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Publications
Publications (87)
This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyosis.
Abstract Objective This study aimed to determine the quality of life (QOL), in patients with endometriosis ± infertility (B and C groups) and compare those to healthy women, and also infertile groups without endometriosis as a control groups (A and D), considering the fact that endometriosis and infertility reduces the quality of life in patients....
Objective:
The present research aimed to determine and compare the value of magnetic resonance imaging (MRI) and transvaginal ultrasonography (TVUS) in the diagnosis of rectal endometriosis.
Methods:
In this cross-sectional study, 555 patients with rectal endometriosis, who had undergone MRI and TVUS before laparoscopic operation, were included....
Aim:
To report single-center outcomes of laparoscopic management of patients with ureteral endometriosis and perform a meta-analysis in order to select the best approach for these patients.
Methods:
The cross-sectional study was conducted during a 6-year period (2015-2021) in the referral endometriosis center on 353 patients with ureteral endome...
Objective
The present work aimed to investigate the feasibility, complications, recurrence rate, and infertility outcomes of the radical and conservative surgical methods for colorectal endometriosis in short- and long-term follow-ups.
Methods
In this prospective study, the patients with confirmed diagnosis of colorectal DIE were included from Mar...
Objective:
This study investigated the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functioning uterus.
Methods:
In this case series study, seven patients with cervicovaginal atresia with a functioning uterus, underwent laparoscopic sigmoid cervicovaginoplasty surgery, b...
Research Question
Does injecting the vasopressin into the mesovarium during endometrioma cystectomy further preserve postoperative ovarian reserve by reducing intraoperative bleeding and electrocoagulation points?
Design
In this randomized controlled trial, from March 2016 to March 2020, 120 patients with unilateral and unilobulated endometrioma w...
Background
As the endometriosis is a hormone dependent disease, this study designed to determine a cut-off point for selecting the appropriate treatment based on the hormone receptors of endometriosis lesions.
Methods
In this retrospective cohort study, all symptomatic endometriotic patients, between March 2017 to March 2019, was divided into two...
Background
This study has been designed to investigate the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functional uterus and stepwise description of surgery.
Methods
Seven patients with cervicovaginal atresia with a functional uterus, underwent laparoscopic sigmoid cervic...
Purpose
The authors compared assisted reproductive technique (ART) outcomes and the recurrence rate of endometrioma in the infertile patients undergoing sclerotherapy vs laparoscopic ovarian cystectomy.
Methods
In this prospective cross‐sectional study, a total of 101 infertile patients, with unilateral endometriomas, were divided into two groups....
The current study was designed to evaluate the relationship between adenomyosis and its subtypes with endometriotic lesions (ovarian endometrioma (OMAs) and posterior deep infiltrative endometriosis (DIE)), to examine the probability of existence of a common cause of these mysterious diseases, and to evaluate the accuracy, sensitivity, and specific...
Introduction:
Naturaly; Inhibin-A plays an important role in the reproduction, and its abnormal level can be associated
with the risk of adverse pregnancy outcomes. The aim of the current study was to evaluate the effect of
high level serum Inhibin-A in the first and second pregnancy trimesters on adverse pregnancy outcomes
doing a systematic revie...
The novel coronavirus was recognised in December 2019 and caught humanity off guard. The virus employs the angiotensin-converting enzyme 2 (ACE2) receptor for entry into human cells. ACE2 is expressed on different organs, which is raising concern as to whether these organs can be infected by the virus or not. The testis appears to be an organ enric...
Background:
Endometriosis is seen in 0.5%-5% of fertile and 25%-40% of infertile women. To investigate this conflict between gynecologists that ovarian endometriomas should be removed or not before making any decision about pregnancy among infertile women, the authors decided to carry out a systematic review and meta-analysis to compare the effect...
Purpose
Studies showed anti-inflammatory and immunomodulatory effects of macrolide antibiotics such as clarithromycin in endometriosis. Therefore, the present study aims to investigate the therapeutic efficacy of clarithromycin in patients with endometriosis.
Methods
This was a double-blinded randomized placebo-controlled trial conducted on endome...
