Egyptian International Fertility center

Cairo, Egypt

Egyptian International Fertility center

Cairo, Egypt

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Youssef M.A.F.M.,Egyptian International Fertility Center | Youssef M.A.F.M.,Cairo University
Middle East Fertility Society Journal | Year: 2013

To report a case of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA syndrome) with uterus didelphys that has been diagnosed successfully with ultrasound and managed with a single stage vaginoplasty. © 2012 Middle East Fertility Society. Production and hosting by Elsevier B.V. All rights reserved.


Wahab H.A.,Cairo University | El-Din D.S.,Cairo University | Zain E.,Beni Suef University | Abdelgany M.,Cairo University | And 2 more authors.
Middle East Fertility Society Journal | Year: 2011

Objective: To evaluate uterine artery blood flow and subendometrial blood flow in women with unexplained recurrent miscarriage (RM) compared to normal fertile women. Design: Case control study. Settings: Departments of Obstetrics and Gynaecology, Cairo university and, Beni Souif University, Cairo, Egypt. Patients and methods: Women were divided into two groups: those with history of unexplained recurrent miscarriage (study group, no. = 40), and those with no history of miscarriage and at least one child born at term (control group, no. = 40), transvaginal 3D power Doppler ultrasonography was performed to all patients in the second phase of non-pregnant unstimulated cycle to detect uterine artery pulsatility index (UAPI) and subendometrial area to detect subendometrial blood flow presented by the indices vascularisation index (VI), flow index (FI), and vascular flow index (VFI). The indices between the two groups were compared. Results: UAPI was significantly higher in the study group (p = 0.000), on the other hand VI (p = 0.000), FI (p = 0.000), VFI (p = 0.000) were significantly lower in the study group. A significant positive correlation was found between UAPI and recurrent miscarriage in the study group (r = 0.8, p = 0.00), whereas a significant negative correlation was found between VI (r = -0.56, p = 0.00), and FI (r = -0.79, p = 0.00) and recurrent miscarriage in the study group, but no significant correlation was found between endometrial thickness and endometrial volume between the two groups. However the application of binary logistic regression analysis model found that adding variables has not significantly increased the ability to predict the occurrence of miscarriage. Conclusion: The presence of good uterine and endometrial blood flow is an important prerequisite for successful implantation and continuation of pregnancy as shown by higher uterine artery blood flow resistance and lower endometrial blood flow in recurrent miscarriage cases and those patients with unexplained RPL may have abnormalities in the uterine and endometrial blood flow. Despite these findings we could not find any cut off values that could predict the occurrence of miscarriage which may be attributed to small sample size and short period of follow up so larger prospective studies are needed aiming to confirm such results and reaching values that can accurately predict the occurrence of miscarriage. © 2011 Middle East Fertility Society. Production and hosting by Elsevier B.V. All rights reserved.


Abdelmoty H.I.,Cairo University | Youssef M.A.,Cairo University | Youssef M.A.,Egyptian International Fertility center | abdallah S.,Cairo University | And 8 more authors.
BMC Women's Health | Year: 2015

Background: To our knowledge, no large population - based studies have been performed on the topic of menstrual patterns among Egyptian adolescent in recent years. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among Egyptian adolescents. Methods: A cross-sectional survey. A total of 800 questionnaires were administered to post-menarcheal Egyptian adolescents attending secondary schools in Giza, Egypt, from September 1, 2012, to December 1, 2013. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included items on girl's socio-demographic and menstrual pattern characteristics, concerning their age at menarche, menstrual cycle length and regularity, duration and amount of flow, type and severity of pain related to menstruation, need for analgesia; and symptoms suggestive of premenstrual syndrome (PMS) Main Outcome Measure: description of menstrual patterns, disorders and source of knowledge. Results: Four hundred twelve (51.5%) out of 800 adolescents completed the questionnaire. The mean age of the girls was 14.67±1.7years. Mean age at menarche was 12.49±1.20years. 382 respondents reported various menstrual disorders, giving a prevalence rate of 95%. Dysmenorrhea was the most prevalent (93%) menstrual disorder in our sample, followed by PMS (65%), and abnormal cycle lengths (43%). Menstrual disorders interfered with social and academic life of 33 and 7.7% of respondents respectively. Most participants lacked menstrual health knowledge and only 8.9% of girls reported consulting a physician. Conclusion: To the best of our knowledge, this is one of the largest studies on menstrual pattern and disorders among Egyptian adolescent girls. Our Findings of the present study are consistent with other studies and reported higher than expected prevalence of menstrual disorders. © 2015 Abdelmoty et al.


