor had significantly higher prevalence of oligohydramnios (p<0.001) and cesarean section delivery (p=0.001). There was no significant difference regarding Apgar score in 1st (p=0.65) and 5th minute (p=0.25), IUGR (p=0.073), gestational diabetes mellitus (DM) (p=0.443) and preeclampsia (p=0.116) between two study groups.

? -thalassemia minor does not significantly influence the pregnancy outcome in the negative way.