MARC details
| 000 -LEADER |
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| fixed length control field |
14401namaa22004451i 4500 |
| 003 - CONTROL NUMBER IDENTIFIER |
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| control field |
OSt |
| 005 - أخر تعامل مع التسجيلة |
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| control field |
20251027115654.0 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
251018s2025 ua a|||frm||| 000 0 eng d |
| 040 ## - CATALOGING SOURCE |
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| Original cataloguing agency |
EG-GICUC |
| Transcribing agency |
EG-GICUC |
| Modifying agency |
EG-GICUC |
| Description conventions |
rda |
| Language of cataloging |
eng |
| 041 0# - LANGUAGE CODE |
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| Language code of text/sound track or separate title |
eng |
| Language code of summary or abstract |
eng |
| -- |
ara |
| 049 ## - Acquisition Source |
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| Acquisition Source |
Deposit |
| 082 04 - DEWEY DECIMAL CLASSIFICATION NUMBER |
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| Classification number |
618.11 |
| 092 ## - LOCALLY ASSIGNED DEWEY CALL NUMBER (OCLC) |
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| Classification number |
618.11 |
| Edition number |
21 |
| 097 ## - Degree |
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| Degree |
Ph.D |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| Local Call Number |
Cai01.11.15.Ph.D.2024.Ah.P |
| 100 0# - MAIN ENTRY--PERSONAL NAME |
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| Authority record control number or standard number |
Ahmed Mohamed Kamal Zaghloul Mohamed, |
| Preparation |
preparation. |
| 245 10 - TITLE STATEMENT |
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| Title |
Progestin-primed ovarian stimulation protocol versus fixed Gonadotropin releasing hormone antagonist protocol in infertile women with polycystic ovary syndrome undergoing intracytoplasmic sperm injection with frozen-thawed embryo transfer : |
| Remainder of title |
A randomized clinical trial / |
| Statement of responsibility, etc. |
by Ahmed Mohamed Kamal Zaghloul Mohamed ; Supervision Prof. Gamal Gamal El-Din Youssef, Prof. Noura Sayed Ahmed El Nassery, Dr. Tarek El Husseiny Mohamed El Husseiny. |
| 246 15 - VARYING FORM OF TITLE |
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| Title proper/short title |
بروتوكول تحفيز المبيض المستعد للبروجستين مقابل البروتوكول الثابت مضاد هرمون إطلاق موجهة الغدد التناسلية في النساء المصابات بالعقم المصابات بمتلازمة تكيس المبايض اللواتي يخضعن للحقن المجهرى مع نقل الأجنة المجمدة: |
| Remainder of title |
تجربة سريرية عشوائية / |
| 264 #0 - PRODUCTION, PUBLICATION, DISTRIBUTION, MANUFACTURE, AND COPYRIGHT NOTICE |
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| Date of production, publication, distribution, manufacture, or copyright notice |
2025. |
| 300 ## - PHYSICAL DESCRIPTION |
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| Extent |
78+ 24 pages : |
| Other physical details |
illustrations ; |
| Dimensions |
25 cm. + |
| Accompanying material |
CD. |
| 336 ## - CONTENT TYPE |
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| Content type term |
text |
| Source |
rda content |
| 337 ## - MEDIA TYPE |
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| Media type term |
Unmediated |
| Source |
rdamedia |
| 338 ## - CARRIER TYPE |
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| Carrier type term |
volume |
| Source |
rdacarrier |
| 502 ## - DISSERTATION NOTE |
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| Dissertation note |
Thesis (Ph.D)-Cairo University, 2024. |
| 504 ## - BIBLIOGRAPHY, ETC. NOTE |
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| Bibliography, etc. note |
Bibliography: pages 68-78. |
