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Mohamed Aboulghar

Publications and source records attributed to Mohamed Aboulghar.

8 recordsLinked to original sources
PubMed2005

Criteria of a successful coasting protocol for the prevention of severe ovarian hyperstimulation syndrome.

BACKGROUND: The aim of this study is to report a large series of patients (n = 1223) at risk of developing ovarian hyperstimulation syndrome (OHSS) who underwent coasting. METHODS: Coasting started when the leading follicle reached 16 mm and continued until the estradiol (E2) level fell to 3000 pg/ml. RESULTS: The E2 level at the start of coasting was (mean +/ SD) 6408 +/- 446 and it fell to 2755 +/- 650 on the day of HCG injection, after (mean +/- SD) 2.89 +/- 0.94 days. The results were analysed according to the duration of coasting (< or = 3 days, group I: n = 983; >3 days, group II: n = 240). The number of oocytes retrieved was (mean SD) 16.45 +/- 6.25 and 14.93 +/- 6.01 in groups I and II respectively (P < 0.05). The fertilization rates were 63 and 65% in groups I and II respectively (P > 0.05). The implantation and clinical pregnancy rates were 26 and 52% in group I compared to 18 and 36% in group II respectively (P < 0.05). Severe OHSS occurred in 16 cases, which represented 0.13% of all stimulated cycles, and 1.3% of patients who were at risk of developing OHSS. CONCLUSIONS: Our protocol of coasting was an effective measure in the prevention of OHSS, without jeopardizing the ICSI outcome. Coasting for >3 days is associated with a moderate decrease in the pregnancy rate.

Adult↗
PubMed2004

Percutaneous aspiration biopsy using an intravenous catheter for testicular sperm retrieval in patients with obstructive azoospermia.

Testicular needle aspiration has been proposed as a simple alternative to open biopsy for the diagnosis and treatment of azoospermia. This study describes a new modification of needle aspiration biopsy using an ordinary intravenous catheter to retrieve testicular spermatozoa from patients with obstructive azoospermia, and compares it to the classical fine-needle aspiration (FNA) method. The study included 86 consecutive patients with obstructive azoospermia. Thirty-one patients underwent FNA using butterfly needles (G21 or G23) and a 20 ml syringe. For the remaining 55 patients, an i.v. catheter (G14 or G16) was used instead of the butterfly needle. When testicular tissue was seen in the aspirate, the catheter was clamped and removed from the testis. If, after a maximum of three punctures, insufficient spermatozoa were retrieved, an open biopsy was carried out. Successful sperm retrieval was achieved in 54 out of 55 patients (98.1%) using an i.v. catheter, compared with 16 out of 31 patients (51.6%) using FNA (P < 0.05). Enough aspirated tissue was obtained for cryopreservation of spermatozoa in all 54 patients using the i.v. catheter, compared with 6/16 (37.5%) of the patients undergoing classical FNA. No significant complications were reported. In conclusion, the use of an i.v. catheter for testicular aspiration biopsy significantly improved sperm retrieval compared with FNA in obstructive azoospermia, and allowed for cryopreservation of excess tissue. The procedure is simple and inexpensive, however regular follow up and testing of possible adverse consequences of this method is indicated to establish its safety.

Adult↗
PubMed2003

Meta-analysis of recombinant versus urinary-derived FSH: an update.

BACKGROUND: The study aim was to analyse the results of randomized controlled trials (RCTs) comparing recombinant FSH and urinary-derived FSH gonadotrophins [hMG, urinary purified FSH (FSH-P) and highly purified FSH (FSH-HP)] in an IVF/ICSI programme. METHODS: All published truly RCTs using a long protocol of GnRH agonists for down-regulation, were reviewed. Data of pregnancy rate per started cycle were extracted, and odds ratios (OR) calculated using a fixed effect model. Subgroup analysis was carried out to compare recombinant FSH (rFSH) with each product (hMG alone, FSH-P alone and FSH-HP alone). RESULTS: There was no statistically significant difference in the pregnancy rate per started cycle between rFSH and urinary-derived FSH gonadotrophins (OR 1.07; 95% CI 0.94-1.22). Subgroup analysis showed no statistically significant difference in the pregnancy rate per started cycle between rFSH versus hMG (OR 0.81; 95% CI 0.63-1.05), rFSH versus FSH-P (OR 1.24; 95% CI 0.98-1.58) and rFSH versus FSH-HP (OR 1.14; 95% CI 0.94-1.40). There was no significant heterogeneity of treatment effect across the trials. CONCLUSIONS: There is no evidence of clinical superiority in clinical pregnancy rate for rFSH over different urinary-derived FSH gonadotrophins. Additional factors should be considered when choosing a gonadotrophin regimen, including the cost, patient acceptability, safety and drug availability.

Female↗
PubMed2003

Prediction of ovarian hyperstimulation syndrome (OHSS). Estradiol level has an important role in the prediction of OHSS.

The cascade of events that leads to the development of ovarian hyperstimulation syndrome (OHSS) is almost always accompanied by elevated estradiol (E(2)) levels. The role of estrogen level in OHSS has not been confirmed; however, it was shown repeatedly in the literature that elevated levels of E(2) constitute a risk for OHSS. Monitoring E(2) was found to be effective in reducing the incidence of OHSS. It was also reported that reducing the E(2) level by coasting helps to prevent OHSS. It is believed that irrespective of the debatable role of estrogen in the pathogenesis of OHSS, there is a general agreement that E(2) assay is an important marker to detect the majority of patients at risk of OHSS.

Chorionic Gonadotropin↗
PubMed2002

GnRH antagonist in assisted reproduction: a Cochrane review.

BACKGROUND: In the present systematic review, we wished to compare the efficacy of gonadotrophin-releasing hormone (GnRH) antagonist and GnRH agonist administration for controlled ovarian hyperstimulation in assisted conception. METHODS: Five randomized controlled trials fulfilled the inclusion criteria. In four studies, the multiple low-dose (0.25 mg) antagonist regimen was applied and, in one study, the single high-dose (3 mg) antagonist regimen was investigated. In all trials, reference treatment included a long protocol of GnRH agonist (buserelin, leuprorelin or triptorelin) starting in the mid-luteal phase of the preceding cycle. RESULTS: In comparison with the long protocol of GnRH agonist, the overall odds ratio for the prevention of premature LH surges was 1.76 [95% confidence interval (CI) 0.75-4.16], which was not statistically significant. There were significantly fewer clinical pregnancies in those treated with GnRH antagonists (OR 0.79; 95% CI 0.63-0.99). There was no statistically significant reduction in incidence of severe ovarian hyperstimulation syndrome between the two regimens (relative risk 0.51; OR 0.79; 95% CI 0.22-1.18). CONCLUSIONS: We concluded that the fixed GnRH antagonist protocol is a short and simple protocol with good clinical outcome, but the lower pregnancy rate compared with the GnRH agonist long protocol and the non-significant difference between both protocols regarding prevention of premature LH surge and prevention of severe ovarian hyperstimulation syndrome necessitates counselling subfertile couples before recommending change from GnRH agonist to antagonist. The clinical outcome may be further improved by developing more flexible antagonist regimens, taking into account individual patient characteristics.

Female↗