Aboulfoutouh I.I.,Cairo University | Aboulfoutouh I.I.,Egyptian International Fertility Center | Youssef M.A.F.,Cairo University | Youssef M.A.F.,Egyptian International Fertility Center | And 4 more authors.
Gynecological Endocrinology | Year: 2011

Cervical twin ectopic pregnancy after IVF-ET is rare and catastrophic complication. However, here is no consensus on the best treatment strategy. Patient and method. Case report of cervical twin ectopic pregnancy after IVF-ET treated by transvaginal ultrasound guided aspiration plus systemic single injection of methotrexate, which followed by full-term delivery in next IVF-ET cycle. Conclusion. Transvaginal ultrasound-guided aspiration and systemic methotrexate administration can be safely and easily used to treat cervical ectopic pregnancies and to preserve the fertility of the patient without any major complications. © 2011 Informa UK, Ltd.


Shaltout A.,Dr Samir Abbas Medical Center | Shaltout A.,Cairo University | Shohyab A.,Dr Samir Abbas Medical Center | Shohyab A.,Cairo University | And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2012

Objective: Dopamine agonists were proposed as a preventive strategy for severe ovarian. The aim of this randomized controlled study is to evaluate the role of dopamine agonist at lower doses (0.25 mg) as a preventive strategy of severe hyperstimulation syndrome (OHSS) in women at high risk in IVF/ICSI treatment cycles. Study design: Two hundred women at risk to develop OHSS undergoing IVF/ICSI treatment cycle were included; the study group received 0.25 mg of cabergoline for 8 days from the day of HCG administration versus no treatment for the prevention of OHSS. Reduction of the incidence OHSS was the primary outcome. Results: The overall incidence of OHSS was significantly reduced, almost 50%, in cabergoline group in comparison with control group (RR: 0.5, 95% CI: 0.29-0.83), with absolute risk reduction following cabergoline administration 11% (ARR: 0.11, 95% CI: 1.09-20.91). The corresponding number needed to treat (NNT) was 9. Conclusion: Prophylactic treatment with the dopamine agonist, cabergoline, at lower doses (0.25 mg) reduces the incidence of OHSS in women at high risk undergoing IVF/ICSI treatment. © 2012 Elsevier Ireland Ltd.


Mahmoud Youssef M.A.,Cairo University | Mahmoud Youssef M.A.,Center for Reproductive Medicine | Mahmoud Youssef M.A.,Egyptian International Fertility Center | Van Wely M.,Center for Reproductive Medicine | And 4 more authors.
Fertility and Sterility | Year: 2012

Objective: To evaluate the role of corifollitropin alfa, a newly developed weekly administrated long-acting recombinant FSH (rFSH), as an alternative for daily rFSH administration in women undergoing controlled ovarian stimulation in GnRH antagonist down-regulated in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment cycles. Design: Systematic review and meta-analysis of randomized controlled trials. Setting: University and private centers. Patient(s): Infertile women undergoing IVF/ICSI treatment. Intervention(s): Comparing long-acting rFSH corifollitropin alfa versus standard daily administrated rFSH in GnRH antagonist IVF/ICSI cycles. Main Outcome Measure(s): Ongoing pregnancy rate, live birth rate, clinical pregnancy rate, miscarriage rate, duration of stimulation, amount of FSH, number of retrieved oocytes, number of mature oocytes, number of embryos obtained, fertilization rate, ovarian hyperstimulation syndrome (OHSS) incidence, and adverse events. Searches (of literature through November 2011) were conducted in Medline, Embase, Science Direct, the Cochrane Library, and databases of abstracts. Result(s): Four randomized trials involving 2,326 women were included. There was no evidence of a statistically significant difference in ongoing pregnancy rate for corifollitropin alfa versus rFSH. There was evidence of increased ovarian response and risk of OHSS in corifollitropin alfa. Conclusion(s): In view of its equivalence and safety profile, corifollitropin alfa in combination with daily GnRH antagonist seems to be an alternative for daily rFSH injections in normal responder patients undergoing ovarian stimulation in IVF/ICSI treatment cycles. © 2012 by American Society for Reproductive Medicine.


Youssef M.A.F.M.,Cairo University | Youssef M.A.F.M.,Egyptian International Fertility Center | Youssef M.A.F.M.,Center for Reproductive Medicine
Middle East Fertility Society Journal | Year: 2013

Applying evidence based medicine (EBM) in our daily practice and health settings is a great challenge for residents due to the lack of time and experience. The following case scenario is an example of real life application of EBM. © 2013 Production and hosting by Elsevier B.V. on behalf of Middle East Fertility Society.