| 520 #3 - SUMMARY, ETC. |
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| Summary, etc. |
Objectives: The aim of the study is to compare the effects of progestin-primed ovarian stimulation (PPOS) protocol versus GnRH antagonist protocol on the ovarian response and clinical outcomes in infertile women with PCOS undergoing ICSI. <br/>Design: A prospective randomized clinical trial (RCT). <br/>Setting: Kasr Al-Ainy hospital, IVF Unit of Obstetrics and Gynecology , Cairo University, Egypt, during the period from July 2023 to November 2024.<br/>Methods: A total of 150 infertile women with PCOS, who were treated at the IVF unit in department of Obstetrics and Gynecology, Cairo university, were evaluated in this study. Among them, 75 patients were treated with PPOS protocol and 75 patients were treated with fixed GnRH-antagonist protocol.<br/>Interventions: PCOS was diagnosed based on the modified Rotterdam criteria with two or more of the following three features; a) Oligo-anovulation. b) Polycystic ovarian morphology on ultrasound scans. c) Signs of clinical or biochemical hyperandrogenism. Group (1) The PPOS Protocol ; In patients with PPOS group down-regulation is achieved by oral progesterone; i.e. (DYDROGESTERONE (Duphaston®; Abbott Healthcare) at a daily dose of 30 mg on three divided doses. Controlled ovarian hyperstimulation (COH) by exogenous FSH and/or human menopausal gonadotropin (hMG) at a dose of 150 to 225 IU/day. Both are started simultaneously from 2-3 of the menstrual cycle.Dose of stimulation decided based on patient age, weight, AFC and homonal profile. Folliculometry is performed 6-7 days later and FSH and/or human menopausal gonadotropin (hMG) at a dose may be adjusted according to the patients’ estradiol concentrations and ovarian responses.Treatment with exogenous FSH/hMG and oral DYDROGESTERONE was continued daily until the day when final oocyte maturation was triggered. Group (2) The GnRH-antagonist Protocol ; Controlled ovarian hyperstimulation (COH) was administrated daily from day 2 or 3 of menstruation using exogenous FSH and/or hMG (150–225 IU) and daily subcutaneous injections of 0.25 mg of cetrorelix (Cetrotide, Merck) from stimulation day 6 to suppress premature LH surges.Treatment with exogenous FSH/hMG and GnRH antagonist was continued daily until the day when final oocyte maturation was triggered.<br/>In both groups, follicular monitoring was started on cycle day 6 or day 7 and was performed every 2 or 3 days through transvaginal ultrasound examination to record the total number of follicles and the diameter of each follicle. <br/>In both protocols ,when three dominant follicles reach 18 mm in diameter, the final stage of oocyte maturation was triggered by GnRH-a (Decapeptyl®; Ferring Pharmaceuticals, Germany) subcutaneous injections of 0.3 mg. Oocyte retrieval was performed under sedation by transvaginal ultrasound-guided follicle aspiration between 34-36 h upon triggering. All the good quality embryos were frozen by vitrification on the third, fourth or fifth days after oocyte retrieval. <br/>The retrieved cumulus-oocyte complexes were counted, denuded and the number of mature oocytes was assessed. The mature oocytes were inseminated approximately 4–6 hours after follicular aspiration by intracytoplasmic sperm injection, method according to the sperm quality.<br/>In another cycle , endometrium was prepared for frozen-thawed embryo transfer (FET) cycles and transfer was performed. In transfer cycles, all subjects received 8 mg/day estradiol valerate (Cyclo-Progynova®; Bayer, NSW, Australia)(only estrogen containing pills ) orally from days 2 or 3 of the menstrual cycle.