Bangladesh Journal of Obstetrics & Gynaecology
When a woman with mullerian agenesis presents with blind or absent vagina, management options inc... more When a woman with mullerian agenesis presents with blind or absent vagina, management options include surgical vaginoplasty or non surgical self dilatation. Vaginal dilation should be the first line management of mullerian agenesis. Because of the need for motivated, mature patients and long term dilatation and follow up, gynecologists usually go for surgical vaginoplasty. We tried a novel approach to nonsurgical dilation of vagina in the cases of mullerian agenesis. We injected normal saline into the potential space of vagina between urethra and rectum and applied digital pressure daily for 14-15 days. This procedure created a vaginal space which was to be further dilated by regular coitus and/ or vaginal dilators. We are presenting here a series of three cases of mullerian agenesis managed by non surgical vaginal dilatation, facilitated by prior saline injection and sustained digital pressure. Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 65-68
International Journal of Gynecology & Obstetrics, 2022
OBJECTIVE The objective of this study was to compare postpartum hemoglobin (Hb) between postpartu... more OBJECTIVE The objective of this study was to compare postpartum hemoglobin (Hb) between postpartum intrauterine device (PPIUD) and non-PPIUD users. METHODS A sample of 3697 postpartum women (475 PPIUD users, 3222 non-PPIUD users) from 5 tertiary referral hospitals in Bangladesh were assessed at multiple time points between 6 weeks and 12 months postpartum. Non-inferiority linear regression analysis compared changes in Hb levels at 29-52 weeks postpartum between the two groups. Non-inferiority was declared if the lower 95% confidence interval of the estimated difference in Hb change since delivery between PPIUD and non-PPIUD users was greater than -0.05 g/dL. RESULTS At approximately 9 months postpartum, 276 women in the PPIUD group (58.1%) and 1086 women in the comparison group (33.7%) attended follow-up. In total, 57.9% of PPIUD users and 61.0% of non-PPIUD users had taken iron supplementation. Change in Hb was 0.02 g/dL (95% CI: -0.16, 0.19) higher in the PPIUD users than the comparison group. The lower limit of the 95% CI was greater than -0.05g/dl, providing good evidence that PPIUD users were non-inferior to the comparison group in their Hb levels. CONCLUSION In the presence of offering iron supplementation, and an uptake of just over 60%, no difference in anemia was observed between the PPIUD and control group.
Bangladesh Journal of Obstetrics & Gynaecology, 2017
Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile wom... more Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of inf...
Bangladesh Journal of Obstetrics & Gynaecology
Background: Cervical cancer (CC) is the fourth most common cancer in women worldwidewith an estim... more Background: Cervical cancer (CC) is the fourth most common cancer in women worldwidewith an estimated 569,847 new cases and 311,365 deaths in the year 2018. In Bangladesh,the incidence of CC was 8068 and 5214 women died from CC in the year 2018.1CC constitutesabout 12% of the female cancer in this country.1 Methods: The present situation of cervical cancer screening program is reviewed. Results: The Government of Bangladesh (GOB) adopted visual inspection of cervix withacetic acid (VIA) method for cervical cancer screening. The major strengths of VIA is itssimplicity, low cost, potential for immediate linkage with investigations/treatment, feasible inlow resource settings and the possibility of rapid training to the providers. The GOB hasextended the program to all districts and selected upazilas.The screening programme hasbeen implemented through capacity building of service providers of Medical College Hospitals(MCHs), District Hospitals (DHs), Mother and Child care Welfare Center...
Journal of Bangladesh College of Physicians and Surgeons
Introduction: The male factor responsible for infertility includes oligospermia. According to WHO... more Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia. Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated. Results: The mean vi...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a tra... more Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a transvaginal ultrasound procedure that uses a contrast medium to assess the endometrial cavity and tubal patency. It could be a safer and more viable alternative to radiographic hysterosalpingography (HSG). The aim of the study was to evaluate the uterine cavity and fallopian tube patency in infertile women by SHSG using transvaginal ultrasound.Methods: The prospective comparative study was carried out in a total of 35 cases of infertile women between the reproductive age of 20-40 years following the inclusion and exclusion criteria, from July 2016 to June 2017. Detailed history and physical examinations were carried out and appropriate management was instituted as per the needs of the individual patient.Results: In the present study, 41.2% of the women belonged to the age range of 25-29 years. Out of 35 women, 50% women were in the state of primary infertility and remaining were in a secon...
