Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of Gynecology Obstetrics and Human Reproduction
OBJECTIVE To establish the prevalence of endometrial hyperplasia in asymptomatic subfertile women... more OBJECTIVE To establish the prevalence of endometrial hyperplasia in asymptomatic subfertile women, identify the clinical characteristics of the group at risk; predict the associated factors, and determine the predictive cut-off value of endometrial thickness MATERIAL & METHODS: Prospective cross-sectional study of asymptomatic subfertile women recruited from university-affiliated tertiary hospital. Patients received hormonal treatment in the last three months, suffered from premature ovarian failure, ovarian cyst, thyroid malfunction, hyperprolactinaemia or underwent endometrial biopsy for abnormal uterine bleeding were all excluded. Endometrial biopsy was performed for the study group during the luteal phase as a screening test for endometrial hyperplasia RESULT (S): Among hundred and eleven patients underwent endometrial biopsy, endometrial hyperplasia was found in 12 cases (11%) and atypical hyperplasia was detected in one patient (0.9%). All cases of and endometrial hyperplasia with or without atypia were reported among women with polycystic ovary syndrome. The study showed that a patient age, BMI, estradiol levels, insulin resistance and endometrial thickness of a cut-off value of 7.5mm, have a positive correlation with endometrial hyperplasia in subfertile women with polycystic ovary syndrome. The areas under the ROC curves for these parameters were greater than (0.5). CONCLUSION(S) In asymptomatic subfertile population, PCOS women at risk to develop endometrial hyperplasia & atypical hyperplasia. Selective endometrial biopsy recommended with BMI ≥ 30, in presence of insulin resistance and with endometrial thickness ≥7.5mm.
Background: Smoking is a common health problem worldwide. Many diseases and life threatening cond... more Background: Smoking is a common health problem worldwide. Many diseases and life threatening conditions have been linked to smoking habits, such as, lung cancer, oral cancer, bronchitis and several gastrointestinal disorders. Infertility link to smoking is still under intensive investigation. Objective: To evaluate the effect of smoking on semen parameters of infertile Bahraini males. Design: Open controlled trial.
International Journal of Reproductive Medicine, 2021
The effect of sperm molecular defects on fertilization and pregnancy outcome after assisted repro... more The effect of sperm molecular defects on fertilization and pregnancy outcome after assisted reproductive therapy (ART) is widely documented by both research and clinical societies. Sperm DNA fragmentation and abnormal chromatin condensation represent critical causes of male infertility. Advanced androgenic techniques for accurately identifying molecular defects help in selecting an appropriate treatment strategy. Additionally, specific markers of apoptosis are increasingly important in predicting male infertility. The ability of flow cytometry to estimate the quantity of sperm with DNA fragmentation or damage and multifactor measurements in immotile sperm have made this developed technique essential in fertility centers. The study is aimed at assessing the level of DNA fragmentation and apoptosis by measuring flow cytometry using new techniques. Flow cytometry analysis revealed a varying degree of DNA damage. It was able to quantify the degree of impairment even in samples with mini...
Background: The contributions of host factors, such as age, in male infertility are still poorly ... more Background: The contributions of host factors, such as age, in male infertility are still poorly understood. Thus, the present work has aimed to evaluate the effect of patient's age on semen parameters of infertile males. Method: Semen samples from 52 infertile patients aged 21-52 years (mean 30.8 ± 6.7) were analysed by conventional semen analysis methods, flowcytometry analysis for sperm DNA integrity, and colorimetric assay for total antioxidant capacity. Results: The study revealed that, as patient's age increases, there was a significant reductionin sperm density, motility, percentage of morphologically normal spermatozoa, total antioxidant capacity and DNA integrity. Conclusion: The study results demonstrated the negative influence of increasing patient's age on semen parameters; and the possible role of patient's age in the aetiology of male infertility.