<br/>The endometrial thickness was checked by vaginal ultrasonography on cycle days 12–14 in patients undergoing a HRT cycle, and progesterone vaginal suppositories (800 mg per day) were administered daily in patients with an endometrial thickness ≥ 7 mm with trilaminar pattern until menstruation or 10th week of pregnancy. <br/>Only surviving embryos were transferred.The transfer of embryos was scheduled based on embryo and endometrium synchronization. Once pregnancy was achieved, progestin supplementation was continued until 10 weeks of gestation. Chemical pregnancy was determined by serum β hCG > 50 IU/L two weeks after embryo transfer. In addition, clinical pregnancy was confirmed by detecting fetal heartbeats 2 weeks following the positive β hCG.<br/>Results: No statistically significant differences between the PPOS Protocol and the GnRH-antagonist Protocol groups regarding demographic characteristics ,baseline hormonal profile , ovarian stimulation characteristics of study participants including age (p=0.195), BMI (p=0.077), levels of FSH (p= 0.706) , LH (p= 0.474) , E2 (p= 324) , AMH (p=387) , gonadotrophins duration (days) (p = 1.000), gonadotrophins daily dose (IU) (p value = 0.845), expected oocytes ( > 14 mm on trigger day ) ( p = 0.077). The incidence of occurrence of severe OHSS in both groups = 0 % in both groups respectively. Infertile PCOS women in PPOS protocol group had significantly higher number of MII oocytes retrieved (p = 0.016) , number of cryopreserved embryos (p = 0.010), the quality of oocytes (number of MII oocytes to the total number of oocytes retrieved) (p value < 0.001) , number of thawed embryos ( p = 0.005 ) than the GNRH antagonist protocol group ,while there were no statistically significant differences between the two groups in numbers of oocytes retrieved (p=0.836) , MI oocytes retrieved (p=0.196), 2 PN fertilized oocytes (p=0.543) , numbers of transferred embryos (p= 0.479) and endometrial thickness prior to embryo transfer (p= 1.000). Patients in PPOS protocol group had significantly higher biochemical pregnancy rate (after 14 days) than the fixed GnRH antagonist protocol group (38.7 % versus 21.3 %; p =0.021). Besides, patients in the PPOS protocol group had significantly higher clinical pregnancy rate (8-10 weeks) than the fixed GnRH antagonist protocol group either singleton or twin pregnancies (p =0.009). <br/>Conclusion: PPOS and GnRH antagonist protocols each have distinct advantages based on patient characteristics and clinical requirements. PPOS is particularly well-suited for patients with PCOS, high ovarian reserve, or recurrent implantation failure. It enhances endometrial receptivity, supports better embryo quality, and significantly reduces OHSS risk. Conversely, GnRH antagonist protocols excel in achieving high oocyte yields and offer shorter treatment durations, making them ideal for patients with standard ovarian response profiles. Future research will undoubtedly continue to shed light on the unique benefits of these protocols, allowing for increasingly precise and personalized treatment approaches. |
| 520 #3 - SUMMARY, ETC. |
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| Summary, etc. |
متلازمة تكيس المبايض (PCOS) — هي اضطراب ايضي شائع واضطراب هرموني غير متجانس — تُعد من أكثر الاضطرابات الهرمونية شيوعاً بين النساء في سن الإنجاب، حيث تمثل حوالي 80٪ من حالات العقم بسبب انعدام الإباضة لدى النساء. يتم تشخيص متلازمة تكيس المبايض بناءً على معايير ورشة العمل التوافقية التي نظمتها Rotterdam ESHRE/ASRM في 2004، والتي تعتمد على وجود اثنين من ثلاثة سمات مثل انعدام الإباضة، والشكل المبيض المتعدد الأكياس في تصوير الموجات فوق الصوتية، وأعراض فرط الأندروجين السريرية أو البيوكيميائية.