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Or Y.,In Vitro Fertilization Unit | Appelman Z.,Genetics Unit
Journal of Gynecologic Surgery | Year: 2014

Background: A septate uterus is a relatively common Müllerian defect that has an impact on fertility; this effect has been debated. Operative hysteroscopy is the preferred method of treatment in patients with recurrent abortions or poor obstetric histories, but it has not yet been determined whether or not to perform prophylactic metroplasty when a septum is incidentally diagnosed in an otherwise healthy patient. Methods: This article reviews existing literature on the clinical significance of a septate uterus, its diagnosis, surgical treatment, and reproductive outcome after hysteroscopic metroplasty. Complications and the controversy surrounding this procedure are also discussed. Results: Available literature suggests that untreated Müllerian defects could impair pregnancy outcomes significantly. Hysteroscopic metroplasty is generally preferred over expectant management in patients with septate uteri and poor obstetrical histories. Conclusions: Although controversial, prophylactic metroplasty may be recommended for nulliparous patients with incidentally diagnosed uterine septa if there is unexplained infertility in patients>35 years of age and in whom assisted reproductive technologies are used. (J GYNECOL SURG 30:325) © Mary Ann Liebert, Inc. 2014.


Sachdeva K.,Guru Gobind Singh Indraprastha University | Saxena R.,Guru Gobind Singh Indraprastha University | Majumdar A.,In Vitro Fertilization Unit | Chadda S.,Sir Ganga Ram Hospital | Verma I.C.,Guru Gobind Singh Indraprastha University
Genetic Testing and Molecular Biomarkers | Year: 2011

Introduction: Microdeletions in the azoospermia factor region on the long arm of Y chromosome are associated with spermatogenic failure. There are many markers for the diagnosis of Y chromosome microdeletion analysis, but in routine practice only a limited set of markers can be tested. Objective: The objectives of this study were to determine the frequency of Y chromosome microdeletion in idiopathic cases of male infertility in India, to attempt genotype-phenotype correlation, and to evaluate whether markers to be tested for diagnosis of Y chromosome microdeletion should be ethnicity specific. Methods: Microdeletions in the Y chromosome were analyzed in 200 infertile males. The six sequence tag site (STS) markers prescribed by the European Academy of Andrology (EAA) were used initially. Patients in whom no deletions were detected by use of these markers were tested by markers selected from other studies from India. Results: The STS markers prescribed by EAA detected deletions in only 6 (3%) of 200 infertile males. However, markers selected from previous Indian studies showed deletions in an additional 15 (7.5%) of infertile males. Overall, Y chromosome microdeletions were observed in 21 (10.5%) of 200 patients. Of these, 13 were cases of azoospermia and 8 were cases of severe oligospermia. Conclusion: The markers prescribed by EAA alone are not suitable for the diagnosis of Y chromosome microdeletions in infertile males. The protocol for identification of Y chromosome microdeletions in cases of nonobstructive azoospermia/severe oligospermia would have to include a different set of STS markers. © Copyright 2011, Mary Ann Liebert, Inc.


Svirsky R.,Assaf Harofe Medical Center | Maymon R.,Assaf Harofe Medical Center | Vaknin Z.,Assaf Harofe Medical Center | Mendlovic S.,Assaf Harofe Medical Center | And 4 more authors.
Fertility and Sterility | Year: 2010

Objective: To present four cases of twin tubal pregnancies and discuss possible etiologies. Twin tubal pregnancies are a rare event, with incidence rates estimated as 1 out of 725-1,580 of tubal pregnancies. Design: Case series. Setting: Department of obstetrics and gynecology at a tertiary health care facility. Patient(s): All women with twin tubal pregnancy diagnosed and treated in the department during the years 2007-2009, according to electronic files and histologic reports. Intervention(s): None. Main Outcome Measure(s): Artificial reproductive technique preceding twin tubal pregnancies Result(s): We diagnosed four twin pregnancies of 163 tubal pregnancies, an incidence of 2.4%. Of the four cases, two conceived after gonadotropin stimulation and intrauterine insemination. The third conceived following in vitro fertilization and intracytoplasmic sperm injection. The fourth was a spontaneous conception diagnosed as monochorial monoamniotic twin tubal pregnancy. Conclusion(s): Twin tubal pregnancies may not be as rare as previously thought. Three of the four cases indentified during a 2-year period followed artificial reproductive technique. We hope that this report will promote the study of the epidemiology of this event, improve diagnosis, and encourage the development of treatment modalities. Copyright © 2010 American Society for Reproductive Medicine, Published by Elsevier Inc.


