The best time of endometrial receptivity is the missing part of the implantation puzzle in patients with recurrent in vitro fertilization (IVF) failure. There are various treatment plans and strategies to meet the best endometrial timing for implantation. However, the lack of synchronization of the good-quality embryo with the patient's individual “window of implantation” is the hypothesis for most IVF failures so far. Sequential embryo transfer (ET) theoretically extends the availability time of embryos on the window of implantation. The study aimed to evaluate the improvement of pregnancy rate in sequential (two-step) frozen-thawed embryo transfer (FET) on day 3/day 5 in individuals who suffer from repeated IVF failures. This randomized controlled trial study was done in a university-affiliated infertility center for women with repeated consecutive IVF failures. Two hundred women aged 20–39 years who met our inclusion criteria were included in the study between January 2020 and September 2021. Participants were allocated with a 1:1 ratio to either sequential (two-step) ET on day 3/day 5 (study group, n=100) and conventional day 5 FET (n=100, control group). The frozen-thawed embryos were transferred to hormone replacement therapy-prepared endometrium in both groups. The primary outcomes were clinical pregnancy and implantation rates. The secondary outcomes were early pregnancy loss and multiple pregnancies. The demographic and clinical characteristics of the two groups were comparable. Clinical pregnancy rates were significantly higher in the sequential (two-step) FET group (40%) compared to the day 5 group (19%) (P<0.001). The sequential transfer of frozen-thawed embryos on day 3/day 5 was more effective than regular day 5 for patients suffering from repeated IVF failure.
Background: The high risk of recurrence of ovarian endometrioma after laparoscopy is a major challenge. Objectives: In this study, we measured recurrence of endometriosis six months after laparoscopic surgery and evaluated its risk factors in these patients. Methods: In this cross-sectional study, patients with endometrioma (based on the pathologic report) who underwent laparoscopic cystectomy in Rasool-Akram Hospital, Tehran, from April 2015 to August 2016, were evaluated by ultrasonography six months after the surgery. Endometriosis surgery was done by a team of expert surgeons. The demographic information of patients, number, size, and location of cysts, disease stage, and medical treatment taken after the surgery were recorded in the study checklist. The pre-operative endometriosis-related symptoms, including pelvic pain, dysmenorrhea, dyspareunia, dyschezia, and dysuria were recorded by visual analogue scale and compared with related symptoms six months after the surgery. Results: Seventy-nine patients completed the study with the mean age of 31.38 ± 5.98 years. The mean cysts' size was 69.2 ± 2.76 mm: 44.3% had multiple cysts and 39.2% bilateral endometrioma. In 53.1% deep infiltrative endometriosis (DIE) was recorded. After six months, 13.9% had a recurrence with the mean size of 37.2 ± 13.3 mm. There was a statistically significant correlation between recurrence and a previous surgery (P = 0.001) and infertility (P = 0.02). All endometriosis-related symptoms significantly decreased six months after the surgery. Conclusions: The recurrence rate, compared to the previous report, indicated that patients with a previous surgery and infertility should be closely monitored for the risk of recurrence. Possibly, damages in the previous surgery and cellular and molecular abnormalities that encountered more deeply in endometriosis-associated infertility predispose the patients to more recurrence rate, which can be further investigated.
Introduction:One of the most common complications of spinal anesthesia in elective cesarean is a headache, known commonly as post-dural-puncture headache (PDPH). Various methods are mainly recommended such as resting and the use of non-opioid analgesics, caffeine, and codeine, but none of them has been fully effective in its treatment. Hence, this study was conducted to evaluate the effect of magnesium sulfate on the prevention of postdural-puncture headache in the elective cesarean.Method: a total of 68 patients candidate for elective cesarean and admitted to Kamali Hospital were selected using convenient sampling and they were randomly divided into two groups. One group received magnesium and other group received saline. Subjects of case group received magnesium at the dose of 50 mg / kg as bolus and the subjects of control group received normal saline at the same dose as bolus. The incidence of headache and its severity 12, 24, 36, 48 , 60 and 72 hours after surgery were measured in both case and control groups.
Results:The mean age of patients in the magnesium sulfate group was 27.94 years with a standard deviation of 5.18 and the mean age of patients in the normal saline group was 29.35 years with a standard deviation of 5.97. The mean body mass index (BMI) in the magnesium sulfate group was 26.34 with a standard deviation of 4.03 and the mean body mass index (BMI) in the normal saline group was 27.15 with a standard deviation of 2.47. Postdural-puncture headache severity was lower in the case group than that in the control group at all times (P <0.05).
Conclusion:The results of this study revealed that intravenous administration of magnesium sulfate before elective cesarean in patients undergoing spinal anesthesia significantly decreases the severity of post-duralpuncture headache (PDPH).
Human papillomavirus (HPV) infection, which often includes high-risk genotype infection, is one of the leading causes of cervical cancer. This cross-sectional research included 503 Iranian women referred to the gynecology clinic of Kamali Hospital in Karaj, Iran, for routine cervical cancer screening between 2020 and 2021. Cervical specimens were collected from all participants with a special brush and transported to the laboratory for cervical cytology diagnosis. Overall HPV incidence among Iranian women was 39.96%, of which 23.06% had high-risk HPV genotypes and 9.7% had low-risk HPV types. The risk associated with HR-HPV types was considerably associated with employment and marital status.
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