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Clinical Medicine Insights. Reproductive Health

Florent Ymele Fouelifack, Jeanne Hortence Fouedjio, Jovanny Tsuala Fouogue, Loic Dongmo Fouelifa
Background and rationale: Viral hepatitis B (VHB) and viral hepatitis C (VHC) are major public health issues in resource-poor countries where vertical transmission remains high. Aim: To assess prevalences and correlates of VHB and VHC among women attending antenatal clinic. Methods: A cross-sectional study at the Yaounde Central Hospital from January 1 to June 30, 2016. We included 360 pregnant women who were screened for hepatitis B virus surface antigen (HbsAg) and VHCAb by rapid diagnostic test (DiaSpot Diagnostics, USA) followed by confirmation of positive results by a reference laboratory...
2018: Clinical Medicine Insights. Reproductive Health
Alessandro Stasi
The National Legislative Assembly of Thailand has enacted on February 19, 2015 the Protection for Children Born through Assisted Reproductive Technologies Act (ART Act). Its primary objective aims at protecting children born through assisted reproductive technologies and providing the legal procedures that the intended parents must follow. The focus of this article is to discuss the ongoing issues involving assisted reproduction in Thailand. After reviewing the past legal framework surrounding surrogate motherhood and the downsides of the assisted reproductive technology market in Thailand, the article will discuss the new ART Act and its regulatory framework...
2017: Clinical Medicine Insights. Reproductive Health
David Shaker, Alexander J Lindgren, Gwenda Chapman
Introduction: Our study aimed to assess the impact of managed complications of tension-free vaginal tape (TVT) on the patients' assessment of the results as measured by Patient Global Impression of Improvement (PGI-I). Materials and methods: This was a retrospective study, supplemented with a telephone interview, comparing patients who had complications of TVT procedures with those where no complications recorded. The primary outcome was the PGI-I score in the 2 groups...
2017: Clinical Medicine Insights. Reproductive Health
Tameh Theodore Yangsi, Fouelifack Ymele Florent, Mbong Eta Ngole, Fomulu Nelson
BACKGROUND: To understand the low modern contraceptive prevalence in Cameroon, we reviewed the methods chosen and determined their side effects among patients in an urban setting. METHODS: We conducted a cross-sectional study at the "Cameroon National Planning Association for Family Welfare (CAMNAFAW) Clinic" in Yaoundé. Data were processed by SPSS software version 20.0 for Windows, and all tests were considered statistically significant at P < .05. RESULTS: Of the 1180 women sampled, the most chosen methods were as follows: depot medroxy progesterone acetate: 72...
2017: Clinical Medicine Insights. Reproductive Health
Nivin Samara, Yaakov Bentov
BACKGROUND: Ovarian pregnancy is a rare and challenging clinical phenomenon. Recent studies have identified assisted reproductive treatments and infertility as risk factors. However, neither a definite mechanism nor clear risk factors were identified and therefore prevention strategies are yet unavailable. CLINICAL CASE: In this article, we present a case of ovarian pregnancy occurring following in vitro fertilization treatment and a fresh embryo transfer. The couple was diagnosed with unexplained infertility and no identifiable risk factors for extrauterine pregnancy...
2016: Clinical Medicine Insights. Reproductive Health
Dirk Wildemeersch, Amaury Andrade, Norman Goldstuck
OBJECTIVE: The aim of this study was to update the clinical experience with the Femilis® 60 levonorgestrel-releasing intrauterine system (LNG-IUS), now up to 10 years in parous and nulliparous women, particularly with regard to ease and safety of insertion, contraceptive performance, retention, acceptability, continuation of use, impact on menstrual blood loss (MBL), and duration of action. STUDY DESIGN: Using the Femilis® 60 LNG-IUS releasing 20 µg of levonorgestrel/day, the following studies were conducted: an open, prospective noncomparative contraceptive study, an MBL study, a perimenopausal study, a study for the treatment of endometrial hyperplasia, and early cancer of the uterus, a residue study...
2016: Clinical Medicine Insights. Reproductive Health
Linda C Rogers, Laurie Scott, Jon E Block
OBJECTIVE: Accurate and timely diagnosis of rupture of membranes (ROM) is imperative to allow for gestational age-specific interventions. This study compared the diagnostic performance characteristics between two methods used for the detection of ROM as measured in the same patient. METHODS: Vaginal secretions were evaluated using the conventional fern test as well as a point-of-care monoclonal/polyclonal immunoassay test (ROM Plus(®)) in 75 pregnant patients who presented to labor and delivery with complaints of leaking amniotic fluid...
