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O26 Consequences of oocyte dysmorphy on the fertilization rate and embryo development after intracytoplasmic sperm injection (ICSI)
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Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
at age of 31–40 years (34.2%) and 41–50 years (36.8%), stage II at age of 41–50 years (31.3%) and over 60 years (28.2%), stage III of disease at age over 60 years (50%). Survival rate in positive lymph node status (stages Ia2-IIb) was 71.3%, and 90.5% in negative. Conclusions: Stage of disease, histology type and differentation, patients age and lymph node status are significant prognostic factors in cervical cancer. These results are similar with those described in other studies, with the exception of the survival rate in patients with adenocarcinoma. O24 Novel tourniquet to reduce blood loss during abdominal myomectomy A. Ait-Allah. Faculty of Medicine-Soahag University Objective: To compare the effect of a new cervical tourniquet and the traditional tourniquet around the uterine artery on the intraoperative and postoperative blood loss during abdominal myomectomy. Design: A randomized prospective controlled trial. Materials and Methods: Sixty patients with uterine myomata were enrolled in this study and allocated equally into two groups (30 patients each). In group I, A Vicryl number 1 suture was tied around the internal os of the cervix to occlude the ascending branch of the uterine artery and remained in situ at the end of the operation. In group II, a Foley’s catheter was tied around the cervix and released at the end of the operation. The operation time was calculated from skin incision to skin closure. Hemoglobin level was measured preoperative and immediately postoperative to estimate blood loss during the operation. Postoperative observation and complications were recorded. Postoperative blood loss was estimated by the amount of blood in the intra-peritoneal drain and Hemoglobin level after 48 hours. Results: Both groups were comparable regarding patients characteristics, clinical presentations and characters of fibroid The operation time was significantly longer in groupie than in group I (87±21 versus 74±18 minutes, P < 0.05). Immediate postoperative hemoglobin level was significantly lower in group II than in group I (9.7±0.6 g/dl versus 10.2±0.4 g/dl, P < 0.05). The amount of blood in the intra-peritoneal drain after 48 hours was significantly higher in group II than in group I (60±6.3 ml versus 25±2.4 ml, P < 0.05). In addition hemoglobin level after 48 hours was significantly lower in group II than in group I (9.3±0.4 Vs10±0.5, P < 0.05). Postoperative morbidities were encountered in few cases in both groups with no significant difference. Conclusion: The use of a semiperminent tourniquet is a simple and effective method for reducing intraoperative and postoperative blood loss in abdominal myomectomy. O25 Analysis of the status of low sex hormone-binding globulin in obese patients with polycystic ovary syndrome (PCOS) M. Ajina1 , N. Chaouach2 , M. Zaouali2 , Z. Tabka2 , A. Saad. 1 Unity of Medicine of Reproduction University Hospitol F Hached, 2 Laboratory of Physiology and Functional Exploration, Sousse, Tunisia Introduction: The aim of the study was to compare the body fat distribution of women with polycystic ovary syndrome (PCOS) with age and body mass index matched healthy controls and to investigate if androgens and insulin resistance associated with fat distribution. Methods: Thirty PCOS women were evaluated in terms of body mass index (BMI). Blood samples were obtained for follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEA-S), total testosterone, sex hormone binding globulin (SHBG), insulin and glucose levels. Insulin resistance was estimated by HOMA IR. The proportioning of the hormones was made by the immunological radio technique.