This study aimed to find the effective method of induction of ovulation; in obese infertile patie... more This study aimed to find the effective method of induction of ovulation; in obese infertile patients with polycystic ovary syndrome. It is a prospective case-control study done at Infertility clinic of Basra Maternity and Child hospital. Sixty obese, hirsute infertile patients for more than two years; with ultrasound findings of polycystic ovary syndrome, subjected to the following investigations: Serum LH, FSH, Testosterone, Prolactin &fasting blood sugar. All investigations were carried on early follicular phase of the cycle. Patients were divided randomly into two groups: Group A and group B. All patients received clomiphene citrate 50-150mg for five consecutive days beginning on day 5 of the cycle. The patients with group B also received 500mg of Metformin tablet three times daily for 6 months. Ovulation-which assessed by transvaginal folliculometry, and ovarian artery Doppler velocimetry; triggered with hCG when one or more follicle measuring ≥ 18 mm in diameter, and blood flow indices of the active ovary; showing the dominant follicles were good; on ultrasonic examination. Ovulation response and pregnancy rate were assessed in both groups. Results obtained from this study pointed out the beneficial effect of Metformin on ovulation induction in obese hirsute women with PCOS. It is concluded that PCOS remains an enigmatic disease. Once considered relatively benign, PCOS is implicated in medical disorders related to hyperinsulinism and hyperandrogenemia. Restoring fertility and treating abnormal hair growth remain important considerations in the physical and psychological health of reproductive-age women. Metformin has shown great promise in the treatment of insulin-resistant PCOS, but whether it would benefit all women who have PCOS remains unclear. Weight loss is the most important primary recommendation that can be made in the treatment of PCOS.
Traditional semen analysis is routinely used for the assessment of male infertility. The present ... more Traditional semen analysis is routinely used for the assessment of male infertility. The present study aimed to evaluate the application of molecular techniques in determining the DNA integrity of the spermatozoa of infertile men in comparison to conventional analysis. Semen samples from 52 infertile patients were analyzed by conventional assays, flow cytometry (FCM) analysis for sperm DNA integrity and colorimetric assays for total antioxidant capacity (TAC). The traditional semen analyses showed that 48.1% of the patients had normospermic samples. The figure decreased to only 25% following the application of molecular tests. DNA FCM revealed that 67.3% of the patients had an abnormal chromatin status (n=36), while at the same time, 36% showed aneuploidy features (n=19), and 59.6% had an abnormal TAC level (n=31). The normozoospermic samples had less DNA fragmentation and a higher mean seminal plasma TAC level (1,500.92±280.29 µM) than the abnormal samples (899.59±375.67 µM). Significant correlations were noted between chromatin condensation and the sperm count (r=587, P<0.001), motility (r=0.625, P<0.001), normal morphology (r=0.658, P<0.001) and white blood cell (WBC) count (r=-0.299, P<0.005). In addition, the infertile subjects with abnormal chromatin condensation had significantly lower TAC levels than the other subjects and the level was markedly decreased in the samples with severe abnormalities (class 7 and 8). The presence of the aneuploidy cells was negatively correlated with the sperm concentration (r=-0.339, P<0.005). In conclusion, traditional semen analysis has limited value in the prediction of male fertility and should be combined with other molecular tests to increase its sensitivity.
This study aimed to find the effective method of induction of ovulation; in obese infertile patie... more This study aimed to find the effective method of induction of ovulation; in obese infertile patients with polycystic ovary syndrome. It is a prospective case-control study done at Infertility clinic of Basra Maternity and Child hospital. Sixty obese, hirsute infertile patients for more than two years; with ultrasound findings of polycystic ovary syndrome, subjected to the following investigations: Serum LH, FSH, Testosterone, Prolactin &fasting blood sugar. All investigations were carried on early follicular phase of the cycle. Patients were divided randomly into two groups: Group A and group B. All patients received clomiphene citrate 50-150mg for five consecutive days beginning on day 5 of the cycle. The patients with group B also received 500mg of Metformin tablet three times daily for 6 months. Ovulation-which assessed by transvaginal folliculometry, and ovarian artery Doppler velocimetry; triggered with hCG when one or more follicle measuring ≥ 18 mm in diameter, and blood flow indices of the active ovary; showing the dominant follicles were good; on ultrasonic examination. Ovulation response and pregnancy rate were assessed in both groups. Results obtained from this study pointed out the beneficial effect of Metformin on ovulation induction in obese hirsute women with PCOS. It is concluded that PCOS remains an enigmatic disease. Once considered relatively benign, PCOS is implicated in medical disorders related to hyperinsulinism and hyperandrogenemia. Restoring fertility and treating abnormal hair growth remain important considerations in the physical and psychological health of reproductive-age women. Metformin has shown great promise in the treatment of insulin-resistant PCOS, but whether it would benefit all women who have PCOS remains unclear. Weight loss is the most important primary recommendation that can be made in the treatment of PCOS.
