International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Exploring and investigating the long-term ramifications of fertility preservation in men with a history of cancer: a 10-year retrospective follow-up study
Get PDFBackground: Cancer treatments such as chemotherapy, radiotherapy, and surgery can adversely affect male fertility, leading to temporary or permanent sterility. Sperm cryopreservation is the standard fertility preservation strategy for young male cancer patients prior to gonadotoxic therapy. However, utilization rates of stored samples remain low despite increased awareness and accessibility.
Methods: This retrospective study analyzed data from 136 male cancer patients who underwent sperm cryopreservation at Madras Medical Mission Hospital, Chennai, over a 10-year period. Patient records were reviewed to assess return rates for assisted reproduction, post-treatment semen analysis outcomes, and psychosocial factors influencing fertility-related decisions.
Results: None of the patients who banked sperm returned for assisted reproductive procedures. Post-treatment semen analysis was available for a subset of patients, among whom 82.9% demonstrated spontaneous recovery of fertility. Psychosocial barriers, including lack of a partner, financial constraints, and diminished reproductive intent, contributed to the non-utilization of cryopreserved sperm.
Conclusion: Although sperm cryopreservation offers an effective safeguard against treatment-induced infertility, its utilization remains minimal. The high rate of spontaneous fertility recovery and psychosocial limitations appear to influence decision-making. These findings highlight the need for individualized fertility counselling, systematic follow-up, and strategies to mitigate financial barriers. Integration of fertility preservation into comprehensive cancer survivorship programs is crucial to optimize reproductive outcomes and improve long-term quality of life in male cancer survivors
A study on knowledge, perception, attitude and barriers among nursing students of Ganesh Das Government Maternal and Child Health Hospital, Shillong: a cross-sectional study on fertility
Get PDFBackground: The inability to get pregnant after a year of unprotected sex is known as infertility. Loneliness and emotional distortion are quite common psychological effects in this population. The causes of female infertility include factors like ovulatory disorders, tubal adhesion, uterine fibroid, endometriosis, STIs, diabetes and cancer. Male infertility can be brought on by low sperm count, low sperm motility, genetic disorders, ejaculatory dysfunctions, testicular injuries or surgeries, excessive obesity, and lifestyle variables like smoking, drinking alcohol and drug usage. The aim was to assess the fertility awareness of nursing students of a tertiary care hospital and its association with demographic factors.
Methods: This cross-sectional study targeted nursing students at Ganesh Das Government MCH Hospital having 154 nursing students. A 33-item FA questionnaire was developed to determine the FA score based on accurate responses. Correct answers scored 1, incorrect scored 0. Participants categorized into low (30%), moderate (31-60%), and high (>61%) FA levels. R-software was used for data analysing.
Results: Out of 154 nursing students 59.09% were aware of their fertility days. 87.01% were sexually active and 74.68% had normal menses. Half of the populations were dissatisfied with their knowledge of fertility. 76.62% responds due to communication barrier. Year of study was the only variable to have significant difference with fertility awareness (FA) (p value<0.05).
Conclusions: Knowledge of fertility awareness was found to be sufficient however, male infertility still lacks. Role of government, primary and specialized health care workers need to emphasize on fertility at an early age to prevent high rate of undiagnosed infertility
Maternal and neonatal morbidity associated with higher-order of four or more repeat cesarean sections: a retrospective cohort analysis in Dubai
Get PDFBackground: Cesarean delivery rates have surged globally over the past few decades, with an increasing trend of repeat cesarean sections (CS), raising significant maternal and neonatal health concerns. The risks associated with higher-order (four or more) repeat cesarean deliveries are underexplored, especially concerning outcomes like maternal hemorrhage, uterine rupture, placenta accreta spectrum (PAS), and neonatal morbidity. This study aimed to analyze maternal and neonatal morbidity in women undergoing higher-order repeat cesarean sections, comparing these with outcomes in lower-order (three or fewer) CS deliveries, to provide insights for risk mitigation and informed decision-making.
Methods: A retrospective cohort study was conducted on patients who underwent repeat cesarean deliveries from January 2018 to December 2023. Data were gathered from electronic health records, focusing on key outcomes including maternal complications (e.g., blood transfusions, adhesions, ICU admissions) and neonatal complications (e.g., NICU admissions, respiratory distress). Statistical analysis was used to assess correlations and compare morbidity
outcomes between groups.
Results: Findings indicated significantly higher morbidity in the higher-order CS group. Elevated risks of hemorrhage, peripartum hysterectomy, organ injuries, and neonatal NICU admissions were observed. These findings highlight the need for enhanced clinical strategies and informed counselling for women with multiple prior cesarean sections.