Results: BMI were significantly higher in patients with PCOS (p < 0.05). Total testosterone was found to be positively correlated with fat BMI (r = 0.401, p < 0.05). There was still significant correlation between total testosterone and SHBG after controlling for age and BMI. Low sex hormone-binding globulin was found in obese women with PCOS. Conclusion: Total testosterone and SHBG levels are positively correlated with the BMI in women with PCOS. O26 Consequences of oocyte dysmorphy on the fertilization rate and embryo development after intracytoplasmic sperm injection (ICSI) M. Ajina1 , J. Othman, S. Boughizane, A. Saad. 1 Unit of Medicine of the Reproduction, University Hospital F. Hached, Sousse, Tunisia Introduction: Abnormal mopholology of human oocyte is highly correlated with lower fertilization rates and impaired embryonic development. The aim of our study is to determine the type of abnormal oocyte is Correlated with the impaired embryos Methods: Tow hundred and two couples have been included during 223 ICSI cycles, and 1470 oocytes have been studied. After decoronisation, 8 morphological criteria, including the size and shape of the oocyte, the zona pellucida and the appearance of the cytoplasm and polar body have been noted. One studied also the influence of the hormonal profile of the woman as well as the day number of the FSH administered on the rate of follicular maturation. Results: In total 61.3% of the oocytes presented a dysmorphy, involving, almost equally, the different oocyte compartments. Among the dysmorphic oocytes, half presented more than one anomaly. On average, 9.2% of the oocytes were lysed the day after the micro-injection. The day after micro-injection, 61.3% of the intact oocytes were fertilized. The rate of fertilization was correlated to the number of abnormalities per oocyte: 1 anomaly: 64.6%; 3 anomalies: 54.6%. We did not see any statistically significant difference between the different types of oocytes concerning embryonic culture. Conclusion: The oocyte of poor quality may represent a disturbed hormonal balance and by consequence affect fertilization rates and embryonic development. O27 Early-onset preeclampsia – Do corticosteroids modify progression of disease process O. Akinola1 , A. Fabamwo1 , A. Tayo1 , A. Akinola2 , R. Awobusuyi1 , B. Shakunle3 , Y. Oshodi4 . 1 Society of Gynaecology and Obstetrics of Nigeria, 2 Radiology Society of North America, 3 Association of Medical Lab. Scientists of Nigeria, 4 Association of Resident Doctors Background: Preeclampsia remains a major cause of feto-maternal morbidity and mortality worldwide. No definitive cause has been identified but the pathogenesis is multifactorial involving coagulation, vascular reactivity or an abnormal immunological reaction between mother and fetus. Delivery is the accepted treatment of preeclampsia but when the pathology develops at an early gestational age, universal protocol is to delay delivery to increase chance of fetal survival without impairing the maternal health. Corticosteroids have been employed to effect fetal lung maturity and improve fetal survival. Hypertension and proteinuria are cardinal manifestation of the disease. It was observed serendipitously that the amount of proteinuria reduced in our practice after administration of corticosteroids. Objective: This study was designed to investigate whether corticosteroids administered to preeclamptics, functionally or structurally affect organs or systems enough, to modify the course of the disease process.
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
at age of 31–40 years (34.2%) and 41–50 years (36.8%), stage II at age of 41–50 years (31.3%) and over 60 years (28.2%), stage III of disease at age over 60 years (50%). Survival rate in positive lymph node status (stages Ia2-IIb) was 71.3%, and 90.5% in negative. Conclusions: Stage of disease, histology type and differentation, patients age and lymph node status are significant prognostic factors in cervical cancer. These results are similar with those described in other studies, with the exception of the survival rate in patients with adenocarcinoma. O24 Novel tourniquet to reduce blood loss during abdominal myomectomy A. Ait-Allah. Faculty of Medicine-Soahag University Objective: To compare the effect of a new cervical tourniquet and the traditional tourniquet around the uterine artery on the intraoperative and postoperative blood loss during abdominal myomectomy. Design: A randomized prospective controlled trial. Materials and Methods: Sixty patients with uterine myomata were enrolled in this study and allocated equally into two groups (30 patients each). In group I, A Vicryl number 1 suture was tied around the internal os of the cervix to occlude the ascending branch of the uterine artery and remained in situ at the end of the operation. In group II, a Foley’s catheter was tied around the cervix and released at the end of the operation. The operation time was calculated from skin incision to skin closure. Hemoglobin level was measured preoperative and immediately postoperative to estimate blood loss during the operation. Postoperative observation and complications were recorded. Postoperative blood loss was estimated by the amount of blood in the intra-peritoneal drain and Hemoglobin level after 48 hours. Results: Both groups were comparable regarding patients characteristics, clinical presentations and characters of fibroid The operation time was significantly longer in groupie than in group I (87±21 versus 74±18 minutes, P < 0.05). Immediate postoperative hemoglobin level was significantly lower in group II than in group I (9.7±0.6 g/dl versus 10.2±0.4 g/dl, P < 0.05). The amount of blood in the intra-peritoneal drain after 48 hours was significantly higher in group II than in group I (60±6.3 ml versus 25±2.4 ml, P < 0.05). In addition hemoglobin level after 48 hours was significantly lower in group II than in group I (9.3±0.4 Vs10±0.5, P < 0.05). Postoperative morbidities were encountered in few cases in both groups with no significant difference. Conclusion: The use of a semiperminent tourniquet is a simple and effective method for reducing intraoperative and postoperative blood loss in abdominal myomectomy. O25 Analysis of the status of low sex hormone-binding globulin in obese patients with polycystic ovary syndrome (PCOS) M. Ajina1 , N. Chaouach2 , M. Zaouali2 , Z. Tabka2 , A. Saad. 1 Unity of Medicine of Reproduction University Hospitol F Hached, 2 Laboratory of Physiology and Functional Exploration, Sousse, Tunisia Introduction: The aim of the study was to compare the body fat distribution of women with polycystic ovary syndrome (PCOS) with age and body mass index matched healthy controls and to investigate if androgens and insulin resistance associated with fat distribution. Methods: Thirty PCOS women were evaluated in terms of body mass index (BMI). Blood samples were obtained for follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEA-S), total testosterone, sex hormone binding globulin (SHBG), insulin and glucose levels. Insulin resistance was estimated by HOMA IR. The proportioning of the hormones was made by the immunological radio technique.