Traditional semen analysis is routinely used for the assessment of male infertility. The present ... more Traditional semen analysis is routinely used for the assessment of male infertility. The present study aimed to evaluate the application of molecular techniques in determining the DNA integrity of the spermatozoa of infertile men in comparison to conventional analysis. Semen samples from 52 infertile patients were analyzed by conventional assays, flow cytometry (FCM) analysis for sperm DNA integrity and colorimetric assays for total antioxidant capacity (TAC). The traditional semen analyses showed that 48.1% of the patients had normospermic samples. The figure decreased to only 25% following the application of molecular tests. DNA FCM revealed that 67.3% of the patients had an abnormal chromatin status (n=36), while at the same time, 36% showed aneuploidy features (n=19), and 59.6% had an abnormal TAC level (n=31). The normozoospermic samples had less DNA fragmentation and a higher mean seminal plasma TAC level (1,500.92±280.29 µM) than the abnormal samples (899.59±375.67 µM). Significant correlations were noted between chromatin condensation and the sperm count (r=587, P<0.001), motility (r=0.625, P<0.001), normal morphology (r=0.658, P<0.001) and white blood cell (WBC) count (r=-0.299, P<0.005). In addition, the infertile subjects with abnormal chromatin condensation had significantly lower TAC levels than the other subjects and the level was markedly decreased in the samples with severe abnormalities (class 7 and 8). The presence of the aneuploidy cells was negatively correlated with the sperm concentration (r=-0.339, P<0.005). In conclusion, traditional semen analysis has limited value in the prediction of male fertility and should be combined with other molecular tests to increase its sensitivity.
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of Gynecology Obstetrics and Human Reproduction
OBJECTIVE To establish the prevalence of endometrial hyperplasia in asymptomatic subfertile women... more OBJECTIVE To establish the prevalence of endometrial hyperplasia in asymptomatic subfertile women, identify the clinical characteristics of the group at risk; predict the associated factors, and determine the predictive cut-off value of endometrial thickness MATERIAL & METHODS: Prospective cross-sectional study of asymptomatic subfertile women recruited from university-affiliated tertiary hospital. Patients received hormonal treatment in the last three months, suffered from premature ovarian failure, ovarian cyst, thyroid malfunction, hyperprolactinaemia or underwent endometrial biopsy for abnormal uterine bleeding were all excluded. Endometrial biopsy was performed for the study group during the luteal phase as a screening test for endometrial hyperplasia RESULT (S): Among hundred and eleven patients underwent endometrial biopsy, endometrial hyperplasia was found in 12 cases (11%) and atypical hyperplasia was detected in one patient (0.9%). All cases of and endometrial hyperplasia with or without atypia were reported among women with polycystic ovary syndrome. The study showed that a patient age, BMI, estradiol levels, insulin resistance and endometrial thickness of a cut-off value of 7.5mm, have a positive correlation with endometrial hyperplasia in subfertile women with polycystic ovary syndrome. The areas under the ROC curves for these parameters were greater than (0.5). CONCLUSION(S) In asymptomatic subfertile population, PCOS women at risk to develop endometrial hyperplasia & atypical hyperplasia. Selective endometrial biopsy recommended with BMI ≥ 30, in presence of insulin resistance and with endometrial thickness ≥7.5mm.
Background: Smoking is a common health problem worldwide. Many diseases and life threatening cond... more Background: Smoking is a common health problem worldwide. Many diseases and life threatening conditions have been linked to smoking habits, such as, lung cancer, oral cancer, bronchitis and several gastrointestinal disorders. Infertility link to smoking is still under intensive investigation. Objective: To evaluate the effect of smoking on semen parameters of infertile Bahraini males. Design: Open controlled trial.
