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INTRODUCTION: Recent studies have addressed the role of micronutrients in fertilization, such as vitamin D. The present study aims to explore the effects of using calcitriol, an active form of vitamin D, on IVF results in women with vitamin D deficiency. METHOD: This double-blinded randomized clinical trial was done on 180 infertile women, undergone IVF treatment. Out of them, 95 were found to have vitamin D deficiency (blood serum 25-dihydroxy vitamin D <30 ng/ml). Fifty one women in experimental group were treated with two 0.25 µg calcitriol pills daily during 4 weeks (discontinued 8 hours prior to the embryo transfer) and 44 subjects to the placebo group (mean vitamin D deficiency 27.5 ±1.8 in case group vs. 27.6±1.8 in control group, P>0.05). Final analysis includes outcomes of chemical and clinical pregnancy was done on 74 women (including 36 in case and 38 in control group). RESULTS: Our study showed that in the experimental group, chemical pregnancy success was significantly higher than that in the control group, 31.4 vs. 18.2% (P<0.05). However, there were no significant differences between the 2 groups in reaching the clinical pregnancy stage (25.5% in case group vs. 13.6% in control group) and continuation of pregnancy into week 20 (9.8% in case group vs. 11.6% in control group) (P>0.05). CONCLUSION: Calcitriol administration by improving the implantation process can significantly increase the chances of successful IVF cycle results in infertile women with vitamin D deficiency.

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PURPOSE: Vaginal atrophy is one of the most common side effects of using tamoxifen in women with breast cancer. Hormone therapy for vaginal atrophy is prohibited in these women. The present study was conducted to investigate the effect of vitamin D and E vaginal suppositories on vaginal atrophy in women with breast cancer receiving tamoxifen. METHODS: Women under breast cancer management receiving tamoxifen and showing symptoms of vaginal atrophy were randomized triple-blind to an 8-week trial on vaginal suppository vitamin E or vitamin D or placebo administered every night before bedtime. The genitourinary atrophy self-assessment tool was administered, and pH was measured in all three groups before the intervention and at the end of weeks 2, 4, and 8 of the intervention. The Vaginal Maturation Index (VMI) was also measured before the intervention and at the end of the eighth week. Data were analyzed with paired t tests, repeated measures analysis of variance, and chi-square test. RESULTS: Thirty-two patients were randomized in each group. The results obtained showed an increase in the VMI by the end of the eighth week of the intervention in the groups receiving the vitamin D and E vaginal suppositories compared with the placebo group (P < 0.001). The vaginal pH also reduced in both groups compared with that in the placebo group (P < 0.001). The symptoms of self-reported genitourinary atrophy also improved in the two intervention groups compared with those in the placebo group by the end of the eighth week (P < 0.001). CONCLUSION: These data support that vitamin D and E vaginal suppositories were beneficial in improving vaginal atrophy in women with breast cancer receiving tamoxifen. Given the prohibition on hormone therapy in these women, the suppositories can be used as an alternative therapy to improve these symptoms.

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BACKGROUND: Considering folkloric use of Tribulus terrestris (T. terrestris) in diabetes and proven anti-hyperglycemic and anti-hyperlipidemic effects of T. terrestris in animal studies, we aimed to evaluate the efficacy of the hydro alcoholic extract of T. terrestris on the serum glucose and lipid profile of women with diabetes mellitus. METHODS: Ninety-eight diabetic women were randomly allocated to receive the T. terrestris (1000 mg/day) or placebo for three months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin and lipid profile. RESULTS: T. terrestris showed a significant blood glucose lowering effect in diabetic women compared to placebo (P<0.05). Also, the total cholesterol and low-density lipoprotein of the T. terrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels. CONCLUSION: This study showed preliminary promising hypoglycemic effect of T. terrestris in diabetic women.

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AIM: Considering traditional use of Tribulus terrestris in diabetes and proven antihyperglycemic and antihyperlipidemic effects of T terrestris in animal studies, we aimed to evaluate the efficacy of the hydroalcoholic extract of T terrestris on the serum glucose and lipid profile of women with non-insulin-dependent diabetes mellitus. METHODS: Ninety-eight women with diabetes mellitus type 2 were randomly allocated to receive the T terrestris (1000 mg/d) or placebo for 3 months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin, and lipid profile. RESULTS: Tribulus terrestris showed a significant blood glucose-lowering effect in diabetic women compared to placebo (P < .05). Also, the total cholesterol and low-density lipoprotein of T terrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels. CONCLUSIONS: The study showed preliminary promising hypoglycemic effect of T terrestris in women with diabetes mellitus type 2.

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BACKGROUND: Vaginal atrophy is a common complication in menopause which does not improve with time and, if untreated, can affect the quality of life for women. The aim of this study was to compare the effectiveness of the vaginal cream of hyaluronic acid and conjugated estrogen (Premarin) in treatment of vaginal atrophy. METHODS: This study was a randomized controlled clinical trial on 56 menopausal women with symptoms of vaginal atrophy; they were randomly allocated to two groups (recipient conjugated estrogen and hyaluronic acid). The severity of each sign of atrophy was evaluated by visual analog signals (VAS) and on the basis of a four point scale. Also to recognize the cellular maturation with pap smear and the maturation degree were calculated according to the formula and scores 0-100. As to the vaginal PH, we used PH marker band, the rate of which was divided into 4 degrees. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. RESULTS: The results of this study showed that the symptoms of vaginal atrophy compared with the baseline level were relieved significantly in both groups. Dryness, itching, maturation index, PH and composite score of the vaginal symptoms were relieved significantly in both groups (P<0.001). Dyspareunia in Premarin (P<0.05) and hyaluronic acid (P<0.001) decreased compared with pre-treatment. Urinary incontinence only showed improvement in the hyaluronic acid group (P<0.05). Improvement in urinary incontinence, dryness, maturation index (P<0.05) and composite score of vaginal symptoms (P<0.001) in the hyaluronic acid group was better than those in the Premarin group. CONCLUSION: According to the results of the present study, hyaluronic acid and conjugated estrogen improved the symptoms of vaginal atrophy. But hyaluronic acid was more effective and this drug is suggested for those who do not want to or cannot take local hormone treatment. TRIAL REGISTRATION NUMBER: IRCT2013022712644N1.

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Nowadays, acupuncture is widely used to manage pain, and childbirth is a condition requiring appropriate pain management interventions. The efficacy of acupuncture in the management of labor pain has recently been studied, but the results are not satisfactory and conflicts exist. In this study, we investigated the effects of acupuncture on labor pain, serum cortisol level, and duration of labor. We conducted a randomized, single-blind, controlled trial that included 63 nulliparous women: 32 in the study group and 31 in the control group. Acupuncture was performed at the SP-6 and the LI-4 points in the study group, and sham acupuncture was performed at the same points in the control group. Pain scores and serum cortisol levels were measured before and after the intervention. Changes in these measures and in the duration of labor were compared between the groups. No significant variations in pain scores or serum cortisol levels were observed between the two control groups. However, the duration of labor was significantly lower (p < 0.001) in the group receiving real acupuncture. Our results show that acupuncture is significantly associated with a decreased duration of labor, even though it was no better than a placebo for the treatment of labor pain.

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