Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting 5-10% of women of reproductive age. The syndrome is surrounded by controversies regarding both its diagnosis and treatment. The introduction of long-acting GnRH agonists in the late 1980s revolutionized the approach to ovarian stimulation in assisted reproductive technologies by providing the means to downregulate endogenous pituitary gonadotropin secretion and thereby prevent a premature luteinizing hormone surge during exogenous gonadotropin stimulation. The relatively recent introduction of GnRH antagonists in clinical practice has provided another option for ovarian stimulation in IVF. The purpose of this study was to compare the efficacy of the fixed GnRH antagonist vs. GnRH agonist long protocol in patients with polycystic ovary syndrome treated by ICSI. Results: There is a statistically significant difference between both groups in view of the received dose of gonadotrophin (1901.7 ± 400.6 vs. 1789 ± 368 with p = .004) and duration of stimulation (11.3 ± 0.8 vs. 10.3 ± 1.1 with p = .017). There is no significant difference between both groups in view of pregnancy outcome (37% vs. 32% with p = .125). There is a significant difference between both groups in view of ovarian hyperstimulation syndrome (OHSS) incidence where the rates were 15%, 6%, and 1.5% vs. 4.5%, 2.5%, and .05% with p = 0.04 for mild, moderate, and severe, respectively, form of OHSS in group 1 and group 2. Conclusion: The antagonist protocol may be the preferred stimulation protocol for PCOS patients treated by ICSI in view of the reduction of OHSS incidence rates without compromising the pregnancy outcome.

Objective: Due to the large increase in the number of reported cases and the impact of COVID-19 on public health, the European Society for Human Reproduction and Embryology (ESHRE) recommended the cessation of all activities related to assisted reproduction. There are many unknowns about the long-term effects of the virus on fertility and pregnancy. We conducted this study to offer some evidence-based guidance on the relationship between COVID-19 and IVF/ICSI cycle outcomes.Methods: This observational study included 179 patients who underwent ICSI cycles at the Albaraka Fertility Hospital, Manama, Bahrain and the Almana hospital, KSA. The patients were divided into two groups. Group 1 included 88 individuals with a history of Covid-19 and Group 2 included 91 subjects without a history of COVID-19.Results: Despite the higher pregnancy (45.1% vs. 36.4%, with p=0.264) and fertilization (52% vs. 50.6% with p=0.647) rates seen in patients without a history of COVID-19, the differences were not statistically significant.Conclusions: There is no clear evidence that exposure to COVID-19 significantly affects ICSI cycle outcomes.

Background Hypogonadotropic hypogonadism (HH) is a rare condition in which there is gonadal hypofunction due to absence of gonadotropin drive. In this condition, there are very low serum levels of gonadotropins. Pituitary gland may itself have some disease or disorder, or there may be loss of gonadotropin-releasing hormone (GnRH) pulses from the hypothalamus. The pharmacological interventions in HH women formed the basis for superovulation strategies for assisted reproduction techniques (ART) with a special reference to the role of LH and its impact on oocyte and embryo quality. Results The medians ±inter quartile ranges for number of oocytes retrieved, number of MII oocytes, and number of embryos transferred were 5±7, 4±3, and 3±1 respectively. The pregnancy rate was 31.5% for this group of patients. The live birth rate and miscarriage rate were 21% and 11.5% respectively. Conclusion The reproductive outcomes of patients of hypogonadotrophic hypogonadism are reasonable after ICSI and clinical trials are recommended to corroborate this concern.

Background: Childbirth is an important experience in a woman life, so high quality postoperative analgesia is important because the mother has to recover from major intra-abdominal surgery for proper caring of her newborn baby. Analgesic medications are either pharmacological or non-pharmacological methods. Pharmacological methods commonly used for postoperative pain relief after caesarean section either opioids or non-opioids and non-pharmacological methods include many techniques that reduce painful stimuli, as used for management of low back pain in labor. Sterile water injection is a simple and inexpensive way to provide a medication -free option to women who want to either avoid or delay use of opioid or non-opioid analgesia Methodology: 94 women who had attended the maternity hospital at Ain Shams University hospital from June 2013 to the end of December 2014 and indicated for Caesarian section, were randomized into 2 groups: group I (n=47) included women who received post Caesarian section subcutaneous injection of 0.5 ml sterile water, and group II (n=47) received intramuscular 3ml of 75mg Diclofenac sodium. Assessment of pain score in total subjects for need additional analgesia and assessment of maternal side effects was conducted in both groups. Results: there are statistically significant difference between both groups as regard onset of pain relief (23±9.9 and 16±6.4) in group 1 and 2 respectively with P-value(<0.001).Also 13 cases in group І needed additional analgesia while no cases needed in group ІІ (28% and 0%) respectively with P-value <0.001.As regard appearance of side effects 5 cases showed side effects(flushing and stinging pain) in group 1 and no recorded side effects in group 2(11% and 0%) respectively with P-value =0.022. Conclusion: sterile Water was found to be safe, simple and efficient method of pain relief after caesarean section and free from major negative side effects which associated with other methods. In spite of these advantages, non-steroidal analgesics seems to has the priority in view of potency, rapid analgesia and the less side effects.