International Journal of Reproductive Medicine, 2021
The effect of sperm molecular defects on fertilization and pregnancy outcome after assisted repro... more The effect of sperm molecular defects on fertilization and pregnancy outcome after assisted reproductive therapy (ART) is widely documented by both research and clinical societies. Sperm DNA fragmentation and abnormal chromatin condensation represent critical causes of male infertility. Advanced androgenic techniques for accurately identifying molecular defects help in selecting an appropriate treatment strategy. Additionally, specific markers of apoptosis are increasingly important in predicting male infertility. The ability of flow cytometry to estimate the quantity of sperm with DNA fragmentation or damage and multifactor measurements in immotile sperm have made this developed technique essential in fertility centers. The study is aimed at assessing the level of DNA fragmentation and apoptosis by measuring flow cytometry using new techniques. Flow cytometry analysis revealed a varying degree of DNA damage. It was able to quantify the degree of impairment even in samples with mini...
Background: The contributions of host factors, such as age, in male infertility are still poorly ... more Background: The contributions of host factors, such as age, in male infertility are still poorly understood. Thus, the present work has aimed to evaluate the effect of patient's age on semen parameters of infertile males. Method: Semen samples from 52 infertile patients aged 21-52 years (mean 30.8 ± 6.7) were analysed by conventional semen analysis methods, flowcytometry analysis for sperm DNA integrity, and colorimetric assay for total antioxidant capacity. Results: The study revealed that, as patient's age increases, there was a significant reductionin sperm density, motility, percentage of morphologically normal spermatozoa, total antioxidant capacity and DNA integrity. Conclusion: The study results demonstrated the negative influence of increasing patient's age on semen parameters; and the possible role of patient's age in the aetiology of male infertility.
This study aimed to find the effective method of induction of ovulation; in obese infertile patie... more This study aimed to find the effective method of induction of ovulation; in obese infertile patients with polycystic ovary syndrome. It is a prospective case-control study done at Infertility clinic of Basra Maternity and Child hospital. Sixty obese, hirsute infertile patients for more than two years; with ultrasound findings of polycystic ovary syndrome, subjected to the following investigations: Serum LH, FSH, Testosterone, Prolactin &fasting blood sugar. All investigations were carried on early follicular phase of the cycle. Patients were divided randomly into two groups: Group A and group B. All patients received clomiphene citrate 50-150mg for five consecutive days beginning on day 5 of the cycle. The patients with group B also received 500mg of Metformin tablet three times daily for 6 months. Ovulation-which assessed by transvaginal folliculometry, and ovarian artery Doppler velocimetry; triggered with hCG when one or more follicle measuring ≥ 18 mm in diameter, and blood flow indices of the active ovary; showing the dominant follicles were good; on ultrasonic examination. Ovulation response and pregnancy rate were assessed in both groups. Results obtained from this study pointed out the beneficial effect of Metformin on ovulation induction in obese hirsute women with PCOS. It is concluded that PCOS remains an enigmatic disease. Once considered relatively benign, PCOS is implicated in medical disorders related to hyperinsulinism and hyperandrogenemia. Restoring fertility and treating abnormal hair growth remain important considerations in the physical and psychological health of reproductive-age women. Metformin has shown great promise in the treatment of insulin-resistant PCOS, but whether it would benefit all women who have PCOS remains unclear. Weight loss is the most important primary recommendation that can be made in the treatment of PCOS.
