Efficacy of dienogest vs combined oral contraceptive on pain associated with endometriosis: Randomized clinical trial.

Objective: To compare the efficacy of dienogest with the combined oral contraceptive pill (COC) Yasmin for the control of endometriosis-associated pelvic pain.

Study Design: Seventy women with endometriosis-associated chronic pelvic pain, dysmenorrhoea or both for >6 months were randomized to either dienogest (Visanne) 2 mg/day or monophasic COC (Yasmin, 0.03 mg ethinyl estradiol and 3 mg drospirenone) for 24 weeks.

Towards the selection of embryos with the greatest implantation potential.

Choosing the most suitable embryo remains challenging as the standard approach to select top-quality embryos for transfer rely on static morphological assessment. It is completed after fertilisation, on days 3 and 5 post oocyte retrieval and evaluates the size and number of blastomeres, presence of nucleation and percentage of fragmentation for cleavage stage embryos. Because of the limited number of observations during the morphological assessment, morphokinetic development of embryos has been implemented.

Novel Physiology and Definition of Poor Ovarian Response; Clinical Recommendations.

Poor ovarian response (POR) to controlled ovarian stimulation (OS) presents a major challenge in assisted reproduction. The Bologna criteria represented the first serious attempt to set clear criteria for the definition of POR. However, the Bologna criteria were questioned because of the persistent heterogeneity among POR patients and the inability to provide management strategies.

Cumulative Live-Birth Rates by Maternal Age after One or Multiple In Vitro Fertilization Cycles: An Institutional Experience.

Background: The aim of this retrospective study is to investigate the cumulative live birth rate (CLBR) following one or more completed fertilization (IVF) cycles (up to 6 cycles) stratified by maternal age and type of infertility.

Materials And Methods: In this retrospective study, five hundred forty-seven women who received 736 fresh ovarian stimulation/embryo transfer cycles between January 2016 and December 2016 were included in the study at a tertiary care center located in Lebanon.

Results: In all women, the live birth rate for the first cycle was 33.

Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures: a randomized clinical trial.

Background: Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO) to insufflate the abdomen is the main contributor to post-operative shoulder pain.

Methods: We aim to assess the effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures.

The effect of religious background on the attitude towards sex selection.

Objectives: Surveys of the general population regarding sex selection using pre-implantation genetic diagnosis are limited and were mainly conducted in the United States and Northern Europe. In those Western societies, surveys have shown that people's interest in using sex selection techniques is encouraged by the desire for a sexually balanced family. It is important to determine attitudes to sex selection in a wider range of countries especially that cultural differences exist among countries.

Vaginoscopic resection of vaginal septum.

We report the resection of a vaginal septum while preserving the virginity of a 12-year-old girl with Herlyn-Werner-Wunderlich Syndrome (HWWS) having a didelphys uterus, obstructed hemivagina, and an ipsilateral renal agenesis with follow-up at 18 months. Successful resection of the vaginal septum with conservation of the hymenal ring and complete drainage of both the hematocolpos and the hematometra were achieved. Cyclic dysmenorrhea and pelvic pain were completely resolved on follow-up visits at 4, 6, and 18 months.

Effect of female nargile smoking on in vitro fertilization outcome.

Objective: Smoking is a significant health hazard that has been associated with poor reproductive outcome and reduced fertility in reproductive age women. The aim of this study was to assess the effect of nargile smoking on intra-cytoplasmic sperm injection (ICSI) outcome.

Study Design: A prospective analysis of the outcomes of 297 women who underwent ICSI treatment at the ART Unit at the American University of Beirut Medical Center between January 1, and December 31, 2006 was done.

Addition of sphingosine-1-phosphate to human oocyte culture medium decreases embryo fragmentation.

Apoptosis is implicated in the fragmentation of preimplantation mammalian embryos, yet the extent of this association remains controversial. The aim of this study was to assess the ability of sphingosine-1-phosphate (S1P), a known anti-apoptotic substance, to reduce the fragmentation rate of human preimplantation embryos when added to their culture microenvironment. Mature human oocytes were inseminated using intracytoplasmic sperm injection, incubated for 3 days and evaluated for embryo quality and fragmentation by the same embryologist.

Effect of religion on the attitude of primiparous women toward genetic testing.

Background: Factors that influence a pregnant woman's decision to accept or decline genetic tests are largely undefined. The objective of this study was to determine the acceptance rate of prenatal diagnostic testing in Lebanon according to religion.

Methods: Prenatal charts were reviewed to obtain information about prenatal genetic testing.

Two dose regimens of nifedipine for management of preterm labor: a randomized controlled trial.

We compared two dose regimens of tocolytic oral nifedipine. Women with singleton pregnancies admitted in preterm labor (24 to 34 weeks) were randomized to high-dose (HD) nifedipine ( N = 49; 20 mg loading dose, repeated in 30 minutes, daily 120 to 160 mg slow-release nifedipine for 48 hours followed by 80 to 120 mg daily until 36 weeks) or low-dose (LD) nifedipine ( N = 53; 10 mg, up to four doses every 15 minutes, daily 60 to 80 mg slow-release nifedipine for 48 hours followed by 60 mg daily until 36 weeks). Uterine quiescence at 48 hours (primary outcome); delivery at 48 hours, 34 and 37 weeks; and recurrent preterm labor were similar.

