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Gap junctional proteins connexin in myomatous uterus and normal uterus effect of treatment with gonadotropin-releasing hormone agonist decapeptyl 3.75
and BMD were performed using simple regression analysis. In addition, correlation of BMI and FSH levels were done. Results: The average age of our subjects was 52.5 +- 4 years, with an mean BMI of 26.2 2 5 kg/m’. The mean FSH level was 74.7 & 27 ID/L, and the average time from last menstrual period was 3.2 + 1.5 years. Body mass index and FSH were positively correlated (r = 0.38; P
GAP JUNCTIONAL PROTEINS CONN-EXININ MYOMATOUSUTERUS AND NORMAL UTERUSEFFECTOF TREATMENTWITH GONADOTROPINRELEASINGHORMONEAGONIST DECAPEXVL 3.75 Ali Farid M. Ali, MD,” Alaa El-Tobgy, MD, Hoda Abd El-Aziz, MD, Sanaa El-Shayeb, MD, Mohamed Hassan, MD, and Abd El-Azeem Sarhan, MD “Ain ShamsUniversity Hospital, Cairo, Egypt
Objective: Gap junctions have been demonstrated to be very important for control of growth of organs and tissues. They are formed by proteins named connexins. Gap junctions may play a role in regulation of uterine tissue growth and remodeling. The aim of this work is to study the role of gap junction in the myoma formation and to know the effect of treatment with gonadotropin-releasing hormone (GnRH) agonist on the gap junctional protein connexin. Subject and method: Ten patients having multiple myoma and 10 cases as control were enrolled in the study for study of gap junctional protein connexin Cx 26, Cx 32, and Cx 43. A laparoscopic biopsy was taken from the myoma and from myometrium; GnRH agonist treatment was started 5 months second-look laparoscopy was done. Laparoscopic biopsy was taken, and the biopsy samples were examined for Cx 26, Cx 32, and Cx 43. Tissue section were fixed in formalin solution and embedded in paraffin, and Cx 26, Cx 32, and Cx 43 were immunolocalized by using specific antibodies. Results: Statistical significant increase in gap junctional protein connexin Cx 26, Cx 32, and Cx 43 is noted in myomata of myomatous uterus than in normal and in myometrium of myomatous uterus and control (P < 0.05 and P < 0.001, respectively). There was a statistically significant decrease in gap junction protein connexin in myomatous uterus after treatment with G&II agonist (decapeptyl 3.75); this illustrates a new mechanism of action GnRI-I agonists in myoma reduction.
28s
Monday Posters
NEW RATIO: ENDOMETRIAL FLUID COLLECTION/PERITONEAL FLUID ACCUMULATION IN CUL DE SAC AND ITS IMPLICATIONS IN HUMAN REPRODUCTION Ali Farid M. Ali, MD,* Alaa El-Tobgy, MD, Hoda Abd El-Aziz, MD, Sanaa El-Shayeb,MD, Magd El Din, MD, and Abd El-Azeem Sarhan, MD *Ain Shams University Hospital, Cairo, Egypt
Introduction: Endometrial fluid accumulation in women with hydrosalpinx has been previously reported. A mechanical barrier for embryo apposition to the endometrial has been postulated, and some consideration has been given to embryo toxicity by the fluid. The presence of endometrial fluid accumulation in women with no hydrosalpinx undergoing ovarian stimulation has not been previously reported. Ovulation triggered iatrogenically or spontaneously is the only mechanism known to cause increased permeability, which is responsible for third-space fluid accumulation, but peritoneal fluid accumulation may be observed in the posterior cul de sac before human chorionic gonadotropin (hCG) injection, especialIy in cycles with impending ovarian hyperstimulation. Aim of the work 1) To put a new ratio: endometrial fluid collection/peritoneal fluid accumulation in cul de sac; and 2) its implication for the detection of pregnancy rate, implantation rate, clinical pregnancy rate, and hyperstimulation syndrome (OHSS). Subject and methods: Thirty cases that had undergone in vitro fertilization were enrolled in the study for detection of endometrial fluid and peritoneal fluid accumulation. None of the women had hydrosalpinx, as documented by normal hysterosalpingography or laparoscopy immediately prior to treatment. Both endometrial fluid and peritoneal fluid accumulate were observed by transvaginal ultrasound; patients with peritoneal fluid accumulation on the first day of the cycle were excluded. High estradiol concentration of more than 3,000 pg/mL, enlarged ovaries over 5 cm, and multiple follicles (n >lO; ~7 mm) on the day of hCG administration were considered as parameters of OHSS risk. Results: A ratio of more than 1 is correlated with poor implantation and pregnancy rate. A ratio of less than 1 is correlated with hyperstimulation syndrome and high implantation rate and pregnancy rate. The sensitivity was 78.5%, specificity was 88.2%, and positive predictive value was 86.5%. Conclusion: Endometrial fluid collection is correlated with poor pregnancy rate; peritoneal fluid accumulation prior to hCG as detected with ultrasound is useful finding for prediction of moderate to severe OHSS and had significantly higher implantation and clinical pregnancy rates.