2016: Clinical Medicine Insights. Reproductive Health
Zeev Blumenfeld, Gabi Kaidar, Nehama Zuckerman-Levin, Elena Dumin, Carlos Knopf, Ze'ev Hochberg
OBJECTIVE: The aim of this study was to assess the activity of cortisol-metabolizing enzymes in women with polycystic ovary syndrome (PCOS), using a fully quantitative gas chromatography/mass spectrometry (GCMS) method. DESIGN: We investigated the glucocorticoid degradation pathways that include 11β-hydroxysteroid dehydrogenase (11β-HSD) type 1, 5α-reductase (5α-R) and 5β-reductase (5β-R), 3α-hydroxysteroid dehydrogenase, and 20α- and 20β-hydroxysteroid dehydrogenase (20α-HSD and 20β-HSD, respectively) in young nonobese women with PCOS, using a fully quantitative GCMS method...
2016: Clinical Medicine Insights. Reproductive Health
Carlos H Trippia, Monica T Zomer, Carlos R T Terazaki, Rafael L S Martin, Reitan Ribeiro, William Kondo
Endometriosis is a benign gynecologic disease characterized by the presence of endometrial tissue outside the uterine cavity. The complexity of the disease results from its multiple clinical presentations, the multifocal pattern of distribution of the lesions, the presence of extra pelvic sites of the disease (mainly affecting the urinary and the intestinal tracts), and the difficulty in the preoperative diagnosis (by means of imaging studies) and in the surgical treatment. The preoperative mapping of the lesions, either by ultrasound or by magnetic resonance imaging, allows for an adequate surgical planning and a better preoperative patient counseling, especially in those women with deep infiltrating endometriosis affecting the bowel...
2016: Clinical Medicine Insights. Reproductive Health
Fatma Fawzy, Amr Hussein, Mostafa Mahmoud Eid, Ahmed Mahmoud El Kashash, Hosni Khairy Salem
Cryptorchidism, the failure of one or both testes to descend into the scrotum prenatally, occurs in 2.4%-5% of newborns. Many of these testes will descend spontaneously shortly after birth, but ~23% will remain undescended unless surgery is performed. Bilaterally cryptorchid men have a six times greater risk of being infertile when compared with unilaterally cryptorchid men and the general male population. Approximately 10% of infertile men have a history of cryptorchidism and orchidopexy. The main reasons for infertility in men with a history of cryptorchidism treated by orchidopexy are maldevelopment of the testes and an improper environment for the normal development of the testes, hyperthermia, and antisperm antibodies...
2015: Clinical Medicine Insights. Reproductive Health
Daniel Luna, Roly Hilario, Julio Dueñas-Chacón, Rocío Romero, Patricia Zavala, Lucy Villegas, Javier García-Ferreyra
PURPOSE: The intracytoplasmic morphologically selected sperm injection (IMSI) procedure has been associated with better laboratory and clinical outcomes in assisted reproduction technologies. Less information is available regarding the relationship between embryo aneuploidy rate and the IMSI procedure. The aim of this study is to compare the clinical outcomes and chromosomal status of IMSI-derived embryos with those obtained from intracytoplasmic sperm injection (ICSI) in order to establish a clearer view of the benefits of IMSI in infertile patients...
2015: Clinical Medicine Insights. Reproductive Health
Javier García-Ferreyra, Daniel Luna, Lucy Villegas, Rocío Romero, Patricia Zavala, Roly Hilario, Julio Dueñas-Chacón
CAPSULE: Male aging effects on aneuploidy rates in embryos. OBJECTIVE: Paternal age is associated with decreasing sperm quality; however, it is unknown if it influences chromosomal abnormalities in embryos. The objective of this study is to evaluate if the aneuploidy rates in embryos are affected by advanced paternal age. METHODS: A total of 286 embryos, obtained from 32 in vitro fertilization/intracytoplasmic sperm injection cycles with donated oocytes in conjunction with preimplantation genetic diagnosis, were allocated according to paternal age in three groups: Group A: ≤39 years (n = 44 embryos); Group B: 40-49 years (n = 154 embryos); and Group C: ≥50 years (n = 88 embryos)...
2015: Clinical Medicine Insights. Reproductive Health
Anna Yliniemi, Kaarin Makikallio, Teemu Korpimaki, Heikki Kouru, Jaana Marttala, Markku Ryynanen
OBJECTIVE: To evaluate the efficacy of first-trimester markers-pregnancy-associated plasma protein A (PAPPA), free human chorionic gonadotropin β (fhCGβ), alpha-fetoprotein (AFP), placental growth factor (PlGF), and soluble tumor necrosis factor receptor-1 (sTNFR1) together with maternal characteristics (MC) for prediction of early-onset preeclampsia (EOPE). METHODS: During 2005-2010, the abovementioned biomarkers were analyzed with logistic regression analysis in 64 EOPE and 752 control subjects to determine whether these biomarkers separately and in combination with MC would predict development of EOPE...
