Journal of Family and Reproductive Health
Volume:8 Issue: 1, Mar 2014

Journal of Family and Reproductive Health 2014. 8(1):1-5. Abstract To compare the effectiveness of letrozole and clomiphene citrate (CC) on uterine blood flow rate in patients with unexplained infertility. In this randomized clinical trial 90 women with unexplained infertility referred to a university clinic from January 2011- December 2013 were enrolled. Thirty patients were randomized for letrozole, 30 patients for CC and 3o patients for control group. On the day 3 of cycle the patients were given letrozole 2.5mg/day or CC 100 mg /day orally or did not receive any treatment. Resistance index (RI) and pulsatility index (PI) of uterine artery were calculated and chemical pregnancy rate was evaluated. Mean age was 26.4±3.2 (20-33) and mean BMI was 26.3± 3.2. After treatment using ultrasonography the Resistance index (RI) and Pulsatility index (PI) showed no significant difference among three groups (P>0.05). Pregnancy rate in letrozole group (58%) was more in comparison to CC (53.6%) and control groups (46%) but the difference was not significant (P>0.05). Our study showed that letrozole and clomiphene citrate have comparable impact on uterine blood flow and pregnancy rate in women with unexplained infertility.

There are some metabolic similarities between women with gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS); it is still uncertain, however, to what extent coexistence GDM and PCOS affects pregnancy outcome. The present study was designed to determine the obstetric and neonatal outcome in PCOS with GDM. A case-control study was conducted involving 261 GDM women. Thirty hundred-one cases had PCOS based on Rotterdam criteria and the other thirty hundred cases (control group) were women without PCOS. The subjects in each group were evaluated regarding obstetric and those women whose documentation’s were complete entered the study. In present study, women with PCOS and GDM had more than twofold increased odds of preeclampsia (p = 0.003, CI = 1.56–5.01, and OR = 2.8) and PIH (p= 0.04, CI = 1.28–4.5, and OR= 2.4). Maternal PCOS and GDM were also associated with threefold increased odds of neonatal hypoglycemia (p= 0.004, CI= 1.49–6.58, and OR= 3.13). Our finding emphasized that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy and neonatal complications including hypertension and hypoglycemia. We suggested that these neonates should be given more care regarding hypoglycemia symptoms.

Present study aimed to evaluate the effects of stress, urge and mixed urinary incontinence on the quality of life and mental health of Iranian women with urinary incontinence (UI). This was a cross sectional study of quality of life and mental health among women without and with different types of urinary incontinence (n = 140). Quality of life (QOL) and mental health were compared and measured using the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the 12-items General Health Questionnaire (GHQ-12). Women with any types of urinary incontinence showed a significant lower degree of mental health. Women with mixed incontinence reported significantly lower QOL and mental health (P<0.0001) compared to those with stress and urge incontinence, while there was no significant difference between women with stress and urge incontinence (P= 0.95). Patients with UI showed inferior mental health and QOL while these symptoms were more severe among patients with mixed urinary incontinence.

To determine the status of serum zinc in pregnant women in different gestational ages and correlation with socio-demographic and anthropometric factors in Iranian women referring to prenatal care public health clinics. We analyzed the zinc concentrations in plasma samples obtained at different gestational ages from 961 women and recorded BMI at the first trimester in pregnant women who were screened for a trial designed to evaluate the zinc concentration. Subjects were from different socio economical backgrounds and attended public health clinics for their prenatal care. All analyses were performed by SPSS (version 16). P values < 0.05 were considered significant. The results showed that after plasma zinc concentrations were adjusted with Parity, weight (early pregnancy), BMI (at early pregnancy), age and educational statues. Plasma zinc deficiency declined as gestational age progressed, however it was not significant. There was no significant correlation between zinc concentration, anthropometric, method of contraception and socio factors. However, there were significant relation between parity (p=0.007) and weight at early pregnancy(p= 0.039) with serum zinc levels. We conclude that plasma zinc concentrations decreased during the late first trimester to the early third trimester and with parity. These findings may indicate that the deficient levels of zinc in the latter third of pregnancy suggest a tendency for insufficient maternal nutrition. However larger studies are required to support this finding.