Conclusions: This study underscored the increased maternal and neonatal risks associated with four or more repeat cesarean sections. These results support the importance of careful prenatal monitoring, informed patient counselling, and targeted interventions to mitigate risks for high-order repeat cesarean deliveries
Comparative evaluation of maternal and neonatal outcomes using the WHO labour care guide versus the WHO-modified partograph: a prospective observational study
Get PDFBackground: Labour and childbirth remain critical phases in maternal care, with significant implications for maternal and neonatal outcomes. Despite declining global mortality rates, disparities persist, particularly in low-resource settings. Effective labour monitoring tools are essential for improving outcomes and reducing complications. This study aimed to compare maternal and neonatal outcomes using the WHO Labour Care Guide (LCG) versus the WHO-Modified Partograph (WHO-MP) for intrapartum monitoring.
Methods: This prospective observational study was conducted at GS Medical College & Hospital over 15-18 months. A total of 200 full-term pregnant women in active labour (≥4 cm cervical dilation) were randomly assigned to either the WHO-LCG group (n=100) or the WHO-MP group (n=100). Inclusion criteria encompassed singleton pregnancies with vertex presentation and no medical or obstetric complications. Labour progression, delivery mode, maternal complications, and neonatal outcomes were recorded and analysed using SPSS v27.
Results: Normal vaginal deliveries were higher in the LCG group (86%) compared to WHO-MP (78%), with lower maternal infection rates (6% vs. 18%, p=0.005) and postpartum hemorrhage (1% vs. 6%). The LCG group showed significantly shorter labour durations and NICU stays. Apgar scores and NICU admission rates were comparable, though early neonatal recovery was more favorable in the LCG group.
Conclusions: The WHO Labour Care Guide provides a structured, patient-centered approach to labour monitoring, potentially enhancing maternal and neonatal outcomes through timely and individualized care
A hospital-based study of hysteroscopic and laparoscopic findings in infertility cases among rural and urban female population of southern Rajasthan
Get PDFBackground: Infertility affects millions worldwide and presents significant medical and psychological challenges. This study assesses the diagnostic role of hysteroscopy and laparoscopy in infertile women from rural and urban Southern Rajasthan.
Methods: A hospital-based descriptive study of 130 women aged 21-40 years with infertility (primary or secondary) was conducted. All patients underwent diagnostic hysteroscopy and laparoscopy with Chromopertubation. Data was analyzed using Jamovi software.
Results: 62.5% had primary infertility, 37.5% had secondary. Laparoscopy revealed ovarian pathology in 56.25%, tubal in 48.34%, uterine in 15.62%, and adhesions in 18.75%. Hysteroscopy revealed uterine abnormalities in 12.5%.
Conclusions: Combined hysteroscopy and laparoscopy enhance the diagnosis of female infertility and help guide treatment, “especially in underserved populations”
Effect of letrozole and dexamethasone combination therapy compared to letrozole alone for ovulation induction in infertile women with polycystic ovary syndrome: a randomized controlled trial
Get PDFBackground: Polycystic ovary syndrome (PCOS), a common cause of anovulatory infertility, affects 5–10% of reproductive-age women. Hyperandrogenemia disrupts follicular development. Dexamethasone may enhance folliculogenesis. This study compared letrozole plus dexamethasone versus letrozole alone for ovulation induction in infertile PCOS women.
Methods: This randomized controlled trial was conducted at the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from September 2023 to August 2024. 72 infertile PCOS women (18-35 years) were allocated into 2 groups. Group A (36 patients) received letrozole 7.5 mg/day for 5 days with dexamethasone 0.5 mg twice daily for 10 days from cycle day 2. Group B (36 patients) received letrozole 7.5 mg/day for 5 days from cycle day 2 for 3 cycles. TVS folliculometry assessed ovarian response on day 12-14. HCG injection was given for mature follicles. Ovulation was confirmed by mid-luteal progesterone and pregnancy by serum B-HCG.
Results: Group A showed more mature follicles than group B, notably in the 3rd cycle (76.7% vs 51.6%, p<0.05). Endometrial thickness was greater in Group A in both 2nd (7.7±1.4 vs 6.6±0.9 mm, p<0.05) and 3rd cycles (7.9±1.4 vs 6.7±1.0 mm, p<0.05). Ovulation rates were higher in Group A, reaching significance in the 3rd cycle (76.7% vs 51.6%, p<0.05). Cumulative pregnancy rates favored Group A (30.6% vs 19.4%), though not significantly.