Bangladesh Journal of Obstetrics & Gynaecology, 2020
Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to ... more Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not alwaysinvolved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics &Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile womenwith surgical diagnosis of endometriosis with the objective to determine the frequency ofgastrointestinal symptoms in our population of women with endometriosis and to find outwhether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women withendometriosis. Bloating was the most frequent gastrointestinal symptom. Among the womenwith severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing withthe women with endometriosis. Fu...
Background: Vitamin D deficiency may be associated with endocrine disturbances including male inf... more Background: Vitamin D deficiency may be associated with endocrine disturbances including male infertility. Vitamin D receptor and metabolizing enzymes are found in the male reproductive system. Expression of Vitamin D inactivating enzyme in spermatozoa may be responsible for sperm motility and vitamin D responsiveness. Vitamin D supplementation may help in improvement of asthenozoospermic infertile males who are vitamin D deficient. Objective: To evaluate the impact of Vitamin D supplementation on sperm motility in vitamin D-deficient asthenozoospermic infertile males. Methods: A total of 110 infertile males who had asthenozoospermia and vitamin Ddeficiency were included in this study. Vitamin D supplementation was given 40000 IU weekly for six weeks and 2000 IU daily for another six weeks and follow up semen analysis was done after 3 months to analyze the changes in sperm motility. Statistical analyses were carried out by paired t test. Result: The mean age was 33.19±5.81 years (ra...
Worldwide intra uterine contraceptive device (IUCD) is a reversible method of contraception. Post... more Worldwide intra uterine contraceptive device (IUCD) is a reversible method of contraception. Postpartum IUCD insertion is labeled when IUCD is inserted within 10 minutes to 48 hours of expulsion of placenta. The objective of the study was to analyze the acceptability and feasibility of immediate postpartum intrauterine contraceptive device (PPIUCD) in a tertiary care hospital of Bangladesh. A cross sectional study was conducted among eligible postpartum women at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Bangladesh. Counseling was done about the procedure of PPIUCD in details. After having the consent, Cu-T 380A was inserted in 343 women. The women were followed up at six weeks after delivery. A total number of 18190 women were counseled during antenatal period and at labor ward. A total number of 6441 were admitted for delivery. Among the admitted patients, 343 accepted this method. Forty nine percent of the acceptors belonged to the age group of 25 – 30 years. Majo...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2018
To evaluate the impact of structured training given to dedicated family planning counsellors on p... more To evaluate the impact of structured training given to dedicated family planning counsellors on postpartum intrauterine device (PPIUD) services across six tertiary hospitals in Bangladesh. Family planning counsellors underwent structured training on postpartum family planning, PPIUD in particular, over a four-day period. Impact of training was evaluated by comparing PPIUD counselling rates, consent rates, insertion rates, and removal rates five months before and five months after the training, using data from women delivering in the participating facilities. A total of 27 622 women were included in this analysis: 11 263 (40.8%) before the training intervention and 16 359 (59.2%) after it. There was an increase in the proportion of women who were counselled (from 75.3% to 83.8%, P<0.001), and a small decrease in the proportion of women agreeing to have a PPIUD inserted following counselling (13.7% vs 12.9%, P=0.03). Overall insertion rate was similar before and after training (9.5...
This cross sectional study was carried out in Center for Assisted Reproduction, Dhaka, and in the... more This cross sectional study was carried out in Center for Assisted Reproduction, Dhaka, and in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2012 to December 2012. The study population was 71 consecutive male partners of infertile couple suffering from at least one year of infertility. Lead and Zinc level was measured in blood and semen in the male partner of infertile couple and compared with semen parameters. Serum zinc at different values did not show any statistically significant change in semen volume, total count of sperm and total motility of sperm. At serum zinc level 80-< 90 μg/dl blood lead and semen lead level was lowest 20.6 ± 8.60 μg/dl and 48.17 ± 51.33 μg/dl respectively and showed highest total count of sperm (54.00 ± 46.67 million/ml) but was not statistically significant. Rapid linear motility and normal sperm morphology was also highest at values 80-< 90 μg/dl and was 45.33 ± 26.62% and 36.67 ± 11.60%...
Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital t... more Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital tuberculosis is a significant cause of infertility in the women of these countries. The diagnosis of genital tuberculosis in infertile women is difficult as most of the cases are usually asymptomatic. A high index of clinical suspicion is required. Genital tuberculosis always affects the fallopian tubes. It affects the endometrium in half of the cases. In addition to tuberculin skin tests and interferon gamma release assays, procedures like hysterosalpingography, laparoscopy-dye test, endometrial curettage and laparoscopy with multiple sampling for smear microscopy and culture for mycobacterium tuberculosis can detect the cases. In recent years diagnosis has been improved by polymerase chain reaction targeted against mycobacterium tuberculosis DNA. Following early diagnosis, treatment with anti-tubercular drugs is favourable for fertility only when tubal and endometrial damage is minimal....
Objective: To evaluate the association of blood and semen lead with male infertility. Design: It... more Objective: To evaluate the association of blood and semen lead with male infertility. Design: It was a case control study carried out in the department of Biochemistry, BSMMU, from January, 2004 to December, 2004.Subjects: Of 52 male subjects, 26 were infertile with oligospermia and / or asthenospermia. Age matched 26 normospermic subjects with normal standard semen parameters (volume, count, motility and morphology) were selected as controls. None had the history of occupational exposure to lead.Results: Median values of blood lead were 19.96 µg/dl and 17.68 µg/dl (normal <25 µg/dl); semen lead were 29.56µg/dl and 28.17 µg/dl (normal 15.37 ± 3.92 µg/dl) in cases and controls respectively. Neither blood lead nor semen lead showed significant difference between cases and controls. There was significant positive correlation between blood lead and semen lead concentrations. There was no significant correlation of semen and blood lead concentrations with other semen parameters & ser...
Lead has for long been known to affect multiple organs and can affect reproduction in male and fe... more Lead has for long been known to affect multiple organs and can affect reproduction in male and female as well as the offspring. The study was done to find out the level of lead in blood and semen of infertile men and to find its effect on the semen parameters, as well as the minimum level of lead in blood and semen that can have negative impacts on semen parameters. The study was cross sectional in design. Male partners of 57 infertile couples attending a tertiary infertility center in Dhaka, Bangladesh were recruited for the study. Blood lead was measured by the Graphite Furnance Atomic Absorption Spectrophotometer and semen analysis was done according to the WHO recommendation (1999). With increasing blood lead concentration there was corresponding increase in the mean semen lead concentration. Reduction of mean semen volume started at level of mean blood lead level of >40mugm/dl. Mean total count of sperm (x106/ml) started decreasing at blood lead level of >30mugm/dl with v...
The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on t... more The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on this condition following ovulation induction and ART. We describe here the clinical features, management and outcome of a case of complete hydatidiform mole with coexisting viable twin fetus following Intra-cytoplasmic sperm injection. A 29 year old lady was pregnant following Intra-cytoplasmic Sperm Injection (ICSI) and Embryo Transfer. Three good quality embryo with two pronuclei on pronuclear check was transferred. A triplet pregnancy with two live fetus and a complete mole was delivered at 37 completed weeks of pregnancy. The antenatal period was uneventful and the human chorionic gonodotrophin returned to baseline by 4 weeks after delivery. There was no further complication at one year follow-up. Continuation of pregnancy as long as maternal complications are absent or controllable can be a safe and rewarding effort in managing the patient.
Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications... more Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications during pregnancy. Polycystic ovarian syndrome women having elevated LH and hyper insulineuia may be at increased risk of miscarriage. The study was done to find out the recurrent pregnancy loss among the PCOS patient. This was a cross sectional case control study in total 100 infertile patients between age 20-40 years attending BSMMU out patient Department from July 2011 to June 2012, among them 50 infertile patients with PCOS regarding as a case and 50 infertile patients without PCOS selected as a control. Regarding case (infertile patients with PCOS) shows 20(40%) recurrent miscarriage and among control (infertile patients without PCOS) shows recurrent miscarriage 6(12%). And also among case group shows insulin resistance 8(16%) and control group insulin resistance 1(2%). Six (75%) abortion occur among PCOS with insulin resistance and 5(62.5%) abortion occur among PCOS with raised tes...