Effect of powdered gloves, worn at the time of embryo transfer, on the pregnancy outcome of IVF cycles.

Purpose: To assess the effect of wearing powdered gloves during embryo transfer as compared to un-powdered gloves on the pregnancy outcome of IVF cycles.

Methods: Patients, undergoing embryo transfer procedures, were prospectively randomized into two groups: In the first (group A, n=356) group embryo transfer was performed while wearing powdered gloves; in the second (group B, n=356) group embryo transfer was performed while wearing un-powdered gloves. The primary end point of the study was the clinical pregnancy rate.

Effect of 1-month war in Lebanon on sex ratio.

Our study showed no effect of 33-day war in Lebanon on sex ratio. More research is needed to explore other modifying factors for a better understanding of the complex effect of wars on sex ratio changes.

Shoulder dystocia: what is the risk of recurrence?

Objective: To study the recurrence risk of shoulder dystocia in women who have previously experienced at least once shoulder dystocia.

Design: A retrospective study of vaginal deliveries complicated by shoulder dystocia. Setting.

Effect of betadine vaginal preparation during oocyte aspiration in in vitro fertilization cycles on pregnancy outcome.

Objective: The objective of this study is to assess the effect of two methods of vaginal scrubbing before egg retrieval on the outcome of in vitro fertilization-embryo transfer (IVF-ET) cycles.

Method: 721 consecutive cycles of IVF-ET, at the American University Hospital of Beirut, were randomized prospectively into one of two groups. In the study group the betadine used to scrub the vagina, prior to egg retrieval, was not washed out, whereas in the control group this betadine was cleansed by saline irrigation.

Attitude of women with IVF and spontaneous pregnancies towards prenatal screening.

Background: Factors influencing a pregnant woman's decision to accept prenatal testing are largely undefined. Our study aimed to compare the acceptance rate of prenatal diagnosis in women who conceived through IVF or ICSI (cases) with that of women who conceived spontaneously (controls).

Methods: Retrospective chart review in Lebanon of all primiparas carrying singletons who were offered prenatal testing (triple screen/amniocentesis) from 2004-2007.

Effect of war on fertility: a review of the literature.

The aim of this study was to review the existing literature on the effect of war on female and male fertility. A MEDLINE search for studies that included participants defined as infertile because they were unsuccessful in achieving a pregnancy after a year and studies that assessed the effect of war on semen parameters and menstrual dysfunction were performed. Twenty articles were included in this review.

Effect of the Lebanese civil war on sex ratio.

Sex ratio is a subject of scientific interest but little is known about the factors that affect the sex ratio of humans. The aim of this study was to assess the effect of the Lebanese civil war on sex ratio. Data on all live births delivered at a large university hospital for the years 1977-2005 were used in this study.

Obstetric outcome of teenage pregnancies compared with adult pregnancies.

Background: To compare the obstetric outcome of teenage pregnancies with that of older women.

Methods: Retrospective chart review of singleton births > or =24 weeks' gestational age at the American University of Beirut from 1994 to 2003. Adolescents (<20 years) were compared to subsequently delivered women aged 25-30 years (controls), n=486 each.

Occupational and environmental exposures to heavy metals: risk factors for male infertility in Lebanon?

A case-control study was conducted to examine whether occupational or environmental exposures, particularly to heavy metals, are associated with male infertility in Lebanon, a war-torn country with a history of environmental degradation. Seventy-four infertile cases and 76 fertile controls were selected from 2 major fertility clinics in Beirut. Data collection involved risk-factor interviews, semen analysis, and blood collection for heavy metal analysis.

Effect of the Lebanese civil war on sperm parameters.

Objective: To assess the effect of the Lebanese civil war on sperm parameters.

Design: Retrospective review of patient records.

Setting: Males providing semen samples at a university laboratory.

Civil war and male infertility in Lebanon.

Objective: To investigate the long-term impacts of the 15-year Lebanese civil war on male infertility.

Design: Clinic-based, case-control study, using reproductive history and risk factor interview data and laboratory-based semen analysis.

Setting: Two IVF clinics in Beirut, Lebanon, during an 8-month period (January-August 2003).

In vitro fertilization in two patients with Kartagener's syndrome and infertility.

Women with Kartagener's syndrome (KS) are at a risk for infertility because of the dyskinetic ciliary activity in the fallopian tubes. In vitro fertilization - embryo transfer (IVF-ET) is considered the treatment of choice for patients with tubal factor infertility. In the literature only 2 patients with KS were treated with IVF-ET, with only one pregnancy achieved.

Effect of 17alpha-hydroxyprogesterone caproate before embryo transfer on the outcome of in vitro fertilization and embryo transfer: a randomized trial.

Objective: To assess the effect of 17alpha-hydroxyprogesterone caproate (17-HPC) given before embryo transfer on the pregnancy outcome of IVF-embryo transfer (ET) cycles.

Design: Randomized controlled study.

Setting: A university-based hospital IVF unit.