Khattab S.M.,Cairo University | Youssef M.A.F.M.,Egyptian International Fertility Center
Middle East Fertility Society Journal | Year: 2013

Vaginal stones are extremely rare and are classified as primary and secondary. A 45 year-old female presented with an unexplained dyspareunia and vaginal discomfort for 2 years unresponsive to traditional treatment. Vaginal examination revealed no prolapse or vaginal fistula. Digital examination revealed multiple small rounded firm to hard or tender masses varying in size from 0.5 to 1.5 cm anterior to the vagina. Patient was treated with midline anterior vaginal wall incision with the extraction of eight smooth surfaced stones with uneventful postoperative course. Stone analysis revealed that they were composed of pure ammonium acid urate (AU). We recommend that for any patient with unexplained dyspareunia or vaginal discomfort that has proved to be unresponsive to traditional treatment, the possibility of anterior vaginal wall stones should be kept in mind. © 2012 Middle East Fertility Society. Production and hosting by Elsevier B. V. All rights reserved.


Mantikou E.,University of Amsterdam | Youssef M.A.F.M.,University of Amsterdam | Youssef M.A.F.M.,Cairo University | Youssef M.A.F.M.,Egyptian International Fertility center | And 5 more authors.
Human Reproduction Update | Year: 2013

Background: The media that are used to culture human preimplantation embryos are considered to be an important factor for the success rates of IVF/ICSI. Here, we present a systematic review of randomized controlled trials (RCTs) on the effect of culture media on IVF/ICSI success rates. Methods: RCTs published between January 1985 and July 2012 were eligible for inclusion. The primary outcome was live birth. Secondary outcomes were health of babies born, ongoing pregnancies, clinical pregnancies, miscarriages, multiple pregnancies, implantation rate, cryopreservation rate, embryo quality and fertilization rate. For those media that were evaluated in more than one comparison, an unconventional meta-analysis was performed by pooling the data of the media they were compared to. Results: Twenty-two RCTs were included that evaluated 31 different comparisons. Conventional meta-analysis was not possible for any of the outcomes as nearly all trials compared different culture media. Only four trials reported on live birth, and one of them reported a significant difference. Nine trials reported on ongoing and/or clinical pregnancy rates, of which four showed a significant difference. Pooling the data did not reveal a superior culture medium. Conclusions: It is yet unknown what culture medium leads to the best success rates in IVF/ICSI. Given the potential importance of culture media for treatment outcome, rigorously designed RCTs are needed for currently available, as well as newly introduced culture media. © The Author 2013. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.


Hashish N.M.,Cairo University | Badway H.S.,Cairo University | Abdelmoty H.I.,Cairo University | Mowafy A.,Cairo University | And 2 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2014

Objective Follicular fluid of mature oocytes is rich in growth factors and cytokines that may exert paracrine and autocrine effects on implantation. The aim of this study was to investigate if flushing the endometrial cavity with follicular fluid after oocyte retrieval improved pregnancy rates in subfertile women undergoing intracytoplasmic sperm injection (ICSI). Study design One hundred subfertile women undergoing ICSI between April 2012 and September 2012 at the centre for reproductive medicine, Cairo University, Egypt were enrolled in this open label, parallel randomized controlled study. Patients were randomized into two groups at the start of treatment using a computer-generated programme and sealed opaque envelopes: the follicular fluid group (n = 50) and the control group (n = 50). Inclusion criteria were: age 20-38 years; basal follicle-stimulating hormone <10 mIU/ml; body mass index <35 kg/m 2; and ostradiol >1000 pg/ml and <4000 pg/ml on the day of human chorionic gonadotrophin administration. Exclusion criteria were: evidence of endometriosis; uterine myoma; hydrosalpinges; endocrinological disorders; history of implantation failure in previous in-vitro fertilization/ICSI cycles; and severe male factor infertility. Results Clinical pregnancy and implantation rates were higher in the follicular fluid group compared with the control group [354% (17/48) vs 319% (15/47); p = 0718] and (18.6% vs 11.3%; p = 0.153), respectively. However, the difference was not statistically significant. Conclusion Flushing the endometrial cavity with follicular fluid after oocyte retrieval neither improved nor adversely affected clinical pregnancy and implantation rates in subfertile women undergoing ICSI. © 2014 Elsevier Ireland Ltd.

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