زينب عبد الكاظم فتنان الشبلي

Background: Miscarriage is defined as the loss of a pregnancy before 20 weeks of gestation or before the fetus reaches 500 g of weight. It is estimated that 30% of all pregnancies end in abortion. 20% occurs in subclinical form (before evidencing it with ultrasound) and 10% later of his clinical detection. Objective: To assess the level of Serum CA-125 in pregnant with threatened miscarriage. Patients and method: A case control study carried at Al-Zahra Teaching Hospital in the period from 1st of October 2018 to the 1st of April 2019, in which167 pregnant respondents at 6-12 weeks of gestation (were calculated from last menstrual period), with regular cycles) were enrolled in the study, and divided into two groups: Case group (n=58) pregnant with threatened abortion and control group (n=109) normal pregnant women. Results: the mean serum level of CA-125 in case group (threatened miscarriage) was (51.2±22.9 IU/ml) and for control group was (22.3±6.7 IU/ml). It was found that the serum level of CA-125 were highly significantly increased in threatened miscarriage group than in normal healthy group (P<0.001) . In the cutoff value at (30.6 IU/dl) of serum CA-125 the sensitivity of the test to diagnose the miscarriage was (80%), sensitivity (87%), PPV (91.5%), NPV (88%) and the accuracy of the test was (83.5%). Conclusion: The level of Serum CA-125 was highly increasing in threatened miscarriage patients.

Abstract Background: Clinically during ICSI, controlled ovarian stimulation (COS) is a famous way to increase the number of mature oocytes picked up. This method must be asseeed with a substantial danger of ovarian hyper stimulation syndrome (OHSS), which occurred if follicular induction is very strong. Along with multifollicular growth, COS is also resulting in increased serum concentration of estradiol (E2) that in turn may has effect on the receptivity of the endometrium .The high serum E2 concentration through COS may resulting either with an increased chance of pregnancy or an impaired reproductive score secondary to change in endometrial receptivity. Aim of the study: to assess the impact of thickness of the endometrium at the day of hCG administration on the winning of intracytoplasmic sperm injection (ICSI) cycles. Patients and method: A retrospective study in which 235 women who were undergo one time of ICSI cycle were evaluated in this retrospective study, All patients were treated with gonadotrophin agonist either short or long protocol. The patients were according to endometrial thickness they were categorized into three groups I (<7mm), II (7-14mm), and group III (>14mm). Results: the rate of clinical pregnancy was increased in-group II (7-14mm) than other two groups depending on endometrial thickness measurement. Conclusion: endometrial thickness 7-14mm is associated with higher rate of clinical pregnancy.

Abstract Background: In addition to multi-follicular development, controlled stimulation of ovaries is associated with a high serum level of estradiol (E2).The increased serum E2 level during COS may therefore be associated either with an increased chance of pregnancy or an impaired reproductive outcome secondary to changed endometrial receptivity. Objective: to assess the effect of serum estradiol level at the day of hCG administration on the success of intracytoplasmic sperm injection (ICSI) cycles Patients and method: A retrospective study, in which a total of 235 women who were undergo a single ICSI cycle were introduced in this retrospective study, all patients were received gonadotrophin agonist either short or long protocol. The patients were classified at the day of hCG administration into three groups according to serum E2 level group A <1000pg/ml, group B 1000-3000pg/ml and group C >3000pg/ml. Results: the mean number of retrieved oocytes and embryos obtained in group C were more than in group A and B but clinical pregnancy rate was higher in group B than in group A and group C which is statistically significant. Conclusion: although there is no high quality evidence to support a positive correlation between serum E2 levels and IVF-ICSI products, the E2 level in the serum may has a level –dependent effect on the success of pregnancy. The optimal range of serum E2 is 1000-3000pg/ml is associated with higher rate of clinical pregnancy.