Traditional semen analysis is routinely used for the assessment of male infertility. The present ... more Traditional semen analysis is routinely used for the assessment of male infertility. The present study aimed to evaluate the application of molecular techniques in determining the DNA integrity of the spermatozoa of infertile men in comparison to conventional analysis. Semen samples from 52 infertile patients were analyzed by conventional assays, flow cytometry (FCM) analysis for sperm DNA integrity and colorimetric assays for total antioxidant capacity (TAC). The traditional semen analyses showed that 48.1% of the patients had normospermic samples. The figure decreased to only 25% following the application of molecular tests. DNA FCM revealed that 67.3% of the patients had an abnormal chromatin status (n=36), while at the same time, 36% showed aneuploidy features (n=19), and 59.6% had an abnormal TAC level (n=31). The normozoospermic samples had less DNA fragmentation and a higher mean seminal plasma TAC level (1,500.92±280.29 µM) than the abnormal samples (899.59±375.67 µM). Significant correlations were noted between chromatin condensation and the sperm count (r=587, P<0.001), motility (r=0.625, P<0.001), normal morphology (r=0.658, P<0.001) and white blood cell (WBC) count (r=-0.299, P<0.005). In addition, the infertile subjects with abnormal chromatin condensation had significantly lower TAC levels than the other subjects and the level was markedly decreased in the samples with severe abnormalities (class 7 and 8). The presence of the aneuploidy cells was negatively correlated with the sperm concentration (r=-0.339, P<0.005). In conclusion, traditional semen analysis has limited value in the prediction of male fertility and should be combined with other molecular tests to increase its sensitivity.
This study aimed to find the effective method of induction of ovulation; in obese infertile patie... more This study aimed to find the effective method of induction of ovulation; in obese infertile patients with polycystic ovary syndrome. It is a prospective case-control study done at Infertility clinic of Basra Maternity and Child hospital. Sixty obese, hirsute infertile patients for more than two years; with ultrasound findings of polycystic ovary syndrome, subjected to the following investigations: Serum LH, FSH, Testosterone, Prolactin &fasting blood sugar. All investigations were carried on early follicular phase of the cycle. Patients were divided randomly into two groups: Group A and group B. All patients received clomiphene citrate 50-150mg for five consecutive days beginning on day 5 of the cycle. The patients with group B also received 500mg of Metformin tablet three times daily for 6 months. Ovulation-which assessed by transvaginal folliculometry, and ovarian artery Doppler velocimetry; triggered with hCG when one or more follicle measuring ≥ 18 mm in diameter, and blood flow indices of the active ovary; showing the dominant follicles were good; on ultrasonic examination. Ovulation response and pregnancy rate were assessed in both groups. Results obtained from this study pointed out the beneficial effect of Metformin on ovulation induction in obese hirsute women with PCOS. It is concluded that PCOS remains an enigmatic disease. Once considered relatively benign, PCOS is implicated in medical disorders related to hyperinsulinism and hyperandrogenemia. Restoring fertility and treating abnormal hair growth remain important considerations in the physical and psychological health of reproductive-age women. Metformin has shown great promise in the treatment of insulin-resistant PCOS, but whether it would benefit all women who have PCOS remains unclear. Weight loss is the most important primary recommendation that can be made in the treatment of PCOS.
Traditional semen analysis is routinely used for the assessment of male infertility. The present ... more Traditional semen analysis is routinely used for the assessment of male infertility. The present study aimed to evaluate the application of molecular techniques in determining the DNA integrity of the spermatozoa of infertile men in comparison to conventional analysis. Semen samples from 52 infertile patients were analyzed by conventional assays, flow cytometry (FCM) analysis for sperm DNA integrity and colorimetric assays for total antioxidant capacity (TAC). The traditional semen analyses showed that 48.1% of the patients had normospermic samples. The figure decreased to only 25% following the application of molecular tests. DNA FCM revealed that 67.3% of the patients had an abnormal chromatin status (n=36), while at the same time, 36% showed aneuploidy features (n=19), and 59.6% had an abnormal TAC level (n=31). The normozoospermic samples had less DNA fragmentation and a higher mean seminal plasma TAC level (1,500.92±280.29 µM) than the abnormal samples (899.59±375.67 µM). Significant correlations were noted between chromatin condensation and the sperm count (r=587, P<0.001), motility (r=0.625, P<0.001), normal morphology (r=0.658, P<0.001) and white blood cell (WBC) count (r=-0.299, P<0.005). In addition, the infertile subjects with abnormal chromatin condensation had significantly lower TAC levels than the other subjects and the level was markedly decreased in the samples with severe abnormalities (class 7 and 8). The presence of the aneuploidy cells was negatively correlated with the sperm concentration (r=-0.339, P<0.005). In conclusion, traditional semen analysis has limited value in the prediction of male fertility and should be combined with other molecular tests to increase its sensitivity.
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