International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Alleviating ashermans: a success story
Get PDFAsherman syndrome (AS) is characterised by formation of intrauterine synechia due to the destruction of basal layer of endometrium. It presents as oligomenorrhea, amenorrhoea and infertility. Treating Ashermans is a challenge. Patient XYZ, 28 years, presented with complaints of amenorrhea for 11/2 years. She was diagnosed with Ashermans Syndrome outside but the treatment did not work. We first gave cyclical hormones followed by hysteroscopic adhesiolysis. She conceived immediately after return of menses and delivered a term baby. Currently she has regular menstruation. Conclusion: Building up the endometrium on hormonal support pre- and post-surgery and instant conception on return of menstruation was the factor leading to successful management
Assessment of contraceptive services for adolescents in the Burundian family welfare association and the youth-friendly centres in Bujumbura, Burundi
Get PDFBackground: Many sexually active adolescents throughout the world do not have access to modern contraception, which can result in unintended births. This study evaluates the quality, accessibility and effectiveness of contraceptive services provided to sexually active adolescents in Burundian Family Welfare Association and youth-friendly centres in Bujumbura / Burundi.
Methods: A mixed-methods study design with cross-sectional study and in-depth interviews was used, which recruited 25 healthcare providers and 25 adolescents for in depth interviews and self-administered questionnaires to 287 adolescents and 43 healthcare providers. SPSS version 25 was used to analyse the quantitative and thematic content for qualitative data.
Results: Among the independent variables, correlation analysis showed that adolescents' sexual experience (p<0.001), knowledge about contraception (p<0.001), fear of side effects (p<0.001) and lack of support/encouragement (p=0.011) influenced their use of contraceptive services. However, service utilization is negatively impacted by knowledge of contraceptive options. Barriers including lack of support and encouragement and fear of adverse effects may be the cause of this. On the provider side, lack of privacy/confidentiality (p=0.022) and limited availability of contraceptive methods (p=0.018) are factors influencing the provision of services to adolescents.
Conclusions: The lack of support from parents, the community and healthcare providers, as well as the fear of side effects, prevent adolescents from using contraceptive services. Teachers, parents and healthcare professionals are essential in helping adolescents learn about sexual and reproductive health
Fetomaternal outcomes in patients undergoing cesarean after previous 1 or more cesarean section at Government Medical College, Saharanpur
Get PDFBackground: There is an increase in trend of caesarean section in most countries worldwide, resulting in the rise of multiple repeat cesarean sections which is known to be associated with increase in maternal and perinatal morbidity and mortality rates. We decided to study the various fetomaternal outcomes in patients undergoing caesarean section at our institution.
Methods: This prospective study was carried out in department of obstetrics and gynecology, Government Medical College, Saharanpur (UP) over a period of 14 months. All patients undergoing caesarean section for various indications at Government Medical College, Saharanpur with previous one or more caesarean section were included. History taking and examination was done. Maternal and fetal outcomes were noted.
Results: Over a span of 14 months (September 2023 - December 2024), out of total 240 cesarean deliveries, 139 patients had at least 1 prior LSCS. Of these, 62.58% were emergency cases, and 37.43% were elective. 42.44% were aged 26-30 years, with only one patient over 40 years. 38.13% were gravida 2. Most common indication was short interpregnancy interval in 15.10%. Most frequent intra operative complication was adhesions in 31.65%. 8 cases with previous 1 LSCS needed NICU admission.
Conclusions: With rise in repeat cesarean section there lies increase in maternal and fetal risks. Hospitals should conduct cesarean audits to reduce primary cesarean section rates, promote trial of labor after cesarean (TOLAC) for successful vaginal birth after cesarean (VBAC), and counsel patients on vaginal birth after cesarean (VBAC) risks and benefits to reduce repeat c-sections and complications
Male factor infertility and assisted conception: a 2-year retrospective analysis of pregnancy rates and treatment outcomes
Get PDFBackground: Male factor infertility contributes nearly half of the burden of infertility among infertile couples, highlighting the importance of understanding the complex interplay between male reproductive health and fertility outcomes. To investigate the relationship between male factor infertility and pregnancy rates after assisted conception.
Methods: We retrospectively analyzed data of couples attending fertility clinics due to inability to conceive spontaneously. The study focused on the patients seen between October 2022 and September 2024.
