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Objective: The aim of this study is to investigate the effect of intrauterine insemination (IUI) performed simultaneously with ultrasound detected follicular rupture during biological reproduction window on pregnancy rates in patients with unexplained infertility undergoing ovulation induction (OI) cycles with gonadotropins. Material and Methods: Three-hundred and twenty-five patients with unexplained infertility were included in this prospective cohort study, who received recombinant follicular stimulating hormone (75-150 IU/day) or Human Menopausal Gonadotropin starting from the 2nd to 3rd days of the cycle. IUI was carried out with ultrasonographic monitoring of the follicles. The presence of free fluid within the Douglas pouch, detection of corpus luteum, and/or loss of the dominant follicle was interpreted as follicular rupture. Pregnancy rates with or without follicular rupture were compared after 14 days. Results: Among those with follicular rupture, the time between administration of recombinant hCG and IUI was significantly longer as compared to those without follicular rupture (p<0.001). ß hCG was positive at 14 days after IUI in 19.01% (31/163) and 13.92% (22/158) of the cases with or without follicular rupture, respectively. The difference in pregnancy rates was not significant (p=0.219). Conclusion: IUI simultaneously performed with ultrasound-detected follicular rupture in OI cycles with gonadotropins does not increase pregnancy rate. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the measurement of beta-human chorionic gonadotropin (ß-hCG) levels in vaginal fluid is useful for the diagnosis of premature rupture of membranes (PROM). Material and Methods: A total of 92 pregnant women between 24 and 40 weeks gestation participated in this study. The patients with fluid leaking from the vagina were designated Group 1, the patients with no fluid leaking from the vagina were Group 2, and those with a suspicion of fluid leaking from the vagina were classified as Group 3. Irrigating the posterior vaginal fornix with 5 mL sterile saline was used to measure ß-hCG levels of the patients. Receiver operator curve (ROC) analysis was used to determine the cut-off value for a positive diagnosis. Results: The ß-hCG levels of vaginal fluid were measured as 20.5±25.0 mlU/mL, 254.6±346.8 mlU/mL, and 74.3+100.8 mlU/mL in Group 1, Group 2, and Group 3, respectively. Vaginal ß-hCG level was higher statistically significantly in Group 2 than Group 1 and 3 (p<0.001). 100 mlU/mL was accepted as a cut-off value by using the receiver operating characteristic curve. According to 100 mlU/mL, sensitivity, specificity, positive predictive and negative predictive values were calculated as 71.2, 100, 100, and 65.1%, respectively. Conclusion: The study showed that the measurement of ß-hCG level in vaginal washing fluid is an efficient and easy diagnostic test for predicting the amount of fluid leaking from the vagina. However, due to the low negative predictive value of the test, it would not be convenient in daily practice. [ABSTRACT FROM AUTHOR]