Conclusions: Letrozole plus dexamethasone is more effective than letrozole alone in enhancing follicular development, endometrial thickness, ovulation, and pregnancy outcomes in women with PCOS
Broad ligament fibroid-clinical presentation and surgical challenges: a case series
Get PDFUterine leiomyomas are benign monoclonal tumors originating from smooth muscle tissue. Their classification is based on anatomical location, with each type presenting unique surgical challenges, particularly in cases involving large, long-standing fibroids in atypical positions. These challenges often stem from limited access to the operative field, distorted pelvic anatomy, difficulty in performing surgical repairs, and increased risk of blood loss. Managing such complex fibroids requires both surgical expertise and refined technique, especially when performing intricate hysterectomies. In this case series of five patients, we examine the varied presentations of broad ligament fibroids, associated clinical findings, and the operative difficulties encountered. Tailored approaches are essential, as each fibroid type demands a specific surgical strategy. Preoperative imaging for fibroid mapping, along with ureteric stenting when indicated, plays a crucial role in minimizing intraoperative complications. Adherence to established surgical principles ensures optimal outcomes, reduces the risk of urinary tract injury, and helps control blood loss during surgery
Hypothyroidism and its influence on maternal and perinatal outcomes: insights from a hospital-based retrospective study
Get PDFBackground: Hypothyroidism during pregnancy is a prevalent endocrine disorder that significantly impacts maternal and perinatal health in the form of infertility, early pregnancy loss, PIH, anaemia, IUGR, PROM, preterm labour, neonatal mortality and morbidity. This retrospective hospital-based study aimed to evaluate the maternal and fetal outcomes associated with hypothyroidism in pregnant women.
Methods: Medical records of pregnant women diagnosed with hypothyroidism were reviewed to assess clinical characteristics, treatment status, and pregnancy outcomes. Maternal complications such as anaemia, preeclampsia, PPH, hypertension, miscarriage were recorded alongside perinatal outcomes including preterm birth, low birth weight, and intrauterine growth restriction. A total of 550 antenatal women with singleton pregnancies and without any pr-existing medical disorder were screened. All patients were monitored up to the point of delivery, allowing for comparison of outcomes across the three groups.
Results: Among the study cohort of 550 antenatal women, 70 were found to have hypothyroidism with an estimated prevalence of 12.72, largely comprising subclinical cases. A higher incidence of hypothyroidism was seen among multigravida patients. Lower segment cesarean section (LSCS) was the most common mode of delivery in the women with hypothyroidism. In addition, hypothyroid mothers experienced higher incidences of adverse outcomes such as preeclampsia, miscarriage, preterm labor, low birth weight infants, IUGR, foetal distress and need for NICU admission as compared to euthyroid mothers. Early identification and treatment with levothyroxine were associated with improved maternal and fetal outcomes.
Conclusions: Hypothyroidism in pregnancy is associated with significant risks for both mother and child. Routine screening and timely treatment are critical measures to mitigate these risks and improve pregnancy outcomes. The findings highlight the necessity of universal thyroid function screening protocols in antenatal care to ensure optimal maternal and perinatal health
Association of maternal neutrophil-lymphocyte ratio with adverse perinatal outcomes in preterm premature rupture of membranes: a case-control study
Get PDFBackground: Preterm premature rupture of membranes (PPROM) is a significant contributor to preterm birth and is associated with both maternal and perinatal complications. Neutrophil lymphocyte ratio (NLR) is an emerging marker of systemic inflammation. This study was conducted to evaluate the association of maternal NLR with adverse maternal and perinatal outcomes in PPROM cases.
Methods: This prospective case-control study was conducted among 60 pregnant women (30 PPROM cases with elevated NLR and 30 controls with normal NLR). Maternal NLR was calculated using complete blood count reports. Participants were grouped based on NLR levels and their association with maternal and perinatal outcomes were study.
Results: The incidence of neonatal intensive care unit (NICU) admission was significantly higher among newborns in the case group (70%) compared to the control group (36.66%). Similarly, perinatal mortality was markedly elevated in the case group (70%) relative to the control group (13.33%), indicating an overall poorer perinatal outcome in the case group.
Conclusion: Elevated maternal NLR is significantly associated with adverse maternal and perinatal outcomes in PPROM. It can serve as a simple and cost-effective inflammatory marker for risk stratification and early intervention
Assessment of the effectiveness of computer assisted teaching programme on knowledge regarding menstrual blood banking among B.Sc. nursing students at SRM College of Nursing, Kattankulathur, Chengalpet District
Get PDFBackground: Stem cells in menstrual blood have regenerative capabilities as the stem cells in umbilical cord blood and bone marrow. Cryo – cell patent – pending menstrual stem cells service offers women in their reproductive years the ability to store and preserve these cells for potential controversy. Cryo–cell is the only bank in the world that can offer women the reassurance and peace of mind that comes with the opportunity. The objective of the study was to determine the effectiveness of computer assisted teaching programme on knowledge regarding menstrual blood banking among BSc Nursing students in study group.
Method: The research approach was Quantitative approach. The research design adopted for the study was quasi experimental research design. The sample size was 302 BSc Nursing students in which 151 in study group and 151 in control group. The samples were selected by non-probability convenient sampling technique at SRM College of Nursing, Kattankulathur 30 samples per day were selected and conducted pretest on the same day, Computer assisted teaching were provided on menstrual blood banking for 15 minutes and post test was conducted on 7th day. The data was collected from the sample were tabulated and analysed and interpreted using both descriptive and inferential statistical method.
Result: The p value is less than 0.01 and is highly significant at 1% level.
Conclusion: Therefore, we can conclude that the knowledge level was increased in study group due to computer assisted teaching programme and it was effective in improving the knowledge of BSc Nursing students regarding menstrual blood banking