Results: Of 298 couples evaluated for infertility during the period under review, 118 had seminal fluid abnormalities of varying degrees, projecting a prevalence of 39.6%. The mean and standard deviation (SD) of 2.26±1.30mL for volume, 15×106±16×106 cells/ml, 32×106±50×106 cells/ejaculate, 14.9±14.3% progressive motility, 15.8±12.5% non-progressive motility and 19.2±15.6% for normal morphology. Nearly 50% had Asthenozoospermia, 33.9% had Oligozoospermia and 13.9% had Azoospermia. Intracytoplasmic sperm injection (ICSI) as the predominantly performed treatment type due poor semen quality. Pregnancy rate and live birth rate were 55.9% and 40.7% respectively. There was no statistically significant correlation between semen parameters and pregnancy rate.
Conclusions: The findings of this study can inform the development of personalized treatment approaches for male infertility and highlight the need for further research to identify the role of individual factor that interferes with semen quality and how it affects fertility outcomes
Human semen profile and mobile telephony: an original research study
Get PDFBackground: Mobile telephony is recent phenomenon; it functions based on electro-magnetic radiation (EMR). It has revolutionized the telephonic communication system. Major population of world is using mobile telephony with android mobile handsets. Mobile users are rapidly increasing every day. Researchers show that Electro- Magnetic Radiation affects the human health and causes tumour, cancer and other diseases. This has also been reported that mobile telephony affects the reproductive health too. But some researchers claimed that mobile telephony does not affect human health. Therefore, this study was planned in male human volunteers to assess the possible effects of mobile telephony on semen profile.
Methods: Eighty-two human male volunteers consented for our research study. Their mobile phone placing, using hour/day was recorded and these volunteers were placed in three Groups A, B and C (exposure of mobile telephony was 3-4 hours, 5-6 hours and 7-8 hours respectively and approximately).
Results: Semen analysis was done using WHO method manual in our infertility research centre, Bengaluru, India. Semen analysis of these volunteers shows that decline in sperm density, motility (quantitatively and qualitatively) and enhanced percentage of abnormal sperm. It appears to be associated with duration exposure dependant.
Conclusions: In conclusion, we may say that sub-fertility in human male may be associated with the use of mobile telephony along with other factors. Further research studies are needed to ascertain the possible effects of mobile telephony on human male reproductive health
Breast cancer screening: a narrative review
Get PDFBreast cancer (BC) is the most commonly diagnosed cancer and a leading cause of cancer-related mortality among women worldwide, accounting for over 2.5 million cases and 670,000 deaths annually. The burden is disproportionately higher in low- and middle-income countries (LMICs) due to limited access to screening, poor infrastructure, low awareness, and socio-cultural barriers. Early detection through screening plays a critical role in improving survival and reducing morbidity. This review outlines the epidemiology of breast cancer (BC), stratification of risk, and current international and national screening guidelines. Various screening modalities are discussed, including mammography, ultrasound, MRI, clinical breast examination (CBE), and emerging technologies such as artificial intelligence and liquid biopsy. The role of innovative tools such as the iBreastExam and, community-based strategies in resource-limited settings is emphasized. Despite advances, key challenges remain regarding accessibility, affordability, and awareness.
Thyroid stimulating hormone and thyroid peroxidase antibodies assessment in screening of hypothyroidism in pregnancy
Get PDFBackground: Thyroid dysfunction in pregnancy is often underdiagnosed due to overlapping physiological changes, yet it poses significant risks to maternal and foetal outcomes. This study aimed to evaluate role of anti-thyroid peroxidase (TPO) antibodies alongside thyroid stimulating hormone (TSH) in diagnosing and guiding treatment for hypothyroidism in pregnant women.
Methods: A prospective cohort study was conducted from September 2019 to June 2021 at a tertiary hospital in Mumbai among antenatal women at booking visit. TSH, free T4, and anti-TPO antibodies were measured using chemiluminescent immunoassay. Follow-up and treatment were based on trimester-specific reference ranges and standard guidelines. Statistical analysis was done with significance set at p<0.05.
Results: Hypothyroidism was found in 11.46% pregnant women (n=253) using TSH cutoff level of 4.0 µIU/ml. The prevalence of anti-TPO antibodies was 5.1%. Among anti-TPO antibody-positive cases, 23.08% had history of miscarriage. Out of 13 participants who tested positive for anti-TPO antibodies, 6 had TSH levels above upper reference limit (4 mIU/l). Participants with borderline TSH levels were followed up; at the second follow-up, 1 out of 72 participants had TSH >4 mIU/l and was started on treatment. At third follow-up, 5 out of 69 participants had TSH >4 mIU/l and were also treated accordingly.
