Diagnostic Value of Hysterosalpingography and Laparoscopy for Tubal Patency in Infertile Women

Background: Tubal occlusion is one of the most frequent causes of infertility in women. The evaluation of the fallopian tube is necessary to determine the management plan for infertility. The two most important diagnostic procedures which are used for the evaluation of tubal patency are hysterosalpingography (HSG) and laparoscopy. Objectives: The aim of this study was to compare HSG and laparoscopic findings in the diagnosis of tubal patency. Patients and Methods: In a prospective study sixty two infertile cases were examined by HSG as part of their routine infertility evaluation, three months after HSG, tubs status were assessed by laparoscopy as a gold standard method. The findings of HSG and laparoscopy were compared. The Laparoscopy findings were used as reference standard to calculate sensitivity, specificity, positive and negative predictive values for unilateral and bilateral no tubal patency. Results: The sensitivity and specificity of HSG on bilateral tubal patency or no bilateral tubal patency were 92.1% and 85.7% respectively. The positive and negative predictive values were 97.2% and 66.7%, and the accuracy was 91.1%. The sensitivity and specificity of HSG for evaluation of the bilateral tubal patency and unilateral or bilateral no tubal patency were 77.8% and 52.94%, the positive and negative predictive values were 81.4% and 47.4% respectively, and the accuracy was 71%. Conclusion: HSG is considered to have a high sensitivity and specificity. HSG and laparoscopy are not alternative, but are the complementary methods in the examination of no tubal patency

The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome

This study was conducted to determine the effects of omega-3 fatty acids and vitamin E cosupplementation on gene expression of lipoprotein(a) (Lp[a]) and oxidized low-density lipoprotein (Ox-LDL), lipid profiles and biomarkers of oxidative stress in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18e40 years old. Participants were randomly assigned into two groups to receive either 1000 mg omega-3 fatty acids from flaxseed oil containing 400 mg a- Linolenic acid plus 400 IU vitamin E supplements (n ¼ 34) or placebo (n ¼ 34) for 12 weeks. Lp(a) and Ox-LDL mRNA levels were quantified in peripheral blood mononuclear cells of PCOS women with RT-PCR method. Lipid profiles and biomarkers of oxidative stress were quantified at the beginning of the study and after 12-week intervention. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids and vitamin E co-supplementation downregulated expressed levels of Lp(a) mRNA (P < 0.001) and Ox-LDL mRNA (P < 0.001) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo group, omega-3 fatty acids and vitamin E cosupplementation resulted in a significant decrease in serum triglycerides (�22.1 ± 22.3 vs. þ7.7 ± 23.6 mg/dL, P < 0.001), VLDL- (�4.4 ± 4.5 vs. þ1.5 ± 4.7 mg/dL, P < 0.001), total- (�20.3 ± 16.6 vs. þ12.2 ± 26.1 mg/dL, P < 0.001), LDL- (�16.7 ± 15.3 vs. þ11.9 ± 26.1 mg/dL, P < 0.001) and total-/HDLcholesterol (�0.5 ± 0.6 vs. þ0.4 ± 0.8, P < 0.001). There were a significant increase in plasma total antioxidant capacity (þ89.4 ± 108.9 vs. þ5.9 ± 116.2 mmol/L, P ¼ 0.003) and a significant decrease in malondialdehyde levels (�0.3 ± 0.4 vs. -0.008 ± 0.6 mmol/L, P ¼ 0.01) by combined omega-3 fatty acids and vitamin E intake compared with the placebo group. Overall, omega-3 fatty acids and vitamin E cosupplementation for 12 weeks in PCOS women significantly improved gene expression of Lp(a) and Ox- LDL, lipid profiles and biomarkers of oxidative stress

Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study

The aim of this study was to compare pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome (PCOS) with healthy women. A prospective cohort study from the beginning to the end of pregnancy for 41 pregnant women with PCOS (case) and 49 healthy pregnant women (control) was completed. Based on the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA), and polycystic ovaries (PCO) on ultrasound, the PCOS (case) group were divided into three phenotypes (HA + PCO (  = 22), M + PCO (  = 9), HA + M+PCO (  = 10). Pre-eclampsia, gestational diabetes, and lower birth weight among newborns were significantly higher in the PCOS case group compared to the control group especially in the phenotype HA + M+PCO (  < .05). High BMI (  = 2.40; =.03) was the strongest predictor of pre-eclampsia in patients with PCOS. High androgen levels (free androgen index) (  = 13.71, 3.02;  < .05), was the strongest predictor of developing diabetes during pregnancy and reduced birth weight baby, respectively.These results suggest that PCOS, particularly in phenotype HA + M+PCO (  < .05), is a risk factor for adverse pregnancy and neonatal outcomes including gestational diabetes, pre-eclampsia, and reduced weight babies

Acute Myocardial Infarction Due to Dissection of the Coronary Arteries Associated with Premature Atherosclerosis in Late Postpartum: A Case Report of Maternal Death

AbstractIntroduction: Atherosclerotic coronary artery disease is the most common form of heart disease that is associated with high rates of acute myocardial infarction (AMI) and death in young people.Methods: Given the importance of pregnancy and the postpartum period and the fact that AMI is associated with poor maternal outcomes in postpartum, the present study reports acute myocardial infarction due to dissection of the coronary arteries associated with premature atherosclerosis in late postpartum.Results: The case was the maternal death of a 34-year-old woman at 42 days postpartum without any history of underlying diseases or symptoms, whose autopsy report read AMI due to coronary artery dissection associated with atherosclerosis.Conclusions: This report emphasizes the importance of postpartum care and attention to any symptoms witnessed during this period