2015: Clinical Medicine Insights. Reproductive Health
Javier García-Ferreyra, Roly Hilario, Daniel Luna, Lucy Villegas, Rocío Romero, Patricia Zavala, Julio Dueñas-Chacón
CAPSULE: Clinical outcomes using INVOcell device with ICSI. OBJECTIVE: Intravaginal culture of oocytes (INVO) procedure is an intravaginal culture system that utilizes the INVOcell device in which the fertilization and embryo culture occur. In this procedure, the vaginal cavity serves as an incubator for oocyte fertilization and early embryonic development. The objective of this study was to evaluate the clinical outcomes of this intravaginal culture system in intracytoplasmic sperm injection (ICSI)...
2015: Clinical Medicine Insights. Reproductive Health
Teena Nagar, Deepak Sharma, Mukesh Choudhary, Shusheela Khoiwal, Rajendra Prasad Nagar, Aakash Pandita
AIM: To study the role of Doppler imaging in prediction of high-risk pregnancies and their outcomes. METHODS AND MATERIAL: This prospective study in a setup of tertiary-level care center includes 500 high-risk pregnant women from rural and urban sectors and evaluates the predictive values of various Doppler indices. RESULTS: Out of 500 patients, 110 patients had abnormal Doppler among them, 70 patients had abnormal uterine artery Doppler, and 50 patients had abnormal umbilical artery Doppler flow indices...
2015: Clinical Medicine Insights. Reproductive Health
Shahar Kol
UNLABELLED: The study evaluated the proportion of patients whose pituitary glands respond with a sharp decrease in luteinizing hormone (LH) levels when exposed to a conventional dose of 0.25 mg gonadotropin releasing hormone (GnRH) antagonist in a prospective, single-center, non-randomized, proof-of-concept study. Fifty women eligible for in vitro fertilization (IVF) received recFSH (Gonal-F) from day 2 or 3 of menstrual period. Basal estradiol, progesterone, and LH were measured on the same day and 4-5 days later-immediately before GnRH antagonist 0...
2014: Clinical Medicine Insights. Reproductive Health
Gleice Cristina Dos Santos Godoy, Bianca Borsatto Galera, Claudinéia Araujo, Jacklyne Silva Barbosa, Max Fernando de Pinho, Marcial Francis Galera, Sebastião Freitas de Medeiros
OBJECTIVE: To determine the prevalence of chromosomal abnormalities and microdeletions on Y chromosome in infertile patients with oligozoospermia or azoospermia in Mato Grosso state, Brazil. METHODS: This cross-sectional study enrolled 94 men from infertile couples. Karyotype analysis was performed by lymphocyte culture technique. DNA from each sample was extracted using non-enzymatic method. Microdeletions were investigated by polymerase chain reaction (PCR). RESULTS: With the use of cytogenetic analysis, five patients (5...
2014: Clinical Medicine Insights. Reproductive Health
Anna Merilainen, Sini Peuhkurinen, Timppa Honkasalo, Paivi Laitinen, Hannaleena Kokkonen, Markku Ryynanen, Jaana Marttala
OBJECTIVE: To evaluate the efficacy of first trimester combined screening for Down's syndrome in Northern Finland during the first 10 years of practice. METHODS: During 1 January 2002 to 31 December 2011, 47,896 women participated voluntarily in combined screening during first trimester. The risk cutoff was 1:250. The study period was divided into two time periods; 2002-2006 and 2007-2011. RESULTS: During the first half of the study period, the detection rate (DR) was 77...
2014: Clinical Medicine Insights. Reproductive Health
Michael Gal, Joseph Orly
OBJECTIVE: Ketoconazole (KCZ) is a known inhibitor of steroidogenic P450 enzymes in the adrenal cortex and the gonads. Previous studies examined the potential clinical use of KCZ for attenuation of ovarian response to gonadotropin treatments. This study aimed to use the superovuating rat model to explore the effect of KCZ on ovarian steroidogenesis, follicular function, and development toward ovulation. METHODS: Prepubertal rats were treated with equine chorionic gonadotropin (eCG)/human CG (hCG) resulting in multiple follicular development and ovulation...
2014: Clinical Medicine Insights. Reproductive Health
Yaakov Bentov, Thomas Hannam, Andrea Jurisicova, Navid Esfandiari, Robert F Casper
BACKGROUND: The age-related reduction in live-birth rate is attributed to a high rate of aneuploidy and follicle depletion. We showed in an animal model that treatment with Coenzyme Q10 (CoQ10) markedly improved reproductive outcome. The aim of this study was to compare the post-meiotic oocyte aneuploidy rate in in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) patients treated with CoQ10 or placebo. METHODS: We conducted a double blind placebo controlled randomized trial that included IVF-ICSI patients 35-43 years of age...
2014: Clinical Medicine Insights. Reproductive Health
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