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The impact of laparoscopic ovarian drilling on AMH and
ovarian reserve: a meta-analysis

Research Abstract
Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials (RCTs) investigating serum AMH concentrations and other ovarian reserve markers in women with PCOS undergoing LOD. Various databases were searched including MEDLINE, EMBASE, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and Cochrane Library from January 2000 to December 2016. Sixty studies were identified, of which seven were deemed eligible for this review. AMH data were extracted from each study and entered into the RevMan software to calculate the weighted mean difference (WMD) between pre- and post-operative values. Pooled analysis of all studies (n = 442) revealed a statistically significant decline in serum AMH concentration after LOD (WMD −2.13 ng/mL; 95% confidence interval (CI) −2.97 to −1.30). Subgroup analysis based on duration of follow-up, AMH kit, laterality of surgery and amount of energy applied during LOD consistently showed a statistically significant fall in serum AMH concentration. In conclusion, although LOD seems to markedly reduce circulating AMH, it remains uncertain whether this reflects a real damage to ovarian reserve or normalisation of the high pre-operative serum AMH levels. Further long-term studies on ovarian reserve after LOD are required to address this uncertainty.
Research Authors
Saad A Amer1, Tarek T El Shamy2, Cathryn James2, Ali H Yosef3,† and Ahmed A Mohamed1,†
Research Journal
Reproduction
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2017

Ovarian reserve after salpingectomy: a systematic review
and meta-analysis

Research Abstract
Introduction. Although there has been a growing concern over the possible damaging effect of salpingectomy on ovarian reserve, this issue remains uncertain. The purpose of this meta-analysis was to test the hypothesis that salpingectomy may compromise ovarian reserve. Material and methods. A detailed search was conducted using MEDLINE, Embase, Dynamed Plus, ScienceDirect, TRIP database and the Cochrane Library from January 2000 to November 2016. All cohort, cross-sectional and randomized controlled studies investigating changes in circulating anti-M€ullerian hormone (AMH) after salpingectomy were considered. Thirty-seven studies were identified, of which eight were eligible. Data were extracted and entered into REVMAN software for calculation of the weighted mean difference (WMD) and 95% CI. Two groups of studies were analyzed separately: group 1 (six studies, n = 464) comparing data before and after salpingectomy and group 2 (two studies) comparing data in women who have undergone salpingectomy (n = 169) vs. healthy controls (n = 154). Results. Pooled results of group 1 studies showed no statistically significant change in serum AMH concentration after salpingectomy (WMD, 0.10 ng/mL; 95% CI 0.19 to 0.00, I2 = 0%). Similarly, meta-analysis of group 2 showed no statistically significant difference in serum AMH concentration between salpingectomy group and controls (WMD, 0.11 ng/ mL; 95% CI 0.37 to 0.14, I2 = 77%). Subgroup analyses based on laterality of surgery, type of AMH kit and participants’ age (40 years) still showed no statistically significant changes in circulating AMH. Conclusion. Salpingectomy does not seem to compromise ovarian reserve in the short-term. However, the long-term effect of salpingectomy on ovarian reserve remains uncertain. Abbreviations: AFC, antral follicle count; AMH, anti-M€ullerian hormone; FSH, follicle-stimulating hormone; IVF, in vitro fertilization; RCT, randomized controlled trial; WMD, weighted mean difference.
Research Authors
AHMED ABOELFADLE MOHAMED1,2, ALI HAROUN YOSEF2,3, CATHRYN JAMES4, TAREK KHALAF
AL-HUSSAINI2, MOHAMED ALI BEDAIWY3 & SAAD ALI K.S. AMER1
Research Journal
Acta Obstetricia et Gynecologica Scandinavica
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2017

Ovarian reserve after salpingectomy: a systematic review
and meta-analysis

Research Abstract
Introduction. Although there has been a growing concern over the possible damaging effect of salpingectomy on ovarian reserve, this issue remains uncertain. The purpose of this meta-analysis was to test the hypothesis that salpingectomy may compromise ovarian reserve. Material and methods. A detailed search was conducted using MEDLINE, Embase, Dynamed Plus, ScienceDirect, TRIP database and the Cochrane Library from January 2000 to November 2016. All cohort, cross-sectional and randomized controlled studies investigating changes in circulating anti-M€ullerian hormone (AMH) after salpingectomy were considered. Thirty-seven studies were identified, of which eight were eligible. Data were extracted and entered into REVMAN software for calculation of the weighted mean difference (WMD) and 95% CI. Two groups of studies were analyzed separately: group 1 (six studies, n = 464) comparing data before and after salpingectomy and group 2 (two studies) comparing data in women who have undergone salpingectomy (n = 169) vs. healthy controls (n = 154). Results. Pooled results of group 1 studies showed no statistically significant change in serum AMH concentration after salpingectomy (WMD, 0.10 ng/mL; 95% CI 0.19 to 0.00, I2 = 0%). Similarly, meta-analysis of group 2 showed no statistically significant difference in serum AMH concentration between salpingectomy group and controls (WMD, 0.11 ng/ mL; 95% CI 0.37 to 0.14, I2 = 77%). Subgroup analyses based on laterality of surgery, type of AMH kit and participants’ age (40 years) still showed no statistically significant changes in circulating AMH. Conclusion. Salpingectomy does not seem to compromise ovarian reserve in the short-term. However, the long-term effect of salpingectomy on ovarian reserve remains uncertain. Abbreviations: AFC, antral follicle count; AMH, anti-M€ullerian hormone; FSH, follicle-stimulating hormone; IVF, in vitro fertilization; RCT, randomized controlled trial; WMD, weighted mean difference.
Research Authors
AHMED ABOELFADLE MOHAMED1,2, ALI HAROUN YOSEF2,3, CATHRYN JAMES4, TAREK KHALAF
AL-HUSSAINI2, MOHAMED ALI BEDAIWY3 & SAAD ALI K.S. AMER1
Research Journal
Acta Obstetricia et Gynecologica Scandinavica
Research Member
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2017

