الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
(PCOS) is the most common cause of anovulatory infertility and responsible for 70% of infertility due to anovulation, which characterized by presence of small follicles in the periphery of the ovary, menstrual disturbance, excess androgen secretion, weak or anovulation. Rotterdam team (2003) were put diagnostic criteria for diagnosis of polycystic ovarian syndrome include two of the three of the followings; oligo or anovulation, presence of the small follicles in the periphery of the ovary and clinical and biological clinical signs of hyperandrogenism. The line of treatment is usually clomiphene citrate and it induces ovulation in approximately 80% of patients although the pregnancy rate is only about 34% - 40%.If patients fail to respond in terms of ovulation to a dose of 150 mg/day, they are considered as clomiphene resistantUsing gonadotrophine hormone agonist as atrigger of ovulation in PCO mainly to reduce incidence of OHSS
The aim of this study was to To evaluate the role of GnRH agonist in triggering ovulation and luteal phase support in women with PCO syndrome
As we tried to evaluate the effect of gonado trophine releasing hormone agonist on luteal phase when used as a trigger of ovulation in PCO in two different doses 0.1 mg and 0.2 mg
We measured mid luteal serum progesterone level in both groups and also endometrial thickness in both groups and also clinical pregnancy rate
So we will detect whether increasing GnRH agonist dose will had anegative or positive result on luteal phase when it is used as atrigger of ovulation in PCO
In this study 100 PCOS patients according to Rotterdam (2004) criteria that, were recruited from outpatient Infertility Clinic of Maternity Hospital of Minia University from July, 2019 to May, 2020.
Complete history was taken as well as physical examination, trans-vaginal ultrasound and hormonal profile (serum FSH, LH, , progesterone, , and AMH) were done for all patients. Patients were randomly allocated into two groups: group (1):
50 patient had induction of ovulation starting from day 3 of the cycle with clomiphene citrate (Clomid) 50 mg, (Aventis Pharma) two tablets daily for 5 successive days followed by folliculometry, starting at day 10 of the cycle till leading follicle reached 18–22 mm in diameter.
they received single dose triptorelin (triptofem_ 0.1 mg/mL prefilled syringe, IBSA) 1syringe (0.1 mg) subcutaneously.
group (2):
Women in this group had induction of ovulation starting from day 3 of the cycle with clomiphene citrate (Clomid_) 50 mg, (Aventis Pharma ), two tablets daily for 5 successive days followed by folliculometry, starting at day 10 of the cycle till leading follicle reached 18–22 mm in diameter. They recived single dose triptorelin (triptofem_ 0.2 mg/mL prefilled syringe, IBSA) 1syringe (0.1 mg) subcutaneously, .
The injections were given at follicular maturation and instructions were given for planned intercourse within the following 36 h which was confirmed by patients on next visit to obtain blood samples.
2 mL of blood samples was taken for serum progesterone assay 7 days after ovulation trigger and the samples will be collected in dry tubes then centrifuged and serum stored at 2–8 _C until hormonal assay by enzyme immunoassay .
And transvaginal us will be done to measure endometrial thickness at the same day if period was missed for aweek pregnancy test was done by immunoassay and pregnant women were followed by trans abdominal us at 6 weeks from LMP to conferm clinical pregnancy using 2D convex abdominal probe 7.5 MHz.
the primary out come is mid luteal serum progesterone level where secondary out come was ovulation rate chemical and clinical pregnancy rate)
Achievement of pregnancy was detected using serum β- HCG or intrauterine gestational sac by ultrasound
And we evaluated the effect of increasing gonadotrophine releasing hormone agonist dose.
There was no statistically significant difference between the two groups as regard age, duration of infertility, menstrual pattern, hirsutism and hormonal profile.There was no Correlation between midluteal serum progesterone and follicle number among two groups.There was no Correlation between midluteal serum progesterone and follicle number among group 1.There was no Correlation between midluteal serum progesterone and follicle number among group 2.There was significant positive Correlation between endometrial thickness and follicle number among two groups (r=0.215, p=0.032).There was no Correlation between endometrial thickness and follicle number among groups.There was significant positive Correlation between endometrial thickness and follicle number among group 2 (r=0.295, p=0.037).There was significant positive Correlation between midluteal serum progesterone and endometrial thickness among two groups (r=0.563, p <0.001).There was significant positive Correlation between midluteal serum progesterone and endometrial thickness among group1 (r=0.597, p <0.001).There was significant positive Correlation between midluteal serum progesterone and endometrial thickness among two groups (r=0.482, p <0.001).
There was significant Correlation between midluteal serum progesterone and clinical pregnancy among two groups (r=0.642, p<0.001) where median level among not pregnant was 11 (IQR= 9.1-12) and among pregnant was 17 (15-22).