الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Anti-Mullerian hormone (AMH) is a member of the transforming growth factor-β superfamily of growth factors. AMH and ovarian sensitivity index (OSI) could be considered as markers for ovarian reserve and ovarian responsiveness to gonadotropins in in-vitro fertilization (IVF). The aim of the present study was planned in one hand to make a correlation between the OSI and AMH in the IVF cycle outcomes for women undergoing assisted reproductive technology and on the other hand to make a model of PCOS by using a non-steroidal aromatase inhibitor (letrozole) on adult female rats. Body weight, organs weight, blood analysis, histopathological changes were taken as the parameters in the study. The study included 70 women attending for the first time the IVF program at Mansoura IVF-ET Centre between June 2015 and April 2016.Ovarian stimulation protocol Patients underwent controlled ovarian hyperstimulation (COH) with the use of a GnRH antagonist protocol. a GnRH antagonist (Cetrotide 0.25 mg sc, Merck-Serono, Switzerland) were injectioned daily to prevent premature ovulation, according to a personalized regimen, from the day the leading follicle reached 14 mm in diameter until the day of hCG injection. Every second– third day vaginal ultrasound and hormonal assessment were used for ovulation induction monitoring.Ovarian sensitivity index (OSI) was calculated by dividing the total administered FSH dose by the number of oocytes retrieved at OPU, thus obtaining the FSH-to-retrieved oocyte ratio.A venous blood sample for AMH measurement was taken approximately one month before the scheduled IVF treatment, independently of the menstrual cycle phase. The most important results can be summarized as follows:1-This study illustrate the base line data the IVF/ICSI cycle outcomes for women undergoing assisted reproduction.2-AMH showed a highly positive significant correlation to the number of retrieved oocytes and significant correlation to MII and fertilization rate but there was no correlation to age, FSH , and division. OSI show positive significant correlation with age , a highly significant inverse correlation between number of retrieved ooctyes, MII, fertilization and division .There was no corelation between OSI and FSH.2nd ExperimentThis study aimed to: 1-Induced PCOS in the rats by using letrozole and study its effect on body weight and weight of ovaries and uterus. 2. Determined the level of hormones (FSH, AMH, estrogen, testosterone, LH). 3. Evaluation of the side effects of PCOS on tissue changes in ovaries and uterus. Animal model for infertility The present study was designated to investigate the infertility in the PCOS induced by chemical agent Letrozole in the female rat model. Sixteen female rats were divided into two groups according to the following: Control group (C) of eight rats that received oral doses of (0.9% NaCl solution) once daily. Treated group (T) of eight animals administered oral doses of letrozole at a concentration of 1 mg/kg. dissolved in 0.9% NaCl solution once daily during 21 days (Jadhav et al., 2013). Effect of Letrozole on body, ovarian and uterine weights(g) Letrozole group exhibited a significant increase in the body and ovarian weights at the end of treatment period (21 days of treatment) while a significant decrease in uterine weight was observed. Effect of Letrozole on hormones: AMH, Testosterone, FSH and LH levels in letrozole group were increased more than in the control group. While estrogen level decreased in letrozole group. Histopathological observations: The histological presentation of both ovaries and uterus in the rats treated with letrozole showed that there were changes in the ovaries and uterus. Ovary in experimental group treated with letrozole showing intense follicular atresia at high degree of degeneration having formation of cysts. These follicular cysts with virtually no granulosa cell layer or large cystic follicles with scant granulosa cells and there was intensive distribution of collagenous fibers in polycystic ovary which revealed fibrosis in ovarian stroma. In group treated with letrozole group showed histopathological lesions in the uterus include necrosis in stromal mesenchymal cells, few numbers of glands, damage and hyperplasia of luminal epithelial cells. There was excessive distribution of collagenous fiber indicating fibrosis in all uterine layers.