To evaluate the effect of honey supplemented to cryoprotectant medium on post-thaw sperm motility, concentration, morphology and agglutination.Thirty semen samples were collected from 30 infertile patients. After assessment of semen analysis, semen samples were divided into 3 aliquots (0.7ml for each) and mixed with 1 ml of cryopreservation solution (G1, control) alone, or enriched with 5% honey (G2) or with 10% honey (G3) for cryopreservation. Cryopreservation was done at -196ºC in liquid nitrogen and thawing was performed after six months. Direct swim up technique was used for in vitro sperm preparation post- thawing. Sperm parameters were assessed and data were statistically analyzed pre- and post- thawing.Results appeared that the percentage of sperm motility for G1 and G2 groups were significantly reduced (P<0.05) post-thawing when compared to pre-cryopreservation. However, there was no significant difference in the total motility (%) of the post-thaw sperm between the G1 and G2 groups. While there was significant increased (P<0.05) in the percentage of normal sperm morphology for G1 and G3 groups post-thawing. Post-thawing normal sperm morphology (%) for G3 group was significantly increased (P<0.05) as compared to G1 and G2 groups. In contrast non significant differences (P>0.05) were observed between G1 and G2 groups. Significant reduction (P<0.05) was seen in the sperm concentration for all groups post-thawing as compared to pre- cryopreservation groups. After thawing the results reveal significant reduction (P<0.05) in the sperm agglutination (%) for G3 group as compared to G1 and G2 groups.The results of this study indicated that the supplementation of honey (10%) to cryoprotectant solution results in enhancement of sperm quality post-thawing.

This study sought to assess the attitude of Healthcare Providers towards providing contraceptives for unmarried adolescents in four Local Government Areas in Ibadan, Nigeria. A cross-sectional descriptive study was conducted among 490 Healthcare Providers in 24 randomly selected healthcare facilities using self-administered, pre-tested questionnaires. More than half (57.5%) of the respondents perceived the provision of contraceptives for unmarried adolescents as promoting sexual promiscuity. The attitude of 42.7% of them was informed by the Nigerian culture which does not support premarital sex. About half (51.7%), reported that unmarried adolescents should be asked to abstain from sex rather than providing them with contraceptives. Over a third (44.2%) reported that providers should not provide services for both married and unmarried adolescents. Many healthcare providers have unfavourable attitudes towards the provision of contraceptives for unmarried adolescents. There is a need for further training of Healthcare Providers to address this situation.

Comparing sublingual and vaginal misoprostol in second trimester pregnancy termination. In this study 268 women at 12-24 weeks of gestation candidate for pregnancy termination were enrolled. Women were randomly divided in two groups. The first group received400 µg sublingual misoprostol and vaginal placebo and the second group received 400 µg vaginal misoprostol and sublingual placebo every 4 hours for a maximum of five doses. The course of misoprostol was repeated if the women did not abort within 24 hours. The median induction-to-abortion interval was shorter in sublingual group (12/72 hours in sublingual and 14/67 hours in vaginal).There was no significant difference in the success rate at 24 and 48 hours and in side effects. The preference for the sublingual route of administration was higher. Both vaginal and sublingual misoprostol are effective for medical abortion in second trimester termination. But it appears from shorter induction interval in sublingual and higher acceptability that sublingual route is a better choice.

The problem of RTI/STI is of growing concern worldwide, especially in developing countries; where each year 340 million new cases curable STI occur. Out of these 151 million are in South and Southeast Asia (WHO, 2001). The present paper attempts to capture the prevalence of leukorrhea, its knowledge and perceptions among currently married women of the age-group, 15-49 years, in a south Asian urban-slum dwelling community.A total of 400 households were selected from an urban-slum of Delhi and 391 were interviewed in a house to house survey.The results showed that the awareness about leukorrhea was almost universal (97 percent), and around 33 percent reported to have experienced the same either at the time of survey or prior to 3 months of the survey date. The perceptions about leukorrhea were varied.The study reports a high prevalence of leukorrhea among the slum dwelling women, and it also reports that there was not a marked difference in the perception and knowledge when it comes to respondent’s education, occupational status, and husbands’ education.