Bangladesh Journal of Obstetrics & Gynaecology
When a woman with mullerian agenesis presents with blind or absent vagina, management options inc... more When a woman with mullerian agenesis presents with blind or absent vagina, management options include surgical vaginoplasty or non surgical self dilatation. Vaginal dilation should be the first line management of mullerian agenesis. Because of the need for motivated, mature patients and long term dilatation and follow up, gynecologists usually go for surgical vaginoplasty. We tried a novel approach to nonsurgical dilation of vagina in the cases of mullerian agenesis. We injected normal saline into the potential space of vagina between urethra and rectum and applied digital pressure daily for 14-15 days. This procedure created a vaginal space which was to be further dilated by regular coitus and/ or vaginal dilators. We are presenting here a series of three cases of mullerian agenesis managed by non surgical vaginal dilatation, facilitated by prior saline injection and sustained digital pressure. Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 65-68
International Journal of Gynecology & Obstetrics, 2022
OBJECTIVE The objective of this study was to compare postpartum hemoglobin (Hb) between postpartu... more OBJECTIVE The objective of this study was to compare postpartum hemoglobin (Hb) between postpartum intrauterine device (PPIUD) and non-PPIUD users. METHODS A sample of 3697 postpartum women (475 PPIUD users, 3222 non-PPIUD users) from 5 tertiary referral hospitals in Bangladesh were assessed at multiple time points between 6 weeks and 12 months postpartum. Non-inferiority linear regression analysis compared changes in Hb levels at 29-52 weeks postpartum between the two groups. Non-inferiority was declared if the lower 95% confidence interval of the estimated difference in Hb change since delivery between PPIUD and non-PPIUD users was greater than -0.05 g/dL. RESULTS At approximately 9 months postpartum, 276 women in the PPIUD group (58.1%) and 1086 women in the comparison group (33.7%) attended follow-up. In total, 57.9% of PPIUD users and 61.0% of non-PPIUD users had taken iron supplementation. Change in Hb was 0.02 g/dL (95% CI: -0.16, 0.19) higher in the PPIUD users than the comparison group. The lower limit of the 95% CI was greater than -0.05g/dl, providing good evidence that PPIUD users were non-inferior to the comparison group in their Hb levels. CONCLUSION In the presence of offering iron supplementation, and an uptake of just over 60%, no difference in anemia was observed between the PPIUD and control group.
Bangladesh Journal of Obstetrics & Gynaecology, 2017
Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile wom... more Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of inf...
Bangladesh Journal of Obstetrics & Gynaecology
Background: Cervical cancer (CC) is the fourth most common cancer in women worldwidewith an estim... more Background: Cervical cancer (CC) is the fourth most common cancer in women worldwidewith an estimated 569,847 new cases and 311,365 deaths in the year 2018. In Bangladesh,the incidence of CC was 8068 and 5214 women died from CC in the year 2018.1CC constitutesabout 12% of the female cancer in this country.1 Methods: The present situation of cervical cancer screening program is reviewed. Results: The Government of Bangladesh (GOB) adopted visual inspection of cervix withacetic acid (VIA) method for cervical cancer screening. The major strengths of VIA is itssimplicity, low cost, potential for immediate linkage with investigations/treatment, feasible inlow resource settings and the possibility of rapid training to the providers. The GOB hasextended the program to all districts and selected upazilas.The screening programme hasbeen implemented through capacity building of service providers of Medical College Hospitals(MCHs), District Hospitals (DHs), Mother and Child care Welfare Center...
Journal of Bangladesh College of Physicians and Surgeons
Introduction: The male factor responsible for infertility includes oligospermia. According to WHO... more Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia. Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated. Results: The mean vi...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a tra... more Background: Women with infertility may be benefitted from sonohysterosalpingography (SHSG), a transvaginal ultrasound procedure that uses a contrast medium to assess the endometrial cavity and tubal patency. It could be a safer and more viable alternative to radiographic hysterosalpingography (HSG). The aim of the study was to evaluate the uterine cavity and fallopian tube patency in infertile women by SHSG using transvaginal ultrasound.Methods: The prospective comparative study was carried out in a total of 35 cases of infertile women between the reproductive age of 20-40 years following the inclusion and exclusion criteria, from July 2016 to June 2017. Detailed history and physical examinations were carried out and appropriate management was instituted as per the needs of the individual patient.Results: In the present study, 41.2% of the women belonged to the age range of 25-29 years. Out of 35 women, 50% women were in the state of primary infertility and remaining were in a secon...
