الفهرس 
Unexplained InfertilityOnly 14 pages are availabe for public view
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Abstract
Infertility is customarily defined as the inability to conceive after 1 year of regular unprotected intercourse. The infertility evaluation is typically initiated after 1 year of trying to conceive, but in couples with advanced female age (> 35 years), most practitioners initiate diagnostic evaluation after an inability to conceive for 6 months. The Practice Committee of the American Society for Reproductive Medicine (ASRM) has published guidelines for a standard infertility evaluation. It includes a semen analysis, assessment of ovulation, a hysterosalpingogram, and, if indicated, tests for ovarian reserve and laparoscopy. When the results of a standard infertility evaluation are normal, practitioners assign a diagnosis of unexplained infertility. Although estimates vary, the likelihood that all such test results for an infertile couple are normal (ie, that the couple has unexplained infertility) is approximately 15% to 30%.
Protein C is a vitamin K-dependent glycoprotein that is synthesised in the liver. It circulates in an inactive form. It is activated by the thrombin-thrombomodulin complex on endothelial cells. Activated protein C degrades the activated clotting factors Va and VIIIa. The actions of protein C are enhanced by the cofactor; protein S. Protein C also has anti-inflammatory and cytoprotective properties.
Protein C deficiency belongs to a group of genetic disorders known as thrombophilias, attention is being paid to the association between inherited thrombophilia and infertility.
The aim of this study was to find out a possible relationship between unexplained infertility and protein C activity.
This study was conducted in Ain Shams Maternity hospital.
Group I [study group]: 48 women with unexplained primary infertility defined as inability to conceive in spite of regular marital life for at least 12 months, were recruited from infertile women attending outpatient infertility.
Group II [control group]: 48 fertile control women, recruited from outpatient gynecology clinic, got pregnant at least in the last year.
All patients had baseline investigations including mid-luteal serum progesterone, FSH, LH, TSH, serum prolactin, hysterosalpingogram (HSG) and/or laparoscopy.
In this study the mean age of included women of group I was 29.04 ±3.32 years and the mean BMI was 26.01 ±3.35 kg/m2. On the other hand, the mean age of included women of group II was 29.77 ±3.89 years and the BMI was 26.23 ±2.54 kg/m2.
There was no significant difference between women of both groups regarding age and BMI, denoting that both groups are matched regarding the demographic data.
We studied the hormonal profile of both groups with special emphasis on FSH, LH, progesterone, TSH and prolactin. All results were within normal ranges and the difference was not significant statistically between cases and controls regarding the above mentioned hormones. That may exclude any factor affecting fertility other than protein C deficiency.
The current study showed no significant correlation between protein C activity and age, body mass index, TSH level, LH level, FSH level, progesterone level, prolactin level, LH/FSH ratio among the studied cases.
In this study the mean protein c level in group I was 92.0 ±24.2 and in group II was 104.19 ±19.35, 8 cases (16.7%) of group I had protein C deficiency and there was one woman (2.1%) having protein C deficiency in group II. There was a statistical significance between the two groups.
In conclusion, there is a relation between women with unexplained infertility and protein C activity.