Although endometriosis is not a newly discovered disease, it has still remained enigmatic. Understanding the pathophysiology of this disease is still one of the challenges of gynecology and reproductive medicine. Therefore, the subject of endometriosis
treatment faces many questions to be answered. Even though this is not considered to be a rare di...
The objective of the study is to determine the effects of clomiphene citrate (CC) on preventing premature luteinizing hormone (LH) surge in infertile patients with polycystic ovary syndrome (PCOS) undergoing intrauterine insemination (IUI). This was a randomized clinical trial being performed at Shiraz Mother and Child Hospital. We included 162 wom...
Introduction
Endometriosis is a common gynecologic disorder defined as ectopic presence of endometrial tissue in extrauterine sites. Endometriosis is associated with infertility and risk of malignancy. Identification of genetic factors responsible for development and malignant transformation of endometriosis can improve therapeutic approaches. In t...
To determine the diagnostic accuracy of pelvic magnetic resonance imaging (MRI), transvaginal sonography (TVS), and transrectal sonography (TRS) in diagnosis of deep infiltrating endometriosis (DIE).
This diagnostic accuracy study was conducted during a 2-year period including a total number of 317 patients with signs and symptoms of endometriosis....
Objectives:
The aim of the present study was to review 6-year experience on the surgical outcomes of laparoscopic endometriosis surgery.
Methods:
A cohort study was performed in Shiraz University of Medical Sciences using data from medical records of 1315 cases of patients with endometriosis undergoing laparoscopic surgery with follow-up of 6 to...
PurposeTo compare the pregnancy outcomes between four regimens of luteal phase support (LPS), including vaginal progesterone, oral dydrogesterone, combination of oral dydrogesterone and gonadotropin releasing hormone analog (GnRH-α), and combination of oral dydrogesterone and human chorionic gonadotrophin (hCG), in Frozen-thawed Embryo Transfer (FE...
Background:
Uterus contractibility is considered a powerful prognostic factor in predicting the embryo transfer outcome. Moreover, uterine contractions are known to be stimulated by prostaglandins which are produced by cyclooxygenase from arachidonic acid. As such, suppressing the inflammatory response and contractions using anti-inflammatory and...
While diminished ovarian reserve (DOR) predicts decreased ovarian response to stimulation, it does not necessarily foretell about the cycle fecundity. According to Bologna's criteria laid down by the European Society of Human Reproduction and Embryology (ESHRE), old age, abnormal ovarian reserve tests such as antral follicle count (AFC) and anti--m...
Purpose:
To report the outcomes of laparoscopic metroplasty in bicornuate and didelphic uteri.
Methods:
This observational study includes 26 women with double uterine cavities (22 bicornuate and 4 didelphic uteri) with history of recurrent pregnancy loss undergoing laparoscopic metroplasty, second-look laparoscopy and hysteroscopy between 2008 a...
Background: Implantation is considered as the rate-limiting step in success of assisted reproduction techniques, and intrauterine insemination cycles. It might be affected by ovarian superovulation and endometrial local scratching.
Objective: This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.
Mater...
Objectives: To evaluate the serum levels of common autoimmune parameters in women with polycystic ovary syndrome (PCOS) and compare with the control group. Design: prospective case-control study. Setting: Academic research institution. Patients: 102 women with PCOS and 100 healthy controls. Interventions: Questionnaire, physical examination, sonogr...
AimThis study aimed to assess the efficacy of thalidomide for treatment of experimental endometriosis.Methods
This study was a parallel-group, double-blind, stratified, randomized controlled animal trial with 1:1 allocation ratio. Endometriosis was induced experimentally in 23 mature, nulligravid, female Sprague–Dawley rats, weighing approximately...
Background: The direct effect of hCG on the human endometrium was studied several times. Objective: The objectives of this study were to evaluate the effectiveness of intrauterine injection of recombinant human chorionic gonadotropin (rhCG) before embryo transfer (ET). Materials and Methods: In this randomized placebo-controlled clinical trial, a t...
To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas.
Prospective study.
Private and university hospitals.
A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy.