Results: BMI were significantly higher in patients with PCOS (p < 0.05). Total testosterone was found to be positively correlated with fat BMI (r = 0.401, p < 0.05). There was still significant correlation between total testosterone and SHBG after controlling for age and BMI. Low sex hormone-binding globulin was found in obese women with PCOS. Conclusion: Total testosterone and SHBG levels are positively correlated with the BMI in women with PCOS. O26 Consequences of oocyte dysmorphy on the fertilization rate and embryo development after intracytoplasmic sperm injection (ICSI) M. Ajina1 , J. Othman, S. Boughizane, A. Saad. 1 Unit of Medicine of the Reproduction, University Hospital F. Hached, Sousse, Tunisia Introduction: Abnormal mopholology of human oocyte is highly correlated with lower fertilization rates and impaired embryonic development. The aim of our study is to determine the type of abnormal oocyte is Correlated with the impaired embryos Methods: Tow hundred and two couples have been included during 223 ICSI cycles, and 1470 oocytes have been studied. After decoronisation, 8 morphological criteria, including the size and shape of the oocyte, the zona pellucida and the appearance of the cytoplasm and polar body have been noted. One studied also the influence of the hormonal profile of the woman as well as the day number of the FSH administered on the rate of follicular maturation. Results: In total 61.3% of the oocytes presented a dysmorphy, involving, almost equally, the different oocyte compartments. Among the dysmorphic oocytes, half presented more than one anomaly. On average, 9.2% of the oocytes were lysed the day after the micro-injection. The day after micro-injection, 61.3% of the intact oocytes were fertilized. The rate of fertilization was correlated to the number of abnormalities per oocyte: 1 anomaly: 64.6%; 3 anomalies: 54.6%. We did not see any statistically significant difference between the different types of oocytes concerning embryonic culture. Conclusion: The oocyte of poor quality may represent a disturbed hormonal balance and by consequence affect fertilization rates and embryonic development. O27 Early-onset preeclampsia – Do corticosteroids modify progression of disease process O. Akinola1 , A. Fabamwo1 , A. Tayo1 , A. Akinola2 , R. Awobusuyi1 , B. Shakunle3 , Y. Oshodi4 . 1 Society of Gynaecology and Obstetrics of Nigeria, 2 Radiology Society of North America, 3 Association of Medical Lab. Scientists of Nigeria, 4 Association of Resident Doctors Background: Preeclampsia remains a major cause of feto-maternal morbidity and mortality worldwide. No definitive cause has been identified but the pathogenesis is multifactorial involving coagulation, vascular reactivity or an abnormal immunological reaction between mother and fetus. Delivery is the accepted treatment of preeclampsia but when the pathology develops at an early gestational age, universal protocol is to delay delivery to increase chance of fetal survival without impairing the maternal health. Corticosteroids have been employed to effect fetal lung maturity and improve fetal survival. Hypertension and proteinuria are cardinal manifestation of the disease. It was observed serendipitously that the amount of proteinuria reduced in our practice after administration of corticosteroids. Objective: This study was designed to investigate whether corticosteroids administered to preeclamptics, functionally or structurally affect organs or systems enough, to modify the course of the disease process.