This study was conducted to determine the efficacy of metformin vs placebo in women with polycystic ovary syndrome (PCOS) undergoing IVF treatment. A total of 66 CC-resistant patients were studied prospectively. The women were randomly assigned to receive 850 mg of metformin (n = 34) or placebo (n = 32) twice daily that started 1 month before commencing the IVF treatment and continued to the day of the pregnancy test. Compared with the metformin-treated group, women who received a placebo had a significant increase in terms of days of stimulation with HMG, number of HMG ampoules, number of follicles >14 mm, number of oocytes retrieved, number of mature eggs, fertilisation rate and oestradiol level on the day of hCG administration. Similarly, women in the placebo group showed a significant increase in poor quality embryos, cancellation rate and the rate of ovarian hyperstimulation syndrome, as compared with the metformin-treated group. On the other hand, women who received metformin showed a significantly higher number of good quality embryos and implantation rate when compared with the placebo controls. Despite the transfer of a similar number of embryos, an insignificant increased in the pregnancy rate along with significant reduction in the abortion rate was observed in the metformin-treated group as compared with the placebo controls. No fetal abnormalities were encountered in the babies born in the metformin-treated group. It is concluded that metformin affects positively the quality of both oocytes and embryos without a significant increase in the pregnancy rate. It decreases significantly the rates of abortion and ovarian hyperstimulation syndrome.

Cornual ectopic pregnancy is a rare form of ectopic pregnancy but has catastrophic presentation when diagnosis is missed. It is usually misdiagnosed as degenerated myoma at uterine fundus but can be differentiated by positive pregnancy test, absence of intrauterine gestational sac and diagnostic laparoscopy when necessary. In this case, we present a case of cornual ectopic pregnancy diagnosed by serial serum beta subunit of human chorionic gonadotropin, vaginal ultrasound and diagnostic laparoscopy, which was managed by evacuation of the cornual ectopic by laparotomy, excision of the tube and then suturing the pedicle adjacent to the uterine wall.

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Objective: To describe the procedure of radical vaginal trachelectomy combined with laparoscopic pelvic lymphadenectomy, its safety, and side effects for treatment of early stage cervical cancer in patients who met the procedure's criteria. Methods: This study was conducted on 10 patients with early stage cervical cancer at Charite Campus Benjamin Franklin-Germany between February 2011 and February 2012. A total of 10 patients were studied according to the protocol, all of them underwent radical vaginal trachelectomy combined with laparoscopic pelvic lymphadenectomy for early stage cervical cancer and where seeking parenthood and followed up for its safety, and side effects. Results: Radical vaginal trachelectomy combined with laparoscopic pelvic lymphadenectomy was an easy procedure with minimal blood loss; the average operating time was about 181 minutes, 80% of cases were squamous cell carcinoma, diagnosed by cone biopsy, while 20% were adenocarcinoma diagnosed by punch biopsy. Two cases were complicated by postoperative pelvic abscess and urinary tract infection and were managed accordingly. Conclusion: Radical vaginal trachelectomy combined with laparoscopic lymphadenectomy was a safe procedure with minimal side effects for preserving fertility in patients with early stage cervical cancer provided it was performed by experienced surgeons.

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