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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.

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.

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.

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.

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.

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