Background: Preterm delivery, defined as delivery before 37 weeks of pregnancy, is the leading global reason for neonatal mortality and morbidity. Preterm neonates have serious

Objectives: To know the incidence and characters of insulin resistance (lR) in polycystic ovaries (PCO) patients, and the efficacy of metformin treatment for induction of ovulation compared to clomiphene citrate (CC); also the effect of .metformin on the clinical, biochemical and hormonal features of the patient would be evaluated.Design: A prospective, blind, controlled study. Setting: Outpatient infertility clinic, Benha University Hospital. Subjects: Sixty infertile PCO patients. Methods: The body mass index (BMI), the hirsutism and the acne scores, the fasting blood glucose, the fasting serum insulin and serum testosterone levels were measured for every patient. A ratio of fasting blood glucose to fasting serum insulin (G/I) of less than 4.5 mgllO-4 untis was considered IR. Insulin resistant patients were randomly divided into three groups and treated for three cycles. The first group was treated with CC + mctforrnin, the second with placebo + metformin and the third with CC + placebo. Main outcome measures:The ovulation and pregnancy rates with metformin treatment compared to CC. Results: IR is present in about 86.6% of PCO patients. They are characterized by having higher BML fasting serum insulin and serum testosterone levIes, than non IR patients. Treatment with CC + mctformin results in higher ovulation and pregnancy rates compared to that obtained with CC alone.Conclusions: IR must be diagnosed in PCO patients. Induction of ovulation with CC + mctforrnin results in higher ovulation and pregnancy rates. In contrast to ce, the longer the duration of metformin treatment, the better arc the results.

Background: A low level of vitamin D is strongly correlated with a decreased calcium level, which in turn leads to inadequate mineralization of bones with subsequent development of rickets in children or osteoporosis in adults. It results not only in bone deformation, but also in high susceptibility of falls and bone fractures. Thus, proper vitamin D supplementation according to recent standards is essential for maintenance of the body homeostasis. The aim of the present study was to clinically assess the effect of empirical vitamin D supplementation on unexplained recurrent early pregnancy loss. Methods: This study was a prospective study (Clinical trial study) which included 80 women suffered from unexplained RPL. They were selected carefully from outpatient clinic in Banha University Hospitals. Results: Parity showed a significant difference between both groups; it ranged from 0-2 in group A and from 0-3 in group B. No significant differences were noted between both groups regarding age. No CMV, toxoplasmosis, or rubella infections were reported in both groups. HCT was significantly higher in group A (37.3 %) compared to group B (36.3%). No positive APA was detected in both groups. Abortion showed non-significant difference between both groups. Conclusion: Vitamin D minimize the incidence of abortion among women with unexplained recurrent early pregnancy loss, but this decrease was not significant. The effects of vitamin D on the immune regulation of RPL indicate that vitamin D might be used as an alternative therapy in the future.