Serum levels of antimüllerian hormone (AMH), FSH, and E2, as well as antral follicle count (AFC) were measured preop...
Background: Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients.
Objective: To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients.
Materials and Methods: The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the cl...
Purpose:
To assess the effects of levamisole on experimental endometriosis in rats through the histopathology of the implants, the blood leukocyte and lymphocyte counts and the concentrations of interleukin-6, vascular endothelial growth factor-A and tumor necrosis factor-alpha in the peritoneal environment at the three healthy, endometriotic and...
To study the effect of clomiphene citrate (CC) on the thickness and echogenic pattern of the endometrium using vaginal sonography.
In this experimental prospective study, CC was given to 31 women with unexplained infertility. Thickness and echo patterns of the endometrium, as well as estradiol (E2) and progesterone (P) levels, were compared in wome...
Since abdominal pregnancies are mostly complicated, they are usually managed by laparotomy, but laparoscopy is an alternative method which some surgeons perform instead of laparotomy; especially in advanced pregnancy. We reported a 31 year old woman with last menstrual period of 18 weeks who had supra pubic pain and vaginal bleeding. After sonograp...
Purpose
To investigate the association rate between abdominal wall and pelvic endometriosis in a population of Iranian patients, in University and private hospitals of Shiraz University of Medical Sciences.
Methods
30 women were diagnosed as abdominal wall endometriosis according to the clinical signs and symptoms (dysmenorrhea, dyspauronia and pe...
To compare the role of an aromatase inhibitor (letrozole) with a GnRH agonist (triptorelin) versus case control on the pregnancy rate and recurrence of symptoms and signs in patients with endometriosis.
In a prospective randomized clinical trial, after treatment of 144 infertile women in their reproductive age by laparoscopy (whose endometriosis wa...
Background: Recurrent abortion is defined as three or moreconsecutive pregnancy losses. We aimed to determine the relationshipbetween male sperm parameters and hypo-osmoticswelling score and recurrent abortion. We also studiedwhether washing of spermatozoa and intrauterine inseminationin patients with recurrent miscarriage and low score hypoosmotic...
Background: For more than four decades clomiphene citratehas been the first line of the treatment for ovulatory disorders.The aim of this study was to compare the effects of letrozoleand clomiphene citrate on ovulation and pregnancy rate in patientswith polycystic ovary syndrome.Methods: In this prospective double-blind study, 100 patientswith poly...
To examine and compare the efficacy and safety of GnRH agonist (GnRHa) vs. aromatase inhibitor in premenopausal women with leiomyomas.
Multicenter, randomized, controlled clinical trial.
University hospitals.
A total of 70 subjects with a single uterine myoma measuring >or=5 cm. Subjects were randomized into two groups with use of a random table. T...
Standard statistical techniques do not always provide answers to project risks questions because often there are no parametric distributions on which significance can be estimated. Resampling methods provide a battery of tests that can be used in such circumstances. In the past few years these methods have been explored theoretically and are now em...
To evaluate ovarian tissue inadvertently excised with benign cysts during laparotomy or laparoscopy.
Prospective study.
Private and university hospitals.
260 women, 20 to 35 years old, with unilateral benign ovarian cysts.
One hundred fifty women operated by laparoscopic cystectomy stripping technique, and 110 women operated by laparotomy with the...
To determine the feasibility of laparoscopic metroplasty in the treatment of bicornuate and didelphic uteri.
Case report.
University and private hospitals.
Four women with a diagnosis of double uterine cavity (two bicornuate and two didelphic uteri) with a history of two recurrent spontaneous abortions at less than 5 months of pregnancy.
Laparoscop...
To evaluate the efficacy of uterine artery ligation before laparoscopic myomectomy compared with myomectomy alone.
Prospective controlled, clinical trial.
Private and Shiraz University-affiliated hospitals.
Of 152 women with symptomatic uterine myomas necessitating surgical intervention who wished to retain their uteri, 65 underwent laparoscopic ut...
To determine whether ovarian damage consequent to laparoscopic ovarian electrocauterization may result in the development of humoral autoimmunity and production of antiovarian antibodies (AOA).
Prospective study.
