الفهرس 
Unexplained InfertilityOnly 14 pages are availabe for public view
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Abstract
Unexplained infertility represents a significant
clinical problem, the evaluation and management of which
leave a lot to be desired. The lack of universally accepted
diagnostic criteria makes it difficult to study this problem
because of the heterogeneity in the samples selected for
study. Agreement on the definitions is a first step in this
process of creating homogeneous groups for study.
The Practice Committee of the American Society for
Reproductive Medicine (ASRM) has published guidelines
for a standard infertility evaluation. It includes semen
analysis, assessment of ovulation, hysterosalpingiogram,
and laparoscopy. When the results of a standard infertility
evaluation are normal, practitioners assign a diagnosis of
unexplained infertility. Although estimates vary, the
likelihood that all test results for an infertile couple are
normal (i.e. the couple has unexplained infertility) is
approximately 15% to 30%.
Couples should then undergo comprehensive
evaluation, before decisions regarding treatment can be
made. Agreement on this process among investigators will
improve the understanding of this disorder and will pave
the way for more valid and useful studies on treatment
efficacy. Infertility affects about 13% to 15% of couples
worldwide and unexplained infertility represents one of the
most common diagnoses in the field of fertility care.
Unexplained infertility accounts is approximately 15% to
30%.
The definition, valuable diagnostic approach and
appropriate management among women with unexplained
infertility remain controversial. Appropriate diagnostic
testing of novel causes for unexplained infertility may
decrease the percentage of patients suffering unexplained
infertility.
H. pylori is a Gram-negative bacterium responsible
for the large majority of chronic gastritis, peptic ulcers and
mucosal-associated lymphoid tissue (MALT) lymphoma.
The pathogenicity of H. pylori infection depend on the
inflammatory response to chronic infection, which is
thought to be determined by many factors, including the
strain-specific factors, the host’s immune response, and
environmental factors.
Four studies, suggested that sero-positivity for
H. pylori infection was higher in women with infertility
than in fertile and one study concluded that no statistically
significant differences between patients with unexplained
infertility and fertile women. No published data regarding the association of unexplained infertility with quantitative
IgG of H.pylori were available. The aim of the current
study was to assess the association between H. pylori
infection and unexplained infertility.
As mentioned before, No published data regarding
the association of unexplained infertility with quantitative
IgG of H.pylori were available, so in order to define the
study sample size, 44 women were selected in each group
based on targeting an effect size that would be clinically
relevant.
By the end of this study, data of 88 participants (44
women in group 1 and 44 women in group 2) were
statistical analyzed. The mean age of included women was
28.3 in study group and 27.8 in control group.
Regarding type of infertility in the study group; three
were complaining of secondary infertility (6.8%), and 41
women were complaining of primary infertility (93.2%).
The mean of the duration of infertility in case group is 4.5.
The median (interquartile range) of the quantitative
essay of serum H. pylori IgG was 70 AU/ml in the case
group with 25% of the cases lie below 1st (lower) quartile
which is 7.5 AU/ml and 50% of the cases lie below 3rd
(upper) quartile which is 70 AU/ml. While the median
(interquartile range) of the quantitative essay of serum H.