Ovarian reserve after salpingectomy: a systematic review
and meta-analysis

Research Abstract
Introduction. Although there has been a growing concern over the possible damaging effect of salpingectomy on ovarian reserve, this issue remains uncertain. The purpose of this meta-analysis was to test the hypothesis that salpingectomy may compromise ovarian reserve. Material and methods. A detailed search was conducted using MEDLINE, Embase, Dynamed Plus, ScienceDirect, TRIP database and the Cochrane Library from January 2000 to November 2016. All cohort, cross-sectional and randomized controlled studies investigating changes in circulating anti-M€ullerian hormone (AMH) after salpingectomy were considered. Thirty-seven studies were identified, of which eight were eligible. Data were extracted and entered into REVMAN software for calculation of the weighted mean difference (WMD) and 95% CI. Two groups of studies were analyzed separately: group 1 (six studies, n = 464) comparing data before and after salpingectomy and group 2 (two studies) comparing data in women who have undergone salpingectomy (n = 169) vs. healthy controls (n = 154). Results. Pooled results of group 1 studies showed no statistically significant change in serum AMH concentration after salpingectomy (WMD, 0.10 ng/mL; 95% CI 0.19 to 0.00, I2 = 0%). Similarly, meta-analysis of group 2 showed no statistically significant difference in serum AMH concentration between salpingectomy group and controls (WMD, 0.11 ng/ mL; 95% CI 0.37 to 0.14, I2 = 77%). Subgroup analyses based on laterality of surgery, type of AMH kit and participants’ age (40 years) still showed no statistically significant changes in circulating AMH. Conclusion. Salpingectomy does not seem to compromise ovarian reserve in the short-term. However, the long-term effect of salpingectomy on ovarian reserve remains uncertain. Abbreviations: AFC, antral follicle count; AMH, anti-M€ullerian hormone; FSH, follicle-stimulating hormone; IVF, in vitro fertilization; RCT, randomized controlled trial; WMD, weighted mean difference.
Research Authors
AHMED ABOELFADLE MOHAMED1,2, ALI HAROUN YOSEF2,3, CATHRYN JAMES4, TAREK KHALAF
AL-HUSSAINI2, MOHAMED ALI BEDAIWY3 & SAAD ALI K.S. AMER1
Research Journal
Acta Obstetricia et Gynecologica Scandinavica
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Member
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Department
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Department
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017

Correlation of anti-cardiolipin antibodies with right ventricular systolic
strain in systemic lupus erythematosus patients

Research Abstract
Introduction: The association between anticardiolipin antibodies (aCL) and cardiac disease in the presence of systemic lupus erythematosus (SLE) has been reported in various clinical trials. However, the correlation between these auto-antibodies and right ventricular (RV) function has been inadequately investigated. Objective: The present study investigated the possible correlation of the plasma anticardiolipin antibodies, as a marker of autoimmune phenomenon, with RV functions, assessed by right ventricular speckle tracking, in patients with systemic lupus erythematosus independent of significant pulmonary hypertension, systolic dysfunction or valvular disease. Methods: Forty-six SLE patients and 20 healthy controls were enrolled in our study and submitted thorough history, complete clinical examination then clinical scoring according to SLEDAI-2K score and then laboratory investigations particularly plasma anticardiolipin Ig_G or Ig_M antibodies. Then echocardiography was done to assess cardiac dimensions, left ventricular systolic functions, right ventricular functions and lastly speckle tracking for assessment of the right ventricular systolic strain. Results: Most of the study patients were young adult females with long-standing SLE (mean = 26 ± 3.1). All study patients had a high clinical SLE score (>6). All patients were normotensives and non-diabetics. No significant correlation was found between anticardiolipin titre and left ventricular dimensions or systolic functions. Significant negative correlation was found between RV strain and plasma level of both anticardiolipin Ig_M and Ig_G. Conclusion: The present study identified that with the use of 2D speckle tracking in patients with SLE, right ventricular systolic function was significantly diminished with rising plasma titre of autoimmune (Ig_G or Ig_M) antibodies independent of cardiovascular risk factors.
Research Authors
Hatem Abdel Rahman Helmy a,, Nady Mohamed Ahmed Abdelrazik a
, Soheir Mustafa Kasem a,Amal M. Abdel-aal a, Madleen Adel A. Abdou a, Ahmed K. Ibrahim b
Research Department
Research Journal
The Egyptian Journal of Critical Care Medicine
Research Pages
pp. 17–22
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 5
Research Website
NULL
Research Year
2017
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