Infertility and gynecologic endoscopy units of one of the medical university hospitals.
Sixty-four reproductive-age infertile women (<or=...
In a comparison of follicular responses to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated by different laparoscopic techniques for ovarian endometrioma in 65 patients with unilateral endometrioma, laparoscopic ovarian fenestration and coagulation was performed in 24 cases (group 1) and laparoscopic o...
To evaluate the clinical features, endocrine and metabolic profiles in clomiphene (CC) responders and non-responders with polycystic ovarian disease (PCOD), and to examine the effects of metformin (MTF) on the above parameters of CC resistance.
A prospective clinical trial was undertaken at the infertility division of a university teaching hospital...
To evaluate the effects of pentoxifylline administration on patients with different stages of endometriosis on whom laparoscopy was performed.
Prospective, double-blind, randomized, placebo-controlled clinical (Canadian Task Force classification I).
University and private hospitals.
Eighty-eight women, all with infertility, some with dysmenorrhea,...
To compare the accuracy of saline infusion sonohysterography (SIS) with transvaginal sonography (TVS) for the screening of causes of abnormal uterine bleeding (AUB) in out-patients.
81 patients with AUB were studied. All cases who were examined with TVS, were further investigated with SIS using saline as contrast medium, finally hysteroscopy was us...
The optimal conservative treatment for endometriotic cysts is unclear, particularly when treated laparoscopically. We performed a systematic analysis of the published literature on ovarian endometrioma especially focused on comparing laparoscopic cystectomy with laparoscopic drainage and coagulation of the cyst with regard to evaluating advantage a...
To investigate the outcome of pregnancy following laparoscopic unilateral tubal fulguration of hydrosalpinges in patients with recurrent spontaneous early abortion.
Prospective randomized controlled trial.
University tertiary center.
Thirteen patients with history of unexplained recurrent early spontaneous abortion and a unilateral hydrosalpinx dia...
To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility.
Multicenter, randomized, controlled clinical trial.
University hospitals.
Twenty-eight women with a diagnosis of complete uterine septum who had a...
To investigate whether the timing of clomiphene citrate (CC) administration affects hormonal levels, follicular growth, endometrial thickness, and ovulation and pregnancy rates in women with polycystic ovarian syndrome (PCOS).
Of the 78 infertile women with PCOS who participated in this prospective, double-blind, randomized clinical trial, 37 colle...
To evaluate the efficacy of a peritoneal graft for the treatment of cervical aplasia.
Four patients with cervical aplasia who had a functioning endometrium and hematometra were recruited for this clinical trial. Through an abdominoperineal approach a plastic stent was inserted between the endometrial cavity and the upper part of the vagina; then, a...
The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome.
This is a prospective controlled study. Thirty-six women with PCOS...
To determine the difference between two laparoscopic methods for the management of endometriomas with regard to recurrence of signs and symptoms and pregnancy rate.
Prospective, randomized clinical trial.
Infertility and gynecologic endoscopy units of two medical university hospitals.
One hundred patients with endometriomas who had either infertili...
The purpose of this study was to examine the effects of of bromocriptin combined with clomiphene citrate in clomiphene-resistant patients with polycystic ovary syndrome and normal prolactin level.
Prospective, double-blind, controlled study.
University teaching hospital.
One hundred polycystic ovary patients and normal prolactin (PRL) who were clom...
To evaluate the role of ketoconazole in prevention of ovarian hyperstimulation syndrome (OHSS) in women with the polycystic ovary syndrome (PCOS) undergoing ovarian stimulation with gonadotropins.
Prospective, randomized, double-blind, placebo-controlled study.
University hospitals. One hundred nine women with PCOS who were referred for treatment w...
To compare a single periovulatory intrauterine insemination (IUI) with a regimen based on double IUI, performed during preovulatory and periovulatory periods, in patients undergoing controlled ovarian hyperstimulation (COH).
Prospective, randomized study.
Infertility and endocrinology units of a medical university.
One hundred ten patients with mal...
To compare the diagnostic accuracy of hysterosalpingography and sonohysterosalpingography in detecting tubal and uterine abnormalities.
