Background: Various strategies have been proposed for polycystic ovary syndrome (PCOS) treatment.
Objective: To investigate and compare the number and size of ovarian follicles, endometrial thickness, and ovulation rate by traditional protocol (TP) and stair-step protocol (SSP).
Materials and Methods: Sixty infertile PCOS women were allocated into two groups (SSP = 30 and control TP = 30) between May and October 2019 in the Besat Hospital, Sanandaj, Iran. In the SSP group, the infertile women were treated with 50 mg/daily clomiphene citrate (CC) for five days, while the nonresponsive women were prescribed 100 mg daily CC for five days in the same cycle. The maximum dose (150 mg) was administered until ovulation occurred. In the control group, in non-ovulatory cases, the dose was increased in the next cycle. Ultrasound was used to detect ovulation.
Results: Endometrial thickness changes with various doses of CC were significantly different in the TP. The comparison of both protocols showed a significant difference in endometrial thickness only at 50 mg CC. The number of follicles in the left ovary was significantly different in both protocols at 150-mg CC. The size of ovarian follicles in the left ovary was significantly different between the two protocols at 100-mg CC. The ovulation rate was significantly different in the SSP at 100- and 150-mg doses of CC. Moreover, 86% of ovulation occurred at 100-mg CC in the SSP, while this rate was 73% in the TP.
Conclusion: The most appropriate dose for ovulation in patients with PCOS is 100 mg CC.
Key words: Polycystic ovary syndrome, Clomiphene, Infertility, Ovulation induction.
Educational performance and executive functions are two factors related to positive outcomes. Delay or the reduction of the development of executive functions in children with Intellectual Disabilities (ID) may result in negative outcomes in social skills and educational competence. The main important aspects of executive functions, including working memory, attention, and inhibition are considered the main predictors of learning social skills, as well as educational skills in life. The current study aimed at evaluating the effectiveness of family-based cognitive rehabilitation on working memory, sustained attention, inhibition, and social skills of children with ID. Materials and Methods: The participants of the present study were a subgroup of 11-14-yearold children with ID, who were studying in the exceptional schools from 2017 to 2018 in Tehran, Iran. The samples were selected by clustering multi-stages method; 15 students were assigned to the experimental group and 15 students were assigned to the control group. Then, they were evaluated by the Boshra test for cognitive inhibition, working memory test for children, Integrated Visual and Auditory (IVA) test, Behavior Rating Inventory of Executive Function (BRIEF), and Vineland social skill scale before and after the cognitive family-based intervention. The experimental group received 12 sessions of intervention. The data were analyzed by SPSS V. 24. Results: Family-based cognitive rehabilitation had significant effects on improving working memory, attention, and inhibition (P<0.001) through addressing underlying executive functions, but had no significant effect on the social skills of children with ID. Conclusion: As a new intervention, cognitive family-based rehabilitation may improve the executive functions of children with ID as supplementary intervention along with behavioral or other cognitive interventions to help children overcome some challenges under social situations.
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