Bassem Aly Islam

Bio: Bassem Aly Islam is an academic researcher from Ain Shams University. The author has contributed to research in topics: Randomized controlled trial & Embryo transfer. The author has an hindex of 2, co-authored 7 publications receiving 12 citations.

The reproducibility of the novel utilization of five-dimensional ultrasound and power Doppler in the prediction of endometrial receptivity in intracytoplasmic sperm-injected women: a pilot prospective clinical study

Abstract: The ultimate goal of this study is to reassess the five-dimensional implantation markers and pregnancy predictors on the day of human chorionic gonadotropin injection in the intracytoplasmic sperm injection and embryo transfer programs. A pilot prospective clinical trial. The Assisted Reproductive Technology Unit of Ain Shams Maternity Teaching Hospital during the period from April 2014 to December 2017. The study was conducted on 400 women undergoing intracytoplasmic sperm injection (ICSI). Those women were not older than 40 years, with normal uterine cavity and with no previous uterine scars. The ovarian stimulation protocol, used in this study for all patients, was the long protocol, before ovarian stimulation therapy, patients were instructed to use oral contraceptive pills from day 2 starting in the preceding cycle, then the standard regimen. On the day of hCG administration, 5D transvaginal ultrasound measurements were performed by the same observer after the patients had emptied their bladders. Measurements included endometrial volume and 3D power Doppler parameters, endometrial vascularization index, flow index, and vascularization flow index. The present study shows that endometrial volume ≥ 5 in the prediction of endometrial receptivity in ICSI patients had good sensitivity and low specificity in a group application; in an individual application it had good predictive negative value and bad predictive positive value. So it could be used as a good test to exclude success. Overall pregnancy rate was 40.5%; endometrial volume, flow index, vascularization index, and vascularization flow index were significantly lower in the nonpregnant group than those of the pregnant group. The area under curve in the receiver operating characteristic for three-dimensional ultrasound and power Doppler angiography parameters was statistically significant, but their values were suggestive but not conclusive in the prediction of endometrial receptivity in ICSI patients, no cutoff points with good diagnostic characteristics could be obtained. Five-dimensional ultrasound and power Doppler angiography is a useful exam to assess the endometrial receptivity in IVF/ICSI and embryo transfer cycles.

Vaginal CO2 laser therapy versus sham for genitourinary syndrome of menopause management: a systematic review and meta-analysis of randomized controlled trials

Abstract: IMPORTANCE The research of new therapeutic modalities, especially with energy-based devices, has been increasing nowadays for genitourinary syndrome of menopause (GSM) management. Microablative fractional CO2 laser has been used for pelvic floor dysfunction management. OBJECTIVE To conduct a systematic review and meta-analysis of randomized controlled trials to compare fractional CO2 laser therapy versus sham therapy for GSM management. EVIDENCE REVIEW We searched for the available randomized clinical trials in Cochrane Library, PubMed, ISI web of science, and Scopus during March 2021. We included randomized clinical trials that compared CO2 laser to sham among postmenopausal women with GSM diagnosis. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. Our main outcomes were total vaginal score assessment using the Vaginal Assessment Scale, sexual function using the Female Sexual Function Index, urinary symptoms using the Urogenital Distress Inventory-6, and satisfaction. FINDINGS Three studies met our inclusion criteria with a total number of 164 women. The CO2 laser was linked to a significant reduction in Vaginal Assessment Scale score when compared with the sham group (mean difference [MD] = -0.49, 95% CI [-0.75 to -0.22], P = 0.004). The CO2 laser was associated with a significant improvement in Female Sexual Function Index score in comparison with sham group (MD = 9.37, 95% CI [6.59-12.14], P < 0.001). In addition, a significant reduction in Urogenital Distress Inventory-6 score was reported among the CO2 laser group (MD = -6.95, 95% CI [-13.24 to -0.67], P = 0.03). More women were significantly satisfied among the CO2 laser group (risk ratio = 1.98, 95% CI [1.36-2.89], P = 0.004). CONCLUSIONS AND RELEVANCE CO2 laser therapy is a promising alternative for GSM management. Further randomized trials with larger sample sizes are required to confirm our findings.

Protein S activity in women with unexplained infertility

Abstract: Aim: To the best of our knowledge, no previous studies have addressed the association of unexplained infertility with protein S activity. This case-control study was performed to evaluate the prevalence of protein S activity in women with unexplained infertility and to compare its prevalence in normal fertile women.Materials and Methods: This is a case-control study conducted to evaluate the prevalence of protein S activity inwomen with unexplained infertility conducted at Ain-Shams University Maternity Hospital. A total of 30 women withunexplained primary infertility and another 30 fertile women of matched age group as their control were recruited fromSeptember 2018 to March 2019. Using STA Compact Max® Coagulation System protein S was measured. STA-staclot kitsupplied by Stago, France is a clotting assay for measuring protein S activity in human citrated plasma. A venous bloodsample (3 ml) was collected from every participant at any day of the menstrual cycle then the samples were collectedin (3.2%) sodium citrate tubes (venous blood must be mixed with the sodium citrate immediately after collection byturning upside down gently the tube 3 or 4 times), then centrifugation performed as fast as possible less than an hour toobtain platelet-poor plasma and centrifuged at 2500g for 15 min (platelet poor plasma). Samples and test reagents areloaded into the instrument where sample handling, reagent delivery, analysis, and reporting of results are performedautomatically. Results: This study failed to find a relationship between protein S activity and unexplained infertility compared to the normal fertile population. Despite finding none in the unexplained infertility sample population with protein S deficiency and one in the control group, this difference failed to reach significance.Conclusion: In conclusion, this study failed to find any association between protein S activity and unexplained infertilitybut this study showed that the mean of protein S percentage in group 1 (cases) is lower than the mean in group 2 (controls).