In a prospective study for the evaluation of uterine and tubal pathologies, 186 patients with primary and secondary infertility rates (51.6% and 44%, respectively), as well as recurrent abortion rates (3.8%), under...
Women with PCOS have significant differences in intra-ovarian and uterine artery haemodynamics. The aims of this study were to compare the ovarian stromal blood flow before and after laparoscopic ovarian diathermy, and to evaluate the value of these parameters in predicting the outcome of treatment in women with polycystic ovaries.
Colour Doppler b...
To compare the effect of intraperitoneal bupivacaine and lidocaine on reducing pain after diagnostic laparoscopy.
Randomized, double-blind, placebo-controlled study (Canadian Task Force classification I).
University teaching hospital.
One hundred thirty-four women with unexplained infertility.
Diagnostic laparoscopy with intraperitoneal administrat...
To evaluate the chance of adhesion formation after laparoscopic salpingo-ovariolysis and determine the efficacy of early second-look laparoscopy (SLL).
Prospective, randomized study (Canadian Task Force classification I).
Shiraz University hospitals.
Ninety women with mean duration of infertility of 7.2 years.
Operative laparoscopy, with early SLL...
Background and Objective: Tubal sterilization is the most popular method of permanent female contraception, yet there is considerable debate concerning the influence of this procedure on the women's health and menstrual pattern. Methods: We randomized 1358 women to one of the five methods of tubal sterilization; unipolar electrocauterization, bipol...
To evaluate the effects of administration of bromocriptine combined with clomiphene citrate (CC) in CC-resistant patients with polycystic ovary syndrome (PCOS) and normal prolactin (PRL) level.
Prospective double-blind, placebo-controlled, randomized.
Referral university hospitals.
One hundred women with PCOS and normal PRL who failed to ovulate wi...
To determine whether sonohysterography can differentiate septate from bicornuate uterus.
Prospective study.
Outpatient infertility clinic of a university hospital.
Twenty patients with history of recurrent pregnancy loss and hysterosalpingographic diagnosis of septate or bicornuate uterus.
Sonohysterography was done in all patients. Laparoscopy was...
Objective: To evaluate the effects of short course administration of dexamethasone (DEX) combined with omiphene citrate (CC) in CC-resistant patients with polycystic ovary syndrome(PCOS) and normal DHEAS. Design: Prospective double blind, placebo controlled, randomized study. Setting: Referral university hospitals. Patients: Two hundred and thirty...
Objective: To assess the efficacy of endometrial ablation for abnormal uterine bleeding in two groups of patients with or without preoperative medication for endometrial suppression. Design: A prospective, randomized study. Setting: Shiraz University Hospitals. Materials and Methods: Between September 1995 to February 1999, 90 patients with chief c...
To evaluate endocrine and ovulatory changes in polycystic ovarian disease (PCOD) in relation to patients' ovarian size.
Three hundred and seventy-one women with clomiphene citrate-resistant PCOD underwent laparoscopic ovarian cauterization [type I or typical with ovarian volume >8 cm(3) or cross-sectional area >10 cm(2) (n=211), type II with normal...
Objective: To evaluate efficacy of a graft of peritoneum for cervical aplasia. Design: Clinical trial. Setting: Shiraz University Hospitals. Patients: Two patients with cervical aplasia who had functioning endometrium and hematometra Interventions: Two cases were considered for this new technique. Through an abdominoperineal approach, a plastic ste...
Fifty-two women with polycystic ovarian syndrome, and a 5.2 years mean duration of infertility, underwent laparoscopic ovarian cautery. Regular ovulatory cycles were established in 75% of the patients. In 26 responders there was a significant fall in mean luteinizing hormone from 20.3 ± 2.3 (SEM) to 14.7 ± 2.1 mIU/ml (p < 0.05), prolactin from 319....
In order to determine the role of different anti-phospholipid antibodies as an etio-logic factor in recurrent pregnancy failure, a prospective study was done on one-hun-dred and thirty-eight women who had unexplained recurrent pregnancy loss (group I) with one-hundred well-matched women with normal reproductive outcome allocated as control group (G...