Conclusions: A significant association was observed between elevated TSH levels and presence of anti-TPO antibodies. A notable decrease in mean TSH levels was observed in second and third visits compared to baseline values among pregnant women with borderline TSH, without thyroid hormone supplementation
Maternal and neonatal outcome in gestational and pregestational diabetes
Get PDFBackground: Diabetes during pregnancy increases risks for both mother and baby, despite medical advances. This study evaluates and compares maternal and fetal outcomes in pre-gestational and gestational diabetes. The aim of the study was to evaluate the maternal and perinatal outcomes in patients with gestational and pre-gestational diabetes.
Methods: This prospective cross-sectional study was conducted at the department of obstetrics and gynecology, BSMMU, and BIRDEM, Dhaka, Bangladesh, from January 2004 to December 2005, involving 150 pregnant women divided into three groups: 50 non-diabetics, 50 with pre-existing diabetes (PDM), and 50 with gestational diabetes (GDM). Data were collected using a structured questionnaire and analysed with SPSS, applying Chi-square and t-tests.
Results: Maternal age and weight were similar across groups (p>0.10). Diabetic patients had significantly more pregnancy complications (66-68%) than non-diabetics (28%) (p<0.05), with higher insulin use in pre-gestational diabetes (90%) (p<0.01). Operative deliveries and post-partum issues were more common in diabetics, though not statistically significant. Pregnancy losses were higher in diabetic groups (14% and 6%) vs. none in non-diabetics (p<0.05). Neonatal resuscitation (65.1%, 59.6%) and morbidities (50%, 38%) were also more frequent in diabetics than in non-diabetics (42% and 20%) (p<0.05).
Conclusions: Well-controlled diabetes, whether pre-gestational or gestational, still poses increased maternal and perinatal risks compared to non-diabetic pregnancies, but with proper preconception management, favourable outcomes are achievable
A comparative study of norethisterone and dydrogesterone in the treatment of heavy menstrual bleeding
Get PDFBackground: HMB is described as bleeding for >7 days or >80 ml per cycle/ having a higher than 100 score on the pictorial blood assessment chart (PBAC). Medical management is the first line of treatment. Norethisterone is most commonly used oral progestin. Dydrogestrone is a C-21 derivative which is highly selective synthetic progestin, closely related to endogenous progesterone.
Methods: The 170 cases of heavy menstrual bleeding (HMB) with ovulatory disorder in the range of 20-45 years of age were assigned into two groups (85 women in each group). Group A received Norethisterone 10 mg and Group B received Dydrogesterone 10 mg twice daily respectively till bleeding stopped, the same dose was continued for another one week and then 10 mg OD for one week till 28 days of LMP whichever was later. Both the groups were followed up for another 3 cycles and response to treatment were analysed using PBAC score and Hb levels before and after treatment.
Results: A significant decrease in PBAC score and improvement in haemoglobin level were observed in both the groups i.e. 82.35% women in Norethisterone group and 78.82% in Dydrogesterone group respectively. In Norethisterone group 3.53% and 7.08% women in Dydrogesterone group underwent hysterectomy whereas 5.9% women in Norethisterone and 4.7% in Dydrogesterone group opted for therapeutic dilatation and curettage respectively.
Conclusions: Dydrogesterone is as effective as Norethisterone in controlling heavy menstrual bleeding. Dydrogesterone can be considered as a safer and efficacious alternative to Norethisterone given its highly selective nature and the absence of androgenic side effects
Surgical management of adnexal masses in adolescent females at a tertiary centre in India: a case series
Get PDFThis case series details 15 adolescent females (aged 13–19 years) who underwent surgery for adnexal masses from January 2022 to January 2025. The most common presenting complaint was abdominal pain (80%). Imaging with ultrasound and MRI showed large complex cystic masses (>10 cm) in 66.7% of patients. Laparotomy was performed in 12 patients (80%) due to large size and limited resources, while laparoscopy was feasible in 3 cases (20%). Histopathology revealed benign lesions in all cases: mature cystic teratoma (66.7%), serous cystadenoma (20%), and functional cyst (13.3%). Mild elevations in CA-125 and LDH were noted in some patients, but no malignancy was identified. Ovarian preservation was achieved in 60% of cases. All patients recovered uneventfully, with no complications or recurrences at six-month follow-up. These findings support the benign nature of adolescent adnexal masses and emphasize individualized surgical management with fertility preservation