Maternal Serum Amyloid A level in Pregnancies Complicated with Preterm Premature Rupture of Membranes

Abstract: Background: serum amyloid A (SAA) is a cytokine-inducible acute-phase reactant whose plasma concentrations can exceed 1 mg/mL during an acute-phase response (500 to 1000 fold of plasma levels greater than in the non inflammatory state) thus representing an ideal marker for clinical use. Preterm premature rupture of membranes (PPROM) complicates only 2% of pregnancies but is associated with 40% of preterm deliveries and can result in significant neonatal morbidity (Prematurity, sepsis and pulmonary hypoplasia) and mortality. Aim of the work: this study aimed to find out association between maternal serum amyloid A level and preterm premature rupture of membranes. Also to compare SAA, CRP levels, N/L ratio in the study group. Patients and methods: this study is a cross sectional study conducted in Ain Shams University Maternity Hospital from December 2015 – December 2016 on 58 pregnant women. Women have been allocated in this study, represented in two groups: 1- Study group: including 29 women complaining of preterm premature rupture of membranes. 2- Control group: including 29 women as control group with no complain. Venous blood sample was taken from each participant (study group within 1hour from onset of PPROM, control group during their follow up visit to the clinics). Serum amyloid A, Micro C reactive pretein, total WBCs and neutrophil/lymphocyte ratio (NLR) were calculated. Results: the results point out that PPROM cases had significantly lower GA and APGAR scores at 1 min and more prone to neonatal sepsis which may lead to death. PPROM women have significantly higher total WBC, N/L ratio CRP and serum amyloid A. There were significant positive correlations between amyloid-A, N/L ratio& CRP in both groups. Serum amyloid A level above 2 ng/ml is a risk factor for PPROM and low Apgar score at 1 min. but has low predictive value. CRP with cut off value 5.0 mg/dl has better predictive value in discrimination between PPROM group and control group.Conclusion: Results assessed possible association between maternal SAA, maternal and fetal parameters in pregnancies complicated with PPROM.

Assisted reproductive technology.

Abstract: Assisted reproductive technology (ART) is the technology used to achieve pregnancy in procedures such as fertility medication, artificial insemination, in vitro fertilization and surrogacy. It is reproductive technology used primarily for infertility treatments, and is also known as fertility treatment. It mainly belongs to the field of reproductive endocrinology and infertility, and may also include intracytoplasmic sperm injection (ICSI) and cryopreservation. Some forms of ART are also used with regard to fertile couples for genetic reasons (preimplantation genetic diagnosis). ART is also used for couples who are discordant for certain communicable diseases; for example, HIV to reduce the risk of infection when a pregnancy is desired.

Endometrial receptivity and pregnancy outcome

Abstract: Human implantation is a highly complex and multifactorial process. Successful implantation requires the presence of a healthy embryo, a receptive endometrium, and a synchronized molecular dialogue between the two, as well as immune tolerance/protection from the host. The endometrial receptivity refers to a hormonally limited period in which the endometrial tissue acquires a transient functional status allowing blastocyst implantation and pregnancy initiation. Global knowledge of endometrial receptivity grew up in recent years. Improvements in genetics, new biomarkers, noninvasive methods, new advanced techniques (Endometrial receptivity assay - the ERA system, proteomic analysis) offer the possibility to evaluate the endometrial status and to manage patients with infertility problems, especially women undergoing assisted reproductive treatment. This overview reports the most relevant knowledge and recent advances in the study of implantation processes from the perspective of the endometrium, often considered as being the main barrier for a successful pregnancy initiation. Endometrial receptivity is a topic of great interest and further studies are needed for the early identification of endometrial abnormalities and the discovery of new strategies for increasing the chance for the establishment of pregnancy.

The evidence behind the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus: A state‐of‐the‐art review

Abstract: In recent years, LASER has been introduced as a minimally invasive treatment for a broad range of vaginal and vulvar symptoms and diseases. However, the efficacy and safety of vaginal and vulvar LASER has continuously been questioned. The aim of this study is to create an overview of the current literature and discuss the controversies within the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus. A search string was built in PubMed. The search was commenced on August 25, 2021 and closed on October 27, 2021. Two authors screened the studies in Covidence for inclusion according to the eligibility criteria in the protocol. The data were extracted from the studies and are reported in both text and tables. This review included 114 papers, of which 15 were randomized controlled trials (RCTs). The effect of LASER as a vaginal treatment was investigated for genitourinary syndrome of menopause in 36 studies (six RCTs), vulvovaginal atrophy in 34 studies (four RCTs) and urinary incontinence in 30 studies (two RCTs). Ten studies (three RCTs) investigated the effect of vulvar treatment for lichen sclerosus. Half of the included RCTs, irrespective of indication, did not find a significant difference in improvement in women treated with vaginal CO2 or Er:YAG LASER compared with their respective controls. However, most non‐comparative studies reported significant improvement after exposure to vaginal or vulvar LASER across all indications. Included studies generally had a short follow‐up period and only a single RCT followed their participants for more than 6 months post treatment. Adverse events were reported as mild and transient and 99 studies including 51 094 patients provided information of no serious adverse events. In conclusion, this review found that the effect of vaginal and vulvar LASER decreases with higher study quality where potential biases have been eliminated. We therefore stress that all patients who are treated with vaginal or vulvar LASER should be carefully monitored and that LASER for those indications as a treatment should be kept on a research level until further high‐quality evidence is available.