Papers by Aboubakr Elnashar
The Egyptian Journal of Fertility and Sterility, May 1, 2024
Clinical and experimental obstetrics & gynecology, Jun 18, 2024
The Egyptian Journal of Fertility and Sterility, Mar 1, 2024
The Egyptian Journal of Fertility and Sterility, Mar 1, 2023
The effect of umbilical cord loops around the fetal neck on the modified Doppler myocardial perfo... more The effect of umbilical cord loops around the fetal neck on the modified Doppler myocardial performance index (Mod-MPI) in a sample of Egyptian population.
The Egyptian Journal of Fertility and Sterility, Sep 1, 2023
The Egyptian Journal of Fertility and Sterility, Jul 1, 2023
The Egyptian Journal of Fertility and Sterility, May 1, 2023
Manuscripts should be written in English, typed with double spacing, submitted and, where possibl... more Manuscripts should be written in English, typed with double spacing, submitted and, where possible, on a disk. Figures and diagrams should, if possible be used instead of tables. The work shall not be published elsewhere in any language without the written consent of the editor in chief. The articles published in this journal are protected by copyright. Contributors should submit their papers and disk to:
The Egyptian Journal of Fertility and Sterility, Nov 1, 2023
The Egyptian Journal of Fertility and Sterility, 2024
Human Reproduction, 2011
To explore the molecular basis of clinically observed volume reduction in uterine leomyoma, expos... more To explore the molecular basis of clinically observed volume reduction in uterine leomyoma, exposed to mifepristone. Background: Treatment of uterine leiomyomas with a selective progesterone receptor modulator (SPRM) as an alternative to surgery is of considerable clinical interest. Steroid homone receptors are overexpressed in leiomyoma tumor tissue compared to adjacent myometrium and involved in the process of leiomyoma growth. Progesterone receptor modulators such as mifepristone are effective and well tolerated in reducing myoma volume and vaginal bleeding. In a previously reported study we observed a significant volume reduction in the dominant myoma in response to mifepristone, but with a wide individual variation (median-23%, range:-81 to + 19%) in response to treatment. Thus, a study was conducted to explore the molecular basis of good response to mifepristone treatment. Material and Methods: Premenopausal women with uterine leiomyoma (n = 12) received treatment with mifepristone 50 mg every other day for 12 weeks. Among them, eight women were sub grouped as good (N = 4, median-49%, range-64 to-31%) or poor (N = 4, median-22%, range-23 to-21%) respnders. At surgery, biopsies were taken from the periphery of the dominant leiomyoma and total RNA was extracted to study the gene expression by microarray. The result was further analysed by Ingenuity Pathway Analysis (IPA, Ingenuity® Systems, www.ingenuity.com) to explore the leading molecular pathway mediating the response to mifepristone. The result from the microarray was confirmed by real time-PCR. Proliferation marker MKI67 and apoptosis marker TP53 were analysed along with apoptotic index by TUNEL assay. Ethical permission for this study was obtained prior to start of the study. Results: Twenty one canonical pathways showed significantly different expression (p < 0,05) on comparing between good and poor responders. The most differently expressed pathway was Metabolism of Xenobiotics by Cytochrome P450 pathway. The second most significant pathway and the pathway more relevant to uterine leomyoma growth is the glutathione pathway harboring glutathione-s tranferases (p = 0.0001, ratio 5%). One of the genes was downregulated (GPX2-1.7 fold) and 4 genes belonging to this family were upregulated (GSTM1 + 8.0-fold), GSTM2(+ 1.5 fold), GSTM3(+ 2.3 fold), GSTM5(+ 2.2 fold) among the good responders. Further analysis by real time PCR showed GSTM1 was not detectable in biopsies from non responders. No correlations were seen for GSTM1, MKI67 or TP53 versus percentual myoma volume reduction. TUNEL analysis showed no difference in the degree of apoptosis between good or bad responders to mifepristone. Conclusion: Our findings indicate that glutothione pathway is involved in the action of mifepristone on leiomyoma volume reduction. GSTM1 positive fenotype is of importance for uterine leiomyoma volume reduction in response to mifepristone exposure in vivo. The mechanism behind the difference in growthregulation is still not clear, but could be suggested to interfere with proliferation or repression co-regulators related to the degree of metabolism of steroids regulated by GSTMs. The finding in the present study of a tentative prognostic marker for leiomyoma volume reduction during mifepristone treatment is of potential importance for the clinical management of millions of women suffering from symptoms from uterine leiomyomas.
Stimulated intrauterine insemination (IUI) should be the first choice treatment for mild male fac... more Stimulated intrauterine insemination (IUI) should be the first choice treatment for mild male factor infertility, unexplained infertility or minimal to mild endometriosis. In mild male factor infertility, unexplained infertility, IUI is as effective as IVF & at 1/3 of the cost per pregnancy. In couples with the most severe semen defects, IUI in natural cycle should be the treatment of choice. In mild to moderate semen defects, mild ovarian hyperstimulation with IUI is recommended. In endometriosis, simplified ultrlong protocol with IUI gives better chances of achieving pregnancy. Ultrasonographic monitoring & human chorionic gonadotropin (hCG) induction of ovulation does not produce an increased pregnancy rate over urinary lutenising hormone (LH) monitoring of ovulation. Double IUI showed no significant benefit over single IUI. Four cycles of IUI are enough. Continued IUI is not recommended.
Assisted Reproduction Techniques, 2021
Contraception, 1992
During a 70-month period, CO2 hysteroscopy was carried out on 52 pregnant women wearing IUDs with... more During a 70-month period, CO2 hysteroscopy was carried out on 52 pregnant women wearing IUDs with retracted tails. Ultrasonography was done prior to hysteroscopy to determine the size of the gestational sac and the site of the device. Successful removal of the device occurred in 46 cases. The technique, the findings of the study, and the limitations of the procedure are described.
The Egyptian Journal of Fertility of Sterility
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Papers by Aboubakr Elnashar