Yuksel Y.,In Vitro Fertilization Unit | Guven M.,Canakkale Onsekiz Mart University | Kaymaz B.,Canakkale Onsekiz Mart University | Sehitoglu M.H.,Canakkale Onsekiz Mart University | And 4 more authors.
Journal of Investigative Surgery | Year: 2016

Aim: The purpose of this study was to evaluate the possible protective/therapeutic effects of aloe vera (AV) on ischemia–reperfusion injury (I/R) of spinal cord in rats. Materials and Methods: A total of 28 Wistar Albino rats were divided into four random groups of equal number (n = 7). Group I (control) had no medication or surgery; Group II underwent spinal cord ischemia and was given no medication; Group III was administered AV by gastric gavage for 30 days as pre-treatment; Group IV was administered single dose intraperitoneal methylprednisolone (MP) after the ischemia. Nuclear respiratory factor-1 (NRF1), malondialdehyde (MDA) and superoxide dismutase (SOD) levels were evaluated. Tissue samples were examined histopathologically and neuronal nitric oxide synthase (nNOS) and nuclear factor-kappa B (NF-κB) protein expressions were assessed by immunohistochemical staining. Results: NRF1 and SOD levels of ischemia group were found to be lower compared to the other groups. MDA levels significantly increased after I/R. Treatment with AV and MP resulted in reduced MDA levels and also alleviated hemorrhage, edema, inflammatory cell migration and neurons were partially protected from ischemic injury. When AV treatment was compared with MP, there was no statistical difference between them in terms of reduction of neuronal damage. I/R injury increased NF-κB and nNOS expressions. AV and MP treatments decreased NF-κB and nNOS expressions.Conclusions: It was observed that aloe vera attenuated neuronal damage histopathologically and biochemically as pretreatment. Further studies may provide more evidence to determine the additional role of aloe vera in spinal cord ischemia reperfusion injury. 2016 © Taylor & Francis Group, LLC


Safar F.H.,Kuwait University | Mojiminiyi O.A.,Kuwait University | Al-Rumaih H.M.,In Vitro Fertilization Unit | Diejomaoh M.F.,Kuwait University
Clinical Chemistry | Year: 2011

BACKGROUND: Insulin resistance (IR) plays an important role in the pathogenesis of polycystic ovary syndrome (PCOS), but identification of insulin-resistant individuals is difficult. The homeostasis model assessment (HOMA), a surrogate marker of IR, is available in 2 computational models: HOMA1-IR (formula) and HOMA2-IR (computer program), which differ in incorporated physiological assumptions. This study evaluates the associations of the 2 models as markers of IR, the metabolic syndrome (MS), and PCOS. METHODS: Anthropometric, hormonal, and biochemical parameters were measured in 92 PCOS women and 110 controls. HOMA1 and HOMA2 were used to assess IR. Regression analyses were used to find the associations of the 2 models with different variables, MS, and PCOS. RESULTS: The cutoff levels for definition of IR were HOMA1-IR ≥2.9 and HOMA2-IR ≥1.7. Mean HOMA1-IR (2.79) and HOMA2-IR (1.42) differed substantially. The difference (HOMA1-IR - HOMA2-IR) was significantly correlated with insulin, fasting plasma glucose, triglycerides, HDL cholesterol, waist circumference, leptin, and adiponectin (all P < 0.05). HOMA1-IR and HOMA2-IR were significantly associated with MS (odds ratio 5.7 and 4.2, respectively) and PCOS (odds ratio 3.7 and 3.5, respectively). CONCLUSIONS: HOMA computational methods significantly affect the associations and cutoff values used for definition of IR. The correlations of the difference in the computational methods corroborate differences in captured physiological mechanisms. As precise identification of IR in PCOS patients is of practical importance, practitioners and researchers should be aware of these differences in the HOMA computational methods. © 2010 American Association for Clinical Chemistry.

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