Bangladesh Journal of Obstetrics & Gynaecology, 2020
Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to ... more Background: Endometriosis is frequently associated with gastrointestinal symptoms, inaddition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not alwaysinvolved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics &Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile womenwith surgical diagnosis of endometriosis with the objective to determine the frequency ofgastrointestinal symptoms in our population of women with endometriosis and to find outwhether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women withendometriosis. Bloating was the most frequent gastrointestinal symptom. Among the womenwith severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing withthe women with endometriosis. Fu...
Background: Vitamin D deficiency may be associated with endocrine disturbances including male inf... more Background: Vitamin D deficiency may be associated with endocrine disturbances including male infertility. Vitamin D receptor and metabolizing enzymes are found in the male reproductive system. Expression of Vitamin D inactivating enzyme in spermatozoa may be responsible for sperm motility and vitamin D responsiveness. Vitamin D supplementation may help in improvement of asthenozoospermic infertile males who are vitamin D deficient. Objective: To evaluate the impact of Vitamin D supplementation on sperm motility in vitamin D-deficient asthenozoospermic infertile males. Methods: A total of 110 infertile males who had asthenozoospermia and vitamin Ddeficiency were included in this study. Vitamin D supplementation was given 40000 IU weekly for six weeks and 2000 IU daily for another six weeks and follow up semen analysis was done after 3 months to analyze the changes in sperm motility. Statistical analyses were carried out by paired t test. Result: The mean age was 33.19±5.81 years (ra...
Worldwide intra uterine contraceptive device (IUCD) is a reversible method of contraception. Post... more Worldwide intra uterine contraceptive device (IUCD) is a reversible method of contraception. Postpartum IUCD insertion is labeled when IUCD is inserted within 10 minutes to 48 hours of expulsion of placenta. The objective of the study was to analyze the acceptability and feasibility of immediate postpartum intrauterine contraceptive device (PPIUCD) in a tertiary care hospital of Bangladesh. A cross sectional study was conducted among eligible postpartum women at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Bangladesh. Counseling was done about the procedure of PPIUCD in details. After having the consent, Cu-T 380A was inserted in 343 women. The women were followed up at six weeks after delivery. A total number of 18190 women were counseled during antenatal period and at labor ward. A total number of 6441 were admitted for delivery. Among the admitted patients, 343 accepted this method. Forty nine percent of the acceptors belonged to the age group of 25 – 30 years. Majo...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2018
To evaluate the impact of structured training given to dedicated family planning counsellors on p... more To evaluate the impact of structured training given to dedicated family planning counsellors on postpartum intrauterine device (PPIUD) services across six tertiary hospitals in Bangladesh. Family planning counsellors underwent structured training on postpartum family planning, PPIUD in particular, over a four-day period. Impact of training was evaluated by comparing PPIUD counselling rates, consent rates, insertion rates, and removal rates five months before and five months after the training, using data from women delivering in the participating facilities. A total of 27 622 women were included in this analysis: 11 263 (40.8%) before the training intervention and 16 359 (59.2%) after it. There was an increase in the proportion of women who were counselled (from 75.3% to 83.8%, P<0.001), and a small decrease in the proportion of women agreeing to have a PPIUD inserted following counselling (13.7% vs 12.9%, P=0.03). Overall insertion rate was similar before and after training (9.5...
This cross sectional study was carried out in Center for Assisted Reproduction, Dhaka, and in the... more This cross sectional study was carried out in Center for Assisted Reproduction, Dhaka, and in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2012 to December 2012. The study population was 71 consecutive male partners of infertile couple suffering from at least one year of infertility. Lead and Zinc level was measured in blood and semen in the male partner of infertile couple and compared with semen parameters. Serum zinc at different values did not show any statistically significant change in semen volume, total count of sperm and total motility of sperm. At serum zinc level 80-< 90 μg/dl blood lead and semen lead level was lowest 20.6 ± 8.60 μg/dl and 48.17 ± 51.33 μg/dl respectively and showed highest total count of sperm (54.00 ± 46.67 million/ml) but was not statistically significant. Rapid linear motility and normal sperm morphology was also highest at values 80-< 90 μg/dl and was 45.33 ± 26.62% and 36.67 ± 11.60%...
Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital t... more Tuberculosis is endemic in many developing countries of the world including Bangladesh. Genital tuberculosis is a significant cause of infertility in the women of these countries. The diagnosis of genital tuberculosis in infertile women is difficult as most of the cases are usually asymptomatic. A high index of clinical suspicion is required. Genital tuberculosis always affects the fallopian tubes. It affects the endometrium in half of the cases. In addition to tuberculin skin tests and interferon gamma release assays, procedures like hysterosalpingography, laparoscopy-dye test, endometrial curettage and laparoscopy with multiple sampling for smear microscopy and culture for mycobacterium tuberculosis can detect the cases. In recent years diagnosis has been improved by polymerase chain reaction targeted against mycobacterium tuberculosis DNA. Following early diagnosis, treatment with anti-tubercular drugs is favourable for fertility only when tubal and endometrial damage is minimal....
Objective: To evaluate the association of blood and semen lead with male infertility. Design: It... more Objective: To evaluate the association of blood and semen lead with male infertility. Design: It was a case control study carried out in the department of Biochemistry, BSMMU, from January, 2004 to December, 2004.Subjects: Of 52 male subjects, 26 were infertile with oligospermia and / or asthenospermia. Age matched 26 normospermic subjects with normal standard semen parameters (volume, count, motility and morphology) were selected as controls. None had the history of occupational exposure to lead.Results: Median values of blood lead were 19.96 µg/dl and 17.68 µg/dl (normal <25 µg/dl); semen lead were 29.56µg/dl and 28.17 µg/dl (normal 15.37 ± 3.92 µg/dl) in cases and controls respectively. Neither blood lead nor semen lead showed significant difference between cases and controls. There was significant positive correlation between blood lead and semen lead concentrations. There was no significant correlation of semen and blood lead concentrations with other semen parameters & ser...
Lead has for long been known to affect multiple organs and can affect reproduction in male and fe... more Lead has for long been known to affect multiple organs and can affect reproduction in male and female as well as the offspring. The study was done to find out the level of lead in blood and semen of infertile men and to find its effect on the semen parameters, as well as the minimum level of lead in blood and semen that can have negative impacts on semen parameters. The study was cross sectional in design. Male partners of 57 infertile couples attending a tertiary infertility center in Dhaka, Bangladesh were recruited for the study. Blood lead was measured by the Graphite Furnance Atomic Absorption Spectrophotometer and semen analysis was done according to the WHO recommendation (1999). With increasing blood lead concentration there was corresponding increase in the mean semen lead concentration. Reduction of mean semen volume started at level of mean blood lead level of >40mugm/dl. Mean total count of sperm (x106/ml) started decreasing at blood lead level of >30mugm/dl with v...
The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on t... more The hydatidiform mole with coexisting fetus is a rare condition. There have been few reports on this condition following ovulation induction and ART. We describe here the clinical features, management and outcome of a case of complete hydatidiform mole with coexisting viable twin fetus following Intra-cytoplasmic sperm injection. A 29 year old lady was pregnant following Intra-cytoplasmic Sperm Injection (ICSI) and Embryo Transfer. Three good quality embryo with two pronuclei on pronuclear check was transferred. A triplet pregnancy with two live fetus and a complete mole was delivered at 37 completed weeks of pregnancy. The antenatal period was uneventful and the human chorionic gonodotrophin returned to baseline by 4 weeks after delivery. There was no further complication at one year follow-up. Continuation of pregnancy as long as maternal complications are absent or controllable can be a safe and rewarding effort in managing the patient.
Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications... more Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications during pregnancy. Polycystic ovarian syndrome women having elevated LH and hyper insulineuia may be at increased risk of miscarriage. The study was done to find out the recurrent pregnancy loss among the PCOS patient. This was a cross sectional case control study in total 100 infertile patients between age 20-40 years attending BSMMU out patient Department from July 2011 to June 2012, among them 50 infertile patients with PCOS regarding as a case and 50 infertile patients without PCOS selected as a control. Regarding case (infertile patients with PCOS) shows 20(40%) recurrent miscarriage and among control (infertile patients without PCOS) shows recurrent miscarriage 6(12%). And also among case group shows insulin resistance 8(16%) and control group insulin resistance 1(2%). Six (75%) abortion occur among PCOS with insulin resistance and 5(62.5%) abortion occur among PCOS with raised tes...
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