Obstetrics 6 Gynecology
GAP JUNCTIONAL PROTEINS CONN-EXININ MYOMATOUSUTERUS AND NORMAL UTERUSEFFECTOF TREATMENTWITH GONADOTROPINRELEASINGHORMONEAGONIST DECAPEXVL 3.75 Ali Farid M. Ali, MD,” Alaa El-Tobgy, MD, Hoda Abd El-Aziz, MD, Sanaa El-Shayeb, MD, Mohamed Hassan, MD, and Abd El-Azeem Sarhan, MD “Ain ShamsUniversity Hospital, Cairo, Egypt
Objective: Gap junctions have been demonstrated to be very important for control of growth of organs and tissues. They are formed by proteins named connexins. Gap junctions may play a role in regulation of uterine tissue growth and remodeling. The aim of this work is to study the role of gap junction in the myoma formation and to know the effect of treatment with gonadotropin-releasing hormone (GnRH) agonist on the gap junctional protein connexin. Subject and method: Ten patients having multiple myoma and 10 cases as control were enrolled in the study for study of gap junctional protein connexin Cx 26, Cx 32, and Cx 43. A laparoscopic biopsy was taken from the myoma and from myometrium; GnRH agonist treatment was started 5 months second-look laparoscopy was done. Laparoscopic biopsy was taken, and the biopsy samples were examined for Cx 26, Cx 32, and Cx 43. Tissue section were fixed in formalin solution and embedded in paraffin, and Cx 26, Cx 32, and Cx 43 were immunolocalized by using specific antibodies. Results: Statistical significant increase in gap junctional protein connexin Cx 26, Cx 32, and Cx 43 is noted in myomata of myomatous uterus than in normal and in myometrium of myomatous uterus and control (P < 0.05 and P < 0.001, respectively). There was a statistically significant decrease in gap junction protein connexin in myomatous uterus after treatment with G&II agonist (decapeptyl 3.75); this illustrates a new mechanism of action GnRI-I agonists in myoma reduction.
28s
Monday Posters
NEW RATIO: ENDOMETRIAL FLUID COLLECTION/PERITONEAL FLUID ACCUMULATION IN CUL DE SAC AND ITS IMPLICATIONS IN HUMAN REPRODUCTION Ali Farid M. Ali, MD,* Alaa El-Tobgy, MD, Hoda Abd El-Aziz, MD, Sanaa El-Shayeb,MD, Magd El Din, MD, and Abd El-Azeem Sarhan, MD *Ain Shams University Hospital, Cairo, Egypt
Introduction: Endometrial fluid accumulation in women with hydrosalpinx has been previously reported. A mechanical barrier for embryo apposition to the endometrial has been postulated, and some consideration has been given to embryo toxicity by the fluid. The presence of endometrial fluid accumulation in women with no hydrosalpinx undergoing ovarian stimulation has not been previously reported. Ovulation triggered iatrogenically or spontaneously is the only mechanism known to cause increased permeability, which is responsible for third-space fluid accumulation, but peritoneal fluid accumulation may be observed in the posterior cul de sac before human chorionic gonadotropin (hCG) injection, especialIy in cycles with impending ovarian hyperstimulation. Aim of the work 1) To put a new ratio: endometrial fluid collection/peritoneal fluid accumulation in cul de sac; and 2) its implication for the detection of pregnancy rate, implantation rate, clinical pregnancy rate, and hyperstimulation syndrome (OHSS). Subject and methods: Thirty cases that had undergone in vitro fertilization were enrolled in the study for detection of endometrial fluid and peritoneal fluid accumulation. None of the women had hydrosalpinx, as documented by normal hysterosalpingography or laparoscopy immediately prior to treatment. Both endometrial fluid and peritoneal fluid accumulate were observed by transvaginal ultrasound; patients with peritoneal fluid accumulation on the first day of the cycle were excluded. High estradiol concentration of more than 3,000 pg/mL, enlarged ovaries over 5 cm, and multiple follicles (n >lO; ~7 mm) on the day of hCG administration were considered as parameters of OHSS risk. Results: A ratio of more than 1 is correlated with poor implantation and pregnancy rate. A ratio of less than 1 is correlated with hyperstimulation syndrome and high implantation rate and pregnancy rate. The sensitivity was 78.5%, specificity was 88.2%, and positive predictive value was 86.5%. Conclusion: Endometrial fluid collection is correlated with poor pregnancy rate; peritoneal fluid accumulation prior to hCG as detected with ultrasound is useful finding for prediction of moderate to severe OHSS and had significantly higher implantation and clinical pregnancy rates.
Obstetrics 6 Gynecology