<br/>لسنوات عديدة، كانت نظائر هرمون الإفراز الموجه للجونادوتروبين (GnRH) هي الخيار الأول في علاجات التخصيب في المختبر لتقليل مستقبلات هرمون الإفراز الموجه للجونادوتروبين ومنع حدوث طفرات مبكرة فى الهرمون اللوتينى (LH). ومع ذلك، كانت استخدامات نظائرهرمون الإفراز الموجه للجونادوتروبين تحتوي على عيوب مثل العدد الكبير من مرات الحقن وخطر متلازمة التحفيز المبيضي المفرط أدى الاستخدام اللاحق لمناهضات هرمون الإفرازالموجه للجونادوتروبين إلى تقليل مدة العلاج وتقليل عدد الحقن بالجونوادوتروبين. على الرغم من أن متلازمة التحفيز المبيضي المفرط حدث أقل تكرارًا في دورات المناهضات مقارنة بدورات المنبهات لهرمون الإفرازالموجه للجونادوتروبين ، إلا أن الخطر لم يتم القضاء عليه بالكامل. يمكن للمناهضات التنافسية لهرمون الإفرازالموجه للجونادوتروبين أن تمنع هرمون الإفرازالموجه للجونادوتروبين الداخلي بشكل فوري وسريع مما يؤدي إلى انخفاض في مستويات الهرمون اللوتينى) LH (والهرمون المنشط للحوصلة (FSH (دون التأثير المفاجئ لنظيرهرمون الإفرازالموجه للجونادوتروبين ، وتعمل حقنها تحت الجلد في المرحلة الحويصلية الجريبية المتأخرة على منع حدوث طفرات فى الهرمون اللوتينى. مؤخراً، تم اقتراح البروجيستيرون كعامل بديل لمنع طفرات الهرمون اللوتينى في دورات التحفيز المبيضي. وقد ثبت أن البروجيستيرون يمنع الافراز النابض للهرمون اللوتينى وهرمون الإفراز الموجه للجونادوتروبين .<br/>في هذا البروتوكول، يتم استخدام البروجيستيرون الفموي (P) مقارنة بالحقن المناهضة لهرمون الإفراز الموجه للجونادوتروبين تحت الجلد، بدءاً من اليوم الأول من تحفيز المبايض في المرحلة الجريبية. باستخدام بروتوكول تحفيز المبيض المستعد للبروجستين الجديد، يتم استخدام مستويات البروجستيرون كبديل لنظير هرمون الإفراز الموجه للجونادوتروبين لمنع طفرات الهرمون اللوتينى المبكرة خلال المرحلة الجريبية. لذلك، لم تحدث أي طفرات تلقائية فى الهرمون اللوتينى خلال تحفيز المبايض في المرحلة الاصفرية في بعض الدراسات. يقدم التحفيز المبيضي المدعوم بالبروجستين (PPOS) نتائج احتمالية حدوث حمل مماثلة، على الرغم من أنه يستهلك جرعة أعلى قليلاً من الجونوادوتروبين مقارنة بالبروتوكولات القصيرة التقليدية، لذا فإن بروتوكول تحفيز المبيض المستعد للبروجستين مع سياسة التجميد فقط يظهر إمكانات جيدة للتنافس مع البروتوكولات التقليدية. بالإضافة إلى ذلك، يتم إعطاء البروجستين عن طريق الفم مما يجعله أكثر ملاءمة .<br/>هدف الدراسة هو مقارنة تأثيرات بروتوكول التحفيز المبيضي المدعوم بالبروجستين مقابل بروتوكول المناهض لهرمون الإفراز الموجه للجونادوتروبين على استجابة المبايض والنتائج السريرية لدى النساء المصابات بالعقم بسبب متلازمة تكيس المبايض اللاتي يخضعن للحقن المجهرى |
| 530 ## - ADDITIONAL PHYSICAL FORM AVAILABLE NOTE |
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| Issues CD |
Issues also as CD. |
| 546 ## - LANGUAGE NOTE |
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| Text Language |
Text in English and abstract in Arabic & English. |
| 650 #0 - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Polycystic ovary syndrome |
| 650 #0 - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
متلازمة تكيس المبايض |
| 653 #1 - INDEX TERM--UNCONTROLLED |
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| Uncontrolled term |
Clinical pregnancy rate |
| -- |
GNRH antagonist protocol |
| -- |
MII oocytes |
| -- |
OHSS |
| -- |
PCOS |
| -- |
PPOS protocol |
| 700 0# - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Gamal Gamal El-Din Youssef |
| Relator term |
thesis advisor. |
| 700 0# - ADDED ENTRY--PERSONAL NAME |
|---|
| Personal name |
Noura Sayed Ahmed El Nassery |
| Relator term |
thesis advisor. |
| 700 0# - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Tarek El Husseiny Mohamed El Husseiny |
| Relator term |
thesis advisor. |
| 900 ## - Thesis Information |
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| Grant date |
01-01-2025 |
| Supervisory body |
Gamal Gamal El-Din Youssef |
| -- |
Noura Sayed Ahmed El Nassery |
| -- |
Tarek El Husseiny Mohamed El Husseiny |
| Universities |
Cairo University |
| Faculties |
Faculty of Medicine |
| Department |
Department of Obstetrics and Gynaecology |
| 905 ## - Cataloger and Reviser Names |
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| Cataloger Name |
Shimaa |
| Reviser Names |
Eman Ghareb |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Source of classification or shelving scheme |
Dewey Decimal Classification |
| Koha item type |
Thesis |
| Edition |
21 |
| Suppress in OPAC |
No |